Reconstructing hope: There are many options available for breast cancer survivors

03-14-2019

When a healthy woman with natural breasts has breast enlargement surgery, her existing breast tissue and muscle support her implants and keep them in place. But in a woman with cancer who’s had a mastectomy, this breast tissue been removed. And if she’s also undergone radiation treatment, the fatty and connective tissue that lies under the breast is further damaged by radiation and unable to support implants.

To anchor a mastectomy patient’s implants, protect them from infection, and create a better cosmetic outcome, doctors cover the implants in one of two ways: with a manufactured material, or with the latissimus dorsi muscle that is located in the mid and upper back.

Traditionally, the muscle is harvested by a surgical incision that leaves an 8-by-12-inch scar across the back. But Jesse Selber, M.D., professor of Plastic Surgery, has pioneered a minimally invasive, robotic surgery that helps patients heal faster and more comfortably.

Selber’s technique uses the mastectomy incision along with three small incisions, each less than a half-inch in length, made under the patient’s arm. Long, slender robotic arms are inserted through the tiny incisions and operated by a surgeon who sits at a console resembling an airplane cockpit. The robotic arms separate the muscle from the surrounding tissue, then tunnel it under the skin to the breast, where it’s draped securely across the implant.

This procedure is routinely performed only at MD Anderson. The success rate, Selber says, is 100 percent.

“There’s been no loss of muscle viability,” he says, “and we’ve not had to convert to the more invasive technique.”