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We would love for you to explain the evolution of the DIEP since we all respect that you were the first surgeon to do these as far back as the 80’s and 90’s.
How many surgeons have you directly trained through your fellowship programs?
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RobertAllenMD (Physician - Surgery - Plastic (Verified) ) - 01 / 08 / 2012
The ideal tissue for breast reconstruction lies transversely across the lower abdomen. The quality and permanence of autogenous breast reconstruction is far superior to implant reconstruction. My goal was to discover the best donor site with the least risk to the patient. The TRAM flap of the early 1980’s was able to make a natural breast without implants, but the abdomen suffered from sacrifice of the rectus abdominus muscles. In 1989 I began investigating the blood supply to the lower abdominal skin and fat. I first concentrated on the superficial inferior epigastric blood vessels. By injecting the superficial inferior epigastric artery(SIEA) on fresh abdominoplasty specimens, I concluded that the skin and fat of the lower abdomen could be transferred using microsurgical techniques to reconstruct a breast without sacrifice of the abdominal muscles. The first cases went great, but I realized some patients either did not have a superficial artery or it was too small. I briefly abandoned the SIEA procedure and began doing free TRAM flaps. Unfortunately the free TRAM resulted in hernias, weakness, and pain. I re-examined the blood supply of the lower abdomen concentrating on the deep inferior epigastric system. By injecting a single dominant perforator of the deep inferior epigastric artery, I demonstrated that this could be used to transfer the lower abdominal skin and fat. Thus was born the DIEP flap for breast reconstruction in August 1992 at Charity Hospital in New Orleans.
As Director and later Chief of the Plastic Surgery Residency Program at Louisiana State University Medical Center until Hurricane Katrina in 2005, I trained one or two Fellows a year in Microsurgical Bresast Reconstruction. Since then I have trained 12 Fellows at the Medical University of South Carolina and New York University Medical Center.
Sincerely,
Bob Allen,MD
As Director and later Chief of the Plastic Surgery Residency Program at Louisiana State University Medical Center until Hurricane Katrina in 2005, I trained one or two Fellows a year in Microsurgical Bresast Reconstruction. Since then I have trained 12 Fellows at the Medical University of South Carolina and New York University Medical Center.
Sincerely,
Bob Allen,MD
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