This type of breast reconstruction uses flaps of skin, fat and sometimes muscle. These are generally taken from the back or abdomen because these areas of the body can provide enough skin, fat and muscle with a good blood supply to create the shape of a breast.

Flaps are either:

• tunnelled to the breast area under the skin, allowing them to remain attached to their original blood supply (known as pedicled flaps), or

• surgically removed, disconnected from their blood supply and moved to the breast area (known as free flaps). With a free flap, microsurgery is needed to re-attach blood vessels to create a blood supply for the newly formed breast. If the free flap consists of skin and fat only, without any muscle, it is known as a free perforator flap. A branch of the main blood vessel, after it has left the muscle situated below the skin and fat, is used to create the blood supply for the newly formed breast.

Any type of breast reconstruction using muscle, fat and skin flaps is a major operation taking at least 6–8 hours and needing a hospital stay of around a week or more.