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What Questions Should You ask your Surgeon about Breast Reconstruction?

The following list of questions may help to remind you of topics to discuss with your surgeon. You may have additional questions as well.

1. What are all my options for breast reconstruction?
2. What are the risks and complications of each type of breast reconstruction surgery and how common are they?
3. What if my cancer recurs or occurs in the other breast?
4. Will reconstruction interfere with my cancer treatment?
5. How many steps are there in each procedure, and what are they?
6. How long will it take to complete my reconstruction?
7. How much experience do you have with each procedure?
8. Do you have before and after photos I can look at for each procedure and what results are reasonable for me?
9. What will my scars look like?
10. What kind of changes in my implanted breast can I expect over time?
11. What kind of changes in my implanted breast can I expect with pregnancy?
12. What are my options if I am dissatisfied with the cosmetic outcome of my implanted breast?
13. Can I talk with other patients about their experiences?
14. What is the estimated total cost of each procedure?
15. How much will my health insurance carrier cover, especially any complication that may require surgery?
16. How much pain or discomfort will I feel, and for how long?
17. How long will I be in the hospital?
18. Will I need blood transfusions, and can I donate my own blood?
19. When will I be able to resume my normal activity (or sexual activity, or athletic activity)?

Other Factors to Consider in Breast Reconstruction Choosing a Surgeon
When choosing an experienced surgeon who is experienced with breast implantation, you should know the answers to the following questions:
1. How many breast reconstruction implantation procedures does he/she perform per year?

2. How many years has he/she performed breast implantation procedures?
3. Is he/she board certified, and if so, with which board?
4. In which states is he/she licensed to practice surgery?
Note that some states provide information on disciplinary action and malpractice claims/settlements to prospective patients either by request or on the world wide web. 5. What is the most common complication he/she encounters with breast implantation?
6. What is his/her reoperation rate with breast implantation and what is the most common type of reoperation he/she performs? Familiarize yourself with the following options in breast implant surgery and be prepared to discuss with your surgeon the following issues:

Implant Shape and Size
Depending on the desired shape you wish to achieve, you and your surgeon may choose a round or contoured implant shape. Generally, the larger you want your cup size, the larger the breast implant the surgeon will consider (measured in cubic centimeters, or cc's). You should be aware that contoured implants that are placed submuscularly may assume a round shape after implantation.

Your surgeon will also evaluate your existing tissue to determine if you have enough to cover the breast implant. If you desire a breast implant size too large for your tissue, the surgeon may warn you that breast implant edges may be apparent or visible post-operatively. You may even risk surgical complications. Also, excessively large breast implants may speed up the effects of gravity and result in earlier droop or sag.

Surface Texturing
Textured surface implants were designed to reduce the chance of capsular contracture. Some information in the literature with small numbers of patients suggests that surface texturing reduces the chance of severe capsular contracture, but clinical information from studies of a large number of women with INAMED implants shows no difference in the likelihood of developing capsular contracture with textured implants compared to smooth surfaced implants.

Palpability
The following may cause implants to be more palpable (more easily felt): textured implants, larger implants, subglandular placement, and the amount of skin/tissue available to cover the implant.

Insurance
Most insurance covers the first breast reconstruction operation. Insurance coverage for reoperation procedures or additional surgeon's visits following reconstruction may not be covered, depending on the policy.

If You Experience a Problem, should you Report It?
If you believe that you have experienced a serious problem(s) related to your breast implants, you should have your health professional report the problem(s) to FDA.

You are encouraged to report any adverse events through your health professional. Although reporting by physicians or other health professionals is preferred, women may also report any serious problem directly through the MedWatch voluntary reporting system.

An adverse event is serious and should be reported when it results in an initial or prolonged hospitalization, disability, congenital anomaly, or medical or surgical intervention. This information reported to MedWatch is entered into databases to be used to follow safety trends (patterns) of a device and to determine whether further follow-up of any potential safety issues related to the device is needed

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