Archives for 2012

Implant Procedure Without Expanders?

breast implantsThe below question is answered by the Charleston breast surgeons at The Center for Natural Breast Reconstruction.

Is it possible to have a simple implant procedure without expanders if you have a lot of skin tissue left?

Yes, absolutely, if you are willing to have Alloderm (acellular dermis) used to help support the implant.  We specialize microsurgical reconstruction using your own tissue so we don’t actually do this procedure in our practice but there are plastic surgeons in every metropolitan area who do.  If you are in or near the Charleston area we can give you names of surgeons who are especially good at this procedure.    We know many out of our area too if you’d like to identify where you are located we can see if we know anyone to suggest you consult.

–The Center for Natural Breast Reconstruction Team

Would you like your breast reconstruction question answered? Just ask us!

 

Music of the Season

 

music of the seasonNow that it’s finally December, the sounds of the festive season have finally begun! Everywhere you go, the holiday spirits infuses the air…a carol here, the Linus and Lucy theme song there!

Immerse yourself in the music that makes the holiday so enchanting. Here are a few of Charleston’s most exciting concerts, symphonies, and ballets for you and your family to enjoy:

  • Nutcracker Ballet: From December 12 to December 13, the Charleston Ballet will be performing the classic ballet, The Nutcracker. Come to the Theatre Gaillard Auditorium on 77 Calhoun Street, and experience the magic of this holiday tradition! For more information, call 843.723.7334, or go to www.CharlestonBallet.com.
  • Charleston Christmas Special: Broadway performers, Brad and Jennifer Moranz, take the stage at the Charleston Music Hall, with 20 talented performers, in this Christmas time tradition in the Lowcountry. Join them at 37 John Street on December 8 through December 22 for a holiday performance you won’t forget! Ticket prices range from $34 for adults, $31 for seniors and military, $19 for students with ID, and $16 for kids 12 & under. For more information, visit www.bradandjennifermoranz.com .
  • Charleston Harbor Sleigh Ride Aboard “The Thriller”: Take a one-hour tour aboard the Thriller Charleston, a speedboat with seating for 43 people. Dress warm, sip on hot chocolate, listen to Christmas carols, and cozy up with warm waterproof blankets for this unique Charleston, SC Christmas event. These Shem Creek  cruises will take place through the month of December in Charleston. Advanced reservations are available, and recommended! Call 843.276.4203 or visit www.thrillercharleston.com for more information.
  • Holiday Choral Performances at Charleston Country School of Arts: Join in the holiday spirit as The Charleston Country School of Performing Arts hosts a series of concerts sure to please the entire family. Performance are held December 6 and December 14-15 at 6:30 pm.  Tickets are $5.00 for adults and $3.00 for students. All shows are held at the Rose Maree Myers Theater for Performing Arts on campus. For tickets and more information visit their website at  www.soavocal.com
  • Charleston Symphony Orchestra: Join the Charleston Symphony Orchestra on December 14, 2012, at 7:30 p.m. for all of your holiday favorites with the CSO Chorus and conductor James Stephenson, whose arrangements have been performed by the Boston Pops, Cincinnati Pops, New York Pops, and more. It all takes place on the College of Charleston main campus in Sottile Theatre. Tickets may be purchased online at www.charlestonsymphony.org.

Which of these musical festivities will you attend this holiday season?

How to Reduce Stress During the Holiday Season

According to the American Institute of Stress, more than 110 million Americans already take medication for stress-related causes each week, and the holidays only tend to perpetuate anxiety. Even if you’re one of the lucky people who don’t ordinarily feel stressed under the pressure of deadlines or events, the holidays have a way of sneaking stress into the most carefree lives.

There are your children’s wish lists to tackle, the holiday expenses to wrangle, the gifts to wrap, parties to plan, cookies to bake and cards to write—all in addition to your normal responsibilities.

Don’t let stress ruin your holidays. Here are some quick tips for how to keep calm during the bustling festivities:

1. Take some “you” time. If there were ever a time to get a massage, this is it. Book one for December to diffuse the chaos of last-minute frenzies. If you’d rather stay in, pamper yourself with a little dark chocolate and red wine—and for solidarity, invite your best friend over to enjoy a much-needed break.

2. Focus on fitness. Not only is exercise  good for the body, but it also releases endorphins that make you feel happier and more content. Frustrated that you couldn’t find that impossible gift for your niece? Take it on the treadmill! You’ll burn calories, improve your state of mind, and give yourself some time to gain perspective. Remember, a fast-paced walk through the mall also counts as an aerobic activity!

