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Archives for December 2016

Ask the Doctor- Can you tell me more about the TUG procedure?

December 30, 2016 by

 

This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question:  I am having mastectomy in January; I would like to know about the TUG procedure – if it can be performed following a mastectomy or does it have to be done at the time. I should not be receiving chemo or radiation. My surgery is in Houston ( MD Anderson ). I live in the Nashville area.

Answer: We do not recommend the TUG flap under most circumstances. A significant incidence of lower extremity lymphedema has been reported following its use, and it is often not large enough to provide a satisfactory breast mound by itself. In addition, the donor site is prone to wound healing problems, and the donor site scars can be difficult to conceal.

Our first choice for autogenous breast reconstruction is the DIEP flap from the abdomen, which is a tried-and-true technique. If this donor site is not available, we recommend the SGAP donor site from the upper buttock. The sGAP can produce arguably the best breast reconstruction of any donor site, but is difficult to perform, which usually means the patient needs to travel to get the necessary surgical expertise.

The PAP (profunda artery perforator) flap, which comes from the “banana roll” of the posterior thigh, is our choice if neither the DIEP nor sGAP are available or adequate. It provides about as much volume as the TUG, but has far less risk of lymphedema, and a dramatically better donor site scar.

Any of these flaps can be done at the time of mastectomy or later, with the caveat that you never want to let a flap get radiated, as it can “shrivel up” dramatically. There are advantages to doing the flap at the same time, and advantages to waiting, but probably most of the time it is better to do it at the same time, if possible.

For completeness’ sake, it bears mentioning that if you are not receiving radiation, you may be able to get a satisfactory reconstruction with implants. However, even the best implant reconstruction does not approach the “naturalness’ of a reconstruction using your own tissue.

Thanks for your question, and good luck!

Have a question about breast reconstruction or post-surgical you’d like answered from our surgical team? Just ask!

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Give Yourself the Gift of Health This New Year

December 27, 2016 by


With the holidays behind us, it’s time to get excited and look forward to the new year ahead of us. Before we officially close out the season of giving, there is one more gift we want to talk about.

And that gift is the gift of health.

We believe that taking care of your body and being aware of your health are the keys to living a happy and healthy life. There’s no better time than right now to put yourself on the path to health and happiness as we begin a new year.

It doesn’t matter how good or poor your health currently is. There are many small lifestyle changes you can make to help ensure you’re giving your body the things it needs while also getting the medical care you need to stay happy and healthy.

The new year means starting fresh. We hope you’ll take advantage of this time to put in place a plan for the year that promotes your health and happiness.

Not sure where to start? No worries, we have a few suggestions!

Keep reading to discover a few things you can do to give yourself the gift of health this year.

Eat Healthy

Your health begins with what you put in your body.

Of course, there’s nothing wrong with indulging in a tasty treat every once in a while. But it’s also important to ensure that you are getting the nutrients from fresh meats (if you’re not a vegetarian), vegetables, and fruits.

Here are a few of our favorite recipes you can add to your weekly meal plan.

Go for Regular Physicals

Visiting your doctor for a yearly exam is a great way to make sure you’re in tip-top shape.
Most important, your doctor might be able to detect health problems before you notice them. And that’s important because early detection is the key to saving lives, especially for cancer patients.

You can’t go wrong with a yearly exam to make sure you’re in good health.

Get Exercise

Exercise is an important part of staying healthy. It helps you build muscles, burn excess fat, and keep your heart strong.

If you’re someone who feels as if you can’t exercise, don’t worry. It’s ok to start slow. Something as simple as a walk around the block is a great place to get started.

Check out some of our favorite ways to get into an exercise routine.

Perform At-Home Breast Exams

Ladies, this one is super important!

As we mentioned before, early detection saves lives. Which is why at-home breast exams are so important, even if you don’t have a family history of breast cancer.

BreastCancer.org gives a great overview on how to do an at-home breast exam. Check it out here.

Your doctor can also teach you how to do a self-exam. Ask your doctor to show you at your next appointment.

Take Note of Changes in Your Body

Nobody knows your body better than you do.

If you notice any changes—including lumps, spots, marks, bumps, rashes, or even less visible changes like unusual headaches or pains—be sure to report those changes to your doctor.

Your doctor can diagnose any health concerns and put you on the path to health and happiness.

What do you do to live a healthy life? Share with us below!

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Ask the Doctor-Are prosthetics right for me?

