I want the names and websites (or addresses in lieu of websites) for
U.S. plastic surgeons who perform two specific types of breast
reconstruction:  GAP and LTP.  I do not want names and websites of
plastic surgeons who perform other types of breast reconstruction if
they do NOT perform the two I specified.  Nor do I want general
information about these two types of reconstruction unless it also
identifies plastic surgeons who perform these types of surgeries.  
Please note that these surgeries are reconstructive not cosmetic,
although there may be doctors who perform both.  I have already
checked the websites of the major associations (e.g., American Cancer
Society, American Society of Plastic Surgeons, etc.).

---

Request for Question Clarification by pinkfreud-ga on 02 Dec 2003 17:59 PST

As you've no doubt learned, finding this information isn't easy. One
thing that sometimes deters Researchers from starting a project like
this one is that it's difficult to tell when we've located enough
information to constitute an answer. We are aware, of course, that you
want as many names as is feasible, but it is very useful to have a
ballpark figure. Approximately how long a list would meet your needs?
Knowing your expectations can help us to budget our time and resources
so that we can provide the best answer for your money.

---

Clarification of Question by klein-ga on 03 Dec 2003 10:36 PST

PinkFreud, I am delighted that you have an interest in answering my
question.  As for clarification, I would be pleased if you could
provide me with a list of names as long as possible, of course.  I
think, however, that you may not find that many U.S. plastic surgeons
who actually perform either or both of these procedures so I will
settle for 5.  The procedures are relatively new.  In my initial
research, I found that these surgeries are practiced more often in
Europe and possibly Japan than in the U.S.

I also want to make sure that you understand that the doctors I am
looking for must be plastic surgeons as opposed to any other type of
doctor.  And it occurred to me that it would be helpful to you to know
for what the acronyms GAP and LTP stand.  They are Gluteal Artery
Perforator and Lateral Thigh Perforator, respectively.  Also in my
initial research, I found that there are more surgeries than the one
in which I am interested which use the acronym LTP.

If you need further clarification, please let me know.  Thanks.

Hello, klein-ga!

 I worked on your question for several hours last night and today and
went running down a number of dead-end rabbit paths. If only this
information was in one place! There is an organization called the
"American Society of Breast Surgeons" but must be a member to gain
access to the membership list. I don't know if it would have made the
search any easier, but if you are qualified to join and have any
interest, the website is at
http://www.breastsurgeons.org/

 I am sure there are other surgeons who perform the "Superior gluteal
artery perforator"  (S-GAP) breast reconstruction surgery but there is
no easy way to find them! I have found several surgeons that offer
"flap" surgery but do not specify what kind....they merely point back
to the generic web page from the American Society of Plastic Surgeons:
http://www.plasticsurgery.org/public_education/procedures/BreastReconstruction.cfm.

 This gives no definite indication concerning which flap procedures
they perform in their office so I have left them off the list. I have
also found many hospital sites that speak about various types of best
reconstructive procedures but do not offer any more detail. Therefore,
I have not included them either. I went through most of the top cancer
hospitals as well, but ran into similar roadblocks on their sites as
well.

 The "lateral thigh perforator" flap procedure (LTP) seems to be very
uncommon in the United States. I found only two centers that "might"
routinely perform that procedure. They are the Louisiana State Medical
Center and "possibly" the Edina Plastic Surgery center.

 In fact, The University of Texas M. D. Anderson Cancer Center
mentions that this is a very rare procedure:

"Other free flaps which have been used successfully for breast
reconstruction include the Rubens Fat Pad Flap, the superior gluteal
myocutaneous free flap, ** the lateral thigh flap, and the gracilis
flap. All these techniques have advantages and indications, but
because they are rarely used will not be described here."
http://www.mdanderson.org/departments/plasticsurg/dIndex.cfm?pn=A57FC450-960D-11D4-80FA00508B603A14


 The following list includes those surgeons who definitely perform the
S-Gap procedure and includes two possibilities for the ITP flap
procedure. In some instances, it was very hard to discern which
surgeon (out of the group) practiced the specific surgery.


