Breast Reconstruction Surgery Program

About the Program

Surgeons in the Breast Reconstruction Program understand the profound impact the loss of a breast or part of a breast can have on your sense of self. Our breast reconstruction experts specialize in surgically recreating natural-looking breasts to help you achieve a positive body image.

Our surgeons are Harvard Medical School-affiliated physicians who have extensive experience in performing a wide range of reconstructive breast procedures, including the newest and most advanced procedures.

Our division performs more than 500 breast reconstruction surgeries each year. Because of this high patient volume, our surgeons have the experience to provide innovative surgical techniques for both cosmetic and reconstructive surgery that improve surgical outcomes and enhance patient satisfaction. We were among the first centers to provide free TRAM (transverse rectus abdominis myocutaneous) flaps, in which muscle, fat and skin from the abdomen are used to shape the breast, and TMG (transverse myocutaneous gracilis) flap, in which tissue from the thigh is transferred to the breast.

We also offer breast reduction and enhancement surgery, as well as other cosmetic procedures.

What to Expect

Whether you are a candidate for a minimally invasive procedure or require breast reconstruction, we have carefully designed a step-by-step pathway for your preoperative and postoperative care.

Our approach to your care centers on your personal preferences and goals for reconstructive breast surgery. During your consultation, the surgeon will review your medical history and treatment goals. Treatment options, including risks and benefits, will be discussed in detail. Photos may also be necessary. We also ask that you bring a list of medications, vitamins and herbal supplements that you take, along with information on dosages.

If you are a breast cancer patient, the plastic surgeon will collaborate with your surgical oncologist to discuss your cancer treatment plan, including postoperative radiation therapy or chemotherapy, to ensure that the reconstruction options provided to you are aligned with your overall cancer treatment plan. The plastic surgeon will work with you and a team of Mass General experts from multiple specialties, including breast surgical oncologists, radiation therapists, radiologists and radiation physicians and nurses, to develop a personalized plan that helps you achieve your breast reconstruction goals. We also have a team of highly trained, dedicated plastic and reconstructive surgery nurse practitioners who are available to answer any questions and assist with post-operative care.

We may share before-and-after photos to demonstrate the benefits of various surgical options. Our goal is to give you a realistic picture of what to expect so that you can make an informed decision. We also review what's involved in any surgery, including:

• Anesthesia
• Anticipated results
• Hospital care
• Postoperative recuperation

The Right Procedure for Each Patient

Our surgeons perform more than 500 breast reconstruction surgeries per year and have extensive experience in all breast reconstruction techniques, including the newest and most innovative procedures, such as deep inferior epigastric perforator (DIEP) flaps, which use only fat and skin from the patient's abdomen, and transverse myocutaneous gracilis (TMG) flaps, in which tissue from the thigh is used to shape the breast. As a result, we can incorporate the most appropriate option based on each patient's anatomy, clinical situation and personal preferences.

Our team collaborates with the world-class surgeons and oncologists in the Mass General Cancer Center. Through this close relationship, we are able to provide breast cancer patients with coordinated care from talented and experienced surgical oncologists and plastic surgeons. Breast cancer patients who are interested in reconstructive surgery may choose to have immediate reconstruction surgery, which is performed at the same time as the mastectomy, or delayed reconstruction, which is often performed months after the mastectomy. Our team will work with you to determine the optimal treatment plan based on your needs.

Patient Safety

Reconstructive breast surgery carries risks, so safety is an important consideration. Our patients enjoy the peace of mind that comes from receiving treatment at a renowned academic medical center known for its unyielding commitment to providing high-quality, safe care.

Our research focuses on exploring and developing cutting-edge procedures to improve patient safety and outcomes that are used around the world.

We also work closely with other specialists at Mass General to provide your care. When preparing for DIEP flaps, for example, we work closely with Mass General Imaging specialists, who perform preoperative imaging of the patient's arteries. Gaining access to this "roadmap" helps our surgeons to complete the procedure faster, improve patient safety and decrease recovery time.

Breast Reconstruction Options

We offer three innovative types of reconstructive breast surgery for patients who have had a mastectomy, undergone radiation therapy or have a congenital condition that requires reconstructive breast surgery.

• Autologous breast reconstruction, which involves transferring tissue from another part of the body to the breast. Common procedures include:
  • TRAM flap: Using muscle, fat and skin from the patient's abdomen for breast reconstructio
  • DIEP flap: A muscle-sparing procedure that uses only fat and skin from the patient's abdomen (the preferable option for bilateral breast reconstruction
  • TMG flap: Patients who have small- to medium-sized breasts and are not ideal candidates for a TRAM flap may consider a TMG flap, in which tissue from the thigh is transferred to the breast
• Breast reconstruction using implants, including:
  • A multistaged approach that involves tissue expansion and then gradually filling in the implant over the course of three to four months
  • A single-staged approach that incorporates acellular dermal matrix (Alloderm®)to support the breast implant
• Latissimus dorsi flap, a procedure that uses tissue from the patient’s back for breast reconstruction

We sometimes combine techniques, using flaps, implants and nipple tattooing to achieve the most natural-looking effect.

Cosmetic Breast Surgery

We also perform cosmetic breast surgery, including breast augmentation and breast lift (mastopexy). The Mass General Cosmetic Surgery Program offers augmentation with breast implants and/or mastopexy procedures. Innovations in Breast Reconstruction Mass General plastic surgeons understand that losing a breast is an extremely emotional experience. We are committed to continuing to advance existing breast reconstruction surgical techniques and developing innovative approaches to improve surgical outcomes for our patients.

Our high patient volume provides our surgeons the experience and expertise to improve and develop a variety of surgical techniques for both cosmetic and reconstructive surgery that improve surgical outcomes and enhance patient experience.

Some improvements come from our experience in the operating room. Other advancements come from our Plastic Surgery Research Laboratory, where we collaborate on solutions to improve methods of reconstruction. Recent innovations in surgical techniques include:

• Single-stage implant reconstructions: Mass General surgeons routinely offer single-stage implant reconstruction, a newer technique that involves placing a full-size implant immediately at the time of the mastectomy. Patients wake up from surgery with a complete reconstruction without having to undergo a more extensive procedure in the future.
• Reconstruction with adipose tissue: Currently, reconstruction using adipose (fat) tissue is not routinely possible. Mass General plastic surgery researchers have made several significant discoveries in adipose tissue reconstruction, leading to potential new innovations in surgical techniques. In addition, adipose tissue contains more stem cells than most other tissues. In the future, these stem cells may be used to not only help reconstruct new tissue but also reduce complications from radiation and chemotherapy.

Education and Training

We are committed to training the next generation of plastic surgeons, and offer a Reconstructive/Aesthetic Breast Surgery Fellowship through our education and training program

Active Studies

The Plastic Surgery department is currently looking for participants in a leading-edge research study.

Body Image and Well-Being During Mastectomy with Breast Reconstruction

If you are scheduled for mastectomy with breast reconstruction at Mass General, you may qualify to participate in this research. This study aims to understand factors that affects women's body image and wellbeing during mastectomy with breast reconstruction. We hope to learn new information from this research that will allow us to support women through the mastectomy process as best as possible.

You can participate from your home (no in-person visits) and you will receive compensation. Participation involves two assessments:

1. Pre-surgery: Complete a brief interview with a mental health professional by phone. You will then complete a questionnaire on the computer.
2. Post-surgery: Complete questionnaires on your computer.