Questions about surgeons for mastecomy and reconstruction

England

So I've just learnt that I have to have a single mastectomy on my left breast, due to several tumors that were only detected in an MRI scan. My right breast is completely clear. I'm still waiting on genetic testing, but at this point, a single mastectomy is being recommended. We are not sure about chemo or radiation at this point. That will become clear after the op. I have met with the surgical team at UCLA (I am based in LA). Dr. Maggie Dinome and Dr. Festekijian. I liked both of them. Dr. F. recommended a DIEP procedure as I have enough tummy to achieve that. He said if I were to do a double mastectomy, there would not be enough fat. Then we would have to do implants. I'm wondering if anybody has experiences with this surgical team and how they like their results?

I'm also thinking of meeting with Dr. Funk and Dr. Orringer also, but I'm not sure about whether they take my insurance. Does anybody know if they accept insurance for surgeries?

I've also been drawn to the center for restorative breast surgery in New Orleans. Their breast reconstruction pictures are fantastic. 

I'd love any input from people who have used the UCLA team (or another UCLA surgeon). I've been happy with UCLA so far and I love how everything is linked so I don't have to worry about showing them results or CDs of MRI's, etc. What about the New Orleans team? Anybody have experiences with them? 

I'm also concerned about the DIEP reconstruction on one breast, in that, if in the future I do have to have the other breast (right) removed, I don't have options for another DIEP and would have to have an implant on the other side. 

Please feel free to also PM with if you're more comfortable with sharing that way.

mitzi458

Hi England,

It’s so nice to talk to someone else from Los Angeles about all of this!

I’ve been researching and interviewing plastic surgeons, both by phone as well as in person since November. It takes s while because it can rake so long to get appointments with everyone. Plus, because I had a bad experience my first time I did reconstruction, I can’t help but be really picky (and nervous) about which surgeon I end up with.

I am not familiar with the doctors that you mentioned. Which is actually funny because I have been meeting with Dr. Tseng with UCLA. I actually have a surgery date set with him for next week for a bi-lateral DIEP flap. However, I still have things to do to get ready, and I’m not sure if I can get them all done in time as I’ve been working a lot. I just have a feeling they won’t be happy if I cancel or ask to postpone it this closevto the actual date!!

Dr. Dionne sounds amazing! I also had s really good surgical oncologist who I loved and trusted, Dr. Carey Cullinane. I just wasn’t happy with my last plastic surgeon. I’m not familiar with Dr. Festekjian. His background is impressive, although so are the other PS’s at UCLA. I wish I had known about Dr. Roostaeian...I can tell he has an artist’s eye, which to me is almost as important as their surgical skills. The doctor I’m scheduled with at UCLA is Dr. Tseng. I like him, but now I’m concerned that his aesthetic is not up to the standards i’m looking for. Both times I met with him, I had so many questions that we never got around to looking at before and after photos much...only for him to point at something technical to show me.

I did meet with Dr. Leif Rogers. He also does DIEP flaps, but he will only do it on my left, and wants to do full fat grafting on my right. I love his personality and I like that he will do a lot of body contouring to give me back my waistline (which is lost during the DIEP procedure). I’m just not sure I like the look of a breast totally made from fat . I’m still researching and I have another appointment with him on Monday.

You mentioned having one DIEP side and one implant? This is what another surgeon recommended for me...because I already have a lat flap with a saline implant on my right side now, he would re-do the implant with a silicone implant and then do a DIEP flap on the left. That would be Dr. James Anderson at City Of Hope, where my oncologist is. I would like to talk to someone who has been through this as well. My concern is that they will look the same, and more importantly, age the same. Dr. Orringer looks really good too. I should make an appointment with him too! Except not sure how many of these consults my insurance will cover.

As far as NOLA...I would cancel everyone here and wait a year if I could go down there and get this done. I would feel 100% confident in all aspects with them. Unfortunately my insurance (Blue Shield PPO) will not cover anything there. Not even out of network charges. Liz told me it would cost &40,000 if I wanted to pay a cash price. : (. If you work and have Aetna through your work, I know they would take that. It seems like I have never heard one bad word about them-no complications, beautiful results, and fast recovery. Not fair!

Anyway, I’m anxious to see who you end up with. Feel free to PM me any time!

Mitzi

Lula73

England- went to NOLA and I would do it again in a heartbeat. I had BMX with immediate DIEP. I just finished stage 2 at the end of last year. They see many women who were told by other PSs that there wasn’t enough tissue to do both breasts and they make it happen oftentimes with just DIEP. Yes you’re right that if you opt for UMX now you can’t do DIEP again on the other breast if needed. However you can do SGAP on the other breast if the need should arise. Or opt for BMX now and reconstruct both. A lot of women looking at UMX figure if they have to have symmetry surgery on their remaining breast anyway, why not have a completely matching set and do BMX. I can also tell you that NOLA is all about quality outcomes in various states of dress/undress, not just making a breast mound that looks good when covered up in clothes and doesn’t worry about how the abdominal incision looks. They work very hard to conceal incision lines as much as possible. The photos on their site are the real deal-no photoshopping at all and nothing too goodbye to be the true. I have the body to to prove it. Their approach to care is different as well and comes through in the employees’ attitudes, the setup of the office & hospital and their attention to things very few other practices/hospitals offer (ie meals not just for you but your spouse too, a real bed in your room for your spouse to sleep in, help with arranging travel and hotel, etc). I live in the middle of 3 nationally highly recognized medical centers and I still chose NOLA & I’m very glad i did. I highly recommend them. Feel free to ask questions or PM me.