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Perforator Flap FAQs

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What Is A Perforator Flap Breast Reconstruction?

In the United States, one out of eight women will receive a breast cancer diagnosis in her life. Yet only one third of mastectomy patients undergo breast reconstruction. Among these patients, only 30% use their own tissue; the rest get implants. Most women do not know it is possible to reconstruct their breasts with their own tissue after mastectomy or failed implant-based breast reconstruction.

Perforator Flap Breast Reconstruction FAQs

How long is the operation?

Perforator flap breast reconstruction is a highly complex procedure that requires two skilled microsurgeons who work together as a team. On average, it takes 3-5 hours to reconstruct one breast or 6-8 hours for two breasts.

What is the recovery time?

The morning after surgery, patients are encouraged to get out of bed to walk, eat, and drink. Patients usually stay in the hospital for 3-4 days after the operation for flap monitoring. Since perforator flap breast reconstruction protects the muscle to minimize postoperative pain and morbidity, many patients no longer need narcotic pain medication by the time they leave the hospital. Patients should take at least 2 weeks off of work to recuperate, but may not feel normal until 4-6 weeks after the operation. At 6-8 weeks, most patients can return to full activities with no restrictions.

Who is a candidate?

Healthy women who are planning to undergo or who have already undergone a mastectomy are candidates for perforator flap breast reconstruction.

How is it different from other types of breast reconstruction?

Most plastic surgeons who do breast reconstruction use implants. The operation is relatively fast and easy in the short term, but the implant is a foreign body that often needs to be changed at a later date - especially after radiation. In fact, 40-50% of implants are removed within 7 years due to capsular contracture, infection, rupture, or extrusion through skin. Also, some patients do not like the artificial feeling of an implant. Another type of breast reconstruction uses a patient's muscle from the abdomen or back (TRAM or latissimus dorsi) to reconstruct the breasts. Although common, sacrificing muscle for breast reconstruction can cause pain and weakness in active patients. Perforator flap breast reconstruction avoids muscle damage so that postoperative muscle function is preserved.

Does insurance cover it?

Yes. In 1998, Congress passed the Women's Health and Cancer Rights Act (WHCRA) that mandates that all insurance companies provide coverage for breast reconstruction under federal law. In 2011, New York State passed the Information and Access to Breast Reconstruction Law that requires that all women undergoing mastectomy, lumpectomy and lymph node dissection surgery must receive written information, prior to signing surgical consents, regarding options for reconstructive breast surgery. While the individual benefits of each plan may vary, Dr. Chen and her staff have been extremely successful in working with insurance companies. We work with all health insurance companies. While the individual benefits of each plan may vary, our staff is experienced in working with the insurance industry. We have been extremely successful in making sure that all patients receive the full care that they deserve. We will hold your hand throughout the entire process to help you with any issues that may arise with your insurance.

Many of our patients have volunteered to speak with other women who may have questions about what it is like to go through restorative breast and body surgery. If you would like to speak with someone who has already gone through the process, please contact us and we will find a “buddy” for you.


The Bosom Buddies are available for emotional support, practical tips, sharing stories, and other types of real life help that can help other women feel more comfortable and safe in their journey.

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News & Media

As one of the leading breast reconstruction specialists in the United States, Dr. Constance Chen has been featured in over 100 news and media publications and journals over her years in practice.

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