Doctors at University of Texas Southwestern Medical Center have developed a new approach for single breast reconstruction using a patient's own body tissue.
Dr. Sumeet Teotia, an associate professor of plastic surgery, and director of the breast reconstruction program at the Harold C-Simmons Comprehensive Cancer Center explained to KERA Vital Signs host Sam Baker how the process uses CT scans to map out a plan to build a breast that reduces complications and achieves better outcomes.
A CT angiogram injects a dye in the blood vessels and it eventually uptakes into these tiny blood vessels. In this case, we’re looking into lower abdominal fatty tissue to look at the blood vessels. We call these names such as perforators because they come through muscle and tissue to eventually supply the skin and fat, because essentially you’re creating a breast to mimic what’s missing and what’s missing is some skin and fat.
How Difficult Is The Operation?
In experienced hands, the success is greater than 99%. You have to find a surgical team that has anesthesiologists and nursing care, and also monitoring after the surgery, so it’s not a one-component aspect. It’s not entirely just for the surgeon to do the operation. It’s also getting the efficiency in the operating room, doing this safely, making sure that the tissue will continue to thrive when it’s transplanted, essentially on to the breast.
Advantages Of The New Approach
You have a very good assessment of:
- What the vessels will look like prior to surgery
- How we will design that prior to surgery and in the operating room
- How we'll map out the sequence of the blood vessels to hook up under the microscope.
That’s where this study is helpful to strategically position the blood vessels in a way that you can shape the breast. It’s a dialog that’s constantly taken in the operating room with the surgical team members to benefit the ultimate outcome – which is, for the woman, enhanced appearance or a better appearance to what they had prior, or to replace the tissue that is missing from them.
In successful centers like UT-Southwestern, the complication of the tissue loss or none of this tissue working should be in the range of 1% or 2%. There are other immediate complications that are certainly common, such as wounds and scabs and healing and pain. They’re all temporary, and eventually the body does heal, but they avoid long-term complications and issues with implants that may occur over time.
The recovery is much more enhanced, earlier return to work, and they have excellent outcome in many studies. But generally, they need to be repeated over the years. And the younger the woman is, the more surgeries they may be looking forward through their lifetime. There are various factors that go into the decision-making before one is undergoing this type of procedure.
Answers have been edited for clarity and brevity.