December 23, 2016 by

This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: I had a double mastectomy 5/2/16. The plastic surgeon placed expanders on both sides with the intention of doing reconstruction surgery in 6 months. I was diagnosed with pre-cancer stage 0 dcis in situ but genetic testing showed I was positive for the BRCA2 gene which led to the double mastectomy. The left expander had to be removed due to thin tissue that wouldn’t knit together and I had a wound vac in place for 10 days. I was thinking of getting natural reconstruction but since I have the right expander was told that it would have to be removed along with the dog ears skin on both sides. I am 64 and don’t know what to do.

Answer: I’m sorry you have had so much trouble so far.

You have already had trouble with implant (expander) – based reconstruction, and that could make it more likely that you will have trouble in the future with additional attempts at implant reconstruction. Fortunately, however, previous failed attempts at implant reconstruction almost never reduce the chances of having successful reconstruction with your own tissue (assuming that you are otherwise a good candidate for that).

Because you have had a somewhat complicated course thus far, apparently with some tissue loss, I would appreciate the opportunity to evaluate you in person, if possible, before giving you any more specific advice. We will give you our honest opinion about what we believe your best options are, whether using more implants or your own tissue, and then even of you just decide to have your expander removed, you may feel better about your decision. If you wish, we can have our P.A. Kim or nurse Chris call you to discuss your situation further.

Thanks for your question.

Have a question about breast reconstruction or post-surgical you’d like answered from our surgical team? Just ask!

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5 Simple Ways to Brighten Someone’s Day

December 20, 2016 by

At The Center for Natural Breast Reconstruction, we believe that spreading cheer is something we should be doing year-round, not just during the holiday season.

There is truly no better feeling than knowing you’re making someone happy. When you spread joy, you’re bound to get some in return.

After all, you tend get in return what you give.

For many of us, spreading cheer is something that’s easy to do. Especially if we are surrounded by people who radiate generosity, kindness, and warmth.

Yet, unfortunately, many people do not experience the warmth and happiness we do during this season. In fact, this is a time of year when many people struggle and are sad.

Some families will be celebrating the holidays for the first time without a loved one. Many people will be feeling the effects of isolation and loneliness at much deeper level over the new few weeks. And we can’t forget that this time of year can also be difficult with the grey and gloom of winter that can bring on the winter blues and depression.

For that reason, it’s vital to remember the importance of making each other’s days as merry and bright as we possibly can.

And it’s not hard to do…

Even the smallest act of kindness and love can have a major impact on brightening someone’s day. So, this season, as well as all year round, we encourage you to think about what you can do to lift the spirits of those you love.

We already have a few ideas of things we love to do to spread some cheer! Keep reading to discover 5 of our favorite ways to make someone’s day merry and bright.

Call a Friend or Loved One

For many of us, our lives are so busy that we neglect to check in with the people we love. We certainly don’t mean to, but between work, taking care of families, and everything else we have on our plate, it’s easy to forget to give our friends and family members a call.

And with social media at our finger tips, it’s even easier to keep tabs on people without actually having to talk to them.

This season, and for the rest of the year, make a commitment to staying in touch more frequently with those you love.

The sooner you start, the better!

Pick a time this week to call a friend or family member and catch up. It’s such a nice thing to be able to hear a person’s voice on the phone. A call will certainly spread some joy to whoever is on the receiving end of it.

Send Handmade Cards

Once again, technology has put a damper on a lot of the communication we have with the ones we love.

Sure, it’s wonderful to be able to send someone an email, a Facebook message, an eCard, or a text message, but sometimes those digital messages come across as a little impersonal.

This year, spend some time making handmade cards for your friends and family members.

Not only will these cards bring a smile to your loved one’s face, but the time you took to make the cards will also show them how much you care.

Make Dinner for Someone

Life is busy, and people often feel overwhelmed in the hustle and bustle of working, raising families, getting chores done, and finding time to relax.

For that reason, bringing a friend or family member dinner one night is a great way to spread some cheer, as well as give someone a much-needed break from the cooking chores.

This meal doesn’t have to be expensive or extravagant. A simple spaghetti dinner, or even pizza from your local pizza place would make just about anyone happy!

We do have one tip before you do this though.

Talk with the person you’re bringing dinner to beforehand. This way they can tell you what they like to eat, can warn you of any allergies, and will be prepared when you arrive with the meal.

Treat Someone to a Free Coffee

It’s nice to go out and treat yourself to a cup of coffee every once in a while. It’s even nicer when you discover the person in front of you is paying for your drink as a random act of kindness.

This month, if you are financially able, try surprising someone in line with a free coffee. This small act of kindness will surely light up someone’s day.

If you’re not comfortable with buying a stranger a cup of coffee, you can always invite a close friend or family member out for a cup of coffee on you.

Bake a Delicious Treat to Share

Everyone loves a tasty treat every once in a while.

If you enjoying baking, make one of your favorite treats to share with those you love.

