Microsurgical Breast Reconstruction After Cancer

Pioneered at The Buncke Clinic:

The goal of breast reconstruction is to restore the appearance of a breast after mastectomy. Recent microsurgical advances allow for improved and safer reconstruction than was available even ten years ago. DIEP flap, SIEA flap, TUG flap, SGAP flap, PAP flap and other free flap types of microsurgical breast reconstruction have significant advantages over implant, pedicled TRAM and free TRAM reconstructions.

Microsurgical flap reconstruction can improve the aesthetics of the reconstructed breast and reduce complications such as fat necrosis and flap loss. Although microvascular autologous reconstruction can be surgically more complex and requires an increased operating time, the long term results have solidly established it as a superb method of reconstruction. Unfortunately, not many surgeons perform microsurgical breast reconstruction, or if they do, they perform it infrequently. Patients may be discouraged from seeking out microsurgical reconstruction as a result because they are concerned about the complexity.

At The Buncke Clinic, we have a vast experience in microsurgical breast reconstruction, including in complex cases, where other reconstructions have failed. Such as failed implants, radiation scarring, exposed implants, osteoradionecrosis, assymetry and flap loss. Just to name a few common conditions we see after reconstruction.

We also commonly perform reconstruction for women having prophylactic mastectomy for high cancer risk, such as carrying the BRCA gene mutation, or strong family history

Although not offered by many plastic surgeons, microsurgical reconstruction with these flaps can be an excellent choice. These procedures offer potential for:

  • Permanent results
  • Sparing of abdominal muscles
  • The aesthetic perk of a tummy tuck or inner thigh lift
  • Breasts that feel more soft and genuine than implants do
  • Breasts that look more natural than implants do

The unique history, circumstances and goals of each specific patient help to define the choice of a reconstruction method. No single technique is applicable to everyone. Some patients may be better candidates for implants, an expander or latissimus reconstruction. Or, for one reason or another, they choose to have implant reconstruction. Although technically more complex, the potential benefits of microsurgical reconstruction can be significant relative to implant or TRAM reconstruction.

Other concurrent factors, like chemotherapy and radiation, physical health, body habitus and patient goals, makes it impossible to cover all the aspects and decision making possibilities in these pages. All these factors play a role in the choice, timing and outcome of reconstruction.

To make an appointment for a consultation, please call our San Francisco Office Number at 415-565-6136.


To make an appointment for a consultation or to refer a patient, please call our office. Do not send any confidential information via this contact form:


45 Castro Street, Suite 121
San Francisco, CA 94114