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Top 10 Questions You Will Want to Ask your Plastic Surgeon

Updated: Feb 4

If you choose reconstruction you will want to be sure that certain questions are asked and answered. This will help you feel confident in your choice and will let you have realistic expectations with your outcome.

Here are some of the top questions I think you should ask on your consultation...

1) Do you specialize in reconstruction or augmentations? Can I see your AFTER pics of your reconstruction patients?

If he has none then do NOT use him. If you see them and they look reconstructed or you want to leave- LEAVE! Despite what some may tell you he or she is not the only game in town or near you.

2) What type of implants and expanders do you use?

Gel like or gummy silicone implants work the best for reconstruction. Did you know that Mentor has a line that they have designed specifically for reconstruction? We have come a long way with silicone implants and the gel type do not leak and if they do they stay in a gel consistency and are not harmful.

3) How often will I need to have my expanders filled?

Your expanders are a flat water balloon that will be filled with air when you leave the operating room allowing you to leave your mastectomy looking like you still have breasts. This mentally saved me. I was so ready to have the cancer gone I did not think about what it would be like to look down and have no breasts. Not to mention the day after my mastectomy I got up to leave the hospital and I looked like I had been beaten with a baseball bat! This surgery is no joke! Having breast mounds even if smaller then what I was used to helped me mentally feel better about this process. Over time these tissue expanders will be filled with saline stretching out your skin until you are at your desired size and ready for the final surgery.

4) How long post radiation will I need to wait until I can have my final reconstructive surgery?

The answer you are looking for is at least 6 months post radiation. You want to be sure your body and skin have healed before the final surgery for best results. If you do not have to have radiation you will be able to have your final surgery much sooner.

5) Do you lipo with reconstruction?

This is extremely important for maximum results. A plastic surgeon who does not do this is not a reconstruction guy but rather a plastics guy that does reconstruction...there is a big difference.

6)How large can I go?

Do not be afraid to go bigger if that's what you want or smaller if you feel more comfortable. Either way this is a personal decision and you are now a blank canvas and should get what you want. Please note: 800cc is max silicone implant size- this sounds large in terms of augmentation but for a mastectomy patient with zero breast tissue this is much different- with the breast tissue gone this is about a D cup.

7) Can I have nipple sparing surgery?

This is a question not just for the surgical oncologist but also for the plastic surgeon. Nipple sparing is usually for women whose cancer is far away from the nipple. Do not be afraid to choose this type of surgery if you are a candidate. Cancer in the nipple is pretty obvious to detect. You will have check up which include breast exams with your oncologist often and they will be able to tell if this has occurred. The beauty of nipple sparing is not having to have an areola tattooed on your chest and its a piece of you that you get to keep- even if the feeling is gone which does occur post mastectomy it mentally can help to keep them.

8) If I can not have a nipple sparing surgery who do you recommend for tattooing on the nipple?

Many women choose to have this done. Tattoo artist are so amazing now and can even do 3D nipple tattooing and you can not tell at all by looking at them that it is a tattoo. Some women choose not to have a nipple tattooed but a beautiful tattoo all over their chest showing the journey they went through which is also a great idea. Many surgeons can make a nipple out of your skin as well- so ask about that too.

9) Is reconstruction covered by insurance?

Most plastic surgeons do NOT take insurance. There is no good way to say it except...Breast cancer is expensive. My 4 rounds of chemo was over $80,000 even though some of that will be covered if you have good insurance. Mastectomy surgery may also be covered or partially covered depending on who you have for insurance. However, reconstruction is not covered with any plastic surgeon worth his salt. Why is that? Because simply put- he does not have to take insurance. However, talk with him and ask about a discount or ways to pay over time. Usually most of the mastectomy with the expander surgery will be covered depending on your insurance because this is part of the mastectomy surgery and you are already in the hospital and on the table so it is partially covered. However, your final or fun surgery as I like to call it- that is not usually covered but you can get creative about paying over time or check into Care Credit.

10) What happens if I have an implant issue?

If you are with a good reconstructive surgeon who is confident in his work he should "guarantee" his work. For example, having an incapsulated implant after this type of surgery due to scar tissue is not uncommon. You may have to have follow up surgeries to get it right and remove some of the scar tissue. This is not a reconstructive surgeon issue but just something that can happen with this type of surgery and multiple surgeries. The more surgeries=more scarring. My plastics guy always tells me I am stuck with him for life. This is because I will always want to have him do check ups and at some point like with any augmentation the implants will need to be switched out. Implants usually last about 10 years. This is even more reason to be sure you like your surgeon!

What questions do you have for me? Ask away by emailing me or using the chat feature!


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