Breast Reconstruction Pasadena

A breast cancer diagnosis arrives with a calendar attached — the breast surgeon, the oncologist, sometimes radiation — and reconstruction is the one appointment on it that is entirely about you. Dr. Wai-Yee Li has spent more than ten years rebuilding breasts after mastectomy and lumpectomy, first through a decade at a busy cancer center in Southern California and now at LA Breast & Body, where she sees patients in Pasadena and Arcadia. She offers both implant-based reconstruction and reconstruction with your own tissue, and she is known among surgeons and patients for direct-to-implant reconstruction without tissue expanders, and for techniques that are not widely available: the Goldilocks procedure, aesthetic flat closure, and her own published refinement of the latissimus flap, the bra-line back lift.

This page is written for women in Pasadena and the San Gabriel Valley who are deciding how, when, and with whom to reconstruct. It covers the timing of reconstruction, the main choices, what insurance covers, and what to bring to a consultation. Dr. Li's main breast reconstruction page goes into far greater technical depth, and How Reconstruction Works walks through each option step by step.

Choosing a reconstructive surgeon in Pasadena

Reconstruction is usually a decision made quickly, at the most overwhelming moment of the process, and the surgeon you choose shapes the result you live with for decades. Dr. Li is a female board-certified plastic surgeon (MD, PhD, FACS) whose special focus is complex breast reconstruction. At the cancer center where she worked for ten years she was the reconstructive surgeon other surgeons sought out, and she now serves as volunteer faculty at Huntington Memorial Hospital in Pasadena, teaching residents in general and plastic surgery. Many of her patients come to her after being referred by a friend, a family member or another surgeon — and many travel some distance to do so.

If you have already scheduled surgery elsewhere, you can still see her. Dr. Li regularly gives second opinions, reviewing your current surgical plan and giving a candid, safe assessment. Your records stay within our HIPAA-compliant system and are not shared without your consent.

Some patients go on to have surgery with Dr. Li; others take her recommendations back to their own surgeon. Either is a good outcome.

When reconstruction happens

Reconstruction can be immediate, performed on the same day as the mastectomy, so that you wake with a breast shape already in place. It can be delayed-immediate, two to three weeks after the mastectomy, once final pathology is known and the team is certain of the treatment plan. Or it can be delayed by months or years, for women who were not ready to decide at diagnosis, who needed chemotherapy and radiation first, or who never had reconstruction offered at all. Each timing has a place, and Dr. Li plans around your cancer treatment and not the other way round.

Implant reconstruction without tissue expanders

Where an implant is the right choice, Dr. Li is particularly experienced in direct-to-implant reconstruction — placing the final implant at the time of mastectomy — and she avoids tissue expanders whenever she can. Expanders are the commonest form of reconstruction in the United States, but they mean weeks of office visits to fill them and a second operation to exchange them for the implant. Dr. Li reserves them for women who have very little tissue after mastectomy or who want a large increase in cup size.

She also prefers, in most cases, to place the implant in front of the chest muscle rather than beneath it — 'prepectoral' reconstruction. The implant sits where the breast tissue naturally lived, recovery is more comfortable, and in her experience the position is associated with less hardening of the scar capsule, particularly in breasts that have been through radiation. Her main page explains the choice between saline and silicone, smooth and textured devices, and the surveillance that all silicone implants need in the years that follow.

Reconstruction with your own tissue: the bra-line back lift LAT flap

Autologous reconstruction uses your own skin and tissue to rebuild the breast, and it is often the only option when breast skin has been removed with the tumor or when the chest has been radiated, because healthy, non-radiated tissue heals where radiated tissue often does not. The two most common flaps worldwide are the DIEP flap from the abdomen and the latissimus (LAT) flap from the back. Having performed both for years, Dr. Li no longer offers abdominal-based flaps: her latissimus patients recovered faster and did better in the long term, and she personally repaired the hernias and abdominal weakness that some abdominal-flap patients were left with.

Over the past decade she refined the latissimus flap into the Combined Bra-Line Back Lift Latissimus Flap, the BLBL-LAT flap. Instead of the traditional diagonal scar across the back, the incision runs horizontally along the bra line, where in most cases it stays hidden — and in patients with excess back rolls the same incision removes them. The flap can stand alone as a fully autologous reconstruction when there is enough back tissue, or be combined with an implant for volume and a lifted, youthful upper breast.

