Dr. David T. Greenspun is a Board Certified Plastic Surgeon (American Board of Plastic Surgery) practicing in New York City and Greenwich Connecticut. His practice focuses on post-mastectomy breast reconstruction using microsurgical perforator flaps including the DIEP flap, SIEA flap and GAP flap. These techniques allow for reconstruction of a breast using a woman’s own tissues without the loss of any muscle. In addition to breast reconstruction, Dr. Greenspun performs a limited number of other reconstructive and aesthetic surgical procedures.

Modern surgical techniques make it possible to reconstruct a natural-looking breast after mastectomy. Following mastectomy, women may experience not just the physical stress of the loss of a part of their body, but also considerable emotional stress.  Women sometimes describe a loss of the sense of “wholeness” that adversely affects their feelings of self-worth, sense of attractiveness, femininity and their sexuality.  Breast reconstruction can restore the form of the breasts, and not surprisingly, many studies have demonstrated important emotional and psychological benefits to undergoing breast reconstruction after mastectomy.

Many different techniques of breast reconstruction are available. Some techniques such as the Transverse Rectus Abdominis Myocutaneous flap (TRAM flap) or the Deep Inferior Epigastric artery Perforator flap (DIEP flap) utilize a person's own tissue, while other techniques use a breast implant or breast prosthesis. Dr. Greenspun is a microsurgeon specializing in perforator flap breast reconstruction. To read about one of our recent patient's experience with DIEP flap breast reconstruction at Greenwich Hospital in Greenwich Connecticut, please visit Focus Magazine's story, Breast Cancer Survivor Feels Whole Again.

Perforator flaps represent the state-of-the-art in tissue-based breast reconstruction. These flaps were developed to overcome drawbacks of flaps that contain muscle (e.g., TRAM flap). In tissue-based breast reconstruction, only skin and fatty tissue are needed to restore the shape and form of the breast. Therefore, an ideal flap for breast reconstruction should contain only skin and fat along with the necessary blood vessels that will nourish it. The muscle that is incorporated into the TRAM flap, for example, serves only as a vehicle for transferring the blood vessels that run within this muscle. The muscle itself is not needed to restore the shape and volume of the breast, and removing functional muscle from a flap’s donor site is not without potential consequence. Fortunately, by carefully separating the blood vessels that supply the skin and fatty tissue of a flap from the muscle through which these vessels travel, it is possible to reconstruct a breast using a woman’s own tissue and not sacrifice important functional muscles such as the rectus abdominis muscle. Flaps that are constructed in this manner are called perforator flaps. Perforator flaps are used to restore a breast removed by mastectomy with soft, warm, living tissue while simultaneously preserving the integrity of muscles at the flap donor site.