Questions & Answers
The questions patients ask Dr. Haddock most often, answered in the office’s own words.
Are implants or flaps better?
Implants vs. Flaps
This is a complex question that is determined by the patient’s health, situation, and desires. Some patients may not be candidates for natural tissue reconstruction with a flap because of previous surgeries or other health-related reasons that make surgery unsafe (contraindications). Some women prefer natural tissue reconstruction because it is a surgery that lasts a lifetime. Others prefer implants because it is an easier surgery, but implants do not last forever so likely surgery will be required again in the future. Dr. Haddock can present the pros and cons of each route in consultation.
When I have a mastectomy, do I lose my own nipples? And if so, what happens?
Nipple Reconstruction
Depending on the type of cancer you have and the location of the tumor, your breast surgeon will determine if you keep your nipples or not. Ductal cancer (cancer that starts in the milk ducts) is sometimes considered a reason to remove your own nipples. If that happens, there are ways that we can reconstruct the nipples, using skin from the front of your reconstructed breast. The reconstructed nipples are 3D and look very much like natural nipples. They are then tattooed to give them a normal pigment. Dr. Haddock and the breast surgeons he works with routinely perform nipple-sparing mastectomy and, when reasonable, try to preserve this part of the breast.
Will breast reconstruction be covered by my insurance?
Breast Reconstruction and Insurance
The Women’s Health and Cancer Rights Act (WHCRA) helps protect many women with breast cancer who choose to have their breasts reconstructed after a mastectomy. This federal law requires most group insurance plans that cover mastectomies to also cover breast reconstruction. It was signed into law on October 21, 1998. This law covers reconstruction of the breast that was removed by mastectomy and procedures on the other breast to provide symmetry. Deductibles and co-insurance still apply.
If I have a lumpectomy, do I still need a plastic surgeon?
Oncoplastic Surgery
Many women choose to undergo breast conservation with a lumpectomy. Depending on the location and size of the lumpectomy this can leave a large dent or missing area in the breast. This ultimately can result in uneven breasts. Dr. Haddock can help balance the breasts and improve the overall aesthetic appearance by a number of methods. This could include a breast lift, breast reduction, a flap reconstruction and/or fat grafting. Often this is offered at the time of the lumpectomy but these techniques can also be considered at a later date.
I have been told I’m too thin for natural tissue reconstruction. What should I do?
Other Flap Options
If a patient would benefit from flap-based reconstruction but does not have abdominal tissue then there are other options. Dr. Haddock has done flap reconstruction on patients with previous tummy tucks and very active patients (including marathon runners and avid yoga enthusiasts). Dr. Haddock is a pioneer in the PAP flap (posterior thigh flap), which is an excellent option for many of these patients. The LAP flap is another option that comes from the love handle or flank. The important thing is that patients should ask questions of their surgeon to confirm they are offered all options.
How long will it take to complete breast reconstruction?
Length of Time to Complete Breast Reconstruction
No matter what technique is chosen, standard breast reconstruction is a process and takes time. Typically, the entire time to completion is between 3 months and 1.5 years. The first stage starts at the time of the mastectomy. A secondary procedure is typically three months later. The need for chemotherapy and/or radiation can delay this secondary procedure. Often a third procedure is required for nipple reconstruction and potential cosmetic refinements. Most patients also choose to complete a tattoo to restore the pigment of the areola.
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