The Surgeon Minute

Creating Something Beautiful Out of Your Own Tissue

Creating Something Beautiful Out of Your Own Tissue

When someone decides to have elective, cosmetic plastic surgery, they never go into it expecting to be unhappy with their result. Choosing a qualified, board certified, experienced plastic surgeon and being sure you are a good candidate for the procedure you seek are very good ways to avoid this unfortunate outcome. However, poor results can happen.  Imagine, if you had a poor result in cosmetic breast surgery, but then also discovered you had breast cancer. Unfortunately, this scenario can happen too.

by Ned Snyder IV, MD
and The Plastic Surgery Channel

Tissue coverage is critical

Dr. Ned Snyder, of Austin, Texas, explains how he was able to salvage just such a case in a very unusual way.  Traditionally, breast reconstruction following mastectomy will be addressed one of two ways.  Either by harvesting the Latissimus Flap from the patients back and adding a tissue expander which is then later switched out for a real breast implant, or if the patient is a good candidate and has enough tissue in her belly, a TRAM flap can be moved from the abdomen to the breast reconstructing it without an implant.  In the latter scenario, the patient gets a kind of a two for one in that she gets new breasts and a tummy tuck at the same time.

A excellent alternative to traditional flaps

However, the patient Dr. Snyder shares with us has already had cosmetic breast surgery with a poor outcome and has very little to no soft tissue coverage in either of the traditional areas where surgeons would look for solutions to reconstruct her breasts.  “We used tissue from her thighs.  It is called a Profunda Artery Perferator flap or PAP flap.  A section of the posterior thigh that is used for transferring tissue from her thighs to her breasts for breast reconstruction,” explains Snyder, “We were able to move more volume from her thighs and were able in increase her breast size by about one cup.”  Most importantly the overall aesthetics of the breasts improved as a result of this reconstruction giving this patient a new kind of two for one.  The poor outcomes of her cosmetic breast surgery disappeared with the changes necessitated by her devastating diagnosis of breast cancer.  So there is hope here on so many different levels thanks to forward thinking, innovative surgical techniques and options.


Dr. Snyder believes, “This has become the new standard of care in breast reconstruction for us in that we expect patients to have cosmetically better breasts following breast reconstruction than they had beforehand.”  This particular patient was a very difficult reconstruction case due to the lack of adequate tissue coverage and all of the scarring previous procedures had left behind.  And yet, that did not deter Dr. Snyder, “We found an adequate supply of tissue from her thighs and were able to do it.”


Never ending possibilities

Never seeing a surgical situation, or certainly, a patient as hopeless should be a beacon of light and hope for all patients who find themselves facing either a poor outcome from a cosmetic case or a devastating diagnosis of breast cancer.  Breast reconstruction techniques continue to advance and become more refined allowing experienced surgeons to truly make dramatic cosmetic improvements in the face of reconstructive challenges.  If you find yourself faced with seemingly insurmountable obstacles in breast surgery, don’t give up.  The surgical skill and technological advancements in breast reconstruction today offer patients amazing options and most of all, hope!

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