FREQUENTLY ASKED QUESTIONS

What is a perforator flap breast reconstruction?

In the United States, one out of eight women will receive a breast cancer diagnosis in her life. Yet only one third of mastectomy patients undergo breast reconstruction. Among these patients, only 30% use their own tissue; the rest get implants. Most women do not know it is possible to reconstruct their breasts with their own tissue after mastectomy or failed implant-based breast reconstruction.

Perforator flap breast reconstruction is a state-of-the-art procedure that gives patients new breasts which look and feel natural. The operation takes excess skin and fat from one area of the body - usually the abdomen, but sometimes the thighs or the buttocks - to create new breasts. The reconstructed breasts are soft, warm, come with their own blood supply, and integrate with the rest of your body.

One advantage of perforator flap breast reconstruction is it uses your body's own tissue to recreate your breasts. Depending on the donor site, this type of "recycling" has the side benefit of giving you a tummy tuck, thigh lift, or buttock lift at the same time as your breast reconstruction.

How long is the operation?

Perforator flap breast reconstruction is a highly complex procedure that requires two skilled microsurgeons who work together as a team. On average, it takes 3-5 hours to reconstruct one breast or 6-8 hours for two breasts.

What is the recovery time?

The morning after surgery, patients are encouraged to get out of bed to walk, eat, and drink. Patients usually stay in the hospital for 3-4 days after the operation for flap monitoring. Since perforator flap breast reconstruction protects the muscle to minimize postoperative pain and morbidity, many patients no longer need narcotic pain medication by the time they leave the hospital. Patients should take at least 2 weeks off of work to recuperate, but may not feel normal until 4-6 weeks after the operation. At 6-8 weeks, most patients can return to full activities with no restrictions.

Who is a candidate?

Healthy women who are planning to undergo or who have already undergone a mastectomy are candidates for perforator flap breast reconstruction.

How is it different from other types of breast reconstruction?

Most plastic surgeons who do breast reconstruction use implants. The operation is relatively fast and easy in the short term, but the implant is a foreign body that often needs to be changed at a later date - especially after radiation. In fact, 40-50% of implants are removed within 7 years due to capsular contracture, infection, rupture, or extrusion through skin. Also, some patients do not like the artificial feeling of an implant.

Another type of breast reconstruction uses a patient's muscle from the abdomen or back (TRAM or latissimus dorsi) to reconstruct the breasts. Although common, sacrificing muscle for breast reconstruction can cause pain and weakness in active patients. Perforator flap breast reconstruction avoids muscle damage so that postoperative muscle function is preserved.

Does insurance cover it?

Yes. In 1998, Congress passed the Women's Health and Cancer Rights Act (WHCRA) that mandates that all insurance companies provide coverage for breast reconstruction under federal law. In 2011, New York State passed the Information and Access to Breast Reconstruction Law that requires that all women undergoing mastectomy, lumpectomy and lymph node dissection surgery must receive written information, prior to signing surgical consents, regarding options for reconstructive breast surgery.

While the individual benefits of each plan may vary, Dr. Chen and her staff have been extremely successful in working with insurance companies. We work with all health insurance companies. While the individual benefits of each plan may vary, our staff is experienced in working with the insurance industry. We have been extremely successful in making sure that all patients receive the full care that they deserve. We will hold your hand throughout the entire process to help you with any issues that may arise with your insurance.