If you have undergone a mastectomy, you deserve results from breast reconstruction that look and feel as natural as possible. Our New Orleans and Metairie practices are proud to offer what we consider to be the best method of breast reconstruction currently available: DIEP flap breast reconstruction. Only a small number of plastic surgeons have the skill and experience to successfully perform this advanced technique and Dr. Kamran Khoobehi and his associates are among this group. Breast reconstruction surgery may be done simultaneously with the mastectomy, or staged in separate sessions, known as delayed reconstruction. Implants are generally used to create a full and shapely appearance, but our surgeons are specialized to complete this process using an autologous fat transfer, which creates natural, gorgeous results. All of the options will be discussed early on during the initial consultation.
Things to Consider
The surgical planning for a breast reconstruction typically begins at the same time as the planning for the mastectomy. There are points to consider such as how soon the patient will have the reconstruction and what type of reconstruction technique is best per the surgical case. It will need to be decided whether implants or tissue grafts are used, what type (if any) nipple and areola reconstruction will be used, and other techniques that are specific to the patient’s circumstance. The general goal is to help the patient regain a normal appearance of the breasts as part of the final phase of breast cancer treatment.
DIEP Flap-Autologous Approach
Unlike other flap procedures that involve the transfer of muscle tissue to create a breast mound, DIEP flap breast reconstruction uses only skin and fat transfer in order to shape the new breast. Because muscle tissue is spared in DIEP flap breast reconstruction, the procedure is not as invasive as other methods, and it involves a shorter recovery period. DIEP flap breast reconstruction also gives patients the added benefit of also having a tummy tuck. The DIEP acronym stands for deep inferior epigastric perforator, and it refers to the stomach tissue that is used in the procedure. As Dr. Khoobehi removes this excess abdominal fat and skin for use in reconstructing the breast, the patient’s midsection is contoured and slimmed. Because the patient’s own tissue and fat are being used to create the breast mound instead of the foreign materials that are used in other techniques, the breast reconstructed using the DIEP flap method is softer and more natural-looking.
Breast Reconstruction Reviews
"62 Y.o. With Breast Cancer. Breast Reconstruction Surgery. - Metairie, LA - Previous surgery with Dr. Khoobehi with an excellent outcome.This procedure, bil.PAP flap, was just as beautiful ,with much attention to detail. I would highly recommend him to anyone. His associate, Dr. Walters, was also detail oriented. He also had excellent bedside manner . I was pleased from my first pre op visit to discharge!"- C. / RealSelf / Oct 07, 2015
"I set up consultations with three recommended plastic surgeons. Dr. Walters was the third and before leaving his office that day, I teared up. I'd found the right surgeon. I was having a mastectomy and then radiation and then reconstruction. I had a lot of questions and concerns. He explained my options, the pros and cons of each option, gave his professional opinion, and took into account my concerns. He set me so at ease right away. After the mastectomy, while still in the hospital, the nurses taking care of me all commented on how good everything looked. After the mastectomy, I had radiation and had to wait six months before reconstruction. Friends who have gone through breast augmentations or have had breast reconstruction warned me that reconstruction would be the most painful part of my breast cancer treatment. I was ready for it. But it wasn't. I didn't even feel like I'd had surgery, at all. I even asked him how it could be that I wasn't in pain. Dr. Walters is the best."- A.M. / Doctor.com / Feb 02, 2017
"Caring and Attentive... with the most Beautiful Results! - I set up consultations with three recommended plastic surgeons. Dr. Walters was the third and before leaving his office that day, I teared up. I'd found the right surgeon. I was having a mastectomy and then radiation and then reconstruction. I had a lot of questions and concerns. Dr. Walters took his time explaining my options, the pros and cons of each option. He gave his professional opinion and listened as I discussed my concerns. He set me so at ease right away. After the mastectomy, while still in the hospital, the nurses taking care of me all commented on how great everything looked. Even my oncologist and the radiation technicians mentioned how great everything looked. I wasn't finished yet, but I already felt great. Before we could do the reconstructive surgery, I had to have radiation and that really complicates the surgery. Dr. Walters followed my progress with radiation closely. He has such a calming manner. Even when my skin was burned and looking awful, his confidence that everything was healing well set me at ease. Friends who have gone through breast augmentations or have had breast reconstruction warned me that reconstruction would be the most painful part of my breast cancer treatment. But it wasn't. I didn't even feel like I'd had surgery, at all. I even asked him how it could be that I wasn't in pain. Tiny scars, new beautiful breasts, and no pain. Unreal. Dr. Walters is the best. He's incredibly talented. There are certainly other talented doctors, but my breasts look better now than they did before the mastectomy and throughout this long process, Dr. Walters has given me confidence and peace of mind."- B. / RealSelf / Feb 02, 2017
