Breast Reconstruction Clubhouse Discussion

This past week, I was fortunate to have Roberta Albany and Dr. Minas Chrysopoulo join me as moderators for a breast reconstruction clubhouse discussion.

Clubhouse is a fairly new app for iPhone users. The sessions generally last an hour in length. Think of it as a casual phone conversation with the members who join. It is not recorded, or at least does not have that feature yet. There are moderators who can invite those who “raise their hand” using an icon on the app to come “up to the stage”. They are invited to speak by a moderator when they raise their hand. Once invited to speak, they unmute their microphone to begin their question, comment, or thoughts.

The topic I chose was “Breast Reconstruction Concerns and Questions Answered”. The discussion and information provided by Roberta and Dr. C was both enlightening and informative. I want to provide some of the concerns presented by patients, questions answered, but more importantly, provide the resources that may further provide insight for the readers of this blog who may have similar breast reconstruction concerns.

Breast Reconstruction Recovery and Pain Management

DIEP flap breast reconstruction involves incisions at the abdominal area to harvest the flap to create a new breast after mastectomy. With incisions at the breast and tummy patients are often concerned about length of stay in hospital, recovery, and pain management. It is a valid and understandable fear. Dr. C spoke at length about ERAS (Enhanced Recovery After Surgery) protocol. Roberta and I both shared that we did not have this protocol in place at the time of our DIEP flap and how much difference we see in patient recovery and length of time in hospital compared to now and patients who experience the advantages of ERAS. Key take away provided by Dr. C: Change is driven by patients so please mention ERAS to your plastic surgeon at your breast reconstruction consult. I will provide links to resources where you can watch and read more:

Real patient stories who had ERAS protocol.

Episode 105: Breast Neurotization Using Nerve Tape® with Dr. Serletti – DiepCJourney Podcast

What role does breast neurotization play in restoring sensation after breast reconstruction, and how are advances in microsurgical nerve repair helping surgeons approach this important aspect of patient care? In Episode 105 of the DiepCJourney® podcast, I am joined by Dr. Joseph Serletti, Chief of Plastic Surgery at the University of Pennsylvania, to discuss his experience using Nerve Tape®, a suture-free solution for connecting nerves during microsurgical procedures. Dr. Serletti is a pioneer in free flap autologous breast reconstruction, using a patient's own tissue to reconstruct the breast, and is internationally recognized for his work in reconstructive microsurgery, including breast, head and neck, and extremity reconstruction. In this episode, we discuss: Challenges with traditional suture and conduit nerve repair techniques Dr. Serletti's experience using Nerve Tape® for nerve repair How using Nerve Tape® has changed aspects of his surgical practice The potential impact on operating-room time and efficiency What Dr. Serletti would tell surgeons considering Nerve Tape® Why restoring sensation after breast reconstruction matters The importance of restoring protective sensation and the potential for returning erogenous sensation The role sensory restoration may play in the future of breast reconstruction Sensation may not be one of the first topics patients think to ask about during a breast reconstruction consultation, but it is an important part of the conversation. The return of protective sensation can be an important patient safety consideration, while neurotization may also provide the opportunity for patients to regain other forms of sensation in the reconstructed breast. This episode provides patients, caregivers, and medical professionals an opportunity to learn more about breast neurotization, advances in nerve repair, and why sensation deserves a place in conversations about breast reconstruction. Published data on the efficacy of Nerve Tape® can be found through BioCircuit Technologies at biocircuit.com. Listen, learn, and share Episode 105 with someone who may benefit from understanding more about breast neurotization and restoring sensation after breast reconstruction.

1. Episode 105: Breast Neurotization Using Nerve Tape® with Dr. Serletti 18:55
2. Episode 104: Understanding Risk-Reducing Mastectomy & Reconstruction 25:15
3. Episode 103: Hormone Replacement Therapy: A Conversation with Dr. Ann Chuang 13:04
4. Episode 102: A Better Decsion Through Self-Advocacy 39:11
5. Episode 101: Fertility Preservation, Legislative Advocacy, and Patient‑Centered Breast Cancer Care 22:38

Breast Reconstruction Wound Healing and Seromas

Patients present with a variety of medical history and prior surgeries that can compromise or make wound healing more challenging for some. One participant shares her experience with prior seromas and healing after being brought to the stage. Dr. C listens carefully to the details and advises her accordingly. Resources discussing these to concerns can be found in the links below for further information and details.

Blog discussing breast reconstruction wounds and management can be found in this link.

Breast Reconstruction Clubhouse Discussion on Sensation

Unfortunately, women are not always aware or told their breasts will have numbness after mastectomy. There is hope restoring some of the sensation lost during mastectomy. If a woman is considering autologous reconstruction sensation can be performed with or without the use of a nerve graft. Resources to understand this process further are provided in the links below:

Sensory Nerve Reconstruction During DIEP flap Breast Reconstruction

Nerve Graft and Restoring Sensation to the Breast

Sensation can also be restored during implant-based reconstruction. Dr. C mentioned the two surgeons who pioneered this work, Drs. Anne Peled and Ziv Peled. You can listen to the podcast and watch the video interviews with these two surgeons in the links below:

Breast Reconstruction and Breast Sensation with the DiepCJourney Podcast in this blog.

Nipple Sparing Mastectomy in Breast Reconstruction

There was also a detailed discussion about nipple sparing mastectomy and why or why not women chose this at the time of breast surgery or breast reconstruction based on choice and oncologic safety. More details are in the links below. Thank you to PRMA for providing the link to the video.

From Nipple Sparing Mastectomy to DIEP flap Breast Reconstruction

Breast Reconstruction Clubhouse

I was grateful to those who participated and joined us that evening. There is a “Club” on Clubhouse titled, “Breast Reconstruction” I set up with the intention of having further discussions for interested participants. I encourage you to give Clubhouse a try and follow me by searching Terri Coutee and my moderators by searching Roberta Albany and Minas Chrysopoulo. I hope you will join me for the next breast reconstruction Clubhouse discussion.

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