My first post and so confused...

I think that you need to go with what you feel is right based on your surgeon's advice, although I can understand your husband's concern.  I am surprised that your surgeon can't take you as a public patient.  One thing I would ask, though - with the second lumpectomy, how much is going to be taken.  I had a wide excision first and was really happy with the result - was very hard to tell.  However, there were no clear margins on the path report so I had to go back for further surgery.  The surgeon said that he had taken as much the first time as he could with the result being that the breast still looked okay.  So, that was one of the reasons for going the full mastectomy.  That side is still flat as I am undecided about further surgery to reconstruct but he has done a really neat job - I'm guessing because there was enough room for him to do so.  My point is - ask what the resulting breast will look like as that may affect your decision.