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MOUNT PLEASANT -- When Celia "Cici" Franklin's third
set of breast implants failed, her plastic surgeon recommended a
fourth. There had to be another option, she thought. That night,
the breast cancer survivor put her two sons to bed in their Eagle,
Colo., home, and she went online to research alternatives.
It only took three search terms -- "breast reconstruction
alternatives" -- and she got an answer: microsurgical breast
reconstruction. In the quiet of the midnight hour, Franklin e-mailed
Charleston-based Dr. Robert Allen, who pioneered the surgery.
Only a handful of surgeons perform the painstaking procedure that
rebuilds breasts from a patient's own tissue, attaching microscopic
blood vessels to nourish the transplanted skin and fat.
Franklin wanted other women to know their options, so she agreed
to tell her story for the Discovery Health Channel show "Plastic
Surgery: Before and After." On Aug. 8 a crew filmed the eight-hour
surgery at the East Cooper Regional Medical Center for an episode
scheduled to air in the fall. Allen and his New York-based partner,
Dr. Joshua Levine, each operated on one side of Franklin.
"If you can look online, you'll find it," Franklin said.
"But if you're just told you have cancer and here are the alternatives,
you might not look."
Franklin's story began in 1999 when she found a lump in her breast
during a self-examination. Even though her mammogram six weeks earlier
was clear, she went to the doctor to get the lump checked out. It
was breast cancer.
She had both breasts removed. The cancer had not spread to her
lymph nodes, so she did not require radiation or chemotherapy.
Her first implants were silicone, but scar tissue soon developed,
encapsulating the implants. Capsular contracture is when fibrous
scar tissue forms a capsule around a foreign body as a defense mechanism.
"You can feel the skin pulling," she said. Her plastic
surgeon removed the set and replaced them with mixed silicone and
saline implants.
The same tightening developed with the second set of implants,
Franklin said, so badly this time that the left one ruptured. The
third set, too, began to tighten. Franklin began her research.
"He was a good surgeon," Franklin said, "but my
body rejected the implants." He discussed with her the TRAM,
or trans-rectus abdominus flap, procedure that takes skin from the
abdomen to construct breasts. But Franklin, an athletic woman, did
not have enough flesh on her abdomen.
Through Allen, she learned about other viable sites on the body
for harvesting tissue. Franklin underwent the SGAP, or superior
gluteal artery perforator, which takes tissue from the upper buttocks.
Allen said operating with a film crew was, for the most part, easy.
The producer would occasionally ask him to explain what he was doing.
The main difference was the producer's request that they not play
music during the operation. Allen usually listens to New Orleans
blues and jazz.
Allen was based in New Orleans with Levine before Hurricane Katrina
drove them out. Allen ended up in Charleston, and Levine landed
in New York. Within 10 days of the storm, Allen began operating
at East Cooper Regional Medical Center, which is owned by the same
company as Memorial Medical Center, where he worked in New Orleans.
Using a patient's own tissue provides several advantages, Allen
said. The frequency of complications is reduced, and the tissue
feels more natural. Within a week, Allen said, new blood vessels
and nerve cells begin to grow.
Six days after surgery, Franklin said she already had more sensation
than with implants.
"It's about having my own tissue," she said. "I
feel whole again."
Abstract (Document Summary)
Franklin wanted other women to know their options, so she agreed
to tell her story for the Discovery Health Channel show "Plastic
Surgery: Before and After." On Aug. 8 a crew filmed the eight-hour
surgery at the East Cooper Regional Medical Center for an episode
scheduled to air in the fall. [Robert Allen] and his New York-based
partner, Dr. Joshua Levine, each operated on one side of Franklin.
"He was a good surgeon," [Franklin] said, "but my
body rejected the implants." He discussed with her the TRAM,
or trans-rectus abdominus flap, procedure that takes skin from the
abdomen to construct breasts. But Franklin, an athletic woman, did
not have enough flesh on her abdomen.
Allen was based in New Orleans with Levine before Hurricane Katrina
drove them out. Allen ended up in Charleston, and Levine landed
in New York. Within 10 days of the storm, Allen began operating
at East Cooper Regional Medical Center, which is owned by the same
company as Memorial Medical Center, where he worked in New Orleans.
The Post and Courier Staff
Credit: The Post and Courier, Section: YOUR COMMUNITY NEWS
Reproduced with permission of the copyright owner. Further reproduction
or distribution is prohibited without permission.
Author: Jill Coley at 937-5719 or jcoley@postandcourier.com
Date: Aug 18, 2006
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