Also Serving Mclean, Alexandria, Loudoun County and Arlington


Overview of Diep Flap Surgery in Washington DC

The DIEP flap (Deep Inferior Epigastric Perforator) is a technique utilized in reconstructive breast surgery, after removal of a whole breast (mastectomy/bilateral [double] mastectomy) or part of the breast (segmental mastectomy, quadrantectomy or wide local excision), whereby the lower abdominal skin and fat are transplanted to rebuild the breast(s). The DIEP flap is one of the most advanced operations for breast reconstruction and patients have experienced significant enhancement in their quality of life and return to normalcy thanks to the natural results, as well as an improvement in abdominal contour achieved by Dr. Rad.

Dr. Rad is considered one of the premier physicians in DIEP flap reconstruction. Dr. Rad works diligently with you to ensure your goals for symmetry, size and proportion are reached. Having performed hundreds of DIEP flap operations, Dr. Rad’s success rate exceeds 99% and his patients enjoy quick, comfortable recovery as well as results that last a lifetime.

Learn The Nuance Of The Washington DC Diep Flap Surgery

Diep Flap Surgery

Dr. Rad’s approach is unique for each patient, and it combines sophisticated, state-of-the-art techniques to achieve natural and long lasting results.

Am I a Good Candidate for Diep Flap Surgery Surgery?

Most women who have experienced a whole or partial mastectomy tend to be ideal candidates for the breast reconstruction technique known as DIEP Flap. This procedure can be performed either at the same time as their initial mastectomy (immediate reconstruction) or months, even years, later (delayed reconstruction). The goal of the procedure is to provide survivors of breast cancer an opportunity to restore their breast/s which were excised during the surgery to remove cancerous cells. This procedure has brought peace of mind to thousands of cancer survivors looking to return to their normal lives.

You may be a candidate for DIEP flap procedure if:

  • • you are healthy
  • • you desire your own tissue for reconstruction
  • • you have extra fat in your lower abdomen
  • • you don’t have long abdominal scars that go across your entire abdomen
  • • you do not want, or cannot have implants
  • • want their breasts to be rebuilt with their own natural tissue
  • • do not have long (across the midline) scars across the abdomen from prior surgery

Even if you’ve had prior abdominal surgery such as liposuction, appendectomy, gallbladder surgery, or C-section, you are still likely to be a candidate for the DIEP flap. Keep in mind that the final determination depends on Dr. Rad’s assessment.

Patients who need, or who have had, radiation therapy are good candidates for DIEP flap reconstruction rather than implants because of internal scarring (called “capsular contracture”) often caused by radiation. In general, if you have about as much abdominal fat as your current (or pre-mastectomy) breast size, then the DIEP flap may be a good option. Even if the volume of abdominal fat is smaller than your breast size, with outpatient fat grafting procedures Dr. Rad often is able to rebuild your breast(s) to the size you desire. Dr. Rad will guide you in this decision.


Your vision for your results will emerge through detailed consultation with Dr. Rad, meticulous examination of your anatomy, and careful pre-surgical planning. While Dr. Rad’s surgical approach is unique for each patient, the goal of naturalness remains constant.

Swipe left/right to view the slideshow

Actual Washington DC Diep Flap Surgery Patient of Dr. Rad’s
See More Top Diep Flap Surgery Results

Sherber+Rad cannot guarantee specific results.
Individual results may vary.

How Does Dr. Rad Approach Diep Flap Surgery Surgery?

99% of plastic surgeons offer outdated techniques such as the TRAM flap not because it’s safer for patients, but rather because they don’t have the skill to perform DIEP flaps. Proper execution of the DIEP flap requires specialized skill in microsurgery to perform it safely and effectively. Dr. Rad is one of a handful in the northern VA and DC area who has the technical experience and 1 of only 30 surgeons worldwide who offer the Love Handle flap, as well. For this reason, Dr. Rad’s experience is sought by women from around the world for whom implant or other traditional reconstructive procedures have failed.

Dr. Rad has performed over 1,000 perforator flap (DIEP flap, Love Handle flap, TUG flap, etc.) breast reconstructions, with a success rate of great than 99.5% which is far higher than the national average of 97.5%. To assure your safety it is so important that patients seek out plastic surgeons who have specialized experience and a high success rate in performing these complex operations.

For tissue reconstruction, the DIEP flap is Dr. Rad’s gold standard. He uses excess skin tissue from the lower abdomen to rebuild the breast with beautiful and symmetrical results following their breast cancer journeys.

Dr. Rad is focused on hiding scars in concealed areas such as the natural under-fold of the breast. Dr. Rad’s wife and Board certified dermatologist, Dr. Noëlle Sherber, often performs Laser Scar Therapy to fade and soften scars. Dr. Rad works with Vinnie Myers, one of the world’s premier professional tattoo artist for nipple and areola tattooing which can also mask mastectomy scars.


