Issue link: https://viewer.e-digitaledition.com/i/808278
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 brea st reconstr uction ha s the benef it of recreating " like with like," a llowing for reconstructions that closely pa ra llel the presurg ica l form. Additiona lly, using one's own tissue avoids the ma intena nce inherent in impla nt-ba sed reconstr uction. There a re mu ltiple a rea s of a woma n's body t hat a re su it able for brea st reconstruction, including the inner a nd posterior thigh a nd abdomen. W hi le t hey a l l closely resemble brea st tex ture a nd ca n be ea si ly shaped into a natura l brea st form, the abdomen excels at this. Composite tissue from the lower abdomen is one of the most commonly used donor sites for autologous brea st reconstruction. Multiple procedures exist for using this tissue for breast reconstruction with va r ying deg rees of functiona l impact. Techniques like the Transverse Rectus Abdominis Myocuta neous f lap (TR A M) ha r vest skin, subcuta neous tissue a nd muscle from the lower abdomen for breast reconstruction, a nd in doing so, sacrif ice the f u nc t ion of t he rec t us abdom i n i s muscle. T he Deep Inferior Epigastric Perforator (DIEP) f lap uses the sa me lower abdomina l tissue a s the TR A M procedures, but does so without sacrif icing the function of the stomach muscles. To achieve this, perforator vessels to the skin a nd subcuta neous tissue a re isolated from surrounding muscle a nd ner ves a nd tra nspla nted to the chest w ith microsurgica l anastomosis. By preser ving the abdomina l wa ll musculature, core streng th is maintained, promoting faster recoveries and a llowing patients to maintain active hea lthy lifest yles. D r. 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 T he Ohio State University College of Medicine and Cleveland Clinic, and he completed his pla stic s urge r y training at S umm a Health . D r. Cody specializes in aesthetic surgery of the face and body and complex reconstructive procedures, including microsurgi- cal 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. n BY DEREK CODY, MD, FACS of Autologous Breast Reconstruction Benefits 1 4❱❱❱❱❱ S P E C I A L C L I N I C A L S E C T I O N : C A N C E R S U R G E R Y