Focus on functionality in breast reconstructions

Nice to meet you: Stefania Tuinder

At the Faculty of Health, Medicine and Life Sciences, staff and students strive to make a difference. For instance, Mark works on treating Parkinson’s and tinnitus, and Carlos works on bioprinting kidney models. In 'Nice to meet you' these individuals introduce themselves and share their work within FHML.

Stefania Tuinder is a plastic surgeon at the Research Institute for Oncology and Reproduction (GROW) within Maastricht UMC+, where she focuses on microsurgery. In her research and work, she primarily focuses on the functionality of head, neck, and breast reconstructions. She investigates how the reconstruction can feel as natural as possible for the patient and positively impact their quality of life. “In today’s society, ‘normal’ is too often associated with ‘aesthetic perfection’.”

Stefania is from Italy and has always lived there. “My father was Dutch,” she explains. “During my final year of training as a plastic surgeon, I came to the Netherlands because there was already a renowned centre for microsurgery here. I was supposed to stay for just one year, but in the end, I never left. I have been part of the staff since 2007. My area of expertise is microsurgery: transplanting tissue with blood vessels and nerves. I particularly focus on functional head, neck, and breast reconstructions, which is also what my research lines are based on.”

Phantom pain

For breast reconstructions using a patient’s own tissue, Stefania has developed new techniques. “With these, we can not only transplant tissue from the abdomen, but also from other areas, such as the buttocks or the flank,” she explains. “Our team can also restore some sensitivity to the transplanted tissue, we are specialised in that field. Patients come to us from other clinics and countries to receive that. For our research, we use MRI scans to examine what happens in the brain when a patient loses a breast and later regains sensitivity in the reconstruction. Phantom pain in an arm is a relatively well-known concept, but it is less often considered for a breast. However, a breast is just as much a part of the body as an arm.”

Functionality

According to Stefania, breast reconstructions often focus too much on aesthetics and not enough on functionality. “In our reconstructions, we explicitly take the patient's quality of life into account,” she says. “Fortunately, nowadays it is possible to be cured of breast cancer. After that, you want to return to your own life. You can only do so if you are not constantly reminded of what happened. If you feel something is wrong in that part of your body, you will keep thinking about it. For example, you do not consciously think about having two hands. But if there is a wound on your hand and you need to use it for various tasks, you are constantly reminded of the pain. That is not positive for your quality of life. The same goes for a the breast: you can create one that is always present and bothersome, or one that you do not have to think about all day. Therefore, we focus on getting to that as close as possible. That sets us apart from other clinics.”

Perfection

Functionality is very important, according to Stefania. “This allows you to create a breast for a woman that suits her and feels normal to her. In today’s society, ‘normal’ is too often associated with ‘aesthetic perfection’. I am against that. Of course, some women want aesthetic perfection, but that is also very subjective. For a patient, a drooping breast could be considered perfect, if it closely resembles her own breast. There is a cultural emphasis on aesthetics worldwide. No one wants to age, and everyone wants to look perfect. Breast cancer patients, however, say that ageing is an honour. After all, not everyone gets the chance to do so. Fortunately, many people with breast cancer can now also grow old, because they are cured of it.”

Appreciation

Stefania loves the technical aspect of microsurgery. “I truly enjoy operating,” she says. “I also appreciate the human aspect of it, I like to build a relationship with my patients. You follow them for a long time, sometimes for years, and can support them, help them, and ultimately create something for them. You receive a lot of appreciation in return because you do so much for their quality of life. That is why I have specialised in this field. If I had to choose again, I would do exactly the same.”

Want to learn more about Stefania’s work and research? On Friday 31 January, she will speak about breast reconstructions at the Informatiedag ‘Erfelijke kanker heb je niet alleen’.

 

Text: Joëlle van Wissen

Photo: Maastricht UMC+

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