Looking for the best Plastic Surgeon for Bilateral Recon - Canberra or Sydney

Buffy

Hi all, I'm hoping some of you out there can help me with some answers and recommendations?

I was diagnosed last year at age 36 with Stage 1, Grade 3, triple negative BC, clear margins, 0/6 lymph nodes.  I had a lumpectomy, followed by chemo (TC x 4) and then radiation.  About half way through my radiation treatment I received the news that I was BRCA 1 positive.

I've had a biateral prophylatic salpingo oopherectomy about 4 weeks ago and now my radiation oncologist has told me to pursue the prophylactic bilateral masectomy and recon sooner rather than later as the radiated skin and tissue will be harder to work with as time goes on.

I am a very active person and was hoping to go the implant path, but I'm starting to think that may be out of the question?

So I am hoping that someone can help me out by answering some or all of my questions!!

Can you have implant based recon after having radiation?

Who can you recommend (plastic surgeon) for breast reconstruction?  I am in Canberra but happy to travel to Sydney if that is going to give me better results.

Also, any information in terms of fees (surgeon and hospital) would be greatly appreciated.  I am privately insured but my policy states that I will receive a

"lower level of hospital cover for... plastic and reconstructive surgery"... "default benefits apply to these services and in a private hospital are nowhere near sufficent (generally between 5% and 30% of the cost).  However, you will be covered (after your excess has been reached) if you go to a public hospital as a private patient in a shared ward"

So does this mean I should do the latter (public hospital), or are the out of pocket charges that I have read in other peoples posts (ie. around $8k) the costs to be treated in a private hospital?

Any information and advice appreciated.
Thanks

Leonie Moore

You sound so switched on.  Good for you to have the confidence that is needed on this journey.  Unfortunately I can't help with any answers for you as I have not had to travel the same road as yourself.  There will be someone on this site though who will be able to answer for you.   I c an think of a couple of blogs that I have read recently.  I have a friend the same age as yourself who was diagnosed a year ago with Triple negative BC.  She has recently had her second mastectomy with reconstruction.  The BC mastectomy site is still to be reconstructed.  The doctor was reluctant to carry out the full operation in "one hit" as it is such a long procedure.  I do know that it is quite an expensive process for her.  This is all happening in Queensland.Best wishes to you in finding out the answers. XLeonie

Leonie Moore

You sound so switched on.  Good for you to have the confidence that is needed on this journey.  Unfortunately I can't help with any answers for you as I have not had to travel the same road as yourself.  There will be someone on this site though who will be able to answer for you.   I c an think of a couple of blogs that I have read recently.  I have a friend the same age as yourself who was diagnosed a year ago with Triple negative BC.  She has recently had her second mastectomy with reconstruction.  The BC mastectomy site is still to be reconstructed.  The doctor was reluctant to carry out the full operation in "one hit" as it is such a long procedure.  I do know that it is quite an expensive process for her.  This is all happening in Queensland.Best wishes to you in finding out the answers. XLeonie

Chris

Hi Buffy, I have had a bilateral reconstruction with implants recently, which I am thrilled with, but didn't have radiotherapy. I can't advise about whether or not implants would work for you, but a plastic surgeon would know in an instant if your skin was good enough to try. In the process of researching reconstruction, I found an excellent Dr at RPA in Sydney who I would have been most confident in had I chosen the DIEP procedure. His name is David Pennington, and I have seen some of his work first hand, and he is really good. He also has a web site. He quoted me $19K for the operation. There may be some reduction if you go as a private patient in a public hospital, but not sure. I had my implants done at the SAN
and it was about $8K just in surgeon fees, but on
top of that there is the anaesthetist and hospital
excess etc. I had an emergency trip into a public hospital in Perth last year, when a massive haematoma deveolped 20 days after my mastectomy. Being on holiday, we went to Royal Perth Hospital, where I was admitted as a private patient. They were really keen for this to happen as they can claim back from my health fund. There was an excellent breast reconstructive surgeon on duty and I received no bills at all for her service. There is a medicare rebate for reconstructive surgery, and so even going privately you should get back 100% of the schedule fee. Of course, most surgeons charge well above this fee. Good luck with your research. Love Chris xx

Chris

Hi Buffy, I have had a bilateral reconstruction with implants recently, which I am thrilled with, but didn't have radiotherapy. I can't advise about whether or not implants would work for you, but a plastic surgeon would know in an instant if your skin was good enough to try. In the process of researching reconstruction, I found an excellent Dr at RPA in Sydney who I would have been most confident in had I chosen the DIEP procedure. His name is David Pennington, and I have seen some of his work first hand, and he is really good. He also has a web site. He quoted me $19K for the operation. There may be some reduction if you go as a private patient in a public hospital, but not sure. I had my implants done at the SAN
and it was about $8K just in surgeon fees, but on
top of that there is the anaesthetist and hospital
excess etc. I had an emergency trip into a public hospital in Perth last year, when a massive haematoma deveolped 20 days after my mastectomy. Being on holiday, we went to Royal Perth Hospital, where I was admitted as a private patient. They were really keen for this to happen as they can claim back from my health fund. There was an excellent breast reconstructive surgeon on duty and I received no bills at all for her service. There is a medicare rebate for reconstructive surgery, and so even going privately you should get back 100% of the schedule fee. Of course, most surgeons charge well above this fee. Good luck with your research. Love Chris xx

Buffy

Thanks all.  Leonie, I will have to seek out some of those blogs you have mentioned.  And thanks for the links and tips Di, I will definitely check those out.

Chris, thanks so much for your advice.  Dr Pennington is a name I have heard a couple of times now, so I will pursue that path a little further, and thanks so much for the detailed info on costs.  Whoa!  but yes, that is what I was expecting, it is nice to have something concrete to help my husband and I in our deliberations.

Cheers, B

kel016

Hi Em, you may just be my saving grace:) I'm about to ask for that exact op when I see my surgeon this coming wed. Have had mast on the left but don't have the confidence to keep the right one so I'm trying to be brave and o for both. My question is how were u when u woke from surgery ? And how much limitations do u have now that they have taken your back muscles?? Thanks in advance xxxxxx kell

Em

Hey Kel,

I'm not going to lie but when I woke up I was in pain, I was very tender and very sore but it is 100% worth it and it was right for me.  Each day my pain got better and better. I was sleeping on my side within 2.5 wks, well once the drains were out?.  I don't have any limitations that I am aware of. I did stretches as soon as all the drains were out (the ones you do if you have lymph nodes out). It took a good 5 - 6 weeks to get that range back but it is back ?

Goodluck with everything?