Mastectomies and Expanders: Your Questions Answered

Ask the DoctorThis week, Dr. Richard Kline of The Center for Natural Breast Reconstruction answers your questions.

Q: Both my mother and my aunt have been diagnosed with breast cancer. If I were to get a mastectomy, would it be covered by insurance in the state of Pennsylvania?

A: The situation with “high risk” patients and prophylactic mastectomy seems to be evolving. If you are tested and found to have the BRCA gene, most or all insurers seem to be covering mastectomy and reconstruction. Even if you do not have the BRCA gene, but have a strong family history such that your medical oncologist recommends mastectomy, your insurer may well cover it. There may be other laws specific to this in the state of Pennsylvania of which I am not aware, but possibly Gail, our office manager and insurance specialist, can help you more.

Q: I had breast cancer in my right breast, and received a double mastectomy in November. They placed expanders in both. I didn’t have any trouble on the left side. However, six surgeries later, I opted to have my right-side expander removed. It feels better. However, I am now scared to undergo reconstruction due to this past trouble with my right expander. I still have the expander in my left breast. Any advice for me? Is it common to have trouble with expanders?

A: Sorry you are having trouble.

Unfortunately, trouble with expanders is pretty common. It’s more likely if you were radiated on the “problem” side, but it also happens with some regularity even if you aren’t radiated.

Fortunately, previous trouble with expander or implant-based reconstruction does not adversely affect your ability to have natural breast reconstruction using your own tissue. Many of our patients come with stories very similar to your own, some already having had over 10 surgeries, and almost all have subsequently achieved satisfactory, natural-feeling reconstructions without the use of implants.

I think there is an excellent chance that we can help you. If you wish, we can have our nurse Chris or P.A. Kim call you to discuss the specifics of your situation in more detail.

Dr. Richard Kline

Center for Natural Breast Reconstruction

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

5 Spas of Charleston to Visit Now

Who doesn’t love a nice pampering spa day? We’ve tried several spas in Charleston, and here are our top picks along with a snippet from their websites so you can get a feel for each one and its people. 

 

Urban Nirvana Day Spa 

In every culture, and in every age, doors have done more than facilitate our physical coming and going. They have also served as powerful symbols of protection and as valuable touchstones for all who seek a deeper sense of themselves and their world.

Doors extend a greeting to all who open themselves up to hear it: Come in, they say, come into a new place, to a new awareness, to a new you.

Urban Nirvana’s team is committed to providing expert, professional spa and salon services. Every team member is trained to listen to the guest, first and foremost. From the first phone call or visit to the end of a reinvigorating session, Urban Nirvana’s team of massage therapists, skin care therapists and client services personnel are focused on exceptional service, quality products and responsive treatments.

 

Simply Your Spa  

As you enter the spa, take a deep breath and begin to relax. Let us pamper you as we take care of the most important thing in your life…simply… you.

Our professional staff will exceed your expectations in customer service, experiences provided and professional knowledge. Whether you visit us one time for a special occasion, or receive frequent services for health and wellness, we will treat you like you deserve to be treated. We encourage you to stay as long as you like and relax in our spa lounge, sip on herbal tea and just take time for…you.

 

Moedim Day Spa

At Moedim Day Spa, we believe there’s a natural state of wellness and energy that we were all born to have and maintain. However, the way we think, eat, and live in this civilization can often be in direct conflict with optimum mental, physical, and spiritual health. There is a way to return to yourself well and more powerful than ever before.

Moedim Day Spa was created to be an oasis from the pace and stressors of your busy life – a place for your mind, body and spirit to rest, be healed and rejuvenated. Your mind is calmed and your energy replenished through a combination of modern and ancient techniques. Through the power of touch, herbal remedies, and naturally designed products, we miraculously see client after client be transformed closer to their natural state and return to themselves healed and energized.

 

Stella Nova

We invite you to unlock your senses, body, and spirit with any of our indulgent spa services. We offer a variety of treatments, but whichever you choose, all of our services are designed to rejuvenate, refresh, and relax.

Explore our spa services in each category and mix and match services to provide your perfect spa getaway, or feel free to choose from our spa packages. Whether your service is 15 minutes or as long as you choose, any visit to a Stella Nova spa will send you for a walk in the clouds.

 

Seeking Indigo

Our intention is to create an ever-evolving creative environment where transformation takes place for each individual that enters Seeking Indigo… A doorway to infinite possibility.

We provide a comprehensive holistic platform to support mind, body and spirit evolution through the products, services, and workshops that we offer.

Our mission is to spark and aid one’s awakening! Welcome to our world of wonder – a true playground for the soul. May all your dreams come true! Enjoy!

 

Which Charleston spa is your favorite? Let us know!

