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Archives for August 2011

Breast’s Anatomy: What Makes Up a Breast?

August 31, 2011 by
Image to the left taken from emedicine.medscape.com.

Breasts are milk-producing (mammary) glands surrounded by fat and are attached to the front of the chest by ligaments. The breast rests on the pectoralis major chest muscle, but has no muscle tissue itself. The fat in the breasts determines their shape and size, which varies among women even though the size of the mammary gland system is relatively standard. In addition, women commonly have one breast that is larger than the other.

Breasts begin developing between the ages of 9 and 14 for most girls, and signal the start of puberty. Breast tissue is highly sensitive to the hormones estrogen, progesterone, and prolactin throughout the menstrual cycle. While breastfeeding, prolactin triggers milk production within the breast, and its anatomy is simple yet complex.

Lobules, Alveoli, and Ducts

Breasts have 15 to 20 sections known as lobes or lobules that converge at the nipple. Each lobule consists of hollow sacs called alveoli, and the lobules are connected through ducts. The final collection area for milk is known as the main duct.

During breastfeeding, prolactin stimulates the alveoli to pull nutrients from the woman’s blood to produce breast milk, and oxytocin causes the alveoli to release the milk through the mammary ducts to the nipple.

Nipple

Also known as the mammary papilla, the nipple is the outlet for the mammary ducts and where milk is secreted.

Areola

Often included when referring to the nipple, the areola is the round pigmented area surrounding the nipple. During breastfeeding, small bumps on the areola known as Montgomery glands produce an oily substance that cleans and lubricates the nipple.

Lymph Nodes and Ducts

The lymphatic system helps fight infection by capturing and excreting pathogens and toxins through lymph nodes and ducts. These nodes are found near the breast, in the armpit, and behind the breastbone. Often, axillary (armpit) lymph nodes are removed during mastectomy.

Cooper’s Ligament

This ligament is often called “nature’s bra” because it lifts the breast and prevents it from sagging.

For a slideshow on breast anatomy, visit http://www.mayoclinic.com/health/breast-cancer-early-stage/BC00001.

Have questions about breast cancer? Visit our blog’s Ask the Doctor section.

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

Kicking Off Breast Cancer Awareness Month in Columbia, SC

August 29, 2011 by

breast cancer awarenessIn or near the Columbia, SC area? If so, join The Center for Natural Breast Reconstruction team and other physicians and clinicians from all over South Carolina and the Green Hair Salon as we host our very own breast cancer awareness party.

During this fun-filled evening, you’ll have the opportunity to socialize with various physicians from across the state and ask questions about breast cancer, prevention, and breast reconstruction. Throughout the night, our team members, as well as other physicians, will speak about breast cancer and what you need to know to make smart, informed decisions about breast cancer.

Whether you know of someone who has faced breast cancer, or are currently fighting the battle with breast cancer, this event is for all women who are eager to educate themselves about their breast health options.

green hair salon

center for natural breast reconstruction

See below for more details on this event:

When: Monday, October 3, 2011, at 6 p.m.

Where: 2000 Park Street, Suite 104, Columbia, SC 29201

Food & Drink: Wine and cheese will be offered

Admission: FREE

RSVP appreciated, but not required: (866) 374-2627

We hope to see you there! And don’t forget, bring your questions.

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

Have a Question About Natural Breast Reconstruction?

August 26, 2011 by

Charleston breast surgeonThe questions below are answered by Charleston breast surgeons, Dr. Richard Kline and Dr. James Craigie of The Center for Natural Breast Reconstruction.

How long does a DIEP flap breast reconstruction last?

Reconstruction of one breast with a DIEP usually takes 4 – 6 hours, and reconstruction of both breasts usually takes 6 – 8 hours. The individual patient’s anatomy accounts for most of the variability. The surgery is usually followed by a 4-day stay in the hospital. Just in case you meant “last” as in will you have to have it redone like with implant reconstruction, the answer is: a successful DIEP breast reconstruction is designed to “last” a lifetime. You may desire aesthetic improvements over time as your reconstructed breasts will behave much like your natural breasts.

Will I have to have another surgery at a future date for maintenance?

Probably not for “maintenance,” but most patients require at least 2 surgeries total (sometimes more) to complete their reconstruction. The second stage of the reconstruction is typically performed 3 months or more after the first stage, taking 2 – 4 hours, and is usually an outpatient procedure. Common things done during the second stage include reshaping the breast mounds, improving the shape of the donor site (tummy or buttocks), and often making new nipples.

For an avid athlete, softball and running, what breast reconstruction do you recommend as the least limiting to continuing sports activities?

All methods have their potential downsides.

Reconstruction with an implant requires elevating the pectoralis major muscle to put the implant under it, as the skin alone is usually not strong enough to hold the implant. While this is usually well-tolerated, it could potentially affect the function of the muscle.

Flap reconstruction using the body’s own tissue usually involves taking extra fat from the abdomen (DIEP flap) or buttocks (GAP flap). No muscle is removed in either case, but it is still possible for muscle function to be affected. While there is room for debate in this area, my feeling is that some disruption of the buttock muscle is probably better tolerated than disruption of the abdominal muscle (rectus abdominus).

Want to learn more about your breast reconstruction options? Visit our Facebook page.

Filed Under: Ask the Doctor

Do You Know Your Breast Reconstruction Options?

August 24, 2011 by

breast reconstruction optionsWe’re thrilled to share some exciting news with you, today! Dr. Richard Kline, Charleston breast surgeon, and the lovely Leslie Haywood, owner of Grill Charms™ and breast cancer survivor, were recently interviewed on one of our local Charleston news channels. During this interview, Leslie shares her inspirational story of breast cancer survival and how she chose to have the breast surgeons of The Center for Natural Breast Reconstruction perform her natural breast reconstruction.

Dr. Richard Kline of The Center for Natural Breast Reconstruction spoke about breast reconstruction options for women who are currently undergoing treatment for breast cancer or who have had a mastectomy.

See below for the interview:

If you want to learn even more about Leslie Haywood’s story (and get a chuckle from her hilarious narrative), click here to view one of our recent blog interviews with her.

For those of you who aren’t aware of The Center for Natural Breast Reconstruction and what we do, here’s a brief description:

Charleston plastic surgeons Dr. James Craigie and Dr. Richard Kline specialize in breast reconstruction for women who have undergone mastectomy and those who are considering risk reducing prophylactic surgery. Some of the procedures performed by these Charleston breast surgeons include DIEP, SIEA, and GAP free flap breast reconstruction, which utilize your own tissue with no implants and no muscle sacrifice.

Our Charleston breast surgeons also perform nipple sparing mastectomy, reconstruction after lumpectomy, microsurgical breast reconstruction, and breast restoration. Visit The Center for Natural Breast Reconstruction website at http://www.naturalbreastreconstruction.com/.

Filed Under: Ask the Doctor, In Her Words Tagged With: , , , , , , ,

Weird Breast Issues That Aren’t Really Weird At All

August 22, 2011 by

breast changesFrom nipple leakage to uneven sizes, our breasts often confuse or scare us. Most of the time, what appears to be a breast problem isn’t a problem at all, but a completely normal occurrence. Breast information isn’t at the forefront of the news unless it’s connected to cancer, so we don’t receive much information about breast issues that aren’t serious.

The following breast issues are typically normal, even though they may seem odd. Let us stress that if you have questions about any breast issue, or feel that something isn’t right, do not hesitate to call your doctor. Always listen to your gut and intuition.

Uneven breast sizes

If you look closely at other parts of your body that come in pairs, such as your eyes, hands, and feet, you’ll see that each one of the pair is different from the other, and this includes your breasts. Some women may find that one breast is a size or two different from the other, and this is normal.

Lumpy breasts

Have you ever driven yourself crazy because you think you’ve found several lumps during a self-exam? This one can be scary, but for some women, lumps are a normal part of their breast tissue. Called fibrocystic breasts, this noncancerous condition is very common, especially among premenopausal women. Dense breast tissue tends to feel lumpy, which is one more reason to know what is normal for your breasts and do thorough monthly self-exams.

Nipple leakage when you’re not pregnant

Nipple leakage is common, and fluid can be almost any color or consistency. Some women experience spontaneous leakage, while for others, the leakage occurs only if the nipple is stimulated. Rarely, leakage signals something more serious, so check with your doctor if you’re concerned or it regularly occurs spontaneously.

Extra nipples

Some men and women are born with extra nipples, much as female animals have. According to Texas ob-gyn Michael Yang, MD, when a fetus forms, it has a milk line with several nipples that runs from the armpits down to the groin. Extra nipples typically disappear before birth, but some don’t, and their appearance ranges from molelike to actual miniature breasts.

Menstrual cycle-related breast changes

Thank your hormones for those breast changes during the month. Estrogen and progesterone increase and decrease during your cycle, which can cause breast tenderness and nipple soreness. If your breasts are unbearably sore, ask your doctor for advice on nutritional support.

