In 2009, Melanie Young was diagnosed with stage 2 breast cancer, estrogen-positive, HER2-negative. Following her double mastectomy, she underwent several months of chemotherapy and then immunotherapy. After genetic testing confirmed she was BRCA2 positive, Melanie chose to undergo a salpingo oophorectomy to remove her Fallopian tubes and ovaries. Initially, Melanie chose implants for her reconstruction, but developed complications in subsequent stages, including mobility issues and capsular contraction. In 2025, she came to the Center for Restorative Breast Surgery to have her implants removed and underwent DIEP Flap surgery to restore her breast using her natural tissue. Melanie says the results have exceeded her expectations, and she no longer experiences discomfort and mobility issues. Melanie continues to advocate for women with breast cancer and is the author of the award-winning navigational book, “Getting Things Off My Chest: A Survivor’s Guide To Staying Fearless & Fabulous in the Face of Breast Cancer” (available on Amazon). Follow @melaniefabulous.

Dr. Christopher Trahan is part of a world-renowned team pioneering revolutionary breast reconstruction techniques at the St. Charles Surgical Hospital and Center for Restorative Breast Surgery.

The Center for Restorative Breast Surgery, founded in 2003 and co-located with St. Charles Surgical Hospital in New Orleans, Louisiana, is the only hospital in the world dedicated exclusively to natural tissue breast reconstruction. The center offers more breast reconstruction options than any other facility in the world. More than 70% of patients travel from out of state or internationally to receive care here. The center specializes in immediate, delayed, and revisional natural tissue breast reconstruction, including DIEP flap, SGAP flap, APEX technique, stacked flap, and complex modular reconstructions for patients who have been told they are not candidates elsewhere.

In this episode of Restore and Reclaim, host Melanie Young — a breast cancer survivor, author, and former patient at the Center for Restorative Breast Surgery — sits down with Dr. Christopher Trahan, a double board-certified microvascular reconstructive surgeon at the Center for Restorative Breast Surgery and St. Charles Surgical Hospital in New Orleans. Dr. Trahan’s path to the specialty began unexpectedly, growing out of a residency in head and neck surgery where he found himself drawn less to removing tumors than to rebuilding what came after. That fascination with reconstruction, combined with an aptitude for microsurgery, led him into natural tissue breast restoration, a field he describes as deeply personal rather than purely technical.

Much of the conversation focuses on demystifying a specialty Trahan says has “no true standards.” He explains that implants remain the most common choice largely because they’re the easiest to offer, even though relatively few women are ideal candidates. He pushes back on the idea that natural tissue reconstruction depends simply on how much fat a patient has to spare, describing it instead as a detailed volumetric and geometric process that accounts for skin thickness, chest wall shape, and projection. He also addresses common misconceptions around age and body type, sharing an example of an 83-year-old patient who underwent successful flap surgery and was back to walking the mall within days.

Trahan and Young also walk through the range of procedures available, including DIEP flap, stacked flap for single-breast reconstruction, and revision surgery for women unhappy with prior implants, and clarify the distinction between immediate, delayed, and revisional reconstruction. They discuss what patients often don’t expect: that natural tissue reconstruction can restore not just shape but sensation, as nerves and lymphatics reconnect over time, along with the softness and mobility many implant patients never experience.

The episode closes on the emotional dimensions of recovery, including intimacy, returning to normal family life, and the importance of patients feeling heard rather than just treated. Trahan emphasizes that the practice’s philosophy is to treat the patient, not just the condition, and to help women feel confident, whole, and unapologetic about wanting to look and feel good again after cancer.

