By understanding the rationale behind each question, you can make informed decisions about your treatment and choose a surgeon who aligns with your needs and goals. Take charge of your journey toward breast reconstruction by leveraging the knowledge provided through these essential questions.

Question 1:

Are you Board Certified provider? At which facilities do you operate? Is a private room available and can my loved one stay with me in the facility?

Board certification indicates that the surgeon has the appropriate qualifications, skills, and expertise to perform breast reconstruction surgery safely and effectively. Patients can have confidence in a board-certified surgeon’s ability to provide high-quality care and achieve optimal outcomes.

Understanding the hospitals where the surgeon operates provides insight into the facilities available, including specialized equipment, support staff, and amenities, helping patients make informed decisions about their treatment.

Question 2:

Are you fellowship trained in microsurgery? in perforator free flap breast reconstruction?

Fellowship training in microsurgery and perforator free flap breast reconstruction indicates specialized education and expertise in the field.

Knowing if the surgeon has undergone fellowship training provides assurance of their advanced skills, knowledge, and proficiency in performing complex reconstructive procedures. Patients can trust in the surgeon’s specialized training and competency, enhancing confidence in the surgical team’s ability to deliver high-quality care and achieve favorable outcomes.

Question 3:

Which breast reconstruction options do you perform? If you perform perforator flap breast reconstruction, which flaps do you offer?

Knowing the range of breast reconstruction options offered by the surgeon allows patients to understand their treatment options and tailor their decision-making accordingly.

Inquiring about specific perforator flap options, such as DIEP, GAP, PAP, or TDAP, helps patients assess the surgeon’s expertise and familiarity with different techniques.

Question 4:

If you perform perforator flaps, how many DIEP have you done successfully as the primary surgeon? GAP? PAP? TDAP? Stacked combination flaps? 4 flaps?

Knowing the number of successful cases they have performed as the primary surgeon in procedures such as DIEP, GAP, PAP, TDAP, stacked combination flaps, and 4 flaps provides insight into their expertise and familiarity with different techniques.

This information allows patients to gauge the surgeon’s capability to handle their specific case and achieve optimal surgical outcomes.

Question 5:

How many years experience do you have performing perforator free flap breast reconstruction as primary surgeon? How many do you perform as primary surgeon per year?

The surgeon’s experience and case volume in performing perforator free flap breast reconstruction directly impact surgical outcomes and patient safety.

Understanding the number of years the surgeon has been performing these procedures and the annual case volume provides insight into their expertise, proficiency, and level of comfort with the technique.

Question 6:

How many hours on average does it take you to perform a unilateral DIEP? bilateral DIEP?

Surgical duration can impact patient outcomes, including postoperative complications and recovery time.

Knowing the average duration of a unilateral and bilateral DIEP procedure provides patients with expectations regarding the length of their surgery and potential associated risks.

It also helps patients plan for their postoperative care and understand the demands of the procedure on their body.

Question 7:

What is your failure rate in perforators free flap breast reconstruction?

The failure rate in perforator free flap breast reconstruction is a critical measure of surgical success and patient safety.

Patients need to know the likelihood of flap failure, which can result in partial or total loss of the reconstructed breast tissue.

Understanding the surgeon’s failure rate allows patients to assess the risks associated with the procedure, including potential need for revision surgery, prolonged recovery, and psychological impact.

Question 8:

What is your percentage of “take backs” to the operating room for complications with perforator flaps specifically?

Understanding this percentage provides insight into the surgeon’s experience, skill in flap harvesting and microsurgery, and the effectiveness of their patient monitoring and complication management protocols.

It allows patients to assess the risk of postoperative complications and the surgeon’s ability to address them promptly and effectively.

Question 9:

Do I have to consent for a procedure that sacrifices muscle such as TRAM or free TRAM when my planned surgery is a muscle-sparing perforator flap such as DIEP?

Patients need clarity on the possibility of surgical plan adjustments based on intraoperative findings or unforeseen complications. This question ensures patients are fully informed about potential variations in the planned procedure and can actively participate in decision-making regarding their treatment.

Question 10:

How many times have you converted a muscle-sparing perforator flap case (i.e. DIEP) to one that sacrifices muscle (i.e. TRAM)?

Knowing the frequency of such conversions provides insight into the surgeon’s experience, adaptability, and decision-making during surgery. Understanding the circumstances under which conversions occur can help patients gauge the surgeon’s expertise and preparedness to address unexpected situations, ensuring optimal outcomes in perforator flap breast reconstruction.

Question 11:

What is your percentage of cases with use of mesh for abdominal closure? instance of hernia following DIEP surgery?

Understanding the surgeon’s experience with mesh usage and their hernia rates provides insight into their approach to abdominal wall closure and the potential risk of postoperative complications.

This information allows patients to assess the risks and benefits of the procedure and make informed decisions about their treatment.

