The Cost of a Breast Reconstruction Surgery in NYC

Cost is one of the largest contributing factors in the decision for someone to pursue cosmetic surgery. Price can often be an important differentiating factor to consider when comparing surgeons. A surgeon’s expertise specific to the procedure you are interested in, the quality of their results, and photos demonstrating high-quality results can often be reflected in a higher price. If a particular surgeon is more expensive but you appreciate their opinion and results more than another, speak with their office coordinator to review payment options. Be very wary of free consultations as these are often not thorough enough for the provider to give you a full education on a procedure. Proper knowledge is essential for making an appropriate, informed decision regarding surgery.  Prices range from $30,000 on the very low end, to above $100,000 for very experienced high-quality surgeons on Park Avenue. All breast reconstruction is covered by health insurance according to New York State law. However, not all surgeons accept health insurance. Going out-of-network to find the most qualified surgeon may require paying for some or all your fees for surgery out of pocket, with the possibility of getting reimbursed, depending on your specific insurance policy.

What Affects the Cost of a Breast Reconstruction Surgery?

The cost of a breast reconstruction procedure can vary depending on several factors. One major factor would be geography. The larger the city (New York City for example), the greater the density of plastic surgeons. Board-certified plastic surgeons look to stand out by obtaining the highest level of training available within their field. A surgeon with advanced training and a well-established practice will often be more costly than a junior surgeon without the same credentials. Many warm-weather cities are known for offering inexpensive plastic surgery. While there are qualified providers in those places, it is important to research the implications of seeking surgery away from home – downtime, hotel/travel expenses, and what would happen in the case of any complication. Another aspect of surgery that can affect the cost is the associated surgical center and anesthesia fees. These are usually billed based on time in surgery, so how effectively a surgeon can achieve the desired result within a certain time constraint is a consideration. The average, uncomplicated breast reconstruction typically takes around two hours. Lastly, the type of practice the plastic surgeon maintains can affect cost. For example, a surgeon seeing many more patients within a given day with less time and attention per patient can charge less due to volume. In this case, patients may often be seen by a lower-level provider (PA, RN) for many of their post-operative follow-up visits. On the contrary, some surgeons prefer to minimize patient overload to allow each patient a large amount of individualized care, and that type of extra attention comes at a higher cost.

Keep in mind that the needs of each patient determine the appropriate treatment and overall eventual cost. A primary reconstruction, for example, is typically covered through insurance. Our practice is out-of-network, meaning that all expenses are due upfront, and insurance may or may not reimburse you depending on your plan. Breast reconstruction revision is very common and less costly because the bulk of the reconstructive work has already been done previously and may just need fine-tuning. This type of surgery would still be considered reconstruction but is most likely best addressed with an implant revision and/or additional fat grafting or reshaping of the surrounding tissue.

What is Covered Under This Cost?

Breast mounds can be reconstructed using implants, fat transfers, and autologous reconstruction techniques. Each method has its own advantages and disadvantages, and a patient’s personal preferences can be as important as their clinical needs in determining which option is right for them.

Regardless of the reconstruction technique used, beginning the reconstructive process at the same time as a mastectomy tends to yield the most favorable results. While each patient’s reconstruction follows its own timeline, you can generally expect reconstruction to follow the steps below:

The patient will be given a medical device like a tissue expander or suction system.

The tissue on the chest will be gradually expanded to make room for the new breast mound.

Once the tissue is expanded to the desired breast size, Dr. Maman will reconstruct the breast using either implants, a fat transfer, or an autologous tissue transplant.

Breast Implant Reconstruction

Because it does not require harvesting tissue or fat from another part of the body, using implants to recreate the natural mound of the breast is the least invasive breast reconstruction technique. It is still more complicated than a simple breast augmentation, but you will not have multiple surgical sites healing at the same time.

Implant reconstruction is an excellent choice if you are not interested in using your own tissue or if your cancer treatment has left your skin, muscle, and breast tissue too damaged to be used successfully. Implant reconstruction usually looks like this:

A tissue expander (a special type of empty breast implant) is placed on the chest wall, usually in a pocket under the pectoral muscle but sometimes between the muscle and skin, at the end of the mastectomy surgery.

