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Our "I need a" series is a helpful guide to finding the care you need when you don’t know where to start. Today, we’re learning how to find a breast surgeon.
If you’re considering having breast surgery—whether it’s to address a health concern like breast cancer, a cosmetic procedure to enhance your self-esteem, or both—choosing your surgeon is a big decision. So, before you start your search, let’s answer some helpful questions.
What Does a Breast Surgeon Do?
Most surgeons focus on certain areas of the body or treating specific diseases. Breast surgeons go one step further to focus on mainly or only breast-related procedures.
While some non-specialized surgeons, or general surgeons, may perform breast surgery, specialized breast surgeons typically fall into two main categories:
- Breast Cancer Surgeons (Surgical Oncologists): These specialists are trained to diagnose and treat health issues that develop in the breast. The most common condition that requires surgery is breast cancer, and many breast surgeons are cancer specialists known as surgical oncologists. Breast surgeons also perform biopsies or procedures to treat benign (noncancerous) breast disease.
These breast surgeons have general surgery residency training plus additional training in dealing with cancers in the breast (a breast surgical oncology fellowship).
- Plastic/Reconstructive Surgeon: These specialists focus on reconstructive and cosmetic procedures. Plastic surgeons perform a variety of cosmetic breast surgeries, including breast augmentations, reductions, lifts, and asymmetry correction. They also perform reconstructive procedures to help repair the appearance of your breasts after cancer treatment or trauma (usually in direct collaboration with breast cancer surgeons mentioned above.)
Plastic/Reconstructive surgeons may have general surgery residency training then specialize with further plastic and reconstructive surgery training, or they may train directly in an integrated plastic and reconstructive residency program that combines general surgical and specialized plastic surgery experiences.
Breast cancer surgeons and cosmetic surgeons may work together to coordinate and perform breast reconstruction surgery after or even simultaneously with breast cancer surgery.
What Credentials Should I Look For?
It can be hard to find a surgeon by looking at credentials alone, but it’s a helpful place to start. Knowing that a surgeon has completed additional training or has been certified by a professional board is a good sign that they have the expertise you are looking for.
- Residency — All breast surgeons will have completed a surgical residency, meaning that after medical school, they trained for years under the supervision of seasoned physicians.
- Fellowship — Fellowship is additional, focused training after residency. A fellowship-trained breast surgeon has completed a specialized training program under the supervision of an experienced surgeon.
- Board Certified — This voluntary process demonstrates that a surgeon has met rigorous standards set by their peers through a governing organization, or board. These boards are recognized by the American Board of Medical Specialties and the American Medical Association.
- Not every area has a board certification. For example, surgical oncologists and plastic surgeons have board certifications recognized by the American Board of Medical Specialties and the American Medical Association, but there is no specific board certification for breast surgery.
- Not every area has a board certification. For example, surgical oncologists and plastic surgeons have board certifications recognized by the American Board of Medical Specialties and the American Medical Association, but there is no specific board certification for breast surgery.
- Professional Societies and Organizations — Membership groups like the American Society of Breast Surgeons indicate that a surgeon is active in their specialty’s clinical and research communities.
The American College of Surgeons (ACS) offers a helpful Find a Surgeon tool that lets you search by the breast surgery subspecialty. The ACS is the world's largest organization of surgeons, and their comprehensive member database of board-certified surgeons is a great place to start looking.
What Else is Important to Look For?
If you’re looking for breast cancer treatment, you might want to focus on designated cancer centers and academic medical centers. Research has shown that working with a surgeon at a cancer center that can offer comprehensive and coordinated care yields the best results. These multidisciplinary groups are more likely to be active in clinical trials, so you may have access to treatment options that aren’t available to the general public yet.
Aesthetics are the main focus of cosmetic procedures, so you may find it helpful to see examples of their work. Many surgeons offer before-and-after images of previous patients. Most cosmetic procedures are considered elective surgery and may not be covered by insurance. So keep that in mind when searching online, since you might consider more surgeons if you know that insurance won't be a factor.
A Word About Top Doctor Awards
When searching for a doctor of any kind, you’ll probably come across advertisements for sites boasting Top Doctor lists, or you may find these awards mentioned in a surgeon’s profile. While many of these awards are legitimate and are based on peer-nominated candidates and vetted feedback, not all lists are created equal. Some are essentially lists intended to promote only the doctors who have paid for the privilege. If you use a Top Doctor list in your search, make sure that’s only part of your criteria.
So I Found Some Surgeons I Feel Comfortable With… Now What?
