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Increase Breast Size Through DIEP Flap Natural Breast Reconstruction Surgery?

July 20, 2012 by

The below question was answered by Charleston breast surgeon, Dr. James E. Craigie  of The Center for Natural Breast Reconstruction:

Can I increase the previous size of my breast during a DIEP breast reconstruction?

Breast reconstruction requires detailed planning before surgery.  One of the most important considerations is the desire of the patient to either be the same as she was before mastectomy or to change some aspect of the breast.  When there is adequate donor tissue (in the case of a DIEP excess tummy tissue) we may have the opportunity to increase the patient’s bra cup size given adequate planning and adequate donor tissue.  The desire of the outcome is always to be proportional and if someone has more tissue on the tummy we can usually achieve this.  In ideal circumstances, we plan to make the reconstructed breast approximately 20% larger at the first stage than the end goal after the reconstruction process is complete.   During the first stage of surgery, the tissue from the tummy is transferred and the primary goal is to have adequate blood supply and healthy nourished tissue.  The shaping of the breast is secondary to the functioning of the blood vessels during this stage. At the second stage of surgery, in order to create a more natural shape, some tissue may need to be removed or any tissue that did not survive the initial transfer (fat necrosis) removed.

Therefore, when planning the first stage procedure, we try to end up with slightly more than desired.  That gives us the ability to shape the breast and we can always make it slightly smaller at the second procedure; which is a much easier adjustment than making it larger.  So, it is possible to increase the current breast size with the DIEP, but it would depend on the size of the breast prior to the mastectomy and  how much donor tissue is available for reconstruction.

Are you thinking of having reconstructive surgery and have questions or just want more information? Then click here to ask our team, we’d love to hear from you!

 

 

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Perseverance: The Valuable Lesson Breast Cancer Taught One Survivor

July 18, 2012 by

Today’s In Her Words post comes to us from a past patient of The Center for Natural Breast Reconstruction, Carlette Holmes. Carlette, is a breast cancer survivor who lives in Anderson, SC and traveled to Charleston to receive her reconstructive surgery. Today, Carlette and her childhood best friend partake in a culinary partnership entitled, Buffa’s Cheese Biscuits. The recipe for these delicious biscuits come from Buffa, a cook for Carlette’s grandmother while she was growing up.

See below for out interview with Carlette and to learn more about Buffa’s Cheese Biscuits. All images included are courtesy of Carlette Holmes.

1.  Buffa’s Cheese biscuits, even the name just melts in your mouth. Can you tell me a little bit about these delicious biscuits and where the recipe came from?

I think my grandmother found the recipe in a Jr. League cookbook and gave it to Buffa to try. They were a staple after that. They were always on hand in a covered dish as you came into the kitchen. Everyone who came in knew they were there & grabbed a handful. Buffa’s were always good but often different…. sometimes “short” as she would call them, sometimes crispy, sometimes light and puffy or sometimes dark and crumbly. I know now it could have been due to the humidity on any given day. One challenge I faced was to get them to turn out the same every time. Family and  friends didn’t seem to care, but I felt it was important when I started selling them.

2. It seems you spent a lot of time in the kitchen with Buffa, do you have a favorite memory with her?

My conversations with Buffa are favorite memories. She loved to talk while she cooked and could tell a great story. Often, I would shell peas or snap beans while she “held court”. I loved to “help” her make jams and preserves.

My least favorite memories are those of grease fires and exploding pressure cookers. I am scared for life, and to this day I don’t like to fry in my kitchen. The first time I tried to fry fish for Edmund is was slightly boiled and awful.

3. You have been making these biscuits for your family and friends for years. What was the turning point for you to finally give in and brand Buffa’s Cheese Biscuits to the public?

