Question: If I have both breasts removed, can I have tissue flap reconstruction done on both sides of my chest?
Answer: Tissue flap reconstruction can definitely be done on both sides, as long as there is enough tissue to donate. Typically we think of doing what's called a 'bilateral tram flap,' and a tram flap is that transverse rectus abdominous micutaneous flap taken from the abdomen -- it's the typical tummy-tuck operation. And if someone is moderately overweight and has had a few children, and has a nice bulge of tissue down there, and is willing to accept a slightly smaller breast if they're already large-breasted, then both sides can easily be used for breast reconstruction. Often, however, in this health-conscious society we live in, women don't have much fat anymore on their abdominal wall, and it's tough to get two breasts out of one abdominal lower segment.
We also have other forms of tissue reconstruction; there is the latissimus muscle from the back, there is the gluteus muscle off the buttocks. There is – really, anywhere you have tissue, we can take tissue and make it; it just depends on which kind of what we call 'donor defect' a patient wants to live with. So certainly, if one very much does not want to have implants, there are usually options to do both sides with one's own tissue; it just may not be both from the exact same area.