PRMA reached a new milestone at the end of December 2022 – we officially completed our 11,000th flap-based breast reconstruction procedure. This accomplishment distinguishes PRMA as one of the busiest breast centers in the world and is a testament to our team’s dedication to rebuilding lives after breast cancer.

“The completion of the 11,000th DIEP flap represents a remarkable achievement for PRMA. Behind this number are real patients who need our help. Each DIEP flap breast reconstruction requires a large team of individuals, consisting of PRMA, nurses, schedulers, support, staff, physician assistants, hospital, nurses, and scrub techs, along with the PRMA physicians,” shares Dr. Steven Pisano. “As one of the co-founders of PRMA, I am especially proud of this accomplishment. It brings together 28 years of PRMA collective experience. I am humbled by the sheer number of people who require our help, and I am grateful for the opportunity to serve our patients with breast–related diseases.”

PRMA Plastic Surgery provides patients with the full spectrum of modern reconstruction options available today, including autologous reconstruction, implants, and aesthetic flat closure options. PRMA specializes in complex perforator flap procedures which use skin and fat from various regions of the body to produce a warm, soft, “natural” breast.

The DIEP flap is the “gold standard” breast reconstruction performed at PRMA. This procedure uses the patient’s own abdominal skin and fat to reconstruct a “natural” breast. Unlike the TRAM flap, the DIEP flap preserves all the abdominal muscles. Patients who have their abdominal muscles spared experience less discomfort, faster recovery, preserve long-term core strength, and have decreased risk of abdominal problems.

Reconstructive breast surgery has progressed tremendously over the last year. In the past, surgeons have focused solely on how the breast looks, rather than how it feels to the patient. Following total mastectomy, it is extremely common for patients to experience numbness after a mastectomy, often total, or altered sensations. Now, PRMA surgeons strive to reconnect the nerve endings after mastectomy, helping to restore as much feeling as possible. This nerve reconstruction can be performed directly  TruSense℠. or using a nerve graft Resensation®.

Sensory nerve reconstruction performed directly without the need for a nerve graft is called TruSense℠.  TruSense℠ is possible when patients use their own tissue for the reconstruction (i.e. a “flap”). A nerve is included in the flap and is connected directly to a cut nerve in the mastectomy site.

Following mastectomy, often the nerves do not show sufficient length to be connected directly and a nerve graft is required to bridge the gap. Sensory nerve reconstruction using a nerve graft is called Resensation®.  Cadaveric nerve grafts are prepackaged and Resensation® can be performed with any type of reconstruction, flap, or implant.  PRMA surgeons use the Avance® nerve graft developed by Axogen when a graft is needed. Both types of nerve reconstruction following mastectomy are performed by suturing two nerve endings together using microsurgery and therefore require specialized training.

While these procedures do not usually restore the same level of breast sensation as Mother Nature provided before the mastectomy, patients undergoing TruSense℠ or Resensation® routinely experience a significantly greater return of feeling compared with those who do not have a nerve reconstruction as part of their breast reconstruction procedure.

“What an honor and privilege it has been to be part of this wonderful team! Helping women in their battle with breast cancer is what we were made to do,” shares Dr. Peter Ledoux. “Watching our patients come through this process whole and happy is extremely rewarding and fulfilling! We thank the Lord for allowing us to be part of His Reconstruction team!”

There is no “best” breast reconstruction procedure for everyone. Before undergoing any type of surgery, it is important to discuss all your opinions with a board-certified plastic surgeon to ensure you make a fully educated decision.

“Completing 11,000 breast reconstruction procedures with patients’ own tissue is an amazing accomplishment! Just thinking about how many patients we have impacted and how many families have benefited from the procedure makes me so happy,” says Dr. Chet Nastala, who joined PRMA in 2002. “We feel that sensation can be better than implants and overall satisfaction can be better in patients who are good candidates.  We couldn’t have accomplished this without our team of dedicated nurses, physician assistants, and those who work in the office as well.”