==


GAP Flap

Dr. Robert J. Allen
====================
The Center for Microsurgical Breast Reconstruction
4429 Clara Street, Suite 440
New Orleans, Louisiana 70115
Toll Free: 888-890-DIEP (3437)
Local: (504) 894-2900
Fax: (504) 894-2901 
http://www.diepflap.com/index.html
http://www.diepflap.com/br_treatmentoptions.html

Dr. Allen has written about the Lateral Thigh Perforator procedure but
I don't know that he actually performs it in his practice:
http://www.diepflap.com/articles/0048.html 



***


GAP Flap

Dr. Scott Sullivan 
===================
Dr. Frank Dellacroce
====================
The Center For Restorative Breast Surgery 
4429 Clara Street, Suite 340 
New Orleans, Louisiana
1-888-899-2288 toll free 
504.899.2800 telephone
504.899.2700 facsimile 
http://www.centerforrestoration.com/
http://www.centerforrestoration.com/breastrecon/ourproc.html



***


GAP Flap


Maurice Nahabedian, MD, Director 
=================================
The Breast Center at Johns Hopkins
601 North Caroline Street, room 8031A 
Baltimore, MD 21287 
PH: 410-614-2853 
FAX: 410-614-1947 
http://www.hopkinsmedicine.org/breastcenter/
http://www.hopkinsmedicine.org/breastcenter/team/index.cfm?group_id=12



***


GAP Flap


The University of Texas M. D. Anderson Cancer Center
1515 Holcombe Boulevard
Houston, TX  77030
1-800-392-1611 (USA) 
1-713-792-6161 
http://www.mdanderson.org/departments/plasticsurg/dIndex.cfm?pn=A57FC450-960D-11D4-80FA00508B603A14

List of doctors: (specific breast surgeons not specified)
http://www.mdanderson.org/departments/plasticsurg/dIndex.cfm?pn=47DBE6AC-9321-11D4-80FA00508B603A14



***


GAP Flap


J. Craig Merrell, M.D. FACS
============================
Helena M. Guarda M.D.
=======================
Adam Billet M.D., F.A.C.S.
===========================
Plastic Surgery Associates of Tidewater
Chesapeake Center For Excellence in Plastic and Reconstructive Surgery
300 Medical Parkway, Suite 316 
Chesapeake, Virginia 23320
Phone: (757) 673-6000  Fax: (757) 673-6007 
http://www.plasticsurgeonforyou.com/index.html
http://www.plasticsurgeonforyou.com/procedures/diep/index.htm


***


GAP Flap

Strong Memorial Hospital
Plastic Surgery Center
601 Elmwood Avenue
Rochester, NY 14642
585-275-2100
http://www.stronghealth.com/services/surgical/Plastic/otherflap.cfm
(no individual doctors listed)


***


GAP Flap

Bernard W. Chang, M.D. 
======================
Armando Soto, M.D.
==================
Mercy Medical Center
301 St. Paul Place
Third Floor, Burk Building
Baltimore, Maryland 21202 
United States
Phone: 410-332-9700
http://plasticsurgery.mdmercy.com/reconstructive/index.html
http://plasticsurgery.mdmercy.com/expertise/index.html



***


The Edina Center makes mention of various Flap surgeries, including
both the buttocks and thighs, but it is hard to know exactly which
doctors performs what procedure (or if they actually do the GAP and
LTI.)

Robert C. Wilke , M.D., F.A.C.S.
=============================== 
Michael T. Philbin, M.D.
========================
Nathan T. Leigh, M.D., F.A.C.S.
=============================== 
William L. Carter, M.D., F.A.C.S
===================================
Edina Plastic Surgery, Ltd.
3625 West 65th Street 
Suite 150
Edina, Minnesota 55345
952-925-1765
1-800-965-1765 
http://www.edinaplasticsurgery.com/index.html
http://www.edinaplasticsurgery.com/procedures/index.html



***


GAP Flap

Mila Mician, M.D. 
===================
St. Josephs Hospital
Town and Country Hospital

Mila Mician, M.D.
3619 W. Waters Ave.
Tampa, Fl 33614
(813) 932-8866

http://plastic-surgery.tampa.mician.net/procedures.html
(This page mentions GAP surgery and is not clear on LTP)