  • The DIEP flap is ideal for one-sided reconstruction for both nipple-sparing and non-nipple sparing mastectomy.
  • An inframammary (under fold) scar placement is ideal to hide the evidence of mastectomy.
  • Dr. Rad endeavors to render the scar invisible and patients can appear never to have had surgery.

In Dr. Rad’s hands, the DIEP Flap is the perfect option for patients who:

  • have plentiful abdominal fat
  • do not want, or can not have (due to radiation treatment), implant reconstruction
  • want their breasts to be rebuilt with their own healthy tissue
  • want to be finished with surgery forever (this cannot be said for implant reconstruction)
One Side DIEP
  • Implant Reconstruction is the most popular option owing to the ease of recovery and simplicity of surgery; however, implant reconstruction often is not a good option due to scar tissue problems caused by prior breast radiation.
  • LSGAP “Love Handle” Flap Reconstruction borrows love handle fat and is the most complex breast reconstructive operation in existence; Dr. Rad is 1 of only 30 microvascular surgeons worldwide who is able to perform it. 
  • Dr. Rad often performs either immediate reconstruction (DIEP flap at the time of the mastectomy) or staged reconstruction (a Tissue Expander is placed at the time of the mastectomy, and then the DIEP flap is performed as a second stage).
  • Breast reconstruction is safe and is performed under general anesthesia and a short hospitalization is standard for most reconstructive procedures.
  • Dr. Rad works with a board certified anesthesiologist and performs surgery in the top hospitals in the Washington DC and northern Virginia area.


  • Bilateral reconstruction with the DIEP flap is Dr. Rad’s preferred method when there is plentiful abdominal tissue.
  • Dr. Rad endeavors to render the scar invisible and patients can appear never to have had surgery.
Recommended Procedures

In Dr. Rad’s hands, the DIEP Flap is the perfect option for patients who:

  • have plentiful abdominal fat
  • do not want, or can not have (due to radiation treatment), implant reconstruction
  • want their breasts to be rebuilt with their own healthy tissue
  • want to be finished with surgery forever (this cannot be said for implant reconstruction)

Double DIEP
Other Options
  • Implant Reconstruction is the most popular option owing to the ease of recovery and simplicity of surgery; however, implant reconstruction often is not a good option due to scar tissue problems caused by prior breast radiation.
  • LSGAP “Love Handle” Flap Reconstruction borrows love handle fat and is the most complex breast reconstructive operation in existence; Dr. Rad is 1 of only 30 microvascular surgeons worldwide who is able to perform it.
How It’s Done
  • Dr. Rad often performs either immediate reconstruction (DIEP flaps at the time of the double mastectomy) or staged reconstruction (Tissue Expander are placed at the time of the double mastectomy surgery, and then the DIEP flaps are performed as a second stage).
  • Breast reconstruction is safe and is performed under general anesthesia and a short hospitalization is standard for most reconstructive procedures.
  • Dr. Rad works with a board certified anesthesiologist and performs surgery in the top hospitals in the Washington DC and northern Virginia area.


  • Angelina Jolie carries the BRCA1 gene. With this gene, she had a 45% chance of developing breast cancer by age 70. She chose a preventive double mastectomy with reconstruction in order to lower that risk.
  • Patients who carry the BRCA2 genes have a 60% chance of developing breast cancer by age 70.
  • Patients who have either gene should undergo preventive mastectomies and reconstruction.
  • Rad’s preferred method of reconstruction is the DIEP flap. If there is not enough fat in the abdominal area then implants are suitable.

In Dr. Rad’s hands, the DIEP Flap is the perfect option for patients who:

  • have plentiful abdominal fat
  • do not want, or can not have (due to radiation treatment), implant reconstruction
  • want their breasts to be rebuilt with their own healthy tissue
  • want to be finished with surgery forever (this cannot be said for implant reconstruction)
  • Implant Reconstruction is the most popular option owing to the ease of recovery and simplicity of surgery; however, implant reconstruction often is not a good option due to scar tissue problems caused by prior breast radiation.
  • LSGAP “Love Handle” Flap Reconstruction borrows love handle fat and is the most complex breast reconstructive operation in existence; Dr. Rad is 1 of only 30 microvascular surgeons worldwide who is able to perform it. 
  • Dr. Rad often performs immediate, one-stage reconstruction (DIEP flaps at the time of the double mastectomy) for prophylactic mastectomy patients.
  • Breast reconstruction is safe and is performed under general anesthesia and a short hospitalization is standard for most reconstructive procedures.
  • Dr. Rad works with a board certified anesthesiologist and performs surgery in the top hospitals in the Washington DC and northern Virginia area.


  • Breast reconstruction is attempted by many but performed successfully by very few.
  • As such many patients, who suffer breast disfigurement caused by radiation and/or prior failed surgeries, seek out Dr. Rad to perform corrective work.
  • Patients who have either gene should undergo preventive mastectomies and reconstruction.

