Reconstructive Plastic Surgery

Pre-pectoral breast reconstruction places the implant above the chest muscle rather than beneath it, eliminating animation deformity and reducing postoperative pain. Dr. Brian Kelley, an Austin reconstructive surgeon, explains the technique, why he uses acellular dermal matrix, how direct-to-implant and staged approaches differ, how radiation factors in, and when sub-pectoral placement still serves patients better — including those without access to fat grafting.

Struggling with chronic chest or arm pain after breast cancer? Austin-based peripheral nerve specialist and breast reconstruction surgeon Dr. Brian P. Kelley explains how post-mastectomy neuromas and radiation neuritis—not your breast reconstruction — may be the true cause. We discuss evidence-based treatments and options for advanced nerve surgeries like TMR and RPNI. Learn how targeted nerve surgery might provide meaningful pain relief while potentially preserving your breast reconstruction.

Nerve graft or nerve transfer? Dr. Brian Kelley, dual board certified nerve surgeon in Austin, walks through the two strategies, where each works best, and how the choice is actually made — covering motor and sensory nerves, hand and brachial plexus and lower-extremity considerations, modern adjuncts including processed nerve allograft, and why timing matters. Patient-reported outcomes data and a framework for selecting a surgeon included.