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Topic: Exchange City

Forum: Breast Reconstruction — Is it right for you? Discuss timing and various procedures and techniques.

Posted on: Jan 30, 2009 07:41PM - edited Sep 24, 2018 07:43AM by Mykidsmom

Mykidsmom wrote:

We love to include everyone's surgery dates - Please PM me and I will update the list to include you! The list keeps changing since we try to move forward as the dates move forward. Thanks. - Jean

Useful web sites:

Mentor: http://www.justbreastimplants.com/implants/mentor_specs.htm

http://www.mentorcorp.com/breastsurgery/reconstruction/breast-implants.htm

Mentor ultra high profile implants: http://www.mentorcorp.com/global/physician-information/silicon-gel-breast-implants.htm

Allergan: http://www.allergan.com/assets/pdf/natrelle_catalog.pdf

5/6 - Gardengirls - Exchange Surgery (completed)

8/8 - Jonella - Exchange Surgery and Fat Grafting (completed)

8/15 - Remi50 - Exchange Surgery (completed)

8/26 - LRG02016 - Exchange Surgery (completed)

11/22 - BigBlueFish - Exchange Surgery and liposuction (for potential fat grafting) and abdominoplasty (completed)

2/27 - Pickmorewildflowers - Exchange Surgery (completed)

3/8 - Imkopy2 - Exchange Surgery (completed)

4-25 - ShoreGirl - Exchange Surgery (completed)

6-1 - Klix - Exchange Surgery (completed)

6-16 - Breastcanceryogi - Exchange Surgery (completed)

6-30 - Mominator - Revision Surgery (fix capsular contraction and reposition implant) (completed)

7-6 - Bevmomduck - Exchange Surgery (completed)

8/7 - Elkay7 - Exchange Surgery (completed)

9/8 - CarlaEM - Revision, switching implants, possible fat grafting (completed)

9/8 - NervousGal - Exchange Surgery (completed)

9/20 - Buffyjc - Exchange and Fat Grafting (completed)

9/22 - Noodlesmom - Exchange Surgery (completed)

10/9 - MotherofTwins - Exchange and Fat Grafting (completed)

11/1 - Lynae23 - Exchange Surgery (complted)

11/3 - MinuteAtATime - Exchange Surgery (completed)

11/3 - T-Sue - Exchange Surgery (completed)

11/15 - LettyF - Exchange Surgery with lipo/fat grafting (completed)

11/28 - Maui-Jen - Exchange Surgery (completed)

11/29 - Shoregirl- Revision Surgery - downsize implants, tighten pocket and skin, and fat graft (completed)

12/8 - Dafne - Exchange Surgery (completed)

12/20 - Bringon2017 - Exchange Surgery (completed)

1/24 - jbrmdr - Exchange surgery (completed)

1/29 - Mooney - Exchange Surgery (completed)

4/25 - lmkopy2 - Nip recon put on hold! Swapping implants and fat grafting. (completed)

5/22 - Mariettamom - Exchange Surgery (completed)

6/19 - Maggiebutterfly - Exchange Surgery (completed)

7/10 - Rascalsmom - Exchange Surgery to Sientra smooth round high profile (completed)

8/31 - Mastectomysister - Bilateral mastectomy 8/31 with TE's. No date set yet for exchange.

9/13 - Rachelcarter35 - Exchange Surgery (completed)

9/25 - LInnyG - L mastectomy with TE and SNB

AnnieAlso - Revision Sister in Waiting!

Prophylactic Bilateral Mastectomy w/ Tissue Expanders - 12/08 Exchange 04/09 Dx 8/25/2008, LCIS, Stage 0
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Page 1311 of 1,368 (41,018 results)

Posts 39301 - 39330 (41,018 total)

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Jan 29, 2017 09:25PM robinblessed54 wrote:

dc, I took two weeks over spring break two years ago but could have gone back in a week. I say Monday is too soon. Like LRGO said, you must allow yourself time to heal.

