Connect

A patient-driven collaboration brought together several UVA Health team members — from UVA Community Health in Northern Virginia, to University Medical Center in Charlottesville — for a critical cause. Amazingly, it all happened in less than a month — and now, the innovative, nerve-sparing mastectomy is available to patients at two UVA Health locations. 

New Opportunities

“This is exactly the kind of collaboration we want to build across UVA Health,” explains Allan Tsung, MD, surgical oncologist and Chair, Department of Surgery UVA Health University Medical Center; and S. Hurt Watts Professor of Surgery, UVA School of Medicine. “We have talented teams and innovative ideas throughout the system, and when people come together across specialties, sites, and disciplines — it creates new opportunities for patients.” 

He adds, “What makes this especially exciting is seeing surgeons, operating room teams, administrative leaders, and staff all collaborate to make this happen so quickly and seamlessly. We’re learning from one another and building a more connected system in the process.”  

‘Collaborative, Thoughtful Plan’ 

The initiative began when a patient inquired about the nerve-sparing procedure. The patient’s surgical team — surgical oncologist, and breast disease and melanoma expert Lynn Dengel, MD, MSc, FACS; and Scott Hollenbeck, MD, FACS, internationally recognized plastic surgeon specializing in breast reconstruction after cancer treatment and Chair, UVA Health Department of Plastic and Maxillofacial Surgery — worked with Ian Greenwalt, MD, to form what’s described as “a collaborative, thoughtful plan” to bring this service to Charlottesville for the patient. 

In 2024, Dr. Greenwalt, a fellowship-trained breast surgical oncologist, joined UVA Community Health at Prince William Medical Center in Manassas, Virginia and Haymarket Medical Center. He brought an extensive background in breast cancer care including advanced surgical techniques such as nerve-sparing mastectomy, which aims to improve post-operative function by allowing breast cancer patients to regain some or all sensation to the breast following mastectomy. 

“Since my start at UVA Health, there has been a consistent effort to collaborate and share expertise among the different breast cancer specialists and reconstructive surgeons regardless of whether we practice in Charlottesville or Northern Virginia,” Dr. Greenwalt shares. “This is a credit to the leadership of Dr. Tsung and Dr. Hollenbeck, as well as the collaborative nature of Dr. Dengel and the multidisciplinary breast cancer specialists at UVA Health. It is a wonderful example of how shared expertise can benefit patients and colleagues directly!” 

On April 24, Dr. Greenwalt traveled to Charlottesville to present the novel surgical technique to Drs. Dengel and Hollenbeck. 

‘The Patient Asked and We Responded’ 

 “This was truly a patient-driven advancement,” describes Dr. Dengel, who also serves as the lead investigator in multiple studies investigating patient decision-making.  “I’m incredibly grateful to the patient who took the initiative to seek a nerve-sparing mastectomy for potential benefits to quality of life. The patient’s persistence helped spark both innovation and collaboration within our team. The patient asked and we responded.” 

"At UVA Health, we’re fortunate to be able to draw on deep expertise across specialties, and that kind of teamwork is what allows us to keep improving care for our patients. I’m especially thankful to Dr. Greenwalt for his leadership in moving this work forward,” adds Dr. Dengel, Associate Professor of Surgical Oncology, UVA School of Medicine, who also serves as a committee member of the Society of Surgical Oncology and of the American Society of Breast Surgeons.  

Rapid Evolution

“Reconstructive techniques for breast cancer patients are evolving rapidly, and our multidisciplinary team at UVA Health is leading the way in many of these approaches,” explains Dr. Hollenbeck. “Restoring feeling to the breast area after mastectomy is possible with advanced techniques in nerve preservation and reconstruction. This is something I discussed with Dr. Greenwalt when we recruited him to UVA Health several years ago. I knew he was interested in this and had experience with this approach. Still, it wasn’t until Dr. Dengel and I had a patient who asked us to consider nerve reconstruction that we decided to reach out to Dr. Greenwalt and formally start our program at UVA Health.”    

Now, the surgery is available at UVA Health Haymarket Medical Center and University Medical Center in Charlottesville. 

One UVA Health Team 

Of course, the work isn’t limited to the operating room. Other UVA Health team members rallied behind-the-scenes to make the collaboration — and the resulting procedure — possible. 

Privileging is defined as the formal process of authorizing a licensed healthcare practitioner such as a physician, nurse practitioner, or physician assistant to perform certain clinical services, procedures, or treatments at a particular facility. 

“It’s also encouraging to see the coordination around privileging, and I appreciate the work Mary Frances Southerland, JD, MBA, UVA Health Chief Administrative Officer, has been doing to help streamline, standardize, and make that process more efficient,” adds Dr. Tsung.  

“All credit goes to our incredible teams at the medical staff offices that serve UVA Health,” says Southerland. “Creating efficiencies in our credentialing and privileging processes is ultimately about serving our patients and creating streamlined access to our world-class physicians."

What’s Ahead? 

“The breast reconstruction program continues to grow across all UVA Health sites with expert, trained plastic surgeons seeing patients in Charlottsville, Haymarket, Prince William, Culpeper, and a variety of other sites,” says Dr. Hollenbeck.