Direct to Implant and Reconstruction Same Day

Posted by toomey79 @toomey79, Jun 28, 2023

My daughter is 43 years old and has the BRCA2 gene. She was just diagnosed with Stage III Invasive Ductal Carcinoma(Breast Cancer). She is a professor at Temple University and lives by herself in Philadelphia. We(her parents), live in Ohio. She does not want to do radiation or chemotherapy. Neither she nor us are in a good financial situation. We are right at that lower middle class line. She has been checking around and is set on a surgeon and plastic surgeon in Beverly Hills, California. We would have to fly out, have someone take care of our two dogs, get a hotel, Uber back and forth to the hospital and of course, eat. We would have to take a loan out for $60,000. We are in our 60’s and I am disabled. The financial burden alone is immense. The place in Beverly Hills is called Cassileth Plastic Surgery. The surgeons name is Dr. Mensick. My question is; does the Mayo Clinic do direct to implant surgery all in one day, and is it safe? Any suggestions for a worried parent who doesn’t know what to do and if it’s the right and safe thing to let her do. She has big breasts with dense tissue and with the BRACA2 gene, both of which make the surgery and follow-up more concerning.

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@cathybrown98

I had a mastectomy, bilateral, and reconstructive at the same time. I was a nightmare! with infections that would make 4 more surgeries within 6 months. I still have a small open wound on the left side. I'll not have any more reconstructive surgeries again. I use foam and silicone inserts. Not to mention the first surgery lasted 6 plus hours.

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Please tell me how you have been advised to treat open wound. I had transfer to implant surgery 3 weeks ago and my incision has opened and oozing. Right now they just want topical antibiotic and gauze. This happened at my initial double mastectomy as well when they placed the expanders...I don't want to go through this prolonged healing process anymore!!!!

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My plastic surgeon at Mayo in MN would not do direct to implant...stated too many things can go wrong. I am on a teacher salary and the expense is overwhelming but we are managing. We drive from Illinois to Minnesota for my appointments because I felt most comfortable with Mayo. I believe Washington University in St. Louis, MO does direct to implant.

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@janisbrede

Please tell me how you have been advised to treat open wound. I had transfer to implant surgery 3 weeks ago and my incision has opened and oozing. Right now they just want topical antibiotic and gauze. This happened at my initial double mastectomy as well when they placed the expanders...I don't want to go through this prolonged healing process anymore!!!!

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I was told the same thing, topical antibiotic and gauge. It's still open, but not oozing anymore. My sick about this husband feels a flap of skin over it s/b removed surgically; I hate that thought. I don't think I can go into that office again. I was lied to, put off, ignored, and there-there.
I'm sick over this and just want it to heal...eventually. I feel like you must.

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@cathybrown98

I was told the same thing, topical antibiotic and gauge. It's still open, but not oozing anymore. My sick about this husband feels a flap of skin over it s/b removed surgically; I hate that thought. I don't think I can go into that office again. I was lied to, put off, ignored, and there-there.
I'm sick over this and just want it to heal...eventually. I feel like you must.

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After my first surgery when they put in expanders it took months before they would actually expand the expanders because of the open wound and chance of expanders being infected. If that happened they said I would Likely have no choice but to go flat. Now I’m afraid if this opening gets worse and it reaches my implants I will be looking at the chance of having to go flat again. I am trying not to use my arms too much, but seriously, it is so hard. I sit here all day, can’t exercise or clean…I’m going to gain so much weight I just know it (also Tamoxifen isn’t helping the waistline). Rant done! 🤪

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@janisbrede

After my first surgery when they put in expanders it took months before they would actually expand the expanders because of the open wound and chance of expanders being infected. If that happened they said I would Likely have no choice but to go flat. Now I’m afraid if this opening gets worse and it reaches my implants I will be looking at the chance of having to go flat again. I am trying not to use my arms too much, but seriously, it is so hard. I sit here all day, can’t exercise or clean…I’m going to gain so much weight I just know it (also Tamoxifen isn’t helping the waistline). Rant done! 🤪

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It's okay, rant away! My husband does all the housework, grocery shopping, and cooking. I feel so terribly guilty. I had expanders, but they had to be removed due to infections. Now, I'm flat.
For a while I had only 1 expander; that wasn't fun.
The surgeon was suppose to remove the dog ears, but he didn't get them all. I feel like a freak!
I've gained 15 pounds since this started. I'll be a fat freak!

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@delormv

@toomey79 I thought insurance was supposed to cover all surgeries related to breast cancer…reconstruction included. Please tell your daughter to check with her insurance company. All the best!

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You are correct! Cancer.gov says it is a law

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I'm wondering of part of the issue with payment is that she is going outside her insurance as she is planning on having surgery outside her current residing state. I think for insurance to cover she would have to actually have a referral from one doctor to an out-of-plan doctor for insurance to cover. I wonder if that is part of the reason the cost is so high and the doctor's office wants so much up front - sounds as if surgery is being done completely out of plan network.

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I'm so sorry to hear this about your daughter. Prayers for you & y'all. I had the same type of cancer, DCIS stage III & had immediate reconstruction surgery following double mastectomy. Had 2 Drs tag teaming for 7 1/2 hour surgery! I was in hospital for 3 days before sending me home to heal. It can be done & it's a lengthy healing process. My surgery was in January of last year & I finally was able to wear a bra at Christmas, without it hurting. I also had large dense breasts so Dr didn't need expanders. Just used my own skin since I had a lot of it. But overall everything went good. But I had to have my family - husband & sister in law- help me. I couldn't do it alone. Just getting out of a chair or couch or bed, someone had to help me.
It's definitely a long healing road but there IS hope at the end of the tunnel. Reach out to friends or extended family. I'm sure there's people around that would help out.
My friends & family kicked in without me even asking when told of the news of the cancer.
A support group too at a local hospital would be good source as well. Good luck to you both.🙏💕🙏

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@delormv

@toomey79 I thought insurance was supposed to cover all surgeries related to breast cancer…reconstruction included. Please tell your daughter to check with her insurance company. All the best!

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I guess if it’s out of network the hospital has an option to make you pay a large chunk up front. It’s definitely not right to keep a cancer patient, especially Stage 3 or 4 from being able to get treatment where they feel will offer them what they need.

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@toomey79

I guess if it’s out of network the hospital has an option to make you pay a large chunk up front. It’s definitely not right to keep a cancer patient, especially Stage 3 or 4 from being able to get treatment where they feel will offer them what they need.

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Sounds to me like it's a private plastic surgery practice, which is standard practice to get full payment before surgery, that is not covered under insurance. I wonder who is doing the actual breast surgery to remove the cancer, plastic surgeons don't do that. From what is written the costs are for the plastic surgery only and not the breast surgery. And then toss in our of network and you have I believe the burden of the entire cost. Health care billing/costs/insurance was an enlightening experience for me and not in a good way ):

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