There are many options for autologous breast reconstruction for patients undergoing mastectomy. It really is multi factorial in choosing which operation is right for each individual patient. It really depends upon their needs, their goals and their body habitants and their overall body conditions. Some of the autologous breast reconstruction procedures including using the lower abdominal fat and skin. This can be done on what is called as the tram which includes the muscle that’s brought up to the chest to reconstruct the breast. If the portion of the muscle can be divided and uses on what we called as the pre-tram where you take the blood supply that usually in the groin area and reattach in the chest that’s called a pre-tram. The next level up is just taking the skin and fat of the lower abdomen and the blood vessels themselves but leaving the muscles intact that’s called a perforator flap DIEP deep inferior upper gastric perforator flap that in the same way is a pre-tram reattached in the chest on through the vessels through the rib cage and put on the chest to reconstruct the breast. Other options for autologous reconstruction include taking the back muscle tesmis muscle and bring over to the chest to soft tissue coverage which is often done in conjunction with implant and then there are other forms of pre-flaps that can be done for breast reconstructions as well.