reconstruction options & insurance

rm22111
rm22111 Member Posts: 54
edited March 2014 in Breast Cancer #1
I just met with my plastic surgeon and I asked him about the DIEP (I think that is what it is called) where they remove muscle from one part of your body and make a breast out of it by reconnecting it to the blood vessels under your arm. He says that most doctors are not doing this any more because it takes 8 hours and the insurance does not reimburse them enough for their time. I am in california. He says that University hospitals may do it. Has anyone else been told this. I will be getting a bilaterial masectomy on Dec. 18th with expanders. I will then have more chemo and maybe radiation. So, I may not be able to have just implants. I may need to have them do the proceedure where they take muscle from my back and twist it to the front. Has anyone had this done? How does your back feel afterwards and what are the future limitations?

Thanks for the info
Dianna

Comments

  • KeriLee
    KeriLee Member Posts: 25
    #2
    DIEP Flap Reconstruction
    Dianna,
    I had the DIEP Flap reconstruction and my insurance paid for everything. Most doctor's don't do the DIEP (which by the way doesn't involve the muscle at all) because it is quite extensive in terms of the blood vessels being cut and reconnected ect. My surgeon was in San Francisco and she is only one a handful that preform this type of reconstruction. I would be happy to further discuss the process and my results with you in greater detail if you wish, just let me know. You do have options.

    Best wishes
    KeriLee
  • karen0423
    karen0423 Member Posts: 67
    #3
    Hi DIEP does not involve
    Hi DIEP does not involve taking any muscle and the surgery is much longer than 8 hours even for one breast. I had the surgery done in January in Boston and my insurance did cover the charges. It was a rough surgery and I had numerous surgeries since but would recommend it to anyone. I waited 7 years for it and it was the best decision. I assume every insurance company is different but by law (Women's Health and Cancer Rights Act of 1998) they are required to cover the services related to reconstuction. I would look into it before you decide. Good luck to you. Karen
  • New Flower
    New Flower Member Posts: 4,294
    #4
    karen0423 said:

    Hi DIEP does not involve
    Hi DIEP does not involve taking any muscle and the surgery is much longer than 8 hours even for one breast. I had the surgery done in January in Boston and my insurance did cover the charges. It was a rough surgery and I had numerous surgeries since but would recommend it to anyone. I waited 7 years for it and it was the best decision. I assume every insurance company is different but by law (Women's Health and Cancer Rights Act of 1998) they are required to cover the services related to reconstuction. I would look into it before you decide. Good luck to you. Karen

    I did DIEP in Los Angeles
    Skin and fat was harvested from abdominal area. As far as I know several places in Los Angeles have been offering DIEP/Tram reconstruction including with back muscles. My friend did DIEP in San Diego.
    As for insurance I had to fight to be reimbursed for procedure. You need to check with your plan. Everyone is entitle to reconstruction.
    Unfortunately, some times it takes extra effort, but could be done.
    I can provide more details in privet message.
    Good luck
    New Flower
  • RE
    RE Member Posts: 4,591 Member
    #5
    I choose to go the easiest route and had an expander put in with silicon implant added later. My doctor who is in Stockton California had no problem getting insurance to pay for any of the 3 surgeries used in reconstruction, he said the choice was mine.

    RE
  • jk1952
    jk1952 Member Posts: 613
    #6
    RE said:

    I choose to go the easiest route and had an expander put in with silicon implant added later. My doctor who is in Stockton California had no problem getting insurance to pay for any of the 3 surgeries used in reconstruction, he said the choice was mine.

    RE

    I had DIEP reconstruction in
    I had DIEP reconstruction in one breast and free flap (same as DIEP but with a little muscle used) in the other in April, and I had no problem with my insurance company. It took about seven hours for the bilateral mastectomy and the reconstruction. From the other posts, I can see that the stories of my pastic surgeon being a 'rock star' (meaning very well-known for his expertise) with this surgery have to be true. I've had no real problems with the exception of my non-radiated breast being quite a bit larger than the other one. That will be corrected later this month.

    My guess is that your plastic surgeon doesn't have the expertise to do the surgery, and that is why he is discouraging you. There are only about 150 surgeons in the US who have this expertise. It definitely is not the case that 'it's no longer being done': that may be an appropriate comment about TRAM flap, but not the DIEP or free flap. I'd recommend that you see if your breast surgeon can recommend and refer you to a plastic surgeon who does this surgery. If you can arrange to have your mastectomy and this reconstruction done at the same time, I would advise it: I've been very happy with the results.

    Joyce
  • survivorbc09
    survivorbc09 Member Posts: 4,374 Member
    #7
    jk1952 said:

    I had DIEP reconstruction in
    I had DIEP reconstruction in one breast and free flap (same as DIEP but with a little muscle used) in the other in April, and I had no problem with my insurance company. It took about seven hours for the bilateral mastectomy and the reconstruction. From the other posts, I can see that the stories of my pastic surgeon being a 'rock star' (meaning very well-known for his expertise) with this surgery have to be true. I've had no real problems with the exception of my non-radiated breast being quite a bit larger than the other one. That will be corrected later this month.

    My guess is that your plastic surgeon doesn't have the expertise to do the surgery, and that is why he is discouraging you. There are only about 150 surgeons in the US who have this expertise. It definitely is not the case that 'it's no longer being done': that may be an appropriate comment about TRAM flap, but not the DIEP or free flap. I'd recommend that you see if your breast surgeon can recommend and refer you to a plastic surgeon who does this surgery. If you can arrange to have your mastectomy and this reconstruction done at the same time, I would advise it: I've been very happy with the results.

    Joyce

    Good luck with whatever
    Good luck with whatever reconstruction that you decide on having.

    HUGS
  • cats_toy
    cats_toy Member Posts: 1,462 Member
    #8
    Dianna, I went to three different plastic surgeons before find the one(s) I was comfortable with doing my procedure. It was the free flap, and it took over six hours with three surgeons. Make sure you are happy with your plastic surgeon, check them out. Mine was done in Pasadena, but they also have an office in Beverly Hills. The results are good, I just have a problem with healing, and they had to re-do one area that wouldn't heal right.
    If I can give you any more information that might be helpful to you, just let me know.
    Cat
  • susie09
    susie09 Member Posts: 2,930
    #9
    cats_toy said:

    Dianna, I went to three different plastic surgeons before find the one(s) I was comfortable with doing my procedure. It was the free flap, and it took over six hours with three surgeons. Make sure you are happy with your plastic surgeon, check them out. Mine was done in Pasadena, but they also have an office in Beverly Hills. The results are good, I just have a problem with healing, and they had to re-do one area that wouldn't heal right.
    If I can give you any more information that might be helpful to you, just let me know.
    Cat

    Nice to see you posting Cat.
    Nice to see you posting Cat. Glad that you are doing ok.

    Wishing you good luck Dianna with your reconstruction.

    ♠♣ Susie ♠♣
  • DianeBC
    DianeBC Member Posts: 3,881 Member
    #10
    RE said:

    I choose to go the easiest route and had an expander put in with silicon implant added later. My doctor who is in Stockton California had no problem getting insurance to pay for any of the 3 surgeries used in reconstruction, he said the choice was mine.

    RE

    I wish you the best of luck
    I wish you the best of luck in your future surgery. You have some great bc survivors here that have shared their experience with you. Good luck!


    Hugs, Diane ♥

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