Choosing a breast reconstruction and DIEP flap surgeon – specialized, fellowship training matters


All plastic surgeons have gone through the same core training, to a certain extent.  Plastic surgeons today often offer several procedures.  How do you choose your surgeon and how do you choose which one is the right one for you?

Certainly, researching a board certified plastic surgeon well-versed in the procedure(s) you desire is recommended.  Checking the American Board of Plastic Surgery website and Medical Board standing is a great place to start.  Plastic Surgery has formal training in aesthetics, breast, body contouring, craniofacial, facial reconstruction, hand, etc.  Just as you would choose a board-certified, fellowship-trained plastic surgeon  for a hand/plastic surgeon specialist for your hand issue or a craniofacial plastic surgeon for your cleft repair, you should choose the same expertise for your breast reconstruction.  A plastic surgeon who concentrates in the procedure you desire will be most apt to treat you, and treat you well.  Consult with surgeons who you are happy with their postoperative photographs and those who you, most importantly, feel comfortable and confident with. Use the opportunity to ask questions as well as visit with staff and investigate the accredited facilities they work out of.  Often times, your breast surgeon recommends the plastic surgeon s/he works with.  Check that surgeon’s credentials and interest/expertise in breast reconstruction and decide for yourself if that surgeon is the right one to meet your desires.  You certainly have your choice in your providers and who you choose to trust in your medical care.  If not, there are other plastic surgeons who may work with your breast surgeon and offer the procedure and results that will meet your expectations.

Experience should not be measured solely by the age of the surgeon or how many years s/he has been in practice.  Checking the education and training is more valuable – a Board Certified M.D. plastic & reconstructive surgeon who was accepted to and completed an integrated plastic surgery residency, in today’s day and age, are excellent choices.  Those are the top students who have superior training at top institutes.  Those who have actually successfully completed additional fellowship training beyond the plastic surgery residency are also passionate about that area and will likely have the most recent, innovative, and up to date techniques in breast reconstruction.  These surgeons are still readily willing and competent to continue to strive for the newest material and remain up to date on literature and conferences in this area.  In today’s specialized training within the various medical specialties, one who concentrates on and specializes in breast reconstruction is likely the most able to perform your procedure with the most expertise.  One who has completed additional fellowship, specialized training, in breast reconstruction is one you should seek.  Fellowship training beyond just a plastic surgery residency is by far the most important factor in competence and expertise for performing breast reconstruction.

In the field of breast reconstruction, there are several options for you – all of which you should be educated on an from there, you can make an educated decision into which one is the right procedure for you.  Seeking a fellowship-trained breast reconstruction surgeon is important as all options will be discussed with you, not just implant reconstruction.  There are flap reconstruction option, microsurgical options (DIEP, SGAP, SIEA, etc.), and fat grafting options.  With very few exceptions, every woman is a candidate for each of these options.  Whether your surgeon performs them is a different story.  In terms of the DIEP flap specifically, “not having enough tissue” or “you’re not a candidate” or “implants are the right choice for you” or a variety of other reasons are not viable.  Perhaps your surgeon just does not have the specialized training to perform this procedure.  Just ask – and how many s/he performs.  Microsurgical procedures, especially in breast reconstruction should be performed by fellowship-trained plastic surgeons in breast reconstruction/microsurgery.  Education, training, and specialized/focused interest dedicated to that area of plastic surgery are the most important factors in choosing your plastic surgeon for breast reconstruction.

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