New trends in breast reconstruction

Women making a decision about breast cancer surgery should include a plastic surgeon in that discussion. Several options for breast reconstruction give women choices, with each choice carrying its own risks and benefits.

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October is Breast Cancer Awareness Month.

“The decision tree is complicated. A plastic surgeon ultimately has to walk through the choices with patients and help them consider which option is best for their individual situation and preferences,” says Adeyiza Momoh, M.D., assistant professor of plastic surgery at the U-M Medical School.

As more younger women at high risk of breast cancer choose to have their breasts removed before cancer develops, a procedure called a DIEP (Deep Inferior Epigastric Perforator) flap has become increasingly popular. The technique involves transplanting tissue from the woman’s abdomen into her chest. But unlike traditional tissue reconstruction, called a pedicled TRAM flap, where the entire rectus muscle was included with the flap, a DIEP flap involves a complex approach to dissecting out the small blood vessels and leaving the muscle behind. The blood vessels are then reconnected to blood vessels in the chest.

The technique preserves the abdominal muscle function and typically has fewer abdominal complications.

U-M is one of only a handful of hospitals in the country with surgeons trained to perform DIEP flaps. The procedure requires highly specialized training in microvascular surgery, which is what allows the surgeon to reattach the fine blood vessels.

“Breast reconstruction with abdominal tissue can be a very good option for patients who have already had radiation therapy. The DIEP flap may decrease detrimental effects to the abdomen and speed up recovery,” says Jeffrey Kozlow, M.D., assistant professor of plastic surgery at the U-M Medical School. However, Kozlow advises that every patient is unique and not all are candidates for this type of reconstruction.

To learn more about breast reconstruction, call the U-M Cancer AnswerLine at 800-865-1125.