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reconstruction may be deferred (relative)"],"operation_hours":{"min":4,"max":8,"unit":"hours","qualifier":"Operating time for uncomplicated unilateral DIEP with microvascular anastomosis; longer if combined with mastectomy or complicated by vessel problems."},"anesthesia":["general"],"sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One primary DIEP free-flap operation with a single hospital admission."},"stages":[{"code":"planning_imaging","label":"Surgical planning and perforator imaging","after":{"min":0,"max":30,"unit":"days","qualifier":"After First consultation: Planning and imaging are scheduled before surgery, counted from the first consultation; timing depends on cancer treatment."}},{"code":"inpatient_monitoring","label":"Inpatient flap monitoring, drain care, and mobilization","after":{"min":0,"max":6,"unit":"days","qualifier":"After DIEP flap surgery: Uncomplicated stay; flap checks continue until discharge."}},{"code":"optional_refinement","label":"Optional contour or nipple-areola refinement","after":{"min":90,"max":180,"unit":"days","qualifier":"After DIEP flap surgery: Conditional, not mandatory; 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Complications or return to theater lengthen the stay."},"source":"parsed_details"},"treatment_conditions":["inpatient"],"rehabilitation_days":{"min":28,"max":84,"unit":"days","qualifier":"Ordinary daily function returns after uncomplicated unilateral DIEP; slower with complications or adjuvant therapy."},"fly_home_after_days":{"min":10,"max":21,"unit":"days","qualifier":"Once discharged, mobile, drains removed or managed, no flap concerns and team clears travel; take VTE precautions."},"back_to_work_days":{"min":28,"max":56,"unit":"days","qualifier":"Desk or light work after surgeon clearance following uncomplicated unilateral DIEP; physical or heavy-lifting jobs take longer."},"exercise_resume_weeks":{"min":6,"max":12,"unit":"weeks","qualifier":"Strenuous exercise, core loading and heavy lifting after surgeon clearance and stable healing; walking starts within days."},"final_result_months":{"min":6,"max":12,"unit":"months","qualifier":"Swelling settles and the breast softens; scars mature longer. Optional refinements extend this."},"result_longevity":"The reconstructed breast is made of the patient's own tissue and is generally long-lasting, changing with weight and aging. Fat necrosis or contour changes may occasionally need revision.","main_risks":["Flap thrombosis or vascular compromise; flap loss uncommon (about 1–3%)","Fat necrosis or partial flap necrosis","Hematoma, seroma, infection, or delayed healing","Abdominal wall weakness, bulge, hernia, or numbness","Mastectomy skin necrosis and altered breast sensation","Asymmetry or contour irregularity needing revision","Venous thromboembolism and anesthesia complications","Long surgery, blood loss, and transfusion"],"complication_rate_pct":{"min":10,"max":30,"unit":"percent","qualifier":"Significant early flap or donor-site complications within about 3 months after unilateral DIEP; varies with risk factors."},"revision_rate_pct":{"min":20,"max":50,"unit":"percent","qualifier":"Later contour, fat grafting, or nipple-related revisions within 1-2 years after unilateral DIEP; many are elective."},"success":{"metric":"Early flap survival without total flap loss","value":97,"horizon":"During the initial hospital stay and first weeks","source":{"status":"missing","reason":"not_collected"},"evidence_status":"limited"},"scars":"Breast scar (mastectomy scar or new incision if delayed), a long low horizontal abdominal scar, and a scar around the navel. Small drain marks; scars mature over 12 months or longer.","pain":"Moderate to significant pain in the first days, mainly at the abdominal donor site, controlled with multimodal analgesia. Discomfort and tightness usually ease over several weeks. Numbness or altered sensation may persist.","preparation":["Oncologic and plastic surgery planning, including timing","Medical assessment, blood tests, and anesthesia review","CT or MR angiography to map abdominal perforators","Stop smoking and nicotine for weeks before and after","Review medications and supplements, including blood thinners","Fasting before general anesthesia","Pre-operative marking and photographs","Arrange home help and nearby lodging after discharge"],"recovery_timeline":[{"phase":"Hospital stay (about 3-6 nights)","description":"Flap monitoring, drain care, pain control, VTE prevention, and early mobilization with sitting and short walks.","restrictions":["No driving","Avoid pressure or tension on flap and abdomen","Nicotine avoidance continues"]},{"phase":"Weeks 1-6","description":"Home recovery with drains managed until removal, gradual walking, and a flexed-hip posture easing as the abdomen heals.","restrictions":["No heavy lifting","No strenuous or core 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place."}},{"purpose":"other","requirement":"conditional","after":{"min":10,"max":21,"unit":"days","qualifier":"After DIEP flap surgery: Drain removal review once output criteria are met."}},{"purpose":"assessment","requirement":"routine","after":{"min":42,"max":84,"unit":"days","qualifier":"After DIEP flap surgery: Healing and activity clearance review."