Symmetry and beauty are elusive goals that require of the surgeon a mastery of technical and artistic skills. Through corrective reconstructive techniques Dr. Rad aims to:

  • Restore symmetry
  • Create natural contour and volume
  • Position the nipples perfectly
  • Minimize scarring
Corrective DIEP

Watch Dr. Rad discuss Microsurgery and the LSGAP “Love Handle” Flap

  • Breast reconstruction is safe and is performed under general anesthesia and a short hospitalization is standard for most reconstructive procedures.
  • Dr. Rad works with board certified anesthesiologists and performs surgery at Inova Fairfax Hospital, a hospital in northern VA.



A DIEP flap is a type of tissue flap that borrows tissue from the abdomen and transfers it to the breast for a complete rebuild (see figure, right). It’s a highly effective tool that only plastic surgeons with specialized training in microsurgery are able to perform. Very few plastic surgeons in the world are able to do these types of flaps. The DIEP flap is an excellent option for those who need radiation treatment, because it solves problems associated with implants, such as ‘capsular contracture,’ which is constricting scar around the implant. It also provides the most natural and permanent reconstructive option to women while also giving patients a ‘tummy tuck,’ or flat and contoured abdomen, which is a desirable outcome for patients with extra abdominal fat. It is also very unique in that it spares the abdominal “core” muscles which are important for core stability. This makes the DIEP flap very different from the TRAM flap which completely removes the core abdominal muscle(s) (in addition to the overlying skin/fat). Most plastic surgeons are unable to perform DIEP flaps due to lack of skill in microvascular surgery, and instead they offer the TRAM flap because it is easier to perform. However, there are down sides to removing the core muscles: while the TRAM flap works well for breast reconstruction, more studies are showing that the problems that removing the core muscles cause is not worth it: weakness of the core, difficult rising from bed or a chair, coughing, sneezing, and providing trunk stability; also hernias or bulges occur much 4 times more frequently with TRAM flap surgery and this often leads to surgery for repair. For this reason, Dr. Rad choose not to offer the TRAM flap.


Dr. Rad borrows tissue from the abdomen, carefully identifies and separates from the muscle the key blood vessels leading to the skin and fat. Dr. Rad takes great care to preserve the core abdominal muscles, and then transplants the tissue to your breast. Dr. Rad then carefully connects the blood vessels of the tissue to blood vessels in your chest (the “internal mammary” vessels) to restore circulation through the tissue. This is a delicate surgery requiring specialized microsurgical skill that very few plastic surgeons have. The DIEP flap is an excellent option because patients can have a more contoured abdomen (a tummy tuck) and complete breast rebuilding.


As the saying goes, “the squeaky wheel gets the oil”! You’ll need to plead your case with your insurance company which often need reasons from you for why Dr. Rad must do your surgery as opposed to another surgeon. Insist your insurance company “I want Dr. Rad to be my surgeon because”:
Dr. Rad has unique expertise in microvascular perforator flap (DIEP, SGAP) surgery
Dr. Rad trained at the world’s top institutions for microvascular perforator flap surgery
Dr. Rad’s flap success rate is higher than the national average (99% vs 97%)
Dr. Rad’s operative times are much lower than the national average even for 2 surgeon teams (for bilateral DIEP flaps : 5.5 hours vs 8-10 hours)
Dr. Rad’s complication rate is much lower than the national average
Dr. Rad’s length of hospital stay is much lower than the national average (3 nights vs 4 nights)
Dr. Rad’s team is highly experienced in DIEP flap surgery
This “the squeaky wheel gets the oil” approach gives you the best chance of success. If they still do not agree to covering Dr. Rad then you should insist on a “peer to peer” call between the Medical Director and Dr. Rad.


Yes! This is the most important decision to make. Surgeons’ experience, training, flap success rate (and flap loss rate), operative times and rate of abdominal hernia/bulge are the most important details for successful and safe surgery. While many surgeons claim to perform the DIEP flap, there is a wide range of experience. High flap loss rates (> 5%) and long operative times (> 10 hours) can lead to complications; removal of abdominal muscle (such as in the TRAM flap) can lead to hernias and bulges which require future reconstructive surgery. For your safety go to the right surgeon regardless of insurance coverage. Dr. Rad is very transparent and honest with patients about his process. Over 10 years of practice Dr. Rad has performed well over 1,200 free perforator flap surgeries for breast reconstruction. His statistics are as follows (national averages shown in [brackets]):
Over 1,200 DIEP, SGAP and TUG flaps
Flap success rate: 99.2% [national average: 97%]
Flap loss: 0.8% [national average: 3%]
Abdominal Bulge Rate: 0.5% [national average: 5%]
Hernia Rate: 0% [national average: 3%]
Hematoma: 0.5% [national average: 4%]
Unplanned return to OR: 2% [national average: 7%]
A number of surgeons who claim to perform the DIEP flap may in fact not perform it. This may be difficult to ascertain. The best way to find out a surgeon’s track record is to ask other patients and read online patient reviews. Also, we are happy to connect you with one or more of Dr. Rad’s patients to give real accounts of their experiences.