Melanie Young (00:00):
Welcome to Restore and Reclaim, a podcast dedicated to the journey of women navigating breast cancer, reconstruction, and the road back to feeling whole and part of a whole life again. I’m your host, Melanie Young, and I am a breast cancer survivor. I am committed to helping women like you make informed, confident choices about their treatment, reconstruction options, and finding a way to live whole and happy again forever. We’re here today with Dr. Christopher Trahan. He is a microvascular reconstructive surgeon, double board certified, who is part of the world renowned team here at the Center for Restorative Breast Surgery in St. Charles Surgical Hospital located in New Orleans. This is the only hospital of its kind dedicated to natural tissue reconstruction. Its clients and patients come from all over the world, not just Louisiana where we are here. And there is another clinic in Dallas. 70% of the patients in fact are from out of state and even around the world.

(01:14):
I can speak from experience because I have been a patient here and I’m so happy with my results. So we’re here today with Dr. Christopher Trahan. First, let me share a little background on Dr. Trahan. He graduated cumulaude from Louisiana State University in Baton Rouge. He received his medical degree from LSU Medical School in New Orleans and interned at his general surgery and residency in otolaryngology, which is kind of interesting. That’s head and neck surgery, both at LSU Health Sciences Center followed by plastic and reconstructive surgery at the University of Nebraska Medical Center. Now that’s interesting combination. He’s been named one of the best doctors in the United States and he specializes in natural tissue breast reconstruction, which is the specialty of this world-renowned hospital and clinic, the Center for Restorative Breast Surgery and the St. Charles Surgical Hospital here in New Orleans. Welcome.

Christopher Trahan, MD (02:16):
Thank you.

Melanie Young (02:17):
As I noted, you are double board certified and you come originally from head and neck and otolaryngology and then into reconstructive surgery with natural tissue restoration being your specialty. Talk to me about that road in your decision to find a discipline in this very demanding specialization.

Christopher Trahan, MD (02:42):
Well, that’s a great question, Melanie. And by the way, thank you for doing this. This is an invaluable service to women who are seeking options when they’re at their most vulnerable. So we appreciate your voice. So that’s a great question. And the long and the short answer is that the specialty found me. So when I was in my head and neck surgery residency, we did a lot of removal. We did a lot of these complicated tumor and rare tumor removals from the head and neck skull base. And these are very intricate removals. They’re around a lot of important structures and it created these,

(03:29):
While the removal process was extremely involved, it left an enormous issue both functionally and aesthetically. I became far more fascinated with how we put people back together than taking them apart. And that’s the part that resonated with me. And the head and neck is extremely complicated and it takes a long time to master that anatomy, but you are still using same principles of not only your reconstructive tools, but also to just be able to fill a space is different from being able to not only fill the space but apply artistic aptitude to it. And I began doing microsurgery when I was in my first residency and did quite a bit of it and felt that I had an aptitude and I really was fascinated with the technical complexity and the demands of it and how you could apply it to other areas of the body.

(04:43):
And when it ultimately came down to gravitating towards the specialty, the people that trained me felt that I had a knack for it. And I resonated and I guess felt way more comfortable with the breast cancer patients than any other group and it just clicked. And once you start attaching names to these procedures that we do and their situations and the challenge and successes of improving their lives, then it’s not just about the procedure, it’s about the people. And that’s what makes us passionate is dealing with the people.

Melanie Young (05:22):
Well, as we stated, this is a very specialized breast clinic and hospital, natural tissue reconstruction, which many women are not even presented with that option when they’re facing a mastectomy. Would you explain it just in simple terms for our viewers and listeners who may be weighing the options or may not haven’t even been presented with an option that they could even come here to New Orleans if it’s not an option where they live? Correct. How is it different from other kinds of reconstruction?

Christopher Trahan, MD (05:56):
So this specialty is very unique from many aspects. And the fundamental thing that people have to understand when either A, faced with a diagnosis or B, having had prior reconstruction and unhappy with the outcome is that this is one of the specialties of medicine, even in this day and age where there are literally no standards. Meaning you can just Google breast reconstruction and if you look at the images, it looks like they’re from different planets. And it makes you a little uneasy because at the end of the day, because this is super specialized, people are only going to offer with a diagnosis you’re vulnerable. And most importantly for this aspect, you’re easy to steer. And the fear part is really something that can overcome people if you don’t have this understanding going into it and don’t understand what the questions to ask are. Because if I don’t have that tool in my bag, I’m not really going to offer it to you.