}},{"purpose":"result_review","requirement":"routine","after":{"min":180,"max":365,"unit":"days","qualifier":"After DIEP flap surgery: Result review and discussion of optional refinement."}}],"sources":{"status":"missing","reason":"not_collected"},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask how many reconstructive breast surgeries the surgeon has performed","scope":"procedure","source":{"url":"https://www.theaestheticsociety.org/procedures/breast/breast-reconstruction/selecting-surgeon","host":"theaestheticsociety.org","quote":"How many reconstructive breast surgeries have you performed?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Ask whether the surgeon has before and after photos of breast reconstruction procedures you can see","scope":"procedure","source":{"url":"https://www.theaestheticsociety.org/procedures/breast/breast-reconstruction/selecting-surgeon","host":"theaestheticsociety.org","quote":"Do you have before and after photos of breast reconstruction procedures that I can see?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check that you have two consultations with the treating surgeon before any surgery","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/conditions/cosmetic-procedures/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"You should have 2 consultations with the surgeon treating you before any surgery.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C4","text":"Check how your aftercare will be coordinated before you agree to treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C5","text":"Check that you understand the possible complications and side effects of the treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Make sure you understand the possible complications and side effects that could arise from your treatment.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Cut-price campaigns or cheap offers for surgery are a warning 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written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T5","text":"Lets a doctor at home identify the breast implants you received","document":"implant registration card","source":{"url":"https://www.canada.ca/en/health-canada/services/drugs-medical-devices/breast-implants/what-to-know.html","host":"canada.ca","quote":"You should also receive a product registration card from your surgeon with information about the implant or implants.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1}},"parsed_details":{"procedure_type":"surgery","fields":{"anesthesia":["general"],"back_to_work_days":{"min":28,"max":56,"unit":"days","qualifier":"Desk or light work after surgeon clearance following uncomplicated unilateral DIEP; physical or heavy-lifting jobs take longer."},"complication_rate_pct":{"min":10,"max":30,"unit":"percent","qualifier":"Significant early flap or donor-site complications within about 3 months after unilateral DIEP; varies with risk factors."},"contraindications":["Unfit for prolonged general anesthesia (severe uncontrolled disease)","Active infection at chest, abdominal donor site, or systemic","Current smoking or nicotine use (usually relative)","Insufficient abdominal tissue or damaged epigastric vessels (relative)","Very high BMI or poorly controlled diabetes (relative)","Prior thrombosis or clotting disorder 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Optional refinements extend this."},"fly_home_after_days":{"min":10,"max":21,"unit":"days","qualifier":"Once discharged, mobile, drains removed or managed, no flap concerns and team clears travel; take VTE precautions."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":5,"max":10,"unit":"days","qualifier":"After Hospital discharge: First outpatient wound and flap check; drains reviewed if still in place."}},{"purpose":"other","requirement":"conditional","after":{"min":10,"max":21,"unit":"days","qualifier":"After DIEP flap surgery: Drain removal review once output criteria are met."}},{"purpose":"assessment","requirement":"routine","after":{"min":42,"max":84,"unit":"days","qualifier":"After DIEP flap surgery: Healing and activity clearance review."}},{"purpose":"result_review","requirement":"routine","after":{"min":180,"max":365,"unit":"days","qualifier":"After DIEP flap surgery: Result review and discussion of optional refinement."}}],"indications":["Breast absence after mastectomy for breast cancer, immediate or delayed","Breast deformity after lumpectomy or radiotherapy","Risk-reducing mastectomy in high-risk patients (e.g., BRCA mutation)","Prior or planned radiotherapy, where implants are less suitable","Inadequate skin envelope for implants, with adequate abdominal tissue"],"main_risks":["Flap thrombosis or vascular compromise; flap loss uncommon (about 1–3%)","Fat necrosis or partial flap necrosis","Hematoma, seroma, infection, or delayed healing","Abdominal wall weakness, bulge, hernia, or numbness","Mastectomy skin necrosis and altered breast sensation","Asymmetry or contour irregularity needing revision","Venous thromboembolism and anesthesia complications","Long surgery, blood loss, and transfusion"],"pain":"Moderate to significant pain in the first days, mainly at the abdominal donor site, controlled with multimodal analgesia. Discomfort