Ask the Doctor – Would I Be A Candidate For DIEP Flap Surgery After Previous Expanders Are Removed And Will You Accept VA Insurance?

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

Question: I had a bilateral mastectomy with reconstruction and I am terribly dissatisfied with my care so far. 11 Months later, the expanders are still painful. I will be asking to have them removed this week.

I have 2 questions for you. After I  have the expanders removed would I still be a candidate for the DIEP flap? I am still going to chemo (Herceptin) which will run until the end of November, provided there are no more setbacks. My second question is, do you accept VA insurance? One form of payment is through the VA another is Veteran’s Choice. I am not sure which would cover outside care. I look forward to your response.

Answer: I’m sorry you have had so much trouble, but there is a very good chance that we can help you.

Your previous unfortunate experience with expanders does not in any way decrease our ability to successfully reconstruct you with DIEP flaps. The blood vessels which we use to vascularize your flaps are well below the area where tissue expanders are placed, and we have successfully reconstructed literally hundreds of patients in your situation. One potential advantage to having the expanders removed sooner rather than later is that we get an MRI angiogram on all patients who are scheduled for perforator flap breast reconstruction, and most breast tissue expanders are not MRI-compatible. If they use a little magnet to find the port before they fill your expanders, then you can’t get an MRI with those expanders in place.

We have worked with the VA many times in the past, and Gail, our insurance expert, will contact you to investigate your situation further.

Thank you very much for your inquiry, and I look forward to meeting you.

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

5 Ways to Celebrate Mom on Mother’s Day

mom and daughter on a park bench

Moms are amazing.

Between juggling sleepless nights, full-time jobs, and keeping up with household chores, it’s hard to wrap our minds around how much they do every day to ensure everyone is healthy, happy, and provided for.

It’s no surprise that moms sacrifice a lot for their families–a sacrifice that we believe should be repaid with a month-long stay on a private island far away from laundry, crying kids, and boo-boos.

But, we know that a private island vacation isn’t in the budget for most families.

That’s why we came up with a handful of things you can do to celebrate mom and honor her this Mother’s Day that are both fun and affordable.

Keep reading to discover how to treat mom on her special day this month…

Serve Breakfast in Bed

breakfast in bed

Breakfast in bed is a classic way to treat mom on Mother’s Day.

After all, who doesn’t like to wake up to the smell of hot coffee and fresh bacon after a morning of sleeping in?

This year, pull out all the stops.

Make a delicious fruit salad, whip up your world famous omelet or stack of pancakes, and splurge for the flavored coffee creamer.

Aside from making breakfast, ensure that someone is awake to take care of small children or pets in the morning so mom doesn’t have to.

And finally, to top it all off, pick up a pretty bouquet of mom’s favorite flowers.

Then, wrangle up all your family members and surprise mom with a gourmet breakfast.

Clean the House

Just because you see mom happily rocking out to her MP3 player while scrubbing toilets on a Saturday morning doesn’t mean she’s actually happy about cleaning up after everyone.

Doing chores like washing dishes, folding laundry, and scrubbing toilets stinks…literally!

And, just as the kids in your house deserve a break to watch Saturday morning cartoons, mom also deserves a break to read a book, watch her favorite TV show, or go to her yoga class.

This Mother’s Day, make it your mission to help out around the house.

Let the kids take a turn cleaning the bathrooms and vacuuming the living room.

Better yet, surprise mom with a chore chart that assigns chores to every family member for the entire year.

Many hands make light work. And, mom definitely deserves a little extra help!

To get you started, check out this post on homemade cleaner recipes!

Take Mom Out to a Show


First and foremost, we want to give a shout-out to all of those brave moms who have had to sit through Barney on Ice, a Raffi concert, or The Wiggles Live for the sake of your children.

They really should hand out margaritas and gold medals for moms who attend those types of events.

In honor of all those hours sitting through various renditions of “If You’re Happy and You Know It, Clap Your Hands,” we think it’s only fair that you treat mom to a show that she actually wants to sit through.

This Mother’s Day, snag some tickets for mom to go see her favorite opera, a live show, a concert, or a movie she’s been dying to see.

Tip: If you have kids that don’t sit nicely through live shows, hire a babysitter and take your significant other out for a night on the town.