I think the turning point was surviving breast cancer. My best friend since 7th grade, and partner in BCB, Lide Vandiver, had been after me for years to brand them, but I had a family to take care of and businesses to help my husband, Edmund run. My 2 daughters, Sally Cade and Brelyn, were in college when I was diagnosed. I got through my treatment and I had been thinking of reconstruction options. I had heard horror stories of implants, expanders and that procedure, and I didn’t think that was an option for me. I researched DIEP flap surgery and was so impressed with the procedure. I truly believe that God led me to The Center for Natural Breast Reconstruction. I called another surgeon and was told that they didn’t take my insurance. They directed me to the The Center for Natural Breast Reconstruction. I called and got Gail on the phone. This was on the day that I took my last chemo treatment. Gail talked to me for over an hour that day. It felt right and I am thrilled with my decision. As you can probably tell, I don’t let much grass grow under my feet and DIEP flap seemed to me like the best & fastest way to get through the reconstruction process and move on.

4. How did you decide upon what reconstructive option was right for you?

I was pretty excited about getting rid of my C-Section Pooch. It was just the right size to make C-cups.

5. How has your decision to undergo breast reconstruction impacted your life moving forward?

I saw the picture Dr. Craigie took of me the day I came to him… on the day I got my tattoos. That was start to finish in a flash. It was definitely a process, but one that I wouldn’t trade for anything. I can remember, 6 weeks after my DIEP flap surgery, sitting on the beach in my bathing suit and feeling comfortable and “normal”. I took out my cell phone and called The Center for Natural Breast Reconstruction to leave Dr. Craigie a message of thanks. I don’t have words to describe how good that felt after living with one breast for 6 months. Now they were both gone, but they were there. How amazing! DIEP flap has allowed me to move on. I know myself, and that I would worry if I had not had both breasts removed even though the cancer was only in one. It has been a great decision… nothing to stuff in my bra, no implants to worry about, just my C-Section pooch made into breasts. Dr. Craigie is a real artist (not to mention a gifted surgeon). I am still amazed at how real they look.

6. What advice do you have for women who have a passion, and want to turn that passion into a business?

I think my advice would be to persevere. Lide and I hit obstacles almost every day, but we just have to work through them. I think maybe that fighting cancer taught me a lesson in this. Every day brought it’s obstacles,  but I had no choice but to keep moving forward.

Click here to see where you can pick up Buffa’s Cheese Biscuits near you or place your order online!

 

 

 

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Slimmed-Down Summer Recipes

July 16, 2012 by

It’s the season of barbeque and picnics, and at The Center for Natural Breast Reconstruction, we know most of our favorite summertime eats are brimming with saturated fat and cholesterol. As a solution, we’ve compiled our favorite recipes for healthy, waistline-friendly alternatives to the usual warm-weather menu items. Serve them proudly at your next cookout—they’re nutritious and delicious!

Trim Potato Salad:
3 med. potatoes
1/3 c. vegetable stock
1/4 c. low fat plain yogurt
3 tbsp. green pepper, minced
1 hardboiled egg (minus the yolk), chopped
1/3 c. onion, minced
1/4 tsp. celery seed
1/4 tsp. parsley flakes
Salt and pepper to taste

Cook potatoes in skins and cut into bite size pieces (potato skins have all the nutrients!). Allow chopped potatoes to cool until just warm. Add the remaining ingredients and toss lightly until well mixed. Chill and serve.

  • No-Pounder Beet Burgers: 1 1/4 cups cooked, cooled brown rice
    1 cup cooked brown or green lentils, cooled, drained well
    1 cup shredded beets
    1/2 teaspoon salt
    Fresh black pepper to taste
    1 teaspoon thyme
    1 teaspoon dill
    3 tablespoons very finely chopped onion
    2 cloves garlic, minced
    2 tablespoons smooth peanut butter
    1/2 cup very fine breadcrumbs
    Olive oil for the pan

Peel beets and shred with the shredder attachment of your food processor, and then change the attachment to a metal blade. Pulse the brown rice, shredded beets and lentils about 15 to 20 times, until the mixture comes together, but still has texture. It should look a lot like ground meat. Now transfer to a mixing bowl and add all the remaining ingredients. Use your hands to mix very well. Place the mixture in the fridge to chill for half an hour.

