Your reconstruction options
| Approach | What it is | Surgery / stay | Best for |
|---|---|---|---|
| Implant-based (direct or two-stage with expander) | Silicone implant under or over the pectoral muscle | 1 to 3 hours; 1 night | Thin patients, bilateral cases, no radiation |
| DIEP flap | Your own abdominal tissue, microsurgical transfer, no muscle taken | 6 to 10 hours; 3 to 5 nights | Radiated tissue, natural feel, patients who want no implant |
| Latissimus dorsi flap | Back muscle and skin, often with a small implant | 3 to 5 hours; 2 to 3 nights | When abdomen is not an option |
| Fat grafting | Refinement of contour after reconstruction | 1 to 2 hours; day case | Touch-ups, hollows, asymmetry |
| Nipple reconstruction and tattoo | Final stage | Office | 3 to 6 months after main reconstruction |
What reconstruction costs in Colombia
In the US, the Women's Health and Cancer Rights Act requires most insurance plans that cover mastectomy to cover reconstruction. If you have coverage, use it. The patients who come to Colombia are typically uninsured, have plans with narrow networks and no microsurgeon, want a revision that has been denied, or are Canadians facing a long wait for DIEP.
Choosing the surgeon: microsurgery is a subspecialty
Any board-certified plastic surgeon can place an implant. DIEP flap requires a microsurgical team, an operating microscope, and a hospital with the ICU-level monitoring to watch the flap for the first 24 to 48 hours. Ask the surgeon how many free flaps they do per year and what their flap loss rate is. Ask which hospital, and confirm on REPS that it is a hospital, not an outpatient surgical center. Colombia's plastic surgeons are trained through a rigorous residency system and the reconstructive community in Medellín and Bogotá is well established; see our cosmetic surgery spoke for the general vetting checklist.
Trip timeline
- Before flying: oncology clearance and records. Oncology note, operative report from mastectomy, radiation summary, any prior reconstruction records, current imaging.
- Day 1 to 2: consult, imaging, pre-anesthesia. For DIEP, a CT angiogram of the abdomen maps the perforator vessels.
- Day 3: surgery. Implant cases go home the next day. DIEP patients stay 3 to 5 nights with flap monitoring.
- Day 7 to 21: follow-up and flight clearance. Implant patients typically fly at 7 to 10 days. DIEP patients at 14 to 21 days.
- Months 3 to 6: refinement stage. Fat grafting, nipple reconstruction and symmetry work on a second, shorter trip, or with a plastic surgeon at home.
How to vet the surgeon and the hospital
- Verify the surgeon on ReTHUS and check that the relevant specialty is registered, not just the medical degree.
- Confirm the facility is registered and habilitated in REPS. For anything under general anesthesia, prefer a hospital or a surgical center inside a hospital campus.
- If a hospital claims JCI accreditation, check the JCI directory yourself. JCI is hospital-level only; no individual surgeon is JCI-accredited.
- Ask for the surgeon's annual volume for this specific operation and how they handle a complication after you have flown home.
- Get an itemized quote: surgeon, anesthesiologist, facility, pathology, implants or devices, medications, and every follow-up visit.
Frequently asked questions
Can I have reconstruction in Colombia if I had radiation?
Often yes, but radiated tissue favors flap reconstruction over implants. Bring your radiation summary and let the surgeon decide.
Will my oncologist at home continue surveillance?
Yes, reconstruction does not change surveillance. Bring the implant card and operative report home.
Is a two-trip plan normal?
Yes. Main reconstruction on trip one, refinements on trip two three to six months later. Some refinement can be done at home.
What implants are used?
Major international brands are available in Colombia. Get the brand, model, size and serial number in writing on your implant card.