Reconstructive Plastic Surgery

The SIEA flap rebuilds the breast from lower abdominal tissue without cutting any abdominal muscle or fascia, the least invasive abdominal option. Dr. Brian Kelley, an Austin microsurgeon, explains what the SIEA flap is, how it compares to the DIEP and to thigh-based PAP flaps, why it is only feasible in a minority of patients, what delay procedures can and cannot do, and who is a candidate. Includes monitoring, recovery, and honest limitations.

BRCA1, BRCA2, and other high-risk genes change how breast reconstruction is planned. Dr. Brian Kelley, an Austin reconstructive surgeon, explains how reconstruction differs for genetic-risk patients, the choice between prophylactic and therapeutic mastectomy, nipple-sparing options and the small residual risk in the preserved nipple, implant versus autologous reconstruction, coordination with other risk-reducing surgery, and lifelong monitoring. Written for patients carrying a hereditary cancer mutation who are weighing risk-reducing surgery and reconstruction.

Persistent pain after knee or hip replacement isn't always the implant. Dr. Brian Kelley, an Austin nerve surgeon, explains the overlooked nerve diagnosis — infrapatellar saphenous neuroma after knee replacement, meralgia paresthetica after hip replacement, and peroneal nerve injury causing foot drop. Covers how to tell nerve pain from mechanical joint problems, why ruling out the joint comes first, who benefits from surgery, and an honest look at the evidence.