Before & After

     ● Immediate or Delayed 
       Breast Reconstruction
     ● Reconstructive Timeline
     ● DIEP Flap
     ● PAP Flap
     ● Tissue Expanders & Implants
     ● Direct to Implant
     ● Lumpectomy Reconstruction
     ● Nipple Reconstruction
     ● Symmetry Surgery
     ● Breast Fat Grafting
     ● Revision Surgery
     ● Lymphedema Surgery
     ● Choosing Not to Have
     ● Young Women with Breast
     ● Patients with High BMI
     ● BRCA 1 & BRCA 2
     ● Advanced Breast Cancer
     ● Lumpectomy or Mastectomy
     ● Skin Sparing Mastectomy
     ● Nipple Sparing Mastectomy
     ● Prophylactic Mastectomy
     ● Radiation Therapy
     ● Chemotherapy
     ● Hormone Therapy


There are two broad categories of breast reconstruction: implant based reconstruction and natural tissue based reconstruction.


When using your own tissues to reconstruct a breast, most often the tissue is taken from the lower abdomen, known as a DIEP flap.  Women who are very thin or previously had an abdominoplasty may not be candidates for this operation.  In those cases the natural tissue can be transferred from the thighs, and is known as a PAP flap.  A consultation with Dr. Dec will help determine if you are an appropriate candidate for this type of breast reconstruction and help you understand the risks and benefits of surgery as well as the reconstructive options you have.  


During DIEP flap surgery excess skin and fat is moved from the abdomen to the breast.  The blood supply to this tissue is reestablished by an advanced technique called microsurgery.  The tissue is then sculpted to acquire the shape of your new breast.  The donor site incision is designed to hide in your undergarment.


After a DIEP flap reconstruction you should expect to remain in the hospital approximately four days.  This time ensures that you are comfortable after surgery and healing is progressing as expected.  After surgery your chest and abdominal donor site will feel tender. Dr. Dec will prescribe medications to reduce pain and risk of infection.  You should expect to leave the hospital with surgical drains.


Bruising and swelling around breasts and abdomen are normal and usually take two to three weeks to resolve.  Scars soften and fade over the course of several months.  You may resume mild activities the day after surgery and strenuous activities after six weeks.  You will see a restored breast contour immediately after surgery, which will continue to improve as you heal.  


There are several reasons women choose natural tissue reconstruction.  Natural tissue reconstruction is optimal for delayed breast reconstruction because it can replace both the missing breast skin and the missing breast volume.  Patients previously treated with radiation therapy see better outcomes with natural tissue transfer because damaged tissue is replaced with healthy tissue to recreate a very natural breast.  Many women choose natural tissue reconstruction because it offers a superior quality breast reconstruction.


The choice of which breast reconstruction is best can be difficult.  Dr. Dec will help guide you to choose the best reconstruction for you.

Copyright © Wojciech Dec, M.D.    |   100 East 77th Street • New York, NY 10075    |    (212) 390-8400  

Specializing in Breast Reconstruction and Microsurgery

Center for Breast Surgery at

Lenox Hill Hospital


Call for Appointment

(212) 390-8400