February 23, 2018 by John Fernandez and Tanya Racoobian
Another Level of Healing: Reconstructive Surgery After Cancer
After cancer treatments, there is another level of healing that often requires skilled plastic and reconstructive surgeons. For these patients, eliminating the cancer is the priority, but it’s not the only goal.
Cancer operations that change how a patient looks, feels or functions may have significant implications on their quality of life after surgery. That’s when plastic and reconstructive surgeon Miguel A. Medina III, M.D., director of microsurgery at Miami Cancer Institute, becomes involved in this next phase of healing.
Dr. Medina recently assumed his new role at the Institute after completing a surgery residency at Massachusetts General Hospital and a plastic surgery residency in the Harvard Plastic Surgery Program at Harvard Medical School.
Treating ‘Defects and Functional Loss’ After Cancer Surgery
“One of our main interests at Miami Cancer Institute is to offer the ability to transplant tissue from one area of the body to another in order to treat the defects and functional loss that people suffer from having their cancer removed,” says Dr. Medina.
(Video: The Baptist Health South Florida News Team hears from Miguel A. Medina III, M.D., director of microsurgery at Miami Cancer Institute, about his new role at the Institute. Video by Alcyene Almeida Rodrigues.)
Reconstructive plastic surgeons play a key role in helping men and women regain their confidence and complete sense of self. Dr. Medina’s clinical focus has included abdominal wall reconstruction and breast reconstructive surgery, including “DIEP flap” procedures. In a DIEP flap surgery, blood vessels called “deep inferior epigastric perforators” (DIEP), along with the skin and fat connected to them, are removed from the lower abdomen and transferred to the chest to reconstruct a breast after mastectomy, without damaging abdominal muscles.
Dr. Medina also treats patients after surgeries for head and neck cancers, as well as skin cancer in which areas of the cheek, nose or lips are affected. His expertise involves “microsurgery,” using cutting-edge operating microscopes and precision instruments to reconnect nerves, muscles and blood vessels.
Transplanting a Patient’s Own Tissue
A typical case in Dr. Medina’s field involves breast reconstruction, which can be done with implants or using a patient’s own tissue.
“When I transplant tissue from the belly, which is usually where we take it from, although we can take it sometimes from the thighs and some other places, we remove it completely from the body and physically transplant it to the chest,” explains Dr. Medina.
Other cases may involve skin cancer patients after a “dermatologist has to remove a specific area of the cheek, nose or lip that’s very cosmetically sensitive,” he says.
Full Spectrum of Reconstructive Surgeries
“We are also getting involved with oral surgeons and head and neck cancer surgeons,” he says, “to help patients who have part of their jaw or cheek missing. We can do these same transplant-tissue operations in order to bring both form and function back to them.”
Reconstructive surgery patients can also include victims of traumatic injuries that leave facial deformities, or those born with functional challenges such as blocked nasal passages that inhibit breathing. “We’re able to fix the inside of the nose, and open areas of the nose, to help them breathe,” he says.
Nonetheless, cancer patients will make up the bulk of patients treated by Dr. Medina and his team.
“Our goal is to bring a robust reconstructive surgical practice to Miami Cancer Institute,” he says. “Certainly, our first and foremost goal is the treatment of cancer patients, but we’ll be performing the full spectrum of plastic and reconstructive surgeries.”