Grants Funded

Abstract
A woman living in the US has a 12.4% (1 in 8 women) lifetime risk of being diagnosed with breast cancer. Women are presented with multiple options for breast reconstruction, including autologous tissue or prosthetic reconstruction. The majority of women elect to undergo prosthetic reconstruction, which can consist either of direct implant reconstruction, or staged tissue expansion (TE) followed by implant reconstruction;. However, use of tissue expanders, especially in a radiated field, carries a high risk of complications, including infection and expander exposure. Such complications often lead to multiple additional surgeries and delays in chemotherapy. Current research into optimizing outcomes is limited to retrospective chart reviews, which cannot adequately control for the large number of variables: patient co-morbidities, breast surgeon, use of acellular dermal matrix (ADM), radiation protocol, and TE fill. Our proposal seeks to identify how the mechanisms of skin adaptation, quantified through modeling of tissue-scale deformation and growth, histologic microstructure, and gene expression pattern, are altered in response to placement of ADM and radiation. The specific aims of our study are: 1) Determine the effect of ADM on tissue growth and regeneration induced by tissue expansion, and 2) determine the effect of ADM on gene expression and morphologic skin changes induced by tissue expansion with and without radiation therapy. The long term objective of this study is: delineate the effects of radiation and ADM on tissues undergoing expander based reconstruction, so that clinicians can optimize post-mastectomy treatment protocols, thereby minimizing complications and improving outcomes.

Biography
Dr. Gosain completed his plastic surgery residency at the Medical College of Wisconsin and a fellowship in craniofacial surgery at the NYU School of Medicine Institute of Reconstructive Plastic Surgery. Dr. Gosain joined Lurie Children's Hospital and Northwestern's Feinberg School of Medicine faculty in 2012. Dr. Gosain has held leadership positions in several professional organizations, including ASPS, American Board of Plastic Surgery, American Society of Maxillofacial Surgeons, Residency Review Committee of the American Council of Graduate Medical Education, and American College of Surgeons. He has published numerous peer-reviewed articles and book chapters, and he has presented at national and international meetings. Dr. Gosain specializes in pediatric plastic surgery and is widely recognized for his expertise in craniofacial and vascular anomalies, congenital nevi and cleft lip and palate repair. Dr. Gosain serves as head of the Craniofacial Developmental Biology Laboratory at Lurie Children's Research Center, which has been supported by numerous organizations including The Plastic Surgery Foundation and the National Institutes of Health. The laboratory is committed to training one plastic surgery resident annually in research related to pediatric and craniofacial anomalies. Dr. Gosain wishes to improve health conditions for children around the world and provides surgical care to children born with cleft lips and palates in impoverished areas in India.