What Is New In Reconstructive Breast Surgery?
New options give patients increased self-esteem
By Dr. Harold Bafitis
It is important and significant for breast cancer survivors to know their reconstructive breast surgery options.
It is also important for them to comprehend and be responsible for creating their team of medical professionals. A team that consists usually of a general surgeon, a plastic surgeon well-versed in reconstruction, and of course, an oncologist who will improve and monitor the immune function of the patient. The intricate dance among these three medical professionals is essential for optimal outcomes. Furthermore, the mindset of the patient is equally important for healing no matter what stage of the disease.
Adjunctive/additive fat grafting by Dr. Bafitis to enhance overall improvement in breast shape.
CLICK TO DOWNLOAD PDF: A Multi-page booklet “Frankly Speaking” developed by Cancer Support Community for patient education on breast reconstruction.
Dr. Bafitis over the last five years has been involved in stem cell research as well as platelet-rich plasma to enhance fat graft survival.
The fat graft has now become a widely accepted modality for enhancing breast shape and contour, be it cosmetically, or be it in revision cosmetic procedures which are essentially reconstructive. Of course, fat grafting has become a staple in breast reconstruction as well.
Dr. Bafitis has been a pioneer of fat grafting and has literally used fat grafts to the breasts in most of his cosmetic augmentations. Bafitis feels that the fat grafts, which usually last and take at least 65% in the area of the breast, absolutely enhance and make up for what implants lack or what patient contour anatomy lacks.
This is significant for achieving the most definitive and natural shape for aesthetic and reconstructive breast surgery. Almost all breast procedures include fat grafting at no additional cost. It is important for the patient to realize that this is something that is additive to give the best overall improvement and is unique with Dr. Bafitis’ breast practice.
Recently technology has brought us a literal biologic scaffold for our own tissue to grow into.
These acellular tissue matrices have expanded in use and are now an important part of breast reconstruction. They literally allow the patient’s own tissue to grow into them. By six months they degenerate and are absorbed by the body, leaving behind new, viable, strong tissue that gives a much more natural look to the reconstruction.
We have also seen the use of a patient’s own fat to fill in contour defects in breast reconstruction. Furthermore, I have personally used a patient’s fat to permanently improve some of the changes seen in the skin after radiation. A thick, leathery, often painful appearance of the skin has been improved dramatically, and this has been documented not only photographically but also histologically (at the cellular level) at one year.
Other surgeons are doing this all over the world.
The advantages of fat may lie in the fact that one gram of the patient’s own fat has more than 5,000 stem cells versus one milliliter of bone marrow having only 100 to 1,000 stem cells. These stem cells are literally building blocks of new tissue. The use of stem cell technology will definitely bring us a new age in bio-engineered medicine and will significantly improve breast reconstruction.
The use of nipple-sparing mastectomy (NSM) has also gained acceptance as a viable option in breast cancer management and obvious breast reconstruction.
The patient satisfaction rate is comparable to traditional reconstructive techniques, although revision rates seem to be slightly higher. Nipple sensation is diminished, but the patient’s own nipple areolar complexes are present. This is certainly something to be discussed with your reconstructive breast surgeon.
Finally, patients do not have to settle for less-than-acceptable breast reconstruction.
Reconstruction, for the most part, should be done at the same time as mastectomy. There are few real indications for waiting and creating another surgery, another anesthetic, and even more anxiety for patients. The use of some of the new concepts in reconstruction have allowed plastic surgeons to redo poor results and significantly influence the patient’s self-esteem and improve the patient’s emotional outlook and even spiritual well being, all contributing to a longer survival.
Dr. Bafitis is double board certified in general surgery and plastic and reconstrucitve surgery. He has fellowships at the American College of Osteopathic Surgeons, American Academy of Cosmetic Surgery, and American College of Angiology.
Dr. Harold Bafitis, D.O., F.A.C.O.S. has led teaching conferences at national cosmetic plastic surgery meetings, and has performed live surgery on closed-circuit TV with literally hundreds of cosmetic surgeons and resident plastic surgeons in attendance.