3. Volunteer. Consider volunteering at a local charity. In addition to benefitting from what experts identify as “helpers’ high,” you may also meet new friends and make lasting connections that will enrich your life throughout the entire year.

4. Rethink gift giving. Streamline the hectic process of gift giving by buying fewer gifts, doing all your shopping online, or making modest online donations to the favorite causes of friends and family. No matter what the catalogues tell you, the best gift you can give is your time—so spend it with your family and friends and relish every minute of it.

5. Don’t take on more than you can handle. Remember, you can always say “no.” Consider this an absolute necessity for protecting your health and sanity during the holidays. As a bonus, it works well the rest of the year, too! Stay positive, anticipate happiness, and you’ll make it through the holidays with the right attitude in place for the coming year.

What are some ways you combat your holiday stress?

Wound Healing Post Breast Reconstruction Surgery

The below question is answered by the Charleston breast surgeon, Dr. James Craigie.

How do you determine when to use a wound vac in place of a traditional drain?

We have discussed the idea of using a wound vac in place of drains.  We have actually determined the use for combining the wound vac and drains under certain circumstances.  Some people have had radiation or have challenging wounds that result from wound healing problems combined with fluid collections caused seromas.  Sometimes drains are needed to evacuate seromas but unfortunately they are not always adequate.  Also, radiated tissues have difficulty healing and wounds developed in radiated tissue sometimes typical wound dressings may not be adequate as well.  We have used the wound vac combined with the drain in order to treat these complex wounds.  We have found that complex wounds are usually a combination of wound separation with fluid collections.  The drain actually passes through the wound vac sponge, the wound vac sponge is then covered with the steel dressing that is connected to a pump and the strong negative pressure generated is greater than the pressure of a normal drain.  This allows a deep pocket of fluid to be dressed with the drain tip and the open skin edge or wound edge to be treated with the sponge.  When the wound vac dressing is changed every 3-5 days, the drain can be backed out slowly and therefore as the wound edge heals, the fluid collection is controlled and the wound eventually heals quicker than other approaches.

-James Craigie, M.D.

Get answers to your questions about breast reconstruction and breast health straight from our surgical team! Submit your questions here today.

 

Packing Guide: What to Pack in Your Hospital Bag for Breast Reconstruction Surgery

At The Center for Natural Breast Reconstruction, we know the key to a comfortable recovery begins with what you pack for your hospital stay. When preparing for your breast reconstruction surgery, pack the right things can give you some control over the upcoming experience, and can help you prepare mentally, physically, and emotionally. Consider what things may give you comfort and peace of mind, and take those items, along with an optimistic outlook.

Here’s our checklist for things you’ll need to bring along for breast reconstruction surgery, as well as some suggestions for items that will offer you comfort during your visit:

Prepare for Hospital Check-In. Get ready for your hospital stay, and make sure you bring everything you need for check-in paperwork. This includes:

  • Your identification
  • Your insurance card
  • Your checkbook
  • Admission papers (if applicable)

 Pack Relaxed, Easy Clothing. While packing for your return trip from the hospital, keep in mind that you may have surgical drains, dressings, and tender incisions. Make comfort your top priority when you choose your clothing to wear after your surgery, and bring along:

  • Loose tops that close in front. You may not feel like lifting your arms or pulling on anything over your head.
  • Elastic-waisted pants. Not only are these are easy to get into and out of, but also easy for someone to help you slip on.
  • Slip-on shoes with a good tread. If you don’t want to bend down and tie up shoelaces, have some slip-on shoes at the ready.
  • Post-surgical bra. Ask your surgeon which will be best for you—a supportive bra, or a sports bra. Look for a front-closure bra—it may have to fit over your dressings, and having the closure in front gives you more control over getting dressed.
  • Robe, slippers and warm, clean cotton socks. There’s nothing more comfortable than a soft bathrobe—and it’s easy to slip on and off without lifting your arms. And it’s always a good idea to keep your feet warm and covered!

Bring the Comforts of Home. Since you will be staying overnight in the hospital, bag up some soothing items that help you pass the time and give you a sense of reassurance, such as:

  • Your regular medications.
  • Your toothbrush, toothpaste, and deodorant.
  • A makeup kit and some skin lotion to help lift your spirits.
  • iPod with earphones so you can listen to your favorite calming music.
  • Novels or magazines to occupy your mind while you recover.
  • A journal, needlework or other items to keep you comfortable and busy as you rest in the hospital.
  • A small comfort pillow for keeping a seatbelt from pressing on your chest during the ride home.