Cook a Delicious Family Meal

The saying “A mom’s job is never done” is very true.

After a long day of working or caring for kids, it’s usually mom’s job to make dinner.

Between picky eaters and the pressure to make a meal everyone will enjoy, this chore isn’t always a fun one.

This Mother’s Day, take over kitchen duty and have your kids help you prepare a delicious family meal so mom doesn’t have to.

Mom gets a break, the kids will learn valuable kitchen skills, and the entire family will have the opportunity to enjoy a nice meal together–a win-win for everyone!

Here are a few quick and easy meal recipes to get you started!

Tip: To kick this gift up a notch, consider making a book of meal coupons for mom that she can use any time she needs a break and doesn’t want to cook.

Send Mom for a Day at the Spa

towels and candles at the spa

You know what they say…“Absence makes the heart grow fonder.”

Perhaps this Mother’s Day, all mom needs is a little time away to relax and recuperate from the chaos of home life. And, what better way to “get away” than to spend a day being pampered at the spa?

This year, treat mom to a variety of calming spa treatments.

After a day of being pampered with mani-pedi, a facial cleanse, and a massage, we have no doubt that she’ll come home rested and ready to resume her motherly duties.

The best part…many spas advertise special discounts in honor of Mother’s Day. Keep an eye out for these specials, or call and inquire about Mother’s Day packages.

Find a good deal, and you’ll be able to give mom a much-needed break without breaking the bank!

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


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!

What to Say to Someone with a New Breast Cancer Diagnosis

two friends chatting together

According to, 1 out of 8 women will be diagnosed with breast cancer this year.

Unfortunately, this means that, over your lifetime, there’s a good chance that you’ll know a friend or family member who has breast cancer.

Sadly, if you receive this type of news, it can be difficult to find the right words to say to bring comfort to the one you love.

For that reason, we want to suggest 5 kind and compassionate things to say to someone who has been recently diagnosed with breast cancer.

It is our hope that you can use these suggestions to find positive, encouraging words that will uplift the women in your life who are fighting this courageous battle.

Keep reading to discover what we recommend…

Idea #1 – “I don’t know what to say, but I’m here for you.”

It’s 100% okay to not know what to say to someone with a new breast cancer diagnosis.

In fact, sometimes, it’s better not to say anything at all and let your loved one do the talking.

The simple line “I don’t know what to say, but I’m here for you” is a great way to let your friend or family member know that you’re at a loss for words.

Most important, this line can prevent you from saying something you can’t promise, like the phrase “Everything will be okay” that many people say out of habit.

The most important part of this sentence is the ending…“I’m here for you.”

It’s a great reminder to your friend or family member that, while you might not know what to say in the moment, you’ll always be there to provide support.

Idea #2 – “I’m here to listen.”

two women looking at the mountains

Actions often speak louder than words.

For this reason, we suggest letting your loved one know “I’m here to listen.”

This line gives your friend or family member the time to express her own thoughts, concerns, or worries before you speak.

It’s important to understand that your loved one will need time to process her thoughts and talking out loud can help her do just that.

After your loved one has had a chance to talk, you can then express what you feel is appropriate to say based on what has been told to you.

If you’re struggling to find the right words to say, don’t say anything at all. It’s just as valuable to lend your friend or family member a pair of supportive, listening ears.

Idea #3 – “Can I help you with X?”

When someone is diagnosed with breast cancer, it’s easy for her to become overwhelmed.

It’s likely that she will be left wondering how she will keep up with daily life while also fighting the battle of her life.

This is why our third recommendation is to simply ask your friend or family member, “Can I help you with X?”

Instead of talking about the diagnosis, simply ask how you can help. Doing this will remind the person you care about that she has people in her life that are going to help her keep moving forward.

We recommend that, when you ask how you can help, you are specific in your request.

For instance, you might ask, “Can I drive you to your doctor’s appointments?” or “Can I walk your dog twice a week?”

People are more likely to accept help when you are specific about what you’re offering to do.

Idea #4 – “What else is new?”

2 friends on a coffee date

Sometimes, talking about a breast cancer diagnosis isn’t helpful–especially if a person has a lot of other people asking her questions and wanting information.

Instead, your loved one might want to take her mind off the situation and talk about other things like a hobby or vacation.

