What is the most durable breast reconstruction?

A number of patients have asked this question, and it relates to the indicated type of breast reconstruction and each individual patient’s needs and history/physical.  Breast reconstruction that involves an implant (either tissue expander or silicone implant, or even with back muscle – latissimus muscle) versus autologous breast reconstruction (using one’s own tissue, most commonly from the abdomen or tummy, either in the form of a TRAM flap, DIEP flap) is one way of viewing the answer.  Both have differences in lengths of procedure, hospital stay and recovery time.