Service chief, Babak J. Mehrara, MD.
At the Center for Advanced Reconstruction at Memorial Sloan Kettering, we save more than just lives — we make every effort to make our patients feel whole again.
Coordinated Care from a World-Renowned Team
Restoring patients’ physical appearance and their ability to function normally after cancer surgery is a complex process. At MSK, our entire care team collaborates every step of the way to give all patients a reconstruction plan tailored just for them.
Our experts are world leaders in the field of reconstruction and perform thousands of procedures a year. Our team includes the highly skilled care of advanced practice providers and nurses who specialize in caring for patients who are recovering from cancer surgery and reconstruction.
Using Research to Guide Care
We are focused on providing the best outcomes for our patients. We lead several clinical trials to build on established approaches and innovate new techniques. Two exciting areas of research include:
- Our work to understand and develop new treatments for lymphedema — we are the only program in the country that has a National Institutes of Health–funded lymphedema laboratory and conducts clinical trials in the surgical treatment of lymphedema
- Our application of AutoCAD — a software program originally developed by architects to allow doctors to more precisely map and measure bone for mandibular (jaw) reconstructions
Patient Satisfaction (Patient-Reported Outcomes)
Patient feedback and satisfaction is at the core of everything that we do. Our BREAST-Q and FACE-Q questionnaires are important tools in providing care and are designed to evaluate the unique needs of patients who are undergoing breast and facial surgeries. These questionnaires help us continually improve patients’ results and quality of life.
Breast Reconstruction
MSK plastic surgeons provide a full range of breast cancer reconstructive options. These include nipple- and areola-sparing mastectomy, autologous reconstruction (which uses tissue from another place in the body), implant reconstruction, including direct to implant, and reconstruction after lumpectomy (oncoplastic reconstruction). Our plastic and reconstructive surgeons are innovators in state of the art reconstructive techniques and perform nearly 3,000 breast reconstruction procedures each year, among the highest number in the country.
Autologous reconstruction
Every year we perform more than 700 reconstructions using patients’ own tissue. MSK has among the highest published success rates in the world for tissue reconstruction. We are committed to helping our patients feel comfortable and happy with their results. Our surgeons are experts at all types of autologous breast reconstructive surgery, including:
- DIEP (deep inferior epigastric perforator) flap
- SIEA (superficial inferior epigastric artery) flap
- DUG (diagonal upper gracilis) flap
- SGAP (superior gluteal artery perforator) flap
- PAP (profunda artery perforator) flap
Implant reconstruction
We have extensive experience with all types of implants and strive to achieve the most natural-looking outcomes for our patients. MSK has led the way in developing innovative implant reconstruction techniques and we routinely speak about our methods at international conferences. Our surgeons are distinctly qualified to help patients select the best reconstructive option for them.
Reconstruction after lumpectomy
We have a dedicated program for patients who are having or previously had a lumpectomy (oncoplastic reconstruction) and radiation therapy. Whether it’s a patient’s first surgery at MSK or they’re coming to us from another institution for a revision, our goal is the same: to achieve the best cosmetic results.
Head and Neck Cancer Reconstruction
Our plastic surgeons use sophisticated software and imaging to prepare plans tailored for each patient as well as innovative reconstruction methods to achieve the best outcomes for patients with head and neck cancers. We have established and perfected many of the techniques used around the world to reconstruct with tissue from another part of the body.
After surgery, our patients complete a satisfaction survey called FACE-Q. From the questionnaire’s results, our specialists can better understand patients’ quality of life after head and neck reconstruction. This helps us provide better counseling before surgery so new patients will more clearly understand what to expect after surgery.
The plastic and reconstructive surgery team at MSK continues to perform all major head and neck cancer reconstructions, which differentiates us from many other institutions. As plastic surgeons, we prioritize restoration of form and function to achieve the best possible outcomes for our patients.
Our team pioneered the use of immediate dental implants in head and neck cancer patients and developed a novel workflow to improve their functional outcome and dental rehabilitation.
Abdominal Wall Reconstruction
We have a very high success rate in abdominal wall reconstruction because we combine surgeries to restore normal function with more traditional means of hernia repair. Using a patient’s own abdominal muscles, we are able to restore the structure and functional integrity of the wall, enabling it to grow stronger over time. Our experts also have training with complex reconstructions in which both the skin and intestinal protection has been removed.
Nerve Reconstruction and Facial Reanimation for Facial Paralysis
Facial paralysis can be a devastating problem for patients, but MSK surgeons have a breadth of experience in this area. For some people with recent or long-standing paralysis, we have ways to restore their ability to smile, close their eyes, make facial expressions, and eat and speak more normally. In addition, our surgeons have pioneered the use of advanced microsurgical techniques including nerve and muscle transfer to replace damaged tissues.
Lymphedema
MSK is developing groundbreaking treatment options for lymphedema. Our surgeons are trailblazers in lymphatic surgery. We combine sophisticated imaging approaches to build individualized care plans for our patients. Our team includes highly specialized physician assistants, lymphedema therapists, and nurses committed to providing lymphedema care.
Our research trials, which are funded by the National Institutes of Health, are developing groundbreaking preventative and treatment options for lymphedema. There are very few centers in the world that offer the range of lymphedema treatment and surgery.
Extremity Reconstruction
We have extensive expertise in extremity long bone reconstruction after cancer surgery. In many cases, we can microsurgically reconstruct portions of the body with a section of the patient’s own leg bone (the fibula) rather than an implant. The bone is then able to grow, which is a better outcome for patients. We also have broad experience doing sarcoma reconstructions in the arms and legs.
Reconstruction after Mohs Excision for Skin Cancer
At the Center for Advanced Reconstruction, we work hand in hand with MSK’s Multidisciplinary Skin Cancer Management Program. The collaboration between our plastic surgeons and dermatology specialists means that our patients experience extremely low recurrence rates and have minimized scarring. Most patients have their Mohs surgery and reconstruction surgery on the same day, which decreases their recovery time.
