Oral Presentation Joint Scientific Meeting of the Australian & NZ Head & Neck Cancer Society & NZ Association of Plastic Surgeons

The Free Abdominoplasty Flap in Breast Reconstruction – The Untold Story (1236)

Richard Hamilton 1 , Ingemar Fogdestam 2
  1. Hamilton House Day Surgery, Adelaide, SA, Australia
  2. Plastic Surgery, Sahlgrenska Hospital, Gothenburg, Sweden

This year marks the fortieth anniversary of the first use of a free abdominoplasty flap in breast reconstruction. Before this operation the options open to a woman who had undergone a mastectomy and who was seeking some sort of breast reconstruction were extremely limited. The main approach available at the time was a multi-staged pedicled flap taken from the abdomen – a procedure that took several months to complete, was extremely taxing on the patient and very uncertain of outcome. Understandably, it was not often performed. The free abdominoplasty flap operation, performed in Gothenburg, Sweden in 1979 changed all that. Microsurgery had made possible an operation that could in one session reconstruct a breast. This operation, and the pedicled TRAM flap which followed two years later, transformed breast reconstructions from rarely performed procedures to common operations. This is all part of recorded history. What is not known is the major Australian contribution to this pioneering work. Bernard O’Brien had established a Microsurgery Research Unit which became part of St Vincent’s Hospital in Melbourne in 1976. The whole operation was planned there, all the anatomical research was carried out in the unit’s cadaver laboratory, and both the microsurgeons who were to perform the operation, one Swedish and one Australian, were trained there. And all the time that this preparation was being carried out in Melbourne, The Sahlgrenska Hospital in Gothenburg , Sweden, where the trailblazing operation was to take place, did not even have a microsurgery unit. On the fortieth anniversary of the operation, it is time to finally acknowledge Australia’s contribution to its success.