Dr. R. Thomas Noel, M.D.

plastic surgeon

Breast Reconstruction Plastic Surgery

Dr. Noel has extensive experience in many different methods of breast reconstruction plastic surgery for women facing breast cancer.

For over 20 years, Dr. Noel has had an active commitment to women facing breast cancer. Dr. Noel completed a prestigious Breast Recontruction Fellowship with world renowned Dr. Carl Hartrampf in Atlanta. Dr. Hartrampf is known for his work with TRAM flap breast reconstruction.

Dr. Noel has extensive experience with several different techniques and many times can offer several options, such as:

  • TRAM flap breast reconstruction using the lower abdominal fat (without the need for any implant)
  • Latissimus flaps from the back, possibly with an implant
  • Tissue expander/implant reconstructions

Patients who have already had breast cancer surgery are evaluated and the options available to each patient’s unique situation are discussed.

For women just diagnosed, Dr. Noel strives to meet with you and evaluate your situation as soon as possible. In coordination with your general surgeon and other cancer doctors, we strive to provide immediate reconstruction at the time of your mastectomy, if it is safe and appropriate for you. Sometimes Dr. Noel and your other cancer specialists might recommend doing reconstruction after initial cancer therapies. Your unique situation, risk factors, and cancer therapy needs are all considered. As a result of Dr. Noel’s experience with many hundreds of reconstructions over the last 20 years, safe, thoughtful and successful recommendations can be made.

Procedures on the opposite breast for symmetry and nipple reconstruction are the finishing touches that can help achieve the best overall results. Breast reconstruction and balancing surgeries of the opposite breast are insurance covered procedures by federal mandate.

Fat Grafting

A basic principle of Plastic Surgery is to try and replace Like with Like. When Dr. Noel reconstructs a breast that was removed for cancer the use of the TRAM brings abdominal fat and skin to rebuild the fat and skin removed by the general surgeon thus replacing Like with Like. Sometimes, particularly with implant reconstructions, the reconstructed breast has areas where additional fill is needed. Recently, the use of fat grafting has given Dr. Noel an additional tool to address these areas. Fat is suctioned, usually from the patient’s abdomen, then rinsed free of blood and broken fat cells and then grafted into the areas of deficiency with thin grafting cannulas.

Sometimes more than one session is needed and healthy nonsmokers are the best candidates. There has been suggestion that improvement in radiated mastectomy sites is seen with fat grafting. Fat grafting is best suited for smaller areas and the upper pole of the breast is the most common area treated in reconstruction patients.

Fat grafting is also used more frequently as a filler in facial rejuvenation and again probably best used in small areas.

3D Nipple Tattooing

Nipple areolar reconstruction can be the finishing touch to a patient’s breast reconstruction. It can turn a mound into a breast. A nipple can be made from the local tissues and tattooing used to add color.

Dr. Noel can tattoo the areola and nipple with 3D nipple tattooing using lighter and darker colors to recreate a more realistic appearing reconstruction.

Optimizing Plastic Surgery

Attention to detail before, during and after surgery provides the best chance of success.

Dr. Noel will meet with you prior to your surgery date to answer all of your questions and to make sure you are ready. He will discuss things to do before and after your procedure to help obtain the best results and optimize safety.

Patients can have a great impact on the risk and success of their procedure with many common sense habits that also improve overall health and wellness.

Dr. Noel will see you frequently following your surgery.

Breast Cancer Care at Baptist Health Louisville