Breast Reconstruction
Using Your Own Natural Tissue (Implant-Free)

Rebuilding your breasts after a mastectomy can be done without the use of breast implants. Your own natural tissue from other areas of your body such as your back, buttocks or abdomen and can be used to rebuild your breasts.

Specializing in Breast Surgery

Dr. Avram’s advanced training and 15+ years of experience with complex cosmetic, and reconstructive breast surgery cases has made Dr. Avram one of Canada’s most sought after breast surgeons.

With his accumulated experience and established record, Dr. Avram is often called upon by other plastic surgeons for additional training opportunities and assistance with complex breast procedures.

Dr. Avram performs 3 different types of implant-free reconstructive breast surgery techniques: 1) DIEP, 2) TRAM, 3) SGAP. At the time of your initial consultation, Dr. Avram will determine the proper reconstructive technique that suits your needs.

1) DIEP — Abdominal Skin & Fat Used For Breast Reconstruction

Your abdominal skin and lower abdominal fat will be moved from your belly to your chest to rebuild your breasts after a mastectomy.

Dr. Avram will remove the skin and fat from your abdomen and will re-attach it to your breast area to rebuild your new breasts. To ensure that there’s enough space for proper blood flow, a small piece of rib cartilage will be removed. Microsurgery suturing techniques will be performed to attach the tiny blood vessels for the survival of your new, all natural tissue transfer.

Once microsurgery has been performed and the blood vessels are attached, Dr. Avram will begin to shape your tissue into beautiful new breasts.

Benefits of DIEP

Dr. Avram is creating your new breasts by removing excess skin and fat from your abdomen, this results in a slimmer, flatter and tighter midsection. Similar benefits as tummy tuck surgery.

Your Incisions

The most common incisions for DIEP reconstruction surgery are located on your breasts and your lower abdominal region. A horizontal incision — from hip bone to hip bone — curved down toward your pubic bone will be made on your abdomen.

Anesthesia

An anesthetist will be present during your surgery to administer a general anesthetic. You will be very comfortable and asleep during your reconstructive DIEP reconstruction surgery.

Length of DIEP Surgery & Recovery

DIEP flap reconstruction surgery can take anywhere from 4 to 6 hours for one breast and 6 to 10 hours for two breasts.

Dr. Avram suggests that you take at least 6 to 8 weeks off work for recovery. You will receive specific return to work and post operative care instructions. For optimal results, be sure to follow your post operative care instructions very carefully.

2) TRAM — Lower Abdominal Skin, Fat, and Muscle Used For Breast Reconstruction

Your lower abdominal skin, fat and muscle will be moved from your belly to your chest to rebuild your breasts after a mastectomy. TRAM flaps are very popular for reconstructive breast surgery because TRAM flap tissue is very similar to breast tissue.

There Are Two Main Types of TRAM Flaps

1. Free TRAM Flap: Your abdominal skin, fat, muscle and blood vessels will be cut and completely removed from your belly then moved up to your chest. Dr. Avram will remove a small portion of your 6 pack muscles for the Free TRAM Flap surgery. Free TRAM Flap involves a small portion of muscle so you will recover quickly and won’t loose much abdominal strength as you heal.
2. Attached TRAM Flap: The blood vessels are left attached to the flap. The fat, skin and muscle are moved up toward the chest — underneath your skin — to rebuild your breast. Attached TRAM Flaps uses a large portion of your abdominal muscle so your recovery will be longer because more muscle is used.

Once microsurgery has been performed, Dr. Avram will begin to shape your tissue into beautiful new breasts.

Benefits of TRAM

Dr. Avram is creating your new breasts by removing skin, fat and muscle from your abdomen, this results in a slimmer, flatter and tighter midsection. Similar benefits as tummy tuck surgery.

Your Incisions

The most common incisions for TRAM reconstruction surgery are located on your lower abdominal region. A horizontal incision — from hip bone to hip bone — curved down toward your pubic bone will be made on your lower abdomen.

Anesthesia

An anesthetist will be present during your surgery to administer a general anesthetic. You will be very comfortable and asleep during your reconstructive TRAM reconstruction surgery.

Length of TRAM Surgery & Recovery

TRAM flap reconstruction surgery can take anywhere from 4 to 6 hours for one breast and 6 to 10 hours for two breasts.

Dr. Avram suggests that you take at least 6 to 8 weeks off work for recovery. You will receive specific return to work and post operative care instructions. For optimal results, be sure to follow your post operative care instructions very carefully.

3) SGAP — Flaps From Your Upper Buttocks & Hip For Breast Reconstruction

Skin, fat and blood vessels from your upper buttocks and hip region will be removed and replaced to your chest to rebuild your breasts after a mastectomy.

Dr. Avram will cut and remove the skin, fat, and blood vessels from your upper buttocks and hip region — also known as your love handles. Once removed, Dr. Avram will re-attach the SGAP flap to your chest to rebuild your new breasts. Microsurgery suturing techniques will be performed to attach the tiny blood vessels for the survival of your new, all natural tissue transfer.

Once microsurgery has been performed and the blood vessels are attached, Dr. Avram will begin to shape your tissue into beautiful new breasts.

Benefits of SGAP

Dr. Avram is creating your new breasts by removing excess skin and fat from your upper buttocks and hip region, this results in tighter, firmer buttocks. Similar benefits as buttock lift surgery.

Your Incisions

The most common incisions for SGAP reconstruction surgery are located on the upper region of your buttocks and on the surface skin of your breasts.

Anesthesia

An anesthetist will be present during your surgery to administer a general anesthetic. You will be very comfortable and asleep during your SGAP reconstruction surgery.

Length of SGAP Surgery & Recovery

SGAP is more complex than TRAM and DIEP and usually takes more time to complete. Many plastic surgeons do not know how to perform SGAP, Dr. Avram has specialty SGAP training.

SGAP flap reconstruction surgery can take anywhere from 6 to 10 hours.

Dr. Avram suggests that you take at least 6 to 8 weeks off work for recovery. You will receive specific return to work and post operative care instructions. For optimal results, be sure to follow your post operative care instructions very carefully.

Breast Cancer Awareness

Alana Somerville, a breast cancer survivor and patient of Dr. Avram’s, wrote a book called Chemosabe Cancer Warrior. This book is written to help guide women through everything you need to know about surviving breast cancer and navigating Canada’s healthcare system. Take a peek at Elizabeth Hurley’s feedback on Chemosabe Cancer Warrior.