Book excerpt: This guide helps women decide whether to have a breast reconstruction procedure after mastectomy—and, if so, which one. For a decade The Breast Reconstruction Guidebook has been the best resource on this topic for women who have had a mastectomy. Equal parts science and support, it is filled with stories that illustrate the emotional and physical components of breast reconstruction. Readers will find advice about choosing a doctor and a procedure, insurance and payment issues, how to prepare for surgery, and what to expect during recovery. Expert commentary by physicians and insights from patients inform this book, as does the exhaustive research by the author, a two-time breast cancer survivor who has twice had reconstructive surgery. New in this edition are discussions of • the pros and cons of saline and silicone implants • solutions for post-lumpectomy cosmetic problems • new immediate-delayed reconstruction when post-mastectomy radiation may be required • the benefits and limitations of nipple-sparing mastectomy • considerations for direct-to-implant reconstruction • newly developed tissue flap procedures • who can best apply nipple and areola tattoos and why tattoos may not last • enriching fat with stem cells so it stays in the breast • patient-controlled tissue expansion • how insurance and health care reform affect reconstruction