Health Team

Procedure offers breast reconstruction with a tummy tuck

Posted May 8, 2008

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— Treating breast cancer is an ordeal causing some women to undergo radiation, chemotherapy and a mastectomy. When it is time for breast reconstruction, women want something as close as possible to what they had.

A new surgical procedure is offering realistic reconstruction and a tummy tuck.

Michelle Malloy of Greensboro was 34 years of age in May of 2006 when she learned she had breast cancer.

“Instantly I just started trying to do my homework and trying to educate myself about what I could do and what was going to be ahead of me,” Malloy said.

Malloy underwent chemotherapy, then a double mastectomy. When it came time for breast reconstruction, she considered her options.

“I wanted something that felt more like natural breast tissue - something that was going to age more like natural breast tissue,” Malloy said.

Malloy considered breast implants and even TRAM Flap surgery, where a surgeon takes a section of skin and fat from the belly along with a strip of abdominal muscle and a main artery for blood supply. The artery and tissue goes through a tunnel under the skin and up into the breast opening where it's attached and shaped. The muscle and belly incisions are closed with the benefits of a slimmer tummy.

“The potential downside of that surgery is you're sacrificing one of the main muscles of your abdominal wall and most women can get by with that,” said Duke plastic surgeon Dr. Michael Zenn.

Zenn said TRAM flap surgery may lead to bulges, hernia, or discomfort, especially if the patient is younger and may still desire more children. "And so being young, I still wanted children. I still want to be active", said Malloy.

Malloy decided on a newer option called DIEP (deep inferior epigastric perforator) flap. During the procedure, no muscle tissue is removed – only the skin and fat layer – and the main artery that feeds it. Using microsurgery, the vessels are reattached to a new blood source.

"The other good thing is that this blood vessel can come from an area that's right next to the tissue, so we get beautiful blood flow throughout the entire tissue," said Dr. Zenn.

Like the TRAM Flap, the patient gets a tummy tuck as well, but recovery takes only half the time.

“So now it's really become in my practice the standard of care,” Zenn said.

Malloy, now 36, said she is looking and feeling better after a year and a half of follow up visits.

“You know you're just thankful to be alive when you look at the options and what could have happened,” Malloy said of her experience with cancer.

The procedure can also be done on women who have had only a single mastectomy. Doctors can make the new breast match the remaining one. Zenn said the procedure would leave a slight belly scar, low enough to be hidden by clothing.


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