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A diagnosis of breast cancer can be overwhelming. VPSI is dedicated to the longitudinal care of our patients, from the time of diagnosis to the surveillance of completed reconstruction. As the highest volume reconstructive microsurgery practice in Las Vegas and the state of Nevada, we offer complete aesthetic restoration after breast cancer surgery and ongoing support post-surgery, including care for patients unsatisfied by a previous, longstanding reconstruction.


Am I a Good Candidate for Reconstruction Surgery?

If you have been diagnosed with breast cancer, and have either had a mastectomy or anticipate a mastectomy, you are qualified for reconstruction. The timing of the reconstruction, along with the specific type of surgery, will vary depending on your needs. We will walk you through the entire process during your initial consultation and give you an individualized recommendation for treatment.

In addition, we often work with patients who have had breast conserving surgery (BCS) like lumpectomy or lumpectomy and radiation, to help them achieve their most aesthetic results. We also work closely with our breast cancer surgery colleagues to offer advanced oncoplastic techniques for the appropriate patient. 

A few considerations:

  • If you are a smoker, you will need to quit smoking before being eligible for certain types of reconstruction.
  • If you are currently going through radiation therapy, you may need to postpone your reconstruction until your radiation treatment ends.
  • Scarring from previous breast procedures can sometimes limit the available types of reconstruction. Our doctors will review the options with you in detail so that you feel confident moving forward.

Meet Our Board-Certified Plastic Surgeons

At VPSI, our surgeons distinguish themselves by their excellent technical skills and artistic eye. Both Dr. Brosious and Dr. Goldman have the versatile experience that allows them to say “yes” to nearly every patient who walks through the door. 

Dr. John Brosious is a full-scope plastic and reconstructive surgeon offering head-to-toe surgeries. His background includes experience in Level I Trauma centers and academic institutions, equipping him to take on the most advanced reconstruction cases. Dr. Brosious performs over 200 chest surgeries a year for both transfeminine and transmasculine patients, and he is also the only surgeon in Nevada performing male to female genital gender affirmation surgery. 

Likewise, Dr. Joshua Goldman is a comprehensive plastic and reconstructive surgeon, well-known in the breast cancer community for his specialization in breast microsurgery. He single-handedly has the highest number of microsurgery cases in the State of Nevada and has been named by Vegas Inc’s Las Vegas Weekly as “Las Vegas 40 Under 40” and a “2021 Top Doctor.” 

To Dr. Brosious and Dr. Goldman, you are family, and they are here to help guide you through your journey to enhance your natural beauty.

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Josh Goldman, MD

John Brosious, MD


Types of Breast Reconstruction

Complete Breast Reconstruction


DIEP Flap Microsurgical Breast Reconstruction

Microsurgical breast reconstruction uses excess skin and fat in the form of flaps to reconstruct the breast. These flaps, also known as DIEP flaps or deep inferior epigastric perforator flaps, are often taken from the abdomen or the buttocks and contain skin, fat, and blood vessels. The flap will be moved to the breast using free tissue transfer techniques, and your doctor will repair the blood vessels and connect them to the internal mammary artery and vein. This autologous reconstruction procedure also involves aesthetic sculpting of the abdomen. 

Implant-Based Reconstruction

If you do not have enough excess skin and fat or do not have much breast tissue to work with, we can perform full breast reconstruction using implants. The implant-based approach is the most common type of breast reconstruction. In this type of reconstruction, your doctor can place breast implants made of either saline or silicone gel over or under the chest muscle. These implants will help restore the shape and volume of your breast or breasts after a mastectomy. This option is a good choice if you have enough tissue to support the implants, want to avoid incisions elsewhere on your body, and wish for a shorter recovery time.

Partial Breast Reconstruction


Oncoplastic Reconstruction

Oncoplastic reconstruction may be a good option if you have not yet had breast tissue removed and wish to optimize your cosmetic outcome during a lumpectomy. With oncoplastic reconstruction, your surgeon will simultaneously remove the cancerous tissue and apply specialized plastic surgery techniques to conserve or reconstruct the breast.

Fat Transfer to the Breasts

Fat transfer can be a viable option if you have had a lumpectomy or a mastectomy and require partial reconstruction. Fat transfer involves excess fatty tissue being harvested elsewhere on your body via liposuction, then injected into the breast area and shaped to form new breast tissue.

“Going Flat” Options

Even if you choose not to move forward with traditional breast reconstruction, you may have options that make going flat more comfortable. Your plastic surgeon may utilize scar revisions, removal of excess skin, or fat grafting to improve your overall comfort or ease the use of prosthetic bras, if desired. 


