Dr Mary Ling (Breast Surgeon) and Dr Mihaela Lefter (Plastic and Reconstructive Surgeon) worked collaboratively to offer breast cancer patients immediate breast reconstruction with an innovative procedure involving nipple sparing mastectomy and implant reconstruction with external oblique muscle flap.
Nipple sparing mastectomy involves removing breast tissue with preservation of the entire breast skin envelope including the nipple areolar complex. Following mastectomy, the external oblique muscle, the most superficial muscle of the abdominal wall, is harvested. The implant is positioned and covered by the pectoralis muscle and the ‘turned over’ external oblique muscle. The entire procedure is performed through a single incision, hidden in the inframammary crease, and with minimal long-term morbidity.
Initially described by Little in 1981 as a ‘living bra’, the external oblique muscle flap is useful in both immediate and delayed implant based breast reconstruction. Compared to the more commonly used surgical meshes that lack its own blood supply, the external oblique muscle flap can provide a more robust protection of the implants against complications (including infection, extrusion and capsular contracture) and achieve a natural breast shape (with reduced implant visibility and palpability).
“Having both Dr Ling and Dr Lefter work collaboratively for this ground breaking procedure, involving intricate reconstructive surgery, is fabulous for the hospital and the Woy Woy Peninsula community,“ said Kathy Beverly, CEO of Brisbane Waters Private Hospital.