Now, innovative medical products and technologies are changing the way doctors perform breast reconstruction surgeries. “There are a number of advancements over the last few years that have made a substantial difference in the types of outcomes we can provide to patients,” says Dr. Mitchell Brown, Associate Professor in the Department of Surgery at the University of Toronto and the Program Director for the Division of Plastic and Reconstructive Surgery.
Breast reconstruction in a single operation

Breast reconstruction in a single operation

Dr. Brown has recently adopted the use of skin biologic material, also known as an acellular dermal matrix or ADM. This material provides soft tissue support for implant-based breast reconstructions. “For years, we placed implants and had a little difficulty getting them to stay exactly where we wanted them to be,” Dr. Brown explains. “The use of ADM products like DermACELL® allows us to place an implant and create almost a hammock underneath the implant to hold it exactly in place.”

Implant-based breast reconstructions are traditionally conducted over the course of two separate operations. During the first surgery, a tissue-expanding device is used to stretch the skin and recreate the breast pocket after mastectomy. Then, a second operation is scheduled wherein the tissue expander device is removed and a permanent breast implant is inserted. “In many patients, we’re able to do the mastectomy, place the permanent final implant with this ADM material, and perform the reconstruction all in a single operation,” Dr. Brown says. As a result, patients experience much less pain and anxiety.
Making better decisions during surgery

“These women have just been through a very traumatic event in their life, with a diagnosis of cancer and removal of the breast, If we can prevent problems for these particular woman, that’s really invaluable.”

Making better decisions during surgery

Another challenge that breast reconstruction surgeons face is judging the quality of skin and tissue that remain following a mastectomy. “The difficulty is knowing whether the skin that’s left behind is compromised in terms of its blood supply,” says Dr. Brown. But, today he uses an innovative medical technology called the SPY Elite® Fluorescence Imaging System during surgery to visualize the quality of blood flow in the remaining tissue — something that has never been possible before SPY Elite.  Dr. Joan Lipa, Associate Professor of Surgery at the University of Toronto, and a partner in the Breast Reconstruction and Oncologic Reconstructive Service and Research Group at Sunnybrook Health Sciences Centre, uses SPY Elite to make objective, real-time decisions during a breast reconstruction operation. “If there’s a kink or a twist interfering with the blood supply to the tissue, SPY imaging can pick it up before the naked eye can actually see a change,” explains Dr. Lipa. “We can fix it then rather than waiting for a problem to evolve in the recovery room or on the ward, and then having to bring the patient back to surgery afterward.”

Reducing anxiety, pain, and suffering

The use of ADMs and imaging technology not only helps to improve the aesthetic outcomes of breast reconstructions but also assists in lowering the risk of complications and the number of repeat surgeries required, which ultimately lowers healthcare costs. More importantly, patients with breast cancer may experience less anxiety, pain, and suffering overall knowing their surgeons have the benefit of SPY Elite and as a result may return to their normal lives sooner. “These women have just been through a very traumatic event in their life, with a diagnosis of cancer and removal of the breast,” Dr. Lipa says. “If we can prevent problems for these particular woman, that’s really invaluable.”