Question 12:

When performing perforator flap breast reconstruction, do you use a second microsurgeon? are they Board Certified? fellowship trained in perforator flaps? Or do you use residents and/or fellows as assistant surgeons?

The involvement of a second microsurgeon and their qualifications can impact surgical outcomes in perforator flap breast reconstruction.

Knowing if the second microsurgeon is board-certified and fellowship-trained in perforator flaps ensures expertise and competence in microsurgical techniques, potentially contributing to better outcomes.

Question 13:

Do you use perforator flap-specific MRA or CT to map blood vessels preoperatively?

Preoperative imaging techniques, such as perforator flap-specific MRA or CT, are essential for precise planning and successful outcomes in autologous breast reconstruction.

These imaging modalities enable detailed visualization and mapping of blood vessels in the donor site, allowing surgeons to identify suitable perforator vessels for flap harvesting and minimize the risk of vascular complications.

Question 14:

Do you perform all perforator flaps as simultaneous bilateral?

Simultaneous bilateral perforator flap procedures offer advantages such as reduced overall surgical time and single anesthesia exposure.

Knowing if the surgeon performs all perforator flaps as simultaneous bilateral procedures allows patients to understand their options for reconstruction.

It also helps patients assess the surgeon’s expertise in performing complex bilateral procedures and their ability to coordinate surgical care effectively.

Question 15:

Do you do the delay of flap procedure as indicated for perforator free flaps?

The delay of flap procedure can enhance blood supply to the tissue and reduce the risk of complications in perforator free flap breast reconstruction.

Knowing if the surgeon performs this procedure indicates their commitment to optimizing surgical outcomes and patient safety.

Understanding the use of delay procedures allows patients to assess the surgeon’s approach to minimizing risks and maximizing the success of their reconstruction.

Question 16:

Do you offer immediate perforator free flap breast reconstruction or do you require a tissue expander placed first?

Inquiring about immediate perforator free flap reconstruction versus the need for a tissue expander provides clarity on the timeline and steps involved in the reconstruction process.

Requiring a tissue expander first before perforator free flap breast reconstruction can prolong the overall reconstruction process and involve additional surgical steps.

Question 17:

Do you offer delayed-immediate whereby I can use my own breast surgeon and have you perform my perforator free flap breast reconstruction within a set timeframe?

This question is crucial for patients who prefer a delayed-immediate approach, where they can first undergo mastectomy by their chosen breast surgeon and then have a perforator free flap breast reconstruction performed by another specialist.

Knowing if this option is available within a specified timeframe ensures seamless coordination between the two procedures and surgeons.

Question 18:

Are you accessible if I have questions/concerns? after hours?

Knowing that the surgeon is accessible for questions and concerns, even outside of regular office hours, can provide reassurance and peace of mind to patients.

In the event of post-operative complications or urgent concerns, being able to reach the surgeon promptly can facilitate timely intervention and appropriate management, leading to better outcomes and patient satisfaction.

Question 19:

Do you have breast surgeons who perform nipple-sparing mastectomy? Do they offer an inframmammy incision? Nipple-delay?

This question addresses the specifics of mastectomy techniques and incision options, which can significantly impact the aesthetic outcome and preservation of breast sensation.

Question 20:

IF MASTECTOMY RELATED, who are the breast surgeons with whom you operate? Are each Board Certified?

Collaboration between breast surgeons and reconstructive surgeons is crucial for comprehensive mastectomy and reconstruction procedures.

Knowing the qualifications and board certification of the collaborating breast surgeons ensures expertise and competence in mastectomy techniques, contributing to successful outcomes for patients.

Question 21:

Do you offer tattooing of the nipple/areola complex in your office?

This service can be essential for completing the final stages of breast reconstruction, enhancing the aesthetic appearance of the breasts, and restoring a sense of normalcy for the patient.

Offering nipple/areola tattooing in-office ensures convenience and continuity of care, streamlining the reconstruction process for patients and contributing to their overall satisfaction with the outcome.

Question 22:

Is a private room available and can my loved one stay with me in the hospital?

This question is important for patients’ comfort and emotional support during their hospital stay. A private room can provide a more conducive environment for recovery, allowing patients to rest and recuperate without disruptions.

Additionally, having a loved one present can offer emotional support, alleviate anxiety, and enhance the overall patient experience.

Question 23:

Do you have an insurance specialist on staff?

Dealing with insurance companies can be complex and daunting, especially when it comes to navigating coverage for medical procedures like breast reconstruction.

Having an insurance specialist on staff can be invaluable in helping patients understand their insurance benefits, navigate the preauthorization process, and address any billing or reimbursement issues that may arise.

This ensures that patients can focus on their recovery without the added stress of financial concerns.

Question 24:

Do you have a list of patients whom I can contact?

Seeking references for previous patients allows potential patients to gain firsthand insights into the surgeon’s approach, surgical outcomes, and overall patient satisfaction.

This transparency and access to real-life testimonials can help patients make more informed decisions and feel confident in their choice of surgeon.