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© Newswise.
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Rebuilding the Breast without Major Scarring
CONTACT: Media Relations Office REBUILDING THE BREAST WITHOUT MAJOR SCARRING NOW AN OPTION FOR BREAST CANCER PATIENTS BOSTON (October 3, 1998) -- Complete skin-sparing breast surgery offers the promise of a scarless mastectomy without compromising the fundamental goals of breast cancer care, according to a study to be presented at the 67th Annual Scientific Meeting of the American Society of Plastic and Reconstructive Surgeons (ASPRS), October 3-7 in Boston. "This technique has definite advantages for women who are having a mastectomy," said David A. Hidalgo, MD, chief of plastic surgery, Memorial Sloane Kettering Cancer Center, New York City. "The final cosmetic result is far superior to that of the normal mastectomy. Women facing breast surgery should know that this option is available and ask for it." The new technique involves placing the incision around the edge of the areola (the circular area around the nipple) so that the breast tissue may be removed. Immediate reconstruction using the skin-sparing technique requires autologous tissue (tissue from the patient's own body) to rebuild the breast mound and replace the nipple area. The most commonly used procedure involves incisions that go across the breast from one side to the other, which leaves obvious scars to the reconstructed breast. This retrospective study reviewed 30 patients, aged 32 to 57, who were diagnosed with cancer or who were having preventative surgery (prophylaxis). Of these, 27 patients had a transverse rectus abdominis myocutaneous (TRAM) flap procedure which utilizes tissue from the patient's abdomen to reconstruct the breast. If a free (disconnected) flap is used in the TRAM flap procedure, microsurgery is required to attach the blood vessels and reestablish circulation in the new breast mound. A pedicle (connected) flap retains its original blood source. A gluteus flap, taken from the buttock, was used for two patients, and one patient had a latissimus dorsi flap, in which tissue was transferred to the reconstruction site from the back. Aesthetic results were judged to be excellent in nearly half the cases (40 percent), good in more than one-third (37 percent) and fair for the remainder (23 percent). After a mean postoperative follow-up of 15 months, there were no instances of flap loss or local recurrence of cancer. There were few complications, and those were minor. Women interested in this procedure should investigate the possibility with a plastic surgeon as well as their general surgeon or oncologist. It is important to know in advance if this surgery will be used so the biopsy can be taken in a place that does not interfere with the surgical design of this procedure. # # # The American Society of Plastic and Reconstructive Surgeons represents 97 percent of all physicians certified by the American Board of Plastic Surgery (ABPS). By choosing an ASPRS member plastic surgeon who is certified by the ABPS, patients can be assured that the physician has graduated from an accredited medical school and completed at least five years of additional residency, usually three years in general surgery and two years of plastic surgery. To be certified by the ABPS, a physician must also practice plastic surgery for two years and pass comprehensive written and oral examinations. Consumers may call Plastic Surgery Information Service at 1-800- 635-0635 or access the ASPRS website at www.plasticsurgery.org for names of qualified plastic surgeons in their areas and informational brochures. NOTE TO EDITORS: Breast reconstruction following mastectomy increased more than 60 percent over the last five years, from 29,607 in 1992 to 50,337 in 1997. In-depth information on virtually all aspects of plastic surgery statistics can be found at www.plasticsurgery.org in the National Clearinghouse of Plastic Surgery Statistics.
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