Dr. Stefan Hofer

They say that if you want a superior surgeon, don’t expect a “bedside manner” to go with it. In the case of Dr. Hofer, you do in fact get both. Dr. Hofer is an exceptional surgeon, trained in Europe and Australia, who fortunately for us, chose to accept the offer to head the Reconstructive Surgery Program at UHN.

He is a quiet, thoughtful, exceptionally talented surgeon who puts all his skills and training into treating his patients in the only way he knows how. He is considerate, and understands what this surgery means to his patients. He is also a great leader, choosing his colleague, Dr. Zhong, and Fellows from around the world to support the treatment of reconstructive breast surgery.

Although Dr. Hofer did not do my initial surgery, he did repair a complication I had in my flap site, and he continues to help me regain a sense of wholeness that disappeared one day in 2004. I can only recommend him and his team to anyone who is searching for the best. We have it here in Toronto at UHN.

NH

Breast cancer patient

Immediate DIEP Flap Reconstruction Reconstruction with Dr. Toni Zhong

I was considering a mastectomy with immediate reconstruction and was very thankful to be given a booklet outlining the Breast Reconstruction options at University Health Network from my breast surgeon’s nurse. It was helpful to be able to educate myself as to the various options and terminology before my initial consultation with the plastic surgeon and had the good fortune of being referred to Dr. Toni Zhong. She put me immediately at ease and with her warm, personal approach guided me through the various methods that I would be a candidate for…we discussed details of two methods and I appreciated Dr. Zhong's direct approach when discussing each, taking my "wish list" and personality into consideration.

I was leaning toward the DIEP flap procedure, left the consultation by selecting implants but in the end chose the DIEP reconstruction and realized that in order to make such an important and final decision not only requires information but has to be the right decision for you and I had needed time to process the choices and to spend time "visualizing" the results. 

Dr. Zhong did come to see me for the pre-op preparation and once again I was put at ease immediately by her smile and confident personality and did not have any second thoughts regarding my decision… once I woke up in the recovery room she was there and assured my the surgery had gone well & this gave me an immense sense of relief. During my 5 day hospital stay, she visited early mornings and was a breath of fresh air walking in the room and gave me reassurance that all was going well.  My appreciation also goes out to her team who were genuinely interested in my surgery and recovery. Once home from the hospital I only required extra strength Tylenol as most of the initial pain had been substantially reduced by day 7.

Initially Dr. Zhong saw me in her office at weeks two and four post-surgery and once again her attention to detail and positive feedback was reassuring and gave me the confidence that I was healing… in fact I did comment that I had not experienced any "sense of loss" that by using my own tissue did give me a natural feeling and choosing the DIEP flap was the right decision for me. My healing does continue and the tenderness and visible scarring is indeed a reminder that I have undergone major surgery however I do have substantially less anxiety and have an immense sense of relief that this is behind me.  I have the greatest respect and admiration for Dr. Zhong and have no hesitation in recommending her to women going through the process of considering breast reconstruction.  She has consistently offered excellent advice and care and I have benefited from her surgical skill and dedication. 
 

Immediate Two-Stage with Expanders

After requiring a double mastectomy at 43 there was no hesitation on my decision to have immediate reconstruction with the mastectomy. It also meant that I could wake up with a little shape instead of concavities. In addition, wearing a prosthesis was not an acceptable option for me. Due to my very slender body type, my treatment was tissue expansion followed by implants. The first week of recovery was the most challenging mainly due to fatigue. Pain was adequately managed with Tylenol 3 for the first couple of days, after which extra strength Tylenol was all I needed.

Although the pain was surprisingly low and short lived, I was "aware" of the expanders. They were a little uncomfortable and I experienced some achiness along the ribcage but this was manageable. I occasionally needed an extra strength Tylenol and warm compress after a "fill". I was happy with the way I looked in clothes with even the temporary expanders. However, the complete numbness after the mastectomy was a little hard to get used to initially. I did experience one of the risks of expansion. My left expander began to leak after my final "fill". This required a weekly visit to the clinic for fills to maintain shape and space for final implant surgery. Although inconvenient, I had no regrets.

After the final exchange surgery, (for me it was 5 months after my mastectomy) again the pain was surprisingly tolerable with just extra strength Tylenol. I had homecare for the first week, but the drain tubes were out within the week. Heating pads and sleeping pills were instrumental in recovery here too. The implants look and feel more natural and I am very happy with the results. The scars are healing nicely. The final nipple reconstruction, which will be done under local anaesthetic, still need to be done (or not) and I am in no hurry.

It has been 8 weeks since the exchange surgery and I feel fantastic. I am back at work and feeling like life is finally getting back to normal. Life is good.

Thank you Dr. Zhong and the UHN Breast Restoration Program for getting my life back on track.

Immediate Two-Stage with AlloDerm®

I was fortunate enough to hear about AlloDerm® from an acquaintance who had been the first AlloDerm® breast reconstruction patient in Canada. I asked my surgical oncologist about it and he referred me to Dr. Toni Zhong at PMH for a consultation. I was planning on having a double mastectomy and given my young age, I was hoping for the best possible cosmetic result post reconstruction. As it turns out, I didn’t have enough tissue for regular reconstruction and was at risk of the implants extruding. The AlloDerm® was able to provide me with additional tissue for implant coverage so that the final result was better than I had hoped. Because of the limited amount of my own tissue, I still had to have tissue expanders put in and was not able to have one-stage immediate reconstruction using permanent implant. But without the AlloDerm®, reconstruction would not have been possible at all.

For a few days after each expansion my chest felt very tight and sore. I was concerned about the recovery after the expanders were replaced with the cohesive gel implants but I think that was the easiest part and I had very little discomfort afterwards. What I think is really incredible about the Alloderm® is that over time, it takes on characteristics of the tissue where it is placed. It acts as a scaffold to support the implant and becomes vascularized like the surrounding tissue.

I consider myself very lucky to have been able to benefit from this innovative product and most importantly to have received such excellent and personable care from Dr. Zhong.

One-Stage with AlloDerm®

I wouldn’t hesitate to give a testimonial about my breast reconstruction experience at the University Health Network because it was a very good one. I had a relatively new procedure with a silicone breast implant supported by AlloDerm® on the same day and was very impressed with the quick recovery time and the excellent cosmetic results.