"Just because you can doesn't mean you should "

Robin


Dx 9/2/2014, ILC, Left, 1cm, Stage IB, Grade 1, 0/5 nodes, ER+/PR+, HER2- Surgery 9/25/2014 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 10/15/2014 Arimidex (anastrozole) Hormonal Therapy 12/30/2014 Aromasin (exemestane) Surgery 3/5/2015 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 3/14/2015 Femara (letrozole) Surgery 12/21/2016 Reconstruction (left): Nipple tattoo; Reconstruction (right): Nipple tattoo
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Jan 29, 2017 10:02PM dccancer wrote:

Ok thanks so much for the information. They will do some lypo and fat grafting. I still have time on STD. I go back to work Feb 1 after being out since late June when this all started. guess I need to be patient and let myself heal. Thank you for the input. I am trying to back through the thread but it was so long I figured i should just ask. Thanks again :)

Triple Positive , Stage II. Multifocal tumors left breast.7/12/16 Neoadjuvant Chemotherapy Six rounds of TCHP with weekly taxol. 12/7/2016 MX left side. SNB 0/4 nodes. Tissue Expander. 3/2017 Reconstruction. Hormonal Therapy - Tamoxifen
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Jan 30, 2017 09:33AM Wildtulip wrote:

dc, exchange IS easier than MX, but it also depends on how much pocket work your PS does. I did not have FG at time of exchange, but had a lot of pain from IMF stitches. You should feel pretty good by the Monday, but my thought is don't push yourself too hard, as it takes energy to heal.

Dx at 46 "It's not simple to say, that most days I don't recognize me. I still remember that girl. She is gone, but she used to be mine." Sara Bareilles Dx 3/5/2015, IDC, Right, 6cm+, Stage IIIA, Grade 1, 3/23 nodes, ER+/PR+, HER2- Surgery 3/26/2015 Lymph node removal: Right; Mastectomy: Right; Prophylactic mastectomy: Left Chemotherapy 4/22/2015 Radiation Therapy 10/15/2015 Surgery 6/7/2016 Reconstruction (left): Tissue expander placement; Reconstruction (right): Latissimus dorsi flap, Tissue expander placement Hormonal Therapy Arimidex (anastrozole), Aromasin (exemestane), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone), Zoladex (goserelin)
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Jan 30, 2017 02:26PM Molly50 wrote:

I need some advice. My PS just went solo after being in a shared practice for a long time. My exchange was already approved and my date set for March 20th. That is the first day of my daughter's spring break at the school she works at. I need to schedule around her because I don't have any other help and I take my grandson to school every morning. I spoke to the new office of my PS. They don't have their agreements with the insurance company yet although they are working on it. She said it could take a few weeks. Well I only have 7 weeks and then I am out of luck until Summer. The other option is to use another PS at the practice my PS just left since I do have authorization with them. I am frustrated and don't know what to do.

54 years old. Chek2 mutation. Family history of BC. Oncotype Dx 13 Extensive LVI Dx 6/8/2015, IDC, Left, 2cm, Stage IIB, Grade 2, 2/9 nodes, ER+/PR+, HER2- (FISH) Dx 7/29/2015, DCIS, Left, <1cm, Stage 0, Grade 2, ER+/PR+ Surgery 7/29/2015 Lumpectomy: Left; Lymph node removal: Underarm/Axillary Surgery 9/4/2015 Mastectomy: Left; Reconstruction (left): Tissue expander placement Hormonal Therapy 10/13/2015 Arimidex (anastrozole) Radiation Therapy 10/20/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 4/22/2016 Aromasin (exemestane) Surgery 7/22/2016 Prophylactic mastectomy: Right; Reconstruction (right): Tissue expander placement Surgery 3/21/2017 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Jan 30, 2017 02:31PM coachvicky wrote:

1/20 Exchange Surgery Completed

Dx 6/2016, DCIS/IDC, Both breasts, Stage IIA, Grade 3, ER+/PR+, HER2+ (FISH) Dx 6/7/2016, LCIS/DCIS/IDC, Right, 4cm, Stage IIA, Grade 3, ER+/PR+, HER2+ (FISH) Surgery 7/11/2016 Mastectomy; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 8/21/2016 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 8/22/2016 Herceptin (trastuzumab) Surgery 1/20/2017 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 2/22/2017 Prophylactic ovary removal Hormonal Therapy 4/4/2017 Arimidex (anastrozole) Surgery 10/19/2017 Surgery Targeted Therapy
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Jan 30, 2017 10:36PM Mominator wrote:

Oh no, Molly! How frustrating!

The insurance approval process makes for very close time constraints.

Did you like any of the other surgeons at the shared practice?

It may come down to a choice between the date you want or the surgeon you want.  

~ ~ ~ ~ Calming vibes ~ ~ ~ ~

Sending prayers your way for guidance

(((HUGS))) Madelyn

.

Mominator, BRCA2+, STK-11 VUS, wife, mom to 3 children of various special needs, musician, volunteer. My Mom dx DCIS age 62, ILC stage IIIA age 79; Mom just passed 2/28/18. My Grandmother died of ovarian cancer age 48. Friend to Lori M, died 5/25/16. Surgery 11/11/2015 Prophylactic mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 1/18/2016 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 6/30/2017 Reconstruction (left): Silicone implant
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Jan 31, 2017 09:01AM Mominator wrote:

Congratulations on your exchange, coachvicky!

I hope your recovery continues to be smooth, and that you are pleased with your results.

Mominator, BRCA2+, STK-11 VUS, wife, mom to 3 children of various special needs, musician, volunteer. My Mom dx DCIS age 62, ILC stage IIIA age 79; Mom just passed 2/28/18. My Grandmother died of ovarian cancer age 48. Friend to Lori M, died 5/25/16. Surgery 11/11/2015 Prophylactic mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 1/18/2016 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 6/30/2017 Reconstruction (left): Silicone implant
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Jan 31, 2017 03:51PM eemaxx wrote:

Hi everyone, I'm new here! I'm 5 weeks out from my BMX performed on 12/27/16 and am already looking forward to my exchange. No chemo or radiation needed! Hooray! Femera for 10 years though (only 9 years and 51 weeks to go!) I've only had one fill in my TEs so far and go for another tomorrow. I am an elementary school music teacher and am always up and down on the floor with my students. I also conduct a 5th grade chorus. I am planning to return to teaching this week. Originally I was hoping for a late April exchange date. Is it realistic to have surgery on a Monday and return to teaching the following Monday? Any other elementary school teachers out there? I didn't want to take too much time away from work since I already missed the whole month of January. Overall, I'm pretty active and healthy (well, I was before the BMX anyway). I could wait until summer for the exchange, but I'm already tired of the iron bra feeling! I also feel like the TEs are too far into my armpit area. Thanks in advance!

Dx 12/12/2016, DCIS/IDC, Left, <1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2-
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Jan 31, 2017 06:05PM MinusTwo wrote:

eemax - Although I found the healing easier & quicker, my PS had the same restrictions - don't reach above your shoulders and no lifting over 5 lbs. Also I had drains again for the exchange surgery - probably for 2 weeks. They are a pain, but I was glad to have them & avoid seromas.

It will also make a difference if your PS has to do any pocket work, or is going to do any fat grafting. I was off heavy pain pills in 2 days but I don't think I could have gone back to active work like you describe in a week.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Jan 31, 2017 07:33PM dccancer wrote:

Wildtulip, LRGO and Robin,

Thank you so much for the info. I will ask about the pocket work. As i said I am pretty sure they are doing lypo and grafting. I was hoping not to have drains again but we'll see. I will meet with the PS on the 22nd and ask about the recovery time again. Scheduled for 3/8! I am excited. I go back to work tomorrow after having been out since June. I was hoping to have all the surgery complete but it didn't work out.


Triple Positive , Stage II. Multifocal tumors left breast.7/12/16 Neoadjuvant Chemotherapy Six rounds of TCHP with weekly taxol. 12/7/2016 MX left side. SNB 0/4 nodes. Tissue Expander. 3/2017 Reconstruction. Hormonal Therapy - Tamoxifen
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Jan 31, 2017 10:16PM robinblessed54 wrote:

eemaxx, I had my TEs in for 6 months which I was told is normal for my PS. 3 months to fill and 3 months to make sure pockets were stretched and settled. I was filled to 420 and have Allergan 410 gummies 475cc FF. I took 2 weeks off during spring break but could have gone back in a week. I too work at a school. I had similar restrictions as well for EX as BMX.

Be good to yourself and your new foobs.

"Just because you can doesn't mean you should "

Robin


Dx 9/2/2014, ILC, Left, 1cm, Stage IB, Grade 1, 0/5 nodes, ER+/PR+, HER2- Surgery 9/25/2014 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 10/15/2014 Arimidex (anastrozole) Hormonal Therapy 12/30/2014 Aromasin (exemestane) Surgery 3/5/2015 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 3/14/2015 Femara (letrozole) Surgery 12/21/2016 Reconstruction (left): Nipple tattoo; Reconstruction (right): Nipple tattoo
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Feb 1, 2017 11:43AM LRGO2016 wrote:

Good morning ladies. 5 days post 2nd exchange of my right implant, and I'm completely off all pain management, not even tylenol. My single drain is slowing down rapidly too! My energy this time has been a bit low so I've been sleeping more the last 2 days, maybe that's why things seem to be improving rapidly.

I recommend anyone undergoing exchange, plan for a week off, minimum! And the less you use or move your arms, the better!

I am going to try to go to work (desk job) on Friday. One week post op. I'll let you know how I fare.

Hope everyone is healing and feeling better!


My new name: "Screams With Twig!" Surgery 10/29/2007 Prophylactic ovary removal Surgery 5/4/2016 Prophylactic mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/26/2016 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Feb 1, 2017 03:12PM - edited Feb 2, 2017 07:33AM by TrmTab

well, to switch gears a little, wanted to share some good news ...

as some of you might remember, I had to postpone by Dec 28th exchange as my mother had a stroke and is now living with us and recovering. Molly I feel for you in the new insurance/doctor business because when I had to miss my Dec 28th EX, I am now a summer EX!

The good news is today I had my first "regularly scheduled" mammogram since this all started in Sept 2015...and I was given the all clear on my remaining R breast! When initially diagnosed, I had so many tests between Sept 2015 and Jan 2016, my MO wanted me to wait a year before another radiology test so that is why it is now...

While I posted this on another board, I started Arimidex ahead of the L-MX...and the pathology at MX was that the DCIS area had shrunk...given the clear mammogram makes up for a lot of the aches and pains of the Arimidex side effects!
Dx 9/2015, DCIS, Left, 1cm, Stage 0, Grade 2, ER+/PR+ Surgery 12/21/2015 Lumpectomy: Left Surgery 1/10/2016 Lumpectomy: Left Hormonal Therapy 2/4/2016 Arimidex (anastrozole) Surgery 6/3/2016 Mastectomy: Left; Reconstruction (left): Tissue expander placement Hormonal Therapy 1/1/2017 Arimidex (anastrozole) Surgery 9/8/2017 Reconstruction (left): Silicone implant Surgery 12/17/2018 Reconstruction (left): Silicone implant
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Feb 2, 2017 10:22AM Molly50 wrote:

Trmtab, how's your mom doing? Great news that the Arimidex is working! This whole thing about my exchange surgery is upsetting. I really am tired of the TE's. I will update once I figure out what I am going to do.

54 years old. Chek2 mutation. Family history of BC. Oncotype Dx 13 Extensive LVI Dx 6/8/2015, IDC, Left, 2cm, Stage IIB, Grade 2, 2/9 nodes, ER+/PR+, HER2- (FISH) Dx 7/29/2015, DCIS, Left, <1cm, Stage 0, Grade 2, ER+/PR+ Surgery 7/29/2015 Lumpectomy: Left; Lymph node removal: Underarm/Axillary Surgery 9/4/2015 Mastectomy: Left; Reconstruction (left): Tissue expander placement Hormonal Therapy 10/13/2015 Arimidex (anastrozole) Radiation Therapy 10/20/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 4/22/2016 Aromasin (exemestane) Surgery 7/22/2016 Prophylactic mastectomy: Right; Reconstruction (right): Tissue expander placement Surgery 3/21/2017 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Feb 2, 2017 10:31AM SpecialK wrote:

molly - most insurance companies will do a stat auth - the folks at your PS office (new one) need to get on the phone with your insurance and lean on them a little - which means you need to lean on the PS office. It is a little unfair for them to assume you can reschedule when they had to have known that they were making this move near the time of your surgery. They need to take your need for assistance and timing into consideration and ask your insurance company for a rapid approval. This is not a cosmetic procedure that has no timetable, so you should be able to jump the line.

BMX w/ TE 11/1/10, ALND 12/6/10. 15 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 6/18/13-present. Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+ (IHC) Dx 9/27/2010, DCIS, Stage 0, Grade 3
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Feb 4, 2017 09:20PM Wildtulip wrote:

Trmtab, Congrats on your mammo results!!

Molly, I'm sorry you've had such a difficult week. I also have to be very strategic in my surgery planning, and if I were in your case I think I would go with current PS, and as SpecialK said, put pressure on to get insurance stuff in order. It's a risk, but it's good to stay with who you know.

Dx at 46 "It's not simple to say, that most days I don't recognize me. I still remember that girl. She is gone, but she used to be mine." Sara Bareilles Dx 3/5/2015, IDC, Right, 6cm+, Stage IIIA, Grade 1, 3/23 nodes, ER+/PR+, HER2- Surgery 3/26/2015 Lymph node removal: Right; Mastectomy: Right; Prophylactic mastectomy: Left Chemotherapy 4/22/2015 Radiation Therapy 10/15/2015 Surgery 6/7/2016 Reconstruction (left): Tissue expander placement; Reconstruction (right): Latissimus dorsi flap, Tissue expander placement Hormonal Therapy Arimidex (anastrozole), Aromasin (exemestane), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone), Zoladex (goserelin)
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Feb 11, 2017 10:48AM LRGO2016 wrote:

Good morning exchange sisters. How's everyone doing? I'm feeling good after the second exchange of the right squishy two weeks ago. This time around, the drain was pulled at my two week checkup! So much better than the previous two surgeries where my drains were in place for over 5 weeks!

Does anyone know where to find information on the insurance rules that pertain to reconstruction following required mastectomy ?

I was told by my oncologist that insurance companies are required to cover reconstruction and all subsequent related surgeries [including replacement or exchange after the 10 year life expectancy of the implants). But I have not found the details of this rule. I'm also wondering if this rule applies to Medicare? I'm worried about the costs of the surgery down the road, after I retire and am on a fixed income and either have limited insurance or Medicare only.

Anyone have a lead on this info they can share?

Lrgo


My new name: "Screams With Twig!" Surgery 10/29/2007 Prophylactic ovary removal Surgery 5/4/2016 Prophylactic mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/26/2016 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Feb 11, 2017 11:44AM new__me wrote:

my PS told me everything is 100% covered. Even fat grafting if required. And subsequent implant exchanges as well if medically necessary. No time limit. The law was enacted in 1996 i think?

Diane. BRCA2+ and a DES daughter (exposed to DES in utero). Age 62, wife, mother of 2 and grandmother of 2. Extensive BC and OC in family. Daughter (31) neg for BRC2. Son (36) not tested yet. Surgery 9/1/2015 Prophylactic ovary removal Surgery 11/20/2015 Lymph node removal: Sentinel; Prophylactic mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 3/16/2016 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Feb 11, 2017 11:51AM new__me wrote:

he also said if you change insurance carriers it doesn't make a difference with the law. I specifically asked about Medicare(i am almost 62) so will be eligible in 3 yrs. It is covered.

