Dr. Christopher Demas, director of Plastic, Reconstructive and Hand Surgery at SIUH, and patient Kim Forstater discuss her breast reconstruction procedure.
The phone call that Kim Forstater received on Valentine's Day 2005 was anything but sweet. She was told that her left breast was cancerous.
What followed were a lumpectomy and partial mastectomy, radiation and a regimen of tamoxifen. The next year, a mammogram showed abnormal cell growth in both of Kim's breasts requiring more surgery, radiation and follow-up mammograms. For three-plus years things seemed OK.
But, by 2010 both breasts again had abnormal cell growth requiring a more extreme course of action: a bilateral mastectomy.
"Either I keep going through the mammos and risk the chance of getting invasive breast cancer or I do this now. And that's where it was at," explained 51-year-old Kim. "So, after seven years of battling, going back and forth with this, that's what we decided."
In March 2011, Kim had both breasts removed. Immediately following her surgery, she underwent breast reconstruction.
Because she had previously had radiation treatments, implants could not be used. Instead, Dr. Christopher Demas, director of Plastic, Reconstructive and Hand Surgery at SIUH, used Kim's stomach tissue to recreate the look of her breasts.
"He said to me, 'I'm going to make them exactly as they were,'" said Kim, who happily reports that she's back to a 36C.
Using microsurgery techniques, Dr. Demas extracted fatty tissue from Kim's abdomen along with skin and blood vessels that supply that tissue and positioned it in the mastectomy sites. Then, the veins and arteries were connected to blood vessels at the sites and Kim's breast skin was folded over the transplanted tissue and sutured. Breast mounds were shaped using the abdominal skin and tissue.
"It looks and feels like a breast because it's nice soft fatty tissue," explained Dr. Demas.
Kim spent several days in intensive care where the blood flow in the newly connected vessels was monitored to make sure there were no clots.
The procedure works somewhat like a tummy tuck in that the fatty tissue removed from Kim's abdomen tightens Kim's midsection. And, since Kim tends to gain weight in her abdomen, the transplanted fatty tissue in her breast will change in size according to any future weight gain or loss that she experiences.
"He did a great job," said Kim, who several months later had her nipples and areolas tattooed by Dr. Demas to complete the look of her breasts. "He's a wonderful, wonderful doctor and surgeon."