Many women who have had mastectomies are not being informed about new breast reconstruction procedures by their doctors because the operations are expensive and not all surgeons know how to perform them.

According to the New York Times, though "flap" procedures have been developed that reconstruct the breasts using tissue and fat removed from a patient's abdomen or buttocks, most women still get implants, which often come with complications and require further surgeries. Compared to implant surgery, the flap procedure requires more advanced medical training, takes much longer, and can cost more than twice as much, leading many surgeons to not even mention it as an option. “It’s really embarrassing to say so, but, from a purely selfish point of view, if you are looking at insurance reimbursement for [the flap procedure], it’s a loss leader,” said Dr. Scott L. Spear, chief of plastic surgery at Georgetown University Hospital. “They really require so much time and effort that a surgeon thinks, ‘Man, I can’t afford to do this.’ ” [NY Times]