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DIEP Flap Reconstruction Surgery After Capsular Contracture

January 18, 2013 by

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

Does anybody have any idea what the difference is “surgically” when DIEP surgery involves removing an implant that has developed a capsular contracture? That is what my situation is. I’m wondering if the skin that has been stretched over the implant will be removed, or become part of the new flap?

Thirty percent of our patients have previous implant surgery that has failed. During the reconstruction we remove the implant, implant capsule and any Alloderm that may have been used.   We also must return the chest muscle to its natural position because the implant always goes under the muscle. Unfortunately the muscle may be permanently changed from implant surgery. The stretched skin over the implant is allowed to recover and usually not removed.  If the skin initially needed to be stretched by the implant/expander then that indicates breast skin has been removed during the mastectomies. Usually skin from the DIEP will be needed depending on previous radiation and size of the DIEP breast. If the remaining breast skin is thin, tight, too scarred or damaged by radiation we may need to remove more of it at another surgical stage.

-James Craigie

Center for Natural Breast Reconstruction

Have questions for our surgeons? Submit your questions today and get answers straight from our surgical team! No matter where you are in your reconstruction process, we are here to help!

 

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Charleston’s Theatre Scene

January 16, 2013 by

Over the past few years, the Holy City has seen a renaissance in performing arts, with each of Charleston’s theatre companies contributing their unique voices to the city.From improv comedy to Shakespearian drama, the talent that abounds Charleston is a delight for every theatergoer.

New to the scene? Get acquainted with our favorite Low country theatre companies here:

Charleston Stage Company: Founded by playwright Julian Wiles in 1978, the Charleston Stageis South Carolina’s largest professional theatre company in residence at the Historic Dock Street Theatre. Charleston Stage provides a full season of plays, musicals, and theatre-for-youth productions. Be sure to explore the upcoming plays for the whole family to enjoy!

The Black Fedora Comedy Mystery Theatre: Leisurely browse the mystery shoppe, but kill no time ordering tickets as this cozy comedy theatre sells out quickly! Featuring Inspector No Clue’s Murder Mystery, the ghostly Charleston History Mystery, and the family-oriented Pirate Mystery Treasure Show, there’s a performance for everyone’s tastes.

Theater 99: For some off-the-cuff laughs, check out Theater 99, Charleston’s home for improv comedy. No scripts—just improve, all the time! As Charleston’s only professional improv theatre, each show guarantees high-energy laughs fueled by audience suggestion. No two shows are ever the same!

Brad and Jennifer Moranz Present: Bringing their Broadway experience to Charleston, Brad and Jennifer Moranz create spectacular musical variety shows for the whole family presented throughout the year. Browse their upcoming events for tickets to a performance you’ll never forget!

Charleston Youth Company : Join the Charleston Youth Company as they present their Winter Spectacular at the Sottile Theatre February 1 and 2. Show tickets can be purchased at the Sottile Theatre box office on the evening of the show, by calling the rehearsal studio at  843-766-4007 , or from any CYC cast member.

Charleston County School of the Arts:   Charleston County School of Performing Arts presents the classic, Hairspray January 21-February 2 at the Rose Maree Myers Theatre for the Performing Arts.  For more information and to purchase tickets please visit their website.

Have you had the chance to catch one of these companies’ performances? Tell us about your experience in the comments below!

 

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8 Tips to Instantly Boost Your Energy

January 14, 2013 by

Are you feeling lethargic and fatigued before it’s even lunch time? Do you notice yourself daydreaming more and more about a mid-afternoon nap?

If you’re searching for ways to feel more energized throughout the day, look no further than these 8 tips. In no time, you’ll be amazed at how bright-eyed you feel!

  • Embrace the midday yawns: Turns out, yawning is your body’s way of cooling down the brain, which helps wake it up. So enjoy your workday yawns, and recharge your brain naturally!
  • Take a 10-minute walk:You’ll feel revved up a whole two hours afterward, and it’s good for your heart.
  • Have a good laugh: Laughing raises your blood pressure and boosts your heart rate, too, which can pump you up when you’re feeling lackluster.
  • Start seeing red: According to research from the University of Rochester, spotting the color red makes your muscles move faster and work harder, giving you a burst of energy when you need it most. Keep crimson flowers in your sight line to pep up a jam-packed day.
  • Sprinkle on the energy: Forget the espresso shots that can make you crash after a few hours.Instead, get your energy from chia seeds. They’re packed with a revitalizing combo of B vitamins, fiber, and protein, so they pick you naturally. Simply stir them into your morning bowl of oatmeal and enjoy!
  • Take time for an invigorating stretch:Stretching warms up your muscles and gets your blood moving, both of which will make you feel more alert. Raise your arms above your head, and then touch your toes. Stand up, and spread your arms out, pushing your chest forward. Hold each pose for 30 seconds.
  • Hit the gym: Before you head to work in the morning, consider carving out a little time to get in some exercise. Most women feel energized the rest of the day after a good workout.
  • Eat nutritious food: Load up on healthy foods throughout the day—especially foods containing omega-3 fatty acids, which improve mood and brain function. Try incorporating a little more salmon or avocados into your diet, and start reaping the benefits of in your workday.

