F. A. Q.
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.
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.
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.
Using tissue from one’s own body in breast reconstruction most naturally mimics the tissue lost in mastectomy. For this reason, it is often the best choice if appropriate. However, using natural tissue 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.
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.
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.