Prof. Yehia Zakariya

Professor Zakaria is a professor of Plastic & reconstructive surgery in Zagazig University, Egypt. He is a consultant of reconstructive microsurgery in the ministry of health hospitals in Egypt

Prof. Zakaria has been actively participating in many local and international courses, workshops and conferences on hand surgery, reconstructive microsurgery and aesthetic surgery as a faculty member. He has many publications in national and international journals on various topics of plastic surgery.

He has special experience in reconstructive microsurgery of the head and neck, breast and extremities.

He is an active member of the WSRM, ESPRS, KSPS, ISAPS. He is a founding member of the Pan Arab federation for reconstructive microsurgery. He is a member of the executive medical committee of the Gulf burn society in Dubai.

He is an invited guest speaker in many regional and international conferences. He is a visiting plastic surgery consultant to the ministry of health, Kuwait.

Prof. Zakaria was recently elected as a member of the board of directors of the ESPRS.

Topic:
Improving the aesthetic outcome in post mastectomy breast reconstruction

Breast is an essential symbol of femininity. It influences the woman’s self-confidence, body image and self-esteem. Breast cancer continues to place a significant burden on the health care systems, the incidence of breast cancer in the United States is 1 in every 8 women. Breast conservation techniques offer the best treatment for local control of breast cancer, but not all the patients are candidates for such techniques and almost 30% of breast cancer patients will be treated by mastectomy.

Breast reconstruction following mastectomy is now considered an essential part in the treatment of those patients because of its positive impact on the patient’s psychology and quality of life. The ideal method for breast reconstruction should be safe, reliable and with minimum donor site morbidity.

The aim of this study was to report and summarize the prospectively collected data of 33 free DIEP flaps used for unilateral post mastectomy delayed breast reconstruction. It included 33 patients with postmastectomy scars. Their ages ranged between 24 and 55 years (average 41.6 years). The average operative time was 377.1 minutes. The success rate was 97% with one case of partial flap necrosis. The rate of take- back to the operative theatre for microvascular related problems was 12%. One patient (3%) developed haematoma underneath the flap, 2 patients (6.1%) developed abdominal seroma and 3 patients (9.1%) developed fat necrosis in an average period of 3.8 (range of 3-5) months after surgery. Two patients (6.1%) had abdominal wound dehiscence. No mortality cases were reported. The average hospital stay was 8.1 days. The average follow up period was 17.1 months. No reported cases of abdominal bulge or incisional hernia. All patients were satisfied about the abdominal contour postoperatively. Twenty-five patients (75.8%) were happy about the cosmetic appearance of the reconstructed breast, 8 patients were satisfied about having a breast mound. Secondary refinement procedures were done to improve symmetry and cosmetic appearance and included; breast reduction, augmentation, mastopexy, NAC reconstruction and scar revisions.