Is Reconstructive Breast Surgery Covered By Insurance?

Breast reconstruction operations should be covered by your health insurance plan whether they are performed immediately after a mastectomy/lumpectomy or several years afterwards. Procedures to improve the reconstructed breast and/or produce symmetry (balance) between the two breasts may be required over time.

All group health plans that pay for mastectomy must also cover prosthesis and reconstructive operations, according to the Women’s Health and Cancer Rights Act of 1998. Furthermore, Medicare covers breast reconstruction, although Medicaid coverage varies by state. You should check with your plan administrator because government and church-sponsored plans are not always obligated to cover rehabilitation.

Even if you’re insured, complications can arise, particularly in certain situations: for example, if you’ve chosen a newer form of reconstructive treatment, if you’re undergoing surgery to create a more balanced appearance, or if you require a thorough repair of a previous reconstruction. If you want to see a plastic surgeon who isn’t in your health insurance plan’s network, coverage can be a problem.

It’s usually advisable to check with your health insurance carrier ahead of time to see what’s covered so you don’t have to deal with the hassle of attempting to collect payment later. You can also work with the insurance claims administrator at your plastic surgeon’s office. Your state’s health insurance agency and commissioner are another potential resource, as several jurisdictions have implemented new legislation requiring coverage for breast reconstruction.

Here are some questions to ask your insurance company and the cosmetic surgeon’s office to help you get started:

  • Is a mastectomy covered by my insurance? (It must cover reconstruction if the answer is yes.)
  • What expenses will be covered if I travel to another surgeon who specializes in a method that isn’t available in my network?

The Breast Reconstruction Guidebook, by Kathy Steligo (Baltimore: The Johns Hopkins University Press, 2017), pp. 207-208.

Remember that your deductible and co-pays will still be your responsibility, so be sure you know how much you’ll be spending out of pocket. If you’re accountable for a portion of the treatment costs, it may impact your choice of reconstruction. Although prices vary, implant operations are generally less expensive than tissue flaps. They are, however, more likely to require change in the future, so the total cost may be equal.

According to Frank J. DellaCroce, M.D., FACS, plastic surgeon and co-founder of the Center for Restorative Breast Surgery, how your plastic surgeon’s office interacts with your insurance company regarding your surgery can make a big difference. The office must utilize wording that makes it obvious that the procedure is medically required rather than merely aesthetic. “If you’re repairing a rebuilt breast that has gotten deformed, for example, or balancing the two breasts, the insurance plan may deny reimbursement right away, claiming, “Well, that’s cosmetic.” Instead, we might have to state, “After mastectomy, she had asymmetry in the breast that caused a cup size discrepancy that made apparel and function problematic, and she has an overall imbalance that is developing a symmetry deformity.” When you set things out like way, it’s tougher for them to respond, “Well, too bad.” It starts to feel more real.”

  • Make sure the office is utilizing the ICD-9 (soon to be ICD-10) code, which is the standard classification system that all insurance companies follow.
  • Don’t give up. If your claim is refused, you and your doctor can amend the description and send a non-identifying photo (of your chest just, not your face) to show the issue area (s).
  • As you move on with your case, keep comprehensive paper records of all communications.

“We normally have success,” Dr. DellaCroce says, “but the way the physician’s office conveys the issue to the insurer will either ensure coverage or guarantee denial.”

Our blog, Reconstruction Coverage Under the Women’s Health and Cancer Rights Act, is also worth reading.

How much does breast reconstruction cost?

In the private sector, the approximate out-of-pocket cost for DIEP flap surgery (as of February 2020) is:

–A bilateral treatment (double reconstruction) costs approximately $25000-30000, which includes the cost of two plastic surgeons, surgical helpers, an anaesthetic, and all follow-up. There are no additional expenses if there are any issues.

–A unilateral treatment (single reconstruction) costs around $17000-22000, which includes the cost of two plastic surgeons, surgical helpers, an anaesthetic, and all follow-up. There are no additional expenses if there are any issues.

