FAQ

Breast Reconstruction

1. Is it best to have breast reconstruction immediately following mastectomy, or to delay the surgery?
2. What surgical options are available?
3. Is breast reduction covered by medical insurance?

The decision whether to undergo a second major surgery concurrent with or immediately following a mastectomy is personal and requires the careful evaluation of all the risks and benefits. The physician should counsel the patient and they should reach the decision together. It is important to note that numerous studies have shown significant psychological benefits for women who have immediate breast reconstruction.

Immediate breast reconstruction does not delay additional treatment for breast cancer. In fact, the vast majority of patients who have immediate breast reconstruction can start chemotherapy within a month of the surgery, which is not significantly different from women who only have a mastectomy.

Many women prefer to use their own tissue, with the TRAM flap (abdomen) as the primary option and the lat. dorsi flap (back) as a secondary choice. With a Transverse Rectus Abdominus Myocutaneous (TRAM) flap, skin and fat from the lower abdomen are used to rebuild the breast. The abdominal closure tightens the abdominal wall similar to a tummy tuck.

Another option is the use of tissue expanders that stretch the skin for implant use, but patients should be aware that these will likely get firmer and harder with time.

Both silicone and saline implants are considered safe. The implant is placed behind the chest muscle, with soft tissue covering the implant.

Federal legislation passed in 1998 mandates that all insurance companies, including MediCare, must cover breast reconstruction after mastectomy. The legislation also states that they have to cover procedures on the opposite breast to obtain symmetry, including reduction, augmentation and breast lifts