The Choice is Yours! Breast Reconstruction Gives You Options

The Choice is Yours! Breast Reconstruction Gives You Options

April 26, 2014
Caroline Glicksman, M.D.

Breast cancer affects about one in eight women in the United States. With improved screening and education, breast cancers are being detected earlier, often giving women far more options in breast reconstruction. Women who choose to undergo a mastectomy have the right to be informed of all of their breast reconstructive options, and in many areas of the country, breast surgeons, oncologists and plastic surgeons work as a team from diagnosis through breast reconstruction.

Pick the Best Procedure for You

Breast reconstruction after mastectomy includes the use of your own tissues, called autologous breast reconstruction, or the use of implants, through a staged procedure.  In some cases, newer techniques allow direct to implant reconstruction, avoiding the need for tissue expanders.  Fat grafting techniques are also improving, allowing the use of one’s own fat to reconstruct the breast, with or without additional implants or flaps.

The newest generation of shaped highly cohesive gel breast implants was designed over twenty years ago. They have been available to American women enrolled in clinical trials since 2002.  In 2013, the FDA approved the “Gummy Bear” implants, giving more options for women undergoing breast reconstruction. These implants are filled with a slightly thicker or more cohesive silicone gel, providing improved form stability. This means that reconstructive surgeons can now create a breast with a more aesthetic shape resembling that of a natural breast, and not just add volume to fill a bra. Patients who require certain larger projecting implants (X styles) to match an opposite breast, or create a breast that closer resembles a natural breast, may still need to enroll in clinical trials, until all of the newest implant sizes are FDA approved.

Does Insurance Mean Full Coverage?

Breast reconstruction was mandated by federal law under the Women’s Health and Cancer Rights Act of 1998. Unfortunately we live in very uncertain times with respect to individual insurance plans and what they will or will not allow. Some patients who remain in network may have very good coverage for all stages of reconstruction, while others who select an out of network facility or plastic surgeon, may have considerable out of pocket expenses. This can be a very difficult time for many breast reconstruction patients and their families.  An experienced plastic surgery office manager can be a very helpful guide through this process, but unfortunately insurance companies and the government keep changing the rules.

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