(07:18):
I’m going to steer you away from it. So people get caught up in it and the fear gets them to have a incision that maybe that doesn’t fit them or a type of reconstruction that is not best for them. So implants are by far the most common,

(07:39):
But they’re the most common because they’re the easiest. And of all the women that get implants, there are very, very few that are actually ideal implant candidates, which ends up resulting in a lot of them coming here. So it’s honestly using… I feel that we’re at a spot in this practice, in this group where we can look at someone from an individual standpoint through that lens and find not only the procedure that fits them the best, but design that procedure to fit them specifically.

Melanie Young (08:23):
I think this is a really great point. Most women do not know what to ask and are not fully prepared and they’re bombarded with their friend so – and-so says go here and their aunt, whoever did this. And that happened to me. It’s completely overwhelming. When you meet with… Well, first of all, how should a patient prepare for her first consult with you or one of your team members, part one? And two, what kind of questions do you ask to assess how they are in terms of the best candidate for a certain type of procedure?

Christopher Trahan, MD (09:03):
And that’s the part that honestly tethers us to this specialty is because when people come to us at that point in the game, wherever it is, whether it’s with a diagnosis or after finishing new adjuvant chemotherapy or with an implant for four or five years or flat, wherever they come from, by the time they get to us, they’ve been through a lot of other things and weighed the options and made that decision. So I think the best thing about this whole entire and the way this practice is run and organized is that we want people just to show up and we’ll handle the rest. So they come with a lot of anxiety. They’re traveling away from home often and we want them to feel at home from the work go. So I tell my patients, I don’t care if you have a thousand questions, I’ll sit here and answer all of them because at the end of the day, I don’t want you to feel like a passenger in this.

(10:09):
I want you to feel like an active participant, like we’re on the same team. And so from that standpoint, I really study their individual stories because there’s so much nuance. Everybody, every single patient over 20 years of doing this is unique in their own right.

(10:31):
And the bottom line is the goal is to see their issue through their eyes first. And once you see it through their eyes, you can understand how it impacts their life, what they’re looking for and what they would define as quality of life improvement. And to be able to deliver to them something that they came for, which is a personalized approach to it, a procedure that fits them, not coming out of a cookie cutter textbook, but it’s designed to their body to fit them like a glove. That’s when we combine either the gold standard M mastectomy and the gold standard, not only the reconstructive planning, but it’s execution and follow-up care, then they have a permanent result that improves the quality of their life.

Melanie Young (11:30):
I’m wondering, Dr. Tran, are there certain women who are better candidates for certain types of surgeries than others? I’m going to give just basic examples and maybe you could illustrate without naming names a case. Age. Obviously as you get older, your skin thins out. Ethnicity, body fat. Are they too muscular? Are they not muscular? I know speaking from personal experience, when the very smidgen of the idea of natural tissue reconstruction was presented to me as an option, I was told I didn’t really have a lot of fat. So talk to us about that.

Christopher Trahan, MD (12:12):
So I’ll address the first one because it’s very interesting. Age. So I tell my patients that aging and gravity are undefeated. So I had a particular case not too long ago, lady was 83 years old and had implants many years prior. And unfortunately the aging process and the thinning of the skin ultimately led to an impending exposure of that implant. And she was very active and very sharp and understood that this is not how she wanted to live,

(13:01):
Which was most places would’ve removed it and gone flat. She had bilateral gluteal flaps and at 83 years old, she was out of the hospital in two days and was late for her appointment, follow-up appointment because she was walking the malls. So every situation has an avenue to improve and restore quality of life completely. But age is a number, it’s a situation, and that was sort of one that we had to address in an urgent manner and it worked out great and she recovered uneventfully. All the technical modifications that we have done over the years have been done so to be more gentle on the body. And she’s one of the cases that proves that. So that was a great example of that. So as far as other, we see every single body type, it’s rare for someone to come with no incisions or prior surgery.