If you can tell that your family member or friend is having a hard time talking about the diagnosis, change the topic and see if that helps.

Ask anything from “What are your kids up to?” to “How did you enjoy that movie you went to see the other day?”

A lighthearted conversation on a topic other than cancer might be the best thing you can do to offer a little peace in the midst of a breast cancer diagnosis.

Idea #5 – “Where or how can I learn more about what you’re going through?”

We all know that getting diagnosed with breast cancer is a difficult, life-changing experience. However, unless you’ve been diagnosed yourself, you’ll never be able to put yourself in the shoes of the person you care about.

That being said, it is possible to educate yourself to get a better understanding of what your loved one is going through.

That’s why we recommend that you ask your friend or family member, “Where or how can I learn more about what you’re going through?”

Having this knowledge up front will equip you with the tools you need to ask the right questions and provide the best support for the one you love.

This knowledge will also help you become more empathetic toward your loved one who is on this challenging journey.

Do you have any recommendations for what to say to someone with a new breast cancer diagnosis? Let us know your thoughts in the comments below!

Ask the Doctor – Could Odd Pains In My Body Be The Consequence Of an Old Abdominal Flap Surgery Following A Halstead Radical Mastectomy?

Poppy in a feild

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

Question:  In 1987, I had abdominal flap surgery following a Halstead radical mastectomy. I keep wondering what is NOW going on in my body! When I feel odd pains I wonder if it could be repercussions of that surgery so long ago.

Answer:  Thank you for your question. If you had your surgery in 1987 and you had reconstruction using your abdominal tissue then I will assume that you had a Tram procedure. That surgery relies on partially removing the muscle from the abdominal wall. Not having the muscle in place can cause problems later in life. People can have pain or bulging of the tummy and even hernias. Of course not all patients have those problems. If your problems are in the tummy area then that is a possibility. If your problems are in the area of your breast or mastectomy then you should consider seeing a breast surgeon that specializes in doing mastectomies to make sure all is well with regard to your breast area. You could also see the doctor who follows you regarding your breast cancer history. Scaring from a “Halstead” mastectomy especially after radiation could cause aches and pains later in life. Regardless of what it might be you should definitely be seen by your doctor so they could do a complete evaluation of your symptoms. After an evaluation they could make more specific recommendations. I hope his information helps. Let me know if you have further questions.

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


The Ultimate Guide to Breast Reconstruction Insurance Questions

There are a lot of questions out there regarding insurance costs for reconstructive surgery.

Because breast reconstruction surgery can be expensive, it’s important that you know as much as you can about whether the procedure will be affordable for you, and what your insurance coverage options are.

Keep reading to check out some of the most common breast reconstruction insurance questions we receive.

Why Won’t Insurance Pay for Reconstruction?

Yellow Lily
Question: I don’t understand why insurance company doesn’t pay for reconstruction if you’ve had a lumpectomy. With radiation, your breasts shrink a lot and you are all out of proportion. I finally did get them to pay for prosthesis and bra.

Answer: That’s not always the case with a lumpectomy. If the surgery results in a significant defect or radiation negatively impacts the tissue, most times we can submit your case to your insurance company along with photos of the affected area, and they will indeed cover a reconstruction surgery for you.

Read the full post here.

I’m Looking for a Plastic Surgeon That Specializes in Microvascular Breast Reconstruction. Are You in My Insurance Network, and Do I Have to Make a Huge Down Payment before Surgery?

Question: I am looking for a p.s. who specializes in microvas. breast recon. I had dcis in 2014 lumpectomy with 6 weeks rads followed by bilat mast. 2016 with immed. recon with expanders then implants in March. Then I got a serious infection in the left (rad) breast, had implant removed and refused to do have lat flap done.

I am thin and one PS said I might be able to do a body lift type or one where they take from my backside and use an implant on both sides. I do not want the implant I have now. It is subpec and is painful. Can someone help? I have anthem BC/BS and you are out of network.

I do not have 8500 to have this done at another location. My insurance is agreeable to a pay if it is in network. I can’t afford much out of pocket. We are low -middle class, but don’t qualify for help.

