Microsurgeons with Orlando Health are among the first in the region to reestablish innervation to breast skin in patients undergoing reconstructive surgery following a mastectomy. The experimental procedure combines advanced microsurgery and allografts utilizing cadaveric nerve grafts to neurotize deep inferior epigastric perforator (DIEP) flaps.
The Orlando Health team performed its first neurotized DIEP flap procedure in August 2023. Since then, skilled specialists have performed more than a dozen of the novel procedures, restoring physical sensation in bilateral breast reconstruction.
"We are a very high-volume institute with experienced microsurgeons specializing in complex breast reconstruction using multiple techniques," says Kenneth Lee, MD, chief of plastic and reconstructive surgery at Orlando Health Cancer Institute. He also is a board certified plastic surgeon with Orlando Health Aesthetic and Reconstructive Surgery Institute.
"With our very robust head-to-toe microsurgery program, we are the perfect institution to dive into the neurotization of flaps;' says Dr. Lee, who specializes in complex reconstruction of oncological and traumatic defects in adults and pediatric patients.
Orlando Health was recently invited to join a multicenter trial for testing breast sensation to create a more standardized vocabulary. "There is no current uniformity in how to determine 'sensation;" says Dr. Lee. "Is it two point discrimination? Light touch? Protective sensation? Everyone talks about it differently. I think as we standardize more research and more data on neurotization, it will become more complete.
While the data on neurotization is still evolving, some things are becoming evident. "Patient satisfaction with this procedure is very, very high, and sensation is more defined and regained faster;' says Dr. Lee. "The neurotization of a mastectomy flap offers a new frontier for implant reconstruction. It is a novel procedure now, but it's going to be the standard of care in the future - a breakthrough that will enable us to help rebuild the body, confidence and lives of our patients.
Plastic and reconstructive microsurgeons at Orlando Health Aesthetic and Reconstructive Surgery Institute collaborate with other Orlando Health experts to provide multidisciplinary patient care. Consistently ranked as a top destination for cancer care, Orlando Health Cancer Institute is on the leading edge of novel therapies and research to improve outcomes and access to care.
Advanced Techniques Used in Tandem Microsurgery Return Sensation to Nipples Post-Mastectomy
