Choosing Your Breast Reconstruction Surgeon

When I learned my breast cancer treatment would require a mastectomy, my process for choosing a reconstruction technique and surgeon was one hundred percent wrong! But geez, what did I know? Plus, I was in shock mode. And I was also in do-whatever-the- doctor-tells-me mode. I've previously written, been written about and spoken of the reconstruction road I stumbled along. htttp://www.cnn.com/2009/HEALTH/10/24/breast.cancer.options/index.html#cnnSTCText

My breast reconstruction experiences – good and bad – turned me into an activist. A reluctant activist, since I'd kept the whole breast cancer thing hush-hush for a long time, even from my own mother. But later I was so appalled at my own ignorance (I have always taken pride in being an intelligent, well-informed woman) that I wanted to help spare other women my own naivety and poor choices that easily might have landed me in a very deep pothole.

Since then, I've heard stories from countless other women who also made reconstruction decisions under pressure, with little information, and with little reason to doubt the doctors they trusted. Most of them weren't saved by a last minute quirk of fate, like I was. Many, after suffering from choices based on incomplete or inaccurate information, got another chance at reconstruction to correct issues caused by their initial surgeries. Unfortunately for some, the damage from surgeons with inadequate experience or using outmoded techniques, left them with problems that can never be repaired. 

Breast reconstruction is not the same as breast augmentation and requires a much higher degree of experience to obtain the very best outcome. If you're going to go through two or more surgeries to have breast reconstruction, you want the very best aesthetic result for your effort. Make sure you choose a highly-experienced and artistic surgeon who has the absolute lowest rate of complications.

Study up on current methods of breast reconstruction before you make your choice, especially if that choice is irreversible, like one that compromises muscles in your body. Don't rely only on the advice of the plastic surgeon who happens to live in your area. Like it or not, he/she has a vested interest in your choosing him/her as your surgeon and, ergo, the reconstructive technique in which they happened to be trained.

After you select your preferred method of reconstruction, seek the opinions of several surgeons certified by the American Board of Plastic Surgery who have extensive experience in those procedures. Not only will you increase your probability of successful results, but you'll also reduce the likelihood they may discourage you from your choice or mistakenly believe you're not a candidate for that surgery. Ask about their success rate and how many of the procedures they have performed. Highly experienced doctors who specialize in the reconstruction you want will give you the best evaluation of your unique situation.

Be assertive. Ask all the questions you need to make an informed opinion. Many people feel intimidated by doctors and are hesitant to ask too many questions. If you're like this, get over it now! Make a list beforehand, bring someone with you and give them a copy, too. They can help you if your courage flags or you feel overwhelmed, as well as provide another brain to process what you're told. Write down the answers to your questions and check off each, only after you're satisfied with the response.

Ask to view before and after photos of the surgeons' work. Since these photos are usually taken within a few months of surgery, be aware that scars and areola tattoos will appear much more prominent than they will be after more time has passed. Instead, focus on the shape of the breasts, symmetry, and the artistry of the surgeon.

Ask for patient references. Many women are happy to talk to others about what to expect and may even offer to show you their results in person. The most experienced surgeons usually have patients who volunteer to mentor newly-diagnosed women as a way to give back after successful treatment and reconstruction.

Surgical oncologists are specially trained in removing cancerous tissues, although your mastectomy surgery may be performed by a breast surgeon or general surgeon. The surgeon removing the cancer should work in cooperation with the plastic surgeon you choose. If there is a breast diagnostic center in your area, it may have a list of surgeons and will schedule consultations for you.

If there is not a surgeon in your area experienced with the reconstruction method you prefer, know that many women travel to access surgeons who are. Their clinics may help with travel arrangements, as well as dealing directly with insurance companies regarding out-of-network patients. Preliminary consultations can occur by phone, and openings in surgical schedules are maintained for women needing surgery in a timely manner. Some cities offer low or no-cost accommodations for cancer patients, as do some airlines.

Good luck, and may your road to new breasts be well-paved!

(A special thank you to Sandy Keller, a co-founder of Breastoration, who contributed to this post.)