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Breast Reconstruction After Mastectomy

After a mastectomy, the last thing you want is yet another major surgery. With our procedure you will not be cut open again.

Welcome to the breast reconstruction page of our site. I am here to help you reclaim what's yours. At the Miami Breast Center we understand that the breast cancer journey is filled with many emotions. This is why we want to ease your mind about your reconstruction decision.

Whether you've had a "simple" or "total" mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, or a subcutaneous (nipple-sparing) mastectomy, or are considering a prophylactic mastectomy, you are probably a good candidate for my breakthrough, minimally invasive breast reconstruction technique.

After a mastectomy, the last thing you want is yet another major surgery. With our BRAVA + AFT (autologous fat transfer) procedure you will not be cut open again. As compared to the traditional methods, this involves no incisions, no new scars, no foreign objects and it recreates a natural feeling breast with the benefit of liposuction.

Plus, you will keep as close to normal sensation in your breasts and nipples.  The procedure is covered by insurance for breast cancer patients. Our technique is explained in detail below. Please also visit the Breast Reconstruction Photo Gallery, Testimonial page and Video pages of the site. You'll have a better idea of how we can help you on your healing journey.

Mastectomy Surgery

Ideally, the procedure begins in the hospital at the time of your breast cancer surgery. Dr. Khouri will join your oncological surgeon in the operating room. Right then and there, he will begin the reconstruction process by removing and then injecting some of your own fat into the breast area, so that you leave the hospital with a slight breast mound.

Note: For those patients who had a mastectomy in the past, the procedure begins with the next step below.

Using BRAVA

The patient will then wear the external expander device called BRAVA, while sleeping, for 3 to 5 weeks prior to the first grafting session. BRAVA is a comfortable soft gel-like bra. See BRAVA page for more details. Not only does BRAVA expand the skin from the outside, it also has the effect of regenerating an edema like breast mound through the expansion of tissues and nerves. BRAVA also increases the blood flow to the mastectomy scar and improves the radiation effect. This does two important things, which are unique to this technique:

1. It creates an adequate vascular matrix into which the liposuctioned fat is later injected.
2. It allows the patient to keep almost normal sensation in her breasts and nipples.

Fat Transfer

These micro-fat grafts are harvested by gentle liposuction from the patient's thighs, buttocks and stomach - wherever there is fat to spare.

Once the patient has worn the BRAVA for a few weeks, the out-patient fat transfer procedure is performed. Fat is removed from one area of the body and meticulously injected back as hundreds of tiny individual droplets at the breast site that has been enlarged by the BRAVA expansion. These micro-fat grafts are harvested by gentle liposuction from the patient's thighs, buttocks and stomach - wherever there is fat to spare.

The transferred fat then survives within this matrix of tissue and the breast mounds are restored 'naturally' over the ensuing three months while the patient receives the benefit of liposuction. This new breast mound feels and looks like the patients' very own but contains no breast tissue - only the transferred fat. Best of all, the mound has sensation, and the nipples we reconstruct look and feel normal.

We are currently able to achieve up to a small B cup natural breast filled with your own fat with only one small outpatient fat grafting procedure. To attain larger breast cup sizes, the fat grafting process usually has to be repeated 2-3 times over a period of 2 - 6 months.

Benefits of Dr. Khouri's Procedure

With Dr. Khouri's micro-fat grafting procedure, the patient is usually up and back to her normal life within 3 days. No morbidity, no foreign material, no cuts or incisions, no new scars, and the patient keeps neear-normal sensation in her breasts. All our patients love the side benefit of body sculpting too.

Issues with Traditional Breast Reconstruction

There are 3 traditional breast reconstruction alternatives. ALL involve major "open" surgery, which means muscle trauma and new scars.

• The implant alternative involves the placement of a foreign object such as silicone or saline under the muscle and leads to an artificial feeling breast mound. Implants are not a permanent solution.
• The tram flap surgery alternative involves taking a piece of muscle and tissue from the back or the abdomen and using it to rebuild a breast mound. The surgery is extensive, it requires major incisions, a prolonged recovery and the result is like patch work and still often requires an implant.
• The DIEP flap procedure also involves a lengthy surgery with the removal of abdominal fat and skin. Though this is some of the best looking results, it is imperative that the procedure be done by a specialist expert who performs lots of these on a routine basis. Otherwise the morbidity, complication and failure rates are very high. And even the best results feel and look like patch work . This procedure also involves a prolonged recovery time.

This innovative procedure is the very first that facilitates reconstruction of an entire breast from fat with no major surgery.

Clinical Trials

Dr. Khouri has done clinical studies to prove the safety and efficacy of his procedure and has presented these studies at all the important medical conferences across the globe including the American Society of Plastic Surgeons Annual Convention. Dr. Khouri has the world's best documented experience on the subject. Dr. Khouri's work was just awarded the best scientific achievement at the Annual Meeting of the European Association of Plastic Surgeons (EURAPS) and he will be delivering his presentation and receiving the award at the Annual Meeting of the American Association of Plastic Surgeons. As a tribute to his contributions to microsurgery (this is how DIEP flaps are done) he will be delivering the Presidential Lecture entitled "Beyond Microsurgery".