Breast Reconstruction Procedure Process Explained

While the breast reconstruction process can look different from one patient to the next, there are a few basic steps to expect. 

The Consultation

The first step in breast reconstruction is meeting with your plastic surgeon for a one-on-one consultation. During this appointment, your surgeon will perform a physical examination, review your medical images, ask questions about your cancer treatment, and assess your personal goals for reconstruction. We will use this information to verify your eligibility for surgery and jointly determine which kind of reconstruction is right for you.

How Long Does the Procedure Take?

The length of your procedure can vary depending on the type of reconstruction and whether the surgery is done at the same time as the cancer removal or afterward. The timeframe for the procedure can range from an hour to six hours, but our doctors will take as long as necessary to deliver outstanding results.

What is Surgery Like?

Your surgical journey will begin with your arrival at our hospital surgery center, where our friendly team will meet you. Once you are relaxed and prepped for surgery, you will be placed under anesthesia to ensure comfort. They will begin surgery based on your custom treatment plan and the reconstruction surgery chosen during the initial consultation. Your doctor will take special care to minimize visible scarring, and, in some cases, they may make incisions using previous incision sites from your cancer surgery. 

At VPSI, we use a nerve repair technique called Resensation® to potentially restore feeling in your breasts and nipples after a mastectomy. Our practice partners with Axogen to offer this new breast neurotization method so that you can look and feel like your old self again.

After our doctors have finalized your reconstructed breasts, you will be in a recovery room for two to three hours to ensure that the anesthesia wears off properly. We will move you to a regular room for further observation until you can safely go home. At this point, you are one step closer to natural-looking, beautiful breasts. VPSI partners with our anesthesiologists for enhanced recovery protocols to minimize post-operative pain and get you back to baseline as soon as possible.

What Kind of Recovery Process Can I Expect?

Recovery from surgery can take up to two or three weeks, and you may experience some swelling, weakness, and discomfort. By allowing your body plenty of time to rest and avoiding any vigorous physical activity, you can regain strength day by day and resume most of your normal activities within a couple of weeks.

Pain medication will be available to manage physical discomfort, and we will provide compression garments to reduce swelling and promote proper healing. Before discharge, you will receive guidelines concerning diet, bathing, caring for incisions, and follow-ups. By carefully following these recommendations, you can minimize the visibility of your scarring and promote optimal results.

Our team will provide you with access to longitudinal breast cancer care and resources to aid your healing and recovery process.  


Want To Know About Pricing?


Frequently Asked Questions

Some patients who have radiation therapy can have successful implant-based reconstruction. However, having radiation before implants may heighten your risk of certain implant-related complications. Talk to your surgeon about whether implant-based breast reconstruction is a safe option for you. In some cases, we may recommend fat grafting, pedicled, or free tissue transfer to minimize the risk of complications and offer you the best outcome.

In some cases, nipple-sparing procedures are an option. When that is not the case, advances in reconstructive surgery have made it possible to create nipples and areolas that are realistic and natural-looking. Your new nipples will match each other and have shading to add contrast and enhance your appearance. At VPSI, our surgeons specialize in creating harmony between your breasts and the rest of your body.

Breast reconstruction does not have to be performed immediately after breast cancer surgery, and you may choose to wait several months or even years. It all depends on where you are on your breast cancer journey. Whether you decide on immediate or delayed reconstruction, multiple surgical options are available. These include breast reconstruction with fat grafting, skin flaps, implants, or fat grafting with implants.

Immediate reconstruction is done simultaneously as the mastectomy, while delayed reconstruction comes months or even years later. There are options available no matter which type of reconstruction you choose.

The risks of breast reconstruction are minimal when you choose an experienced and highly trained surgeon. Our doctors have performed hundreds of microsurgical procedures in Nevada and have years of experience performing all types of breast reconstruction. They dedicate their lives to putting the safety and well-being of patients first.

While coverage can vary from one insurance policy to the next, insurance plans provide immediate or delayed breast reconstruction coverage and ongoing care coverage. Our office can help you navigate questions related to insurance or financing.


You’re In Good Hands With VPSI

Vegas Plastic Surgery Institute is a full-scope plastic and reconstructive surgery practice, offering both head-to-toe reconstruction and cosmetic surgery. Our doctors and team abide by uncompromising standards to provide you with a high level of care and a positive experience in a judgment-free zone. Schedule a consultation at our Las Vegas office today at (702) 727-8500.