and tightness usually ease over several weeks. Numbness or altered sensation may persist.","preparation":["Oncologic and plastic surgery planning, including timing","Medical assessment, blood tests, and anesthesia review","CT or MR angiography to map abdominal perforators","Stop smoking and nicotine for weeks before and after","Review medications and supplements, including blood thinners","Fasting before general anesthesia","Pre-operative marking and photographs","Arrange home help and nearby lodging after discharge"],"recovery_timeline":[{"phase":"Hospital stay (about 3-6 nights)","description":"Flap monitoring, drain care, pain control, VTE prevention, and early mobilization with sitting and short walks.","restrictions":["No driving","Avoid pressure or tension on flap and abdomen","Nicotine avoidance continues"]},{"phase":"Weeks 1-6","description":"Home recovery with drains managed until removal, gradual walking, and a flexed-hip posture easing as the abdomen heals.","restrictions":["No heavy lifting","No strenuous or core exercise","Wear supportive garments"]},{"phase":"Weeks 6-12","description":"Ordinary function and desk work fully resume; physical work and exercise return stepwise after clearance.","restrictions":["Heavy lifting and high-impact sport only after surgeon clearance"]},{"phase":"Months 6-12","description":"Swelling resolves, the breast softens, and scars mature; optional refinement can be planned.","restrictions":[]},{"phase":"At any time","description":"Seek urgent care for flap color change or coolness, sudden swelling, fever, wound discharge, chest pain, breathlessness, calf swelling, or severe abdominal pain.","restrictions":[]}],"rehabilitation_days":{"min":28,"max":84,"unit":"days","qualifier":"Ordinary daily function returns after uncomplicated unilateral DIEP; slower with complications or adjuvant therapy."},"result_longevity":"The reconstructed breast is made of the patient's own tissue and is generally long-lasting, changing with weight and aging. Fat necrosis or contour changes may occasionally need revision.","revision_rate_pct":{"min":20,"max":50,"unit":"percent","qualifier":"Later contour, fat grafting, or nipple-related revisions within 1-2 years after unilateral DIEP; many are elective."},"scars":"Breast scar (mastectomy scar or new incision if delayed), a long low horizontal abdominal scar, and a scar around the navel. Small drain marks; scars mature over 12 months or longer.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One primary DIEP free-flap operation with a single hospital admission."},"stages":[{"code":"planning_imaging","label":"Surgical planning and perforator imaging","after":{"min":0,"max":30,"unit":"days","qualifier":"After First consultation: Planning and imaging are scheduled before surgery, counted from the first consultation; timing depends on cancer treatment."}},{"code":"inpatient_monitoring","label":"Inpatient flap monitoring, drain care, and mobilization","after":{"min":0,"max":6,"unit":"days","qualifier":"After DIEP flap surgery: Uncomplicated stay; flap checks continue until discharge."}},{"code":"optional_refinement","label":"Optional contour or nipple-areola refinement","after":{"min":90,"max":180,"unit":"days","qualifier":"After DIEP flap surgery: Conditional, not mandatory; timing depends on healing, swelling, and any adjuvant therapy."}}],"qualifier":"Primary numbers cover only the single DIEP operation. Later refinements are optional, and implant-based reconstruction is outside this profile."},"success":{"metric":"Early flap survival without total flap loss","value":97,"unit":"percent","horizon":"During the initial hospital stay and first weeks","population":"Adults after unilateral DIEP free-flap breast reconstruction in specialist microsurgical centers","evidence_status":"limited"},"techniques":[{"name":"Unilateral DIEP free-flap breast reconstruction (primary profile)","suits_whom":"Patients with enough lower abdominal tissue and suitable perforator vessels who want autologous reconstruction after mastectomy.","recovery":"Several inpatient nights with flap monitoring; ordinary functional recovery takes several weeks."},{"name":"Alternative: implant or tissue expander-based reconstruction (outside primary numbers)","suits_whom":"Patients with adequate skin envelope who prefer a shorter operation or no donor site.","recovery":"Shorter initial stay; may need expansion visits and later implant exchange."},{"name":"Alternative: other flaps (e.g., muscle-sparing TRAM, latissimus dorsi, thigh flaps) (outside primary numbers)","suits_whom":"Patients unsuitable for DIEP because of insufficient abdominal tissue or vessel anatomy.","recovery":"Varies by flap and donor site."},{"name":"Optional nipple-areola reconstruction and contour refinement (outside primary numbers)","suits_whom":"Patients who have healed after breast mound reconstruction and want nipple restoration or symmetry adjustment.","recovery":"Usually short procedures, often day-case; recovery is shorter than for the primary operation."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":4,"max":8,"unit":"hours","qualifier":"Operating time for uncomplicated unilateral DIEP with microvascular anastomosis; longer if combined with mastectomy or complicated by vessel problems."