Minas Chrysopoulo MD, PRMA Plastic Surgery

10/14/2026

At the best microsurgical centers, flap survival is 99% or higher, and it remains the most basic measure of success in flap reconstruction. Moving the field forward means addressing what reconstruction has long underappreciated or never recognized at all. Sensory restoration is the prime example.

Most women lose significant sensation after mastectomy. Some are completely numb; others keep patchy feeling. An increasing number of breast surgeons now try to preserve sensory nerves at the time of mastectomy, where tumor location and breast anatomy allow. Some patients recover feeling over time even without nerve reconstruction. TruSense®, the nerve reconstruction technique we pioneered at PRMA, connects the sensory nerves transplanted with the DIEP flap to a severed sensory nerve in the chest during the initial reconstruction. The goal is meaningful return of feeling and protective sensation, which matters tremendously for something as ordinary as knowing when a shower is too hot. While it doesn't typically restore what the patient had before mastectomy, studies are showing that reconstructing nerves improves the degree and quality of the feeling that returns compared with leaving them unrepaired.

Efforts at PRMA and across the ARSA network are also expanding access to care for what lingers after cancer treatment: chemotherapy-induced neuropathy, post-mastectomy pain, and lymphedema. I'm proud to be part of this work as it scales.

Learn more about TruSense®: https://prma-enhance.com/lymphedema-restorative-procedures/sensation-restoration

Learn more about the other innovations happening across ARSA: https://www.linkedin.com/pulse/pushing-boundaries-surgical-precision-advanced-cancer-removal-bdz3e/



PRMA Plastic Surgery - Center for Advanced Breast Reconstruction Advanced Reconstructive Surgery Alliance -ARSA

PRMA restores breast and chest sensation after mastectomy with advanced nerve reconstruction surgery. Feel more like yourself again—schedule a consult.

09/29/2026

A person with a diabetic foot ulcer often sees more than one provider before anyone traces the wound back to the fact that they can no longer feel it forming.

This recent piece explains why diabetic foot ulcers have gone three decades without a new treatment. Nearly one in three people with diabetes will develop one, and 85% of diabetes-related amputations start there. Peripheral neuropathy, nerve damage from diabetes, leaves the foot unable to feel that pressure, and it goes untreated for years.

PRMA is best known for microsurgical breast reconstruction, but this is a different microsurgical specialty: nerve surgery. Expanding into it was already the plan before we recruited Dr. Tyler Merceron, who trained extensively in advanced nerve procedures to bring them to our practice. Nerve decompression relieves pressure on the nerve for patients with diabetic or chemotherapy-related neuropathy, and many of those patients developed it from taxane and platinum-based drugs used to treat breast cancer. That damage can outlast cancer treatment by years. In 75% of well-selected patients, feeling improves, pain eases, and the risk of a future wound drops dramatically.

https://medcitynews.com/2026/08/the-silent-epidemic-why-diabetic-foot-ulcers-have-been-overlooked-for-three-decades/



PRMA Plastic Surgery - Center for Advanced Breast Reconstruction Advanced Reconstructive Surgery Alliance -ARSA

Chronic wounds demand clinicians willing to act outside of their defined role, not because the system incentivizes it, but because without it, the wound will not heal.

09/22/2026

I practiced microsurgical breast reconstruction for almost two decades. I saw the same thing again and again: someone who might qualify for a clinical trial, and a research team three states away who had no idea they existed.

That's a distance problem. There's a bigger one underneath it. A new study of more than 11,000 cancer trials found drug companies run about 82% of them, almost all testing one drug at a time. Federally funded trials, the smaller share, are where research on combining surgery, radiation, and drug treatment happens, along with rare and childhood cancers, the questions closest to what reconstruction patients actually need and the ones that don't turn a profit.

PRMA joined the ARSA network in 2023, where I also lead Clinical Operations. Closing exactly this kind of gap is part of why that network exists: generating the real-world outcomes data multimodality research depends on, data industry alone won't fund, and pairing it with network physicians and outside partners willing to bring trials into community practices instead of only academic centers. That moves both problems at once: getting the patient to the trial, and making sure the trial worth reaching exists in the first place.

Every physician we add, and every partner willing to meet a patient where they are, gives one more person more options to choose from.

https://medicalxpress.com/news/2026-08-clinical-trial-distance-hidden.html
https://medicalxpress.com/news/2026-08-cancer-clinical-trials-federal-industry.html


PRMA Plastic Surgery - Center for Advanced Breast Reconstruction Advanced Reconstructive Surgery Alliance -ARSA

Connecting people with clinical trials is complicated—even if people identify a promising match, there's a slew of potentially thorny factors, including geographic incompatibility and financial and time considerations.

