Surgery
Plastic and Reconstructive Surgery
The Division of Plastic and Reconstructive Surgery at the Dana Farber/Brigham and Women's Cancer Center is a recognized leader in plastic and reconstructive surgery for cancer patients.
As part of our multi-disciplinary approach, our division team is comprised of plastic surgeons and other health care experts that work directly with each patient to address all of their special needs.
All of our plastic and reconstructive surgeons are experts in a wide range of procedures in the field of plastic surgery. All of our surgeons are faculty members of Harvard Medical School and board-certified by the American Boards of Surgery and Plastic Surgery and General Surgery.
Consultation
The division members review various treatment options with patients in cooperation with their referring physician. The reconstructive options for patients vary and are discussed by the plastic surgeons in accordance with the patient's diagnosis.
Choosing a plastic surgeon is an important decision. After a patient has chosen one of our nine ABPS board certified plastic surgeons, we will schedule an initial consultation with the patient to discuss all aspects of his or her procedure(s).
During the initial visit, our surgeons will share with you the following information:
- your recovery in detail, including restrictions on certain activities, when you can return to work, and what preparations you should make for surgery;
- risks of surgery and the best way to avoid them; and
- the impact of any underlying medical problems you may have and how this might effect planning for surgery.
Prior to your visit with us, we advise that you write down your questions. Many patients forget what they wanted to ask the doctor and having a list may help.
Don't be afraid to ask for a second visit to discuss surgery. Most doctors offer to see patients more than once (at no extra charge) to make sure that the patient is comfortable with the plan.
Our surgeons are very attentive to patient's needs and work diligently to ensure that they feel as good about the procedure as they do about the desired result.
To contact us, please call (800) 789-8157 or (617) 732-5282.
- Preparing for surgery at Brigham and Women's Hospital
- Learn more about the Division of Plastic Surgery
Our Services
We specialize in the following plastic and reconstructive procedures:
On this page
Breast Cancer
The ultimate goal of breast reconstruction is to create breast symmetry by forming a breast that will be similar to the opposite breast.
- Implant with Tissue Expander: An expander is inserted at the time of mastectomy in most cases, and the expansion process will begin after incisions have healed and continue over the next several weeks. Saline will be injected into the expander to enlarge it sufficiently to accommodate the implant. The replacement of the expander with the implant will take place in approximately three months or when the expansion process is completed. This is done as a day surgical procedure.
- TRAM (transverse rectus abdominus muscle) Flap: This flap is taken from the abdomen and consists of skin, fat, and a small piece of muscle tissue, which is tunneled between the skin and ribs to the breast area. This technique is called a pedicle flap, and allows the flap to maintain a constant blood supply from its site of origin. The tissue is then trimmed and sutured into place to create a new breast mound. The abdomen will then be closed.
- Latissimus Dorsi Flap: This flap is taken from your back and consists of skin, fat, and a small piece of muscle. It will be tunneled over the ribs to the operative site and will be trimmed and sutured into place to form a new breast. Very often, a small implant will be required to assist in matching the opposite breast.
- Free Flaps: A free flap is a piece of tissue that is completely removed from its donor site along with an artery and a vein and will be connected to an artery and a vein at the recipient breast site. Sources of free flaps are the abdomen, gluteal (buttock), and latissimus dorsi muscle. This surgery is more complicated, requiring microsurgery and a stay in the Intensive Care Unit for monitoring for 24 to 48 hours.
In cases where symmetry is not easily attained, the opposite breast may require a breast reduction or a breast lift.
- Nipple/Areola Reconstruction: Approximately three months after reconstruction, once the breast has healed, nipple/areola reconstruction will be performed as a day surgery procedure.
- Tattooing: Tattooing of the nipple/areola complex will take place a few weeks later in the doctor's office.
Skin Cancer
Depending on the severity and location of the cancer, skin cancer reconstruction options can range from simple closure to flaps.
- Excise and closure
- Excise with skin graft: After excision, the area may need to be repaired with a skin graft. A skin graft is a thin piece of skin taken from one area and placed on a prepared recipient site.
- Local Flap: If the defect is larger, excision would be followed by local tissue rearrangement. This is tissue that is moved from an area adjacent to the wound.
- Free Flap: In the case where there is insufficient local tissue, a free flap would be required. A free flap is a piece of skin, fat and muscle that is completely removed from a donor site with an artery and a vein and transferred to the recipient site, where the artery and vein are connected to vessels in that area. The flap is trimmed and sutured into place.
Sarcoma
Reconstruction is individualized to each patient. A sarcoma is a cancer arising from connective tissue such as muscle or bone. The reconstruction options depend on the severity, size and location of the cancer. Options consist of simple closure, skin grafts, and tissue rearrangement with local flaps, pedicle flaps, or free flaps.
- Simple Closure: After excision, the area is sutured closed.
- Skin Graft: A thin layer of skin is taken from one area and placed on a prepared recipient site.
- Local Flap: A local flap is tissue rearrangement adjacent to the wound.
- Pedicle Flap: A pedicle flap is tissue that is moved on a vascular pedicle (an artery and a vein that will be connected to an artery and a vein at the recipient site) and is sutured into place at the recipient site.
- Free Flap: A free flap is a piece of tissue that is completely removed from its donor site with an artery and a vein and will be connected to an artery and a vein at the recipient site. Free flaps are more complicated because they require microsurgery.
Head and Neck Cancer
Plastic surgery options for head and neck cancer range from primary closure in conjunction with a skin graft, local flap, pedicle flap, or a free flap.
- Primary Closure with Skin Graft: A skin graft is a thin layer of skin that is taken from one area and placed on a prepared recipient site.
- Local Flap: A local flap is tissue rearrangement adjacent to the wound.
- Pedicle Flap: A pedicle flap is tissue that is moved on a vascular pedicle (an artery and a vein which will be connected to an artery and a vein at the recipient site), and is sutured into place at the recipient site.
- Free Flap: A free flap is a piece of tissue that is completely removed from its donor site with an artery and a vein and will be connected to an artery and a vein at the recipient site. Free flaps are more complicated because they require microsurgery.
Pelvic Cancer
Plastic surgery options for pelvic cancer range from primary closure in conjunction with a local flap, regional flap, or a free flap.
- Local Flap: A local flap is tissue arrangement adjacent to the wound.
- Free Flap: A free flap is a piece of tissue that is completely removed from its donor site with an artery and a vein and is connected to an artery and a vein at the recipient site. Free flaps are more complicated because they require mircrosurgery.
