Have you searched endlessly perhaps days and weeks, for a microsurgeon to perform breast reconstruction? Access to care is a real concern for patients who are affected by breast cancer. Finding a plastic surgeon who specializes in tissue reconstruction in the area you live in is not always a service afforded to all patients. Traveling for breast reconstruction is not out of the ordinary. It was something I did myself for my DIEP flap. This is a summary of the DiepCJourney podcast. I interview one such surgeon and practice breast cancer patients travel as we discuss Breast Reconstruction Surgery In New Orleans at CRBS, the Center for Restorative Breast Surgery.
Why Dr. Zafar chose Microsurgery and Breast Reconstruction
I interview Dr. Sarosh Zafar, a double board-certified microsurgeon in plastic and reconstructive surgery and general surgery. She specializes in the most advanced methods of breast reconstruction, complex reconstruction, and microsurgery.
She chose to specialize in microsurgery after her medical residency. Dr. Safar wanted to choose a specialization that included variety and options in surgical techniques. Breast reconstruction combined her surgical skills with helping patients, their families, and loved ones in the breast cancer community.
She shared with us she feels challenged each day and feels that will continue through her entire career in microsurgical breast reconstruction. From medical school, plastic surgery training and fellowship training in microsurgery, Dr. Zafar explains the path one takes to become a breast reconstruction microsurgery specialist. It takes performing the flap surgery, getting the “repeats” and numbers in, and gaining more and more independence in the operating room. Not everyone does a fellowship. However, it is important to ask your surgeon the pathway to reach the skill it takes to do microvascular breast reconstruction.
The Breast Reconstruction Practice in New Orleans and the IFAR Network
Dr. Safar’s group in New Orleans is also a part of the Institute for Advanced Reconstruction (IFAR) Network based in New Jersey. The IFAR Network of Surgeons for Breast Reconstruction is part of a multiple group of private practice surgeons across the entire country, east coast to west coast, and everywhere in between. These private practice IFAR surgeons share like-minded goals serving patients affected by breast cancer. Their focus includes the following:
- Exchange ideas.
- Exchange some administrative help.
- To collaborate to help take care of different patients across the country.
Dr. Zafar’s group offers all the various types of flaps that patients might consider for breast reconstruction. They do implant reconstruction as well. Her group does hybrid reconstruction which is using your own tissue in combination with an implant. The gold standard, is the DIEP flap using the abdominal tissue. They offer SGAP and TDAP flaps along with other tissue flaps from the body. Each patient’s overall well-being and preferences are taken into account during the consultation. This helps them come to a plan together with each patient. I add, “Shared decision-making” and Dr. Zafar quickly chimes in, “Absolutely! Always!”
A Surgeon’s Perspective a Patients Biggest Challenges
Dr. Zafar compassionately speaks of the challenges patients face, especially the newly diagnosed. She shares some of what she feels are the biggest challenges.
- Getting patients up to speed and understanding everything in a short amount of time.
- Helping patients who are newly diagnosed and feeling their life is completely flipped upside down.
- Assisting the patient and family discussing work related issues and time off.
- Dealing with the urgency of getting the cancer out combined with the time it takes for the final aesthetic results.
She points out the value of support groups for women. Dr. Zafar emphasizes, however, that just like everyone’s DNA is different, everyone’s diagnosis is different, and everyone’s reconstruction is going to be a little bit different. This is not the time to compare your reconstruction with someone else’s.
The Team-Based Approach to Breast Reconstruction
The value of working with a team of microsurgeons in breast reconstruction, often called the co-surgeon model, has shown to have great benefits for patients. Dr. Zafar’s team practices the co-surgeon model. She points out the benefits for the patient and the surgeon.
- At CBRS they are all microsurgeons and perform breast reconstruction routinely as part of their work every day.
- The co-surgeon helps shorten the length of anesthesia for the patient.
- Studies show that outcomes are significantly improved (less complications, less fat necrosis, greater flap success).
- Learning skills from each other.
Dr. Zafar finds one of their biggest strengths at CBRS is the team-based approach. She points out it takes so much more than just the surgeon to get patients through the process of breast reconstruction. Their team also includes:
- The intake team gathers pertinent medical history.
- Financial team to sort through the insurance process.
- Travel coordinator.
- Clinic nurses.
- Staff in the operating room.
- Their physician assistants (PA’s).
- Nurses in the nursing unit of the floor.
- A dedicated free-standing hospital.
They all collaborate and work together to get patients through the entire process.
If patients have any questions, never hesitate. That would be my number one message. Always ask. Always ask for clarification. It can be a very confusing, intimidating process, but that’s what we’re here for is to help you figure everything out and help you get the best outcome that you can.
Dr. Sarosh Zafar
You can listen to the entire podcast interview here: