NEW YORK, NY - Despite federal protections ensuring access to breast reconstruction after mastectomy, many women across the United States remain unaware that the procedure is often covered by insurance. This unawareness leads some to delay or forgo care altogether.

According to Dr. Tomer Avraham, a board-certified plastic and reconstructive surgeon who also leads Breast Reconstruction Specialists of NYC, this knowledge gap continues to impact patient outcomes at a critical time in their recovery. The New York City-based practice focuses exclusively on advanced breast reconstruction and is trusted by patients who travel from across the country to seek specialized care.

"Many patients are surprised to learn that breast reconstruction is not just an option. It's a legal right in many cases," says Dr. Avraham. "Unfortunately, by the time some women discover this, they may have already ruled it out or postponed it due to cost concerns."

Under the Women's Health and Cancer Rights Act (WHCRA), most health insurance plans that cover mastectomy are also required to cover breast reconstruction. This includes:

• All stages of reconstruction
• Surgery to achieve symmetry between breasts
• Prosthetics and treatment of complications

Yet despite these protections, real-world data suggests that a significant number of women still do not undergo breast reconstruction following mastectomy. Research shows that only 37.5% of women who undergo mastectomy for breast cancer choose reconstruction, highlighting a substantial gap between eligibility and utilization.

Further insights from Surveillance, Epidemiology, and End Results Program (SEER) data reveal that among patients who did not pursue reconstruction:

• 18% were unaware that reconstruction was an option
• 11.8% reported lack of insurance coverage
• Others cited barriers such as difficulty finding a qualified specialist (5.6%) or lack of insurance acceptance (7.8%)

Building on these findings, Dr. Avraham - who previously served as Director of Breast Reconstruction at Yale School of Medicine - notes that several factors continue to contribute to this disconnect:

• Timing during cancer treatment - patients are often focused on diagnosis and survival, leaving reconstruction as a secondary consideration
• Insurance complexity - pre-authorizations and varying policies can create confusion and delays
• Lack of early education - reconstruction options are not always discussed in depth during initial consultations
• Misconceptions about cost - many patients assume reconstruction is cosmetic and not covered by insurance

"As reconstruction surgeons, we see firsthand how misinformation or lack of clarity can influence decisions," says Dr. Tomer Avraham. "Education is just as important as the surgery itself."

Modern breast reconstruction has evolved significantly, offering patients more personalized and natural-looking outcomes than ever before.

At Breast Reconstruction Specialists of NYC, Dr. Avraham provides a comprehensive range of options tailored to each patient's needs, including:

• Implant-based reconstruction
• Autologous (natural tissue) reconstruction, such as DIEP flap procedures
• Immediate and delayed reconstruction approaches

These techniques aim not only to restore physical form but also to support emotional healing and quality of life following breast cancer treatment.

"Every patient's journey is different," says Dr. Avraham. "Our goal is to create a plan that aligns with their medical needs, personal preferences, and long-term well-being."

Dr. Avraham emphasizes that patients should feel empowered to explore all available options early in their care journey - including insurance coverage.

"Patients should never assume they can't afford reconstruction," he says. "Having the right information and the right surgical team can make a significant difference."

As awareness grows, Dr. Avraham and other specialists emphasize that early education and access to accurate information remain critical in helping patients make informed decisions about their care.

About Breast Reconstruction Specialists of NYC

Breast Reconstruction Specialists of NYC is a premier New York City practice focused exclusively on advanced breast reconstruction following mastectomy and other breast procedures. The practice is led by Dr. Tomer Avraham, a board-certified plastic and reconstructive surgeon with specialized training in microsurgical techniques, including DIEP flap and other autologous reconstruction procedures.

The practice offers a comprehensive, patient-centered approach to breast reconstruction, providing both implant-based and natural tissue options tailored to each individual's anatomy, medical history, and personal goals. With a strong emphasis on education, surgical precision, and long-term outcomes, Breast Reconstruction Specialists of NYC works closely with patients throughout every stage of the reconstruction process - including insurance coordination, surgical planning, and recovery.

Media Contact

Name
Breast Reconstruction Specialists of NYC
Contact name
Avraham
Contact phone
1 646-586-0837
Contact address
535 5th Ave 32nd Floor
City
New York
State
NY
Zip
10017
Country
United States
Url
https://breastreconstructionnewyork.com/