What Is Hybrid Breast Reconstruction?

By Peter Henderson, MD

That technique gives slender patients large, natural-looking breasts without requiring several donor sites for stacked flaps or fat grafting operations to conceal implants. Some women believe it to be the “best of all worlds.” In hybrid breast reconstruction, an implant is used in addition to flap repair to give the breasts more projection, much like in breast augmentation.

Diagram showing types of implants


In a hybrid reconstruction, a breast implant made of silicone or saline (salt water) is positioned over the muscle and then covered with a layer of your own body fat obtained from a donor area like the belly, thigh, or buttock.

In particular, if you’re skinny or don’t have much body fat, combining natural tissue with an implant enables the construction of a more extensive breast than possible using only your own tissue from a single donor location. The breast feels warmer and more natural than a breast made by implant repair because the implant is coated with raw, live fat. In hybrid breast reconstruction, a collagen “sling” called the acellular dermal matrix (ADM) is frequently utilized to keep the implant in place.

Typically, hybrid reconstruction begins concurrently with mastectomy. The whole process, which entails inserting an implant and removing a flap of tissue from a donor place on your body (such as the belly, thigh, buttock, etc.), may frequently be finished during the mastectomy.

However, specific individuals could require delayed (two-stage) repair. A tissue expander is implanted beneath the breast skin during the mastectomy, similar to implant-only reconstruction. The tissue expander resembles a balloon with a port or plugs inside. Saline is put into the port over several months to progressively increase the tissue expander. This stretches the skin and muscle around the permanent implant until there is adequate room for it. The permanent implant can then be placed in the tissue expander during outpatient surgery. Hybrid breast reconstruction is also an option many years after a mastectomy.

Hybrid Breast Reconstruction: Influencing Factors

Radiation Therapy

Your skin is altered by radiation, becoming less elastic and reducing the amount of fat in the tissue. Additionally, it raises your risk of developing capsular contracture, a condition in which the scar tissue around the implant tightens. The implant’s form may become distorted over time as the capsule tightens. Talk to your surgeon about your alternatives if you believe you’d want a hybrid reconstruction and radiation is a component of your therapy. On the other hand, hybrid reconstruction may be a viable option if you’ve previously undergone radiation therapy or if the skin around your breasts has been damaged in some other way. In contrast to the native breast skin alone, the flap obtained from the donor site—typically the abdomen—will have fatty tissue and skin that may be used to restore the damaged skin in the breast region. It will also offer superior coverage for an implant.

Breast Size and Shape

You could be a good candidate for hybrid breast reconstruction if you have minimal loose skin in your belly, are slender yet want bigger breasts, and have thin breast tissue.

Various Breast Implant Types

Saline or silicone implants may be utilized in hybrid breast reconstruction. Each kind of implant has a unique appearance and feel.

Breast implants come in a variety of varieties. Each kind of implant has a unique appearance and feel. Based on the shape of your breast region and your particular cosmetic objectives, your plastic surgeon can assist you in selecting the ideal implant.

Your Recuperation Recovery Period

Your tissue flap donor site will determine how long it takes for you to recover from the hybrid reconstruction. The DIEP Flap technique, which has a typical hospital stay of 2-3 days, is the most popular donor treatment. Most activities can be resumed after 6–8 weeks. However, heavy lifting shouldn’t be done for 6–12 weeks following surgery. Your tissue may take up to a year to recover fully.

Surgery lines on bottom of right breast

Prepare to feel

All surgical sites, including the donor tissue site, are likely to experience pain, swelling, and bruising (abdomen, thigh, buttock, etc.). At the location of the donated tissue, you can suffer some temporary loss of sensation.


Depending on your donor site and the operation type you choose, the incision for your natural tissue procedure may vary. Scars usually disappear after 12 to 18 months. The type of mastectomy you ultimately get will significantly impact your breast scars.

Additional Techniques

Diagram showing the placement of Breast Implants
FW72ND Illustration of Plastic surgery of breast implant

Whether made of silicone or saline, breast implants do not last a lifetime. Usually, both implant types require replacement after 10 to 20 years. The replacement of an implant often requires no hospitalization.

Peter Henderson

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