Weight gain or loss from breasts

Speaking of breast changes, women often lament the fact that when they lose weight, it comes from their breasts first. Because breasts are mostly fat, it’s normal for them to change size when you lose weight.

Again, call your doctor with any breast-related concerns or questions.

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

Your Questions About Breast Reconstruction Answered

August 19, 2011 by

nipple sparing mastectomyThe questions below are answered by the breast reconstruction surgeons of The Center for Natural Breast Reconstruction, Dr. James Craigie and Dr. Richard Kline:

If a woman has flap reconstruction, are the nipples reconstructed at the same time or at a later date?

While it is sometimes possible to reconstruct the nipples at the same time, usually for various reasons it is preferable to delay the nipple reconstruction until a later time. Nipples must be positioned very carefully to look their best, and that means the final shape of the breast mound must be stable prior to choosing the nipple position. Tissue flaps must be carefully monitored for several days following the initial reconstruction to assure early detection of any problems, and temporarily leaving extra flap skin on the breast mound helps greatly with this. Additionally, FWIW, the skin that the nipples are reconstructed from, whether flap skin or native breast skin, frequently has no sensation, making it even easier to reconstruct the nipples as a small procedure in the office.

If a woman is a candidate for a nipple-sparing mastectomy, can she have flap reconstruction and retain her nipples?

Yes, in many cases. Problems arise when the breasts are very “ptotic” (droopy), especially if the flaps cannot be made as large as the breast tissue that was removed. The nipples can often be saved even in this situation with special techniques (examples include performing a delayed breast lift some months after flap reconstruction with the flap nourishing the nipple, or, in the case of a prophylactic mastectomy, having a breast lift or reduction some months before the mastectomy), but the overall reconstruction is more complicated and prolonged.

Can you explain what you mean by a muscle-sparing free flap breast reconstruction?

“Muscle-sparing” simply means that NO MUSCLE TISSUE at all is removed. This does not necessarily mean that the muscle suffers no injury, as the blood vessels which nourish the flap usually must be removed from the muscle, but the amount of damage is commonly small enough that the muscle ultimately recovers its function.

What are some criteria that may disqualify a patient for breast reconstruction?

Any serious medical conditions which would prevent a patient from tolerating 4-8 hours of general anesthesia would prevent her from having flap reconstruction. Some medical conditions, such as diabetes, increase various risks (in particular, risks of wound healing problems), but do not disqualify the patient from having reconstruction. We do not perform reconstruction on patients who are currently cigarette smokers (or use nicotine in any form) because nicotine’s effects on wound healing after flap surgery is frequently catastrophic. However, most patients will clear all nicotine form their system after a month’s abstinence. Some very slender patients do not have enough donor tissue anywhere on their bodies for flap reconstruction, but this is quite uncommon.

For more information on breast reconstruction, visit our website.

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

Dining Out in The Charleston Area: Mount Pleasant

August 17, 2011 by

charleston restaurantsCharleston is famous for its restaurants! From succulent Lowcountry fine dining to zesty Italian bistros, and quaint barbecue hot spots to vibrant Mexican eateries, Charleston truly is a culinary melting pot.

For many of you who are visiting from out of state, you may not be aware that Charleston is segmented into various different areas that include downtown Charleston, Folly Beach, James Island, Johns Island, Mount Pleasant, North Charleston, West Ashley, and Daniel Island (there are a few other neighboring cities, towns, and islands thrown in there, but these are the main ones). Each and every area in Charleston is home to exciting restaurants, cafes, bars, and pubs that naming them all in one blog post would be way too much. This is why we’ve decided to create a series on Charleston restaurants. Each post in the series will focus on a different area of Charleston and some of the best restaurants found in that area.

This first post will focus on Mount Pleasant, which is located right across the Ravenel Bridge from downtown Charleston.

Below are just 5 of our favorite restaurants and cafes in Mount Pleasant:

Crave: Serving up artisan sandwiches, pasta, steak, and seafood, Crave provides an eclectic mix of various foods that are sure to delight your palette. The atmosphere is casual and the food is moderately priced. One of our favorite dishes is the turkey club sandwich complimented by a mermaid martini!

1968 Riviera Dr # O, Mount Pleasant, SC 29466 / (843) 884-1177 / brunch, lunch, dinner

Mustard seed: For some great food, a casual atmosphere, and excellent service, take a trip to the Mustard Seed. This quaint restaurant features everything from creamy pasta dishes to fresh salads, chicken entrees to mussels and linguine, and much more. The bread that they put on your table at the beginning of dinner is also exceptional and is covered in seasoning and cheese.

