Hybrid Breast Reconstruction Surgery
WHAT IS HYBRID BREAST RECONSTRUCTION?
Hybrid breast reconstruction, sometimes referred to as “composite breast reconstruction,” provides a solution for rebuilding the breasts with natural living fat (excess tissue) combined in a single stage with supplemental breast implants.
The surgical techniques used in hybrid reconstruction give added size and projection to the new breasts when a single donor site doesn’t have enough body fat. In thin patients, adding a small breast implant beneath the living body fat transfer (natural tissue) can provide the surgical equivalent of breast augmentation after mastectomy — giving such patients their desired breast size.
Hybrid breast reconstructive surgery can restore shape and size beyond that of ordinary flap reconstruction procedures. A DIEP, APEX Flap℠, SGAP, or TDAP breast reconstruction can be combined with a gel or saline-filled implant underneath breast skin to support volume while providing the softness and natural look of living tissue breast reconstruction.
The careful preservation of strength and muscle function, along with the characteristics of modern implant-based breast reconstruction, is a “hybrid” combination that can bring outcomes that are not possible with either individual technique.
The plastic surgeons at CRBS have other options for the thin woman who prefers a breast made up entirely of natural tissue without saline and silicone implants, which are the Body Lift Flap®, SGAP, & Stacked Flap℠ breast reconstruction procedures.
The Center for Restorative Breast Surgery is a pioneering institute in the field of modern breast reconstruction and has led the way for improved outcomes for women seeking the best in reconstructive options for over 15 years.
No matter if you’re interested in implant-based reconstruction, microsurgical breast reconstruction, free flap breast reconstruction, or one of our many hybrid breast reconstruction options, our plastic surgeons will work tirelessly to produce your preferred results.
WHEN ARE HYBRID PROCEDURES USED?
Hybrid breast reconstruction is used to recreate a soft, natural breast made of living fat that is “boosted” with an implant to reach proper size and projection in the breast area. It is used when the abdominal donor site and other donor site tissues are too thin for an ordinary flap procedure.
For women who need a larger breast size than their fatty donor tissue site can provide, this technique can give the best of both natural tissue softness and breast mound volume support from an underlying implant. It is used for women who understand the risks and benefits of implant reconstruction as a part of their aesthetic breast reconstruction plan.
The combination of more than one technique in this way produces a larger breast and allows the incision in the donor site to be designed in a cosmetically ideal location. In almost every case, the hybrid breast reconstruction procedure can be done on the same day as mastectomy; this is known as “immediate reconstruction” (sometimes referred to as immediate microsurgical breast reconstruction). For women with a previous mastectomy, the hybrid breast reconstruction may be performed after treatment. This is known as “delayed reconstruction.”
Almost ALL women are candidates for immediate reconstruction, so speaking with your team prior to mastectomy about reconstruction is important.
The hybrid breast reconstruction procedure gives thin women a new option to fully restore the breast after mastectomy by combining the best of both natural living donor tissue and implant-based reconstructions.
Speak with your CRBS consultant about our nipple sparing mastectomy options.
WHAT ARE THE BENEFITS OF HYBRID BREAST RECONSTRUCTION?
There are several benefits of the hybrid breast reconstruction. The primary benefit comes from adding the soft tissue coverage of living fat from a donor site to cover the look and feel of breast implants. This makes hybrid breast reconstruction superior to an “implant-only” breast reconstruction for a number of reasons.
After skin or nipple sparing mastectomy, the remaining skin in the breast area is thin. This tends to produce palpable or visible wrinkling with implant-only reconstructions. Additionally, if capsular contracture occurs (scar tissue around the implant), it is readily visible, and the resultant firm texture is easily felt.
Adding a natural living fat layer over the implant reduces the size of the implant required on the chest wall. This allows the permanent implant to be “camouflaged” by the overlying texture and volume of the soft fat layer. The thickened coverage over the implant also protects the thin layer of mastectomy skin. The result is a more durable, trouble-free solution than a generic implant reconstruction can provide. Taking less fat from the donor site and supplementing it with an implant also allows the donor incisions to be narrower and the feminine form to be enhanced as a nice compliment to the newly reconstructed breast.
Women who choose hybrid breast reconstruction should understand the risks and potential maintenance requirements of modern breast implants. The FDA recommends screening for “silent rupture” of silicone implants using MRI beginning at 3 years post-implantation and then every 2 years thereafter. You should also continue to receive routine follow-up with your physician as recommended by your care team.
WHAT ARE THE RISKS OF HYBRID BREAST RECONSTRUCTION?
As with any surgery, the risks of surgery can be minimized by carefully following your pre-surgical instructions. The specific risks of adding a breast implant to your reconstructive plan can include “capsular contracture,” which is the body’s response to a foreign material implanted beneath the skin. Although relatively rare, the result can be a distorted shape and, in some cases, chronic pain. The use of the smallest implants covered by living fat with the “hybrid” technique is thought to reduce this risk compared to an “implant-only” breast reconstruction.