Questions should zero in on a surgeon’s experience and what to expect:
How many DIEP flap surgeries have you performed? (The more experience the better)
What is your “flap loss rate”? (This should be no higher than 2.5%)
How long is your operative time? (On average this should be less than 4 hours for unilateral, less than 8 hours for bilateral. Excessively longer OR times are usually not necessary and may indicate inexperience.)
Will there be another surgeon participating in my surgery? (Two surgeon teams are usually not necessary and may speak to relative inexperience of both)
What is the chance of returning to the OR to address a blood flow problem? (This should be less than 7%)
Do you use mesh to reinforce the abdominal wall? (This is usually unnecessary – routine reinforcement of the abdomen usually indicates that muscle may be taken in surgery)
How long will I be in the hospital? (For Dr. Rad’s patients, 99% of the time patients stay 3 nights).


Dr. Rad performs DIEP flap reconstruction at multiple hospitals. His preferred hospital is Inova Fairfax Hospital because Dr. Rad’s support teams (anesthesia, nursing, OR technicians) are highly experienced in DIEP flap surgery and care, and the hospital has the resources (equipment, processes and recovery unit) to optimize your experience. Dr. Rad also performs DIEP flap surgery at Sibley Memorial and George Washington Memorial Hospitals. This is a good second option.


If you have abdominal scars (aside from very small ones as from laparoscopic surgery) then Dr. Rad will advise you whether you’re a candidate for a DIEP flap. The most common scar is from a C-section – the majority of the time these scars do not pose an issue. However, in about 1% of patients, a C-section scar has cut through the blood supply to the abdominal skin/fat which makes the DIEP flap impossible to perform. You will need to have a CT Angiogram, a specialized cat scan that shows the blood vessels to the abdominal tissues. This is an excellent test to determine if you are a candidate for a DIEP flap, especially if you have scars that may be an issue. Other reasons that patients may not be a good candidate for a DIEP flap are those with a history of clotting problems such as deep venous thrombosis, pulmonary embolism, known coagulation problems, or patients with severe medical problems such as heart, lung, kidney disease.


This is a rare situation because Dr. Rad performs the full spectrum of reconstruction and usually he can come up with a unique plan that fits your goals. If you are slender and Dr. Rad determines that the amount of abdominal tissue does not match your breast size goal, then the following are good options to achieve your goals: 1. DIEP Flap(s) [1st stage]; Liposuction Flanks and Fat Transfer [2nd stage] 2. DIEP Flap(s) + Implants [1st stage] 3. DIEP Flap(s) + TUG Flap(s) (called “stacked flaps”) [may require a 2nd stage] 4. DIEP Flap(s) + Latissimus Flap(s) (“stacked flaps”) [may require a 2nd stage] These are all excellent options and the final choice depends on your goals and Dr. Rad’s assessment of the best path forward.


A CT scan of your abdomen for pre-operative planning of the DIEP flap is necessary and will need to be done not later than 2 weeks prior to your DIEP flap surgery. The CT scan provides important information, specifically: (1) the exact location of the dominant blood vessels (this helps to decrease surgery time and optimize flap success), (2) whether C-section scars have compromised blood flow to your abdominal tissues, and (3) presence of hernias. We will provide a prescription for the CT scan. You should have this done at Fairfax Radiology – please call 703-698-4441 to arrange the appointment. Their fax is 703-698-0864. Dr. Rad will review the images and determine if the CT scan shows good blood supply making you a good candidate for DIEP flap(s).


Operative times vary by surgeon, usually from 5 to 8 hours for bilateral DIEP flaps. For your safety OR and anesthesia time should be minimized – the key is to be under the care of a high experienced and skilled surgeon and team. For Dr. Rad’s patients, unilateral DIEP flap takes about 3+ hours. Bilateral DIEP flaps take about 5-6 hours. The reason it takes this long is because it’s a very delicate and precise operation. Dr. Rad’s operative times are very efficient because he has over a decade of experience performing the DIEP flap with over 1200 perforator flaps he has personally performed. Furthermore, Dr. Rad has the same team to assist him which optimizes efficiency. By comparison, there are other surgeons who take much longer to perform DIEP flap surgery, and even some who take well over 20 hours even with another surgeon to assist. This speaks to inexperience and lack of skill: do not proceed in these situations.


