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Does Lymphedema Affect Success of Breast Reconstruction?

December 30, 2011 by

breast reconstructionThe below question is answered by the team at The Center for Natural Breast Reconstruction:

Does having lymphedema (arm and trunk) affect success of breast reconstruction?

We primarily have experience using perforator flaps for breast reconstruction, so I’ll answer from that perspective. Arm lymphedema does not directly affect breast reconstruction, although there are reports of arm lymphedema improving after reconstruction using your own tissue (such as DIEP, GAP, or other perforator flaps). Trunk lymphedema (including breast), while not affecting the survival of the flap, can result in prolonged edema of the breast skin overlying the flap, leaving the reconstructed breast with a heavy, “wooden” character. We have seen this edema gradually resolve in some patients, however, over a period of up to two years, and it is possible that the flap is actually helping with this.

For more answers to your breast reconstruction questions, visit our Ask the Doctor section of this blog.

Filed Under: Ask the Doctor Tagged With: , , , , , , ,

5 Things You Wish You Were Told About Menopause

December 28, 2011 by

menopause symptomsEven though the majority of women experience menopausal symptoms, and menopause is regularly discussed on talk shows and in magazines, the symptoms still take women by surprise. This can be a very stressful time for all your personal relationships, especially your marriage. Do not hesitate to get professional help if relationships become strained.

Following are a few things our patients wish they had been told about menopause.

You may start having symptoms 10 years before you actually enter menopause.

Beginning in your mid-forties or even earlier, you may begin experiencing menstrual irregularity, mood swings, hot flashes, and sleep problems. This stage, called perimenopause, can last several years.

According to the Mayo Clinic, once you have gone 12 consecutive months without a period, perimenopause is over, and you have reached menopause. You can find more information on perimenopause by clicking here.

You won’t feel like yourself.

The symptoms of menopause include hot flashes and cold flushes, night sweats, irregular periods, hair loss, facial hair, memory lapses, and inability to concentrate. You won’t feel like yourself, and you may not act like yourself either. It will pass, but it will take time. Talk to your doctor about your symptoms; he or she may be able to help you get some relief.

Your sex drive may go down.

Fluctuating hormone levels, mood swings, and vaginal dryness may make you less desirous of sex. Make the effort to stay connected with your spouse or significant other, even if you don’t want to have intercourse, and consider other ways to please each other.

You may have severe mood swings and outbursts.

Many of our patients have been surprised at the speed and severity of their mood swings. Understandably, their families feel confused about the sudden changes in mood. Talk to your doctor if your mood swings are severe, and consider other ways of relieving stress, such as yoga or exercise. Don’t be afraid to let your family know when you need time alone to work through your moods.

You won’t want to hear any advice.

It’s human nature to try to come up with solutions for problems, and your family may feel your menopausal symptoms are an issue they can solve. If their well-intended advice grates on your nerves, lovingly tell them that you appreciate their concern, but that you need them to listen and just be there for you.

For more information on possible symptoms of menopause, click here.

If you have been through this, what advice do you have for other women?

Filed Under: Health and Wellness Tagged With: , , , , , , ,

How to Spark Creativity and Find More Joy in Each Day

December 26, 2011 by

creativityWhen you feel creative, you feel more happiness in your life because you’re living more consciously and seeking beauty. Following are several ways to spark your innate creativity and live a more joy filled life.

Explore the world of art.

Sculpting, painting, drawing—all are creative pursuits, and all unlock your creative mind. The satisfaction of creating something new is fulfilling, and you’ll find joy every time you pick up a brush or pen. Experiment with colors, details, textures, and dimensions. You should feel free as air while you’re creating.

Even if no one else ever sees your work, you’ll know it’s there and that you did it.

Learn a musical instrument.

Much like creating art, creating music elevates your mood and happiness. Learn the instrument you really wanted to take up when you were in fifth grade and didn’t. As you go down the path of learning to play it, you become one with it and raise your joy factor significantly. You’ll feel happy and joyful every time you pick up the instrument and begin to play.

And no one ever said you had to play only songs that have already been written.

Work with your hands.

Whether you like woodworking, knitting, embroidery, or origami, create something. Anything. Use your hands to form what’s in your mind. The simple act of creating raises your level of joy, no matter what you create or how you do it.

Journal.

Putting your thoughts, hopes, dreams, and desires on paper creates a record of you—what better way to spend your time? When you journal, don’t hold back. Often, you can break through barriers in your life by simply writing them down. Once they are on paper, they have no hold over you anymore. The power of journaling is, in a word, amazing.

Write that book you’ve always contemplated.

Whether you want to share 101 ways to decorate your home or a new biography of Eleanor Roosevelt, it’s time to write that book you’ve thought about for years. It doesn’t matter if you prefer fiction or nonfiction—it’s the creation of the book, the words flowing on the paper or computer screen, that matter. If you choose, you can even publish your journal.

One major barrier for up-and-coming authors is now gone: you can self-publish now, both paperback and electronically, so you don’t need a publishing house or an editor. Your options are wide open; take advantage of them to create the newest book the world needs.

Do what your heart wants you to do. Start today.

We’d love to hear from you, so please feel free to contact us or leave a comment for us on Facebook!

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Breast Implant Alternatives to Adding Volume, Shape, and Projection to a Breast

December 23, 2011 by

charleston breast surgeonsThe below question is answered by Charleston breast surgeon, Dr. Richard M. Kline, Jr. of The Center for Natural Breast Reconstruction:

In July 2010 I had I-GAP reconstruction. The results are awful. Do you have techniques that can work with a flap and add volume, shape, and projection to a partially recreated breast without the use of implants?

Sorry to hear about your problem, but it’s not terribly unusual to not have quite enough tissue after flap reconstruction. That’s actually good for you, because it means we have some experience dealing with this. The most desirable techniques to try, and in what order, depend on your body type and preferences, but here are some options:

1) Fat grafts: Your fat from anywhere you don’t want it can be harvested with liposuction and injected into the breast mounds in the desired areas. Survival of the fat is not strictly predictable, but often a significant amount remains permanently. Several sessions may be required, however.

2) Vth intercostal artery perforator flap: This is a fancy name we give when we utilize the extra roll of skin and fat that a lot of patients have (& hate) on the side of their chest behind the breast, under the armpit. It is left attached at the front, the skin is removed, and the flap is tunneled under the skin at the side of the breast, then across the top of the breast as far as it will reach. Besides making the breast bigger, this technique has the particular advantages of covering the upper border of the pectoralis muscle (often visible just under the skin after reconstruction), and lifting the breast in what is often a very aesthetically pleasing way. The disadvantage is that it adds a scar under the arm from where the flap was taken.

3) Additional perforator flaps: No one likes to hear this, but sometimes it is the best answer. We have always been able to find suitable blood vessels and add flaps successfully whenever we have had to try this, and the results have been favorable. Definitely not the first choice for most people, but good to know it’s a tried-and-true technique if you absolutely need it.

4) Finally, a small implant under a too small but otherwise healthy flap is often surprisingly well-tolerated, even in radiated patients. Not for everyone, but an option that has been used quite successfully in some instances, nonetheless.

We went through our “iGAP phase” some years ago, and abandoned it not because of the reconstructive results, but because we decided the sGAP donor site resulted in far more favorable buttock aesthetics.

–Dr. Richard M. Kline, Jr.

Share this post with your followers on Twitter. And if you have a question for our breast surgeons, please feel free to send us an email!

Filed Under: Ask the Doctor Tagged With: , , , , , , , , , , ,

Top 3 Holiday Related Activities to Enjoy in Charleston

December 21, 2011 by
festival of lightsImage to the left taken from the Charleston County Park & Recreation Commission website.

 

Charleston comes alive during the holidays, and enchanting activities for all ages abound. Here are just a few of the festive holiday celebrations to enjoy right now.

Holiday Festival of Lights
James Island County Park, November 10, 2011–January 1, 2012

With over 2 million lights, the Holiday Festival of Lights is a must-see event. Set up as a 3-mile driving tour or a fun-filled train ride, the Festival of Lights also offers several activities besides twinkling lights, such as marshmallow roasts, gift shops, carousel rides, life-size greeting cards, and a tree lighting.

The driving tour is $12 per car, and the train ride is $3 per person. Children under 2 are admitted free.

Charleston Christmas Sleigh Ride 2011
Charleston Harbor, December 1–31, 2011

Every night in December excluding Christmas, Thriller Charleston hosts sleigh rides by boat to look at the Christmas lights and decorations. You’ll depart from Shem Creek in Mt. Pleasant and see the sights in Charleston, James Island, and Mt. Pleasant. As you drink hot cocoa, you’ll hear charming stories of Charleston’s Christmas customs. You keep your travel mug and rain poncho.

Sleigh rides are $45 for adults and $35 for children ages 5–12. Children under 5 are admitted free, but do not receive the hot chocolate or rain poncho.

What’s your favorite Charleston holiday tradition?

Filed Under: All Things Charleston, Upcoming Events Tagged With: , , , , , , , , , ,

The Importance of Taking Time to Reflect on Your Year

December 19, 2011 by

new yearEvery year, we take time not only to reflect on how thankful we are for our families, freedoms, and lives, but we also reflect on what we’ve accomplished during the year. We celebrate our successes and learn from our mistakes, and we decide what we’d like to achieve in the New Year. Here are a few ways to commemorate 2011 and plan 2012.

Make a list of your accomplishments.

What have you done in 2011? What were your successes and your leaps forward? No matter how small your wins may seem, they are still wins and should be celebrated. List them all so you can see what a tremendous year you’ve had. You may want to list them in categories, such as financial, health, family, etc. Rejoice in how long your list is.

Create a second list of your attempted successes that didn’t quite reach the mark. Those are worth celebrating too, even if the outcome wasn’t quite what you had anticipated or wanted. Simply attempting them is a win, and you can always try again.

Pat yourself on the back.

Look over your lists, and ensure you’ve included everything you’ve accomplished and attempted. You probably didn’t realize you made so many strides in 2011. Spend a little while remembering each accomplishment and how it made you feel. Re-create that feeling. Celebrate you and your success!

Use the lists to set your goals for 2012.

With the future in mind, decide what you want to try for next year. For each accomplishment, there is probably a natural next step. For example, if you lost 15 pounds, perhaps you would like to lose 10 more—or maybe you’d like to make sure you keep those pounds off by starting an exercise program.

If you attempted a goal and didn’t reach it this year, do you want to try again? Chances are that you learned something from trying it this year, and your odds of succeeding are even higher now. Give it another shot!

Finally, treat yourself to something special.

You deserve it for all your hard work, and this is the perfect time to treat yourself. Whether you book a spa day, take a trip during the holidays, or buy something you’ve had your eye on, celebrate yourself!

Tell us what you’ve accomplished this year so we can rejoice with you!

Filed Under: Health and Wellness Tagged With: , , , , , , , , ,

Join the Fight to Stop Breast Cancer with These Four Gift Ideas

December 16, 2011 by
Grill Charms pink collection

Grill Charms Pink Collection

Breast-cancer research organizations, doctors, and patients are continually amazed at how many people donate to fight this terrible disease. It’s always special when you can donate to a worthy cause when you purchase gifts, and here are four great gift ideas that help stop breast cancer.

Grill Charms:

A perfect gift for your favorite grill master, Grill Charms are dime-sized stainless steel discs with serrated stems that are inserted in food before grilling. The charm stays in place during the cooking process to distinguish each person’s food. Grill Charms are perfect for those who like their food cooked a certain way, or for those who may be allergic to certain foods or spices.

The inventor of Grill Charms, Leslie Haywood, was diagnosed with breast cancer not long after she began the company. She created The Pink Collection and donates 10% of each sale to the Susan G. Komen Foundation.

Yes Ma’am Tees:

“Yes Ma’am, mammograms are a must!” says the pink Yes Ma’am Tee, created by Lee McCracken of Charlotte, NC. Lee was diagnosed with breast cancer and came to us in 2009 for reconstruction. The tees are $20 and can be ordered from the website, and Lee donates 15% of the sale of each tee to help pay for screenings for uninsured and underinsured women through the Carolinas Breast Cancer Fund.

If you would like to partner with Lee to raise funds for uninsured and underinsured women in your city, contact her at sales@yesmaamtee.com.

 

Yes Ma'am Tees

CHI Pink Breast Cancer Awareness Flat Iron Gift Set:

When you purchase the CHI Pink Breast Cancer Awareness Flat Iron Gift Set, you’ll support breast cancer research. The gift set includes the CHI Pink Breast Cancer Awareness 1” Ceramic Flat Iron, a pink comb, pink sectioning clips, Pink CHI 44 Iron Guard, and Pink CHI Helmet Head.

With the CHI Pink Breast Cancer Awareness 1” Ceramic Flat Iron, you’ll add shine and cut hair straightening time in half—without frizz. The ergonomically designed flat iron heat up in 10 seconds or less and has curved-edge plates to straighten or curl. Pink CHI 44 Iron Guard keeps your hair soft while it protects your hair from damage from heat styling and helps your style last longer. Pink CHI Helmet Head provides hold that lasts and adds shine.

NFL Paraphernalia:

You may have noticed NFL players wearing pink lately to bring awareness to breast cancer. The NFL shop has launched their own program, A Crucial Check, a collaboration with the American Cancer Society to bring awareness to the importance of annual breast cancer screenings for women 40 and over.

The pink apparel worn by coaches and players, along with special game balls and pink game coins, will be auctioned at NFL Auction, with the proceeds going to team charities and the American Cancer Society. You can also support the fight against breast cancer by purchasing special merchandise at www.nflshop.com.

If you know of anyone else who is making a difference to breast cancer research, please share their information with us!

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Feel Confident in the Decisions that You Make with the TalkAboutHealth.com Online Community

December 14, 2011 by

talkabouthealthWhenever an individual is diagnosed with cancer or any other type of disease, they often struggle to find the right information, which, in turn, can make them feel alone and frightened. In an effort to provide personalized answers and a greater understanding for health issues, Murray Jones, founder of TalkAboutHealth, decided to create an online community for people seeking support and medical information and advice.

See below for our exclusive interview with Murray, where he discusses what TalkAboutHealth is and how it benefits individuals seeking support and personalized health advice:

1. What inspired you to start TalkAboutHealth.com?

I was inspired to start TalkAboutHealth based on needs that I saw from being a caregiver to my father, who is a two time melanoma survivor. We had so many questions and it felt impossible to find the right information and then understand it in a limited amount of time. We felt alone and lacked confidence in the decisions we had to make. We needed personalized answers to understand our health situation. We needed perspectives from others like us who had been through similar circumstances. We needed guidance to help find relevant information.

As time passed and I met more people in cancer communities, both medical professionals and survivors, I realized that there was so much knowledge that everyone wanted to share that just needed a place to live and someone to organize it. I thought to myself, I can do that. I can build a website where people can share their experiences.

2. How does TalkAboutHealth.com benefit patients? In other words, what does it offer to patients, survivors, and experts?

Our goal is to help patients get the right information at the right time, so they can understand their health needs and make the right decisions for them. We want to help people feel confident in the decisions they are making, know that they are not alone, and have hope after hearing the stories of others.

To accomplish this, we provide personalized answers from leading medical professionals and experienced survivors. When a patient asks a question, we find and notify the right experts, survivors, and organizations to answer. Each question has answers from several perspectives and provides context and narrative to help the patient.

We then curate and provide structure for all of this information so that it is easy to find. In the future, we will test many different formats to educate—from custom web and email tutorials to working with medical experts on video courses.

3. Why did you decide to make TalkAboutHealth.com a community-based structure, as opposed to a website that featured medical information without the opportunity to ask questions and provide feedback?

For two main reasons:

1. Because the combined knowledge and experiences of the community can have an amazing impact in helping others.

2. Community makes it possible to provided personalized and individualized support.

The purpose of TalkAboutHealth is to be a community where all of us share knowledge, stories, and experiences to support each other.

4. Is there anything else you’d like to add?

I encourage everyone, including medical professionals, to tell their story and share their experiences in whatever format is comfortable for them. It is so important for us to share and support each other. None of us are alone, we need each other. If you share your story, you will help others and find the support you need.

Have any questions about TalkAboutHealth or want to learn more? Visit TalkAboutHealth.com or contact Murray directly at murray@talkabouthealth.com.