Diane. BRCA2+ and a DES daughter (exposed to DES in utero). Age 62, wife, mother of 2 and grandmother of 2. Extensive BC and OC in family. Daughter (31) neg for BRC2. Son (36) not tested yet. Surgery 9/1/2015 Prophylactic ovary removal Surgery 11/20/2015 Lymph node removal: Sentinel; Prophylactic mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 3/16/2016 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Feb 11, 2017 11:54AM new__me wrote:

signed into law Oct 28, 1998

Diane. BRCA2+ and a DES daughter (exposed to DES in utero). Age 62, wife, mother of 2 and grandmother of 2. Extensive BC and OC in family. Daughter (31) neg for BRC2. Son (36) not tested yet. Surgery 9/1/2015 Prophylactic ovary removal Surgery 11/20/2015 Lymph node removal: Sentinel; Prophylactic mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 3/16/2016 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Feb 11, 2017 06:56PM cateyz2 wrote:

I believe its called the Women's Healthcare Act

Surgery 4/2/2013 Lumpectomy: Left Dx 4/8/2013, DCIS, Stage 0, Grade 2, ER+/PR+ Surgery 5/30/2013 Lymph node removal: Left; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Dx 5/31/2013, DCIS, <1cm, Stage 0, Grade 2, 0/2 nodes, ER+/PR+ Surgery 11/25/2013 Reconstruction (left); Reconstruction (right) Surgery 8/25/2014 Reconstruction (left); Reconstruction (right) Surgery 8/25/2014 Reconstruction (left); Reconstruction (right)
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Feb 11, 2017 07:06PM MinusTwo wrote:

All those comments are correct - but LRGO might be talking about when our reconstruction/exchange implants might have to be replaced 10 or 15 or 20 years down the road??? I don't know that answer. Except I did see my PS last fall and he noted a difference in how they were hanging. He said "I can fix that for you". Other than the fact that I'm not excited about more surgery, it's 5-1/2 years since my exchange and he was indicating he could still fix it under Medicare. Interesting question.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Feb 11, 2017 08:39PM Molly50 wrote:

Hi ladies, I am tentatively scheduled for exchange on March 21st. I am very excited to have these TE's out. It's been way too long.

54 years old. Chek2 mutation. Family history of BC. Oncotype Dx 13 Extensive LVI Dx 6/8/2015, IDC, Left, 2cm, Stage IIB, Grade 2, 2/9 nodes, ER+/PR+, HER2- (FISH) Dx 7/29/2015, DCIS, Left, <1cm, Stage 0, Grade 2, ER+/PR+ Surgery 7/29/2015 Lumpectomy: Left; Lymph node removal: Underarm/Axillary Surgery 9/4/2015 Mastectomy: Left; Reconstruction (left): Tissue expander placement Hormonal Therapy 10/13/2015 Arimidex (anastrozole) Radiation Therapy 10/20/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 4/22/2016 Aromasin (exemestane) Surgery 7/22/2016 Prophylactic mastectomy: Right; Reconstruction (right): Tissue expander placement Surgery 3/21/2017 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Feb 11, 2017 10:01PM - edited Feb 11, 2017 10:04PM by MrsB88

Re: MASTECTOMY & BREAST RECONSTRUCTION INSURANCE COVERAGE

This is my understanding of the insurance coverage for mastectomy reconstruction. It's a federally mandated law which requires ins. companies & medicare to cover the cost of mastectomy & mastectomy related surgeries including revision surgery if health related, i.e., capsular contracture, infection, implant failure & subsequent exchange of implants when they expire. It covers nipple & areola surgery & cost for a medical professional to tattoo areolas. I'm not sure if it covers 3D nipple tattooing by a medical professional. They don't cover the cost of the medical ink. They also don't cover areolas & 3D nipples created by tattoo artists. Hope this helps.


