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Advice on explant/DIEP surgery

I’ve had my implants for over 10 years, and lately, they’ve started feeling uncomfortable. I’ve also been dealing with some health issues, though I’m not sure if they’re related to the implants. I’m also worried about the potential risk of developing another type of cancer from the implants.

Looking back, I probably would’ve chosen DIEP flap reconstruction at the time of my mastectomy, but I didn’t have enough body fat then. (That’s not an issue now!) I’m seriously considering having my implants removed and going forward with DIEP reconstruction, but I’m unsure how to start the process.

Here are my main concerns:

  1. Did anyone have trouble convincing a doctor to agree to perform the surgery?
  2. How difficult was it to get insurance to cover the explant and DIEP reconstruction?
  3. Are you happy with your decision to switch?

My original plastic surgeon retired, and my oncologist moved away. I’m not happy with my current oncologist, and I don’t have a plastic surgeon right now. I’m feeling overwhelmed and don’t know where to begin. Any advice or recommendations would be greatly appreciated

Comments

  • moderators
    moderators Posts: 8,699

    Hi @jojo69 and welcome to Breastcancer.org!

    We're so sorry for the issues that bring you here, but we're glad you've found us. You're sure to find our amazing Community a wonderful source of advice, information, and support.

    While you wait for the everhelpful input from others here, you may be interested in checking out this page, which explains the process and how you can move on to autologous reconstruction:

    https://www.breastcancer.org/treatment/surgery/breast-reconstruction/types/breast-implant-removal

    Specifically, this paragraph about health insurance covering the procedure:

    "The Women’s Health and Cancer Rights Act (WHCRA) of 1998 requires all group health plans that pay for mastectomy to also cover reconstructive procedures. This means that breast implant removal surgery and whatever you choose next — such as flat closure or flap reconstruction — should be covered, as long as the initial mastectomy is deemed medically necessary. However, it’s important to work with your plastic surgery practice to make sure your health insurance plan understands that your current surgeries are medically necessary and not just cosmetic. "

    And, some great information on finding a plastic surgeon with experience with explant surgery.

    We hope this helps, and that you get some responses here from others with their experiences. Thanks for posting and welcome again!

    —The Mods

  • gramto4
    gramto4 Member Posts: 28

    Hi jojo69

    Have you seen a doctor and discussed the discomfort you are having? I had a unilateral mastectomy of my right breast in 2018 and the implant has been replaced 4 times since then with the most recent time being two weeks ago. I develop what is called capsular contracture. A complication that occurs when the body forms a thick, hard scar tissue capsule around an implant. It caused pain and discomfort and pushed the implant up higher in the breast pocket. Not sure if this could be the cause of your uncomfortable feeling but worth getting checked out. Ask your primary doctor for a referral to a plastic surgeon who is experienced in breast cancer patients. Good luck and hope you get the reconstruction you are looking for.

  • rockym
    rockym Member Posts: 386

    I would definitely google plastic surgeons/doctors who perform DIEP on a regular basis. You could go in for a consult, ask what they can do for you and see some of their before and after pics. Once I knew I was going to have a DMX, I ended up having 3 opinions from 3 different breast surgeons. Mine is a recurrence so I had no idea how the surgery would be handled. My first doctor who did my original surgery wasn't really a specialist so he suggested I look around. The 2nd doctor was at a big cancer center and she proceeded to TELL ME what she would do instead of talking to me about what is best and why. My 3rd ended up being in the office of my original MO and was pleasant and specialized so I locked in with her.

    For weeks before meeting her, I googled plastic surgeons and not knowing which doctor was suppose to come first, I found an office that got rave reviews everywhere in my state. I was a little ambivalent at first, but soon came to find out these guys were the best of the best. When I asked the breast surgeon who she works with she said all of them so once I knew my insurance covered them I made the appointment.

    I didn't know that I was really a candidate for DIEP and that it was considered the gold standard now. I thought I wanted implants, but found out because of my past radiation it would be foolish to try. My surgery is scheduled for 3 weeks and my fingers are crossed. Now that I have gone on a bit I am back to saying that researching doctors in your area and checking with your insurance may get you what you are looking for.