University of California San Francisco

Piper, Merisa
Merisa L. Piper, MD

Assistant Professor of Surgery
Division of Plastic and Reconstructive Surgery


2200 Post Street, #C3-48
San Francisco, CA 94115
United States

Phone: 415-353-4320
Fax: 415-353-4285


    Dr. Merisa L. Piper is a plastic and reconstructive surgeon who specializes in breast reconstruction and general reconstruction, with expertise in all methods. With the goal of restoring appearance after partial or complete breast removal, she focuses particularly on microsurgery and free tissue transfer, using skin, fat and muscle from another part of the body. Piper's research focuses on improving outcomes after breast reconstruction, particularly after microsurgery and oncoplastic surgery, which combines tumor removal with reconstruction. She is interested in how the timing of breast reconstruction and various interventions may affect the development or prevention of capsular contracture (the body naturally encapsulates a synthetic implant, and the capsule sometimes shrinks and causes discomfort). She also studies how to improve outcomes in patients who have had tumor removal in combination with breast reconstruction. Piper earned her medical degree from the University of California, Irvine. She completed a combined general surgery and plastic surgery residency at UCSF. During her residency, she spent one year investigating breast reconstruction outcomes and developing a phase II clinical trial, a study that examines a treatment's efficacy and safety. She then completed a fellowship in microsurgery at the University of Pennsylvania. Piper has authored more than 25 papers and presented her work nationally and internationally. She is a breast section editor for Annals of Plastic Surgery and a guest reviewer for four scientific journals. In her free time, Piper enjoys running, swimming, baking and being with her husband and two kids.


    Institution Degree Dept or School End Date
    University of California Diversity, Equity, and Inclusion Champion Training 2019

    Clinical Expertise


    Body Contouring

    Botox and Fillers

    Breast Reconstruction

    Breast Surgery

    General Reconstructive Surgery


    Microsurgical Breast Reconstruction

    Microvascular Surgery

    Reconstructive Microsurgery

    Skin Cancer Reconstruction

    Trauma Reconstruction

    Clinical Trials

    1. Related Conditions: Breast Cancer| Start Date: | End Date:
    2. Related Conditions: Breast Cancer| Start Date: | End Date:

