S.P.A.R.E. (Sensory Preservation with Allograft Reconstruction)

The advancement in materials and surgical techniques in mastectomy and breast reconstruction has ushered in a new era for women who have suffered through the diagnosis of breast cancer. Expectations regarding cosmetic results have risen accordingly, and women can now hope for restoration and even, sometimes improvement of the shape, form, and size of their breasts.

Despite the cosmetic improvements in breast reconstruction, the result may always feel “foreign”. As with any body part that is restored, function is a primary outcome of success. The breast is a functional organ with specialized sensation that is often incorporated into the body image. After mastectomy, the nerves that supply the special sensation to the breast are necessarily cut. There have been many attempts in the past to improve upon the resulting sensation, most notably attaching nerves from flaps (tissue imported from other parts of the body) to intercostal and other nerves in the area. However, these nerves are not part of the apparatus that supplies the human breast and resulting sensation is lacking.

A new innovation may bring us closer to the final frontier of complete reconstruction of the breast. This would achieve both restoration of the form and the sensation of the breast. The SPARE procedure is a new technique in which the main nerves that supply the nipple and breast that would normally be cut during a mastectomy, are identified under magnification, tagged and protected.

Specialized nerve grafts are then used to bridge the gap prior to breast reconstruction and secured to allow regeneration of the native nerve. Peer-reviewed data to date have indicated that this procedure not only allows faster recovery and better sensation but is the first technique that preserves the natural kind of sensation. (Ref here)

Dr. Tessler and Dr. Turin’s unique skill set in peripheral nerve surgery, arising from his pioneering work in migraine surgery, initially drew his interest towards this possible game changing technique. Leveraging and applying these special skills, he has collaborated and communicated with other leading peripheral nerve and breast surgeons in perfecting this technique for appropriate candidates. He is the first surgeon to have performed this groundbreaking procedure in Arizona, and continues to innovate improvements to expand the scope and reach of this technique.

Not everyone is a candidate for this procedure and therefore proceeding requires careful evaluation with a plastic and reconstruction surgeon that has experience with this procedure. Please feel free to inquire about attempting to spare the loss of sensation to your breast after mastectomy.