–These costs assume adequate health insurance coverage and exclude payments for a breast surgeon (if necessary) and the hospital excess.

How much does a double mastectomy and reconstruction cost?

What Is the Price of a Double Mastectomy? A Double Mastectomy costs between $2,944 and $17,730 on MDsave. Those with high deductible health plans or those who do not have insurance might save money by purchasing their procedure in advance with MDsave.

Does insurance cover mastectomy and reconstructive surgery?

Is it legal for insurers to drop people from their plans so they don’t have to pay for breast reconstruction?

No, the WHCRA prohibits insurance plans and corporations from kicking people out of plans or preventing them from enrolling in or renewing their coverage to evade WHCRA requirements.

Is it legal under the WHCRA for insurance companies to pay doctors to discourage women from seeking breast reconstruction after a mastectomy?

No. The WHCRA prohibits insurance plans and issuers from penalizing doctors or pressuring them to deliver care that is incompatible with the WHCRA. It also prohibits insurance companies from rewarding doctors who do not advise their patients to consider breast reconstruction.

Is it necessary for my insurance company to inform me that I am insured for breast reconstruction under the WHRCA?

Yes. The law also requires insurance companies to advise you of this coverage when you first enroll in their plan and then every year thereafter.

Several states have passed legislation requiring health insurers that cover mastectomies to cover reconstructive surgery following the procedure. These state laws only apply to health plans purchased from a commercial insurance carrier by an employer. State laws do not apply to self-insured employers, but federal laws do.

A self-insured (or self-funded) plan is one in which the employer pays for the insured person’s medical bills rather than a commercial insurance provider. Even while the money for the payments still comes from the employer, some self-insured firms will hire a commercial insurance company to make the checks and handle the paperwork. So unless you inquire, it’s difficult to tell if you’re in a self-insured or commercially insured plan.

I’ve been told I have breast cancer and will need a mastectomy. What impact will the WHCRA have on my benefits?

Group health plans, insurance companies, and HMOs that provide mastectomy coverage must also include reconstructive surgery after the mastectomy, according to the WHCRA. This coverage includes mastectomy reconstruction, reconstruction of the other breast to create a more balanced appearance, breast prosthesis, and treatment of physical problems, such as lymphedema, at all stages of the mastectomy.

This federal statute establishes a minimum standard to ensure that women who have had a mastectomy can get breast reconstruction, even if they live in states where insurance companies are not required to pay it.

Is it true that the WHCRA mandates that all group plans, insurance companies, and HMOs cover reconstructive surgery?

Yes, in most situations, as long as the insurance plan also covers mastectomies’ medical and surgical benefits. Certain church and government plans, on the other hand, may not be required to cover reconstructive surgery.

Check with your plan administrator if you are covered by a health plan provided by a church or a municipal government.

Can insurance companies apply deductibles or co-insurance requirements for reconstructive surgery after a mastectomy under the WHCRA?

Yes. However, the deductibles and co-insurance must be the same as those for other plan or coverage advantages. The insurance company cannot require you to pay a larger deductible or co-pay for breast reconstruction than you would for other procedures.

Am I eligible to the state and WHCRA-mandated minimum hospital stay if I get a mastectomy and breast reconstruction?

It is debatable. You would be entitled to the minimum hospital stay needed by state law if you have coverage via your work and your employer is insured. State law does not apply if you receive coverage through your workplace but it is not supplied by an insurance company or HMO (i.e., your employer “self-insures” your coverage). Only the federal WHCRA applies in this case, and it does not impose any minimum hospital stays. Contact your plan administrator to learn whether your group health plan is insured or self-insured.

If you have private health insurance (not through your company), check with the office of the State Insurance Commissioner to see if state law applies.

No. The WHCRA does not prevent a plan or health insurance issuer from haggling with doctors regarding payment amounts and types. However, the law prohibits insurance companies and issuers from penalizing doctors or giving incentives to encourage them to provide care that is in violation of the WHCRA.

No. The Affordable Care Act made no changes to the WHCRA, and there are no rules or regulations that affect it. Breast reconstruction must be included in health insurance policies that provide mastectomy.

Even so, if you underwent a mastectomy due to breast cancer, Medicare will cover breast reconstruction.

Because Medicaid coverage varies by state, you’ll need to find out what’s available in yours.

  • For WHCRA information, go to the US Department of Labor’s website or call 1-866-487-2365, which is a toll-free number.
  • For information about employer-based health insurance, contact the Department of Labor’s Employee Benefits Security Administration at 1-866-444-3272.
  • Your insurance company’s administrator (a number should be listed on your insurance card)
  • The office of your state’s insurance commissioner (The number should be in the state government section of your local phone book, or you can look it up on the National Association of Insurance Commissioners’ website or call 1-866-470-NAIC) (1-866-470-6242.)

Is breast reconstruction medically necessary?

It had been four years since Marianne Sarcich first felt the lump in her right breast as she toweled off following a shower on a hot July night.

Although the cancer was discovered early enough that it had not spread to other regions of her body, doctors advised that she undergo a mastectomy to remove the breast and the malignancy within it.

After the procedure, the implant she received developed scar tissue, became painful, and had to be removed.

Sarcich chose a fresh type of surgery this time, in 2020, in which tissue from her left thigh was transplanted to her chest to make a breast.

“I couldn’t look at my chest for months after the mastectomy, so I avoided mirrors.” Sarcich, 55, of Wilmington, said, “It took me so long to realize this was me.”

Her relief was fleeting. Her health insurance covered the repair surgery, but she quickly discovered that a follow-up procedure to slim her right thigh to match the left was not.

Health insurance must cover breast reconstruction after a mastectomy, as well as any follow-up surgeries to restore symmetry between the breasts, according to federal and state legislation. However, when tissue is extracted for reconstruction, patients frequently struggle to obtain insurance reimbursement for surgery to restore the appearance of other portions of their body.

The process of appealing insurance denials can be intimidating, especially for people who have been through cancer treatment and recovery and are physically and emotionally tired. Those who are unable to navigate the denials process may be denied follow-up care.

“A woman should not have to fight her insurance provider at a time when she is literally fighting for her life in obtaining breast cancer treatments and a very disfiguring operation,” said Pat Halpin-Murphy, president of the Pennsylvania Breast Cancer Coalition. “She’ll need all of her might to heal.”

How long does it take to recover from reconstructive breast surgery?

Within 6 to 8 weeks, the majority of women can resume routine activities. Your healing period may be reduced if implants are utilized without flaps. There are a few things to bear in mind: Certain types of restoration surgery do not restore normal breast sensation, while some sensation may return over time in others.

How soon after mastectomy can you have reconstructive surgery?

Breast reconstruction can be done at a variety of times, depending on your circumstances:

At the same time as the mastectomy. This is what is referred to as “instant reconstruction.” Following the breast cancer surgeon’s removal of the breast, the plastic surgeon reconstructs the breast using tissue from another part of your body or an implant (and sometimes both). Almost all of the work is completed in one operation, and you wake up with a breast that has been rebuilt (or breasts). This strategy necessitates collaboration between the breast cancer and plastic surgery teams. If you need additional treatments like chemotherapy or radiation therapy, immediate repair may not be possible. In some circumstances, a surgeon may advise delaying reconstruction until after these treatments are completed. Alternatively, depending on your circumstances, a surgeon may advise completing part of the reconstruction right away and then finishing it after chemotherapy and/or radiation therapy. You and your surgeon can talk about your specific circumstances and requirements. When you get a preventive mastectomy — a mastectomy to lower your risk of breast cancer — reconstruction is always performed right away.

Following a mastectomy or lumpectomy, as well as following radiation therapy, chemotherapy, or targeted therapies. This is referred to as postponed reconstruction. Following surgery, treatments like radiation therapy and, in certain cases, chemotherapy can cause the reconstructed breast to lose volume and change color, texture, and appearance. Radiation therapy, in particular, has been documented to alter implant reconstructions in unfavorable ways. Radiation therapy is more likely to be required following surgery for cancers that are larger than 5 cm and have spread to the lymph nodes. Research also suggests that a rebuilt breast may prevent radiation therapy from reaching the cancerous area, albeit this varies from case to case. Some surgeons advise patients to postpone reconstruction until after the radiation and chemotherapy treatments are completed. This indicates that following a mastectomy or lumpectomy, reconstruction may be done 6 to 12 months later.

If desired, reconstruction can potentially be done years afterwards. Some women aren’t ready for surgery right away, or they change their minds about whether they want to “go flat” or use a prosthesis.

As part of a phased approach, some reconstructive surgery is performed during a mastectomy or lumpectomy, and more reconstructive surgery is performed following any additional therapies. This type of reconstruction is also known as delayed-immediate reconstruction. The University of Texas M.D. Anderson Cancer Center was the first to use the newly tiered strategy. After the breast is removed, a tissue expander or standard breast implant is put under the chest muscle and preserved breast skin in delayed-immediate reconstruction. Using a temporary expander or implant to preserve the shape of the breast and breast skin during the impending radiation treatments will allow for the final advantage of a skin-sparing mastectomy method. Tissue expanders are balloon-like devices that stretch the skin to create a “pocket” under the skin for the reconstructed breast. After the radiation is finished and the tissues have healed (usually 4-6 months), the expander/implant that was used to keep the shape of the breast is removed and replaced with a flap from the appropriate donor site, as determined by your surgeon.

Doctors sometimes don’t know if radiation and chemotherapy will help a woman until the cancer and certain lymph nodes have been removed and evaluated. This analysis can take up to a week to complete. If radiation is required, the tissue expander or implant must be left in place until the radiation is finished. The expander is equipped with a port (a metal or plastic plug, valve, or coil) that allows the surgeon to gradually add or remove liquid (a salt water solution). During radiation therapy, some doctors prefer to deflate the expander to allow the radiation oncologist to accurately target the cancer-affected breast region. The tissue expander is progressively reinflated to its original size about 2 weeks after radiotherapy is completed in this example. After extra liquid is given to the expander, you may experience some pain or pressure for a few hours. By the next day, this is usually gone. Approximately 4 to 6 months following radiotherapy, the breast reconstruction is usually done.

One of the most hotly debated areas in reconstruction research is the timing of breast reconstruction. Your complete team of doctors, including your breast surgeon, plastic surgeon, radiation oncologist, medical oncologist, and other caregivers, should meet as a group to discuss your specific condition. This group should meet before you decide whether to have a mastectomy or a lumpectomy, because the type of breast surgery you have can affect the success of your reconstruction. Some women, for example, may choose mastectomy over lumpectomy because their plastic surgeon recommends reconstruction following mastectomy for better cosmetic results. Because every breast cancer is different, so is every reconstruction operation and its timing. You and your team can decide on the best method for you together.

Women with stage I or stage II breast cancers who select mastectomy based on a biopsy are less likely to require radiation or other therapies following mastectomy and are often suitable candidates for rapid reconstruction. Because it combines the mastectomy and reconstruction into one surgical surgery, this is their greatest option. The tiered technique may be employed instead if there is a good possibility that radiation will be required. Your surgeon will assist you in determining the best time for you.

Because of the size of the disease or the number of lymph nodes involved, women diagnosed with stage III or stage IV cancer nearly usually require radiation therapy or other treatments after mastectomy. Some doctors advise deferring reconstruction until all other breast cancer therapies have been done in this scenario. Reconstruction may necessitate additional healing time, which could cause radiation and chemotherapy to be delayed.