    Program Affiliations

    Research Interests

    Breast reconstruction clinical outcomes

    Capsular contracture

    Extremity sarcoma


    1. Paraspinous Muscle Flaps in Complex Pediatric Spine Surgeries: A 12-Year Single Institution Experience.
      Falade I, Park KM, Conkling N, Kim EA, Hansen SL, Hoffman W, Piper ML| | View in PubMed
    2. ASO Visual Abstract: Nipple-Sparing Mastectomies in Patients over the Age of 60 Years: Factors Associated with Surgical Outcomes.
      Parmeshwar N, Dugan CL, Barnes LL, Cheng JK, Patterson AK, Miller A, Mukhtar R, Piper M| | View in PubMed
    3. ASO Author Reflections: Evaluating Nipple-Sparing Mastectomies in Patients Over Age 60.
      Parmeshwar N, Piper M| | View in PubMed
    4. Evaluating mesh use for abdominal donor site closure after deep inferior epigastric perforator flap breast reconstruction: A systematic review and meta-analysis.
      Parmeshwar N, Lem M, Dugan CL, Piper M| | View in PubMed
    5. Nipple-Sparing Mastectomies in Patients over the Age of 60 Years: Factors Associated with Surgical Outcomes.
      Parmeshwar N, Dugan CL, Barnes LL, Cheng JK, Patterson AK, Miller A, Mukhtar R, Piper M| | View in PubMed
    6. The impact of post-mastectomy radiation timing on overall outcomes of autologous free-flap breast reconstruction.
      Parmeshwar N, Barnes L, Martins D, Nicholas C, Piper M| | View in PubMed
    7. Reviewing the Impact of Topical and Intravenous Tranexamic Acid Use in Breast Plastic Surgery.
      Parmeshwar N, Mehta SR, Piper M| | View in PubMed
    8. Modifiable Post-Mastectomy Radiation Therapy Factors and Impact on Implant-Based Breast Reconstruction Outcomes.
      Barnes LL, Chew J, Lem M, Park C, Yang JC, Prionas N, Piper M| | View in PubMed
    9. Evaluation of Microvascular Autologous Breast Reconstruction in Patients Older Than 60 Years.
      Parmeshwar N, Barnes LL, Dugan CL, Patterson AK, Lem M, Piper M| | View in PubMed
    10. Relationship between Body Mass Index and Outcomes in Microvascular Abdominally Based Autologous Breast Reconstruction.
      Barnes LL, Lem M, Patterson A, Segal R, Holland MC, Lentz R, Sbitany H, Piper M| | View in PubMed
    11. Immediate Versus Delayed-Immediate Autologous Breast Reconstruction After Nipple-Sparing Mastectomy.
      Barnes LL, Patterson A, Lem M, Holland MC, Lentz R, Sbitany H, Piper ML| | View in PubMed
    12. Long-Term Outcomes in Prepectoral versus Subpectoral Two-Stage Implant-Based Breast Reconstruction after Nipple-Sparing Mastectomy.
      Alcon A, Rosser M, Gedallovich J, Foster RD, Sbitany H, Piper ML| | View in PubMed
    13. Expanding Candidacy for Nipple-sparing Mastectomy in Women with Large or Ptotic Breasts: Staged Reconstruction Outcomes.
      Barnes LL, Foster R, Mukhtar RA, Esserman LJ, Ewing C, Alvarado M, Wong J, Piper M| | View in PubMed
    14. Safety of Incision Placement with Nipple-sparing Mastectomy and Immediate Prepectoral Breast Reconstruction.
      Holland M, Wallace A, Viner J, Sbitany H, Piper M| | View in PubMed
    15. Prepectoral Breast Reconstruction Reduces Opioid Consumption and Pain After Mastectomy: A Head-to-Head Comparison With Submuscular Reconstruction.
      Holland M, Su P, Piper M, Withers J, Harbell MW, Bokoch MP, Sbitany H| | View in PubMed
    16. Surgical Skills Coaches: Preparing for a peer-assisted learning model to train medical students in surgical skills.
      Kim EK, Conroy PC, Johnson CL, Kelly Y, O'Sullivan PS, Chern H, Piper ML| | View in PubMed
    17. A novel microsurgical reconstruction technique in a living-related liver donor hepatic artery dissection using the native hepatic artery.
      Sitta R, Roberts J, Gardner J, Ascher N, Piper M| | View in PubMed
    18. Direct-to-Implant Versus 2-Stage Breast Reconstruction: Which Technique Is Better? An Analysis of 104 Patients at a Single Institution.
      Piper ML, Rios-Diaz AJ, Kimia R, Cunning J, Broach R, Wu L, Serletti J, Fosnot J| | View in PubMed
    19. The Impact of a Single Dual-Trained Surgeon in the Management of Mastectomy and Reconstruction.
      Piper ML, Nathan S, Henderson S, Lee A, Broach RB, Kozak G, Davis H, Wu LC| | View in PubMed
    20. Diagnosis and Treatment of Lymphatic Complications of the Groin Following Open Lower Extremity Revascularization with Plastic Surgery Closure.