Over the next six to eight weeks, Dr. Maman will fill the tissue expander with either saline solution or air, adding more every few weeks to gently stretch the skin and tissue until the breast reaches the desired size.

One to two months after you have finished the tissue expansion process and completed your chemo/radiation therapy, Dr. Maman will place either a permanent breast implant, a fat transfer, or an autologous tissue transplant.

You can choose between implants filled with a silicone gel or saline solution. While both are safe, most patients choose silicone implants because they deliver results that are closer to natural breasts in terms of look and feel. You can read more about the types of implants on our breast augmentation page.

Fat Transfer Reconstruction

Fat transfer can be a good reconstructive option for patients who are repairing damage from a lumpectomy or other partial breast trauma.

The first step in a fat transfer reconstruction is to expand the tissue on the chest to make room for the fat transfer. Unlike an implant reconstruction, a fat transfer reconstruction does not aim to create an empty cavity to fill later. Fat is living tissue, and for it to survive the transfer, it needs to be placed in well-vascularized tissue.

Instead of using a tissue expander to separate and thin tissue, a fat transfer reconstruction utilizes an external suction system that you will wear on your chest multiple hours a day for up to three months. The suction cups slowly expand the tissue, increasing the blood flow to the area.

After the tissue is adequately expanded, Dr. Maman will perform liposuction, usually on the stomach or hips, to harvest fat. Once the fat is processed to remove debris, dead cells, and extra fluid, it is injected into the prepared tissue on the chest.

Advantages of fat transfer reconstruction include:

• No risk of fat grafts being rejected
• Minimal scarring
• Shorter hospital stays and recovery time
• Unwanted fat is minimized

The disadvantage of a fat transfer is that it often takes multiple sessions to reach your desired cup size. There is also a risk that your body will resorb some of the fat transfer, leaving you with a lumpy reconstruction.

Autologous Breast Reconstruction

Similar to a fat transfer, autologous reconstruction, also called perforator flap reconstruction, uses tissue from different parts of the body to create a new breast.

Autologous reconstruction is highly complex and requires advanced microsurgery techniques to be successful, but it also delivers long-lasting results that look, feel, and move like natural breasts. This technique is also more successful for delayed breast reconstruction or a revision of the original reconstruction.

A DIEP flap is the most common type of autologous reconstruction. In a DIEP flap surgery, Dr. Maman will make a long incision along the pubic line and remove a section of skin, fat, and blood vessels from the abdomen. This piece of tissue is shaped to form the breasts and connected to blood vessels in the chest, then the abdomen is closed using tummy tuck techniques.

How Can I Set Up a Consultation?

The first step to schedule a consultation would be doing thorough research. There are many ways to find a plastic surgeon. Arguably the best way would be to receive a referral from another physician, such as primary care, dermatologist, or OB-GYN. These providers often see multiple patients with good results and can attest to those by referring their patients somewhere. Friends are a secondarily good referral source, especially if they are patients themselves. When it comes to advertising, the most essential consideration is the plastic surgeon’s education, board certification ONLY by the American Board of Plastic Surgery, and before/after gallery. If those components match your desired outcome, then they would be a good source of information to seek in consultation. You will often come across taglines such as “no downtime surgery” or “no anesthesia required”. If it seems too good to be true, it probably is. There are no shortcuts to SAFE plastic surgery.

The next step would be to contact the office of a board-certified plastic surgeon to find a time to meet them. First impressions last a lifetime, so pay attention when speaking to the receptionist upon calling. Should you decide to have surgery, this is the team you will be dealing with multiple times per month for at least a year. The administrative team directly reflects the surgeon’s ways of working. Another thing to clarify would be a potential timeline for surgery. This is sometimes best done before reaching out to qualified providers because they are booked one to six months out. Knowing well enough in advance will give you adequate time to interview surgeons, get any preoperative lab work done, and feel confident moving forward with your scheduled procedure.