5 Under 40

I’m operating at Redbud Surgery Center this morning and wanted to talk about aesthetic flat closure. What it is, why it matters, and why we’re fighting to protect it. Today I revised a patient who previously had mastectomies where the incisions were simply closed. She wanted a smooth, flat chest contour, something she could wear a prosthetic with and feel confident wearing a fitted shirt without lumps or irregularities, That requires time, skill, and reconstruction beyond just closing the patient’s skin. For her reconstruction today, we spent over an hour carefully operating. We removed, moved, and reshaped the skin and fat of her chest, and we gently reshaped the sides of her chest to create as smooth a contour as possible. Sometimes this involves liposuction, but today that wasn’t needed. In this case I used the adjacent tissue transfer code This is real reconstructive surgery and it deserves real coverage. This is why chest wall reconstruction for aesthetic flat closure is included in the proposed WHCRA modernization, and why we’re working to refine the language to protect coverage of this procedure. Patients deserve access to all forms of reconstruction — including flat closure — and we’re committed to working with all stakeholders to make sure the law reflects that. More to come.

On January 7th, 2025 I shared a video, after I was asked to call UnitedHealthcare from the operating room to answer administrative questions about the patient who was having surgery to treat breast cancer. Despite my efforts, they denied her stay. UnitedHealthcare didn’t stop at calling me during surgery. Now, they’ve sent me a legal threat—and even worse? They ended up denying my cancer patient’s hospital stay. Exactly what I was afraid would happen. Staying overnight after major surgery isn’t optional—it’s medically necessary. But UnitedHealthcare decided they know better than the doctors caring for the patient. When they called me while I was operating, I knew that if I didn’t step out and respond immediately, they might deny her stay—leaving her with a massive bill. So, with another surgeon in the OR, I scrubbed out and called them back. But after all of that? They denied her stay anyway. And instead of fixing their broken system, they sent me a legal threat for speaking out. I’m sharing their response in full, letting their words speak for themselves. Let me be clear: I stand by everything I said. I told the truth. I was honest about what’s happening in our healthcare system. And I will not be silenced by legal threats when it comes to advocating for my patients and my ability to care for them. Denying an overnight stay that a doctor orders is dangerous. The doctor caring for the patient should be able to make these decisions without delay, pressure, or harassment. If I don’t speak up, I lose—my integrity, my voice, and the opportunity to make a difference. And while it’s intimidating to receive a letter like this from a company as powerful as UnitedHealthcare, I know where I stand. I am a woman taking care of women affected by breast cancer. I do this work with all of my heart, and I will continue to speak up for my patients—because they deserve better. I ask you to follow along, share this story, and have these conversations in your own communities. I know I’m not the only one dealing with this, and real change will take all of us telling our stories and standing up for what’s right. I’m here for it. Are you?