Preheat a cast iron pan over medium-high. Form the patties by taking a heaping 1/2-cup of mixture, and shaping it into burgers with your hands.

Pour a very thin layer of oil into the pan and cook patties for about 12 minutes, flipping occasionally. Burgers should be charred at the edges and heated through. Serve on a whole-wheat bun with all your favorite trappings.

  • Skinny Pasta Salad 1/2 lb. rotini (springs)
    2 lg. carrots, diced
    3 ribs celery, diced
    1 lg. red pepper, diced
    1 med. white onion, diced
    20 sliced black olives
    1 lg. cucumber, diced
    1 lg. tomato, diced
    Dill weed, black pepper, Mrs. Dash, basil
    1/2 bottle low fat Italian dressing (or more if needed)

Cook the pasta as per instructions on box, then chill. Chop all the vegetables and mix together.

Add dill, black pepper, and basil to taste (fresh is best). Add the chilled pasta, Italian dressing, and toss together. Chill and serve cold.

  • Low Fat Hot Dogs:The trim tip for this summer favorite is easy—simply make the switch from meat to meatless. Smart Dogs by Lightlife are fantastic hot dog substitutes without the mystery meat or saturated fat. In fact, each link has 0 grams of fat, 45 calories, and 8 grams of protein. All that nutrition and they still taste great! Grill these puppies, and top them off with a whole-wheat bun, diced onions, relish, ketchup, and you’ve got a new summer classic!

What is your favorite summer-time food?

 

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The Advantages of ICAP Flap Breast Reconstruction and When to Use This Procedure

July 13, 2012 by

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

When would we use the ICAP flap for breast reconstruction and what are the advantages of this procedure?

The TCAP flap is a procedure for reconstructing the breast or partial breast reconstruction and is another of the muscle-sparing flaps. The ICAP does not require microsurgery or reattachment of the blood vessels, but usually the amount of tissue available is small.  In our experience it is most frequently used to perform partial breast reconstruction of mainly the outer side of the breast or to add volume to a previously reconstructed breast or when the resulting size is not as quite as large as desired from the original planned procedure.  An advantage of the ICAP flap is that it removes tissue from the side of the body that is usually in excess and sometimes bothersome following a mastectomy.  It is just above the bra line and the scar, and although it extends to the back, can almost always be covered in a bathing suit or a support type bra.  Again, the ICAP’s best use is in adding additional tissue to an already reconstructed breast or providing small amounts of tissue for partial breast reconstruction.  It typically does not involve microsurgery to reconnect the blood vessels and the blood vessel that nourishes the tissue is conveniently located on the side of the body near the breast just above the bra line.

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

 

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Around the Harbor: A Guide to Experiencing Charleston by Sea

July 11, 2012 by

Charleston is our favoite place to be during the summer months, with its great beaches and waterways helping to temper the heat. If you’re looking to experience our beautiful city from another vantage point, consider taking a cruise around the Charleston Harbor. You will truly get a feel for life in this city by the sea. While you’re out there, you might even encounter some dolphins playing in your wake!

Charleston Harbor Tours

Step aboard the “Carolina Belle” and immerse yourself in the history of maritime life with Charleston Harbor Tours! This 90-minute tour comes with a well-educated tour guide who will point out some of Charleston’s most historic landmarks and tell the fascinating stories behind them. You can also purchase a carriage or plantation tour package when booking a harbor tour.

Spirit Line Cruises

Tour Ft. Sumter, have dinner, and sail around the harbor with the same cruise company! Spirit Line Cruises offers private charters, three-hour dinner cruises, and even wedding receptions. This company offers something for the history buff and socialite alike.

Charleston Dolphin and Eco Tours

Looking for something a little less historical? Grab your family and see Charleston’s watery wildlife up close and personal! Charleston Dolphin and Eco Tours offers fun for the whole family, with nature-oriented tours and harbor cruises. Choose the perfect excursion for your family, and enjoy the ride!