You will stay in the hospital typically 3 nights. This is to monitor the flaps and make sure that they stay healthy and to get you back to normalcy as soon as possible. While in bed immediately after surgery, you will be flexed up at the hip so that there’s minimal tension on your abdominal wound. You may have a warming blanket, and the nurse will be checking on you every hour to ensure that there is good blood flow through the flaps. You will not be given food or drink the night after surgery, but you will be well hydrated with IV fluids. The next day after surgery you’ll be moved to a chair and given liquids and your diet advanced. The 2nd day after surgery you’ll be able to walk with assistance, and you’ll be weaned off of IV medications and fluids and started on oral pain medications. The 3rd day after surgery you’ll be able to go home.


In the hands of a highly experienced microsurgery such as Dr. Rad, the DIEP flap is very safe. The risks of dangerous complications are hundreds of times lower than the risks of driving a care. The main risks relate to problems with blood flow through the flap(s). In Dr. Rad’s experience problems with 5% of the time. This is a reason to go back to the operating room to remove the clot and restore circulation. About 75% of the time the circulation is restored and the flap is fine, whereas 25% of the time, the flap does not work and must be discarded. In this situation, Dr. Rad usually places a temporary tissue expander so that you may heal and recover, and future reconstruction will be done with another technique down the road. Keep in mind that the loss of a DIEP flap is NOT dangerous to you, and it is rare as it only happens 2% of the time. Flap failure is usually due to factors out of anyone’s control (such as a clotting disorder that may or may not be known or detectable). In the hands of a skilled microsurgeon such as Dr. Rad, about 98% of the time the flap works – this is an excellent success rate. While complications can happen to anyone, and they can be worrisome for patients, the reality is that it’s much more dangerous to drive a car every day than it is to undergo DIEP flap surgery.


Most patients benefit from a subsequent outpatient surgery referred to as a “revision” or “touch up” procedure. Dr. Rad will discuss with you whether you would benefit from a revision. Most often after DIEP flap reconstruction patients slight asymmetries in breast shape, surface contour and volume. Patients may also elect larger or smaller overall breast size and they need nipple reconstruction. All of these issues are addressed to achieve the most beautiful result possible. Insurance does cover revisions and recovery is much easier, lasting on average 3-7 days.


You will have a low positioned abdominal scar that extends from hip to hip as well as a scar around your belly button similar to a cosmetic “tummy tuck” procedure. In the first weeks to months the scar may have slight “pleating” or “puckering” due to the dissolvable sutures beneath the skin but this smooths out over time. Sometimes slight bunching at the incision ends occurs but this can easily be revised at your “touch up” procedure. We initiate scar therapy immediately after your hospital discharge with Aquaphor and then Embrace surgical scar strips once drains are removed. Dr. Sherber (Board certified dermatologist and Dr. Rad’s wife) often performs laser scar therapy for particularly visible or thickened scars, or for patients who desire the best scar appearance (note scar therapy is not covered by insurance).


The cosmetic improvement of the abdomen from the “tummy tuck” is one of the advantages of DIEP flap reconstruction. Dr. Rad endeavors to give you the most beautiful abdominal contour. Dr. Rad makes a gently curving incision in the lower abdominal skin, the skin and fatty layers are elevated, and the excess is removed. The belly button is brought through the abdominal skin and sutured in place.


Muscle weakness, abdominal bulge and hernia are extremely rare as Dr. Rad endeavors to preserve and protect your core abdominal muscle. In Dr. Rad’s hands usually 95% or more of the core muscle is left intact. Dr. Rad has even performed surgery on body builders who reported no functional deficit post-surgery. Mesh material is rarely needed, only in about 2% of patients. Some surgeons place mesh in all patients, however this usually means that more muscle is removed. Ask your surgeon if mesh is placed as a routine – this may indicate that his/her technique is more of a TRAM flap operation (muscle is removed) than a DIEP flap (muscle is preserved). The TRAM flap is an inferior procedure due to the significant weakening of the abdominal wall and higher risk of bulge and hernia. Although TRAM surgery is technically easier for surgeons to perform, Dr. Rad never performs TRAM flaps because of the downsides. Dr. Rad will always optimize your surgery by preserving as much muscle as possible.


Yes! Child care is necessary and therefore is not subject to lifting restrictions that otherwise apply. Use your best judgment with respect to the child care that is necessary and when you’re able try to have other family members assist.


Yes! It is safe to have future pregnancy. This has been studied and published and DIEP flap does not result in additional risk to the fetus.


After DIEP flap reconstruction you will not need mammograms as there are no breast gland tissue in the DIEP flap (abdominal fat). Therefore the risk of cancer developing within the DIEP flap tissue is zero.


