Jenny Deng-Dr. Spector-Week 7: Breast Microenvironment Platform, Clinic, and OR

Dr. Catherine Ly and Dr. Spector presented in this week's didactic meetings. Dr. Catherine Ly is associated with NYPW and has been tasked to build free flaps into the plastic surgery practice up there. She mentioned that it was challenging to start this project from the ground up due to NYPW having no recent memory of free flaps, limited plastic surgery exposure, having no SICU (only an ICU), no residents, and the fact that the OR set up wasn't optimal. Surgical instruments that were standard at her previous locations needed to be factored in-- along with working the team of nurses to prep the OR for microsurgery. She then went into two cases she saw: 1) breast reconstruction after patient dissatisfaction with asymmetry following a DIEP-breast implant procedure, and 2) a lower extremity reconstruction for a foot injury with bone exposure. 

Dr. Spector presented on his work with scleroderma patients and reconstructive surgery. He talked about cases where these patients often have skin tightening and thinning. In one case, a patient's peri-oral skin was more deficient than that around their cheeks, making it hard to open the mouth. He had performed an adipose fat tissue into the area, reasoning that fat is an ideal filler because it's non-immunogenic, has adipose stem cells, feels like soft tissue, is easily harvested, and is widely available. But AFT has its own complications, namely, resorption, fat necrosis, oil cysts, infection, hypertrophy, and donor site complications. 

In the OR this week, an interesting perioral advancement flap was performed on a patient desiring a more aesthetic mouth area. The patient had undergone prior facial reconstructive surgeries, but felt the previous surgeries made the area bulky, causing trouble in closing the mouth. To improve mouth competency, tension had to be released from around the area so the skin can lax, providing better lower lip visage. 

Finally in lab, I helped Sophia with isolating breast adipose and fibrous tissue for another run and revision of the breast microenvironment platform. This gave me practice with the tissue isolation protocol. As of writing this, there is an attempt underway to utilize this platform with spheroids in the following way (see figure below). 



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