08/13/2026

A new study out of Stanford, published in a leading medical journal, followed more than 500 people who’d been living with chronic pain and taking prescription opioids for years. Instead of rushing anyone off their medication, researchers let each patient set the pace, lowering the dose slowly with real input along the way. After a year, about half had either cut their dose in half or eased their pain without needing more medication.

https://medicalxpress.com/news/2026-07-chronic-pain-patients-opioid-voluntary.html

There’s another part of chronic pain care that barely gets talked about, and it’s especially relevant to breast cancer survivors: chronic pain after mastectomy, and nerve pain caused by chemotherapy. Both are common, and both are too often treated as something patients just have to live with. Patients often say the same thing: no doctor they saw before, including the ones who cared for them well, ever mentioned that a nerve-level surgical option might help.

When conservative care has genuinely been tried, patients deserve a clear path to every option that could help, and their doctors deserve the knowledge to point them there. That’s an education gap we’re working to close. At PRMA, as part of the ARSA network, we're expanding these nerve-focused surgical solutions specifically for post-mastectomy pain and chemotherapy-related neuropathy (sensation loss).

Learn more about surgical solutions for chronic pain here: https://www.advancedreconstruction.com/distinguished-centers/surgical-solutions-for-chronic-pain



PRMA Plastic Surgery - Center for Advanced Breast Reconstruction

07/29/2026

A rise in breast cancer among younger women changes what happens in my part of a patient's care, not just the oncologist's.

A recent UCSF study found invasive breast cancer climbing fast among Asian American women, more than 3% a year across nearly every group, and rising fastest in women under 50. More of these cancers are aggressive types. The researchers are honest that they don't yet know why.

More younger patients doesn't necessarily mean more mastectomies. Modern chemotherapy given before surgery is often shrinking tumors and opening up breast-conserving options. What it does mean is more women, earlier in life, facing real decisions: lumpectomy or mastectomy, reconstruction with implants or their own tissue, going flat, sensation, timing.

The rise is steepest in certain communities and in women under 50. A change this fast is exactly what a good care system can get ahead of. Screening aimed at who's really at risk, outreach in the right languages, and clear paths that carry these women to specialist care without losing them along the way.

https://medicalxpress.com/news/2026-07-breast-cancer-fast-asian-american.html



PRMA Plastic Surgery - Center for Advanced Breast Reconstruction Advanced Reconstructive Surgery Alliance -ARSA

A new study led by UC San Francisco has found an alarming rise in invasive breast cancer among Asian American women over the last two decades.

07/22/2026

When a medical device gets recalled, it's easy to see it as paperwork between a company and the FDA. For the patient it was used on, it's much more personal.

A new study in JAMA Network Open looked at 903 AI-powered medical devices authorized by the FDA. Devices with no publicly reported clinical evidence behind them were more likely to end up recalled.

Here's what I want patients to take from this: you're allowed to ask questions about any device involved in your care. What's the evidence behind it? A good care team welcomes those questions.

Asking isn't second-guessing your doctors. It's part of good care.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2850190



PRMA Plastic Surgery - Center for Advanced Breast Reconstruction

This cohort study examines characteristics of artificial intelligence (AI)–enabled medical devices, including clinical study evidence, associated with US Food and Drug Administration (FDA) recall.

07/15/2026

"No shared records. No standard handoff. No common language." That's how two primary care physicians and an oncologist described cancer care coordination recently, and the specific gap they're naming is the handoff from oncology to primary care once active treatment ends.

That's the moment a patient's survivorship plan, their ongoing surveillance needs, and who's actually responsible for catching problems all move to a doctor who wasn't in the room for any of the decisions that got them there.

Breast reconstruction tends to show the same pattern. Follow-up runs on its own track, separate from oncology's surveillance, with no formal bridge between the two once the acute phase passes.

A standardized survivorship care plan handed to the P*P at the point of transition would close most of that gap on its own. Pair it with a single point of contact on the oncology side the P*P can actually reach, and a good part of this resolves itself.

At PRMA, our doctors close this gap well because they care, not because the system requires it. That's the part we still need to fix.

https://www.medscape.com/viewarticle/lost-translation-cancer-cares-coordination-problem-2026a1000mkw



PRMA Plastic Surgery - Center for Advanced Breast Reconstruction Advanced Reconstructive Surgery Alliance -ARSA

No shared records. No standard handoff. No common language. Three physicians break down why cancer care coordination keeps failing.

06/24/2026

Patients are often told their new breast will likely be numb after a mastectomy and reconstruction. Most don't make the connection that numb means they won't feel their skin burning from a hot compress, or a scratch, or a graze from a sharp edge.

Neurotization doesn't restore the degree of feeling that Mother Nature provided before the mastectomy, and it doesn't typically come close to erogenous sensation. What it does deliver is meaningful sensory recovery, protective sensation to prevent skin injury, and being able to feel a hug or a touch. For most women, that's a significant difference in how they experience their body after reconstruction.