The DIEP flap is made of abdominal fat. Once transplanted to the breast, it is impossible for the fat to turn into breast tissue. Therefore, it is impossible for you to get breast cancer inside the DIEP flap tissue. Sometimes a lump can form within the DIEP flap – this is common and is called “fat necrosis.” This just means that some of the fat didn’t get enough blood flow and formed scar tissue that feels like a lump. If this happens, it shows up a few months after surgery – this is NOT a cancer and is very different from having a local recurrence of breast cancer. Local recurrence is rare, but if it were to happen, it would grow slowly over many months to years. It is caused by some breast tissue being left behind that then become breast cancer, or some breast cancer cells being left behind after the mastectomy – this can happen but it is extremely rare. If you’re concerned about this risk, then please speak with your breast surgical oncologist. The most common site of recurrence is in the breast scar, but this is not from cancer growing within the DIEP flap.


You should remain flexed at waist at all times for 3 nights while in the hospital. This means that when you’re lying down in bed, you should have pillows behind your back and under your knees. And when you walk, your knees and waist should stay flexed like being “hunched over.” This position is important to maintain after surgery since your abdominal wound will be under tension. Once you are home, you will still be flexed at the waist but you’ll be able to stretch slightly each day. At 7 days after surgery you should be standing completely straight. You may sleep in your bed with pillows under your back and knees. Do not sleep on your stomach or sides for 4 weeks (the weight of your body can put too much pressure on the DIEP flap tissue). You should avoid strenuous upper body activity such as lifting more than 20 lb (child care is ok), push-ups, running, or jumping activities. Walking is encouraged and you should get up to move around the house several times per day. You may shower when you get home and you may gently wash over your wounds with soap and water. Pat your wounds dry and apply Aquaphor ointment over the incisions. In the shower, you may find it useful to have a plastic stool so that you may sit down. Walk-in showers are best – avoid bathtub due to risk of slipping and falling. If you have family members to assist you. Patients who live out of town more than 3 hours away should stay locally in a hotel for at least the first week.


You will have 2 abdominal drains and 1 drain in each breast. At 1 week after surgery your breast drain(s) and 1 abdominal drain will be removed. The remaining abdominal drain will be removed the following week.


Wound and drain care is straight forward (see separate wound care and drain care documents for details). Dressings will be removed by your nurse prior to discharge on day 3 after surgery. You will then shower daily, scrub incisions and drain sites, and apply Aquaphor over incisions. Perform drain care twice daily. Instructions for how to use the drains will be provided by the nurse who discharges you from the hospital.


BCBS Carefirst – individual contract,
BlueChoice Advantage,
BlueChoice HMO,
BlueChoice HMO Open Access,
BlueChoice HMO Referral,
BlueChoice Opt-Out Open Access,
BlueChoice Opt-Out Plus Open Access,
BlueChoice Plus,
BlueCross BlueShield Preferred (MSP),
BluePreferred PPO,
Comprehensive Major Medical,
FEP – Federal Employee Program,
HealthyBlue 2.0,
HealthyBlue Advantage,
HealthyBlue HMO,
HealthyBlue Plus,
HealthyBlue PPO,
Maryland Point of Service (MPOS) – requires a Carefirst referral for all services rendered,
Personal Comp,
BCBS Out of State– individual contract,
Only BlueCard PPO Plans – the insurance card with have a suitcase logo with a PPO inside,
Cigna – group contract,
Cigna HMO,
Cigna PPO,
Cigna Open Access Plus (OAP),
Medicare – individual contract


Yes, and the good news is that most insurance companies recognize that Dr. Rad is one of the few surgeons with microsurgery (DIEP flap, SGAP flap, TUG flap) expertise in breast reconstruction. Therefore, if you have OON benefits then our billing department usually can convince your insurance company that Dr. Rad is the only surgeon capable of performing your surgery. Keep in mind that you must have OON benefits as part of your insurance plan to have insurance coverage. If you do not have OON benefits then you should add these to your plan, or switch to an insurance plan with which Dr. Rad is in network (see separate Q+A).


Your out of pocket cost (OOPC) is determined by your insurance plan and are comprised of co-payments, co-insurance and deductible. If you are unsure what your deductible/co-payment/co-insurance amounts are, call your insurance company and inquire. This information should be freely provided. If you would like us to help determine your OOPC then we can give an estimage after you consult with Dr. Rad. Call 202.517.7299 to schedule your consultation.


If you do not have out-of-network benefits as part of your insurance plan then be aware that your insurance company may refuse payment for any of Dr. Rad’s services and they may transfer the responsibility of payment to you. In this situation, we would work with you to request an exception with your insurance company so that your financial responsibility is minimized. If your insurance plan does not have any out-of-network benefits, then we recommend taking the following steps to ensure that your surgical fees are covered:
1. Please call your insurance company and request that out-of-network benefits be added to your insurance plan.
2. If your insurance company states that this is not possible, then request that an exception be made for Dr. Rad’s care and to reimburse for Dr. Rad’s fees.
3. You should mention to your insurance company that it is federal law that insurance companies must pay for breast reconstruction following breast cancer surgery, including surgery on the opposite normal breast.
4. If your insurance company refuses to cover Dr. Rad’s fees then we recommend switching insurance plans.