},"initial_assessment_documents":["Front, side and back photos of torso","Mastectomy operative and pathology reports","Oncology treatment summary with radiotherapy dates","Abdominal CT or MR angiography (if available)","Previous abdominal surgery history and scars"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single DIEP operation; about 2-3 weeks total for stay, drains and travel clearance. Follow-ups can be done at home."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask how many reconstructive breast surgeries the surgeon has performed","scope":"procedure","source":{"url":"https://www.theaestheticsociety.org/procedures/breast/breast-reconstruction/selecting-surgeon","host":"theaestheticsociety.org","quote":"How many reconstructive breast surgeries have you performed?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Ask whether the surgeon has before and after photos of breast reconstruction procedures you can see","scope":"procedure","source":{"url":"https://www.theaestheticsociety.org/procedures/breast/breast-reconstruction/selecting-surgeon","host":"theaestheticsociety.org","quote":"Do you have before and after photos of breast reconstruction procedures that I can see?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check that you have two consultations with the treating surgeon before any surgery","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/conditions/cosmetic-procedures/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"You should have 2 consultations with the surgeon treating you before any surgery.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C4","text":"Check how your aftercare will be coordinated before you agree to treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C5","text":"Check that you understand the possible complications and side effects of the treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Make sure you understand the possible complications and side effects that could arise from your treatment.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Cut-price campaigns or cheap offers for surgery are a warning sign","scope":"treatment_type","source":{"url":"https://bapras.org.uk/media-government/news-and-views/view/cut-it-out-surgery-societies-and-britain's-largest-surgical-royal-college-slam-summer-discounts","host":"bapras.org.uk","quote":"Surgery should never be subject to cut price campaigns or cheap offers, it is too important.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"A consultation only with sales staff, not the surgeon, is a warning sign","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/conditions/cosmetic-procedures/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"make sure you have a consultation with the surgeon (avoid meetings only with sales people)","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F3","text":"A surgeon who cannot show before and after pictures of their work is a warning sign","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/conditions/cosmetic-procedures/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"They should be able to show before and after pictures of their work.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-12","next_check_at":"2027-02-10"},"take_home":{"status":"ok","items":[{"id":"T1","text":"Gives your home doctor information about your treatment and future care needs","document":"discharge letter for gp","source":{"url":"https://www.nhs.uk/nhs-services/hospitals/going-into-hospital/being-discharged-from-hospital","host":"nhs.uk","quote":"You'll also be given a letter for your GP, providing information about your treatment and future care needs.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"T2","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T5","text":"Lets a doctor at home identify the breast implants you received","document":"implant registration card","source":{"url":"https://www.canada.ca/en/health-canada/services/drugs-medical-devices/breast-implants/what-to-know.html","host":"canada.ca","quote":"You should also receive a product registration card from your surgeon with information about the implant or implants.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"You would rather not have reconstruction surgery after mastectomy","name":"Breast prosthesis","source":{"url":"https://my.clevelandclinic.org/health/articles/breast-reconstruction","host":"my.clevelandclinic.org","quote":"Instead, they wear a breast form (prosthesis) inside a special bra.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200},"operation_id":null}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"technique_details":{"status":"ok","items":[{"id":"unilateral-diep-free-flap","name":"Unilateral DIEP free-flap breast reconstruction (primary profile)","how_it_works":{"text":"Tissue is moved to the chest using microsurgery","source":{"url":"https://health.ucdavis.edu/plasticsurgery/procedures/diep.html","host":"health.ucdavis.edu","quote":"The prepared tissue (\"flap\") is then disconnected from the body and transplanted to the chest using microsurgery.