Breast Cancer

Fight Breast Cancer.

Scottsdale – An article in the September (2009) issue of Plastic and Reconstructive Surgery, suggests that a relatively new technique, using perforator flaps, can offer patients with difficult reconstructive scenarios better results after breast cancer treatment. The article includes an overall experience with almost 4000 breast flaps performed for breast reconstruction. The success rate was 99 percent. The researchers concluded  that perforator flap breast reconstruction is an accepted surgical option for breast cancer patients electing to restore their body image after mastectomy.

A “perforator flap” is quite different from traditional tissue flaps used in plastic surgery. Previously, tissue flaps would depend on oxygen and nutrition derived via the blood vessels in muscles and fascias, called musculocutaneous or fasciocutaneous flaps. While use of these techniques is important, transfer of the tissue would inevitably removed the underlying muscle or fascia from the donor region for good.  The perforator tissue flaps only use the blood vessels that penetrate muscle and fascia and supply oxygen and nutrition to the skin and fat tissue being harvested. Perforator flaps allow the reconstructive surgeon to provide tissue while preserving underlying muscular structures, such as the rectus muscles of the abdominal wall, seen with dissection of the Deep Inferior Epigastric Perforator flap. The muscle can left intact, while the tissue for breast reconstruction, the skin and fat, is transferred to reconstruct the breast.

With the introduction of the deep inferior epigastric perforator flap, microsurgical techniques have evolved to support a 99 percent success rate for a variety of flaps with donor sites that include the abdomen, buttock, thigh, and trunk.  With this experience, the authors are tackling more difficult cases and scenarios. They concluded that the current trends for the use of perforator flaps suggest an application of these techniques in patients previously felt to be unacceptable surgical candidates with a focus on safety, aesthetics, and increased sensitization. Moreover, recent experience highlights the use of perforator flaps as a proven solution for patients who have experienced failed breast implant-based reconstructions or those requiring irradiation in the treatment of breast carcinoma.