Autologous flap breast reconstruction: Surgical algorithm and patient selection

Whole breast reconstruction using autologous tissue is the gold standard in many regions of the world. Reasons include breast replacement with native skin and fat, ability to shape and mold the tissue into a breast, no foreign materials are necessary, and it lasts forever when successful. There are now many options for autologous breast reconstruction and the decision making process regarding which flap to choose will depend on ones experience and comfort, ability to perform microvascular surgery, and the milieu in which one operates. This chapter will review many of the options for autologous breast reconstruction and provide an algorithmic approach for flap and patient selection. J. Surg. Oncol. 2016;113:865-874.