      Wallace AB, Kim EA, Holland M, Lee S, Orringer M, Piper ML, Hansen SL| | View in PubMed
    21. Prophylactic Muscle Flaps in Primary Vascular Procedures of the Groin.
      Wallace AB, Piper ML, Holland M, Lee S, Orringer M, Eichler C, Kim EA, Hansen SL| | View in PubMed
    22. Evaluation of Dual-port versus Single-port Tissue Expanders in Postmastectomy Breast Reconstruction.
      Parmeshwar N, Piper M, Viner J, Foster R, Kim EA| | View in PubMed
    23. Positive margins after mastectomy in patients with invasive lobular carcinoma of the breast: Incidence and management strategies.
      Hewitt KC, Miller P, Piper M, Prionas N, Son JD, Alvarado M, Esserman LJ, Wong JM, Ewing C, Mukhtar RA| | View in PubMed
    24. A Systematic Review of the Utility of Indocyanine Angiography in Autologous Breast Reconstruction.
      Parmeshwar N, Sultan SM, Kim EA, Piper ML| | View in PubMed
    25. Quantifying the Psychosocial Benefits of Masculinizing Mastectomy in Trans Male Patients with Patient-Reported Outcomes: The University of California, San Francisco, Gender Quality of Life Survey.
      Alcon A, Kennedy A, Wang E, Piper M, Loeliger K, Admassu N, Lentz R, Kim EA| | View in PubMed
    26. Assessment of Arm Volume Using a Tape Measure Versus a 3D Optical Scanner in Survivors with Breast Cancer-Related Lymphedema.
      Mastick J, Smoot BJ, Paul SM, Kober KM, Cooper BA, Madden LK, Conley YP, Dixit N, Hammer MJ, Fu MR, Piper M, Cate SP, Shepherd J, Miaskowski C| | View in PubMed
    27. A world-wide survey on kidney transplantation practices in breast cancer survivors: The need for new management guidelines.
      Hansen KS, Ghersin H, Piper M, Tavakol M, Lee B, Esserman LJ, Roberts JP, Freise C, Ascher NL, Mukhtar RA| | View in PubMed
    28. Laparoscopy allows the harvest of the DIEP flap with shorter fascial incisions as compared to endoscopic harvest: A single surgeon retrospective cohort study.
      Shakir S, Spencer AB, Piper M, Kozak GM, Soriano IS, Kanchwala SK| | View in PubMed
    29. Developing Human Skin Contains Lymphocytes Demonstrating a Memory Signature.
      Dhariwala MO, Karthikeyan D, Vasquez KS, Farhat S, Weckel A, Taravati K, Leitner EG, Clancy S, Pauli M, Piper ML, Cohen JN, Ashouri JF, Lowe MM, Rosenblum MD, Scharschmidt TC| | View in PubMed
    30. Oncological Outcomes of Total Skin-Sparing Mastectomy for Invasive Lobular Carcinoma of the Breast: A 20-Year Institutional Experience.
      Son JD, Piper M, Hewitt K, Alvarado M, Esserman LJ, Ewing C, Wong JM, Mukhtar RA| | View in PubMed
    31. Minimally invasive robotic-assisted harvest of the deep inferior epigastric perforator flap for autologous breast reconstruction.
      Piper M, Ligh CA, Shakir S, Messa C, Soriano I, Kanchwala S| | View in PubMed
    32. A Bipedicled Flap for Closure of the Anterolateral Thigh Flap Donor Site.
      Piper ML, Stranix JT, Bast JH, Kovach SJ| | View in PubMed
    33. A Critical Analysis of Prosthetic Augmentation of Autologous Microvascular Breast Reconstruction.
      Piper ML, Lentz R, Gomez-Sanchez C, Withers J, Hu A, Sbitany H| | View in PubMed
    34. Attributes of Perforator Flaps for Prophylatic Soft Tissue Augmentation Prior to Definitive Total Knee Arthroplasty.
      Azoury SC, Stranix JT, Piper M, Kovach SJ, Hallock GG| | View in PubMed
    35. Medial Femoral Condyle Free Flap Reconstruction of Complex Foot and Ankle Pathology.
      Stranix JT, Piper ML, Azoury SC, Kozak G, Ben-Amotz O, Wapner KL, Levin LS| | View in PubMed
    36. Success rates of re-excision after positive margins for invasive lobular carcinoma of the breast.
      Piper ML, Wong J, Fahrner-Scott K, Ewing C, Alvarado M, Esserman LJ, Mukhtar RA| | View in PubMed
    37. Development and Validation of a Nipple-Specific Scale for the BREAST-Q to Assess Patient-Reported Outcomes following Nipple-Sparing Mastectomy.
      Peled AW, Amara D, Piper ML, Klassen AF, Tsangaris E, Pusic AL| | View in PubMed
    38. The "Dual-Plane" DIEP Flap: Measuring the Effects of Superficial Arterial and Venous Flow Augmentation on Clinical Outcomes.
      Sbitany H, Lentz R, Piper M| | View in PubMed
    39. Prepectoral Breast Reconstruction in the Setting of Postmastectomy Radiation Therapy: An Assessment of Clinical Outcomes and Benefits.
