Prof. Aldona J. Spiegel: breast reconstruction plastic surgery—restoring the patients’ best quality of life
Expert’s introduction
Prof. Aldona J. Spiegel (Figure 1) is the Director of the Center for Breast Restoration at the Houston Methodist Hospital’s Institute for Reconstructive Surgery. Her clinical expertise is in advanced breast reconstruction techniques and microsurgery, particularly in the area of surgical reconstruction with reinnervated autologous muscle-preserving perforator flaps, including the DIEP Flap, SIEA Flap, SGAP Flap, TUG Flap and TAP Flap. She specializes in both cancer and non-cancer related breast correction, lymphedema procedures, advanced implant and latissimus reconstruction and has pioneered sensory innervation procedures which have the ability to reestablish sensation to the breast, resulting in the most complete form of breast restoration.
Editor’s note
October 19, 2017, the 9th Shanghai Breast Reconstruction Symposium successfully ended with wide-range scientific content and different categories. The Symposium is aimed at providing a nationwide academic platform for breast cancer experts to have further communication and brainstorming.
During the meeting, we were honored to have an interview with Prof. Aldona J. Spiegel, Plastic Reconstructive Surgeon at Houston Methodist Hospital, Texas, USA. Prof. Spiegel has dedicated her career to plastic reconstructive surgery for sixteen years. As an invited speaker at the symposium, she gave an excellent presentation on the topic “Refinements in Microsurgical Breast Reconstruction”.
During the interview, Prof. Spiegel discussed the current status of microsurgical breast reconstruction, and her inspiration to do breast reconstruction plastic surgery. Prof. Spiegel pointed out that now is an exciting time for microsurgery because many more new techniques are being developed, which actually benefits those who are battling with the disease. The role of breast reconstruction for a woman is about restoring emotional well-being much more than just replacing the lost breast(s), we set up a strong support group named “Pink Sisters” to support the patients who are undergoing reconstructive surgery. With the help of this group, they expect to give the patients a full and healthy recovery both in body and spirit. For the original content, please enjoy the video (Figure 2).
Interview
ABS: Could you briefly introduce your presentation “Refinements in Microsurgical Breast Reconstruction” to the audiences?
Prof. Spiegel: It’s an exciting time for microsurgery, because now we can use a lot of new techniques to allow better outcomes for the patients. When it comes to autologous breast reconstruction, we transplant tissue from one area of the body to another. Now we can also use aesthetic techniques to attempt to make the breast look like the original breast, match the existing breast or enhance the appearance. We are gaining experience with lipofilling to improve our breast reconstruction results, and are developing techniques to help with regaining sensation.
ABS: What are the advantages that Microsurgery brings to Breast Reconstruction?
Prof. Spiegel: When it comes to breast reconstruction, we have a lot of options. But of course, what we love to do is to replace like with like. When we are removing the breast gland, the patient’s own tissue is more natural than an implant. So, when possible, we try to use the patient’s own tissue. This is the beauty of microsurgery. We can look at the body of the patient, and see the areas that we can use to restore the breast.
Our hope and expectation in breast reconstruction is to help the patients to restore the best quality of life as possible, helping the patients in their breast cancer journey and to restore their femininity.
ABS: How many breast reconstruction surgeries have you done so far? Could you share a case that impressed you most to us?
Prof. Spiegel: I have been in practice for sixteen years. I’ve done 1,200 free flap reconstructions, and also many non-flap reconstructions. I really try to have a special connection with each patient that undergoes breast reconstruction so that I can understand what their reconstructive goals are and help them choose the best procedure for them. One particular patient that comes to mind is an older woman who didn’t have breast reconstruction for very long time, which really limited her life, her ability to go out with her family, enjoy swimming with her grandchildren etc. For many years she felt limited because she felt uneasy about herself. When she had the reconstruction it totally changed her life. She said she didn’t understand why she waited so long to have the surgery which completely transformed her. This patient case illustrates the power of reconstructive breast surgery.
ABS: What is the role of breast reconstruction for the patients?
Prof. Spiegel: Breast cancer diagnosis is difficult for women on many levels. Not only do they have to make many decisions on their cancer treatment but also on the type of reconstruction. This can be overwhelming for patients. As plastic surgeons, we try to help them by restoring them back to feeling like they have a good quality of life. That’s really the major role of breast reconstruction.
ABS: What is the Pink Sisters Support Group? What is the goal of this group?
Prof. Spiegel: It is a support group that we developed to help patients to go through the journey of breast cancer and reconstruction. We actually match a patient who is about to go through breast reconstruction with an existing patient who has already undergone the procedure. It helps them along the way. They feel like they can talk to somebody that understands what they are going through. This group has been very successful in helping patients with their recovery. After they are done with their breast reconstruction, the patients remain in the group and we have activities that bring the patients together, so it’s also a survivorship program.
ABS: What drove you to be a breast surgeon at the very beginning?
Prof. Spiegel: I fell in love with breast reconstruction because I think it combines two parts of plastic surgery: the technical and the artistic. And to be able to do that and to help patients change their life is very satisfying. That was my inspiration to do breast reconstruction plastic surgery.
Acknowledgments
On behalf of the editorial office of ABS, the editor would like to extend her gratitude to Prof. Aldona J Spiegel for sharing her experience and perspectives.
Funding: None.
Footnote
Provenance and Peer Review: This article was commissioned by the editorial office, Annals of Breast Surgery. This article did not undergo external peer review.
Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/abs.2018.01.03). VZ reports that she is a full-time employee of AME Publishing Company (publisher of the journal).
Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
References
- Zhao V. Prof. Aldona J. Spiegel: breast reconstruction plastic surgery—restore the patients’ best quality of life. Asvide 2018;5:041. Available online: http://asvidett.amegroups.com/article/view/22542
(Science Editor: Vanessa Zhao, ABS, abs@amegroups.com)
Cite this article as: Zhao V. Prof. Aldona J. Spiegel: breast reconstruction plastic surgery—restoring the patients’ best quality of life. Ann Breast Surg 2018;2:2.
