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Your Questions About Breast Reconstruction

Everything you need to know when you are considering reconstructive surgery.

There are many aspects of reconstruction surgery; here are the 5 most common questions. For more information on the types of reconstructive surgery check out the story:


1. Which procedure should I have?

Your doctor can alert you if you're not a good candidate for one of the surgeries -- because your weight is so low or high that complications are more likely, or scars from previous stomach surgeries rule out a TRAM flap. If you've had a lumpectomy and radiation and later have a mastectomy, you may need a breast implant along with a flap created from your back muscle and skin. "Most women do not have enough fat on their back to make an adequate sized breast, so they'll need an implant to do a breast reconstruction," says Joseph J. Disa, MD, a Memorial Sloan-Kettering Cancer Center reconstruction surgeon.


2. When should I have it done -- at the mastectomy time or later?

If you need radiation, you should delay reconstruction till afterward, as radiation may change the shape or texture of the new breast. Radiating a flap also may cause it to contract or become lumpy. You should discuss the pros and cons and the effects of radiation in detail with your surgeon.


3. Can reconstruction cause problems if I have a recurrence?

The American Cancer Society says reconstruction should not cause problems with further treatment if ever needed. Most doctors don't recommend a mammogram for a reconstructed breast with an implant and you do not need one with a tissue flap. A physical exam is typically done to screen for recurrence.


4. Who should do my surgery?

A plastic surgeon usually does reconstructive surgery. Your surgeon should be board-certified in plastic surgery and comfortable and familiar with the procedure of your choice. He or she can provide before-and-after photos of previous work.


5. How will I pay for surgery?

The Women's Health and Cancer Rights Act of 1997 requires health insurance to provide coverage for reconstruction, nipple construction, and surgery to create symmetry of the other breast.


 

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