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"alternative-implant-tissue","name":"Alternative: implant or tissue expander-based reconstruction (outside primary numbers)","how_it_works":{"text":"Saline or silicone implants are used to recreate breast tissue","source":{"url":"https://my.clevelandclinic.org/health/articles/breast-reconstruction","host":"my.clevelandclinic.org","quote":"In implant reconstruction, surgeons use saline or silicone implants to recreate breast tissue.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"alternative-other-flaps","name":"Alternative: other flaps (e.g., muscle-sparing TRAM, latissimus dorsi, thigh flaps) (outside primary numbers)","how_it_works":{"text":"A flap of your own tissue rebuilds the breast","source":{"url":"https://my.clevelandclinic.org/health/articles/breast-reconstruction","host":"my.clevelandclinic.org","quote":"Other techniques use a flap of tissue from your body (such as tissue from the lower belly).","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"optional-nipple-areola","name":"Optional nipple-areola reconstruction and contour refinement (outside primary numbers)","how_it_works":{"text":"Surgeons can create a new nipple if needed","source":{"url":"https://my.clevelandclinic.org/health/articles/breast-reconstruction","host":"my.clevelandclinic.org","quote":"If necessary, providers can create a new nipple.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1}}},"techniques":[{"id":"unilateral-diep-free-flap","name":"Unilateral DIEP free-flap breast reconstruction (primary profile)","how_it_works":{"id":"H1","text":"Tissue is moved to the chest using microsurgery","source":{"url":"https://health.ucdavis.edu/plasticsurgery/procedures/diep.html","host":"health.ucdavis.edu","quote":"The prepared tissue (\"flap\") is then disconnected from the body and transplanted to the chest using microsurgery.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"},"suits_whom":"Patients with enough lower abdominal tissue and suitable perforator vessels who want autologous reconstruction after mastectomy.","price_from":{"status":"missing","reason":"not_collected"},"recovery":"Several inpatient nights with flap monitoring; ordinary functional recovery takes several weeks."},{"id":"alternative-implant-tissue","name":"Alternative: implant or tissue expander-based reconstruction (outside primary numbers)","how_it_works":{"id":"H1","text":"Saline or silicone implants are used to recreate breast tissue","source":{"url":"https://my.clevelandclinic.org/health/articles/breast-reconstruction","host":"my.clevelandclinic.org","quote":"In implant reconstruction, surgeons use saline or silicone implants to recreate breast tissue.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"},"suits_whom":"Patients with adequate skin envelope who prefer a shorter operation or no donor site.","price_from":{"status":"missing","reason":"not_collected"},"recovery":"Shorter initial stay; may need expansion visits and later implant exchange."},{"id":"alternative-other-flaps","name":"Alternative: other flaps (e.g., muscle-sparing TRAM, latissimus dorsi, thigh flaps) (outside primary numbers)","how_it_works":{"id":"H1","text":"A flap of your own tissue rebuilds the breast","source":{"url":"https://my.clevelandclinic.org/health/articles/breast-reconstruction","host":"my.clevelandclinic.org","quote":"Other techniques use a flap of tissue from your body (such as tissue from the lower belly).","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"},"suits_whom":"Patients unsuitable for DIEP because of insufficient abdominal tissue or vessel anatomy.","price_from":{"status":"missing","reason":"not_collected"},"recovery":"Varies by flap and donor site."},{"id":"optional-nipple-areola","name":"Optional nipple-areola reconstruction and contour refinement (outside primary numbers)","how_it_works":{"id":"H1","text":"Surgeons can create a new nipple if needed","source":{"url":"https://my.clevelandclinic.org/health/articles/breast-reconstruction","host":"my.clevelandclinic.org","quote":"If necessary, providers can create a new nipple.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"},"suits_whom":"Patients who have healed after breast mound reconstruction and want nipple restoration or symmetry adjustment.","price_from":{"status":"missing","reason":"not_collected"},"recovery":"Usually short procedures, often day-case; recovery is shorter than for the primary operation."}],"alternatives":{"status":"ok","items":[{"id":"A1","text":"You would rather not have reconstruction surgery after mastectomy","name":"Breast prosthesis","source":{"url":"https://my.clevelandclinic.org/health/articles/breast-reconstruction","host":"my.clevelandclinic.org","quote":"Instead, they wear a breast form (prosthesis) inside a special bra.