In this interview with Medical Tourism Magazine, Dr. Frank DellaCroce, one of the founding surgeons of the Center for Reconstructive Breast Surgery explores advances in reconstructive breast surgery for women who require surgery for breast cancer. A pioneer in reconstructive surgical techniques, Dr. DellaCroce shares state-of-the-art procedures in breast reconstruction that offer excellent aesthetic outcomes for women undergoing breast cancer surgery.
What is Advanced Breast Reconstruction?
Breast cancer is the most commonly diagnosed cancer in the world. One in eight women will be affected in her lifetime. It is estimated that 2.3 million new cases are diagnosed annually, and there are over 7.8 million survivors globally who were diagnosed in the last five years. Yet, according to the American Society of Plastic Surgeons, only half of all women diagnosed with breast cancer are provided enough information about the options available to them for modern breast reconstruction. Advanced microsurgical tissue transplantation now allows women to have a new breast created from natural living tissue on the same day as their mastectomy, with immediate preservation of wholeness and an early return to activities after surgery. For those who have had mastectomy in the past, these modern techniques also offer an opportunity to restore shape and recreate a living breast without the use of implants.
Why choose advanced breast reconstruction?
The technology pioneered at our Center has blossomed into a set of tools that allow the true artistic goal of breast reconstruction to be realized. What was impossible 20 years ago is now an everyday alternative to breast implants. Natural microsurgical tissue transplantation provides a permanent solution for the impact that mastectomy otherwise carries. The tools and expertise in our repertoire combine these elements with attention to the avoidance of injury to the muscles, structure, and function in the donor site at the same time. The newly reconstructed breast is warm, soft, and a living reflection of the advancements we’ve been able to create with singular focus for more than two decades.
Can you tell us about the options women have for advanced breast reconstruction?
There are several reconstructive options women can choose from. The gold standard, and first choice for those with excess tummy fat, is the DIEP (deep inferior epigastric perforator flap) procedure. This advanced microsurgical technique transplants excess fat from below the belly button to the chest, recreating a soft breast made entirely of living tissue.
As we move up the ladder to the more sophisticated options, one of the more advanced techniques is known as the APEX Flap SM. We pioneered the procedure at The Breast Center in 2011 and published our experience with it in the Journal of Plastic and Reconstructive Surgery in 2019. The APEX Flap SM is a highly sophisticated technique for tummy fat transplantation that allows the natural anatomy and blood vessels to be rearranged to perfectly preserve muscles and nerves while improving blood flow to the tissue transplant to maximize softness.
Other perforator flap procedures include our various “Stacked Flaps” SM as we’ve labeled them. They are for thinner women who need more fat than a single layer of fat from the tummy or hip can provide. Next in our portfolio is the “GAP Flap.” It is a completely different option when the abdomen’s fat is too thin to accomplish the goals we have in mind. Even in the most athletic body types, it allows us to use precise microsurgery to move fat from the hip area to rebuild a new living breast. Those are our primary tools, and we have various ways of tailoring them to each individual’s particular needs.
What advice can you share for women just receiving a breast cancer diagnosis?
I tell patients, “Don’t forget to breathe.” What I mean by that is to do the best you can to intentionally slow it all down and take time to do your homework. Be your own advocate and research the options that are available to you. I have countless patients who tell me, after making a rushed decision or just following along with their first caregiver’s advice, that they “wish they had known.” They wish they had known that mastectomy incisions could be hidden. They wish they had known that Nipple Sparing Mastectomy was available and appropriate for almost all women with newly diagnosed cancers. They wish they had known that there was a good alternative to implant reconstruction. They wish they had known that natural tissue reconstruction could be done without damaging muscles or impacting their strength and function. They wish they had known that the results after mastectomy could be beautiful and not just a lump to fill clothing...and on and on.