It’s time to start making appointments. Reach out to your top choices for what’s called a surgical consultation, or consult. Skilled surgeons are in high demand, so keep in mind that sometimes it can take some time to get scheduled. When making the appointment, their care team will ask about what you’re looking for, so be ready to explain what your needs are. But don't worry: you don't need to know exactly what surgery to ask for; the surgeon will be able to explain your options when you meet them.
During My Consultation, What Should I Ask?
In a word: everything. This meeting is your chance to learn about your surgical options, but it’s also your opportunity to learn about the surgeon: their approach, their demeanor, their experience, and their understanding of your condition. No question is silly or useless if it helps you feel more confident about the procedure. Bring notes if you’re concerned about remembering complex medical terms. Here are some helpful questions to consider:
- About the Surgeon
- How many breast surgeries have you performed? How many do you perform each year?
- Based on the procedure you would recommend for me, how many times have you performed that specific surgery?
- Do you only perform breast surgeries?
- Have you done a breast fellowship? Do you have any board certifications?
- Who is part of your care team? What specialists do you work with?
- What professional societies do you belong to?
- Are you involved in clinical trials that I might be able to participate in?
- About your procedure
- What will my procedure involve?
- What are my risks? What complications have you seen?
- Will I need to stay in the hospital? If so, for how long?
- What will my breasts look and feel like after my surgery?
- How much scarring will there be?
- Will I lose sensitivity in my nipples or breasts?
- Can I breastfeed after the operation?
- For Cancer Care
- Will I need a mastectomy (complete removal of the breast)?
- Is breast-conserving surgery (lumpectomy) an option for me?
- Is breast reconstruction surgery an option? What would it mean in my case?
- Do you work with a plastic surgeon at the same time as the surgery to remove the cancer? If not, can you recommend a plastic surgeon I could speak to about reconstruction options?
Do They Take My Insurance?
Money might not seem important when your health is at stake, but surgery can be very expensive. Avoiding another stressful element can help you focus on your health. So verify that they accept your insurance, even if their website states they do. Nothing is more frustrating than finding a surgeon who's a great fit, only to learn that your insurance won't cover the procedure. Some insurance plans also require a referral, so talk to your primary doctor about what you'll need.
Should I Get a Second Opinion?
Absolutely. Even if you think a surgeon is perfect for you, a second opinion can make you feel more confident about your decision. It can also help you become better educated about the procedure and your options. Second opinions can often be done with telehealth appointments, so they may not be as challenging to schedule.
🚩 Be wary of any surgeon that discourages you from getting a second opinion. An ethical surgeon will encourage you to get all the information you can and to consider every option.
Word of Mouth
Do you know anyone who has had the surgery performed by the surgeon you’re considering? It can be helpful to get feedback from someone who has been through the procedure and recovery process. Keep in mind that everyone’s health circumstances are unique, so their experience won’t be the same as yours. But speaking with others can help you feel better informed about the real-world results and can give you some insight into how the surgeon and their team treat their patients.
🚩 Word of mouth can also be a great way to find a surgeon that you might not have considered, especially if someone you know had a positive experience working with them. But make sure to then research the surgeon for yourself.
Online Reviews
Looking at online reviews or forums can also give you a sense of the experience other patients had while working with a specific surgeon. But it’s important to also remember that online reviews are often skewed towards patients that are unhappy with their results. And forums can be flooded with bots that make it harder to know which reviews are legitimate. So you should take these sources with a grain of salt.
What Other Factors Should I Consider?
The decision to have surgery is about you and your health, so you should consider what's important to you. If you’ve reduced your options to a few surgeons who have convinced you they will provide the best care possible, practical considerations may help you make the final decision. These include:
- Do you want a doctor that can perform a surgery at a hospital closer to home? Or is it worth it to travel for your procedure?
- Do you want to work with a surgeon that has a relationship with your specialists, to make it easier to coordinate your care?
- Is finding an in-network surgeon a priority because of your health insurance?
- How urgent is your health issue? If you had to wait to schedule your surgery for an opening on a surgeon’s calendar, is it worth the wait?
- Am I able to pay for a procedure out of pocket if my insurance doesn’t cover it?
Once you have settled on a surgeon who can perform the procedure you need, where you want it, and when you want it, it’s time to focus on getting ready for your procedure. That means following all instructions your surgical team gives you.
Breast surgery can be a life-saving operation, and it can provide an enormous boost to your self esteem. Choosing the right surgeon can help you look and feel like your best self.
Finding a Breast Surgeon at Columbia
If you would like to learn more about your surgical options, get a second opinion, or find out if working with the Breast Surgery team at Columbia is right for you, we’d love to hear from you. Call (212) 305-9676 or fill out our appointment request form.