Filed Under: Ask the Doctor, Health and Wellness Tagged With: , , , , , , , , , , ,

How to Enjoy Christmas Parties without Compromising Your Waistline

December 12, 2011 by

Christmas CookiesChristmas is one of the most challenging times of year when it comes to watching your weight. Temptations are everywhere, and difficult to resist. Here are a few ways to watch your waistline while still enjoying holiday festivities.

Decide which parties to attend.

If you’re invited to three parties in one night, it might be tempting to attend all of them, but if you do, you’ll have three times the food and drink. Perhaps going to one or two is a better idea.

If you can, find out what will be served.

Some parties serve a full meal, while others have only snacks and drinks. If you know ahead of time how much food and drink will be available, you can create a plan and stick with it.

Don’t go to the party hungry.

If you’ll have a meal, eat a light snack before you go so you won’t overindulge in appetizers. It seems like meals are always delayed at parties! If you’ll enjoy snacks only, eat a small meal before you leave. You’ll be less likely to eat too many Christmas cookies.

Decide how many drinks you can have.

If you’re driving, ideally you shouldn’t drink at all—but if you decide to indulge, have no more than one glass or wine, one beer, or one single-shot mixed drink per hour. And yes, watch the clock. Your liver can process approximately one drink’s worth of alcohol every 60 minutes. Wait an hour after your last drink before driving.

Better yet, have a designated driver, or plan to call a cab.

Follow the 30-minute rule.

Take half of the amount you really want to eat, enjoy it, and then wait 30 minutes before you eat anything more. It takes that long for your stomach to signal to your brain that it’s full. In that 30 minutes, you’re likely to get involved doing something else and won’t miss eating more.

Eat two or three bites of anything you wish.

If you can’t resist Aunt Millie’s Mississippi mud pie, have a small slice and eat just a couple of bites. You’ll get the taste you want without too many extra calories. The same applies to high-calorie drinks—order that raspberry margarita, enjoy three sips, and then give it to someone else.

If you overindulge, make up for it the next day.

Don’t skip meals, but if you overindulge one day, eat less the next couple of days, and be sure to drink plenty of water.

What’s your favorite waistline-watching tip?

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Are Overweight Women Better Candidates for DIEP Flap Reconstruction?

December 9, 2011 by

The below question is answered by Richard M. Kline Jr., M.D. of The Center for Natural Breast Reconstruction

I’ve read that women who are overweight are better candidates for DIEP flaps since they have “extra” to use, what is your opinion?

Many women with high BMIs (exceeding 40) have enjoyed successful flap reconstructions; however, they are at significantly higher risk of developing post operative complications.

It is well-demonstrated in the plastic surgery literature, that people with a significantly higher BMI are far more likely to experience complications than those with a lower BMI. There is no magical “line-in-the-sand” cut-off point, though—many factors, such as proportion of fat, which is intra-abdominal (vs. subcutaneous, which is what can be used in a flap), undoubtedly play a role in determining each person’s risk. Besides wound-healing problems, increased BMI also increases the risk for blood clots, which can, of course, be lethal.

Some lay-posters on blogs have stated that you shouldn’t worry about blood clots because injectable blood thinners will prevent them. This is a VERY DANGEROUS misconception—blood thinners only REDUCE the incidence of blood clots, and nothing can completely prevent them in all patients. We feel that it is your surgeon’s duty to you to assess your individual risks, and propose a plan that will get you through the surgery as safely as possible. Other surgeons, and other patients, may feel differently.

Our practice has demonstrated that it IS possible to have an outstanding safety record, while simultaneously maintaining a high reconstruction success rate. My personal flap survival rate over the last 10 years exceeds 99%, and the overwhelming majority of our patients are pleased that they went through the procedure at our facility. Our primary goal, however, is not to try and push limits by seeing what we can “get away with” in higher-risk patients. Instead, we strive to give everyone the best possible Natural Breast Reconstruction with perforator flaps, while at the same time doing everything possible to ensure their safety.

—Richard M. Kline Jr., M.D.

The Center for Natural Breast Reconstruction

Filed Under: Ask the Doctor Tagged With: , , , , , ,
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