A systematic review just published in *Cancers* looked at 40 studies and confirmed that reconnecting sensory nerves during reconstruction leads to earlier, better, and more protective sensation. Non-neurotized flaps left 64% of patients with no return of protective sensation at all.

At PRMA we pioneered TruSense®, a technique that neurotizes DIEP flaps without cadaveric nerve grafts, because we believe feeling should be part of what holistic reconstruction delivers, not a bonus if it happens to return on its own. The evidence behind that belief keeps getting stronger.

Sensation is part of what reconstruction is for. That's the paradigm shift in thinking the field needs to embrace.

Learn more about TruSense®: https://prma-enhance.com/lymphedema-restorative-procedures/sensation-restoration

Read the full review: https://pmc.ncbi.nlm.nih.gov/articles/PMC13072177/



PRMA Plastic Surgery - Center for Advanced Breast Reconstruction Advanced Reconstructive Surgery Alliance -ARSA Methodist Health System Baptist Breast Center

Breast sensation is often lost at the time of mastectomy and has a significant impact on a patient’s quality of life and survivorship. New approaches seek to restore sensation in the setting of breast reconstruction. This review summarizes the ...

06/03/2026

The standard post-surgical exercise advice for breast cancer patients has been: go easy, go slow, don't lift heavy. This study challenges that directly.

At the recent American Society of Breast Surgeons annual meeting in Seattle, researchers from Allegheny Health Network presented data on 197 breast cancer survivors who completed a three-month supervised resistance training program with dose escalation. The findings held regardless of whether patients had undergone mastectomy or axillary lymph node dissection. Strength, range of motion, and muscle mass improved to the same or greater levels than before surgery, in months, not years.

Dr. Colin Champ put it plainly: "We don't want to injure anyone, but to underdose someone is equally bad."

Some of the caution has real clinical basis. Lymphedema risk is real, though Champ noted those concerns around resistance training have been largely disproven. Many of these patients are also genuinely deconditioned after surgery, chemotherapy, radiation, and sometimes a year or more of accumulated treatment burden. The question isn't so much as to whether to be careful. It's whether what we've been recommending matches what patients can actually do and benefit from.

At the breast cancer tumor board level, we've seen tremendous patient benefit when oncorehab approaches are incorporated into multidisciplinary clinical pathways, both as prehab to prepare patients for surgery and as part of structured recovery afterward. When it's treated as a clinical priority from the start, not an afterthought, patients do better.

Appropriate resistance training improves every physical aspect that correlates with outcomes after cancer treatment. For those of us working with breast cancer survivors, it's worth revisiting what we're recommending and giving serious consideration to the role exercise oncology and oncorehab can play.

https://medicalxpress.com/news/2026-05-high-intensity-breast-cancer-surgery.html



PRMA Plastic Surgery - Center for Advanced Breast Reconstruction Advanced Reconstructive Surgery Alliance -ARSA Methodist Healthcare System Baptist Breast Center The American Society of Breast Surgeons

After breast cancer surgery, many women are told to limit how much—and how soon—they exercise.

05/20/2026

Cancer survivorship is growing. That's genuinely great news. Survivorship with lymphedema is a different story.

For many breast cancer patients, lymphedema is a direct consequence of the treatment that saved their life. Chronic swelling, limited movement, recurrent infections, the daily burden of compression garments. Studies suggest it affects somewhere between 20% and 30% of those treated, depending on treatment type. For years, the main options were compression garments and massage. Helpful, but not a solution.

Microsurgical procedures can now treat and in some cases prevent lymphedema. LVA (Lymphaticovenous Anastomosis), VLNT (Vascularized Lymph Node Transfer), VOLT (Vascularized Omentum Lymph Node Transfer): procedures that redirect or rebuild the lymphatic system. They work. The problem is that most patients never learn these options exist, because only a handful of centers in the country have the expertise to do this work. PRMA is one of them.

Dr. Anton Fries leads our lymphedema program at PRMA. Patients come to us from all over the world because this work requires a level of microsurgical specialization that most centers simply don't offer.

If you or someone you know is living with lymphedema after cancer treatment and has been told compression is the only option, it may not be. A consultation is the right place to start.

Learn more about your lymphedema surgery options here: prma-enhance.com/post-mastectomy-care/lymphedema-treatment/



PRMA Plastic Surgery - Center for Advanced Breast Reconstruction Advanced Reconstructive Surgery Alliance -ARSA Methodist Healthcare System Baptist Breast Center

PRMA offers advanced lymphedema treatment in San Antonio. Discover surgical options for relief and recovery after breast cancer and mastectomy.