Breast Reconstruction Consultation Guide

Navigating breast reconstruction can feel overwhelming. These questions are designed to help you understand your options and know what to expect:

1. How many DIEP flap procedures have you performed?

PRMA's surgeons have performed thousands of microsurgical breast reconstructions, typically completing over 700 DIEP flap procedures annually.

2. How closely will the reconstructed breast match my opposite healthy breast?

There will be aesthetic differences between your natural breast and your reconstructed breast, particularly at first. However, patients should not worry about this initially. More than one surgery is almost always required for the most cosmetic results. Revision surgery will be performed a few months after the initial reconstruction to ensure that your breasts are as aesthetically pleasing and matching as possible. If required, nipple-areola tattooing is performed as an additional step in the office under local anesthesia to complete the reconstruction. Please also remember that most women are not 100% symmetric to begin with, even if they have never had any breast surgery.

3. How long will my DIEP flap surgery take?

The duration of breast reconstruction surgery varies depending on the procedure. A unilateral (one-sided) reconstruction typically takes less time than a bilateral (two-sided) reconstruction.

4. What's your success rate?

PRMA boasts a success rate of over 99% for DIEP flap procedures, surpassing the 97% success rate of top specialist centers.

5. How many microsurgeons will be performing my surgery?

Since the DIEP flap procedure is so technically demanding, having two microsurgeons perform the surgery (as is always the case at PRMA) rather than just one is preferable. Not only will this ensure you benefit from the expertise of two specially trained surgeons, but it will also significantly reduce the length of the procedure and anesthesia.

6. Do you have residents or fellows?

PRMA does not have residents or fellows. All surgeries are performed by fully trained and experienced surgeons, ensuring consistent and expert care.

7. Will my reconstructed breasts have any feeling?

Mastectomy often results in the loss of breast sensation due to nerve removal. However, PRMA offers a procedure called microneurorrhaphy, performed during flap reconstruction, which repairs the nerves cut during mastectomy and significantly improves the return of feeling to the reconstructed breast.
While very few centers worldwide offer this additional procedure, PRMA has been successfully performing sensory nerve reconstruction since the late 1990s.

8. How often do you plan to perform a DIEP flap but convert the procedure to a free TRAM flap during the surgery?

PRMA specializes in DIEP flap procedures and aims to preserve abdominal muscles. Conversion to a free TRAM flap is rare and typically only considered if necessary during surgery.

9. How long will the recovery be?

Recovery from DIEP flap breast reconstruction usually takes 4–6 weeks before patients can resume normal physical activity.

10. How long will I need to stay in San Antonio if I travel from out of town?

Out-of-town patients typically need to stay in San Antonio for a little over a week, including the hospital stay. The exact duration is determined on a patient-by-patient basis.

11. What accommodation options are available if I'm traveling from out-of-town?

PRMA's office is conveniently located near several hotels with easy access to the Medical Center. They have partnerships with the American Cancer Society and can offer reduced or free hotel stays for out-of-town patients.

12. Are you in-network with my insurance? How much will this cost?

Yes, we are in-network for most major US insurance plans. We do NOT balance bill. Costs vary depending on the type of reconstruction surgery chosen and your insurance coverage level of benefits. It is important to speak with a billing coordinator prior to your surgery so you are fully aware of your coverage and patient responsibilities. Our billing coordinators are always available to answer any questions you may have regarding your insurance coverage.