After a breast cancer diagnosis, many patients seek breast reconstruction to reflect their restored health. Breast reconstruction can be a critical step in moving forward, but how do you know which type of procedure is the right choice for you? In some situations, a combination of reconstruction techniques, also known as hybrid breast reconstruction, may provide the most aesthetically pleasing outcome, so you once again feel and look like you. Hybrid breast reconstruction is not a common choice, but it is one that Dr. Christine Fisher has been offering her patients for a number of years.

Dr. Fisher specializes in breast reconstruction with natural and beautiful results for women in the Austin area and across the country, helping them boost their confidence in their appearance after a breast cancer diagnosis and treatment. By educating yourself about the different techniques available, you can make the best decisions for your reconstruction, so you enjoy beautiful breast reconstruction results.

What is Hybrid Breast Reconstruction?

Hybrid breast reconstruction combines a flap procedure (such as DIEP flap) with implants to create a fuller, more natural upper body contour. The addition of implants with a flap provides more fullness than flaps alone. The technique of placing implants underneath the body’s own tissue results in a look and feel more like a natural breast. These procedures are individually customized to the unique needs and aesthetic goals of each patient, requiring substantial experience and skill on the part of the board-certified plastic surgeon to achieve an optimal outcome. Dr. Fisher has the expertise in this specialized technique to provide superior results for her patients.

Is a Hybrid Reconstruction Right for Me?

There are different reasons why Dr. Fisher might recommend a hybrid reconstruction approach. For example, some women may only have a small amount of fat in areas like the buttocks, abdomen or thighs. In these cases, Dr. Fisher may use the available tissue in combination with a small implant to create the fullness and projection a patient desires. In this way, Dr. Fisher can provide a natural-looking outcome without compromising on the breast size the patient may want. Studies, including one published in PRS Global Open in 2017, have shown that this hybrid approach offers excellent results for the right patients.

Implant Options

Dr. Fisher prefers silicone (versus saline) implants for her reconstruction patients because they look and feel more like natural breast tissue. With various sizes available, Dr. Fisher will help you determine the size that will match your body proportions and desired results. Keep in mind that when you are combining the implants with a flap technique, you will be able to select smaller implants that will reduce your risk for some complications after surgery. When the smaller implants are combined with a patient’s own tissue, Dr. Fisher can typically achieve the fullness and projection they desire.

Other implant variations will involve the outer shell of the implant (smooth or textured), implant shape (round or teardrop) and profile (projection versus width). The profile refers to how the breast will project from the chest wall and will be determined by the width of your chest and the look you desire. Dr. Fisher will walk through all your choices with you so that you are comfortable with your surgical plan when the day of your surgery arrives.

Flap Options

Flaps are skin and fat (and rarely, muscle) taken from one area of the body used to replace the breast tissue removed during a mastectomy. Flaps can be taken from different areas of the body, depending on where the best donor tissue may be located. Dr. Fisher offers the following flap options:

    • DIEP Flap – fat and skin taken from excess lower abdominal tissue, which creates a flatter abdomen contour
    • GAP Flap – fat and skin removed from the upper or lower buttock region
    • PAP Flap – fat and skin taken from the posterior and inner thigh
    • Latissimus Dorsi (LD) Flap – skin, fat and muscle from the upper back rotated to the front to create the breast mound

Dr. Fisher will review your options at your consultation and help you choose the best approach for your reconstruction surgery.

When to Perform Hybrid Reconstruction

Hybrid breast reconstruction can be performed at the same time as your mastectomy (immediate reconstruction) or some time afterward (delayed reconstruction). Many women can have their reconstruction at the same time as their initial breast surgery, so be sure to meet with your entire surgical team before your mastectomy to find out if that is a possibility. If you opt for delayed reconstruction, there is no timeframe as to when the surgery needs to be completed to ensure success.

Some women may require a staged approach to their reconstruction. During the first stage, an expander is placed in the breast tissue to create a space for the implant. The expander is like a balloon which can be gradually filled with a sterile saline solution. As more fluid goes into the expander, the space for the implant becomes larger until you are ready to have the implant placed in the breast pocket. At that time, Dr. Fisher can often do both the implant placement and the flap procedure in the same surgery to create your final results. Expanders can be placed during your mastectomy or at a later time.

About the Surgery

Hybrid breast reconstruction is performed under general anesthesia, and Dr. Fisher will also administer a long-lasting pain blocking medication to reduce your discomfort after surgery. Incision placement will vary, based on the type of flap used and the size of the implants. Dr. Fisher focuses on techniques to place incisions in hidden areas to minimize visible post-operative scarring.

If done in two stages, you will typically not stay overnight in the hospital after implant placement surgery. If this procedure is done at the same time as your mastectomy, you may stay in the hospital overnight. After you go home, you will spend time resting and recuperating so that your breasts have plenty of time to heal. It is helpful to have a family member or friend with you for the first day or two so you can focus on your recovery. While the actual surgical process and recovery time will vary based on how this procedure is performed, most women are back to their regular activities within about four weeks after their operation.

Finding the Best Fit for You

There are numerous options in aesthetic breast reconstruction today, but not every approach will work the best for you. Dr. Fisher and her all-women team are committed to helping all our reconstruction patients achieve optimal results. She will spend ample time with you throughout the process, starting with thoroughly getting to know you and understanding your concerns, so together you can form a surgical plan that fits with your needs, aesthetic goals and lifestyle. She is a female board-certified plastic surgeon with extensive experience in breast reconstruction and a wide range of techniques available for her patients. When you work with Dr. Fisher, you will receive superior care and attention, as well as a safe and successful surgical experience. To learn more about your choices in breast reconstruction, contact Dr. Fisher’s office today at 512-815-0123.

Christine Fisher MD

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