What are some ways you fight fatigue during the day?

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Are You Comparing Apples to Apples When Weighing Your Breast Reconstruction Options?

January 11, 2013 by

We at The Center for Natural Breast Reconstruction know that the Internet is a great place to read and share information, but it is also a great place to become misinformed. Before making any decisions about your breast health, please make sure to contact a surgeon to discuss all your options and make the most informed decision you can. Keeping with the spirit of the Internet as a research tool, today’s Ask The Doctor Question comes from a discussion forum we participated in on WebMD.com. The answer highlighted below in pink comes from our team and showcases the importance of making sure you really are comparing apples to apples when weighing your breast reconstruction options.

Q: Has anyone had a hard time with breast reconstruction after bilateral mastectomy? I had two infections in my right expander, 2 and 3 months after my surgery. The first we conquered with antibiotics; the 2nd we did not, and I had to have it removed 4 months later. I spent the last 5 months healing from that, and just last week had the expander replaced. Hoping for the best this time! But there is significant skin loss on my right side, and my surgeon wonders if there will be enough stretch to accommodate saline fills to match my other side. And of course we all wonder if THIS expander will behave itself and not get infected. Has anyone had this experience, or one similar? Thanks.

A: Why don’t you go with the DIEP Flap procedure – they use the fat and skin from your abdomen area – I have had no problems from this procedure and I have heard of a couple of people who have had issues with infection with the expanders. Find yourself a Plastic Surgeon who does the DIEP Flap procedure

A: I also had a bilateral mastectomy but had to wait 2 years before reconstruction. I also had the expanders but had no problems, maybe it was too soon after your surgery. I would not recommend a tram flap ,it just sounds like an awful surgery.

A: There is a difference between and DIEP Flap and a trans flap.
The DIEP Flap they only take the fat and skin from your abdomen nothing else – they find a good blood supply at the reconstruction site. The Trans Flap is they take your stomach muscle and pull it up through to the breast cavity and also bring the fat and skin from the abdomen area. I for sure was glad that I did not do the Trans Flap.

A: (The Center For Natural Breast Reconstruction’s Answer) The free TRAM flap sacrifices a portion of the transrectus abdominus muscle (hence the acronym TRAM) but doesn’t tunnel it up through the abdomen. The DIEP flap does not use any of that muscle to transfer the blood supply to the reconstruction site. A skilled micro-surgeon with fellowship training in muscle sparing free flap reconstruction provides a permanent reconstruction option with a successful DIEP without sacrificing needed abdominal musculature. There is A LOT of great information on the web about this and what questions you should ask to make sure you are choosing a microsurgical team who has the experience and at least a 98% success rate. Talk to ladies who have had DIEP, GAP, HIP, SIEA flaps ( but not TRAM, it’s not the same) and see what kind of downtime they have had, you’ll probably find it similar to the amount you have had with the repeated implant/expander problems. Best wishes on your research and recovery.

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

 

 

 

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5 Most Scenic Places in Charleston

January 9, 2013 by

There are many places in Charleston that steal our breath away, but perhaps none more so than the parks, beaches, and historic sites that abound in the city. Regardless of the time of year, a trip to The Battery or a seaside meal on Sullivan’s Island can make any day memorable.

If you’re craving a peaceful day in Charleston’s open air, check out these scenic venues for your next outing:

Image Above Taken From: www.sciway.com

  • The Battery: Famous for its’ stately antebellum homes, The Battery is a landmark defensive seawall and promenade in Charleston. It stretches along the lower shores of the Charleston peninsula, bordered by the Ashley and Cooper Rivers, which meet here to form Charleston harbor. Visible from the Cooper River side and the point, is Fort Sumter, Castle Pinckney, the World War II aircraft carrier USS Yorktown (CV-10), and Sullivan’s Island. Take a pleasant stroll along the promenade, and you can almost feel the centuries of history that resonate throughout the peninsula.
  • Waterfront Park: Along the Cooper River, you’ll find Waterfront Park, which received the 2007 Landmark Award from the American Society of Landscape Architects and the National Trust for Historic Preservation. This award “recognizes a distinguished landscape architecture project completed between 15 and 50 years ago that retains its original design integrity and contributes significantly to the public realm of the community in which it is located.” Enjoy a relaxing walk along the pier, and be sure to check out the incredible pineapple water fountain!
  • Sullivan’s Island: If you’re looking for a seaside venue, you’ve come to the right place. Sullivan’s Island is one of the most relaxing and family-friendly beaches on South Carolina’s coast. Year-round, visitors enjoy the island’s tranquil beaches, seaside neighborhoods, and waterfront dining venues.

