Advanced procedure for microsurgical breast reconstruction offered at Baptist Health hospitals

Oct 27 2010

When pediatrician Julie A. Buckley, MD, learned that she had breast cancer last year, she chose breast reconstruction using the “DIEP flap” procedure. DIEP (Deep Inferior Epigastric Artery Perforator) flap is available mainly at regional academic centers in the United States.

Board-certified plastic surgeon Ankit Desai, MD, started performing the DIEP flap a year ago at Baptist Medical Center Jacksonville and Baptist Medical Center South. He has performed about 35 of the procedures so far.

Dr. Buckley, of Ponte Vedra Beach, decided to have a double mastectomy in one surgery in order to eliminate her future cancer risk and to avoid multiple reconstructive procedures that would take time away from her work and family.

“My mom is a 30-year survivor of breast cancer and has had a few scares over the years. I wanted to eliminate my risk all at once,” Dr. Buckey said.

But she did not want to be implanted with a foreign body, so synthetic breasts were not an option.

Nor did she want the hernia risk and long recovery time associated with traditional reconstructive flap procedures, which rebuild the breast using some of the patient’s abdominal muscle.

The DIEP flap is advanced microsurgery that involves taking only fat from the tummy area (not muscle like in a traditional TRAM flap) and creating a natural-looking breast. Tiny blood vessels – and often nerves –are reconnected using microsurgery. Since no muscle is taken, the patient is able to maintain her core strength and the chance of hernia is significantly reduced. The patient receives breasts made of healthy, natural tissue and receives a tummy tuck at the same time.

Dr. Buckley had the initial reconstructive surgery, then returned 12 weeks later for nipple reconstruction, and next had a final procedure to tattoo the nipple and areola color.

“It was a fabulous option for me,” she said. “I had my chemotherapy first, and I could feel my cancer melting away. Then I went into the hospital with breasts, and I left the hospital with breasts. There was a finite end to my cancer. And I have these fabulous ta-tas now that are as real as they can be.”

Buckley later visited a special bra store in Atlanta that had been featured on the “Oprah” show, where the sales staff told her that she had received some of the best reconstructive surgery they had ever seen.

The success rate of DIEP flap breast reconstruction is greater than 95 percent. Most private insurance companies cover the procedure.

“Patients from our area may be traveling to other regions of the country for the DIEP flap procedure because they don’t know it is available here,” Dr. Desai said.