Here are frequently asked questions:

Am I a candidate for breast reconstruction?

Does my insurance cover breast reconstruction?

When is the best time for reconstruction?

What types of reconstruction are there?

What are the advantages/disadvantages of autologous tissue reconstruction?

Where can tissue be taken from for breast reconstruction?

What is with the alphabet soup...TRAM, DIEP, SIEA, SGAP, IGAP?

What are the advantages and disadvantages of implant reconstruction?

Am I a candidate for breast reconstruction?

In most cases, the answer is yes! There are many different types of breast reconstruction and the choices continue to grow as advances continue. What type of breast reconstruction is best for you depends on a variety of factors from the type of cancer treatment that you have had, your body size and shape, as well as your short and long term personal goals. We individualize treatment plans and would look forward to a consultation in our office to help you decide your best choice.

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Does my insurance cover breast reconstruction?

In most cases, the answer is yes. We are providers for most insurance plans and have a dedicated staff that is happy to work with you and your insurance carrier to enable you to pursue breast reconstruction. Federal law requires that insurance companies that cover treatment for breast cancer must also provide coverage for breast reconstruction as well as for procedures to the opposite breast to make it match the reconstructed breast. For more information on this federal legislation click here.

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When is the best time for reconstruction?

Breast reconstruction can be performed at the time of mastectomy (immediate reconstruction) or any time after the mastectomy has been performed (delayed reconstruction). While immediate reconstruction often provides the best cosmetic result, delayed reconstruction is often a good choice for women who will require radiation therapy as part of their cancer treatment.

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What types of reconstruction are there?

Generally speaking, breast reconstruction can be performed using the body's own tissue (autologous reconstruction), breast implants (implant-based reconstruction), or a combination of the two. Which type is best depends upon the availability of tissue for reconstruction as well as the body shape of the patient. While Dr. Rosenberg generally prefers to use a patient's own tissue for a more natural reconstruction, there are some patients whose body type makes them better candidates for implant based reconstruction.

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What are the advantages/disadvantages of autologous tissue reconstruction?

Using tissue from one's own body in breast reconstruction most natuarally mimics the tissue lost in mastectomy. For this reason, it is often the best choice if appropriate. However, using natural tisse requires that it be taken from another area on the body (donor site). Transferring tissue (called the "flap") from one part of the body to another carries a small risk of partial or complete loss of the flap.

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Where can tissue be taken from for breast reconstruction?

Most commonly Dr. Rosenberg chooses to use the abdominal skin and fat in breast reconstruction. Many patients have sufficient excess abdominal tissue to reconstruct one or two breasts of adequate size. Abdominal fat closely mimics natural breast tissue and makes an excellent choice for autologous breast reconstruction. In some cases tissue from the gluteal area or back may be used if there is not enough tissue in the tummy area.

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What is with the alphabet soup...TRAM, DIEP, SIEA, SGAP, IGAP?

These letters are all acronyms for different ways to transfer tissue from one part of the body to another for breast reconstruction. The TRAM (Transverse Rectus Abdominus Myocutaneous) flap was among the first ways to transfer skin and fat from the abdomen to the chest. It involves the complete sacrafice of one of the abdominal muscles. This procedure carries with it the risk of weakness of the abdominal wall with the potential for one-sided weakness or bulge of the abdomen. The DIEP (Deep Inferior Epigastric Perforator) flap, and the SIEA (Superficial Inferior Epigastric Perforator) flap are variations of the TRAM that involve leaving behind the muscle of the abdomen and transferring just the skin and fat of the tummy for breast reconstruction. While more technically demanding of a procedure, in the appropriately selected patients these procedures can minimize some of the risks of abdominal weakness, hernia or bulge. The SGAP (superior gluteal artery perforator) and IGAP (inferior epigastric perforator) flap are procedures for transferring tissue from the buttock area for breast reconstruction that do not require the sacrafice of muscles in that area.

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What are the advantages and disadvantages of implant reconstruction?

Implant reconstruction alone is, in Dr. Rosenberg's opinion, not a good option for patients who have had radiation therapy for their breast cancer. Radiation combined with implants increases the potential for complications with infection, hardening of the implants (capsular contracture) and wound healing complications. It is also difficult to match a breast implant reconstruction with a natural breast on the opposite side.

However, in thin paitents who need bilateral (both sides) reconstruction and have not had radiation, implant reconstruction can offer very good results. Implants are mechanical devices and do carry the risk of deflation, capsular contracture (hardening), and will require replacement over time.

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