What are your options for breast reconstruction after a breast cancer diagnosis? For Breast Cancer Awareness Month, Dr. Jason Rosenberg and co-host Meredith Reis dedicate this episode of In the BEST of HANDS: The Plastic Surgery Podcast to a topic close to Dr. Rosenberg’s heart: mastectomy and breast reconstruction.

Fellowship-trained in microsurgery at MD Anderson Cancer Center, Dr. Rosenberg has spent 30 years helping women rebuild after breast cancer. He explains when to see a plastic surgeon, what insurance covers, and how to choose between implants and natural tissue (flap) reconstruction. He also covers nipple reconstruction, 3D nipple tattoos, the risks involved with surgery and how partners can support someone through the process.

To see Dr. Rosenberg's DEIP Flap breast reconstruction before and after photos, click here.

Timestamps

02:00 – When to see a plastic surgeon after diagnosis

04:45 – Why many women skip reconstruction

07:00 – Does insurance cover breast reconstruction?

08:45 – Lumpectomy and oncoplastic surgery

10:45 – Implants vs. natural tissue: why radiation matters

12:00 – Prophylactic mastectomy, BRCA and implants

14:15 – Natural tissue (flap) reconstruction

20:00 – Sensation and nipple-sparing mastectomy

22:00 – Nipple reconstruction and 3D tattoos

25:15 – Fat grafting and the three stages of reconstruction

27:00 – Flap risks and complications

29:00 – Emotional support and the Butterfly Sisters

31:45 – Advice for partners

34:30 – “Today’s the day”: a patient’s story

In this episode, we cover:

Starting the Reconstruction Journey

• Dr. Rosenberg’s priority list: alive and healthy, cancer-free, then reconstruction
• Why only about 30% of women once chose reconstruction
• The law requiring insurance to cover reconstruction and matching the other breast

Lumpectomy & Oncoplastic Surgery

• How a plastic surgeon helps reshape the breast after a lumpectomy

Implant Reconstruction

• Why radiation changes the plan
• Prophylactic mastectomy for BRCA and other genetic risks
• Who is a good candidate, and why implants need maintenance

Natural Tissue (Flap) Reconstruction

• Using tummy tissue to rebuild the breast, with a tummy tuck-like benefit
• Muscle-sparing flaps vs. the techniques of the ’80s
• Immediate vs. delayed reconstruction

Nipples, Sensation & Finishing Touches

• What sensation may return after a mastectomy
• Nipple-sparing mastectomy: who’s a candidate
• Nipple reconstruction vs. 3D nipple tattoos
• Fat grafting and combining a flap with an implant

Risks & Recovery

• Flap success rates (97 to 99% with an experienced microsurgeon)
• The critical first 8 to 10 hours after surgery

Emotional Support

• The Butterfly Sisters patient network and Survive and Thrive
• How partners can help, and why they’re patients too

🎧 Thanks for checking out In the BEST of HANDS: The Plastic Surgery Podcast! New episodes drop twice a month, on Wednesdays.

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Keywords: breast reconstruction, breast reconstruction after mastectomy, mastectomy, breast cancer, flap reconstruction, DIEP flap, implant reconstruction, prophylactic mastectomy, BRCA, oncoplastic surgery, nipple reconstruction, 3D nipple tattoo, nipple-sparing mastectomy, Breast Cancer Awareness Month

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