However, in some circumstances, quick reconstruction may be necessary. If you undergo chemotherapy as your first treatment for breast cancer, for example, your tumor may be able to be downstaged. After that, you might be a candidate for a skin-sparing mastectomy, which keeps as much of the breast skin as possible. While radiation may still be required, your doctor may be comfortable with its potential consequences on a flap restoration done right away. Alternatively, your doctor may recommend a phased reconstruction with a tissue expander or saline implant to keep a breast pocket during your therapies. You and your doctor can talk about which option is best for you.

If you’re not sure whether stage of breast cancer applies to you, consult your doctor. You might also want to look at the Breast Cancer Stages page.

The resources and expertise accessible in your region are as follows: If you want immediate reconstruction with your own tissue (autologous reconstruction) or an implant, you’ll need two surgeons with credentials and operating privileges in the same hospital who can collaborate: a breast cancer surgeon who will perform the mastectomy and a plastic surgeon who is experienced in the type of reconstruction you want. Some of the latest flap reconstruction techniques necessitate microsurgery expertise, which entails connecting the tissue flap’s tiny blood veins to vessels in the chest area so the flap can receive the blood supply it requires in its new “home.” This is a skill set that not all plastic surgeons possess. Microsurgery frequently necessitates the involvement of two plastic surgeons in addition to the breast surgeon.

Also, because the delayed-immediate approach is new and involves a little more work than either instant or delayed reconstruction timing, it isn’t available everywhere now. Surgeons having experience with this method are more likely to be found in large city cancer centers and cancer centers linked with universities. If you have strong feelings about a certain scheduling strategy, you may need to speak up for yourself and consult with many breast surgeons. Discuss the best scheduling possibilities for your specific circumstance with your oncologist, as well as the surgeons in your area.

Your decision-making style is as follows: Receiving a breast cancer diagnosis can be terrifying and stressful. Making decisions about mastectomy or lumpectomy, as well as other treatments, can be draining emotionally. Making even more decisions regarding what type of reconstruction to have and when to get it may be too much for you to handle. However, keep in mind that, despite appearances, mastectomy is not usually an emergency procedure. You have time to consider and halt. Take some time to clear your mind, conduct your own study, and weigh the pros and cons of other viewpoints. Instead of reacting to current situations, try to make a decision that is long-term oriented. Ask your doctor about the differences between immediate and delayed reconstruction in terms of near-term healing and long-term outcomes if you opt not to have reconstruction right away.

Your general wellbeing: If you have diabetes, cardiovascular issues, or a bleeding disorder, your doctor may advise you to wait until you have fully recovered from your mastectomy before undergoing reconstruction. You may, nevertheless, be qualified for urgent reconstruction; however, this decision must be decided on a case-by-case basis. Heavy smoking might impair your ability to heal, so your doctor may advise you to stop smoking for a period of time prior to reconstruction surgery so that your body can heal more quickly.

How long is hospital stay for mastectomy?

After your mastectomy surgery, you’ll be sent to the recovery room, where nurses will monitor your heart rate, body temperature, and blood pressure. Let someone know if you are in discomfort or sick from the anaesthetic so that you can be given medicine.

After that, you’ll be admitted to a hospital room. The usual length of stay in the hospital for a mastectomy is three days or fewer. You may spend a little longer in the hospital if you get a mastectomy and reconstruction at the same time.

Your surgeon or nurse will show you an exercise plan the morning after your surgery to help avoid arm and shoulder stiffness on the side where you had the mastectomy, as well as the production of considerable scar tissue. Until the drains are eliminated, some exercises should be avoided. To ensure that the fitness plan is correct for you, ask your surgeon any questions you may have. In addition, your surgeon should provide you with written and graphical instructions on how to perform the exercises.