Charles Towne Landing State Historic Site: On a marshy point off of the Ashley River, you’ll find Charles Towne Landing State Historic Site. This is the very place where a group of English settlers landed in 1670 and established what would become the birthplace of the Carolinas colony. Charles Towne Landing depicts life in Colonial Charleston through interpretive rangers in 17th century dress, a self-guided history trail with an audio tour, and in the interactive museum in the Visitors Center. Take the whole family and tour the Adventure, Charleston’s only 17th-century replica sailing ship. You can also see cannons fired or take a peek at otters, bears, and bison at the Animal Forest natural habitat zoo. If you prefer a more low-key day, the grounds include 80 acres of gardens, with an elegant live oak alley—the perfect place to be alone with your thoughts.

Where do you go in Charleston for a scenic stroll?

Filed Under: All Things Charleston Tagged With: , , , , ,

How to Keep a New Year’s Resolution

January 7, 2013 by

It’s hardly surprising how quickly most of us tend to break our New Year’s resolutions (some before the end of January!). Yet each year, we take the time to reflect on our aspirations and set goals to improve our lives, even though less than 12% of resolution-makers succeed.

So what’s the secret to actually seeing these goals through?

If you really want to see results this year, it’s critical that you set your goals with sincerity, and concentrate on the intention of your resolutions. Read on to discover 5 ways to create attainable resolutions—and keeping them:

1. Be specific. A common mistake people make is setting ambiguous goals like, “I’ll lose weight.” Instead, make your resolution specific, with a tangible, achievable outcome. Determine how much weight you want to lose and what diet or exercise regime you will begin. Ask yourself, why do you want to lose weight, and what will you do once you reach your goal? Remember to visualize the good that will come when your desires are met.

2. Put it in writing. Write down your goals and outline the small, manageable steps you’ll take in order to achieve them. When you set a big goal, like learning how to silversmith, it can be overwhelming and frustrating if you don’t have a plan that lays out smaller steps toward achieving the larger goal. Plan ahead and focus on accomplishing one small thing at a time to keep yourself on track and optimistic.

3. Give yourself enough time. Be sure to set aside ample time for yourself to achieve your goals. If you want to exercise more, plot out time in your weekly schedule for runs and time at the gym. Additionally, you’ll want to make time to track your progress, either with monthly measurements, heart rate monitoring, or weigh-ins.

4. Find a partner. Having someone to keep you accountable is one of the key ingredients to changing your life. Try finding a friend who has a similar resolution, and check in with each other every week to talk about your progress and challenges. Or, ask a family member or significant other to keep you accountable—just make sure they’re supportive and encouraging. You can also seek professional assistance, such as a personal trainer to help you meet your fitness goals, or a tutor to help you finally learn French.

5. Take a deep breath. When you’re stressed or overwhelmed, it’s easy to get off track from your goals. Spend time every day collecting your thoughts and getting centered. You may try a breathing exercise, a scenic stroll, or even a little yoga. Be sure to push away self-sabotaging thoughts, such as: “I’m not good enough” or “I can’t do it.” The truth is, you can do it, but you have to fully channel all your intentions into achieving what you want.

What are your resolutions for 2013?

 

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What to Know Before Seeking Implants as Your Breast Reconstruction Option

January 4, 2013 by

The below question is answered by Dr. Richard M. Kline of The Center for Natural Breast Reconstruction.

I am weighing my options for breast reconstructions and  considering silicone implants. What should I know before I continue—what questions should I ask a doctor?

Silicone or saline implants, while generally very safe from a medical perspective, are still subject to some complications. The most common problem is that either type implant can develop a hard capsule of scar tissue around it (capsular contracture), which is sometimes painful, and makes the breast mound hard (and often unattractive). Generally speaking, the thicker and more normal the soft tissue covering around them, the better result implants tend to give when used for reconstruction. The presence of radiation injury greatly decreases the chances of success when using either silicone or saline implants for breast reconstruction, and flaps may be a better alternative in that case.

-Dr. Richard M. Kline Jr.

The Center for Natural Breast Reconstruction.

Have questions for our surgeons? Submit your questions today and get answers straight from our surgical team! No matter where you are in your reconstruction process, we are here to help!

 

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Charleston’s Best Wine Bars

January 2, 2013 by

Looking for a sophisticated night on the town in beautiful Charleston? Perhaps you hear a Bordeaux calling your name from a low-lit atmosphere where jazz lilts through the air.