Answer: Hi, and thanks for your inquiry. Glad you found us – you’ve definitely found a team that specializes in microvascular breast reconstruction. Regarding your insurance, does your card have a little suitcase on the lower corner of your card? If so, we’re actually in network for your, utilizing the Blue Card program through our contract with BCBS of S.C.

Read the full post here.

Does Insurance Cover Breast Reconstruction for Poland Syndrome?

Purple flower in a green field
Question: I was wondering what insurance would cover breast reconstructive surgery that’s due to having Poland Syndrome? My case I where I was born without having my right breast muscle and a smaller areola.

Answer: The good news is that we’ve been able to get breast reconstruction for Poland syndrome covered for past patients and certainly know how to navigate the process to make that happen for you.

Read the full post here.

Will My Insurance Cover a Prophylactic Mastectomy If I’ve Had Gene Testing?

Bright pink lily on water

Question: I did the gene testing in February; tested positive for BRCA 2. I want to go full steam ahead and be proactive with prophylactic mastectomy. I am a 31-year-old single mom.

However, in regards to insurance, I am in a pickle. I just switched jobs and will be obtaining new/different insurance with a new company. Will the new insurance I am obtaining most be okay with the gene testing from the prior company and proceed to pay for the mastectomy/reconstruction? I can provide all the results and positive test results as well to them to suffice.

Answer: Most insurances do pay for prophylactic mastectomies when you have a gene conferring increased risk. While I cannot tell you with certainty, the companies that offer the tests are pretty standardized, and there is no logical reason not to accept the results of a prior test.

Read the full post here.

How Much Will Insurance Cover?

Question: Hi, I am 19 years old and 13 months ago I had a benign lump removed from my right breast. Since then, my right breast has increased in size significantly but my left one has not. My left breast is a full size smaller than my right breast and I’m very self-conscious about it.

I want to get a procedure done that will even them out. I’m just having a hard time finding the right doctor to do it, and I’m unsure how much the insurance will cover. If you could help me with the insurance policies and what your surgeons could do for me, I would greatly appreciate it. Thank you so much.

Answer:  Thanks for your question!

It is difficult to sort out exactly what is going on and what would need to be done based on your brief description. While your insurance company may not be obligated to cover any treatment without the diagnosis of breast cancer, that does not automatically mean that they won’t.

Read the full post here.

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

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!

Earth Day: How to Reduce Harmful, Cancer-Causing Waste from the Environment

Earth Day–a day in which we reflect on how amazing our planet is and how we should care for it–is just a few days away on April 22

With the holiday just around the corner, we thought we’d share a few simple ways to keep toxic pollutants out of our air and keep our planet clean so we don’t destroy the earth and endanger the lives of friends and family.

Pick Up Cigarette Butts

Smoking cigarettes releases harmful carcinogens that pollute our air. And these carcinogens affect more than just the people who are smoking the cigarettes.

In fact, states that secondhand smoke causes approximately 7,330 deaths from lung cancer every year. If that’s not bad enough, many smokers feel it’s ok to throw their cigarette butts on the ground.

Not only does this make our streets dirty, but it puts small animals–like birds or chipmunks–in harm’s way as they often mistake this waste for food.

Although we advise against it, it’s your personal choice to smoke. But, that personal choice shouldn’t hurt others via air pollution or waste on the ground.

If you’re going to smoke, be responsible. Don’t smoke in public outdoor areas. And certainly, don’t leave your trash on the ground for small animals, or even children, to pick up and eat.

Recycle Plastics

Many people don’t think twice when burning waste, especially when it comes to plastics.

However, the fumes that are emitted into the air can contain dangerous materials like mercury, polychlorinated biphenyls, and dioxins.

Over time, these harmful chemicals bioaccumulate. This bioaccumulation often occurs in our water and food sources.

Eventually, these pollutants can cause cancer, deformities, reproductive failure, and immune diseases in both humans and animals.

Instead of burning your plastics, be sure to sort them out and recycle them.

To help remind you, grab a special plastic recycling bin and place it in your kitchen. If you have kids, get them involved by decorating the bin as a fun Earth Day activity.

Avoid Barrel Burning

A lot of people burn their own trash in burn barrels because it’s easier than hauling it to the local disposal site or to avoid paying for a waste collection service.

We understand the importance of saving time or pinching a few pennies. However, what you might not understand is that burning your own trash is dangerous and not good for the environment.