Your surgeon or nurse will offer you information about healing at home before you leave the hospital:

  • Taking pain medication: When you leave the hospital, your surgeon will most likely give you a prescription to take with you. You might want to fill it on the way home, or have a friend or family member fill it for you as soon as you get home, so that you have it.
  • Taking care of your incision’s bandage (dressing): Inquire with your surgeon or nurse about how to care for your mastectomy bandage. The surgeon may request that you refrain from attempting to remove the bandage and instead wait until your first follow-up appointment so that he or she can do so.
  • Taking care of a surgical drain: If you have a surgical drain in your breast or armpit, it may be removed before you leave the hospital. However, a drain may be left in place until the first follow-up appointment with the doctor, which is normally 1-2 weeks after surgery. You’ll need to empty the fluid from the detachable drain bulb a few times a day if you’re going home with a drain. Before you leave the hospital, be sure your surgeon has given you instructions on how to care for the drain.
  • Sutures (stitches) are used by the majority of surgeons, and they dissolve over time, so they don’t need to be removed. The end of the suture will periodically poke out of the incision like a whisker. If this occurs, your surgeon will be able to quickly remove it. Surgical staples, which are another method of closing the incision, are removed on the first visit to the doctor following surgery.
  • How to tell if you have an infection in your incision and when to call the office: Your surgeon should explain how to tell if you have an infection in your incision and when to call the office.
  • Exercising your arm: Your surgeon or nurse may demonstrate an exercise plan to prevent arm and shoulder stiffness on the side where surgery was performed. The exercises will usually begin the morning after surgery. Until the drains are eliminated, some exercises should be avoided. To ensure that the fitness plan is correct for you, ask your surgeon any questions you may have. In addition, your surgeon should provide you with written and graphical instructions on how to perform the exercises.
  • Recognizing lymphedema signs: If you’ve undergone an axillary dissection, you’ll be given instructions on how to care for your arm and recognize lymphedema symptoms.
  • When you can wear a bra again or start using a prosthesis: Before you can wear a prosthesis or bra, the site after mastectomy surgery, especially mastectomy with reconstruction, needs to recover. Your doctor will advise you on how long you should wait.

Do reconstructed breasts have feeling?

Breast reconstruction surgery should result in a balanced appearance (also known as breast symmetry). You want to seem and feel balanced. Breast reconstruction procedures and timing are continually being refined by plastic surgeons to guarantee that the results are both physically and emotionally satisfactory. Even so, there’s a chance you won’t be completely delighted with your breast reconstruction outcomes.

Size, position, angle, and balance of your new breast or breasts may not meet your expectations. They might not be as silky or natural-feeling as you expected. In a breast that has been repaired with an implant, you will likely experience no sensation and little sensation in a breast that has been reconstructed with autologous tissue.

Asking your medical staff a lot of questions about what to expect is one of the best ways to ensure that you’re completely satisfied with your reconstructed breast. Even before your first mastectomy incision, this is crucial since the placement and “design” of the incision might affect your reconstructive results. Inquire for photos of breast reconstructions that your surgeon has completed. You can also inquire about the names of ladies who have undergone the treatment you’re considering with your surgeon. You might find it beneficial to speak with another woman about her decision-making process, doctors, and satisfaction with the outcomes.

A woman’s happiness with her breast reconstruction results appears to be influenced by a number of factors:

