Had liquid silicone injections in both breasts in 1970. Had double mastectomies in Nov. '09, and "clean-up" Sept. 1 2010. I have Kaiser insurance, and I am looking for either a good Kaiser plastic surgeon anywhere in California (not happy with current plastic surgeon. He left me worse off, with very unsightly bulges in many places on my chest, and problems with both arms. Bedside manner stinks, too!) or, a non-Kaiser doc who has experience with my situation. Please help! Thank you! Mary
Doctor Recommendations in Bakersfield for Post-Mastectomies Due to Silicone Injection - Want DIEP
Doctor Answers (5)
Diep in Bakersfield
The best way to start to find a plastic surgeon to perform a DIEP flap would be to look up doctors in your area at the ASPS website.
DIEP Flaps after silicone injection
It is not uncommon for plastic surgeons who specialize in perforator flap surgery to see patients that have experienced complications after other types of breast surgery (following either cosmetic or reconstructive procedures). Unfortunately, it is also not uncommon for patients who have had silicone injections to have persistence of lumps and bumps following the removal of the injected silicone. This is because it is often almost impossible to "clean up" all of the silicone without causing other problems. For example, some of the injected silicone may be too close to the skin to be removed without damaging the skin.
Getting the opinion of a microsurgeon who specializes in perforator flap breast reconstruction seems like a very reasonable idea. I do not know specifically of any Kaiser surgeons specializing in DIEP flaps (that does not mean that there are not any).
You should know that both federal and state laws protect a woman's right to insurance coverage for reconstruction following mastectomy. If your insurance plan provides coverage for the cost of a mastectomy, it must also, according to Federal law, provide coverage for the method of breast reconstruction you wish to undergo; this coverage includes perforator flaps such as the DIEP, GAP and LAP flaps. This law applies both to reconstruction done at the same time as a mastectomy, and also to reconstruction done at a later date. If a surgeon in your network of participating providers does not offer the method of reconstruction you prefer, your insurer must still provide coverage, even if this means covering the cost of surgery with a “non-participating” physician.
Double mastectomy reconstruction with DIEP flap
You still have many options for breast reconstruction. The more conservative method is tissue expansion followed by cohesive gel implants. That depends if you had Radiation therapy or not.
Another method is the Latissimus dorsi muscle from your upper back with or without implants.
And finally if you have enough tissue in your lower abdomen you could be a good candidate for a DIEP flap.
It is best to find a plastic surgeon who specializes in different breast reconstructions to tailor the ideal one for you.
The best of luck.
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Experienced DIEP surgeon
When it comes to health insurance coverage for breast cancer reconstruction, there are laws in place that require insurance company's to cover your procedure. I would recommend that you seek out the best and most experienced surgeon you can find, regardless of location or your insurance plan.
Most large breast reconstruction practices are experienced in getting approval for all types of reconstruction, regardless of your plan.
I wish you a safe recovery.