MASTECTOMY AND BREAST RECONSTRUCTION IN BAJA CALIFORNIA SANER, SAFER, BETTER AND ONE FIFTH OF STATESIDE COSTS

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Breast reconstruction surgery in the United States costs between twenty and twenty five thousand dollars. Mastectomy surgery is typically covered by insurance but reconstruction is often excluded.

In Ensenada, Baja California a more labor intensive and caring approach to breast cancer is being offered that results in better treatment, fewer traumas and a superior breast reconstruction. Breast reconstruction in Baja California costs between five and seven thousand dollars, that represents close to an 80% savings.

Women, who’s self esteem and sometimes even their marriages are crumbling because reconstruction is prohibitively expensive, now have an affordable solution. For those that cannot afford the five to seven thousand dollar tab (includes hospital and all other related costs), financing is available.

You say: “Yeah sure, I’m going to a roach infested, border town hospital and let some Mexican surgeons with dirty instruments cut on me.” Since my name is Jose I know which way you don’t want to go.

After five years of researching comparative border care I can state that Ensenada, Tijuana and Mexicali do not take a medical back seat to San Diego. Hospitals, operating rooms, and medical/dental offices are equipped with state of the art technology and treatment modalities. The care givers are well trained and committed to providing the best treatment available anywhere.

Intrigued by the difference in costs for breast reconstruction I began interviewing doctors, breast cancer support group leaders and victims of breast cancer. My data supports the premise that breast cancer treatment and reconstruction surgery in Baja California is often superior to stateside treatment and surgery.

A case in point is a breast cancer and reconstruction team headed by a French plastic and reconstruction surgeon, Dr. Francois Gouin. Yes, you read that right, a French surgeon practicing in Mexico. More about him later, his treatment concept is the important issue. The doctor’s approach is to involve a cancer specialist, the surgeon performing the mastectomy, a radio therapist, a chemo therapist, a pathologist, sometimes a psychologist and himself prior to any surgeries.

Gouin’s team does not use breast implants, they use natural tissue, usually from the woman’s midsection (a tummy tuck is a bonus). The result is a more natural breast, both to the touch and appearance. Medically there is less risk of body rejection and future problems common to breast implants.

The team disagrees with a common U.S. procedure which is getting pre approval for breast removal. In the case of obvious cancer, during the biopsy surgery, the woman awakens to a loss of her breast, a fear that the cancer will spread and the stressful decisions regarding treatment alternatives. Gouin feels this approach is cruel and not in the best interest of the patient. His team only performs a “biopsy only” surgery first. If the biopsy is positive a three day thorough laboratory analysis is conducted to profile the type and size of the cancer. Only then do they feel confident in recommending the best treatment plan. The team then considers all the treatment alternatives: chemo therapy, radio therapy, surgery and reconstruction. A specific and well-debated plan for that patient’s unique needs.

This two step approach also allows the patient to be involved in her own treatment plan decision making. As mentioned earlier, Gouin also utilizes psychologists, experienced in treating breast cancer patients, when appropriate or requested. If surgery is a treatment alternative, the plastic surgeon, cancer specialist and mastectomy surgeon confer on how to best perform the surgery. The objective is removal of the cancer with a procedure that will enhance reconstruction.

Gouin insists that a plastic surgeon should always be part of the breast or tumor removal surgery. The manner and type of incision the surgeon makes for cancer removal greatly affects reconstruction results: ranging anywhere from making reconstruction nearly impossible to a breast almost identical to the original.

In some instances the cancer removal, if only a small lesion, can be combined with reconstruction surgery. The woman awakens from the mastectomy with an already reconstructed breast. In attitude studies among breast reconstruction patients, more than 70% of the women felt that they were not healed until the breast was reconstructed. Dr. R. Rouger, a psychiatrist who has treated mastectomy patients, says: “Reconstruction allows a woman to leave her existence as a patient and return to her life as a woman.”

I believe the U.S. medical system has not given enough importance to the psychological impact a mastectomy has for a woman. Maybe it is because Mexico’s medical community are more “Latino caring” and less medically efficient. It is more efficient to use an implant, it is more efficient to remove the breast at the biopsy stage. Efficiency is of the utmost importance when a day in the hospital exceeds one thousand dollars for the room alone. In Mexico you could stay in a hospital for a month for less than a one day stay in the States and receive better care. Cardio Med hospital in Ensenada is where Gouin and team do most of their surgeries. The nurse to patient ratio at this ultra modern facility, with only private rooms, is one nurse to every two patients.

There are 100,000 retirees residing in Northern Baja and their approval rating for medical and dental care is reflected in the waiting rooms of local physicians and dentists. English speaking doctors and dentists in Ensenada estimate that 35% (low estimates) to 95% (high estimates) of their patients are U.S. retirees. They could drive 70 miles North to cross the border for Medicare or an HMO but prefer their Ensenada physician or dentist whose office visits cost less than the gas to travel to San Diego.

The largest medical consumer group in Baja California are of course the three to four million Mexicanos who live in this wealthier of Mexican states. Tijuana’s per capita income is slightly higher than that of San Diego. Comparing education levels, the residents in TJ also score higher. A socio economic group who have medical options. They could go to the state socialist medical system at no cost or use the private medical system, which treats 30% of the nation’s wealthier citizens. The private system has to be especially caring in order to compete with the state run system and the nearby San Diego medical community.

Baja California specialists often refer Mexicano patients to specific treatment programs unavailable in Mexico. Scripps Hospital, Alvarado Medical Center and U.C.S.D Opthamologists refer certain patients for laser surgery in Tijuana . There, a type of laser that is pending FDA approval in the States, is successfully treating thousands of U.S. citizens annually. The patient has the choice of going to Canada or Mexico to correct their extremely poor vision or cope with coke bottle thick lenses.

Good medicine is good medicine and has nothing to do with borders. Francois Gouin is a good example. He received his plastic surgery specialty in Paris under the tutelage of Dr. Paul Tessier, the father of craneofacial surgery. Fifty five percent of Dr. Gouin’s patients travel from the United States, Canada and Europe to be treated in Ensenada.

So whether it is breast reconstruction, dental implants, RK or any other elective surgery that you, the consumer, must pay for I suggest you compare the care and costs in Baja. I have and I can tell you that it will be at least 70% less expensive than the same treatment alternative in the United States. If the physician or dentist has U.S. patients you can talk to as a reference (they do not resent you asking) you can assure yourself of excellent care

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