Reconstructive procedures Reconstructive procedures include the following: Prosthetic reconstruction: Placement of a silicone or saline implant, sometimes after a tissue expander is used Autologous reconstruction: Muscle flap transfer (using the latissimus dorsi, gluteus maximus, or the lower rectus abdominis) or muscle-free flap transfer Breast reconstruction can be done during the initial mastectomy or breast-conserving surgery or later as a separate procedure.