By Lydia Caplan Blank | Photograph by Michael Fornataro

When Dr. Jim O’Toole chose plastic surgery as his specialty, he knew it was a profession where he would enjoy technical problem-solving and using his artistic skills to repair and reshape the human form. But he never imagined how impactful one particular patient population would be on his career and life.

While working as the plastic surgery chief resident at Long Island Plastic Surgical Group, PC in New York, Dr. O’Toole was meeting with a patient who had just undergone a bilateral mastectomy. “From a surgeon’s perspective, it was a victory. We successfully removed the cancer,” he says. “But when I went to see her in the clinic, she was sobbing. I asked her what was wrong. She looked down at her standard, conventional mastectomy scar and said, ‘I look like a 14-year-old boy who was attacked by a lion.’ When you are involved with a surgery that leaves a woman feeling that way, what do you say?”

The conversation inspired Dr. O’Toole to look into standard mastectomy incisions. His research revealed they had not changed in years. “In training, I was told that if you can recreate shape and form for the breast, then you’ve done your job,” he explains. “But I realized that wasn’t enough. I also realized that the same scar pattern was used regardless of breast or body type for breast cancer operations, and that these same incisions would never be used in cosmetic breast surgeries. There are 20 to 30 different incision patterns that we use for cosmetic breast lift and reduction surgeries that are used to make the scars less visible. I wondered why we didn’t use them for breast cancer patients.”

That concern became fuel for his new approach. In 2005, Dr. O’Toole, now practicing in Pittsburgh, began applying cosmetic surgery techniques to breast cancer procedures, an innovation in the industry at that time. He says he immediately noticed a significantly positive effect. “Patients have told me, ‘I didn’t expect to look like myself after surgery,’ or ‘I love that I never have to wear disguising clothing or feel self-conscious again,’” O’Toole says. “When you operate on the female breast, you’re dealing with how women identify their sexuality, sensuality, and femininity. To not take those feelings into account is unacceptable in my opinion.”

Operating on and then supporting patients through medical procedures is one thing. Watching how they flourish after treatment is something special to behold. To Dr. O’Toole, his patients’ happiness and recovery means everything to him. “I’m close with my patients and love to hear how they are enjoying life after cancer. I’m still a clinician, but I’m here to help them through everything,” he says. “And I love seeing what they’ll do next once their treatment is complete.”

While there are countless patients who have inspired Dr. O’Toole over the years, one patient population that has been particularly compelling are those who are genetically susceptible to the development of breast cancer. Generally speaking, these patients tend to be younger and in a more dynamic phase of their life. “Knowing I can help these cancer survivors and ‘pre-vivors’ — those who have not yet developed cancer, but voluntarily choose to have their breasts removed because of a genetic predisposition — continue to lead productive, full lives while looking and feeling their absolute best is the most rewarding part of my career,” says O’Toole.

A few years ago, a patient of Dr. O’Toole’s told him about an organization called Facing Our Risk of Cancer Empowered (FORCE). He had never heard of it before, but when he discovered details about its mission and values, he knew he had to become more involved. FORCE is a national nonprofit organization with 50 local outreach groups across the U.S., including Pittsburgh. Through research, support, and education, the organization strives to improve the lives of individuals and families affected by hereditary breast, ovarian, and other related cancers. The match between FORCE’s mission and Dr. O’Toole’s passion for his patients’ well-being was ignited.

Dr. O’Toole’s first step was to contribute to FORCE financially. But he didn’t stop there. While O’Toole Plastic Surgery is currently a sponsor of the Post Mastectomy Photo Gallery on FORCE’s national website, and is also a sponsor of the Pittsburgh chapter’s website, too, Dr. O’Toole himself was selected to participate as a speaker at the 10th annual Joining FORCEs conference in Orlando this past June. The weekend-long event attracted more than 600 people from around the world who have been touched by hereditary cancers in some way.

At the conference, Dr. O’Toole joined a panel of nationally recognized breast cancer experts to present information on various techniques for breast reconstruction following mastectomy. Dr. O’Toole discussed details of his progressive fat-grafting techniques, a newer procedure that he uses for many breast reconstruction revision patients. Unlike other more complex surgeries, this 30-minute, outpatient procedure helps to improve skin quality on the breast. It also improves or eliminates contour deformities and irregularities, as a result of multiple surgeries or radiation.

“Essentially, we take the fat from stubborn problem areas on the body and inject it into the breast,” he says. “It’s a quick procedure that requires a very tiny needle. Aside from the amazing results, the best part is that we can remove fat from somewhere you don’t want it and put it somewhere you do!”

In addition to speaking at the conference, Dr. O’Toole also contributed to the FORCE scholarship fund, a source of financial aid to those who may not otherwise be able to afford to attend. This year, 100 individuals were able to attend the conference with the help of the $59,000 that was raised.

Sue Friedman, executive director and founder of FORCE, says the informative conference empowers attendees and reassures them that viable options are available. “Choosing whether or not to have reconstruction after a mastectomy and deciding on the type of reconstruction is very personal and can be challenging,” Friedman says. “Each procedure has advantages and disadvantages, and no one type of reconstruction is perfect for everyone. The most important actions a woman considering reconstruction can take is to learn about her options, decide which is best for her, then consult with and choose a surgeon who is experienced and an expert in the technique she prefers.”

Presenting at the conference was “an incredible experience” for O’Toole. “It felt really good to talk to so many people who have been searching for the right approach to address their specific medical concerns and offer them options. I was honored to join a panel of such respected experts in the field as well.”

Facing Our Risk Of Cancer Empowered (FORCE), 866.288.7475. O’Toole Plastic Surgery, 5830 Ellsworth Ave., Suite 300, Shadyside. 412.345.1615.

+ The 11th annual Joining FORCEs conference will be held October 18-20, 2018, in San Diego. Dr. O’Toole has already been invited to speak there again and is looking forward to making the trip!

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