Ask questions and do your research. And then do some more. Seek multiple opinions. Any qualified expert would tell you the same. There are so many resources available today. Each woman has a different path to walk and her own set of goals and priorities to achieve. Having all the knowledge you can gather is vital in making the right decision for you and yourself alone. At The Breast Center, we have patient advocates who are willing to share their experiences with newly diagnosed patients and those in the process of making decisions on their surgical options. Nothing is more valuable than the voice of someone who’s been there. I believe it is also essential to see outcomes in living color, which is why we’ve made it a point to include that as a centerpiece in our educational materials.
Why is it important for a woman to understand all her options?
Because if you don’t know what CAN be done, then how else do you make the right decision for yourself? You have a single opportunity to “choose best care first,” slow it down, take control, and reach out to the resources that can complete the story for you before you make that decision. For those that have had an unsuccessful or unsatisfactory attempt at breast reconstruction in the past, there is also good news. We have dedicated ourselves over the last 20 years to attending to those that need a “re-do” or a “corrective” or “salvage” reconstruction, whatever moniker you choose; the point is we have enough technology at our disposal now to do some amazing things, even for those who’ve been told there’s nothing else that can be done.
What sets The Center for Restorative Breast Surgery apart from others performing breast reconstruction?
20+ years of laser focus on one thing. We have dedicated our entire professional effort to the betterment of breast reconstruction for women affected by breast cancer. We are proud of our pioneering work and the procedures we’ve developed and perfected over the years. We are unique in that we have fortified that effort with an entire hospital built from the ground up just for these women and the work we do for them. We have taken care of women from around the world, and we feel privileged to attend to them in a holistic way and to help them reclaim what cancer threatens to take away, or in some cases, has already taken away.
Why should women consider traveling for a breast reconstruction procedure?
Recall my earlier comments about “best care first.” It’s worth the trouble, and the time, to seek out what you consider to be the best when it concerns your health and well-being. This will be a page in the book of your life, and once it is turned, you will not regret doing a little more to be sure that you have done the most you can to live happily and healthily beyond breast cancer. Every woman deserves the best possible outcome available, whether it’s immediate reconstruction on the day of her mastectomy, risk-reduction preventative mastectomy for those with genetic tendencies towards breast cancer, or a woman seeking removal of painful, distorted breast implants or in need of correction following a failed reconstruction. At our Center, we offer the most groundbreaking breast reconstruction methods on the planet with a no-compromise philosophy.
By combining this foundation with a state-of-the-art hospital, all under one roof, we’ve made the experience turn-key for a comprehensive service experience. Traveling for medical care may seem daunting, but our dedicated team of caregivers and on-site concierge can reduce that burden by assisting with travel arrangements, accommodations, meals, and even sightseeing when time allows. Our goal is to make your travel for medical care as stress-free and successful as possible.
About the Center for Reconstructive Breast Surgery
The Center for Restorative Breast Surgery, affiliated with the St. Charles Surgical Hospital—the only hospital in the world dedicated exclusively to breast cancer care and breast reconstruction for women facing mastectomy—was established to serve as a dedicated center of excellence for women seeking the most advanced methods of breast care. David S. Cabiling, MD; Frank J. DellaCroce, MD, FACS; Stacy R. Henderson, MD; Scott K. Sullivan, MD, FACS; Chris Trahan, MD, FACS; and M. Whitten Wise, MD are pioneers in the art of rebuilding breasts lost to cancer, preventive mastectomy, developmental defects, replacing breast implants with natural tissue, lymphedema treatment, and correcting deformities associated with previous breast surgery.
Their sophisticated microsurgical techniques allow for recreation of the breast with natural tissue while preserving strength and restoring beauty. Together with Board Certified Breast Surgical Oncologists W. Karl Ordoyne, M.D., FACS, and Alan Stolier, M.D., FACS, they comprise a group of international leaders in breast cancer surgery options, pioneering groundbreaking procedures including Nipple-Sparing Mastectomy, the Stacked DIEP, the GAP flap, and the BODY LIFT Flap®. They have performed thousands of these procedures over two decades for women from around the world. Their Center is tailored and staffed to cater to the needs of our traveling clientele. For more information, please visit www.breastcenter.com or www.scsh.com.