Dr. Khouri Explains Mastectomy Reconstruction Procedure

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If you have; if you're contemplating mastectomy, whether it's prophylactic (because you're at high risk) or whether you've just been diagnosed with cancer, we can restore your breast back. We can give you back breasts that feel just like your own, without any new incision. They will grow back in place, they will feeling; sensation. We'll put a nipple there that will feel pretty much close to your original nipple, with the benefits of doing some liposuction and improving your entire body contour. And a small procedure. Small surgery. Small risk. We're not doing big operations to have big risks. The only drawback is, you know, we can't make it grow overnight. It takes a few months to grow that breast back.

Ideally, we would love to be there at the time of your mastectomy, because when the general surgeon, the cancer surgeon, takes the breast, he leaves behind the muscle. And we can lay down fat inside this muscle, which is a very good soil and very good recipient, so that you can wake up from the mastectomy with already some fullness in the muscle. It won't be concave. It's not a real breast, but there's something you can start with, and within two, three months, we can give you back small breasts that would be your own. No new cutting. No scar anywhere else. A little more liposuction, and all of it's outpatient. Now, if you already had a mastectomy and have had no reconstruction, it's a straight-forward thing. We stretch that mastectomy scar.

We actually create a little edema breast. It's just full of water; edema. But the fibrous network is there. It doesn't; it lacks the cells. Through liposuction, we harvest the cells and put it in there, so that within one or two procedures, sometimes three, we can give you back a breast that feels just like your own. It looks like your own, grown back inside you. I used to do flaps. I've done hundreds of flaps. It was known as a flap expert. You take a big block of tissue with the arterial vein and you reconstruct it. That whole network that you transfer here was a big operation. We've bypassed this. I create that network. I create the vessels and the fibrous and the stretchy skin and I take the cells with the needle and syringe and re-inject them there. So, we grow back a breast at the mastectomy defect site. My whole career as a plastic surgeon, 25 years spent doing microvascular free flap. Back in the early '90s, I had the world's largest experience with bilateral: doing two free flaps at the same time for bilateral mastectomies.

It's a big operation. Results are OK. But big operation means big risks, even in the best hands. I think with this procedure we have better results, less surgery, less chance of complications. And, truly, you are restoring a breast. It is no longer a reconstruction. It is a restoration of a breast. We grow back a breast inside you. What's lost is regenerated you inside by stretching a scaffold, stretching the envelope, and filling it back with liposuction fat. It's getting back what you've lost, and getting it truly back, not as a patch or a foreign material. It's truly regenerating what's been lost.

Having it back with feeling, with sensation, bouncy, and matching the other side. If you have lost both, getting them both. Young again! You get new ones. The deformities associated with previous reconstruction, we can correct. I see a lot of women who have had either previous; either the flap, were not looking very good, or, more commonly, implants that were just not right. And we can correct that. We can sometimes save the implants and do some fat around it, or, more often, just remove the implant altogether and re; start back from scratch and give them back a nice, healthy, nice-looking, fatty breast. The procedure to reconstruct the breast after mastectomy typically would take two, three, sometimes four or five, if the breast is radiated. But this is no different than the time or the number of procedures that it takes to reconstruct the breast if you use an expander and an implant.

And the beauty here is, once you're done, you're done. You don't have to worry about the implant rupturing or scarring or contracting or extruding, etcetera. So, it is really, in terms of time frame, and in terms of number of procedures, it is no different. The advantages are: lower morbidity, no foreign body, no scarring, and, by far, a much better result. You get a sensate breast that's your own, as compared to that of an implant or a patch taken from anywhere else on the body.