From diagnosis to reconstruction, breast cancer introduces you to many healthcare providers with different specialties. What’s more confusing? There are specialists within those specialties.
One of the specialists you may hear about during breast reconstruction is a microsurgeon. These are plastic surgeons with advanced training in microsurgery. Microsurgery is very important in most types of natural breast reconstruction, which uses your own tissue to rebuild a breast. Their expertise is critical for reconnecting tiny blood vessels from one part of your body to another, which keeps transferred tissue alive an healthy as your newly constructed breast.
As you navigate your options, it’s helpful to know the which types of doctors and surgeons could be involved in your care. If you’re looking into natural breast reconstruction, it’s helpful to know what a microsurgeon does, how that role differs from your other surgeons, and what they don’t do.
What is a microsurgeon?
A microsurgeon is usually a plastic and reconstructive surgeon with advanced training in microsurgery.
Microsurgery is a surgical technique using a microscope to reconnect blood vessels and other tiny structures. In natural tissue breast reconstruction, microsurgeons create a natural tissue flap using tissue from one part of your body (like your abdomen) and attach it the chest to create a breast. The microsurgeon is skilled at maximizing blood supply to the new breast so it functions like a regular body part.
What microsurgeries are used for breast reconstruction?
Despite the word “micro,” microsurgeries aren’t small surgeries. Instead, they are surgeries that are done under microscopes for attaching small blood vessels when sculpting a new breast.
Microsurgeons are most often involved in natural (autologous) breast reconstruction. That happens when you take part of your body called a “flap” and reconstruct it into a breast.
Here are some common microsurgical breast reconstruction procedures:
- DIEP flap: This surgery takes a flap of skin and fat from the lower abdomen and transplants it to the chest wall, leaving the abdominal muscles in place and intact.
- TUG/PAP flap: This type of reconstruction brings tissue and muscle from the inner thighs to the chest wall to create a breast.
- LTP flap: This flap uses tissue from the outer thighs to create a breast.
Is a microsurgeon the same as a plastic surgeon?
Yes and no. A microsurgeon is a type of plastic surgeon, but not every plastic surgeon is a microsurgeon.
Microsurgeons who perform breast reconstruction are plastic surgeons who seek out extra training. A plastic surgeon may perform many kinds of reconstructive procedures, but not all plastic surgeons are experts in reconnecting tiny structures under a microscope. That expertise requires a specific fellowship. Most modern natural tissue reconstruction options require microsurgical expertise.
Is a microsurgeon the same as a breast surgeon?
No. A breast surgeon’s job is to remove the cancer, while a microsurgeon reconstructs the area where the cancer used to be.
Your breast surgeon is the primary surgeon for:
A microsurgeon is the primary surgeon once the cancer is cleared and the area is ready for reconstruction.
Do microsurgeons and breast surgeons work together?
Yes, and sometimes they work simultaneously.
First, the breast surgeon removes the cancerous tissue. At the same time, the plastic surgery team can begin preparing the flap that will become the reconstructed breast. Most flaps come from the abdomen, so the plastic surgery team works on that part of your body while the breast surgeon removes the tissue from your chest.
Once the breast surgeon (with the help of a pathologist) has confirmed that there is no cancer left, the microsurgeon goes to the same surgical site where the breast surgeon removed the cancer. There, they take the flap and connect the blood vessels to create a reconstructed breast.
Do all breast reconstruction surgeries require a microsurgeon?
Microsurgeons usually are not the specialists patients think of for implant reconstruction. All microsurgeons are also trained plastic surgeons, so some do perform implant reconstruction, however, microsurgical techniques are not required to do those types of procedures (unless they include breast neurotization). Most natural tissue reconstruction requires microsurgery.
If you trying to choose between implant and natural tissue breast reconstruction, it can be helpful to speak to a plastic surgeon who regularly does both types of breast reconstruction. Plastic surgeons who are specialize in both types of reconstruction are often able to help you figure out what makes the most sense for your body, your life, and your goals. If you cannot find someone who does both, you can try to speak to one specialist in each sub-specialty.