In fact, the chemicals that are released while burning trash can…

  • Cause heart disease.
  • Aggravate respiratory ailments such as asthma and emphysema.
  • Cause rashes, nausea, or headaches.

Loose pieces of trash also often fly away and end up as trash that gets buried in the ground.

Last but not least, burn barrels have the potential to cause fires, especially during times of drought. When a forest fire occurs, thousands of animals and plants are destroyed.

In order to protect the earth, we advise that you let garbage disposal specialists take care of your trash for you.

They know how to properly sort trash and safely burn it so that it doesn’t cause major damage to the earth.

What do you do to help keep the earth clean? Let us know in the comments below!

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


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!

The 5 Best Plants for Improved In-Home Air Quality

Aloe vera

It’s important to know what we’re putting into our bodies, and that includes the air we breathe.

After all, the oxygen we breathe (even inside our own homes!) is often polluted with formaldehyde, sulfur, and carbon monoxide–just to name a few things.

If you’re someone who spends a lot of time inside and are worried about your home’s air quality, keep reading, because today we’re going to walk you through some of the best, easy-to-maintain houseplants that naturally filter the air.

Here’s what we recommend…

Spider Plants

spider plant

Spider plants are one of the easiest indoor houseplants to grow and maintain and can easily be found at your local greenhouse or plant nursery.

The plant is native to southern Africa, but due to its pretty leaves and air-filtering properties, it can be easily found all over the world.

This plant in particular is amazing at removing formaldehyde from the air. In fact, NASA, which tested the abilities of three common houseplants to remove formaldehyde from the air, found that spider plants were able to remove 95 percent of the toxic substance from a sealed chamber in less than 24 hours.

It’s also a superstar at removing a chemical called xylene from the air.

Aside from these particular chemicals, spider plants continuously recycle and clean the air we breathe.

Peace Lily

peace lily on a side table

If you love decorating your home with beautiful, fresh flowers, a peace lily might be right up your alley.

Not only does this plant blossom with a stunning white lily on a yearly basis, the plant itself is a pro at removing ammonia, benzene, formaldehyde, and trichloroethylene from the air in your home.

This plant is able to quickly remove toxins from the air by absorbing them in and filtering and neutralizing toxic gases through its root system.

While this plant originates from Southeast Asia, it can now commonly be found in grocery stores and greenhouses all across the U.S.


bamboo stalks

If you’re someone who doesn’t have a green thumb, a bamboo plant is a great option for your home. As long as you keep it watered, it is almost impossible to kill.

Aside from their hardiness, bamboo plants are also great at filtering benzene, formaldehyde, and trichloroethylene from the air.

In fact, bamboo can filter and neutralize many chemicals that come from ovens, carpets, glues, cleaning solutions, and plastics.

The best part…bamboo is very cheap! It won’t cost you an arm and a leg to purchase a small plant for each room in your home! You can find bamboo in most grocery stores, Asian markets, or plant nurseries.

Aloe Vera

aloe vera plant

Most people think of aloe vera as a green goo that’s used to soothe sunburns. Yet, not everybody realizes this plant has a superpower that’s far greater than relieving sunburn.

Aloe vera plants are highly effective at removing formaldehyde–a chemical that becomes very toxic when you’re overexposed to it.

The plant also has a knack for removing a chemical called benzene which is commonly found in paint and home cleaners.

Whether you’re suffering from a burn, are worried about your air quality, or are experiencing digestive issues (yes, people cook with it!), it’s a houseplant you simply can’t go wrong with.

You can find aloe vera plants at farmers markets, greenhouses, and grocery stores.

Boston Fern

boston fern frond

A Boston fern is one of the most classic houseplants that exists. And it’s no surprise as to why many people have this plant in their homes.

First and foremost, Boston ferns are able to filter air and remove harmful toxins like formaldehyde out of the air like every other plant we’ve discussed thus far.

However, what makes this plant extra special is its ability to restore moisture into the air. This plant is nature’s natural humidifier.

If your hair, skin, and lips are dry, try introducing some water back into your air with a Boston fern.

On average, a decent size fern costs less than $20! Now that’s an inexpensive home air purifier and humidifier package deal!

What’s your favorite indoor air purifying plant? Let us know in the comments below!