Hey there Reddit, I am Dr. Lisa Cassileth, board-certified plastic surgeon in Beverly Hills, Chief of Plastics at Cedars-Sinai, 13 years in private practice. I am here today with Dr. Kelly Killeen, Dr. Heather Richardson and Dr. Leslie Memsic — we specialize in breast cancer reconstruction. We are so frustrated with the bad-looking results we see. The traditional process is painful, requires multiple surgeries, and gives unattractive outcomes. We are working to change the “standard of care” for breast reconstruction and to help women #KeepTheNipple, because women deserve better. We want women to know that newer, better options exist.

Proof, More Proof, #KeepTheNipple Proof

Dr. Cassileth, Dr. Killeen, Dr. Richardson, Dr. Memsic

Comments: 537 • Responses: 8  • Date: 

ProfessionalDicker110 karma

No nipples? Not on my watch.

To whom do I make the cheque payable?

CassilethMD121 karma

We think it's a no brainer too. Unfortunately it's not yet the standard approach in the breast cancer industry. Make demands and put the word out, women!

noob_1234584 karma

My aunt was just diagnosed with breast cancer and is completely freaked out. She wants to do EVERYTHING by the book and won't even talk to any doctor outside of her specialist. He is telling her she will completely loose her left breast and there is no other option. How do I approach this with her and what do I tell her so she will even consider other options and so doesn't think I just have some crazy idea that is going to kill her?

CassilethMD152 karma

This is a very typical reaction, women double down and just want to get the cancer out, but then they end up with bad aesthetic results that affect them for life, as the majority (by far) of breast cancer are curable. First, unless she has cancer in her nipple, saving the nipple provides THE SAME CURE as cutting it off. Second, if she has a traditional tissue expander surgery, it is a minimum of two surgeries, where with the direct to implant technique we put it in immediately. Only 50% of women are given the option to talk to a plastic surgeon at all, much less about our technique, where we really consider both aesthetics and fast recovery. I beg her to get informed, or it will be extremely difficult for her to fix the problem later.

CassilethMD92 karma

Also she is welcome to email us here. Happy to help and our surgical oncologists are amazing.

Youped35 karma

I have had two friends fly to Mexico to get breast surgery and both rave about the results but I have also heard horror stories. A there liablies specific to regulations in other counties or is it just good and bad doctors like in America?

CassilethMD27 karma

OMG!!! I am psyched for your friends, as it is rolling the dice to go to Mexico as they don't have the same requiremenets they do here. You know, little things, like BOARD CERTIFICATION showing you are trained before you unleash your skills on the general public. There are great ways to find cheap plastic surgery here from good doctors. Please don't go to TJ (that's Tijuana for you non-SoCal people)!!!

snackkkkkkkz27 karma

My friend is worried about Breast Cancer and her chances of getting it (it runs in her family), but she seems to be equally concerned about her breasts continuing to look natural. Is there any advice that I can give her to calm her down?

CassilethMD60 karma

First, she should see a counselor or breast cancer specialist about her cancer risk. She may be concerned about nothing, but many patient are diagnosed with a genetic high risk for breast cancer that can get rather scary with 90% risks. Good to know the facts before you go imagining that you will have to have surgery at all. Next, if she DOES have increased risk and decides to have a mastectomy, she MUST insist on NIPPLE SPARING, as it give the most beautiful natural result. I also recommend after reconstruction a round of fat grafting, where your own fat is placed all over the top of the implants and it makes them look and feel very natural.

mix4kix15 karma

I feel like what makes a nice breast from an aesthetic standpoint is so subjective. Having seen and built a lot of breasts do you have any science, intuition, bias as to what makes the perfect breast?

CassilethMD19 karma

What makes the perfect breast? We get a different answer from each and every different patient. That key to plastic surgery is that there is never a perfect ideal, for example, a higher breast looks great on someone shorter waisted. I usually ask patient to bring in pictures of their perfect breasts and then we can see if we can get there and if that is the best idea for that person.

ZLERBER5 karma

Do you ever get tired of being a plastic surgeon in beverly hills with all the pretense and body obsession and wish you lived in the midwest or something?

CassilethMD8 karma

We do a lot of breast reconstruction, so I think think living here has actually helped. When I trained on the East Coast everyone cut off the nipples and we thought women didn't mind it it was just fine. It takes some demanding patients to really push the envelope, but as a doctor you end up getting better and better results. Shouldn't women across the country have the same awesome results? If you are a sweet non-demanding Midwesterner will appreciate you all the more, these are actually patients that are the most pleased that that can get great results, as they were expecting nothing!

_siriuslyme5 karma

What are your prices like compared to other doctors offering the same services? And have you had any plastic surgery done yourself?

CassilethMD5 karma

We are always looking to make great breast cancer care completely affordable. We now have providers that do Medicare, Aetna, and Blue Cross. We still don't take Medi-Cal.