Every year, 200,000 women are diagnosed with breast cancer. This diagnosis and its treatment exact a heavy toll on patients and families. Recognition of the beneficial role of breast reconstruction in addressing the physical and psychological effects of breast cancer can be seen in the passage of multiple legislative acts aimed at increasing breast reconstruction awareness. Despite these efforts, only about 40% of eligible patients undergo breast reconstruction. The vast majority, 80%, will undergo an implant-based procedure. While great results are achievable with implants, other options exist, including autologous procedures which have been shown to have higher satisfaction ratings in patient-reported outcomes data.
Autologous breast reconstruction has the benefit of recreating “like with like,” allowing for reconstructions that closely parallel the presurgical form. Additionally, using one’s own tissue avoids the maintenance inherent in implant-based reconstruction. There are multiple areas of a woman’s body that are suitable for breast reconstruction, including the inner and posterior thigh and abdomen. While they all closely resemble breast texture and can be easily shaped into a natural breast form, the abdomen excels at this.
Composite tissue from the lower abdomen is one of the most commonly used donor sites for autologous breast reconstruction. Multiple procedures exist for using this tissue for breast reconstruction with varying degrees of functional impact. Techniques like the Transverse Rectus Abdominis Myocutaneous flap (TRAM) harvest skin, subcutaneous tissue and muscle from the lower abdomen for breast reconstruction, and in doing so, sacrifice the function of the rectus abdominis muscle. The Deep Inferior Epigastric Perforator (DIEP) flap uses the same lower abdominal tissue as the TRAM procedures, but does so without sacrificing the function of the stomach muscles. To achieve this, perforator vessels to the skin and subcutaneous tissue are isolated from surrounding muscle and nerves and transplanted to the chest with microsurgical anastomosis. By preserving the abdominal wall musculature, core strength is maintained, promoting faster recoveries and allowing patients to maintain active healthy lifestyles.
Dr. Derek Cody is a board certified plastic surgeon and a member of Crystal Clinic Plastic Surgeons in Montrose (Akron), OH. A native of Cleveland OH, he obtained his medical training at The Ohio State University College of Medicine and Cleveland Clinic, and he completed his plastic surgery training at Summa Health. Dr. Cody specializes in aesthetic surgery of the face and body and complex reconstructive procedures, including microsurgical breast reconstruction and facial reanimation. He is a member of the American Society of Plastic Surgery, the American College of Surgeons and the California Society of Plastic Surgery.