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Feb 11, 2017 10:07PM - edited Feb 11, 2017 10:13PM by MrsB88

This Post was deleted by MrsB88.
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Feb 11, 2017 10:12PM MrsB88 wrote:

Congrats Molly! I hope you are able to have your exchange surgery during the time frame you requested with your original PS. It has been way too long & you deserve to get rid of those uncomfortable TE's. Best wishes for an excellent outcome!

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Feb 12, 2017 03:37PM Molly50 wrote:

Thank you, MrsB88. Just waiting for confirmation and a pre op appointment with PS.

54 years old. Chek2 mutation. Family history of BC. Oncotype Dx 13 Extensive LVI Dx 6/8/2015, IDC, Left, 2cm, Stage IIB, Grade 2, 2/9 nodes, ER+/PR+, HER2- (FISH) Dx 7/29/2015, DCIS, Left, <1cm, Stage 0, Grade 2, ER+/PR+ Surgery 7/29/2015 Lumpectomy: Left; Lymph node removal: Underarm/Axillary Surgery 9/4/2015 Mastectomy: Left; Reconstruction (left): Tissue expander placement Hormonal Therapy 10/13/2015 Arimidex (anastrozole) Radiation Therapy 10/20/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 4/22/2016 Aromasin (exemestane) Surgery 7/22/2016 Prophylactic mastectomy: Right; Reconstruction (right): Tissue expander placement Surgery 3/21/2017 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Feb 12, 2017 06:24PM Mominator wrote:

LRGO, here are two fact sheets that should help answer your questions. If you need more information, there are links on both of these pages for more information.

Mominator

===================================================================

https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/fact-sheets/whcra

Fact Sheet: Women's Health and Cancer Rights Act

U.S. Department of Labor
Employee Benefits Security Administration

The Women’s Health and Cancer Rights Act of 1998 (WHCRA) provides protections for individuals who elect breast reconstruction after a mastectomy. Under WHCRA, group health plans offering mastectomy coverage must provide coverage for certain services relating to the mastectomy, in a manner determined in consultation with the attending physician and the patient.

The required coverage includes:

  • All stages of reconstruction of the breast on which the mastectomy was performed;
  • Surgery and reconstruction of the other breast to produce a symmetrical appearance;
  • Prostheses; and
  • Treatment of physical complications of the mastectomy, including lymphedema.

Under WHCRA, mastectomy benefits may be subject to annual deductibles and coinsurance consistent with those established for other benefits under the plan or coverage.

Group health plans, health insurance companies and HMOs covered by the law must provide written notification to individuals of the coverage required by WHCRA upon enrollment and annually thereafter.

Additional consumer information on WHCRA is available in the publication Your Rights After A Mastectomy.

Information for group health plans and employers on WHCRA and other health benefit law requirements is available in the publication Compliance Assistance Guide – Health Benefits Coverage Under Federal Law.

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https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/whcra_factsheet.html   

The Center for Consumer Information & Insurance Oversight

Women's Health and Cancer Rights Act (WHCRA)    

The Women's Health and Cancer Rights Act of 1998 (WHCRA) is a federal law that provides protections to patients who choose to have breast reconstruction in connection with a mastectomy.

If WHCRA applies to you and you are receiving benefits in connection with a mastectomy and you elect breast reconstruction, coverage must be provided for:

  • All stages of reconstruction of the breast on which the mastectomy has been performed;
  • Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
  • Prostheses and treatment of physical complications of all stages of the mastectomy, including lymphedema.

This law applies to two different types of coverage:

  1. Group health plans (provided by an employer or union);
  2. Individual health insurance policies (not based on employment).