      Sbitany H, Gomez-Sanchez C, Piper M, Lentz R| | View in PubMed
    40. Breast Conservation and Negative Margins in Invasive Lobular Carcinoma: The Impact of Oncoplastic Surgery and Shave Margins in 358 Patients.
      Mukhtar RA, Wong J, Piper M, Zhu Z, Fahrner-Scott K, Mamounas M, Sbitany H, Alvarado M, Foster R, Ewing C, Esserman L| | View in PubMed
    41. Commentary on: The Nasal Ligaments and Tip Support in Rhinoplasty: An Anatomical Study.
      Gruber RP, Piper M, Chang J| | View in PubMed
    42. Commentary on: Medial Osteoectomy as a Routine Procedure in Rhinoplasty: Six-Year Experience with an Innovative Technique.
      Gruber RP, Chang J, Piper M| | View in PubMed
    43. Correction of Breast Animation Deformity following Prosthetic Breast Reconstruction.
      Lentz RB, Piper ML, Gomez-Sanchez C, Sbitany H| | View in PubMed
    44. Autologous Fat Grafting as a Novel Antiestrogen Vehicle for the Treatment of Breast Cancer.
      Thomas S, Chen S, Sbitany H, Kwon E, Piper M, Park J, Terranova Barberio M, Pawlowska N, Munster PN| | View in PubMed
    45. Prepectoral Breast Reconstruction: A Safe Alternative to Submuscular Prosthetic Reconstruction following Nipple-Sparing Mastectomy.
      Sbitany H, Piper M, Lentz R| | View in PubMed
    46. Characterizing infections in prosthetic breast reconstruction: A validity assessment of national health databases.
      Piper ML, Roussel LO, Koltz PF, Wang F, Singh K, Chin R, Sbitany H, Langstein HN| | View in PubMed
    47. Immediate Reconstruction for Plantar Melanoma: A Paradigm Shift.
      Oliver-Allen H, Piper M, Vaughn C, Sbitany H| | View in PubMed
    48. An Innovative Risk-Reducing Approach to Postmastectomy Radiation Delivery after Autologous Breast Reconstruction.
      Piper ML, Evangelista M, Amara D, Daar D, Foster RD, Fowble B, Sbitany H| | View in PubMed
    49. Do Prolonged Prophylactic Antibiotics Reduce the Incidence of Surgical-Site Infections in Immediate Prosthetic Breast Reconstruction?
      Wang F, Chin R, Piper M, Esserman L, Sbitany H| | View in PubMed
    50. The Novel Application of Genomic Profiling Assays to Shorten Inactive Status for Potential Kidney Transplant Recipients With Breast Cancer.
      Mukhtar RA, Piper ML, Freise C, Van't Veer LJ, Baehner FL, Esserman LJ| | View in PubMed
    51. Axillary Web Syndrome: Current Understanding and New Directions for Treatment.
      Piper M, Guajardo I, Denkler K, Sbitany H| | View in PubMed
    52. Outcomes Following Oncoplastic Reduction Mammoplasty: A Systematic Review.
      Piper ML, Esserman LJ, Sbitany H, Peled AW| | View in PubMed
    53. Distraction Osteogenesis of Multiple Ribs for the Treatment of Acquired Thoracic Dystrophy.
      Piper ML, Delrosario L, Hoffman WY| | View in PubMed
    54. Pediatric lower extremity sarcoma reconstruction: A review of limb salvage procedures and outcomes.
      Piper M, Irwin C, Sbitany H| | View in PubMed
    55. Comparison of Mammographic Findings Following Oncoplastic Mammoplasty and Lumpectomy Without Reconstruction.
      Piper M, Peled AW, Sbitany H, Foster RD, Esserman LJ, Price ER| | View in PubMed
    56. Oncoplastic breast surgery: current strategies.
      Piper M, Peled AW, Sbitany H| | View in PubMed
    57. Total skin-sparing mastectomy: a systematic review of oncologic outcomes and postoperative complications.
      Piper M, Peled AW, Foster RD, Moore DH, Esserman LJ| | View in PubMed
    58. Impairment of central leptin-mediated PI3K signaling manifested as hepatic steatosis independent of hyperphagia and obesity.
      Warne JP, Alemi F, Reed AS, Varonin JM, Chan H, Piper ML, Mullin ME, Myers MG, Corvera CU, Xu AW| | View in PubMed
    59. Functional role of suppressor of cytokine signaling 3 upregulation in hypothalamic leptin resistance and long-term energy homeostasis.
      Reed AS, Unger EK, Olofsson LE, Piper ML, Myers MG, Xu AW| | View in PubMed
    60. Functional role of c-Jun-N-terminal kinase in feeding regulation.
      Unger EK, Piper ML, Olofsson LE, Xu AW| | View in PubMed
    61. Specific physiological roles for signal transducer and activator of transcription 3 in leptin receptor-expressing neurons.
      Piper ML, Unger EK, Myers MG, Xu AW| | View in PubMed