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200},"operation_id":null}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"diagnostic":{"status":"not_applicable"},"country":{"why":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-11","next_check_at":"2027-02-09"},"travel":{"status":"ok","items":[{"id":"V1","item":"passport_validity","audience":"uk","volatile":true,"text":"The passport must have an expiry date at least 3 months after you plan to leave the Schengen area","source":{"url":"https://www.gov.uk/foreign-travel-advice/spain/entry-requirements","host":"gov.uk","quote":"have an ‘expiry date’ at least 3 months after the day you plan to leave the Schengen area (the expiry date does not need to be within 10 years of the date of issue)","tier":"official_travel","fetched_at":"2026-11-11","http_status":200}},{"id":"V2","item":"medicines","audience":"all","volatile":false,"text":"Carry prescription medication in its original packaging, along with your doctor's prescription","source":{"url":"https://travel.state.gov/content/travel/en/international-travel/International-Travel-Country-Information-Pages/Spain.html","host":"travel.state.gov","quote":"Always carry your prescription medication in original packaging, along with your doctor’s prescription.","tier":"official_travel","fetched_at":"2026-11-11","http_status":403}},{"id":"V3","item":"prescriptions","audience":"us","volatile":false,"text":"Medications that require a prescription in the United States also require a local doctor's prescription in Spain","source":{"url":"https://travel.state.gov/content/travel/en/international-travel/International-Travel-Country-Information-Pages/Spain.html","host":"travel.state.gov","quote":"Medications requiring prescriptions in the United States also require a local doctor’s prescription in Spain.","tier":"official_travel","fetched_at":"2026-11-11","http_status":403}},{"id":"V4","item":"ghic","audience":"uk","volatile":false,"text":"A GHIC or EHIC is needed to get medically necessary state healthcare in Spain","source":{"url":"https://www.gov.uk/foreign-travel-advice/spain/health","host":"gov.uk","quote":"To get medically necessary state healthcare in Spain, you need a Global Health Insurance Card ( GHIC ) or a European Health Insurance Card ( EHIC ).","tier":"official_travel","fetched_at":"2026-11-11","http_status":200}},{"id":"V5","item":"hospital_payment","audience":"all","volatile":false,"text":"Private hospitals usually require payment or proof of insurance or funds before admitting a patient","source":{"url":"https://travel.state.gov/content/travel/en/international-travel/International-Travel-Country-Information-Pages/Spain.html","host":"travel.state.gov","quote":"Private hospitals usually require payment or proof insurance or funds before admitting a patient.","tier":"official_travel","fetched_at":"2026-11-11","http_status":403}},{"id":"V6","item":"emergency_number","audience":"all","volatile":false,"text":"Dial 112 and ask for an ambulance","source":{"url":"https://www.gov.uk/foreign-travel-advice/spain/health","host":"gov.uk","quote":"Dial 112 and ask for an ambulance.","tier":"official_travel","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2026-12-11","version":1},"other_countries_with_page":["austria","azerbaijan","brazil","colombia","costa-rica","czech-republic","dominican-republic","egypt","france","germany","greece","india","israel","italy","lithuania","mexico","poland","portugal","republic-of-korea","switzerland","thailand","turkey","ukraine","united-arab-emirates","united-kingdom","united-states"]},"often_combined_with":{"status":"missing","reason":"not_collected"},"reviews":{"avg_rating":4.7,"count":519,"scope":"clinic","rating_scale":5,"pros":{"status":"missing","reason":"not_collected"},"cons":{"status":"missing","reason":"not_collected"}},"current":{"seo_text":"<p>Breast reconstruction surgery in Spain typically costs from _op_108_price_from_ to _op_108_price_to_. The final price depends on the surgical technique, the clinic’s prestige, and the specific city. In the US, similar procedures cost around _price_compare_US_average_ on average. Patients can save approximately _price_percent_discount_% compared to US prices. These costs generally include surgeon fees, anesthesia, hospitalization for 1 to 2 nights, and follow-up care.</p>\n\n<ul>\n<li><strong>Implant-based reconstruction:</strong> Typically starts around 10-15% lower than the national average for tissue-based methods.</li>\n<li><strong>DIEP flap reconstruction:</strong> This complex microsurgery using abdominal tissue generally adds 30-50% to standard costs.</li>\n<li><strong>Regional variations:</strong> Major medical hubs include Barcelona, Madrid, and Marbella.</li>\n<li><strong>Elite clinic premiums:</strong> Facilities in Madrid and Barcelona often charge 15-20% more than regional centers.</li>\n</ul>\n\n<p><strong>Bookimed Expert Insight:</strong> Spain offers a unique value for complex microsurgery. The Instituto Perez de la Romana established the country's first breast reconstruction unit in 1980. This deep institutional experience often costs less than at newer US centers. High-volume hospitals like Centro Médico Teknon use 3D surgical planning to improve symmetry. These JCI-accredited clinics provide elite-level technology at roughly half the US price.</p>","faq":[{"q":"Which clinics in Spain are best for breast reconstruction?","a":"<p>Spain is a global hub for breast reconstruction, offering advanced microsurgical techniques like DIEP flap and oncoplastic surgery. Top-rated clinics include Centro Médico Teknon in Barcelona, Hospital Ruber Internacional in Madrid, and Clínica Universidad de Navarra, all known for multispecialty cancer care.</p> <ul> <li><strong>Centro Médico Teknon:</strong> Barcelona facility featuring JCI accreditation and 400 specialized doctors.</li> <li><strong>Instituto Perez de la Romana:</strong> Established Spain's first dedicated Breast Reconstruction Unit in 1980.