Group health plans can either be “insured” plans that purchase health insurance from a health insurance issuer, or “self-funded” plans that pay for coverage directly.  How they are regulated depends on whether they are sponsored by private employers, or state or local (“non-federal”) governmental employers.  Private group health plans are regulated by the Department of Labor.  State and local governmental plans, for purposes of WHCRA, are regulated by CMS.  If any group health plan buys insurance, the insurance itself is regulated by the State’s insurance department.  

Contact your employer’s plan administrator to find out if your group coverage is insured or self-funded, to determine what entity or entities regulate your benefits.

Health insurance sold to individuals (not through employment) is primarily regulated by State insurance departments.

WHCRA requires group health plans and health insurance companies (including HMOs), to notify individuals regarding coverage required under the law. Notice  about the availability of these mastectomy-related benefits must be given:

  1. To participants and beneficiaries of a group health plan at the time of enrollment, and to policyholders at the time an individual health insurance policy is issued; and
  2. Annually to group health plan participants and beneficiaries, and to policyholders of individual policies.

Contact your State's insurance department to find out whether additional state law protections apply to your coverage if you are in an insured group health plan or have individual (non-employment based) health insurance coverage.
WHCRA does not apply to high risk pools since the pool is a means by which individuals obtain health coverage other than through health insurance policies or group health plans.

WHCRA does NOT require group health plans or health insurance issuers to cover mastectomies in general. If a group health plan or health insurance issuer chooses to cover mastectomies, then the plan or issuer is generally subject to WHCRA requirements.

Note: A non-Federal governmental employer that provides self-funded group health plan coverage to its employees (coverage that is not provided through an insurer) may elect to exempt its plan (opt out) from the requirements of WHCRA by following the “Procedures & Requirements for HIPAA Exemption Election” posted on the Self-Funded Non-Federal Governmental Plans webpage at http://cms.gov/cciio/resources/files/hipaa_exemption_election_instructions_04072011.html. This includes a requirement to issue a notice of opt-out to enrollees at the time of enrollment and on an annual basis.  For a list of plans that have opted out of WHCRA, go to http://cms.gov/cciio/resources/other/index.html#nonfed and click on “List of HIPAA Opt-out Elections for Self-funded Non-Federal Governmental Plans.”

If you have concerns about your plan’s compliance with WHCRA, contact our help line at 1-877-267-2323 extension 6-1565 or at phig@cms.hhs.gov.


Mominator, BRCA2+, STK-11 VUS, wife, mom to 3 children of various special needs, musician, volunteer. My Mom dx DCIS age 62, ILC stage IIIA age 79; Mom just passed 2/28/18. My Grandmother died of ovarian cancer age 48. Friend to Lori M, died 5/25/16. Surgery 11/11/2015 Prophylactic mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 1/18/2016 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 6/30/2017 Reconstruction (left): Silicone implant
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Feb 12, 2017 07:49PM MrsB88 wrote:

Mominator - Thanks for the complete WHCRA by-laws!

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Feb 13, 2017 01:19AM LRGO2016 wrote:

Thanks everyone for the information about the Women's health care law! Thus is exactly what I was looking for. Mominator, thanks especially for the detailed links and info. I'm not retirement age yet and medicare seems a long way off but by the time my implants need replacing, I will be relying on Medicare for my health care. I wanted to gather all this information and understand it well before I need it. THANKS, THANKS THANKS everyone!

Molly50, good luck with your exchange! Implants are so much more comfortable than TE's.

Be sure to follow your PS's orders during the healing period. I just had my right implant exchanged because it rotated and was hanging sideways. We don't know why it rotated but it is possible that I started working out too hard too soon after I was released to exercise or maybe I stopped sleeping in my sports bra too soon. I really don't want my new one moving around. So this time I'm taking it easier and will not begin any workouts for at least 4 or 5 months and this damn bra is not coming off for 6 mos! I'm so ready to move on to the nipple reconstruction phase and then tattoos. This delay is disappointing.





My new name: "Screams With Twig!" Surgery 10/29/2007 Prophylactic ovary removal Surgery 5/4/2016 Prophylactic mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/26/2016 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant

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