Do you have other questions about how to prepare for breast reconstruction surgery ? Let us know in the comments section below!

8 Ways to Catch a Better Night’s Sleep

According to the National Institutes of Health, more than 40 million Americans suffer from chronic, long-term sleep disorders, and an additional 20 million report sleeping problems occasionally. Between work, family, and a wealth of other demands, many people struggle to shut out their stressful day  when it’s time to turn in. Fortunately, some factors that interfere with your sleep can be controlled.

If you’ve been daydreaming about a good night’s rest, then take a look at our checklist of things to do (or avoid!) before you hit the hay:

  1. Cut out caffeine. 6 hours before you turn in, it’s a good idea to switch to decaf. Though caffeine is well know for keeping us awake during the day, it is also linked to interrupted sleep during the night.
  2. Skip the booze. Or, at the very least, don’t drink alcohol 4 hours before bed. As the alcohol wanes from the body at night, it could pull you out of a much-needed slumber.
  3. No more exercise. Exercise stimulates us and can make it harder to fall asleep. When your blood is pumping, your heart rate is up, which puts your body in an active mode rather than a restful state. Try to do your workouts earlier in the afternoon and save the evening for more gentle practices, such as yoga or meditation.
  4. Reduce your fluids. An hour before bed, have a glass of warm milk (the tryptophan promotes relaxation), then cut off fluids. Otherwise, your bladder is likely to wake you up from an otherwise sound sleep.
  5. Turn off your computer. Painful as it may be, put your cell phone aside, too. The light from the screens reduces melatonin production—that magical sandman hormone that whisks us to dreamland. Besides, at this point, looking a work emails will only keep you wired (and stressed).
  6. Take a warm bath. After your skin warms, your core body temperature will drop, which triggers sleep.
  7. Relax. Thirty minutes before bed, read a book, listen to music, meditate, or simply get in bed and breathe deeply. These calming activities will unwind your body (and your mind) and help usher in sleepiness.
  8. Hit the lights. Once you adjust thermostat to 68 to 74 degrees—ideal sleeping temperature—turn off the lights. Darkness triggers the release of melatonin, the hormone that induces sleep. If it’s impossible to make your room completely dark, invest in an eye cover.

What helps you fall asleep?                                 

Breast Reconstruction Options To Correct Uneven Breasts

The below question is answered by the Charleston breast surgeon, Dr. James Craigie.

I had TRAM flap reconstruction in 2006 with revision and a follow up surgery in six months later. Since then some shrinkage has occurred in the reconstructive side and I have a hollow area on the upper portion. Do I have options for more normal looking breast without the hollow area?

You potentially have many options to improve your reconstruction. No one solution is perfect for all situations, but some options include repositioning the flap to a higher location, augmenting the hollow area with your own fat grafts (taken usually from abdomen, thigh, or buttocks), or using any excess skin / fat from under your armpit as an additional flap to lift and augment the TRAM (we call this a 5th intercostal artery perforator flap). Some more aggressive options would include placing a small breast implant under the TRAM flap, or adding a whole new microvascular flap from another area, although this is rarely in practice necessary.

Hope this helps. Please feel free to email or call with any additional questions.

Dr. James Craigie

The Center for Natural Breast Reconstruction

Would you like your breast reconstruction question answered? Just ask us!

6 Tips for a Thinner Thanksgiving

Thanksgiving is one of the most challenging times of year when it comes to watching your weight. Temptations are everywhere—from that buttery bird, to the table glowing with homemade pecan pies and pumpkin cheesecake.

Check out these simple tips, and you’ll be ready to spare your waistline while still enjoying your family’s holiday feast.

Prepare a dish or two you can eat guilt-free.

Sure, vegetables are never the stars of Thanksgiving meals. However, if you make a lovely salad, butternut soup, mashed sweet potatoes, or creamed spinach, you can make sure you have healthy dishes to snack on throughout the evening. Besides, every table needs some color to spruce up the spread!

Don’t fast before the feast.

While waiting for the turkey to cook, it’s tradition to save our appetites for the main event. Yet, fasting throughout the day is an easy way to overeat once you sit down for the feast. Have a light snack before the finale so you won’t overindulge at dinnertime.

Decide how many drinks you can have.