Only one side of the back is used for each breast, so nothing is spent that might be needed later. Dr. Li published the technique in two major plastic surgery journals in 2024, and you can see her results in the BLBL-LAT flap gallery.

Other paths: Goldilocks, flat closure, oncoplastic surgery, nipple reconstruction

Not every reconstruction involves an implant or a flap. The Goldilocks procedure uses the breast skin that remains after mastectomy to shape a smaller breast mound in a single stage, with no implant at all. Aesthetic flat closure is for women who choose not to reconstruct and want a smooth, comfortable, flat chest — a result that is harder to achieve than it sounds, and one Dr. Li is frequently asked to correct after surgery elsewhere.

After a lumpectomy, oncoplastic surgery reshapes the breast on the day of the cancer operation to hide the defect before radiation. And nipple and areola reconstruction, including 3D nipple tattooing, is the finishing step for many patients.

Is breast reconstruction covered by insurance?

Most breast reconstruction is covered, because coverage is required by law. The federal Women's Health and Cancer Rights Act requires most health plans that cover mastectomy to also cover reconstruction, including surgery on the other breast to produce symmetry and treatment of complications. Revision reconstruction is usually decided case by case.

The practical complication is that many experienced reconstructive surgeons are no longer in network, and depending on your plan you may not be free to choose the surgeon you want. Dr. Li is not a Medicare provider and is not in network with any commercial insurance. In many cases she and her team can work with commercial PPO plans as an out-of-network surgeon, on a case-by-case basis, and some patients elect to pay directly for revision work because they value her skill and care. Bring your insurance information to your consultation and our team will tell you, plainly, what your plan is likely to do.

What recovery looks like

A flap reconstruction means a stay in hospital, while many implant reconstructions go home the same day. Either way you shower from the day after surgery, and after a flap Dr. Li and her team check on you the next morning and an occupational and physical therapist assess how you move and teach you how to avoid injury. Dressings come off before each shower and are replaced afterward for three days.

With a LAT flap, the back scar is closed with buried dissolvable stitches and sealed with skin glue, so it needs no dressing at all. Dr. Li's team gives you written before- and after-surgery instructions, and her patient resources pages cover drains, activity and out-of-town stays in detail.

The women at higher risk of complications from any reconstruction are active smokers — Dr. Li asks patients to quit at least six weeks before surgery — those with poorly controlled diabetes, patients with a very high or very low body weight, and anyone with a bleeding or clotting disorder. Those risks are discussed openly at your consultation, alongside the technique-specific ones: with implants, capsular contracture and eventual exchange; with flaps, the small risk that part of the transferred tissue does not survive.

If your first reconstruction did not go to plan

A large part of Dr. Li's practice is revision: correcting reconstructions that hurt, that sit unevenly, that hardened after radiation, or that never looked the way the patient was promised. If that is why you are reading this page, her revision breast reconstruction page is written for you.

Your consultation in Pasadena

Bring whatever you have: your pathology report, the operative notes from any previous surgery, your oncologist's treatment plan and the timing of any radiation, your implant card if you have one, and the questions you have been writing down at night. Dr. Li will listen first, examine you, and then explain the options that fit your situation, using photographs and diagrams so that you leave understanding the plan. Partners and family are welcome. LA Breast & Body is an all-female practice, built so that patients feel seen and heard, never intimidated.

Getting to us from Pasadena and the San Gabriel Valley

Dr. Li's Pasadena office is at 675 South Arroyo Parkway, Suite 310B, a few minutes from Old Pasadena and Huntington Hospital, and her Arcadia office is at 624 West Duarte Road, Suite 101a, a short drive east on the 210. Both serve patients from Pasadena, South Pasadena, San Marino, Altadena, Sierra Madre, La Cañada Flintridge, Alhambra, Glendale, Monrovia and the wider San Gabriel Valley, with a South Pasadena office coming soon. Call or text 626 888 9728, or request a consultation online and tell us the best time and way to reach you.