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Many women who have had breast cancer and are seeking reconstruction want an alternative to implants. Breast implants are very safe and certainly popular, yet some women would prefer something more natural. This is where free flap breast reconstruction becomes an option.

What is free flap breast reconstruction?

Free flap breast reconstruction surgery transfers tissues, fat, and blood vessels from the lower abdomen, lower back, or thighs to reconstruct the breast. This procedure requires the skill and artistry of an experienced reconstructive surgeon like Dr. Craft, as it involves the use of a microscope to connect the small blood vessels together (microsurgery).

Benefits of free flap breast reconstruction

As stated before, there’s nothing wrong with breast implants—they are FDA approved, and very safe. However, some women would simply rather use natural tissue from their own body as opposed to a foreign substance. For this reason, free flap breast reconstruction is an ideal option for many patients. The procedure also offers different techniques to best match a woman’s anatomy, needs, and personal aesthetic goals. Furthermore, the results from a free flap breast reconstruction last forever.

Free Flap Breast Reconstruction

Free flap breast reconstruction surgical details

Free flap breast reconstruction is performed under general anesthesia and takes 4 to 6 hours.

Free flap breast reconstruction techniques

These techniques may also be combined:


Fat and skin are transferred from the lower abdomen to the breast area. Because the blood supply to the flap is provided by deep inferior epigastric perforator vessels and not the rectus abdominus muscle, the rectus muscle does not need to be transferred. The vessels are dissected out through openings made in the rectus muscle. Once the flap has been raised, it is moved to the breast area and connected to the blood vessels using microsurgery. The flap tissue is then constructed into a breast mound.

SIEA flap

This technique is similar to the DIEP method, but uses the superficial inferior epigastric vessels to provide the blood supply to the flap instead of the perforator vessels. This means the openings are made in the skin and fat only.

PAP/TUG flap

A TUG flap or PAP flap breast reconstruction uses fatty tissue from one or both inner thighs, below the buttocks. A TUG flap transfers the fat with the muscle, which includes the flap blood vessels—whereas a PAP flap does not remove any muscle.


Free flap breast reconstruction is a procedure that requires considerable recovery time. Patients should expect to spend several days in a medical facility for the best healing and care. We will provide you with detailed instructions and what to expect; however, in general patients will need 4 to 6 weeks to fully recover.

There will be surgical dressings to wear, and drains will be placed to collect fluids. Strenuous activity, including lifting and intercourse, should be avoided for six weeks to help with healing. You should not take baths, use a hot tub, or swim until your drains have been removed and your skin has totally healed.

Patients should take short, frequent walks to help with circulation and healing. At the end of week two post-op, most women can begin wearing a sports bra instead of surgical garments. At week three, patients can return to desk-type jobs.

Free flap breast reconstruction candidates

If you’re interested in this procedure, you may be a great candidate. Good candidates are women who are seeking breast reconstruction for one or both breasts without implants, and who meet the following criteria:

  • Have adequate tissue in another area of the body to create one or both breasts
  • Are in general good health and do not smoke
  • Are emotionally ready for reconstruction surgery
  • Have realistic expectations of what the procedure can accomplish

Why choose Dr. Craft?

Dr. Randall O. Craft at the Arizona Center for Advanced Reconstruction and Aesthetics (ACARA) brings his years of reconstructive surgery expertise to every procedure he performs. Dr. Craft is an expert in the field of free flap breast reconstructive surgery. As a double board-certified, Harvard-trained surgeon, he has the credentials, the experience, and the artistry to carry out safe reconstructive surgeries that achieve life-changing results. Dr. Craft provides patient-centric, compassionate care with an emphasis on safety and patient wellbeing. To schedule a consultation, please call (602) 899-6444 or contact us online.

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