For those of you that are stay-at-home parents or work from home, bring the treats you make to your neighbors. Or, if you work outside your home, put together a tray of goodies to take with you.

It’s amazing that something as simple as a homemade cookie can brighten a person’s day.

What have you done to make someone’s day merry and bright? Share below!

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Ask the Doctor- What are my reconstruction options using only my tissue?

December 16, 2016 by

This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: I am 39 years old and seeking options regarding a double mastectomy with reconstruction using only my own tissue. I was treated for an aggressive breast cancer in my left breast 3 years ago; went through neoadjuvant chemo, then lumpectomy followed by radiation. Due to my lifetime high risk status, I feel a double mastectomy is necessary using my own tissue for reconstruction.

Answer: Thank you for your question, I am glad to hear that you have completed your breast cancer treatment 3 years ago and are doing well. It is very likely that using your own natural tissue is going to be a very good option for you.

Since you have already had radiation on one side the option of removing the remaining breast tissue and having a preventive mastectomy on the other side is the most effective option to minimize your chance of getting breast cancer again.

Although i imagine it is already very low. Have you had any previous surgery on your tummy? Do you feel that you have extra fatty tissue there or any other area of your body? If so then you can probably achieve a proportional natural tissue result without having to sacrifice your important muscles.

If you like I could arrange for a convenient time to answer any other questions by phone. Let me know and ill have one of my staff contact you to make arrangements.

Thanks again.

Have a question about breast reconstruction or post-surgical you’d like answered from our surgical team? Just ask!

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Spread Joy to Cancer Patients with Cheerful Holiday Cards

December 13, 2016 by

There is so much to be cheerful about during the holiday season. It’s a time where many people travel to visit loved ones, indulge in delicious food, and revel in the joy of the holiday season.

How lucky are we to be able to enjoy this time of year!

Unfortunately, there are also many people that will struggle this season due to illness or disease, like breast cancer. Many of these people will have no choice but to celebrate the holidays from the hospital.

That definitely puts a damper on all of the holiday joy and festivities.

We truly wish there was a way to bring everyone home to spend time with their loved ones during this time of year.

Sadly, there is no way we can make that possible, but we can do the next best thing…

Bring some of the holiday spirit to those who are the hospital.

Every year, thousands of people create holiday cards to share with adults and children who can’t go home for the holidays.

It may seem like a small gesture, but there is no doubt these cards bring a lot of happiness to those who receive them.

The best part is that it only takes a little bit of your time to brighten someone’s day.

So, this year, if you feel the desire to spread some cheer, we encourage you to make a few holiday cards to give to people who are in the hospital.

How to Get Involved with Sending Holiday Cards

Many hospitals conduct holiday drives during December to collect cards for their patients.

We suggest you give your local hospital a call to see if they are collecting cards. If they aren’t, they may know of other medical care facilities that are, and can get you hooked up.

Another great resource to contact would be your local community groups, like Boy Scouts, Girl Scouts, or local charities.

These groups may already be involved with creating cards and can help you get connected.

American Cancer Society Greeting Cards

If you’re not very crafty but still want to give back, we suggest checking out the American Cancer Society greeting cards fundraiser.

Every year, the American Cancer Society sells holiday cards and the proceeds benefit cancer research.

You can purchase a variety of different cards to hand out to your family and friends this year. Or better yet, order some to hand out at your local hospital!

To check out the American Cancer Society cards and find more information, please visit their website.

American Cancer Society Greeting Cards Website

Have you ever handed out hospital holiday cards? Let us know where below!

 

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Ask the Doctor- Is the icy hot patch a good option for fat necrosis?

December 9, 2016 by

This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: I had breast reduction surgery a few months ago and have developed fat necrosis. I keep reading it may resolve, I’m scared it won’t! My right breast has a 4″ X 1.5″ area of it. Is that considered a large area? I’ve read that only small areas have a chance of resolving on their own. I keep massaging the area and applying heat. Is the icy hot patch a good option for heat?

Answer: Fat necrosis usually resolves on its own, but it is true that large areas may persist indefinitely. If the area is not painful, it probably does no harm, other than potentially complicating mammograms and breast exams. If it concerns you, however, you may wish to consider having it removed. There are no firm guidelines, but large areas persisting more than 6-12 months are less likely to go away on their own.

Thanks for your question.

Have a question about breast reconstruction or post-surgical you’d like answered from our surgical team? Just ask!

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3 Delicious Hot Chocolate Recipes to Keep You Cozy and Warm

December 6, 2016 by

There’s nothing better than curling up on the couch with a warm cup of hot chocolate on a cold winter day!

Just think about it…warm blankets, cozy slippers, your favorite movie playing in the background, and a cup of decadent hot chocolate in your hands.

