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    Peter Ledoux, MD

    5.0 (3 reviews)
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    Steven Pisano, MD

    Steven Pisano, MD

    1.5(2 reviews)
    0.0 mi

    I turned to Dr. Pisano and PRMA after a failed breast reconstruction with another surgeon. They…read morespecialize in the DIEP flap reconstructions like the one I had, and I have no doubt that PRMA generally delivers good results with the DIEP flap. But they're a DIEP assembly line, and I wouldn't recommend going there for anything else. It's a volume practice that doesn't have the time to deal with more complicated cases. Dr. Pisano recommended a back flap for me. He warned me that it might not result in any cosmetic improvement depending on the amount of damage from the previous surgeries, but it would at the least replace damaged tissue with healthy tissue so that the next surgery could be successful. That turned out to be the case. I was disappointed after the first surgery but hopeful that the next one would work. The second surgery wit Dr. Pisano was a complete flop. We did a reduction on the healthy breast and fat graphs on the reconstructed breast. After the surgery, I was still a D cup on one side and a B cup on the other. I assume Dr. Pisano knew that the results weren't good because right after the surgery he told my husband that we might be able to try the fat graphs again and be more creative about where to take the fat or we could talk about an implant. But a few days later, his nurse told me that he "didn't recall" that conversation, that my insurance wouldn't cover anything else, and that I would have to pay Dr. Pisano's higher cosmetic rates if I wanted a better outcome. I felt like I'd been kicked in the head. When I asked his nurse why the fat graphs didn't work, she told me that I was "a trim little thing." Who knew that would be such a surprise to my surgeon? At that point, I had lost all faith in Dr. Pisano so I went to another surgeon. He told me that my insurance would cover as many revisions as necessary to achieve symmetry, but the reimbursement was low so some surgeons wouldn't accept it. I don't know why PRMA doesn't just explain that to patients. It's hard to imagine that people who work all day with cancer patients could be so cruel and heartless. As for Dr. Pisano, I'm sure he has more successes that failures, but I can't recommend a surgeon who has so little personal integrity. I remember during my first appointment, he was talking about all that I had been through and he reached up and touched the cross he wore around his neck. I was touched by the move, but in hindsight it would have been more appropriate if he had been wearing a dollar sign.

    I experienced almost every complication possible and some not mentioned. The way in which problems…read morewere handled was with avoidance, so cowardly on a human level and unprofessional. I would strongly suggest avoiding this Doctor.

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    Steven Pisano, MD
    Steven Pisano, MD
    Steven Pisano, MD

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    Chet Nastala, MD

    Chet Nastala, MD

    3.7(3 reviews)
    0.0 mi

    From the moment I spoke with the Patient Liaison to the end of the reconstruction process I have…read morereceived nothing short of the most outstanding care. Dr. Nastala and his staff are the most loving and yet professional staff I have ever had the pleasure to deal with. I am 100% satisfied with my results and would highly recommend them to anyone seeking reconstruction.

    I had an accident and the emergency room doctor asked me to go to Chet next day. I went there and…read morethey told me that I should go for skin grafting to avoid scarring. I asked about the cost but they kept saying you will just pay 20% but that can be $50 or $5000. Since I was under shock and did not know what was right, I agreed. They setup an appointment 2 days later for grafting. I felt very uncomfortable and was able to find a doctor in friend's family. I consulted her on phone. She told me that they should not be doing grafting on fresh wounds. Grafting can be done anytime, even years later, so there is no hurry. First I should see how much it heals. This made lot more sense to me. I cancelled the appointment. Later that week i received letter from insurance telling me that my hospitalization request for 3 days has been approved. WTF? They did not even mention that I will need to be admitted in hospital for 3 days. Thankfully the wounds healed on their own. The scarring is so minimal that grafting scars would have been more obvious. Essentially I think Chet (I am ashamed to call him doctor) wanted to fix the problem before it fixes itself. He makes money at the cost of YOUR health. I recommend stay away from him.

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    Chet Nastala, MD
    Chet Nastala, MD
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    PRMA Plastic Surgery - The surgeons of PRMA

    PRMA Plastic Surgery

    4.6(22 reviews)
    0.0 mi

    I wanted to share this for anyone trying to choose a surgeon...because I know firsthand how…read moreoverwhelming and important this decision is. When I first met Dr. Gassman, I'm not even going to lie... my first thought was, "He looks like Doogie Howser" I remember thinking, wait... are you old enough to be doing this?! But that feeling didn't last long. I came in with a million questions (seriously), and he answered every single one with patience, confidence, and detail. He never made me feel rushed or like I was asking too much which meant a lot during such a big decision. I also did a ton of research on him where he's worked, reviews, everything. That's when I learned how much he specializes in DIEP flap reconstruction and microsurgery, which made me feel even more confident in choosing him. I also loved learning that he has a passion for art and uses that in his work--and honestly, it shows. He is incredibly talented and takes pride in what he does. For reference, I'm 5'3" and about 205 pounds, so if you're someone who's plus size and wondering how this surgery might go for you--I hope this helps ease your mind. Also--before surgery, I was a very small A cup. I actually joked with Dr. Gassman and told him, "I'm the president of the itty bitty titty committee, and if you can get me out of the committee, I would greatly appreciate it" Let's just say... I woke up from my first surgery officially out of the committee--whoop whoop! I had my first DIEP flap surgery on December 3, 2025. I want to share this part because I know it's something everyone worries about--pain. For that first surgery, Dr. Gassman used nerve blocks, and he is phenomenal at them. I actually didn't use any pain medication at all, which still surprises me looking back. The recovery itself was tough (as expected with a major surgery), but the pain control was handled so well. I just had my second surgery on March 20, 2026, and I was honestly nervous...but it ended up being so much easier. I didn't have nerve blocks that time, and it honestly just feels like I did a really intense workout--more sore than actual pain. That was a huge relief. My results are looking good so far, and I even got a new belly button and was able to lower my scar, which I'm super grateful for ! I also want to recognize Dr. Elmi, who performed my double mastectomy. I originally started this journey as a preventative measure, but after my first surgery, she sat down with me and gently explained that I did in fact have cancer. She took the time to draw everything out and explain exactly what type it was in a way I could truly understand. Even though I don't live in San Antonio, she made sure I was set up with care back home in Florida, which meant so much to me. Looking back, I laugh at my first impression--but I'm so grateful I trusted both of these doctors. They are not only highly skilled, but they truly care about their patients. If you are trying to make this decision, I hope my experience gives you a little peace of mind. You will be in very good hands.

    If you're looking for the gold standard in reconstructive breast surgery, PRMA is it. From the…read moremoment you walk in, you're treated like a person, not a procedure. The surgeons are masters of their craft -- meticulous, compassionate, and refreshingly human. The nurses and staff keep you informed, comfortable, and cared for every step of the way. My outcome exceeded my expectations both aesthetically and functionally, and the recovery support was outstanding. PRMA isn't just where you go for surgery -- it's where you go to feel whole again.

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    PRMA Plastic Surgery
    PRMA Plastic Surgery

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    Peter Ledoux, MD - cosmeticsurgeons - Updated May 2026

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