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Benefits of Autologous Reconstruction vs. Implant Reconstruction

September 9, 2019 by

When considering breast reconstruction, a woman is faced with a few options — she can

choose autologous reconstruction — which is the use of her own skin and tissue to

create a breast mound, implants, or go flat.

Recently, the recall of certain breast implants has made the news, as the FDA reported

their connection to 573 rare cases of anaplastic large cell lymphoma and 33 patient

deaths. As a result, the FDA asked Allergan to recall its BIOCELL textured breast

implants and tissue expanders and they obliged.

We are sure that this news is upsetting and leaves questions in the mind of patients

who wonder about implants and their safety, as well as the choice they should make for

their own breast reconstruction procedure.

At The Center for Natural Breast Reconstruction, we educate our patients on the

differences between all types of procedures and their risks, but our emphasis has

always been on autologous reconstruction. Here’s a little about each autologous

procedure that we do:

DIEP flap: This is the most popular type of perforator flap reconstruction due to its high

success rate and its ability to reconstruct the breast without the patient having to

sacrifice much needed abdominal muscles. In addition to reconstructing the breast, the

contour of the abdomen is often improved – much like a tummy tuck.

GAP flap: Similar to the DIEP, tissue is taken from the buttock area instead of the

stomach.

PAP flap: The Profunda Artery Perforator Flap (PAP) utilizes the tissue of the upper

thigh just below the buttock to reconstruct the breast following mastectomy.

So now that you know the difference between each procedure, why should you choose

autologous reconstruction over implants?

● Autologous reconstruction lasts a lifetime: Breast reconstruction using tissue

from someplace else on your body will last a lifetime. There is nothing synthetic

that can break or cause illness or other major issues. On the other hand,

implants will normally have to be replaced between 10 and 20 years.

● Breasts made by autologous reconstruction feels more natural: When your

breasts are reconstructed, you want them to feel just like your old breasts.

Implants do not always feel real, but since the tissue on your belly, buttocks, and

upper thighs is very similar to your breast tissue, it makes for a good, more

natural substitute.

Deciding what kind of procedure is best for you is a big decision. The best thing to do is

to gather all of your facts, talk with your doctor and your surgeon and weigh all of the

pros and cons before deciding on what’s right for you.

Filed Under: Breast Cancer Awareness, Health and Wellness, In Her Words

Autologous vs. Implant

March 6, 2019 by

Benefits of Autologous Breast Reconstruction vs. Implants

 

If you had a mastectomy as part of your breast cancer treatment, you may be considering reconstruction to get back the look and feel of your natural breast. The two reconstruction options that patients normally choose between are autologous breast reconstruction and implant reconstruction.

Autologous breast reconstruction involves using your own tissue to recreate your breasts and can be done either when you have your mastectomy (immediate reconstruction) or at a later time (delayed reconstruction). Autologous breast reconstruction typically involves multiple stages; however, implant reconstruction often requires several stages as well.

With autologous reconstruction, a plastic surgeon uses the tissue from another place on your body (called a donor site) — typically from your abdomen, buttocks, or thighs – to recreate natural looking (and feeling) breasts. Using microsurgery, the surgeons attach vessels from the donor site to vessels in your chest to provide adequate blood flow to your new breasts.

Many patients who undergo autologous reconstruction, after having implants placed previously, state that their new breasts look and feel more like their old breasts compared to when they had implants.

Women who need radiation therapy before or after their mastectomy may also want to consider autologous breast reconstruction instead of implants because of the higher rate of failure associated with placing an implant under radiated skin and tissue. However, it is important to note that radiation must occur before undergoing autologous breast reconstruction.

Whether you decide to have autologous breast reconstruction or implant reconstruction depends on several factors, including your age, health status, location of the tumor, previous surgeries, and the availability of extra tissue in your body. There are pros and cons of each procedure, so it’s important to talk to your doctor about which one is best for you.

Implant reconstruction carries its own unique set of risks. Risks include inflammatory reaction, leaks, and mechanical implant failures.  There is also a chance that excessive scar tissue can form around the implants (capsular contracture) and cause pain and malposition necessitating removal or revision of the reconstructed breast. Due to these possibilities, implants may have to be surgically replaced or exchanged at a later time.

The Center for Natural Breast Reconstruction believes in good health for everyone. If you or someone you know is in need of breast reconstruction, contact them at NaturalBreastReconstruction.com or toll-free at 866- 374-2627.

Filed Under: Health and Wellness Tagged With: ,

Ask The Doctor – I Recently Received Concerning Results on a Mammogram. Should I Wait the Recommended 6 Months to Discuss Implant Removal or Begin the Process Now?