About Charleston:

The Charleston area is home to wonderful resources for our patients and their families. If you are traveling here for surgery, rest assured that we have world-class medical and post-operative facilities. Patients of the Center for Natural Breast Reconstruction are cared for at the East Cooper Medical Center, a state-of-the-art regional hospital, located very near to our offices.

The region is also filled with hotels, villas and homes available for short- or long-term rental.

Charleston is routinely ranked one of the nation’s most beloved destinations. And we’ve also been voted most polite so often, that we’ve politely pulled out of the competition. Charleston enjoys a temperate climate, a vibrant historic district, wide beaches, majestic homes and a friendly ambiance. No matter the season, there are plenty of things to see and do here.

You can get more information about Charleston and its’ harbor tours and cruises at the Charleston Area Convention and Visitor’s Bureau.

 

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Tired of the Heat? Escape with Cool Getaways.

July 9, 2012 by

IMAGE ABOVE TAKEN FROM: GROVEPARKINN.COM

Summertime in the Lowcountry can be beautiful, but it is certainly hot. If you’re tired of the heat, take after Charleston’s oldest residents and escape to the mountains for a slight reprieve.

The Grove Park Inn

Asheville, NC, is famous for the Biltmore House, but it is also home to one of the South’s best Inns and Spas. Take a trip to the luxurious Grove Park Inn, nestled in the mountains of North Carolina, and beat the heat in style. This charming getaway includes a full-service spa, five-star restaurant, and spacious front porches with rocking chairs for everyone. While you’re there, visit America’s largest private-owned home, the Biltmore Estate, and admire the beauty of its gardens and rooms.

Vail Mountain Lodge and Spa

Vail, Colorado, might be famous for its skiing, but this small town is just as beautiful in the summertime. Take a trip to mountainous Colorado, where nights are cool enough that you’ll need a jacket! The Vail Mountain Lodge and Spa is nestled at the foot of Vail Mountain, and offers world-class amenities, including a full-service spa. Let your stress melt away as you drink in the breathtaking beauty of the Colorado mountains.

The Napa Valley Lodge

Escape to Napa Valley for a romantic getaway in California’s beautiful wine country. The Napa Valley Lodge is the ultimate getaway for wine country living, offering wine tastings, vineyard tours, and a relaxing atmosphere. Take a drive up the California coast and cool off on the shores of the Pacific during your stay!

Wherever you go, we hope that you find the perfect place to relax and escape from the heat.

We’d love to hear your favorite cool getaways!

 

 

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TDAP Flap Breast Reconstruction Surgery: When and Why to Choose This Option

July 6, 2012 by

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

When would we use the TDAP flap for breast reconstruction and what are the advantages of this procedure?

The TDAP flap or thoracodorsal artery perforator flap is a procedure for reconstructing the breast or partial breast reconstruction and is another of the muscle-sparing flaps.  The procedure allows for the fatty tissue from the side and back to be mobilized and then transferred to the breast without disconnecting its blood supply and performing re‑anastomosis of the small blood vessels.  The tissue that is used is in the area above the latissimus dorsi muscle, which is the largest muscle in the body; however, the procedure does not involve transferring the muscle or destroying the muscle.  The advantages of this procedure are that the tissue can be used for breast reconstruction without performing the microsurgery and without damaging or removing the muscle.  The disadvantages of the procedure are that there is a limited amount of tissue available to use for breast reconstruction and because the blood vessel remains attached and is not divided, there is a limit to the shaping and positioning of the new tissue.  It is most frequently used for reconstruction of a part of a breast, mainly the outside, but in some circumstances can be used for reconstructing the entire breast.  However, this is usually a smaller reconstruction and the amount of skin available is typically limited as well.  The TDAP can be used for transferring fat to the breast at the time of mastectomy or can be used later after mastectomy and the body has healed.

