A study published in the May issue of the ASPS’s Plastic and Reconstructive Surgery journal, headed by Dr C.R. Albornoz of Memorial-Sloan-Kettering Cancer Center, report that only a tiny portion of breast reconstructions is performed with microsurgical approaches. He says it was mostly because of patient preference and anatomic characteristics.
Dr Albornoz and the rest of the authors used a large hospital database, amounting to almost 16,000 breast reconstruction patients in the US in 2008. Around 6,000 of them had the surgery at once, while 1,300 had delayed reconstruction. The total rate was approximately 38%, compared to 24% in a previous study of the same database but covered patients between 1999 and 2003.
The employment of breast reconstruction allocated 60.5% to breast implants, 34% to conventional plastic surgery skin flaps, and a measly 5.5% to advanced microsurgical flap techniques.
Although both conventional and microsurgical flap techniques use the patient’s own tissues, the microsurgical approach is able to provide much better results without the side-effects and discomfort often found in the conventional approach.
Implants were discovered to be more likely the choice of younger women, Caucasians or Asians, and those with higher incomes in the US. Breast reconstruction using conventional autologous tissues were more likely for women in their 50s, women treated at hospitals with surgical training programs, and women with private insurance. Microsurgical reconstruction was more probable also for women who were treated in teaching hospitals and women with private insurance. In addition, it was more frequent for delayed than immediate reconstructions.
Microsurgery is performed by surgeons specially trained to use a surgical microscope. This research suggests that while the overall breast construction procedure is thriving, microsurgical techniques account only a miniscule percentage of it. Due to the status of teaching hospitals, only a small amount of surgeons and hospitals offer the newer approach.
Findings also reveal that reconstruction decisions may be driven by the patient’s race, demographic properties, and the hospital where treatment would take place.