</li> <li><strong>Clínica Planas:</strong> Houses one of Southern Europe's premier microsurgery and lymphedema units.</li> <li><strong>Hospital Ruber Internacional:</strong> Ranked among the top 6 Spanish hospitals by Forbes magazine.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> While Madrid and Barcelona clinics dominate rankings, Alicante's Instituto Perez de la Romana offers a unique historical advantage. Having pioneered the country's first reconstructive breast unit in 1980, they offer highly specialized expertise in complex revisions at a smaller, more personalized patient volume.</p> <p><strong>Patient Consensus:</strong> Patients emphasize prioritizing the specific surgeon's reconstructive history over clinic branding. They frequently advise comparing up to 10 consultations to ensure the surgeon’s technique aligns with natural-looking aesthetic preferences.</p>"},{"q":"What are the main types of breast reconstruction performed in Spain?","a":"<p>Breast reconstruction in Spain includes implant-based methods, autologous DIEP flap microsurgery, fat transfer, and Latissimus flap techniques. Spanish surgeons at clinics like Centro Médico Teknon often prioritize immediate reconstruction. These procedures utilize 3D surgical planning and computer-assisted navigation to achieve natural symmetry and precision.</p> <ul> <li><strong>Implant-based reconstruction:</strong> Traditional two-stage approach using tissue expanders followed by permanent silicone or polyurethane implants.</li> <li><strong>DIEP flap:</strong> Advanced microsurgery using abdominal skin and fat while preserving the rectus muscle.</li> <li><strong>Fat grafting:</strong> Autologous fat transfer used for volume refinement or improving irradiated skin elasticity.</li> <li><strong>Latissimus flap:</strong> Utilizes back muscle and skin, often as a hybrid procedure with implants.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> Spain is a global hub for microsurgical innovation, evidenced by specialists like Dr. Federico Pérez de la Romana, who founded the country's first dedicated Breast Reconstruction Unit in 1980. Our data shows that top Spanish centers integrate 3D surgical visualization software, pioneered by local experts like Dr. Javier Herrero Jover. This level of historical expertise and technological integration ensures high success rates for complex autologous transfers.</p> <p><strong>Patient Consensus:</strong> Patients value the choice between DIEP flaps for a natural feel and implants for quicker recovery. Many suggest clarifying the exact number of surgical stages and activity restrictions, like the 8-to-12-week swimming limit for flap procedures.</p>"},{"q":"How long is the recovery time for breast reconstruction in Spain?","a":"<p>Recovery for breast reconstruction in Spain typically takes 6 to 8 weeks for a complete return to daily activities. Patients generally remain in JCI-accredited hospitals for 1 to 5 days, depending on whether they undergo prosthetic implant placement or complex autologous tissue transfer like DIEP flap surgery.</p> <ul> <li><strong>Hospital stay:</strong> Expect 1–2 days for implants and 3–5 days for microsurgical flap techniques.</li> <li><strong>Initial mobility:</strong> Surgeons encourage gentle walking within 24–48 hours to promote circulation and healing.</li> <li><strong>Drain removal:</strong> Doctors typically remove surgical drains between day 7 and day 14 post-operation.</li> <li><strong>Work timeline:</strong> Most patients return to sedentary office work within 3–6 weeks after surgery.</li> <li><strong>Physical activity:</strong> Strenuous exercise and heavy lifting are restricted for 8–12 weeks following reconstruction.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> Spanish specialists like Dr. Federico Pérez de la Romana pioneered dedicated reconstruction units, leading to highly efficient recovery protocols. Data shows that clinics using 3D virtual surgical planning often see better patient outcomes. Choosing a facility with this technology allows for more precise incisions, which can minimize postoperative discomfort.</p> <p><strong>Patient Consensus:</strong> Patients report that comfort levels improve significantly once surgical drains are removed around the second week. While light activity begins early, those undergoing flap procedures emphasize the need for a full 2-month recovery period.</p>"},{"q":"Is breast reconstruction covered by public health in Spain?","a":"<p>Breast reconstruction is fully covered by Spain's public health system when performed as part of oncological treatment following a mastectomy or lumpectomy. Coverage typically includes initial reconstructive surgery, nipple and areola reconstruction, and necessary implants for patients eligible for the Spanish National Health System.</p> <ul> <li><strong>System eligibility:</strong> Coverage is available to residents, workers, and those contributing to Spanish social security.</li> <li><strong>Treatment scope:</strong> Public care includes both immediate reconstruction and delayed procedures based on medical necessity.</li> <li><strong>Wait times:</strong> Patients often face significant delays in the public system due to hospital capacity.