Breast Reconstruction Surgery

William P Clements Jr University Hospital building.

The breast reconstruction team at UT Southwestern Medical Center has pioneered a number of techniques that preserve muscle, minimize recovery time, and reduce pain.

Our plastic surgeons work with our breast cancer specialists at UT Southwestern's Harold C. Simmons Comprehensive Cancer Center – the only National Cancer Institute-designated comprehensive cancer center in North Texas – to help patients make the best decision for reconstruction after breast cancer.

What Is Breast Reconstruction?

Breast reconstruction is a transformative surgical procedure aimed at rebuilding the shape and appearance of the breast, often following a mastectomy.

This reconstructive surgery plays a crucial role in restoring not only physical wholeness but also emotional well-being for individuals who have undergone breast cancer treatment. Various techniques, such as implant-based reconstruction or autologous tissue transfer, are employed to recreate a natural-looking and balanced breast.

The goal is to help individuals regain confidence and a sense of normalcy after the challenges of breast cancer, empowering them on their journey toward physical and emotional recovery.

Why Choose UT Southwestern for Breast Reconstruction Surgery?

Restoring a Natural Look and Feel

The decision to have breast reconstructive surgery goes far beyond what happens in surgery.

At UT Southwestern, our goal is to help each patient look and feel her best, long after surgery – applying safe, highly innovative techniques to create breasts that look and feel natural.

Leading-Edge Breast Reconstruction Procedures: Reduced Pain, Enhanced Recovery

Our surgeons have pioneered a number of techniques that preserve muscle, minimize recovery time, and reduce pain.

In North Texas, many of the newest muscle-sparing procedures, such as autologous tissue-based reconstruction, as well as a combination implant-autologous tissue reconstruction, are performed only at UT Southwestern Medical Center.

"Our breast reconstruction surgeons combine a unique, artistic perspective with groundbreaking surgical solutions to help us create breasts that look and feel natural."

Sumeet Teotia, M.D.
Professor of Plastic Surgery at UT Southwestern.

Doctor discussing breast reconstruction surgery with patient in hospital bed.

What Are the Types of Breast Reconstruction Surgery?

We offer a broad spectrum of breast reconstruction options. Surgeons talk to each patient about options to help her make the best decision based on her health and future breast cancer treatments, projected recovery time, body shape, and other factors.

There are main types of breast reconstruction:

Autologous tissue-based reconstruction: This procedure offers the newest advancements to sculpt and shape breasts that look and feel natural. It can allow for sensation to the reconstructed breast.
- We create a fat graft or flap using tissue transplanted from elsewhere on the patient’s body. If tissue is taken from the abdomen, the patient also receives a tummy tuck.
- This procedure is suitable for women who do not have enough skin to cover an implant.

Implant reconstruction: During the initial surgery, a tissue expander is placed under the pectoralis muscle. It’s then filled with saline until the proper volume is achieved. Our surgeons then use either a saline or silicone implant for the reconstruction. Implant reconstruction offers the shortest operative time and is the simplest breast reconstruction surgery. The typical candidate includes women:
- With an adequate skin pocket to hold an implant
- Who do not have adequate tissue for reconstruction or who do not want to use their own tissue
- Without a history of radiation treatment
Combination implant and autologous reconstruction: This technique combines both implants and flaps, where tissue from another part of the body is used in the reconstruction.
Oncoplastic surgery: This direct-to-plastic reconstruction surgery, single-surgery option combines mastectomy and reconstruction. Instead of using tissue expanders to fit implants above or below the muscle, our surgeons position the final implants in the mastectomy envelope – the hollow space between the skin and muscle after the breast tissue is removed. Oncoplastic surgery offers:
- Shorter and less painful recovery
- Lower infection risk
- A natural, attractive outcome
Aesthetic flat closure: This option can be done at the same time as a mastectomy or breast implant removal. The procedure creates a smooth, flat chest contour.

Autologous Tissue-based Reconstruction: Flap Procedures

One area in which the UT Southwestern team in Dallas has gained distinction involves the use of flaps, where tissue is transplanted from other parts of the body to reconstruct the breast. Basically, “flap” means any tissue with a blood supply or that is connected to a main artery and vein. By using flaps, patients should expect less downtime and more natural, aesthetic results.

The main types of flap procedures we perform to create a new breast include:

Deep inferior epigastric perforator (DIEP): Uses tissue from the lower abdomen
“Efficient” deep inferior epigastric perforator (eDIEP): Uses tissue from the lower abdomen efficiently
Profunda artery perforator (PAP): Uses tissue from the back of the upper thigh (upper posterior thigh area)
Stacked flaps: Uses tissue from different parts of body in combination – generally two areas
4-flaps: A type of stacked flap generally using DIEP, PAP, or LAP flap in combination
Double-pedicle DIEP flap: Uses tissue entirely from the lower abdomen for one side breast reconstruction
Lumbar artery perforator (LAP): Uses soft tissue of the waistline (flank/‘love handle’ area)
Lateral thigh flap (LTP): Uses tissue from the upper side of the thighs

Also, if a patient has one breast surgically removed, we can suggest additional procedures to reshape or lift the natural breast. The goal is to match the existing breast with the reconstructed breast. We can perform reconstruction procedures in conjunction with a mastectomy or years after breast cancer treatment.

The procedures include:

Immediate breast reconstruction after a mastectomy, which offers the advantage of preserving as much of the breast skin envelope as possible, maximizing cosmesis and retaining as much of the breast’s own skin as possible
Delayed reconstruction, where the final results can be very comparable to immediate reconstruction
Surgery to revise a previous procedure

A man and woman in business attire smiling.

Well-Coordinated Care

For patients undergoing breast cancer treatment, breast reconstruction surgery should never delay or affect cancer treatments.

Meet Our Breast Reconstruction Surgeons

Bardia Amirlak, M.D.

Reconstruction offered:

Aesthetic flat closure
Autologous: DIEP flaps, fat grafting
Implant
Oncoplastic surgery

See profile

Jonathan Cheng, M.D.

Reconstruction offered:

Aesthetic flat closure
Autologous: DIEP, PAP, SGAP, TUG flaps
Implant
Oncoplastic surgery

See profile

Nicholas Haddock, M.D.

Reconstruction offered:

Autologous: DIEP, PAP, LAP, LTP flaps
Implant
Oncoplastic surgery

See profile

Ronald Hoxworth, M.D.

Reconstruction offered:

Aesthetic flat closure
Implant
Oncoplastic surgery

See profile

Purushottam Nagarkar, M.D.

Reconstruction offered:

Autologous: DIEP flaps
Implant
Oncoplastic surgery

See profile

Shai Rozen, M.D.

Reconstruction offered:

Autologous: DIEP flaps
Implant
Oncoplastic surgery

See profile

Rita Shelby, M.D.

Reconstruction offered:

Aesthetic flat closure
Implant
Oncoplastic surgery

See profile

Sumeet S. Teotia, M.D.

Reconstruction offered:

Autologous: DIEP, LAP flaps
Implant

See profile

What Should Patients Expect During Breast Reconstruction Surgery?

The time it takes for breast reconstruction varies. Breast reconstruction typically happens in three phases.

Initial reconstruction for patients with breast cancer begins in combination with (or after) surgery to remove the cancer.
Refinements are made after the initial reconstruction.
A nipple and areola are added as a final step.

“My philosophy is simple: I’m not satisfied until my patients really understand their diagnosis, and the pros and cons of each option. Each patient is unique, and there are no cookie-cutter solutions.”

Purushottam Nagarkar, M.D.
Associate Professor of Plastic Surgery at UT Southwestern.