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Reconstructive Surgery Called Alternative to Silicone Implants With PM-Breast Explants

January 10, 1992

DETROIT (AP) _ More women who want their breasts reconstructed after mastectomies - but who worry about artificial implants - are considering using their own abdominal tissue, a surgeon says.

″Women love it. They’re my happiest patients,″ Dr. Herman P. Houin of Henry Ford Hospital said Thursday. ″I’ve got five scheduled for this new procedure already this month.″

Surgeons at Henry Ford have performed about two dozen transverse rectus abdominus myocutaneous flaps procedures over the past two years. The operation, developed in 1980 by Dr. Carl Hartrampf of St. Joseph Hospital in Atlanta, involves using a woman’s own abdominal muscle and fat tissue to reconstruct her breasts.

The hospital says it has fielded many more inquiries about the procedure since the U.S. Food and Drug Administration asked doctors on Monday to temporarily stop using silicone-gel implants in breast surgery.

Concerns have been raised that silicone can leak from the implants and cause serious health problems, including immune system, connective tissue diseases and cancer.

The implants’ makers maintain that they are safe.

The hospital has stopped using the silicone-gel implants for now, Houin said, but continues to perform breast surgery using saline-gel implants, as well as doing the so-called TRAM flap surgery.

In the TRAM flap procedure, a flap of tissue is taken from a woman’s lower abdomen and inserted beneath the skin of the upper abdomen to create a new breast mound. Later, the patient returns to have the nipple reconstructed and tattooed to a natural color.

″One patient who came in the other day said it’s like the best of both worlds,″ said hospital spokeswoman Doreen Buckland. ″She said, ’Now I have a flat stomach and breasts, too.‴

The surgery leaves a hip-to-hip scar, but Houin said that can be concealed beneath the bottom of a two-piece bathing suit.

Because the surgery is more extensive than for breast implants, patients face a longer, more painful recovery. Houin said the extra pain and scarring lead few women to choose the procedure for cosmetic breast enlargement, although it is available for that purpose.

″It’s a major piece of surgery,″ said Robert T. Rylee, vice president of Dow Corning Wright Corp., which makes silicone implants. ″Whenever you have a choice between a greater procedure and a lesser procedure, you’re going to choose the lesser one.″

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