Pretty great, right? We think so!

There is one thing, however, that makes the experience even better. And that’s making your hot chocolate from scratch.

Keep reading to discover a few of our favorite hot chocolate recipes that are delicious, easy to make, and will keep you cozy and warm this winter.

Traditional Creamy Hot Chocolate Recipe

If you enjoy a tasty mug of old-fashioned hot chocolate, this recipe is for you!

This particular recipe is made using cocoa powder for a rich chocolate taste, milk, and cream to give it a thick and creamy texture.

Give it a try!

Ingredients:

  • 1/3 cup unsweetened cocoa powder
  • 3/4 cup white granulated sugar
  • 1 pinch salt
  • 1/3 cup boiling water
  • 3 1/2 cups milk
  • 3/4 teaspoon vanilla extract
  • 1/2 cup half-and-half cream

Directions:

#1 Combine the cocoa, sugar, and pinch of salt in a saucepan.

#2 Blend in the boiling water. Bring this mixture to an easy boil while you stir.

#3 Simmer and stir for about 2 minutes. Watch that it doesn’t scorch.

#4 Stir in 3 1/2 cups of milk and heat until very hot, but do not boil!

#5 Remove from heat and add vanilla.

#6 Divide among 4 mugs.

#7 Add the cream to the mugs of cocoa to cool it to drinking temperature.

Recipe Source: http://allrecipes.com/recipe/20211/creamy-hot-cocoa/

White Chocolate Hot Chocolate Recipe

For those of you that don’t care for traditional dark or milk chocolate, this recipe might be right up your alley.

This recipe uses milk, white chocolate chips, and vanilla that all come together to make this delectable drink.

Here’s how it’s made…

Ingredients:

  • 4 cups of milk of your choice (or you can substitute heavy cream or half and half, or do a mixture)
  • 1 tsp. vanilla extract
  • 8 oz. white chocolate, chopped into small pieces (or white chocolate chips)
  • whipped cream or marshmallows for topping

Directions:

#1 Stir together milk, vanilla, and chopped white chocolate in a medium saucepan.

#2 Cook over medium-low heat, stirring occasionally, until the white hot chocolate comes to a simmer.  (Do not let it come to a boil.)

#3 Remove from heat and serve immediately, topped with whipped cream or    marshmallows if desired.

Recipe Source: http://www.gimmesomeoven.com/homemade-white-hot-chocolate/

Peppermint Hot Chocolate Recipe

Last, but certainly not least, is a classic peppermint hot chocolate recipe for the holiday season.

This recipe uses heavy cream, chocolate chunks, and peppermint oil to give it a special kick of holiday flavor.

Try this recipe out!

Ingredients:

  • 1 1/2 cups heavy cream
  • 1 1/2 cups milk
  • 1/4 cup sugar
  • 1/8 teaspoon salt
  • 6 oz. bittersweet chocolate, chopped
  • 3 drops peppermint oil
  • Sweetened whipped cream, for garnish
  • Chocolate shavings, for garnish

Directions:

#1 In a saucepan, combine the cream, milk, sugar, and salt and heat over medium-low heat.

#2 When the cream mixture just begins to steam, add the chopped chocolate, and stir, until melted.

#3 Stir in the peppermint oil.

#4 Divide the hot chocolate among mugs and top with whipped cream and chocolate shavings.

Recipe Source: http://www.foodnetwork.com/recipes/peppermint-hot-chocolate-recipe.html

Do you have a favorite hot chocolate recipe?

Share with us below!

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Ask the Doctor- Will this be a bloodless surgery?

December 2, 2016 by

This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: I had a prophylactic double mastectomy 9 years ago. I am BRCA 1 positive and have lost several family members to both breast and ovarian cancer. I would like to have my silicone implants removed and have the DIEP surgery. However, I don’t know if my insurance will cover this procedure and how being out of state will affect the payment of it if it is covered.

Also, I am one of Jehovah’s Witnesses and I wanted to verify the surgical team is okay with performing bloodless surgery. Maybe this surgery is designed to be bloodless but I wanted to make sure everyone is comfortable with working on Witness patients.

Answer: Thank you for your question. Yes we frequently help women who have problems with their implant breast reconstruction. If you feel like you have extra tummy tissue there is a very good chance that removing the implants repairing the chest muscle and rebuilding the breasts with the DIEP procedure would be our recommendation.

I am very familiar with the Jehovah witness faith regarding surgery and blood products. I have quite a few patients and would be glad to discuss this with you. Let me know if you have more questions or if you would like to arrange a time to discuss your situation.

Have a question about breast reconstruction or post-surgical you’d like answered from our surgical team? Just ask!

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