</li> <li><strong>Professional guidance:</strong> Patients should consult their hospital social worker or GP to confirm local regional coverage.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> Spain’s public system provides high-quality reconstructive care, but surgical units like the one founded by Dr. Federico Perez De La Romana at Hospital La Paz established the national standard for private-tier quality. Patients seeking faster access or specific microsurgical techniques like DIEP flaps often choose private centers like Clinica Planas or Centro Médico Teknon, where specialists perform over 1,000 surgeries annually with significantly shorter waiting lists.</p> <p><strong>Patient Consensus:</strong> Residents report that while cancer-related reconstruction is free, the process is often slow. Many suggest starting the eligibility paperwork immediately through a GP to navigate regional variations in hospital workflow.</p>"},{"q":"When is the best time to have reconstruction surgery?","a":"<p>The best time for breast reconstruction depends on your cancer treatment plan and personal health. Immediate reconstruction occurs during the same surgery as the mastectomy, while delayed reconstruction happens months or years later. Surgeons often recommend waiting 6 to 12 months after completing radiation therapy to ensure skin healing.</p> <ul> <li><strong>Immediate reconstruction:</strong> Performed during mastectomy to limit surgeries and maintain the natural breast skin.</li> <li><strong>Delayed reconstruction:</strong> Scheduled 6–12 months post-radiation to reduce risks and ensure healthy tissue.</li> <li><strong>Radiation factor:</strong> Completed treatments require skin recovery time to prevent complications or implant displacement.</li> <li><strong>Recovery timeline:</strong> Full physical recovery typically takes 2 months before resuming all normal activities.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> Spain hosts pioneers like Dr. Federico Perez De La Romana, who founded the country's first Breast Reconstruction Unit. Data shows Spanish clinics specialize in balancing oncology with aesthetics, often using tissue expanders as a 12-month bridge. This temporary measure allows patients to maintain their silhouette while safely completing intensive radiation protocols.</p> <p><strong>Patient Consensus:</strong> Patients emphasize waiting a full year after radiation leads to much better aesthetic results. Many find tissue expanders comfortable under clothing while they wait for their permanent reconstruction surgery.</p>"},{"q":"How do I choose a surgeon in Spain?","a":"<p>To choose a surgeon in Spain for breast reconstruction, verify they are members of the Spanish Society of Plastic, Reconstructive and Aesthetic Surgery (SECPRE). Look for specialists at JCI-accredited facilities in Barcelona or Madrid with over 20 years of experience in advanced microsurgical techniques.</p> <ul> <li><strong>Specialist credentials:</strong> Ensure certification by the European Board of Plastic Surgery (EBOPRAS) for international quality.</li> <li><strong>Hospital accreditation:</strong> Select clinics like Centro Médico Teknon or Ruber Internacional with JCI or ISO standards.</li> <li><strong>Clinical experience:</strong> Prioritize surgeons like Dr. Federico Perez De La Romana who founded specialized reconstruction units.</li> <li><strong>Technology access:</strong> Confirm availability of 3D surgical planning and advanced imaging for precise reconstruction results.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> While Madrid and Barcelona are primary hubs, high-tier surgeons in Alicante or Marbella often offer more personalized care. For example, Dr. Federico Perez De La Romana in Alicante brings 40 years of experience, rivaling the volume of major metropolitan centers while maintaining high ratings. Patients can find world-class expertise outside the two largest cities without sacrificing clinical safety or surgical quality.</p> <p><strong>Patient Consensus:</strong> Focus on surgeon techniques and clear revision policies rather than cost alone. Patients often recommend budgeting extra for recovery binders and ensuring the surgeon is reachable via WhatsApp for post-op questions.</p>"}],"h2":[{"text":"Как это работает","kind":"content"},{"text":"Какая цена хирургической реконструкции груди в Испании?","kind":"content"},{"text":"Лучшие клиники по хирургической реконструкции груди в Испании — 11 проверенных вариантов с ценами","kind":"content"},{"text":"Обзор процедуры Хирургическая реконструкция груди в Испании","kind":"content"},{"text":"Лучшие специалисты по хирургической реконструкции груди в Испании — 9 докторов с отзывами и ценами","kind":"content"},{"text":"Видеоистории пациентов Bookimed","kind":"content"},{"text":"Отзывы о Bookimed: узнайте о реальном опыте пациентов","kind":"content"},{"text":"Поделитесь этим материалом","kind":"content"},{"text":"FAQ по хирургической реконструкции груди в Испании","kind":"content"},{"text":"Получить бесплатную консультацию","kind":"content"}]},"placeholders":{"price_from":"{{price_from}}","clinics_count":"{{clinics_count}}","cities_count":"{{cities_count}}","savings_pct":"{{savings_pct}}","data_date":"{{data_date}}"},"legal":{"restricted_markets":{"status":"missing","reason":"not_collected"}},"conflicts":[]}