(14:19):
I think one of the most common things that people who consult for tissue before they come here is they get told, “Oh, I don’t have enough tissue. I don’t have this. ” And so that’s a pretty big misconception. It’s not so much, “Oh, how much tissue can you grab?” This is a geometry equation. I mean, this is really detailed volumetric analysis that takes into account their skin thickness, their chest wall narrowness, their chest wall morphology, bony prominences, surface area, projection. So it’s way more nuanced than how much fat you can grab. And many of these places that they come from, I like to call them one trick ponies. It’s either the DIP or bust. And so we look at it through a more nuanced lens and that’s okay, would we rather overextend or really push an abdominal harvest to meet these needs and create a problem in the donor site?

(15:30):
Or do we have other tools in the bag to look at this through that fit them better? And even in the most athletic bodies, the design modifications over time of the gluteal flap have really allowed us to balance that with really aesthetic techniques to put the donor site in areas where that actually improved the donor site. We don’t look at it, hey, we subtract here to add there. We want to add to both. So that’s how the design process starts.

Melanie Young (16:07):
So it’s very customized. It’s interesting. As you said, deep flap is very common and that’s where the tie fat come from the lower belly area. That was the one presented to me at the time I didn’t have enough. But you can also take, I think on this website there’s 10 different procedures. Correct. It’s amazing. I went through every single one of them and looked at the amazing photos and the results, which I encourage anyone to do if you’re considering coming to this center. It’s really helpful. Very good Q&A. You can also take from the buttocks area, the lateral area, just about anywhere. Can you take a little bit from everywhere or do you tend to, during your surgery, concentrate on one area?

Christopher Trahan, MD (16:50):
And it depends. And so one of the things I want to say is that most people, even if they hear of a DIEP procedure, what’s your natural instinct is to go Google it. Well,

Melanie Young (17:07):
What does it mean?

Christopher Trahan, MD (17:08):
Well, DIP stands for deep inferior epigastric artery perforator flap. But what I would tell you is that if you Google it and look at the results, you don’t see any consistency amongst the results. It’s dependent upon mastectomy or whether mastectomy incisions. And so the collaboration between the breast surgeon and the microsurgeon is imperative

(17:37):
To fit that whether they have ptosis, whether there’s nipple preservation. But to be clear, I think it’s way more important to research the name of the surgeon doing it than the name of the procedure. Because experience in this, it’s so nuanced and technically demanding that experience and wisdom matter in terms of being able to meet your individual needs. As far as other procedures, the technique that involves all of them is perforator flap surgery, which is, as its name somewhat implies, is that it’s muscle sparing. Very important. So the perforator flap techniques can be applied everywhere. So these are the same… I don’t like to look at them as individual procedures. I like to look at them as these are techniques that are applied to areas of the body where we can aesthetically exchange fat.

(18:45):
So in other words, if we could improve the gluteal aesthetic or the tummy aesthetic or the torso aesthetic by removing tissue, we try to make a flap out of it. And that’s the mindset that goes forward in terms of giving people the best shape and balance to give them the best outcome. And I think that’s another way you understand that there’s no true standard in this specialty is that you ask different surgeons what they consider a successful outcome and you’ll get results that are all over the place or answers that are all over the place. And so I think the fundamental things that define a good outcome are do you get excited to get dressed up and do you have no qualms about taking your shirt off for your partner or significant other?

Melanie Young (19:40):
Well, I was so impressed going through the website because there’s also, for women who may only have one single breast removed, there’s actually a terrific procedure to help rebuild that one breast so it really is symmetry and looks just like the original.

Christopher Trahan, MD (19:59):
Correct.

Melanie Young (20:00):
What is the name of that process called?

Christopher Trahan, MD (20:02):
So anytime we have somebody who’s had one removed and wants it restored, whether they’re flat or have an implant, that’s taken into account because we have to understand what kind of volumes they’re needed. So one of the more common unilateral reconstructive procedures is a stacked.

