|
Breast op first in Britain
RACHEL BULLER
12 August
2004
12:39
|
 |
|
Elaine
Sassoon, left,
joined by US doctor Bob Allen as he demonstrated ground-breaking
breast reconstruction
surgery |
A
pioneering operation that could ease the suffering of hundreds of
breast cancer patients was carried out for the first time in Britain
yesterday, at the Norfolk and Norwich University Hospital.
A team of surgeons, led by renowned American doctor Bob Allen, used
fat taken from a woman's buttock to reconstruct the breast that was
removed years ago during cancer treatment.
Now, following yesterday's successful teaching case, the procedure
could be offered to many more breast cancer patients across the
region.
The delicate microsurgical operation involves tissue to be used for
reconstruction being taken from the bottom of the patient's buttock.
Previously it has been taken from the stomach or the top of the
buttock.
The new technique will mean that the resulting scar will be well
hidden and help maintain a patient's body shape - reducing the trauma
for women facing what can be distressing treatment.
The hospital is already one of very few in the country to use the
Perforator Flaps techniques - pioneered by Dr Allen in the USA in 1992
- which uses the patient's own tissue to rebuild the breast without
sacrificing muscle.
Dr Allen has taken the procedure one step forward and since March he
has performed the buttock lift technique, to give women more choice
and limit the physical and emotional impact of breast reconstruction
surgery.
Dr Allen was invited to Norfolk by consultant plastic surgeon
Elaine
Sassoon, who has performed the pioneering surgery on 70 local patients
since visiting him in America four years ago to learn more about his
techniques.
She hopes that the procedure could now be opened out to more women at
the Norfolk and Norwich University Hospital as well as encouraging
more surgeons nationwide to adopt it.
“It was just great in the theatre today because now I am quite happy
to go in and do the other breast for this lady in a few months' time.
I am going to be able to do this procedure here now,” she said.
“A lot of patients previously didn't want their buttocks used, but now
we can do it and they won't be able to see the scarring.”
Dr Allen performed the operation with a team of surgeons and support
staff and it was relayed by video into another room, allowing trainee
surgeons and doctors from other hospitals to watch.
He also gave a lecture to staff at the hospital detailing the new
technique and the advantages of using fat, rather than muscle, for
reconstruction.
Yesterday's patient was in her late 40s and had had a double
mastectomy some years ago following breast cancer.
Dr Allen said her options were somewhat limited because she was very
athletic and did not have enough tissue in her stomach.
However, rather than leaving a prominent scar and possible change of
shape of one of her buttocks, she was recovering this morning with
evidence of the procedure camouflaged by the natural crease of her
body.
“Elaine said she had a difficult case and they were considering
raising money for the patient to be sent to me in the USA and I said I
would be happy to come over to demonstrate the development myself. Now
this can be part of what this hospital has to offer,” said Dr Allen.
“You are able to create a natural breast. They have less pain with
these techniques than with others and now you can hide the scar with
this development and not affect the contour of the body. It is a
wonderful hospital here. They have a great team and they obviously
want to increase the options available to women, which is fantastic.”
The operation, which takes between four and six hours and costs about
£5000, sees anything from a few grams to 1kg of fat taken from the
buttock depending on the size of the patient.
The tissue is removed teasing out the main blood vessels from the
muscle. While another team works on the breast area of the patient,
the surgeons shape the removed fat to fit with the natural shape of
the woman's breasts. It is then reattached, along with some of the
skin from the buttock, using minuscule blood vessels, less than a
millimetre in diameter, to enable the blood to begin pumping through
the transplanted tissue.
Dr Allen said yesterday's patient had previously been extremely active
and participated in tennis coaching and other sports, but had felt
unable to enjoy such things following her original mastectomy.
“If we can get her back to doing all the activities she used to do
then it will have a big impact on her quality of life,” he said.
“Breast cancer affects many women and there are still a lot who end up
losing a breast because of it. The subject of breast reconstruction is
complex because we need to make the woman feel whole again, the breast
is about how a woman feels about herself, about femininity and
sexuality.
“It is more of a psychological reconstruction and if a woman has a
mastectomy and they wear a prosthesis in her clothes it affects her
whole lifestyle and if they can have reconstruction with their own
tissue then eventually I believe they can feel whole again. The new
breast is warm, it feels like your own body and it grows with you.”
The procedure also gives surgeons more options if there is not enough
excess tissue around the stomach area - without having to possibly
disfigure patients' buttocks.
Dr Allen said the majority of hospitals in England still used muscle
from the buttocks, stomach or back for reconstructive surgery, which
was more painful and had greater implications for the patient.
“If women now have a choice to save the muscle and still have
reconstructive surgery then I believe they would choose that.” |
The
site where 
