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Frequently Asked Questions

Breast reconstruction after mastectomy surgery can be performed with either your own tissues or an implant.  The best option for you is a personal decision but is influenced by your breast size, body size, need for radiation therapy, and your personal goals with regard to how you want your new breasts to look and feel.

Breast conservation or lumpectomy has equivalent or better cure rates than mastectomy with fewer risks of surgical complications.  Patient satisfaction is typically better after breast conservation and especially after oncoplastic* surgery.  Dr. Schwartz is a recognized national expert in oncoplastic breast conservation.

*Oncoplastic breast surgery combines the techniques of traditional breast cancer surgery with the cosmetic advantages of plastic surgery. The goal is to remove cancer while minimizing the unwanted effects of surgery, helping patients heal both physically and emotionally.

Dr. Schwartz performs nearly 100% of his reconstructions at the same time as the mastectomy or lumpectomy surgery.

In October of 1998, Congress passed the “Women’s Health and Cancer Rights Act,” which requires group health and individual health insurance coverage for reconstructive surgery following a mastectomy. In general, the law states that these plans should cover:

  • Reconstruction of the breast on which the mastectomy was performed
  • Surgery and reconstruction of the other breast to produce a symmetrical appearance
  • prosthesis (artificial breast) and treatment of physical complications at all stages of the mastectomy

Dr. Schwartz has performed several thousand breast reconstruction procedures. He specializes only in breast surgeries and is one of only a few oncoplastic surgeons in the US. 

As 80% of women choose an implant-based reconstruction after mastectomy, this is the most common type of reconstruction Dr. Schwartz performs. Having said that, Dr. Schwartz has significant experience and has published several techniques on autologous reconstruction or using your own tissues to reconstruct your breast.

Dr. Schwartz makes every effort to match your newly reconstructed breast with your other healthy breast and has published several approaches describing strategies to accomplish this.

During your consultation, Dr. Schwartz will recommend surgery on your other breast if he thinks this is important to make the breasts look alike.  This might involve a breast reduction, lift, or breast augmentation.

Nipples are often reconstructed in a second surgery after the mastectomy surgery.  Dr. Schwartz makes every effort to reconstruct your nipple at the same time as your mastectomy, to avoid this additional surgery.  Nipples are typically reconstructed from excess breast skin.

Dr. Schwartz exclusively uses round, smooth silicone breast implants.  These are the safest and best breast implants for reconstruction.

Tissue flaps require scars in other parts of the body that “donate” this tissue to the breast after mastectomy.  These scars are typically hidden in creases that are difficult to see.  Pain after flap surgery typically resolves in 1-2 weeks.  These sites do not appreciably change after surgery retaining most of their original shape and form.

Tissue flap surgery usually does not require using an implant as well unless you don’t have enough excess fatty tissue to reconstruct a breast.

Dr. Schwartz performs all of his mastectomy and implant-based reconstructions without hospital admission.  For patients that undergo mastectomy and flap surgery on one side, hospital admission is not required either.  Patients that undergo mastectomy and flap reconstruction on both sides are typically recommended to spend one night in the hospital.

The use of high-volume fat transfer is a new, minimally invasive breast reconstruction approach that can provide many women a naturally-appearing breast using their own fat without significant scarring in other parts of the body.

Breast reconstruction does not interfere with the delivery of chemotherapy unless there are healing problems or an infection.

Breast reconstruction almost always can be performed without affecting the delivery of radiotherapy.  However, radiotherapy typically has a negative impact on the breast reconstruction result which may require additional surgeries to correct.

Based on your height and weight, most insurance companies require a certain amount of tissue removed from your breast during reduction surgery. Dr. Schwartz will examine you and determine if this is a reasonable amount of tissue to remove, reducing your breast size but still leaving you with a good breast appearance.

Depending on how large your breasts are and how much tissue needs to be removed, Dr. Schwartz performs breast reduction surgery in 90 to 120 minutes.

Most health insurances cover breast reduction surgery if certain criteria are met with regard to symptoms (back pain, neck pain, etc.) and the amount of tissue that is removed during surgery

Breast reduction surgery costs about $6000 without insurance.

Dr. Schwartz typically considers breast reduction surgery in patients as young as 18 but will make exceptions in certain circumstances.

It is preferable that you lose weight before surgery if possible, so your new breasts are matched to your body size and the risks of complications are lower. If you are planning to lose a significant amount of weight before or after surgery, discuss it with Dr. Schwartz as this can affect the resulting shape of the breast

Liposuction can be used for breast reduction surgery although this is more of a cosmetic procedure and typically not covered by health insurance. Dr. Schwartz does not routinely perform this procedure.

All breast reduction surgeries include a breast lift.

Many women who present to dr. Schwartz with significant breast asymmetry also require breast reduction surgery. Dr. Schwartz corrects this breast asymmetry during breast reduction surgery. It should be emphasized that certain asymmetries cannot be completely corrected but will certainly be improved.

Most women can be reduced by several cup sizes, often down to a B or C cup if that is their preference.

Doctor Schwartz performs approximately 150 breast reductions per year.

Patients do not require hospitalization after breast reduction surgery.

While most patients can breastfeed after breast reduction surgery, it is not absolutely guaranteed. If this is critical for you, you should wait until after you finished breastfeeding to consider breast reduction surgery.

Breast reduction scars are required to perform effective breast reduction surgery. These scars fade and become less noticeable over time.

The overwhelming number of women who have breast reduction surgery do not require additional surgery to reduce their breasts in the future. A small percentage of women do have significant regrowth of breast tissue after breast reduction surgery and will present for a repeat breast reduction several years after their first surgery.