"Dr. Walters is a highly skilled surgeon with a huge heart. He turned my double mastectomy and reconstruction into a mommy makeover by telling me that I "deserved" to look great. I have never felt this good about my body and I am not even two weeks post surgery yet! He answers text messages quickly, spends a lot of time answering questions during office visits and ensures that his patients are catered to on every level while in the hospital. I will recommend Dr. Walters to anyone I can find needing breast reconstruction. He turned a very difficult, life-changing diagnosis into a positive experience. That is a gift and my husband and I are truly grateful."- H.H. / Facebook / Aug 27, 2016
"Breast Reconstruction - There are not enough superlatives to describe my experience with Dr. Walters. He was completely professional and compassionate to all of my needs. I thank God every day for giving Dr. Walters through this most trying time in my life."- Anonymous / Vitals / Aug 10, 2017
Reconstruction With Implants
Breast implants are a common method used with a reconstruction procedure. When implants are being considered, the reconstruction process is usually performed in a multi-stage treatment session. A tissue expander is placed in between the chest muscle and the skin during the mastectomy. This expander will be gradually filled with a saline solution to expand the skin and eventually replace it with an implant. Sometimes, the saline-filled expander is retained instead of an implant.
When a breast is surgically removed, the nipple and areola are not spared. To recreate this area, skin and muscle tissues are grafted and formed to look like a nipple while the areola is achieved by tattooing. This is done when the breast reconstruction has fully healed.
Breast reconstruction uses general anesthesia, and the patient is often required to stay in a hospital if done simultaneously with the mastectomy. Patients who have flap surgeries sometimes stay up to 5 days for monitoring. There will be discomfort and pain within the first week, and the patient may feel disoriented with the newly formed chest. Temporary drain tubes and bandages are placed to assist in healing. It can be unnerving to go through a major body change; however, patients find it gratifying and relieving that they are able to once again look and feel normal as they start their new journey towards becoming a cancer survivor.
While most cosmetic procedures are not covered by insurance, breast reconstruction as part of cancer treatment is usually covered. The Women’s Health and Cancer Rights Act of 1997 allows the recovering cancer patient to undergo the surgery and apply insurance coverage towards the total cost. It is difficult to place an actual dollar amount towards this surgery as many factors are involved. Our billing and insurance coordinator will work to define the costs and confirm benefits that may apply.
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Breast Reconstruction FAQs
With breast reconstruction, a plastic surgeon will work alongside the cancer surgeon and be primarily involved and responsible as it pertains to restoring the appearance. It is a highly specialized surgery so it is critical to choose a plastic surgeon that has years of successful experiences in this type of surgery.
If a patient knows she will want to restore her breasts with a reconstruction procedure, it is recommended that this process begins at the time as the mastectomy. During the breast removal portion, the tissue expanders can be put into place, which eliminates a new surgery. This ultimately decreases the risk for complications.
During a mastectomy, the breast tissue is removed, severing the nerves that provide feeling to the breast, skin and nipple. Although there is a possibility that sensation can slowly be regained, there is generally a loss of sensation.
However, patients undergoing DIEP flap surgery may be candidates for ReSensation™, a highly advanced nerve repair technique designed to restore sensation after a mastectomy. The technique uses allograft nerve tissue to reconnect the nerves in the flap with those in the chest wall. Over time, this guides regrowth of nerve fibers and can potentially restore sensation to the breast. ReSensation gives breast cancer survivors the opportunity to not only look – but potentially feel – more like themselves again.