Yes, certainly.
The first obstacle is not having enough plastic surgeons to begin with. Part of a plastic surgeon's practice would be a private practice and cosmetic surgery, and in rural areas, that is not something that is in high demand, basically. What has been happening and what my patients are facing are due to the lack of enough plastic surgeons.
Ideally, you should plan for the actual surgery, with the general surgeon performing the mastectomy, to happen at the same time as the reconstructive surgery to get the best cosmetic outcomes and minimize the downtime for the patient. It should be the standard of care, but unfortunately, it's not right now due to the lack of enough plastic surgeons, which, unfortunately, adds to the negative mental effects of having to deal with a mastectomy and having a flat chest for God knows how long until you have your plastic surgery.