Join Us At the Komen Survivor Celebration!

pink directWe are so proud to sponsor the 2014 Survivor Celebration for Susan B. Komen Lowcountry. Please join us on Sunday, April 27 from 3-5 pm for food, fellowship and fun. We will share our stories, as well as honor those we have lost in the battle against cancer.

Check-in time is between 2-3 pm. For more details, visit the website. See you there!

Tram Reconstruction and Recurring Cancer in Breasts–How Should I Proceed?

This week, Dr. James Craigie of The Center for Natural Breast Reconstruction answers your questions.

Ask the DoctorQ: I had a mastectomy on my left breast with the tram–which partially failed–then Latisimis Dorsi surgery. I now have breast cancer in my right breast. What is the likelihood of decent symmetry and matching both breast shapes during this procedure?

A: I’m sorry to hear about your new diagnosis. In our practice, we have treated quite a few people referred to us with similar situations. We do not perform tram reconstruction but instead use the skin and fat of the lower tummy without taking the tummy muscle. If we have a patient that later develops a second breast cancer we would use skin and fat from either the upper buttock or the back of the upper thigh below the buttock. This can create a very good match for the tummy fat or a tram reconstruction. I would be glad to give you a more detailed answer with more specific information about your situation, let me know. I do think you most likely have good options without needing to give up any other important muscles. For more specific answers I will need to have my staff contact you for more details about your medical history.

Dr. James Craigie

Center for Natural Breast Reconstruction

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

Is It Possible to Have My Current Implants Enlarged?

IFThis week, Dr. Richard Kline of The Center for Natural Breast Reconstruction answers your questions.

Q: I had a breast augmentation surgery last year in August. I did NOT get a bad surgery, but I can tell the doctor didn’t listen to my wishes about size. Is it possible to have the implants I have now enlarged? Or would I have to have the surgery all over again with new implants? Thanks for your time!

A: If you have saline implants, it may be possible to enlarge them by putting more saline in, but it will void your implant warranty. Also, the more saline that is put in an implant, the firmer it gets, which is not how most people want breasts to feel.
If you have silicone gel implants, they cannot be enlarged, and new ones must be purchased to go larger.
Keep in mind that the larger you go with implants, the less natural your breasts will look. We talk to our augmentation patients extensively before surgery to try and determine what they want in their final result, but we also try to educate them about the relationship between size and naturalness.

Good luck, and thanks for your question!

Q: Hi! I had a breast reduction procedure when I was fourteen. I am 23 years old, and when my nipples get cold, I get a sharp pain in them and it hurts. What does this mean, and should I be concerned?

A: We don’t actually treat breast problems, we just reconstruct breasts that are damage or missing, so I’m not the best person to answer your question.The best person to consult with would be a general surgeon specializing in breast surgery. I’m not sure they’ll be able to help, but it’s worth a try.

Dr. Richard Kline

Center for Natural Breast Reconstruction

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

Unusual Facts about Charleston

We love living here in Charleston, partly because the history of the city is so fascinating. For example, did you know that Charleston has survived the Revolutionary War, the War of 1812, and the Civil War as well as pirates and hurricanes? All three wars had battles that took place in or near Charleston, and the city has survived to tell the tale.  

Read on for more fascinating, unusual, and fun facts about Charleston and South Carolina.

  The Isle of Palms is thought to be at least 25,000 years old and first inhabited by the Seewee Indians.

  • Four men from Charleston signed the Declaration of Independence: Thomas Heyward Jr., Thomas Lynch Jr., Arthur Middleton, and Edward Rutledge.
  • Charleston is known as “The Holy City” because of the number of churches.
  • South Carolina was the eighth state to join and the first state to secede from the U.S. It had to print its own stamps and money because it couldn’t participate in the federal postal system.
  • In 1736, the Dock Street Theater was America’s first. In 1773, the Charleston Museum, America’s first, opened.
  • The first golf game in the U.S. took place in Charleston.
  • The city’s baseball team, the Charleston Riverdogs, is partly owned by actor Bill Murray.
  • The Arthur J. Ravenel Jr. Bridge is North America’s longest cable bridge and connects Charleston with Mount Pleasant.
  • Charleston, which became a city in 1783, is about halfway between Washington, D.C. and Miami, Florida.
  • Citadel Cadets on Morris Island fired the first shot of the Civil War.
  • Some buildings in downtown Charleston have metal circles about the size of a plate on the exterior. They are the ends of earthquake rods, which were added to buildings after the Charleston earthquake of 1886.
  • South Carolina has two state mottoes: ‘Dum Spiro Spero’ (‘While I breathe I hope’) and ‘Animis Opibusque Parati (‘Ready in Soul and Resource’).
  • The Port of Charleston is the largest on the southeast Atlantic coast. Close to 10 million tons of cargo go through the port every year.
  • The first significant victory in the American Revolution was the Battle of Fort Sullivan.
  • Charleston’s first female newspaper publisher and editor was Elizabeth Timothy.
  • Sweetgrass basket making has taken place in the Mount Pleasant community for more than 300 years.
  • Historic Charleston homes and buildings have decks that face south or west to ensure a breeze in the summer, as air conditioning didn’t exist then.
  • On Nov. 2, 1954, Strom Thurmond became the first U.S. senator elected by write-in vote. Thurmond received 139,106 votes to Edgar Brown’s 80,956 votes.
  • When slaves were sold at the Old Exchange Building, they had to wear tags with their assigned number and skills.

