The Plastic Surgery Foundation
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Grants We Funded

In 2019, The Plastic Surgery Foundation (The PSF) awarded 33 investigator-initiated projects and allocated $891,274 to support the newest, clinically relevant research in plastic surgery.

The American Society of Plastic Surgeons/PSF leadership is committed to continuing to provide high levels of investigator-initiated research support to ensure that plastic surgeons have the needed research resources to be pioneers and innovators in advancing the practice of medicine.

Research Abstracts

Search The PSF database to have easy access to full-text grant abstracts from past PSF-funded research projects 2003 to present. All abstracts are the work of the Principal Investigators and were retrieved from their PSF grant applications. Several different filters may be applied to locate abstracts specific to a particular focus area, or PSF funding mechanism.

Upper Extremity Biomechanics Following Breast Reconstruction

Principal Investigator
Daniel Lyons MD

Year
2017

Institution
University of Michigan, Section of Plastic Surgery

Funding Mechanism
Pilot Research Grant

Focus Area
Breast (Cosmetic / Reconstructive)

Abstract
There are over 250,000 new cases of breast cancer diagnosed in the United States each year. In women pursuing post-mastectomy breast reconstruction, an implant-based technique is commonly used requirnig disinsertion of either the pectoralis major muscle or latissimus dorsi muscle to provide soft tissue coverage of the breast prosthesis. These muscles are principal stabilizers of the shoulder girdle and their disinsertion has been shown to increase shoulder instability with short- and long-term functional deficits. Despite the growing evidence that post-mastectomy breast reconstruction produces shoulder morbidity, clinicians have a poor understanding of the pathophysiological mechanisms leading to shoulder impairment, or what might be done to prevent or improve these issues. The overall objective of this proposal is to identify the mechanism responsible for shoulder morbidity after implant-based breast reconstruction by investigating changes to the mechanical properties of the shoulder joint and its underlying musculature. We hypothesize that alterations in muscle length following disinsertion of either the pectoralis major muscle or latissimus dorsi muscle at the time of implant-based breast reconstruction will result in a reduction in the stiffness capacity and force generation of the donor muscle leading to increased shoulder instability. The proposed work is the first attempt to characterize physiological changes within both the donor muscle and the shoulder following implant-based breast reconstruction. Our study will utilize a cross-sectional design to identify the effects of two different implant-based breast reconstruction techniques on upper extremity biomechanics using objective functional measures. Additionally, patient reported outcomes measures utilizing validated questionnaires will characterize the reliability of the biomechanical assessments in predicting a patient's upper extremity dysfunction post-operatively. By understanding the mechanisms of why certain patients develop post-reconstruction shoulder disability, we hope to develop prospective strategies to identify and rehabilitate at-risk patients to improve the quality of life in cancer survivors.

Biography
I am a fourth-year plastic surgery resident with an interest in breast reconstruction and clinical outcomes research. The goal of this proposal is to identify the mechanisms responsible for shoulder morbidity after implant-based breast reconstruction by investigating changes to the mechanical properties of the shoulder joint and its underlying musculature. My previous work in breast reconstruction outcomes related to acellular dermal matrix use in implant-based breast reconstruction provided me with experience in scientific presentations and manuscript preparation, and the mentors chosen for guidance and leadership with the current proposed biomechanical study are experts in clinical outcomes research. The combination of a focused research plan and mentors with expertise in breast reconstruction and musculoskeletal biomechanics will ensure successful completion of the proposed project.