If you decide to indulge in the festive beverages, be sure to decide how many you’ll have over the course of the evening and stick to it. Remember, every glass of wine, every bottle of beer, and each shot rack up the extra calories, so plan accordingly.

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—take 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 make selections that are low in fat and full of nutrients. Also, make sure you drink plenty of water!

 We Hope Everyone Has A Happy Thanksgiving Holiday!

5 Delicious Ways to Get More Pumpkin in Your Life

That’s right, pumpkin. It’s not just a Halloween symbol or the star ingredient of your Thanksgiving pie. In fact, this magical gourd is any health nut’s dream. This often-underappreciated veggie is exceptionally low in calories and loaded with potassium, beta-carotene, and Vitamin A. Studies show that pumpkin prevents cancer and heart disease and protects eye health—which means your diet deserves a little more pumpkin.

Here are our five favorite ways to enjoy pumpkin and rack up the health benefits:

  • Roast whole pumpkins and use it in a variety of vegetable dishes. The roasted flesh makes a perfect base for a creamy, low-fat  fall-infused soup.
  • If you’re looking for a sweeter way to relish your freshly roasted pumpkins, you can blend the pumpkin flesh and add it in your smoothies. Another option is to puree the flesh with apple juice, brown sugar, maple syrup, cinnamon, and nutmeg, then boil the mixture to make fresh homemade pumpkin butter.
  • One of our favorite tricks for using canned pumpkin is to buy a box of cake mix, and instead of adding any milk or eggs, simply add one whole can of pureed pumpkin, stir with the mix, and bake! Not only is this a breezy way to make a sweet treat on the fly, but you also save good deal of calories and saturated fat by using pumpkin. Try it with a chocolate cake mix—the result is somewhere between a muffin and a cupcake. In a word, it’s heavenly.
  • Pumpkin pie may be more popular this time of year, but cheesecake made with a cup or two of canned pumpkin is the perfect combination of creamy, sweet and savory. Bake it all in a crust made of crushed ginger snaps and you’ll never want to eat your cheesecake any other way.
  • Perhaps best known for their role in prostate health, pumpkin seeds are nutritional powerhouses. Just scoop them out of the pumpkin, wash them thoroughly, season with sea salt, and bake in the oven at 375 for 10 to 15 minutes. These toasted seeds make a healthy snack  for only 187 calories per a one-quarter cup serving.

What are your favorite ways to enjoy pumpkin?

Could I Be A Candidate for DIEP Reconstruction After Implants?

The below question is answered by Charleston breast surgeon Dr. James Craigie of The Center for Natural Breast Reconstruction.

I had a bilateral mastectomy and had 850cc silicone implants placed after tissue expansion. I am not happy at all with the result as I had radiation on the right side and that breast is considerably smaller than the left. I am also not happy with the shape and look of the breasts with silicone implants. I currently wear prosthetics in my bra to achieve symmetry and a normal shape. Even with the bra and the prosthetics I am not happy with the result. I am currently a D/DD and would like to maintain that size. Given this situation, could I be a candidate for a DIEP or Stacked DIEP breast reconstruction?

Thank you for your question. I’m sorry you are having some concerns about the shape and evenness of your breast reconstruction. Because you had radiation on the right side it is almost certain that the two sides will be different to some degree regardless of the type of reconstruction. Unfortunately, when this occurs with implant techniques it is usually more noticeable and nearly impossible to fix long-term as long as the implants are in place. The reason for this is the implants will be treated as foreign material by your body and the right side will always react more severely due to previous radiation even if radiation was done before the mastectomy. Also, the process of scar formation continues as long as the implants are in place, making the firmness, shape change, and stiffness more noticeable to you as time goes by. These are the reasons that women who have implant reconstruction have multiple procedures to revise results as time passes.

Fortunately when someone has had problems of this nature with implants we can frequently solve them by removing the implants and replacing them with their own fatty tissue (DIEP, stacked DIEP). We can do this without taking tummy or back muscles. Immediately the fatty tissue takes on a more natural shape compared to implants. Thirty percent of my patients have had failed implants before we start over and use their own tissue. My opinion and answer to your question is that you could have a DIEP to replace your implants and I can usually predict that many of the implant problems are much improved immediately after the surgery. I cannot predict what size you would be without seeing you but the size depends on how much extra tummy tissue you have as well as any previous surgery.

I hope I have answered your questions.

—James Craigie MD

 Would you like your breast reconstruction question answered? Just ask us!