You can take the following steps to minimize your out of pocket costs for breast reconstruction:
1. Ensure your insurance plan is one with which Dr. Rad is in-network (see separate Q+A).
2. If Dr. Rad is OON with your insurance plan, then either have the highest level of OON benefits, or switch to an in-network plan.
3. Ensure your plastic surgeon’s practice works with expert billing department with expertise specifically in breast reconstruction surgery. Insurance claims processing can be complex and not all billers can successfully navigate it.
4. Avoid two-microsurgeon teams: this increases your out of pocket cost potentially by thousands of dollars due to higher billing.


Dr. Rad has performed thousands of free flap operations. His flap success rate is 99.2%. Put into perspective, the average success rate amongst highly skilled microsurgeons nationwide is 97.5%, representing a 3x higher rate of flap failure as compared with Dr. Rad’s. Dr. Rad has been able to achieve this level of flap success not only by having well over a decade of experience and high volume of microsurgery, but also having a hand selected and highly trained team in place to ensure patient care is smooth and safe.


Sometimes, but with Dr. Rad as your surgeon, the answer is no! Dr. Rad’s success rate and operative time is comparable to, if not better than, most 2-surgeon teams. With an average OR time of 3.5 hours for unilateral, and 5.5-6.5 hours for bilateral DIEP flaps, Dr. Rad’s efficiency and precision are unparalelled. Oftentimes, multiple surgeons team up because individually they do not have the skill or precision to carry your surgery independently. Furthermore, multiple surgeons involves higher billing which increases your out of pocket cost by thousands. Being in the right hands and in the right environment are the key, not necessarily how many surgeons are involved.

What are Dr. Rad’s patients saying?

“Dr. Ariel Rad is the finest physician I’ve ever met! I’ve worked with Dr. Rad over the last five years and he encompasses everything you’d hope from a physician and much more. He possesses the highest intellect, sophistication, dedication, and compassion. I can’t say enough about Dr. Rad. Every appointment I’ve had with him has exceeded my expectations. He’s the absolute best! I wouldn’t hesitate to recommend Dr. Ariel Rad to my family and friends for medical care.”

Esther A. | May, 2018

Consultation with Dr. Rad


Our plastic surgery office in Washington DC is centered on your comfort and privacy. You’ll be received by our exquisitely attentive staff, and escorted to your own private cabana wherein you’ll feel relaxed and comfortable while consulting discreetly with Dr. Rad. First Dr. Rad will determine if you are a good candidate for surgery and during your consultation you should decide if Dr. Rad is the right surgeon for you. Credentials are crucial and, in addition to being Board certified in plastic surgery, Dr. Rad is Assistant Professor at Johns Hopkins, and he enjoys an impeccable reputation as a top flight aesthetic surgeon. His facial plastic surgery expertise is sought out as one of the best surgeons in Washington DC, northern Virginia and the US.

Your safety is Dr. Rad's primary concern and he will review your medical history. You should inform Dr. Rad of any medical problems or medications that may affect your healing. If you are medically appropriate to undergo surgery then Dr. Rad's focus will be to understand what specific aesthetic concerns you have. Washington DC patients expect natural results with minimal downtime. Dr. Rad will spend time carefully listening to your concerns, asking clarifying questions and then masterfully guiding you, step by step, to understand how your unique anatomy can be improved to convey a rested appearance. Dr. Rad’s goal is to determine the most comprehensive approach for long lasting, natural results while minimizing downtime. Dr. Rad first needs to understand your specific concerns and you should prepare your thoughts prior to your consultation. Think of words that convey how you feel about your appearance. For example, Washington DC patients often say they look fatigued, tired or lackluster because of undereye bags or dark undereye circles, or they look sad, upset or disinterested such as from heavy eyebrows, excess skin above the eyes or downturned corners of the mouth. Patients often relate concerns of looking older than how they feel and this can be caused by jowls, nasolabial folds, loose neck skin, lines and wrinkles. Try to put into words how your appearance bothers you, and the priority you give to each area. Dr. Rad will then present to you his expert opinion about which procedures would be best to restore your anatomy to create a rested and refreshed appearance. And since surgery is intricate Dr. Rad will guide you through a stepwise approach of aesthetic analysis and he’ll deliver his recommendations in a clear and honest manner. Dr. Rad will present all options available in modern day surgery, both non-surgical and surgical.

Dr. Rad and Board certified dermatologist Dr. Sherber often collaborate to optimize patients’ results and to minimize invasiveness. As such Dr. Rad’s modern approach to surgery harnesses the power of both dermatology and plastic surgery as both specialities address different aesthetic challenges. For example, plastic surgery is effective to lift, tighten and volumize loose, atrophied tissues, whereas dermatologic treatments such as laser, radiofrequency tightening and skincare are best to improve skin texture, pigmentation and tone. Dr. Rad can address any concerns regarding skin quality and how to obtain and maintain optimal results.