Melanie Young (20:26):
That’s the term. Stacked

Christopher Trahan, MD (20:27):
Flap. And so what that means is if it’s the tummy, it’s combining both sides of it across the right and the left abdomen halves that we harvest and it’s combining them into a single microvascular construct. Now it involves a little plumbing, which involves connecting several additional connections. In our hands, it doesn’t take that much extra time, but it gives us a way to not only restore the footprint of the breast, but actual the shape and projection.

Melanie Young (21:07):
I think that’s really important because I think a lot of it is not only the loss of your breasts, but for someone who’s had a single breast removed, that lack of symmetry, you feel lopsided and knowing you can feel whole again in symmetry again is really important.

Christopher Trahan, MD (21:23):
Right. And a lot of times in people with ptosis or they feel like even their opposite breast is deflated, sometimes a lift alone doesn’t solve the problem because it doesn’t matter how tight you lift it, lifted breasts tend to have a tendency to bottom out, follow gravity. So the reconstructive breast typically has more fullness than the upper part. So sometimes what we have to do for that even is we’ll take a small flap from another side of the tummy and actually fill volume. Instead of adding an implant for the upper pull volume, we’ll have a small flap and do a lift around that to restore the entire upper pull fullness and projection and it’ll give a more lasting result that matches the opposite side.

Melanie Young (22:19):
Very customized. So speaking of lasting, this is important. So a lot of women get breast implants. I have had two sets, silicone and saline before I came here because I had capsular contraction and other issues, which I read is actually quite common.

Christopher Trahan, MD (22:37):
Yes, very

Melanie Young (22:38):
Common. And I learned, you learn all this when you’re wiser, that you do have to often get breast implants replaced. They don’t have a permanent lasting shelf life. I chose revision surgery, which I want you to explain, but I also want you, let’s start with what you get a lot of revision surgery candidates here. Let’s explain the difference between revision surgery immediate after reconstruction and delayed reconstruction so that women know they have choices, not just at the very beginning, which is what I though I only had that one choice.

Christopher Trahan, MD (23:11):
Right. Well, that’s very important distinction because for every diagnosis over the years, people have had one of those options or none of those options. But if it’s so their choice to pursue one of those options, at the time of diagnosis, reconstruction at the same time as mastectomy is immediate. And that has become more desired. We consider it sort of the gold standard because you’re in a field with no standards. It’s the gold standard. So from the time you show up, you go to sleep with breasts and you wake up with breasts. And they’re both soft natural tie and you most importantly. Now you can also have immediate implant reconstruction. If people have had no reconstruction or implant reconstruction and are unhappy with it, those implants can get removed. Or if they’re flat, they can get reconstructed later. If it’s not at the time of mastectomy, it’s a delayed reconstruction.

(24:32):
If people have had prior reconstruction and are unhappy with it, usually it’s a symmetry firmness contracture of implants, unsightly donor sites or other issues with the donor site and significant symmetry issues. Those are revision surgeries. And those have a significant degree of complexity because sometimes the other donor sites that we would’ve chosen from have been used. And so we have to tailor a plan that steps up in complexity to match their volume needs and shape needs.

Melanie Young (25:14):
I didn’t even think revision of surgery was possible when I came here. I came just in a query figuring, why not? Because I felt like my breast implant was leaking. And if anything, I needed to address that. And it was an option, which is really exciting. A lot of women want to know, because when I had implants, I had no sensation, period. They were just there, firm, didn’t go anywhere. But I have noticed that I have more sensation having undergone natural tissue reconstruction. Let’s talk about what a woman can gain beside symmetry and this amazing sense of feeling whole again. Let’s talk about the emotional, but also the tactile aspects of it.

