Because Dr. Duffy is one of the few surgeons in the country providing all currently available options in breast reconstruction, including the DIEP and SIEA flaps, our practice sees patients from around the country. Of course, traveling for surgery involves additional considerations.

Although Dr. Duffy is always happy to have new patients, he recognizes that travel may present problems for some patients. Therefore, he recommends that patients first research whether there is an experienced surgeon in their home town area who can provide the DIEP/SIEA reconstruction. If there is not someone in your home town area, the next best option may be a surgeon in a city where you have family or friends who can provide additional support and assistance. Our office is happy to assist you with names of other practices if we know of one in your area to recommend. The first priority is finding the best option for you, the patient.

There are a couple of websites which we have found to be very useful in assisting patients who are looking for an experienced DIEP/SIEA surgeon. The first of these is that of Drs. Robert Allen, Joshua Levine, and Marga Massey. Their website contains information about their own physicians as well as others who they know to be experienced - on the page www.diepflap.com/about-otherdoctors.html.

Another excellent resource is a site put together by a couple of sisters who have gathered names from other patients. We do not know all of the listed physicians personally and therefore cannot necessarily recommend them directly but this is an excellent starting point for getting names of physicians in your area. Of course, as with any physician you are considering, you will want to be sure the doctor is board certified and experienced at the procedure. That website is www.diepsisters.com/diepdoctors.html.

When considering traveling for surgery, the first decision is whether this is a primary reconstruction or secondary. Primary reconstruction means you will be needing the mastectomy performed by a breast surgeon at the same time as the reconstruction performed by Dr. Duffy. Secondary reconstruction means the mastectomy has already been done at a previous surgery and you are now ready for the reconstruction.

Traveling for a primary reconstruction is more difficult than for a secondary. There are numerous reasons for this. First, you would not only need to locate the reconstructive surgeon but also find a new breast surgeon in the same city. Since the breast surgeon will need to review your history, including any biopsies, mammograms, etc, before recommending the type of surgery this may entail additional time and/or additional trips. Depending on the urgency of the mastectomy, it is often better for patients to proceed with the mastectomy in their home town with the surgeon who is already providing your care locally and then do the reconstruction at a later date. For patients whose mastectomy is not as urgent and who really want to proceed with a primary reconstruction, it is possible to do so with traveling but we believe it is important for patients to recognize this is not always the best option.

The most important consideration is always the treatment of the cancer. The recommendations of your local breast surgeon and/or oncologist relating to the urgency of the mastectomy are very important. If you have the mastectomy and reconstruction done out of town, you will need to be certain the information from the mastectomy including pathology reports and any test results done out of town are all provided to your local oncologist for followup treatments, if any are necessary.

Although traveling for a primary reconstruction is an option, we want patients to understand traveling for surgery is much easier and may be better for your overall results if it is done as a secondary reconstruction. For this reason, the information below relates to traveling for a secondary reconstruction. If you are considering a primary reconstruction our office can assist you in the additional needs beyond those described below.

Of course, prior to any reconstructive surgery you will want to meet with the physician to learn about your options, determine if you are a candidate for the DIEP/SIEA, and about the physician himself. That first consultation involves an office visit that is typically an hour in length or more as we want you to have as much time as necessary to ask questions. Some patients choose to schedule a mid-day appointment so they can fly in and out on the same day for this consultation. Because it is often difficult for patients to make multiple trips, many will call or email with questions before and after this consultation in addition to what is discussed at the appointment.

After that initial consultation and a decision about the type of reconstruction, the actual scheduling of the surgery can be done. For patients who are proceeding with a DIEP/SIEA reconstruction, you typically will need to arrive 1-2 days prior to your surgery for preoperative appointments and testing. The length of stay in the hospital varies with each patient but is usually 3-5 days. You will need to stay in town after being discharged from the hospital until Dr. Duffy has determined you are ready for travel and he has seen the early postoperative results. The length of stay after being discharged from the hospital varies with each individual also and with how quickly you heal. However, as a very general guideline most patients should expect to be in Dallas for a total of approximately 2-4 weeks.

It is important to remember that no one can predict exactly how quickly an individual patient will heal from surgery, and complications sometimes develop, although rarely. Therefore only an estimate of the length of stay can be provided and you should be prepared for a longer stay.

Once you are home you will still need to be followed by a physician throughout the healing process. This is typically done by your local breast surgeon or a plastic and reconstructive surgeon in your home town. If appropriate, Dr. Duffy can speak with that physician prior to your leaving Dallas to update him or her on your surgery and how you are doing at that time so they are prepared to take on your care. Of course, we will want you to continue to update our office on how you are doing after you are home!

Dr. Duffy will need to see you again postoperatively. Typically this is at 6 months postop and a year postop, although it may vary depending on the patient. Ideally he likes to see patients regularly postoperatively but we realize travel makes this difficult so we try to keep the number of trips to a minimum and to structure them at times that are as easy as possible for the patients.

Some patients need additional surgeries after their first reconstruction. This can occur for a variety of reasons. In some cases, the reconstructed breasts need minor revisions to improve the size/shape. For patients who choose to have nipple/areola reconstruction there is an additional procedure for this (it can usually be done at the same time as any revisions of the size/shape of the breast). If a patient has had a unilateral (one-sided) breast reconstruction and needs surgery on the other breast to improve the symmetry, this can be done as a later stage or can be done at the same time as any revision on the reconstructed breast.

Depending on the type of additional surgery needed, you may be able to have it done by a local surgeon rather than having to make an additional trip. Dr. Duffy prefers to be able to do the additional surgeries himself but it is not always possible for patients to do this so we are happy to work with your local surgeons as well.