Dr. Rad will review with you photos of his patients’ results (many of which you’ll not find online due to privacy concerns) to highlight his aesthetic approaches and skill. He will take your photographs, which remain confidential, to assist with the planning of your surgery. For your safety Dr. Rad performs surgery in a hospital-based operating room, considered to be the safest environment, rather than in the office. Anesthesia is delivered by a board certified anesthesiologist (MD) and you’ll be under light anesthesia which is important for your safety and comfort.

You will receive a customized quote for the procedures in which you’re interested. Once approved we may then move forward with pre-operative preparations and you will meet with Dr. Rad again at your final in person consultation prior to surgery. Dr. Rad’s reputation as one of the most technically gifted surgeons attracts patients nationally and from around the world. We cater to patients from across the globe by arranging virtual consultations, luxury accommodations at The Jefferson hotel, Washington DC’s most luxurious 5 star boutique hotel, as well as private nursing care. Your privacy, comfort and safely achieving exceptional results are our top priorities.

About your Washington DC surgeon

Dr. Rad’s credentials speak for themselves: Princeton (B.S.E, Magna Cum Laude), Duke School of Medicine (M.D.) and University of London (Ph.D.) educated and Johns Hopkins Plastic Surgery trained, he is a Diplomate of the American Board of Plastic Surgery, Assistant Professor at Johns Hopkins, and long-standing member of the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgery. Dr. Rad is considered an expert in facial plastic surgery and microsurgery. He is ranked the #1 plastic surgeon in Washington DC based on aggregate ratings from all independent ranking websites: “top rated local“, “three best rated” top plastic surgeon and “top plastic surgeon reviews“. SHERBER+RAD have never engaged in paid advertising, and all rankings, reviews are from vetted and respected sources.

Meet Dr. Rad

What is the cost of Diep Flap Surgery in DC?

Many patients wish to anticipate their personal financial responsibility when planning for surgery. First, keep in mind that you have the right to insurance coverage of reconstruction by the 1998 Women’s Health and Cancer Rights Act. This includes coverage for surgery on your affected breast as well as your other breast for symmetry. Second, Dr. Rad is in-network with Cigna as well as several Blue Cross Blue Shield (BCBS) insurance products including CareFirst, BlueChoice and others (call us to find out if Dr. Rad is in network with your provider). If you have United, Aetna, Anthem BCBS, Humana, Kaiser Permanente, TriCare or any other insurance plan, then ask your insurer if you have out-of-network benefits. If you do then you likely qualify for coverage under Dr. Rad’s care. If you’re not sure, our professional billing department can help you determine what your benefits are.

If you are interested in highly specialized microsurgery flap techniques such as DIEP flap, SGAP “love handle” flap or TUG flap surgery then you may qualify for coverage under Dr. Rad’s care because these are highly specialized procedures and very few plastic surgeons have the skill to perform them. Dr. Rad is the only surgeon in the DC/Northern Virginia area performing the SGAP flap.

When 2 or more plastic surgeons are involved in your surgery your out-of-pocket cost can increase by thousands. Plastic surgeons often team up to perform microsurgery because (1) they are unable individually to perform these surgeries with high degree of safety and precision, and/or (2) surgeon reimbursement is higher. With his highly specialized team, Dr. Rad operates as a solo surgeon which greatly reduces your out-of-pocket cost. Importantly, Dr. Rad’s patients enjoy beautiful outcomes and >99% flap success rate – a much higher success rate than most two-surgeon teams (97.5%) – and his average surgery time is approximately 6 hours for bilateral DIEP flaps (national average is 8-12 hours, and can even exceed 20 hours even for two-surgeon teams). More surgeons being involved is not necessarily better; technical skill and experience are most important.

Our billing department uses a proven 3-step process to settle claims with your insurance so that your out-of-pocket costs are minimized:

1. We take the necessary steps to maximize insurance coverage for your surgery by requesting insurance “prior authorization.” This is an agreement from your insurance company to cover the costs of surgery and we will do everything in our power to obtain your insurance company’s prior authorization before surgery.

2. We are your ally! Dr. Rad and his team work with a professional billing service to ensure your insurance company agrees to cover the cost of surgery.

3. We don’t give in! Even with prior authorization some insurance companies push back on total coverage. We work with other professionals in the legal sphere to convince your insurance company that full coverage is required.

Many hundreds of patients have enjoyed beautiful lifelong results under Dr. Rad’s care, and we will be happy to answer your questions. Call us at 202.517.7299 to schedule your consultation with Dr. Rad.

Get Started

We look forward to welcoming you for your private consultation with Dr. Rad

Enjoy a unique experience centered on your privacy and on unhurried attention to your concerns


Or Send a confidential inquiry and our staff will be happy to reach out to you


Sherber+Rad1101 15th St. NW, Suite 100, Washington, D.C. 20005