July 13, 2018 by

pink rose

This week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I am a 61-year-old female with breast implants that were placed in 1986. I have been pregnant 6 times, 5 c-sections and one miscarriage. 2 infant deaths and 3 living children. I was able to breastfeed 4 of my children. Approximately 4-5 years ago I had an abnormal mammogram.  (I am in the process of obtaining those records) I underwent an ultrasound to the left breast and was informed that everything was “ok”. Following mammogram was normal. I retired from nursing 2 years ago and moved from Virginia to West Virginia. My most recent mammogram 5/2/2018 stated “There are bilateral breast implants. There is mild to moderate residual parenchyma tissue bilaterally. There is an asymmetric parenchyma nodule in each breast anteriorly, most likely benign. Six month bilateral mammogram advised to confirm stability.” Doctor, I’m not sure I should wait another six months or peruse implant removal and breast tissue removal. You know us nurses “overthink”. I’d like to know if you have another suggestion vs wait for the next mammogram. Thank you so much for you’re valuable time and consideration.

Answer:

Thank you so much for your question. It sounds like you are getting frustrated, and it’s easy to see why.

We don’t actually treat breast cancer per se, we just do reconstruction, so I can’t actually recommend a particular imaging technique or schedule. I can, however, recommend that you see a surgical oncologist who treats breast diseases (if you haven’t already), as they often have a good “feel” from experience for how to manage these type situations. They see many, many images, and, unlike radiologists, later correlate many of those images with what they see in surgery, which gives them a unique perspective. He or she may recommend an MRI or ultrasound, or may just agree with your previous recommendations, but even that might be reassuring.

Thanks again for your question, and have a great weekend!

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

Filed Under: Ask the Doctor

Ask the Doctor – What Can Be Done To Fix a Previous Radiated Breast with Implant?

July 6, 2018 by

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

Question: What can be done for a 2004 radiated breast with implant. As common, it has encapsulated to a high degree and is painful, misshaped and raised, looking very unnatural. Thank you

Answer:  Without question, the course of action most likely to work is to remove the implant and proceed with reconstruction using your own tissue. If you still have breast tissue remaining, it can be removed by a breast surgeon at the same time that your healthy tissue is transferred.

The most common source for the new tissue (the “flap”) is the abdomen, which is usually harvested as a DIEP flap. If the abdomen is not available or not adequate, then the buttocks (“sGAP flap”) can often be used. Our success rates over the last 13 years are 99.07% using the DIEP flap, and 95.7% using the sGAP flap. The initial surgery requires on average 4 nights in the hospital, but subsequent stages are much easier.

If you can’t or don’t want to use your own tissue, there are a couple of other options which may offer some hope, although the chances of success are nowhere near as good as using your own tissue. One is a course of hyperbaric oxygen, which has been shown to bring new blood vessels to the radiated tissue.

Another potential option, which must be regarded as experimental at this point, would be to completely cover the implant with acellular dermal matrix, or “ADM” (Alloderm being the most commonly used variety). This material has some efficacy in preventing contracture, but the effect would be less pronounced in radiated tissue.

Hope this helps. I would be happy to discuss your situation further with you, if you wish.

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

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

Ask the Doctor – Can I Have Large, Under Muscle Implants Replaced With Smaller Ones? Will This Make Them More Comfortable?

June 29, 2018 by

This week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I’ve had my breast tissues removed and I now have implants. They are under my muscles, too large and very uncomfortable. Is there anything you can do to fix this and make a smaller implant? I am very unhappy with the way my breasts look, This is contributing to already very low self-esteem issues. Can you help me? What are my options?

Answer:  There is an excellent chance that we can help you. The country is currently undergoing a paradigm shift in implant-based breast reconstruction, with more and more surgeons placing the implants in front of the muscle, rather than behind. This allows for numerous potential advantages, and few disadvantages. We have been converting patients with unsatisfactory sub-muscular reconstructions to reconstructions in front of the muscle for a few years, with generally good-to-excellent results.

Another option is to remove your implants and re-build your breasts only with your own natural tissue, usually from tummy or buttocks. This is a larger operation than implant reconstruction but obviously results in an even more natural result.

I would be happy to discuss your situation further with you by phone, if you wish, or see you in my office when convenient.

Thanks for your question.

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

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

Ask the Doctor – Exams Of My Implants Have Shown Nothing Wrong But Increasing Symptoms Have Me Very Worried. Is There Anything I Can Do?

May 4, 2018 by

Daisies

This week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I have pain on the side of my breast where an implant was attached at reconstruction surgery in 1987. It has always hurt but recently has become much worse. Inflammation increases with sinus and allergy problems.

The implants are still soft so my recent visit to a plastic surgeon was uneventful. As I am 75 years old, they would not remove them. MRIs have shown they are not leaking. The pain keeps me on edge thinking something is very wrong. What are my options?

Answer:  I’m sorry you are having problems so long after your surgery.