Christopher Trahan, MD (25:55):
Right. So it never ceases to amaze me what the human body can do. And when we transfer a tissue, we talk about connecting blood vessels. And that’s obviously an essential part of it. We do it every day. But what happens after that is quite remarkable. And we witness that in many ways. Number one, if it’s the implant patient who’s had very thin cold skin and we replace that implant with healthy tissue, that tissue rejuvenates that skin because the capillaries find each other and the vessel that we transplanted and connected to drive that and perfuse that tie now has support from everywhere else on the chest wall. And theoretically you can cut that blood vessel after some time. The other important thing about it is that lymphatics and nerves find each other too. So there are no nerves and implants or lymphatics in implants. So that is a significant benefit over what they’ve had.

(27:12):
But even if they’ve not had implants before, the plasticity within the human body over time to improve sensation. And I’ve seen it when our patients have come for nipple tattooing. If they’ve waited some time, they feel it and that’s remarkable. So the actual feeling that you can feel your clothes on you, that you can feel touched is really remarkable.

Melanie Young (27:44):
And softness.

Christopher Trahan, MD (27:45):
And softness. Yeah, that’s huge.

Melanie Young (27:47):
It’s very huge immobility. The process, most women are not prepared for the process and length of time it takes to undergo reconstruction. Now we talked about how when you have immediate reconstruction, you wake up and you have breasts. What happens after that? Because with provisionist surgery, it’s a much more involved and timely process as I can speak if there’s two surgeries. So how does it differ in terms of the timeframe?

Christopher Trahan, MD (28:23):
So again, each situation we look at it from a very unique standpoint. Now, because of the volume that we take care of, we have standard recovery and postoperative protocols, but a lot of it begins with their starting point. Where are they? And what is it going to take? What is the plan? And what kind of health are they in before? What kind of activity level were they in before? But at the end of the day, as I look over the years of being in this practice, we went from a very long exhaustive list of recovery instructions to a much shorter list with just guardrails. We want an active recovery. And a lot of the modifications that have been done over the years have not only been technically in surgery, but in the post-op recovery aspect, because we want people active the next day. And the sooner people get moving, because one of the things I explain is that if you’re rigid and not moving, scar tissue comes and it becomes something you got to break out of.

(29:35):
But if you’re doing your more normal natural activities early, then the healing process feels more natural, you feel less restricted and the effort involved in the recovery is much less. But in the early postoperative period, we use a combination of nerve blocks and medication combinations that are unique to their tolerance. And we don’t just use opioids, we use medications in combination that help people move early, feel better early and get back to their normal routine. And so not only as part of the physical healing process, but the emotional healing process, you get back into what you do early. So if you take a mother of young children, tell them not to mother their children, they’re not going to be happy. So we want them to integrate back into their normal life as quickly as possible. And that’s where I think the emotional healing starts.

Melanie Young (30:43):
So this is a little sensitive subject, but I’m going to bring it up because it’s the truth. At what point can a woman feel that she can have intimacy with her husband or spouse again? Because most men are afraid to… Most husbands are there to help their wives and it’s a little traumatizing because often they’re the caregivers helping with the drains. How do you counsel and advise your patients who may say, “What can I do? When is it appropriate? Does the center offer any help in that area?

Christopher Trahan, MD (31:16):
We do. And again, each case is individual, but it goes in line with us wanting people to get back to their normal, resume their scheduled programming after the surgery. And there have been some cases where I’ve told, okay, four weeks and they say, too late. And these are guidelines. But I think if you get over the initial healing process, once you get closer to that four-week process, which is the same time that we say you can sleep on your side, you can start increasing your activity, lifting a little bit more, usually it’s about that time. I think one of the best indicators is people know when they’re ready. There are very few people that I see week one that are ready, but the trajectory is there and it’s a frequent question. I think it’s a great question. And I think it’s a shared decision between the patient and their caregiver and there are no absolute no lines, but I think we give people suggestions.

Melanie Young (32:40):
Well, it’s also during the mastectomy and treatment. I mean, she won’t break.

Christopher Trahan, MD (32:46):
Correct.

Melanie Young (32:47):
That’s number one. She’s not going to break and intimacy, even if it’s touch, really matters because the sensations are still there.

