There are 2 basic ways that plastic surgeons reconstruct a breast after a mastectomy. One is through the use of your own tissue to rotate a portion of fatty tissue and muscle to form a new breast mound. The other is through the use of tissue expanders and implants. Today I will describe a few of the most common ways to use your own tissue to reconstruct the breast (called autologous reconstructions). Two of the most common procedures that I use to reconstruct the breast is using the rectus abdominus muscle or the latissumus mucle. The rectus abdominus muscle is the most common autologous reconstruction option. The blood supply to the muscle also provides the blood supply to the overlying fatty tissue and skin that is transferred along with the muscle. This can be while the muscle is still attached to the origin of the blood supply. This is called a pedicle flap. It can also be transferred after disconnecting the blood supply and suturing it to a set of blood vessels close to the breast. This is called a free flap. There are many variations of each kind of flap. Most patients are candidates for possible flap reconstruction however, sometimes I specifically recommend flap reconstruction for those that have had prior radiation to the breast. Patients that receive breast conservation therapy by lumpectomy and radiation do not typically get breast reconstruction. Flap reconstruction is typically anywhere from a 4-6 hour surgery and requires about 3-5 days of hospitalization and 4-6 week recovery time.