Strong Plastic Surgeons Present Results of Microsurgical Breast Reconstruction
January 13, 1999
For many women with breast cancer, the option of a lumpectomy followed by radiation therapy is a preferred and viable alternative to mastectomy. But in cases when the cancer reoccurs and a full mastectomy is in order, reconstructive surgery presents serious challenges.
Many physicians have felt that these patients either couldn’t be reconstructed or that their reconstruction would be less successful. "Generally, the national standard in breast reconstruction has been to use implants," said Strong Memorial Hospital plastic surgeon Joseph Serletti, M.D. A balloon is inserted and then inflated to stretch the skin. Subsequently an implant – usually saline-filled – is placed. "This procedure works well for most patients, except in cases where the skin has been radiated and cannot be stretched."
Plastic surgeons at Strong Memorial Hospital, however, have been successful using a technique called "free-flap surgery" in which a section of fatty tissue removed from the abdomen is used to fashion a new breast. Similar to a "tummy tuck," the surgery leaves the patient with a firmer middle section and a safer, more natural looking breast. The grafted tissue remains in place even without the support of a brassiere. "Normal breasts are made up of thin skin covering a fatty tissue," he said. "Using this technique, we can replace a breast with almost identical tissue."
The challenge in successfully ‘transplanting’ the abdominal tissue lies in ensuring proper blood flow. "We use microsurgery to redirect blood flow through the arteries and veins so that the tissue can adapt and live in its new location," Serletti said.
Strong’s plastic surgeons have performed this operation on over 300 Rochester area women for both immediate and delayed breast reconstruction.
This weekend, Serletti and fellow plastic surgeon, Greg Orlando, M.D., will travel to Hawaii to present to the American Society for Reconstructive Microsurgery the results of 14 Rochester area women who underwent free-flap reconstructive surgery after their cancer recurred following lumpectomy and radiation therapy. "The experience of these women shows that this technique can be applied to give this most difficult group of patients the most natural and longest-lasting reconstructive results."
According to Serletti, the frequency with which the free-flap procedure is performed is higher in Rochester than in other cities, a fact which has drawn the attention of the nation’s other plastic surgeons. "We have a community of plastic surgeons who have worked together to make this the community standard," he said. Serletti performs microsurgical reconstruction more than 200 times per year, a number which he says is nearly four times the national average.