Christopher Trahan, MD (32:54):
Correct.

Melanie Young (32:55):
And your breasts are not going to be squished. Correct. I was afraid my breasts were going to be squished.

Christopher Trahan, MD (33:00):
Right. Well, I think that because it’s your owntissue, it’s built to be resilient. And the same thing goes for, I mentioned earlier, parents of young children. If your child falls and is reaching up to you crying and you say, “Well, I can’t lift anything more than 10 pounds.” I say, “Lift your child up, pick your child up. You’re going to be okay. So you can still be a mother.” And so to that end, these are precautions and guidelines and suggestions. And everybody reaches the point where they feel that it’s okay at that time and I’m all about whatever gets you back into your normal life the quickest.

Melanie Young (33:49):
It’s all about trying to feel normal again and whole and thriving and not living in cancer land or feeling insecure or not comfortable in your body. I mean, every woman wants to feel comfortable in her body and also in her head and feel attractive. And this is a great way to… It’s a process, but it’s a transformative process in a very positive way. I’ve read a lot about you, Dr. Tran, and you’ve had so many high remarks for your bedside manner and your capacity to help listen to patients. The listening process is really important. And I remember going through my interview process when I was looking for my breast surgeons and one just talked to me on a PowerPoint and she immediately got checked off the list because this is important. When you are with and working with each individual patient, what do you try?

(34:44):
How do you want to make them feel? And how do you try to go the extra mile to help their journey be even better?

Christopher Trahan, MD (34:54):
So I’ve gotten to the point where I think you can look at the individual’s story, where they came from and whether it’s prior reconstruction, whether it’s a new diagnosis or I like to know, okay, what are your kids’ ages? I want to know about them. I want to know them. And to know them means that I want them to feel heard. And because a lot of revision patients or people who’ve had implants, I can ask them, “How many times have you been told just be happy you don’t have cancer?” And that usually strikes a chord. And if they’ve traveled where their family from where they’re coming from is probably saying, “Well, you don’t need that. You don’t have cancer anymore.” Because it is going to tax their support structure. So it’s not lost on me the amount of hurdles that it takes when I walk in a room for that patient to be sitting there.

(36:08):
All of the coordination of childcare, work, all that stuff. We don’t have their experience, but we understand their experience. And that’s I think understanding it from that level and allowing them to feel heard without judgment and to tell them it’s okay to want to look good in a bathing suit. It’s okay to want to look good and it’s okay to want to get excited to get dressed up. And that just looking good in clothes often isn’t good enough. And it’s okay to say that because there has been a breast reconstruction and aesthetics have been not really intertwined. It’s been looked at more as a functional issue. And I think the common denominator for outcomes in the United States has remained poor because of that. So we want to elevate what their expectations are because ours are fairly elevated.

Melanie Young (37:14):
Yeah, you’ve got very high standards here and a team of the most skilled surgeons in a very highly, I can’t underscore enough how highly specialized this type of surgery is. Microvascular surgery is already specialized when you’re doing it with reconstruction with women who have lost their breasts, may be in treatment, may not be in treatment, maybe recovering from treatment, or may be coming back many years later like I did saying, “I need help.” Correct. Every case is different. And I think what you’ve punctuated is that you don’t treat the condition, you treat the patient.

Christopher Trahan, MD (37:46):
Correct. And that is a huge distinction. And that’s what I get asked, “Well, how can you do the same thing every day?” Well, because it’s different people, it’s different problems. And it’s a shared vision. And we plan with the idea of we want the home run every time. And what can we do to get them through this and on with their life? Not just existing, just on with their life and thriving. And it’s an angle of vision that we feel we can offer from not just a patient, but when I take care of the patient or when we take care of the patient, we take care of their whole family. We take care of the people that love them too because we want to give them back the best version of that person.

