Source Good Housekeeping Volume: 230 Number: 3 March 2000

Innovative Breast Reconstruction Uses Natural Tissues and Improves Quality of Life

Robert J. Allen, M.D., FACS

What price should a breast cancer patient pay to regain a normal body profile after surgery? According to Robert J. Allen, M.D., FACS, the price should not include unnecessary risks with her health and her quality of life. "A new and very safe alternative to artificial implants or traditional fat transfer is available," he says. "Per/orator flaps eliminate the possibility of rejection, implant breakdown and permanent muscle loss resulting from traditional procedures."

Dr. Allen is the inventor of the perforator flap procedures for breast reconstruction. "The benefits of the perforator flap procedures are dramatic," he says. "It uses the patient's own tissues and, unlike the traditional fat transfer method (TRAM), it does not require that muscle be removed from the donor site. As a result, the patient experiences no muscle function loss, no hernia formation, decreased postoperative pain and a shortened hospital stay. The main difference of the perforator flap is that a meticulous microvascular technique is required."

It is the microvascular technique that makes the perforator flap procedure a superior alternative to TRAM. In the early 1990s, Dr. Allen applied his creative talents to improving the older reconstructive procedures. "Since the breast mound is made up of skin and fat," Dr. Allen reasoned, "we should be able to reconstruct it with a flap made up only of skin and fat. But, because the blood vessel network that nourishes the flap comes up through muscles, conventional approaches removed muscle from the donor site as well."

He found that certain blood vessels, called perforators, could be freed without causing long-term damage to the muscle. "The procedure is intricate and time consuming but the results are extraordinary," reports Dr. Allen who has performed hundreds of these procedures with a 99.5 percent success rate.

The perforator flaps can be donated from a number of sites on the body: the lower abdomen, the upper buttock, the lower buttock, the back, and the lateral thigh. The lower abdomen is the more common choice, resulting in a tummy tuck as well as breast reconstruction (DIEP flap).

"The perforator flap is an amazingly positive thing we can do for the breast cancer patient," says Dr. Allen. "It allows her to return to her usual style of life, feeling attractive and confident in day and evening clothes, swimsuits, and lingerie, often with an even better figure than she had before. And the physical price she pays for the procedure? A scar that fades over time."

Breast replacement therapy can be performed during the breast removal surgery or at a later date. It doesn't matter what kind of mastectomy the patient has had, or what kind of scar was left behind. Breast reconstruction can begin even if considerable time has passed since the initial surgery.

For further information, visit www.diepflap.com or contact Dr. Allen's office at 4429 Clara Street, Suite 440, New Orleans, La., 70115, phone 504-894-2900, or 888-890-DIEP (3437).

Good Housekeeping Volume 230, Number 3, March 2000