1036 Chuck Dawley Boulevard,Mount Pleasant, SC 29464-4178 / (843) 849-0050 / lunch, dinner (not open Sundays)

Yamato: If you love Hibachi-style cooking as much as we do then you’ll definitely want to check out Yamato. With a fun and social atmosphere, great food, huge portions, and silly chefs, Yamato will instantly steal your heart. This restaurant is particularly great for larger groups.

1993 Riviera Drive, Mount Pleasant, SC 29466 / (843) 881-1190 / dinner

Red Drum: With somewhat of a Tex-Mex thing going on Red Drum will add a flair to your night. Serving up excellent culinary masterpieces such as lamb shank, fresh seafood, and enchilada appetizers this elegant restaurant is sure to knock your socks off. Note that Red Drum is considered fine dining and we suggest calling in advance to book a reservation.

803 Coleman Boulevard, Mount Pleasant, SC 29464 / (843) 849-0313 / sunday brunch, dinner (closed Mondays)

Mozzo: This deli is a must when visiting the Charleston area. With a huge selection of artisan sandwiches, pasta salads, cole slaws, and desserts, it can be easy to go overboard when dining at Mozzo. They’re a deli that definitely knows what they’re doing. Some of our favorite sandwiches include the Roma, The Godfather, Fusion, Dig the Fig, and Fat Boy.

730 Coleman Boulevard, Mount Pleasant, SC 29464 / (843) 388-5755 / breakfast, lunch

Some other Mount Pleasant restaurants that we love include Opal, Langdon’s, Jacob’s Kitchen, Basil, Next Door, Sette, and Uno Mas (great margaritas).

Have you ever been to Mount Pleasant? What’s your favorite restaurant in the area?

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

The Truth behind High-Fructose Corn Syrup

August 15, 2011 by

high fructose corn syrupHigh-fructose corn syrup (HFCS) is corn syrup that is processed to convert some of its glucose into fructose to make it sweeter. HFCS is the sweetener of choice for most food companies, and is found in everything from bread to baby food. It has replaced sugar (sucrose) in processed food and baked goods because it costs less than sugar.

HFCS has become controversial recently because of its widespread use in products that one wouldn’t expect to contain sugar. As studies have found an alarming number of ill effects that appear to be caused or worsened by HFCS, such as higher triglycerides, greater insulin resistance, increased abdominal fat, and elevated blood pressure, the food industry and corn growers maintain that HFCS is safe, even preferable to cane or beet sugar. HFCS has also been linked to weight gain in a Princeton animal study.

As noted, the effects of HFCS are controversial and still being studied, but one fact remains: the amount of sweeteners in our food today is very high—we’re simply eating too much sugar in general. Most HFCS consumption is in the form of soft drinks. According to the USDA Economic Research Service, in 2003 the average American consumed 63 pounds of HFCS, 75% in soft drinks. As the use of HFCS has exploded over the past decade, that number is likely to be much higher today, and does not include all the other sugars that we consume, most of which have no nutrient value.

Some food manufacturers are removing HFCS from their products, which is an encouraging step, but we’d like to suggest that you become vigilant about your sugar intake. A good place to start is to reduce soft drink intake; read labels; avoid sugar, especially HFCS, whenever possible; and eat whole, fresh foods whenever you can. The less your food has been processed, the healthier it is.

When you’re reading labels, anything with the word syrup or sweetener (or ending in –ose) is a sugar. Some other sugars and sugar derivatives to watch for are maltodextrin or dextrin, sorghum, brown rice syrup, agave nectar, treacle, xylose, fruit juice concentrate, and dehydrated cane juice.

Have you reduced your intake of HFCS?

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

What Are My Reconstruction Options After a Lumpectomy?

August 12, 2011 by

DIEP flapThe below question is answered by The Center For Natural Breast Reconstruction team:

What are the options for reconstruction surgery after a bilateral lumpectomy?

Great question! Your options would be very similar to those you would have if you had a mastectomy. Keep in mind that if your lumpectomy was followed by radiation, the behavior of the radiated skin and tissue can complicate a reconstruction procedure utilizing implants and your best option may be to use your own tissue to restore your breast size and shape. Nonetheless, it’s your plastic surgeon’s responsibility to tell you all of the options available to you and let you choose how to proceed. Also, discuss with your surgeon any procedure that may need to be done on your unaffected breast to achieve symmetry.

Here’s my short list of options:

1. Tissue expanders and subsequent replacement with permanent implants. Ask about silicone vs. saline implants. How about the use of a skin and tissue replacement like fat or a dermal matrix (like Alloderm)?