Melanie Young (38:44):
Oh, that’s so wonderful. That’s a great way to end the conversation. It’s so inspiring because people make a commitment to come here, you make a commitment to treat them, and it is a family decision in many cases, and it is timeout to come back to the way you want your life to be. And every woman has the right to have that choice.

Christopher Trahan, MD (39:05):
Correct. And to that end, despite the volume that we do, and we do more of this than anybody, most importantly, we’re not a factory. This is where I feel people can come to be heard and not only heard, but understood in a way that they probably haven’t experienced ever before. And that takes the entirety of this institution, that takes the people in intake, that takes everybody here pulling in the same direction. And that’s one of the more unique and inspiring things about this place that everyone here is pulling in the same direction.

Melanie Young (39:48):
The teamwork is amazing. The follow-up, the teamwork, it’s incredible. I felt cared for from the day I stepped in to the day I walked out after my second surgery and I’m still in touch with everybody. It has really been a pleasure talking to you, Dr. Trahan. You’re just like all the great reports I’ve read about you. You’ve got this great manner.

Christopher Trahan, MD (40:08):
Well, we appreciate it and I appreciate it. I think this is a wonderful thing that you’re doing is to give a voice to many of these women when they feel alone and vulnerable. So thank you for doing what you do, and I can’t wait to read your book.

Melanie Young (40:26):
Oh, thank you. I really appreciate that. I really do. And of course, the website is breastcenter.com. Really, it is important. If you are a woman facing a breast cancer diagnosis, facing the choice of reconstruction, the emphasis is choice. You have choices. You didn’t choose to have cancer, but you have so many choices on how you want to be treated, surgeons you select, how you want to reconstruct if you choose to. Your oncologist will help you choose your treatment and listen to your oncologist, but the timing and everything, it’s all teamwork and you are part of the process when you’re working with your team of doctors. So it’s great to know that you have that team, the confidence and the choices here in your cancer journey and here at the Center for Restorative Breast Surgery and St. Charles Surgical Hospital. So thank you.

Christopher Trahan, MD (41:14):
Thank you.

What topics does Restore & Reclaim cover?

Restore & Reclaim features conversations with the surgeons, specialists, and patients at the Center for Restorative Breast Surgery in New Orleans. Episodes explore the full range of breast reconstruction options, the surgical and emotional journey of recovery, advances in microsurgical technique, insurance and logistics for out-of-town patients, and what it means to feel whole again after breast cancer. New episodes are added regularly.

What types of breast reconstruction surgery are available after a mastectomy?

Women have more options today than ever before. Natural tissue reconstruction uses the patient’s own skin and fat, commonly from the abdomen or upper buttock, to rebuild the breast without implants. Implant-based reconstruction is also an option, as is a hybrid approach combining natural tissue with an implant. Some women choose not to reconstruct at all. The right path depends on body type, cancer treatment, personal goals, and timing, and the surgeons at the Center for Restorative Breast Surgery help each patient understand every option available to her.

Does insurance cover breast reconstruction after a mastectomy?

Yes. Federal law requires insurance carriers that cover mastectomy to also cover breast reconstruction, including immediate, delayed, and revisional procedures, as well as any procedures on the opposite breast for symmetry. This applies to both natural tissue and implant-based reconstruction. Women who had mastectomies before the law took effect in 1998 may still be eligible for coverage today.

Who is a candidate for breast reconstruction surgery?

Most women are candidates for some form of breast reconstruction, regardless of age, body type, or prior treatment. Even women who were told they are not candidates elsewhere, due to prior radiation, failed implant reconstruction, or having chosen to go flat, may have options. Timing, technique, and the order of procedures all vary by patient, which is why a consultation with an experienced reconstructive surgeon is the most important first step.

When should a woman start thinking about breast reconstruction?

Ideally, before a mastectomy. Meeting with a reconstructive surgeon early, even before deciding between a lumpectomy and mastectomy, allows women to understand how different treatment paths will affect their reconstruction options. That said, reconstruction is possible at many stages: immediately at the time of mastectomy, months or years later, or as a revision of prior reconstruction.