Do you have a little-known fact about Charleston to share below?

How Exercise Keeps You Young

We’ve all heard that exercise keeps us young, but that’s often not enough to get us to start moving. We’ll look at one study that says yes, it’s true, and we’ll talk about reasons to exercise and how it keeps us from aging prematurely.

The study shows how exercise keeps us young at a cellular level and comes from WebMD:  

Reviewed by Elizabeth Klodas, MD, FACC

Dec. 1, 2009 — People who exercise regularly tend to stay healthier as they age, and now new research may explain why at a cellular level. Compared to people who did not exercise, elite runners in the study had cells that looked much younger under a microscope. 

Specifically, investigators measured the length of telomeres — the DNA on either end of thread-like chromosomes. Just as the plastic tips on the ends of shoelaces keep the laces from fraying, telomeres protect the chromosomes that carry genes during cell division. Each time a cell divides, telomeres get shorter. When telomeres get too short, cells can no longer divide and they die.

Researchers now believe telomere shortening is critical to aging, making people more vulnerable to diseases such as heart disease, diabetes, and cancer. Telomeres can be thought of as a biological clock,” lead researcher Ulrich Laufs, MD, of Homburg, Germany’s Saarland University tells WebMD. “If they are shorter than a critical length, the process of programmed cell death starts.”

In the human studies, middle-aged professional athletes who ran about 50 miles a week and had done so for many years had longer telomeres than healthy, age-matched non-athletes who did not exercise regularly. Not surprisingly, the athletes also had slower resting heart rates, lower blood pressures, and less body fat.

The study appears in the December 15 issue of the American Heart Association journal Circulation.  This is the first time it has been shown at the molecular level that exercising has an antiaging effect on the cardiovascular system,” Laufs says.

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Besides keeping telomeres long, what other anti-aging benefits does exercise have?

  •  When we exercise, we work our muscles, which keeps them healthy and prevents shrinkage and atrophy that commonly happens as we age. Muscles also help us burn more fat as we age, so it helps us keep our weight down.
  • Exercise promotes better sleep, which helps our bodies repair and rejuvenate.
  • Weight-bearing workouts increase bone mass, which prevents osteoporosis and falling in older people. One of the leading causes of nursing home admittance and death in the elderly is broken bones from falls, specifically broken hips.
  • Daily exercise helps prevent diabetes, which can cause blindness, neuropathy, limb amputation, and death.
  • Exercise improves circulation, giving us younger looking skin, lower blood pressure, less pain, and more energy.

What anti-aging effects have you noticed from exercise? Tell us below or on our Facebook page.

 

What Should I Do About My Post-Surgery Scar Neuromas?

1416012_gerber_daisy_isolatedThis week, Dr. Richard Kline of The Center for Natural Breast Reconstruction answers your questions.

Q: I have scar neuromas as a result of breast reduction surgery. I have been told it is not recommended to have a surgery to excise the neuromas by my pain specialist and breast surgeon. Would it make a big difference if a surgeon who specialized in peripheral nerve surgery did this type of surgery? Thanks for your help.

A: The problems with operating for pain in this situation are potentially several-fold. Firstly, it’s hard to know with certainty that a neuroma is the culprit, although a well-defined area of touch-tenderness is certainly suggestive. Secondly, the neuromas are often too small to be readily seen, so it’s hard to know if you’ve actually gotten it out. Finally, you could end up with another neuroma from the “hopefully corrective” surgery as easily as you got the first one.

I would definitely try for a few months with injections, etc. with your pain specialist. However, if that fails and your symptoms are bad enough, I don’t think it would be unreasonable to try excising the area one time, and seeing what happened.

 

Dr. Richard Kline

Center for Natural Breast Reconstruction

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

5 Buildings in Charleston with Fascinating Histories

The rich history of Charleston lives on today in some of its buildings, such as the Old Exchange and the Vendue. Read on to discover the fascinating history of these historic sites.

The Old Exchange & Provost Dungeon

During the 1700s, Charleston’s wealth grew as the shipping trade took off. As with anywhere that has a booming trade industry, the city needed somewhere to manage the trade, and the Royal Exchange and Custom House was built. The Exchange had a dual purpose: a business house / Post Office and a prison for pirates. It was also a meeting place for ratifying the Constitution. The Old Exchange is still owned by the Daughters of the American Revolution and offers public tours.