  • Size: The reconstructed breast may be slightly larger than the other breast following surgery. This is due to surgery-related edema. The swelling of the reconstructed breast will go down as it heals, and the reconstructed breast will be closer in size to the other breast. If the size discrepancy is still obvious, your surgeon can remove fat from the reconstructed breast.
  • Weight increase: If you gain or lose weight, a breast that has been reconstructed with an implant does not gain or lose weight. If you have implant reconstruction and gain weight afterward, you and your surgeon may decide to replace your initial implant with a larger one to help your breasts regain equilibrium. Because a breast that has been repaired with a flap operation gains and loses weight with the body, this is less of a concern. Significant weight gain (or decrease) may, however, cause an imbalance between the rebuilt and natural breasts.
  • Drooping or sagging: It’s difficult to replicate your original breast’s natural droop. With time and gravity, a breast repaired with an autologous technique may sag, whereas a breast reconstructed with an implant rarely sags. Your other breast may sag with time, but the reconstructed breast will remain higher and firmer. When you’re wearing a bra or swimming suit, it might not bother you, but when you’re naked, it might. If it does, your surgeon will likely find it much easier to decrease and raise your other breast to match the reconstructed one. See Altering the Opposite Breast for further details.
  • Changes in breast sensation: When you or someone else touches your reconstructed breast, it will feel quite similar to your natural breast. Even so, you’re unlikely to feel much feeling in your breast when it’s touched. This is due to the fact that the majority of the nerves in the area are cut during mastectomy and reconstruction, causing the area to go numb. For women whose breasts were an essential erogenous zone, this can be concerning. The nerves have the ability to regrow, but it takes a long time. You may experience tingling or other feelings in your breast if the nerves begin to regenerate. If any sensation in your breast returns, it’s likely that you’ll notice something in a year or two. If you lose feeling in your breast, it’s possible that you’ll regain it in the area next to your breast. Some women discover that the armpit close to the reconstructed breast becomes extremely sensitive to touch, indicating the presence of a new erogenous zone.

Talk to your surgeon and other members of your medical team if you’re not happy with your reconstructed breast as much as you expected. There may be things you and your team may take to improve the reconstruction’s appearance and feel. Find out more about the benefits of corrective breast reconstruction.

Watch the movies below to learn about two women who suffered issues from their initial surgery and elected to have corrective breast reconstruction.

Corrective Breast Reconstruction: Caren’s Story

Caren had a double mastectomy with implant reconstruction after being diagnosed with breast cancer. Her surgeon offered her D-cup implants despite her desire for B-cup breasts. Her ability to exercise, date, and feel good about herself was harmed as a result of complications and subsequent surgery. Then she went to the New Orleans Breast Center and saw Dr. Frank DellaCroce, who did a hybrid stacked DIEP/SGAP breast reconstruction. “I’ll be eternally thankful to the Breast Center, and Dr. DellaCroce is one of my favorite doctors. They returned my life to me.”

Corrective Breast Reconstruction: Peggy’s Story

After a double mastectomy with implant reconstruction, Peggy struggled to accept her new figure. She had a surgery revision with DIEP flaps, nipple reconstruction, and 3D nipple tattooing after one of her implants ruptured. Peggy claims that this operation helped her gain a lot of confidence in her figure.

For more information, listen to the podcast Revision Reconstruction: What You Need to Know.

Is a mastectomy expensive?

Breast cancer may necessitate a mastectomy in some women. This procedure is costly on its own, therefore it’s often combined with chemotherapy. The treatment costs around $13,000 on average, not including any kind of reconstruction.

Will my insurance cover a preventative mastectomy?

Women may opt for a preventive mastectomy to alleviate their fears of developing breast cancer. It may also make them feel as if they’ve done everything they can to reduce their breast cancer risk.

Pros and cons of bilateral prophylactic mastectomy

If you’re at a high risk for breast cancer, talk to your doctor about the benefits and drawbacks of a preventative mastectomy. You should also speak with a plastic surgeon about your breast restoration alternatives.

Younger women appear to benefit more from preventive mastectomy than older ones. This is due to the fact that younger women have more years ahead of them.

  • Prophylactic mastectomy may add 3-5 years to the life of a 30-year-old woman with a BRCA1 or BRCA2 hereditary gene mutation.
  • After a preventative mastectomy, the increase in lifespan for women 60 and older is minimal.

Aside from the emotional burden of losing both breasts, some women struggle with body image concerns, which can affect how they feel sexually following a preventive mastectomy. These difficulties can be addressed by speaking with a health care practitioner or counselor, or by joining a support group.

Breast reconstruction

You may want to get breast reconstruction if you had a preventive mastectomy. This might be done concurrently with the mastectomy or at a later date.

Insurance coverage

Prophylactic mastectomy is required by some state legislation, however coverage varies by state.

It’s wise to call your insurance carrier to find out what your plan covers.