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Aug 26, 2009 08:03AM
I think an important aspect to your question is WHEN did you have reconstruction, in conjunction with how much out of pocket.
My own guess is that as DIEP /microsurgical construction has become more readily available by other microsurgeons, insurance companies are becoming less inclined to pay for private doctors.
I don't know their charges, etc., but it seems unlikely to me that private doctors can price match the surgical bills presented by University type hospitals. Most universities are subsidized by grants, etc., so they can afford to accept what insurance companies will pay.
Whatever people's opinions are, there is little data that actually supports a big difference in outcomes between microsurgical free trams and DIEPs.
However, there are significant differences between pedicled trams and the microsurgical procedures (MS Free TRAMS, DIEPS) in terms of donor site morbidity...damage to the rectus abdominis particularly in the case of bi-lateral reconstructions. And that fact is well-documented.
I'm sure I'm going to be attacked for this...but, from my reading, I would encourage you to have about $10,000 squirrelled away before going to a private doctor for reconstruction. Maybe you will be one of the lucky ones...maybe something can be worked out to your advantage and you don't have to pay that much, but that is a common figure that I have seen tossed around.
One of the ladies that I know needed bi-lateral GAPs...definitely a challenge to find a microsurgeon, and seriously a challenge to find one that will do both sides in one surgery. She sold her car and used the money to finance the surgery...then, she bought a new one at a very low interest rate and payments that she could afford.
It is understandable that people have emotionally, physically and financially invested in their reconstructions and would encourage you to go to the "best" microsurgeons in the country; however, it is worth keeping in mind that there are thousands of women who have had very good microsurgical reconstructions at multiple facilities across the country.