I chose this topic for my weekly blog after doing a retrospective look at the writing, interviews, podcasts, and connections I have had over the past few years since having my own DIEP flap breast reconstruction. I love talking about DIEP flap. It is sophisticated and intricate surgery requiring great skill and expertise. I often refer to it as a profession of passion. Patients who choose to undergo this surgery spend long, often agonizing hours searching for a microsurgeon to perform their surgery. They spend equally long recovering from surgery. Thus the topic I have chosen to write about this week: Microsurgery and DIEP flap breast reconstruction and all it’s worth.
Microsurgery: A Profession of Passion
I am so fortunate that microsurgeons share the story of who inspired them to choose microsurgery. It is a glimpse into the human side of their lives and why they chose to do DIEP flap breast reconstruction. There are two that come to mind. The first is from Dr. Ergun Kocak of Midwest Breast and Aesthetics and the inspiration from his mother’s diagnosis plus the skill of her surgeon that inspired him. The link to the YouTube video is here: Microsurgery in Breast Reconstruction.
The second video interview is with Dr. Minas Chrysopoulo of PRMA and Founder of the Breast Advocate App. Sitting long hours with his father as a young boy watching the “telly” and World War I and World War II history programs was a form of bonding for them. He became fascinated with the earliest type of reconstruction surgery used on the soldiers during the war to repair things like shrapnel wounds. A fascinating look at these surgeries as well as the touching moments with his dad can be viewed in this video: What Inspired this Plastic Surgeon to Choose His Work: A Tribute and Some History.
Breast Reconstruction Education
Sitting and talking to surgeons about various conversations they have with patients about the process, risks, benefits, and planning of reconstruction gives one a sense of the scope of their work and hours spent in clinic, after surgery, and preparing the patient for DIEP flap. I had an in-depth conversation with Dr. Santosh Kale about Planning your Breast Reconstruction on the DiepCJourney podcast.
DIEP flap is not always an option for those choosing to use your own tissue for breast reconstruction. For that reason, I reached out to two surgeons at The Center for Natural Breast Reconstruction, Dr. Richard Kline and Dr. James Craigie. Dr. Craigie discusses the PAP flap in this video, PAP Flap Breast Reconstruction: Using the Back of the Thigh His colleague Dr. Kline discusses the SGAP in this video, SGAP Breast Reconstruction: Using Tissue from the Top of the Buttocks.
Training Required for Microsurgery and DIEP Flap
Dr. Daniel Liu of City of Hope in Chicago (formerly Cancer Treatment Centers of America) sat down with me at a medical conference to share the training and accreditation patients should look for and ask about when choosing a microsurgeon to perform their DIEP flap or other autologous breast reconstruction. He points out it is a very rigorous program and takes years not only in medical school but also in the operating room practicing the skill.
Microsurgery is an elegant and complex surgery that has improved over time. Microsurgeons look for ways to hone their skill, find new methods to improve patient outcomes, and must train to do this. In a recent interview with an internationally trained microsurgeon in Australia, Dr. Joe Dusseldorp, we discuss Robotic Assisted DIEP flap surgery. He looked to surgeons in the United States who have written papers and are currently using this tool in microsurgical breast reconstruction. I summarized our conversation in a blog that also contains a video with Dr. Joe in the surgical operating room while using the robot to perform a DIEP flap on a patient. The early data and patient reported outcomes is promising. You can view the video and read the summary here.
What is DIEP Flap Worth to Patients?
This is where my heart becomes full. When I hear patient stories of why they chose DIEP flap, it resonates with me thinking back to my own choice to have this type of reconstruction. One of the earliest videos I recorded was with Jan, who shares how this improved her mental ability to deal with life after breast cancer. She talks about how breast reconstruction changed her life in so many positive ways.
I often reach out to the global members of the DiepCJourney private Facebook page to ask various questions about DIEP flap surgery. One recent inquiry resulted in them sharing some truly meaning gifts patients appreciate after breast reconstruction surgery based on what they enjoyed.
Young women considering or who have already had DIEP flap breast reconstruction are still considering having children. Because DIEP flap surgery spares the abdominal muscle, this is a great choice for breast reconstruction. These women, although they lose the ability to nurse due to a mastectomy, still can carry a child through a pregnancy and then snuggle them against a warm soft breast. If they have had nerve reconstruction, they also have the added benefit, like me with my grandchildren, to feel those snuggles against their breasts.
Microsurgery and DIEP Flap Breast Reconstruction is Worth so Much to so Many
This is a tiny window and peak into my world since having my own DIEP flap in 2014. It changed the trajectory of my life forever. I have been surrounded by surgeons and patients who find great value in DIEP flap. My sincere hope is surgeons will continue to be compensated for their years of training. My sincere hope is surgeons will be fairly compensated by insurance for the hours they spend in clinic, behind the microscope, and being able to pay the staff and use the equipment that it takes to perform DIEP flap breast reconstruction.
To the patients who wish to have this surgery, my sincere hope is you continue to have full access to DIEP flap breast reconstruction. We work for our livelihood and pay for our insurance to cover the cost of our healthcare when we must temporarily take time off work for surgery like DIEP flap. It is our desire to continue working after a health event to pay the cost of this insurance. All we ask is that insurance, the decision makers in healthcare, be fair to us and keep the most advanced form of breast reconstruction after a mastectomy available for all those affected by breast cancer.