I don’t think you necessarily have to just accept your situation. You can have very bad, and painful scarring internally, especially with old implants, even if they are not ruptured. Additionally, if you are otherwise healthy, there is no reason you couldn’t have them removed, even at 75. I’m not saying that this would solve your problems (although it may), but don’t discount the option just because of your age. For what it’s worth, we have actually done DIEP flaps successfully on patients your age, and that is a much larger procedure than removing implants.

I would be happy to speak with you and discuss your situation further if you wish.

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

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

Ask the Doctor – Can I Have Large, Under Muscle Implants Replaced With Smaller Ones? Will This Make Them More Comfortable?

April 20, 2018 by

This week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I’ve had my breast tissues removed and I now have implants. They are under my muscles, too large and very uncomfortable. Is there anything you can do to fix this and make a smaller implant? I am very unhappy with the way my breasts look, This is contributing to already very low self-esteem issues. Can you help me? What are my options?

Answer:  There is an excellent chance that we can help you. The country is currently undergoing a paradigm shift in implant-based breast reconstruction, with more and more surgeons placing the implants in front of the muscle, rather than behind. This allows for numerous potential advantages, and few disadvantages. We have been converting patients with unsatisfactory sub-muscular reconstructions to reconstructions in front of the muscle for a few years, with generally good-to-excellent results.

Another option is to remove your implants and re-build your breasts only with your own natural tissue, usually from tummy or buttocks. This is a larger operation than implant reconstruction but obviously results in an even more natural result.

I would be happy to discuss your situation further with you by phone, if you wish, or see you in my office when convenient.

Thanks for your question.

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

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

Ask the Doctor – What Are My Chances With DIEP Flap Surgery After Several Failed Reconstructions With Tissue Expanders and Implants?

April 13, 2018 by

Sunflowers

This week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I have had several failed reconstructions with tissue expanders and implant. I have also been put on IV antibiotics due to a staph Infection. I am wondering what my chances are with the DIEP Flap.

Answer:  Great news! Your prior failures with implants does not in any way decrease your ability to get soft, warm breasts with DIEP flaps. Many, many, many of our patients have histories of prior failures with implants, some with (10-20) prior failed surgeries, and we have been able to successfully 99+ % of them with only their own tissue. Once the infection from prior implants is eradicated from your body (if you have been healed for at least 6 months, you can generally assume that all the prior infection is gone), then subsequent reconstruction with your own tissue carries only a minuscule fraction of the infection risk of reconstruction with implants. You didn’t mention if you were radiated, but it makes no difference, breasts reconstructed with your own tissue are still extraordinarily unlikely to have problems with infection.

We would love to chat with you and discuss your options further. Looking forward to speaking with you, and thanks for your inquiry.

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

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

Ask the Doctor – What Options Do I Have When Removing My Breast Implants?

February 16, 2018 by

This week, Audrey Rowen, PA-C, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I had silicone implants in 1988 under skin, which ruptured. In 2012, had bilateral implant exchange with saline implants under muscle. In 2016, the right saline implant ruptured; it was always hard with capsular contraction. I have been trying to find a plastic surgeon who will do a capsulectomy on Rt & Lt… and ideally tissue transfer from my body. (I read the FDA has 356 MDRs of lymphoma including 9 deaths, with saline implants, mostly textured but also smooth.) So, as long as I have a rupture (the right breast is flattened), I may as well have both saline’s removed. Does the fat transfer go under the skin or muscle? Would this be a good option for me at this point? Is the capsulectomy better than the explant-ation? Of course, it also depends on cost! Thank you.

Answer: Thanks for reaching out! I’m sorry to hear that you’ve had quite a lot of trouble with implants over the years. Were your implants placed for reconstruction or for cosmetic purposes? We do a lot with both implant reconstruction and natural tissue, both of which are almost always placed above the muscle. Our office also mostly prefers to use smooth silicone gel implants instead of saline, and we choose not to use textured implants often for a few reasons, one of them being what you researched about the Anaplastic large cell lymphoma.

The biggest question that determines what your best options would be whether you had a breast cancer diagnosis or other factors that would make your case reconstruction vs. cosmetic. Once we get that information from you, I feel we can better give you an idea of what we might be able to do for you.

I look forward to hearing back from you to see how we can help you!

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

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

Ask the Doctor – I Have Implants But They Feel Horrible And My Reconstruction Looks Terrible. Is There Any Hope After Reconstruction?

February 2, 2018 by

This week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question:  I have implants. Do not like them they feel horrible and my reconstruction looks terrible. Is there any hope after reconstruction. I have appointment 2/23/2018.

Answer:  Fortunately, your previous unfortunate experiences with implants in all probability do not affect our ability to get you a satisfactory reconstruction using only your own tissue.

I look forward to meeting with you!

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

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