Additional risks include the possibility of implant rupture. Modern implants are more durable than those of the past, but they can still fail and need replacement over time. The likelihood of this for an individual is unpredictable and varies from patient to patient. Smaller implants tend to be more durable than larger ones. The “hybrid” combination typically only requires a very small implant to supplement the volume of the DIEP, APEX Flap℠, SGAP, or TDAP breast reconstruction procedures. If an implant does rupture, it is replaced surgically with a new one at a time convenient for the patient.
Saline implants show volume loss in the breast if the fluid leaks out. The liquid content is salt water and is absorbed harmlessly by the body. Silicone implant leaks can be harder to detect, and MRI screening for “silent rupture” is recommended by the FDA, as noted above.
Implants have not been determined to interfere with cancer screening and have been judged to be otherwise safe when used as a part of modern breast reconstruction.
If you have other medical problems or items that increase your risk, we will work with you to educate you on proper preparation and arrange your clinical care to maximize your safety and proper recovery.
WHAT TO EXPECT THROUGHOUT YOUR HYBRID BREAST RECONSTRUCTION PROCEDURE
PRE HYBRID RECONSTRUCTION SURGERY OFFICE VISIT
In most cases, you will be seen in our office 1-2 days prior to your surgery. At that time, we will go over the planned procedure, review consents, answer any questions you may have, and apply any surgical planning markings as may be required.
YOUR HYBRID RECONSTRUCTION SURGERY
When you arrive at St. Charles Surgical Hospital, you will be escorted to the preoperative holding area, where you will change into a gown and be given foot coverings. The nurse or anesthesiologist will start an IV so that fluids and necessary medications may be given to you. Family members will be allowed to visit with you in the preoperative area once you are prepared for surgery.
Your procedure will be performed in a state-of-the-art operating suite that is part of a fully accredited hospital that has been recognized by the American College of Surgeons for Excellence in care quality. Highly trained professionals using the most modern equipment and techniques will attend to you. In addition to your surgeons, the surgical team includes anesthesiologists, operating room technicians, nurses, and physician assistants.
POST HYBRID RECONSTRUCTION
After your surgery is complete, you will awaken in the recovery room under warm blankets with a dedicated nursing attendant at your side. You will be carefully monitored and kept comfortable. You will then be transferred to a private inpatient room that is prepared to allow you to rest and recover under the supervision of your attending physician and nurses. One adult caregiver may stay with you overnight during your hospitalization. A fold-out Murphy bed will be integrated into your room for individualized comfort.
RETURNING HOME AFTER RECONSTRUCTIVE SURGERY
If you are traveling from out of state or internationally for care with us, your caregiver will need to be with you throughout your stay post-discharge and on the same flight home to assist you at the airport. Your caregiver’s education will be provided by our nursing staff during your time with us, and our team is available to you and your assistant 24 hours/day should any questions arise after you are released from the hospital. Your arrangements for assistance after surgery should include an estimated seven to ten days of availability from your caregiver.
HYBRID BREAST RECONSTRUCTION FAQS
WHAT IS AUTOLOGOUS BREAST RECONSTRUCTION?
Autologous breast reconstruction is a surgical technique that uses a patient’s own tissues, often from a donor site like the abdomen, thigh, or back, to recreate the breast mound after mastectomy. Unlike implant placement, which involves using synthetic materials, this method uses natural tissues, sometimes in combination with autologous fat grafting, to achieve a more natural look and feel. The primary advantage is reduced risk of complications associated with implants, though, like any other procedure, there can be donor site morbidity or complications where the tissue is harvested.
WHAT’S THE DIFFERENCE BETWEEN AUTOLOGOUS AND PROSTHETIC TECHNIQUES?
Autologous techniques for breast reconstruction utilize a patient’s own tissues from a donor site to recreate the breast mound. Prosthetic techniques involve the use of synthetic materials.
WHAT IS A DEEP INFERIOR EPIGASTRIC PERFORATOR?
In breast reconstruction, a DIEP flap uses skin, fat, and blood vessels from the lower abdomen (without taking the underlying muscle) to reconstruct the breast. This method preserves abdominal muscle strength and reduces donor site morbidity. It’s a popular choice for autologous breast reconstruction because the tissue is similar in texture to natural breast tissue.
WHAT IS BILATERAL RECONSTRUCTION?
Bilateral reconstruction refers to the reconstruction of both breasts, either after bilateral mastectomies or for symmetry purposes. This can be done using a variety of techniques, including implant placement, tissue expanders, or utilizing natural tissue.
LEARN MORE ABOUT THE HYBRID RECONSTRUCTION PROCESS
Be reassured that you are being attended to by some of the most highly skilled healthcare providers in the world using the latest autologous techniques. Do your best to relax knowing that we are going to take excellent care of you from the moment you enter our facility. Do not hesitate to ask for any special needs you may have — patient satisfaction is our number one goal.
From DIEP flap breast reconstruction to other forms of autologous reconstruction, our team of plastic surgeons has you covered.
Hear From Our Patients
“I asked her what was so different about mine and others she had seen. She said the cleavage and the fullness of the breast against the top of the chest looked so good, that she’d never seen it look so real!”