UT Southwestern one of two institutions to offer innovative four-flap microsurgery approach to breast reconstruction

The technique, known as a four-flap breast reconstruction, uses fat and skin from the back of each leg and from two spots on the stomach to reconstruct natural breast materials.

"It reaches a new height in breast reconstructive surgery, using your own tissue," said Dr. Sumeet Teotia, Assistant Professor of Plastic Surgery, who performs the procedure along with Dr. Nicholas Haddock, Assistant Professor of Plastic Surgery and Orthopaedic Surgery.

Success with the new four-site technique gives more options to women, especially those who are thinner and have less body fat for surgeons to use in reconstruction, Dr. Haddock said.

"The aesthetic benefits are pretty dramatic. You get all the volume at once," Dr. Haddock said. "It allows us, as surgeons, to use the same blood vessels in the chest instead of having to use blood vessels in the back."

The microsurgery techniques are part of UT Southwestern's Breast Reconstruction Program, directed by Dr. Teotia, in association with UT Southwestern's Harold C. Simmons Cancer Center. UT Southwestern's breast reconstruction specialists work with breast cancer specialists to help women make the best decision for reconstruction after breast cancer, based on health, anticipated cancer treatments, projected recovery time, body shape, and other factors. Dr. Haddock is a pioneer in the surgery from back of the thigh, and his expertise, combined by Dr. Teotia's pioneering work in multiple flaps from the abdomen, continues to improve the aesthetic outcomes for patients seeking a high level of breast reconstructive care.

Kim Starr, a 45-year-old mother of two from Frisco, sought breast reconstruction options after a 2013 double mastectomy. One of the patients to have the four-flap breast reconstruction surgery at UT Southwestern, she said she found the benefits appealing. In addition to reconstructing her breasts, the surgery brought added benefits of a "tummy tuck" and sculpting to the back of her legs.

"Dr. Haddock said you've got some room on the back of your legs that I could take off, and I was like, 'OK, that's kind of a no brainer,' " Ms. Starr said. "This was almost like a mommy makeover. It was one heck of a way to get it, but my stomach is flat, and the back of my legs look great."

About 90,000 breast reconstructive surgeries are conducted every year, according to the American Society of Plastic Surgery. More than two thirds of them are implants.

Dr. Haddock said use of the patient's own fat and skin is often more attractive to patients.

"The advantage of using your own tissue is once it's up there and living it's hers. It's hers forever; it will be there 30 years from now," he said. "Implants don't feel the same as your own skin or fat would."

Dr. Teotia said surgery like this can only be done with highly competent surgical teams because the surgery involves an 8-hour to 10-hour operation that includes diligent and precise surgical work to link veins and arteries under a microscope.

"It's a combination of engineering microsurgery and art, so we concentrate on the fact that our product ultimately has to have a beautiful result," Dr. Teotia said. "If we don't have that, none of the things we talk about will be worthwhile for the patient."

The Harold C. Simmons Cancer Center is the only National Cancer Institute-designated cancer center in North Texas and one of just 66 cancer centers in the nation designated by the National Cancer Institute. The center brings innovative cancer care to the region, while fostering groundbreaking basic research that has the potential to improve patient care and prevention of cancer worldwide.