Dr. Casey describes the common ways reconstructive breast surgery is performed.
I consider the breast essentially skin and fat. It’s more complex than that. There’s ducts and what not, but our job is to replace what’s been taken away and as a general rule, most people perform pedicle tram flaps, which takes one of the rectus muscles from the abdomen. The tough part is that takes away part of the core strength that a woman has and the risk of hernias.
The technique that we have actually employed here is one called the DAP flap and what that does is we move the skin and fat from the lower abdomen. Essentially it’s a tummy tuck operation. I am hesitant to say that because it’s not as ideal as far as we put the incisions, but we move the tissue from the lower abdomen, leave the muscle in place, but take the skin and fat with the blood vessels to keep it alive and hook them up to blood vessels up in the chest. So we are essentially replacing skin and fat providing a more natural appearance to the breast, replacing what’s been taken away.
The other advance these days is the skin-sparing mastectomy, whether it be with or without nipple-sparing because we essentially have a skin bra that we are filling in with either an implant or the patient’s own tissue. The benefit of their own tissue is it’s a lifelong better material for them. It’s their own tissue, it grows as they grow, loses weight as they lose weight, behaves more like what used to be there.
About Dr. William Casey, M.D.:
Dr. William J. Casey, M.D., is a plastic and reconstructive surgeon at Mayo Clinic in Arizona. Dr. Casey graduated from Bowman Gray School of Medicine, Wake Forest University Medical Center in North Carolina. He then completed his residency in plastic surgery at Mayo Graduate School of Medicine in Minnesota and in general surgery at Greenville Memorial Hospital in South Carolina.