2. Autologeous reconstruction with latissimus flap (back). Will implants be needed, as well?

3. TRAM flap (transverse rectus abdominus muscle). Uses the muscle, skin, and fat of the abdomen to rebuild the breast. Make sure you have been told of the risks involved in removing this muscle.

4. DIEP, SIEA (deep inferior epigastric perforator or superficial inferior epigastric artery). Uses the skin and fat of the abdomen to rebuild the breast but leaves the muscle of the abdomen intact.

5. GAP (gluteal artery perforator). Uses the skin and fat from the upper (inferior) or lower (superior) buttocks. Like the DIEP, no muscle is removed for this procedure.

6. TUG (transverse upper gracilis). Inner thigh donor area, utilizes skin, fat, and muscle of the upper inner thigh.

7. Intercostal perforator. Utilizes skin and fat from under the arm.

8. Maybe you’re happy with the size of your post-lumpectomy breast but would like the shape addressed. Procedures such as mastopexy or reduction mammaplasty on the unaffected breast may be the procedures to investigate.

9. If it’s a small defect, a simple fat transfer from another part of your body may remedy the problem.

Best Wishes,

The Center for Natural Breast Reconstruction Team

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

How One Survivor Used Meditation and Support to Find a Brighter Future

August 10, 2011 by

breast cancer survivorWe’re superexcited to share Part II of our guest interview with Debbie Woodbury on our blog, today!

For those of you who missed Part I of this interview, click here.

See below for Part II of our guest interview, where Debbie shares more of her inspirational story, including a look into her Meditation Mondays:

1. Our team at The Center for Natural Breast Reconstruction loves how you started a Meditation Mondays blog series! Tell us what inspired you to begin meditating and what benefits it provides to you.

Thank you, I love that series too! I was inspired to begin meditation by simple necessity. My cancer diagnosis completely blindsided me. Up until that point, I thought of myself as a healthy person, who looked and felt fine. However, as testing and treatment chipped away at my body, I slowly sunk into sickness. My mastectomy cured my noninvasive cancer, but healing was a whole different matter.

Physically, I had lots of guidance and healed with rest and good care. Emotionally, I was on my own. Luckily, I discovered guided imagery just a few weeks before my mastectomy and used it to calm my anxiety about the impending surgery and loss of my breast. I continued searching for emotional healing and discovered meditation.

Meditation provides me with many, many benefits. As a cancer survivor, it is so easy to drive yourself crazy, worrying about doctors’ appointments, tests, and every ache and pain. Through meditation, I became aware of the voice in my head whose job is to worry. Meditation brings me back to the present moment, where the only thing that exists is what is happening right now.

The funny thing is that I actually had an easier time meditating during my disability, when there was lots of time to sit still. Now that the stresses of family, home, work, and survivorship fill my day, finding time to meditate takes a bigger commitment. It is well worth it, however, and can be done in just minutes a day. Meditation is one of the many gifts cancer brought me and I am so grateful for the “Peace and Joy, Love and Light” it brought into my life.

2. What one piece of advice would you give to women who are struggling with breast cancer and are finding it difficult to look toward a brighter future?

When I was actually going through the diagnostic and treatment phases, I kept going by sheer force of will. I just needed to get through it, especially for my husband and children. After my mastectomy, however, the emotional fallout was overwhelming. Luckily, my cancer center offered free oncology therapy, which I committed to on a weekly basis for approximately a year. I don’t know how I could have processed it all without the help of my wonderful therapists. Without their help dealing with cancer’s losses, I never could have eventually recognized cancer’s gifts.

My one piece of advice would be to get all the support you need, from family and friends, but also from professionals. No one can walk this road alone and no one person can be your only source of support. Ask for and find the help you need to create your brighter future beyond cancer.

Debbie WoodburyAbout Debbie Woodbury:

Debbie Woodbury is a cancer survivor, blogger, speaker, and advocate. She entered the diagnostic and treatment phases of breast cancer in 2008. When she completed treatment in 2009, she was left to deal with cancer’s emotional impact. With the support of family, friends, and wonderful oncology therapists, she was able to create her Gifts and Losses List and eventually realize that “Survival > Existence.” The Gifts and Losses List became the heart of WhereWeGoNow.com, a community of survivors sharing the gifts and losses of lives lived beyond cancer.

Connect with Debbie on Twitter and Facebook. And be sure to visit her blog, Where We Go Now; it’s one of our favorites!

Filed Under: In Her Words Tagged With: , , , , , ,
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