***


Possible LTI Surgery
===================== 


Louisiana State Medical Center:

"FREE FLAP BREAST RECONSTRUCTION: THE LSU EXPERIENCE (1984-1996)."
Author: Allen R; Guarda H; Wall F; Dupin C; Glass C. Address:
Louisiana State University, New Orleans, USA.
Source: J La State Med Soc, 1997 Oct, 149:10, 388-92
http://216.239.57.104/search?q=cache:g41mL2exsnEJ:www.geocities.com/HotSprings/8689/tramflip/t14.html+%22lateral+thigh+perforator%22+breast+reconstruction&hl=en&ie=UTF-8

Abstract: From 1984 through 1996 the section of Plastic and
Reconstructive Surgery at Louisiana State Medical Center has performed
over 330 breast reconstructive procedures with free flaps. Seven types
of reconstructive procedures have been used during this time span,
each with its specific salient positive and negative points. The
breast reconstruction techniques included the use of (1) Superior
Gluteal Myocutaneous Free Flap, (2) Superficial Inferior Epigastric
Artery Flap, (3) Transverse Rectus Abdominis Myocutaneous Free Flap,
(4) Deep Inferior Epigastric Perforator Flap, (5) Superior Gluteal
Artery Perforator Flap, (6) Inferior Gluteal Artery Perforator Flap,
and (7) Lateral Thigh Perforator Flap.
The experience with these different methods of breast reconstruction
has led us to believe that the ideal material for breast
reconstruction is skin and fat, rather than muscle or prosthetic
devices. At our institution we have evolved from the myocutaneous flap
to the use of perforator flaps for breast reconstruction: the donor
site morbidity is less, the 99% success rate is superior, and it
allows more options with the perforator free flaps than ever realized
with the myocutaneous free flap technique. We feel that, in the
future, these perforator techniques will become the standard for
autogenous breast reconstruction.

==

Louisianna State Medical Center Dept of Plastic and Reconstructive Surgery
http://www.medschool.lsumc.edu/surgery/Plastic/default.htm

"The high point of the plastic surgery residency is the six-month
rotation at Charity Hospital of New Orleans. Here, residents are able
to treat an enormous range and volume of disorders, with faculty
supervision and guidance available as needed.

Ample opportunities abound for reconstruction of traumatic hand
injuries, facial fractures, acquired neoplastic deformities of the
head and neck, trunk deformities, breast disorders......."

===


University of Iowa Plastic Surgery Center
Breast Reconstruction Procedures
http://srn.surgery.uiowa.edu/surgery/plastic/brecon.html

"Other common donor sites for breast reconstruction using the free
flap technique are the buttock region and the lateral thigh region."

(Although they mention these two procedures on the page, it is hard to
know if they actually practice them)


Plastic Surgery Faculty at University of Iowa Plastic Surgery Center:
http://aboutplastic.surgery.uiowa.edu/surgery/plastic/

Dr. Albert Cram 
===============
(319) 356-2777 
albert-cram@uiowa.edu

Al Aly, MD 
===========
Phyllis Chang, MD 
=================
John Canady, MD 
================


***


 I hope the references I have provided are useful. Please let me know
if you need further clarification and I will be happy to do what I
can!


Sincerely,

umiat-ga

Google Search Strategy
GAP surgery
S-GAP reconstructive breast surgery
LTP reconstructive breast surgery OR surgeons 
LTP reconstructive breast surgery
GAP reconstructive breast surgery
GAP reconstructive surgery 
surgeons breast reconstruction 
+US "breast reconstruction" +surgeons
+GAP +LTP reconstructive surgeons
"lateral thigh perforator" breast reconstruction
"breast surgeons"

---

Clarification of Answer by umiat-ga on 03 Dec 2003 16:53 PST

Please excuse both instances where I substituted the wrong initials
for the LTP procedure (in one case calling it LTI and another ITP!!!!)
I promise there is nothing wrong with my eyes, but I admit my brain
was getting fuzzy after sifting through so many initials for FLAP
procedures!

umiat