Boone Hall Plantation and Gardens

From the websiteBoone Hall Plantation was founded in 1681 when Englishman Major John Boone came to Charleston and established a lucrative plantation and gracious home on the banks of Wampacheone Creek. The family and descendants of Major Boone were influential in the history of South Carolina, the colonies and the nation.

The McRae Family purchased the plantation in 1955, and it was Mrs. McRae who furnished the house with antiques and began giving tours. Today, the McRae Family still owns the property, and they continue to make improvements to the plantation so that visitors can experience what plantation life was like.

The Vendue Hotel

Located in Charleston’s French Quarter, the Vendue was originally a warehouse used by French merchants engaged in the shipping trade, with all the interesting and sometimes out-of-bounds activity that entails. Sailors who needed a place to stay asked the owners of the warehouse to help them, and the first rooms were added to the warehouse.

During the Civil War, the original building was badly damaged and later rebuilt as a two-story brick building. Many well-known people, including the first female newspaper editor, Elizabeth Timothy, have stayed at the Vendue. 

Fort Sumter and Fort Moultrie

From the websiteFort Sumter National Monument incorporates several sites around Charleston Harbor, which tell the unique stories of the people and places that shaped the United States of America. 

Confederate forces fired the first shots of the Civil War upon Federal troops at Fort Sumter at 4:30 a.m. on April 12, 1861. The roots of that conflict are buried deep within the stories of the development of the United States. Fort Sumter would continue to serve as the focal point in Charleston throughout the Civil War.

Sullivan’s Island has long served as Charleston Harbor’s first line of defense against disease or foreign invasion. Quarantine stations checked every person that came into the harbor, including enslaved Africans. Later a palmetto log fort was built by Colonel Moultrie and the Second South Carolina Infantry. This fort came to be known as Fort Moultrie, and was replaced and modified as technology and warfare changed through the mid-twentieth century.

The Fort Sumter Visitor Education Center at Liberty Square sits on the site of Gadsden’s Wharf, where hundreds of thousands of enslaved Africans were brought into the United States. Today the site interprets the causes and catalysts of the Civil War and the results of that war on the nation.

What is your favorite Charleston building and why? Tell us below.

 

 

How to Take Care of Your Décolletage Area

What is the décolletage area? We’ve all heard the word, but what, exactly, does it mean? The commonly accepted definition is the area from the chin to the upper chest, including the neck and shoulders. While the area truly shows our feminine side, it also tends to show our age quickly and requires special care, ideally starting in our 20s.

We all want to keep our décolletage youthful, so here are a few tips to take care of it properly.

Be gentle.

When in the shower or bath, gently wash with a mild soap and water. There is no need to scrub away or use a harsh cleanser on your décolletage. The skin on the neck and upper chest is thinner and less resilient than the skin on other parts of our bodies. Be careful that shower water isn’t too hot, as it can strip the natural oils from the skin.

 

Anything that you use to treat your face, such as a warm mask or a paraffin treatment, will benefit your décolletage too, so make your products do double duty. Don’t forget to exfoliate with a soothing, mild product that won’t scratch the skin.

Moisturize frequently.

This area also has fewer oil glands than skin elsewhere on our bodies, so moisturizing often is necessary. Use a moisturizer with some staying power, such as a body oil or body butter. Products specially formulated for the décolletage area can be expensive, and regular, high-quality emollients are all you need.

Watch the sun.

The easiest way to damage your décolletage is to let it sunburn a few times. That’s easy to do, as we tend to forget to put sunscreen on the area. Remember to cover it or use sunscreen every time you go out.

Feed and hydrate it properly.

If you don’t stay well nourished, your décolletage will show it—the skin will become dry, wrinkled, and pale. Be sure you get plenty of good fats from avocados, fish, and nuts to keep the skin supple and moist. Eat fruits and veggies for their vitamins, minerals, and phytonutrients. Water is a must for beautiful décolletage also.

Carry yourself properly.

Poor posture can cause the skin on your décolletage to droop or sag, and if you lie on your stomach or side while sleeping, you can create sleep wrinkles in your neck and chest skin. Stand up straight, with shoulders back and chin up. Lie on your back to avoid those wrinkles… and moisturize every night before bed, just in case.

See a dermatologist if necessary.

If you notice that your décolletage area is showing signs of age, see a doctor. He or she can prescribe special anti-aging creams or offer other alternatives to halt or reverse the signs of aging. Often, creams containing vitamin A and fruit acids are given, which have been shown to improve appearance.

What are your best tips for caring for the décolletage area? Share them with us here or on our Facebook page