Breast reconstruction after mastectomy is a common procedure. For Dr. Seballos, the most common reconstructive procedure is using a tissue expander to stretch the skin, and then subsequent replacement with either a saline or silicone implant. The whole expansion and replacement process can take 6 or more months. This procedure can be done immediately after mastectomy, or after completion of chemotherapy or radiation. If radiation is anticipated, tissue expansion reconstruction is discouraged. Another option is using your own tissue such as a pedicled TRAM flap (skin, fat, and muscle from the abdomen still attached to the muscle and rotated into the breast defect), a latissimus flap (skin, fat, and muscle from the back) with or without an implant, or a free flap (tissue completely removed from one part of the body and whose blood supply is restored using micro vascular techniques). Dr. Seballos does not do free flaps and recommends that you have this done at a tertiary center such as the Cleveland Clinic Foundation, University Hospitals, or Metro. TRAM flap or latissimus flap reconstruction require longer recovery and longer hospital stays in general compared to tissue expander reconstruction. To obtain symmetry, the opposite non-cancerous breast can be reduced, lifted, or enlarged after completion of the breast reconstruction.