Master Surgeon

A breast cancer diagnosis can elicit a near heart-stopping response for many women.

Those who undergo a mastectomy can opt for reconstructive surgery, including skin expansion and an implant or flap reconstruction. Surgeons performing flap reconstruction harvest tissue from another area of the body and use it to recreate a new breast.

But it’s just in the past 10 years that women with little or no tissue in their back or abdomen can look to their derrières for the necessary tissue, a welcome prospect for those feeling like they are already well-padded.

“S-GAP flap has been a viable procedure for about 10 years; consistently, there are only about five to six surgeons [in America],” said Dr. Bernard W. Chang, Director, Plastic & Reconstructive Surgery, Mercy Medical Center in Baltimore, Md. “It is such a small group because it is a difficult operation,” added Chang.

Superior gluteal artery perforator (S-GAP) flaps “provide a reliable flap and an excellent aesthetic reconstruction,” according to an article published in Annals of Plastic Surgery, February 2004. The makeup of the gluteal region’s fatty tissue enables surgeons to design and create breasts with “good projection” and mass, resulting in a breast that looks and feels natural.

“I suppose it does take some artistic sense to do an S-Gap flap,” admitted Chang with a twinge of humility. “It is a combination of technical skill and aesthetics.”

Chang, a soft-spoken and gentle practitioner, was operating on the cutting edge when he started doing S-GAP flaps in 1997. “I have been focused on breast reconstruction since starting in plastic surgery at [Johns] Hopkins [University School of Medicine] in 1992.”

Chang said that over the years he has worked with many women dealing with cancer and surgical problems. He has witnessed many “with much strength in the face of adversity.”

“I feel a great sense of joy in knowing that so many women were able to regain their sense of wholeness and self-esteem," said Chang. “I wish more women could benefit from what we do, and hopefully in the future more plastic surgeons will be able to offer these procedures to patients.”