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Breast Reconstruction Restores a More Natural Appearance

For patients who have undergone a mastectomy, Dr. Ramon Robles offers breast reconstruction surgery at our Phoenix, AZ, practice. The doctor uses this procedure to restore the breast to a size, shape, and appearance as close to normal as possible. He can perform the procedure using implants, tissue from the patient’s own body, or a combination of the two. If the patient needs reconstructive surgery on only one breast, the doctor may recommend a breast lift or breast reduction on the other breast, to provide symmetry. The decision to have this surgery is completely up to the patient, but Dr. Robles can explain the procedure and go over all benefits and risks associated with it during your consultation.

Dr. Robles works hard to provide his patients with the most natural-looking breasts possible, and makes himself available every step of the way to address questions or concerns.

Reconstruction Using Implants

Close-up of two hands holding a breast implantIf the patient decides to use implants for her reconstruction surgery, two possibilities exist.

One-Stage Immediate Reconstruction

Also called direct-to-implant reconstruction, this procedure involves the placement of the implant at the same time the patient has the mastectomy. The doctor places the implant under the chest muscle, and uses an acellular tissue graft or an absorbable synthetic mesh to hold it in place. Not every patient is a candidate for immediate reconstruction. A second reconstruction may still be needed after the initial surgery heals in order to obtain a good result. 

Two-Stage Reconstruction

When the patient's tissue will not support an implant immediately, the surgeon places a pouch resembling a balloon in the chest. Over a period of two to three months, the patient will make regular visits to the doctor to have the pouch, called a tissue expander, injected through a valve under the skin with sterile saline. This process gradually creates a soft pocket in the chest tissue, preparing it to support an implant. Patients who require radiation treatment following their mastectomy may need to complete treatment before the doctor places the expander.

Reconstruction Using Tissue Flaps

The patient may choose to have her breast reconstruction performed using tissue from her own body, either in conjunction with implants or instead of them. Flap reconstruction requires more surgery and has a longer recovery time, but when the breast heals, it looks and feels more natural than when surgery is done with an implant. The most common flap procedures involve tissue taken from the abdomen and back.


The TRAM (transverse rectus abdominus myocutaneous) flap uses muscle and tissue taken from the abdomen. Patients can choose to use it with an implant, but many have enough tissue available to rebuild the breast without one. During the procedure, the doctor moves skin, fat, blood vessels, and at least one abdominal muscle to the chest, using one of two types of flaps.

  • Pedicle TRAM Flap – The pedicle flap leaves the tissue attached to its original blood supply, and moves it under the patient’s skin to her chest.
  • Free TRAM Flap – The doctor completely disconnects this flap, so it doesn’t require as much muscle. The blood vessels need reattaching with microsurgery, which causes this surgery to take longer.


A DIEP (deep inferior epigastric perforator) flap uses tissue from the same area, but uses no muscle. The doctor removes the tissue as a free flap, so the blood vessels need reattaching.

Latissimus Dorsi Flap

This flap uses tissue and muscle from the upper back, which the doctor moves under the skin to the chest. Patients typically choose this option to provide added coverage for an implant, but the doctor can sometimes perform reconstruction using this technique without an implant.

Call Us for a Consultation

A mastectomy can be a traumatic experience for a woman. Dr. Robles works hard to provide his patients with the most natural-looking breasts possible, and makes himself available every step of the way to address questions or concerns. If you would like to learn more about breast reconstruction surgery with Dr. Robles, call our office today and schedule a free consultation.

Contact Dr. Robles

Set up your consultation today! Call now 602.266.5100 or fill out the form below.