Procedures: Transforming Healthy, Living Tissue
Microsurgery has come a long way since its invention by vascular surgeons in the 1960s. The term refers to any surgery involving a surgical microscope. And it has found one of its best applications in breast reconstruction. Through microsurgery, our skilled surgeons are able to harvest healthy tissue from one part of a womans body and reattach it to the breast area. Through the careful process of attaching blood vessels, microsurgery allows patients to have natural looking breasts made from their own, living tissue. Another benefit is the minimized impact and injury to muscles, allowing patients to enjoy a faster, fuller recovery.

Did you find this post helpful? We’d love to hear from you in our comments section.

 

 

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Happy Fourth of July!

July 4, 2012 by

 

We at The Center for Natural Breast Reconstruction wish our readers a happy and safe Fourth of July holiday!

 

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The Best & Brightest Fireworks in Charleston this Fourth of July

July 2, 2012 by

Of course Charleston, historic landmark city that it is, would never settle for anything less than the brightest to rein in the 4th of July, and we at the Center for Natural Breast Reconstruction wouldn’t have it any other way! To set your patriotic heart a-soaring this holiday, we’ve rounded up the places where you’ll want to get a good seat come sundown:

  • Patriots Point will host one of Charleston’s biggest and brightest pyrotechnics displays yet with the USS Yorktown as the center stage. Patrons can sit aboard the Flight Deck for $10, but spectators can also enjoy the fiery spectacle landside as well. With food vendors abound and plenty of entertainment for the kids, it’s a walk-through-friendly environment. The real selling point, though, is the view: the fireworks overhead and reflected off the waterfront will saturate your senses in awe.
  • In the heart of Summerville, catch the “Red, White, and Blue on the Green” in Town Square from 5-8 PM. As a special patriotic treat, the Fort Dorchester Garrison re-enactors will set up a Revolutionary War era camp on Hutchinson Square. A reminder of the reason for the holiday, World War II jeeps owned by Summerville locals will be on display. The fireworks sizzle shortly after dusk.
  • The North Charleston Fireworks and celebration take place at Riverfront Park
    where you can enjoy local live music provided by CoastRunner, The Blue Dogs, and Quianna Parlor. A little dancing is good for your health, and a great way to celebrate our country’s independence!

  • Folly Beach, only 15 minutes from downtown Charleston, is yet another perfect star-spangled spot this Fourth of July. Tour the local restaurants, then settle down with your blanket on the sand to watch the sky dazzle above you.

Happy Fourth of July, Charleston! Where will you go to see the fireworks this year?

 

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Am I A Candidate for Natural Breast Reconstruction?

June 29, 2012 by

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

I was diagnosed with breast cancer in 1999 at age 24 (infaltrating ductal, triple negative). I had a lumpectomy with a lymph node dissection, chemotherapy and radiation. I found out I was positive for the BRCA1 mutation in 2008 and had a myomectomy (c section cut) and subsequent full hysterectomy (via davinci) in 2010, since pathology found the mass to be Endometrial Stromal Sarcoma.

I am now considering a mastectomy to decrease my chances of reoccurrence. Would you recommend a prophylactic mastectomy? If so, what type of reconstruction can I have? I prefer natural reconstruction rather than implants, but do not know if I am eligible since I’ve had two abdominal surgeries and do not have a lot of extra tissue anywhere else.

Hi and Thank you for your question. I’m sorry you have been faced with these difficult decisions. Removing as much breast tissue as possible is the most effective thing you can do to reduce your chances of getting breast cancer. I  refer to this type of mastectomy as “risk reduction” because it does not make the chances 0 but is as close as one can get. Your previous tummy surgeries have probably not affected your ability to have natural breast reconstruction, as we have had many people who have had the same types of surgery before using the extra tummy. Even the people who have had surgeries that compromise the tummy we can almost always come up with an option for natural breast reconstruction. Many of our patients have been told they do not have enough extra to use but when we see them we can usually give them a very nice result without implants. I hope this answers your question.

Sincerely,

James Craigie, MD

Center for Natural Breast Reconstruction

 

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

 

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