Q: I was wondering if I would be able to schedule a phone consult? I was recently diagnosed BRCA1 positive in April 2019. I have been working with a breast surgeon and plastic surgeon in the Midwest and I am interested in a double mastectomy with immediate DIEP reconstruction. After the initial consult with our local plastic surgeon, he thought this would be possible. In addition to that he wanted to do a mastopexy in preparation for nipple sparing mastectomy and DIEP. We did complete the mastopexy almost four weeks ago. At my last appointment, our plastic surgeon told us that he is not comfortable doing the immediate DIEP reconstruction after the mastectomy. This is due to limited resources and being the only microsurgeon capable of doing this near my hometown. He typically will complete these in two steps. We are interested in looking into a second opinion, as we would like to try and complete both surgeries in one step if possible. We are also wondering what a schedule or timeline to get in for this type of procedure would be. In the consult I would also like to discuss my journey so far, including screening results, and my past recommendations. A: Sorry you are having to go through this, but congratulations on having a great plastic surgeon. I’ve never met him, but I know he’s good because 1) he suggested / did the preliminary mastopexy, and 2) he is obviously putting your welfare first by referring you for bilateral DIEP. We would be honored and delighted to help you through the next stage of your journey. I will be happy to discuss the details with you by phone as soon as it can be arranged. --Richard M. Kline, Jr., MD