No matter if you prefer a glass of red or white, these wine bars are sure to transport you into a mood of utter relaxation with their unforgettable wines:

  • Social Wine Bar: Since its opening in 2007, Social Wine Bar has received much acclaim, including four stars from the Post & Courier and “Best Wine Selection,” “Best Happy Hour,” and “Best Upscale Bar” by the City Paper. Social Wine Bar supports small, artisinal producers whose prime concern is making the best possible wines and who utilize sustainable methods. If you’re looking to experience a glass of an “old world” wine, rest assured, you’ve come to the right place!
  • Bin 152: Bin 152 is a wine bar, cheese bar, art gallery, and antiques market. Located in the heart of downtown Charleston in the French Quarter, this wine bar offers 30 different wines by the glass and over 100 wines by the bottle. They also offer 35 different cheeses and charcuterie all served a la carte with their freshly baked bread.
  • Cypress: Looking for a world-class meal to go with your wine? Cypress sources ingredients from the Lowcountry’s finest farmers and fishermen, and Chef Craig Deihl serves a dynamic seasonal menu featuring the regional fare. The menu is complemented by an expansive wine list featuring over 4,500 bottles from well known vineyards to small, private vineyards from around the world.
  • Gaslight Art and Wine: Gaslight Art and Wine is an upscale, unique bar situated between Historic Charleston and the Sanctuary Resort at Kiawah Island. The Gaslight is the perfect stop for any wine, art, and animal lover visiting the Charleston area. Once you walk into this elegantly casual bar, you’ll quickly feel the classic speakeasy vibe. Not only are the wine and atmosphere exceptional, but this bar is also pet-friendly. Bring your pampered pooch on by and enjoy a glass of Lost Dog Wines. A portion of the proceeds help many local pet rescue organizations.

Which of these fabulous Charleston wine bars are you most excited to visit this year?

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10 Easy Health Tips to Start the New Year Right

December 31, 2012 by

With 2013 right around the corner, it’s time to gear up for a year full of optimism and good health!

If you’ve been waiting to write your resolutions until last minute, consider incorporating any—or all—of these health tips into your plan for a shining new year:

1. Drink more water. Many of us may not even realize that we go through our entire day dehydrated. If you feel tired often, take a look at what you’re drinking during the day—dehydration is known to cause fatigue and muscle cramps. This coming year, make the resolution to drink more water. After all, it’s calorie-free and readily available.

2. Cut down on caffeine. Caffeine is fine for an early morning boost, but if you need a cup of joe, tea, or soda just to get your through the day, you’re training your body for dependence. In addition, too much caffeine can disrupt your sleep and lead to dehydration, so consider replacing one caffeinated beverage each day with a healthier alternative, such as water.

3. Get more beauty sleep. Make 2013 the year of feeling bright-eyed and busy-tailed by getting more sleep at night. A number of experts agree that we need seven to nine hours of sleep each night to feel adequately rested.

4. Celebrate in moderation. If you want to live a healthier lifestyle in the New Year, choose to celebrate in moderation and reduce your alcohol consumption.  Not only will you help keep your liver happy, but you’ll also avoid extra calories. Try to limit your intake to no more than one drink of alcohol per day (1 drink = 12oz. of beer, 5oz. of wine or 1.5 oz. of liquor).

5. Quit smoking. We’ve written extensively about how smoking can increase your risk of breast cancer and generally wreak havoc on your health. But a new year is as good a reason as any to finally kick the habit for good. If you need help, click here to read more about tobacco quitlines.

6. Walk more. Walking is a great and easy form of exercise. Not only does it burn calories, but it helps build muscle as well. It’s also low impact and most people can do it comfortably and effortlessly. If you’re looking to improve your health in the New Year, you don’t have to walk much; only 30 minutes a day at a brisk pace will dramatically improve cardiovascular health and help maintain a healthy weight.

7. Lift weights. Make the resolution to build your body’s strength this year with moderate weight training. Not only will you help protect your bones, but you’ll also prevent the muscle loss that occurs with aging. Try lifting weights or doing resistance exercises for 20 minutes 2 to 3 times per week to keep your body healthy and active.

8. Focus on eating in moderation. Forget the diets that pervade most people’s new year. If you deprive yourself too much and remain hungry all day, you’re more likely to overindulge, particularly in the evening. Focus on moderate eating by enjoying healthy, mini-meals every few hours to keep your energy up throughout the day.

9. Cut back on the sweets. Last year, nearly 2 million people were diagnosed with diabetes. Eating too much sugar or carbohydrates floods the body with insulin in response to the spike in blood sugar. In turn, this can lead to a condition called “insulin resistance.” Over time, insulin resistance may develop into type 2 diabetes. In 2013, do your body a huge favor by cutting back the sweets and increasing fiber to prevent insulin resistance and diabetes.

10. Take vitamins. Ask your doctor what nutrients you may be missing and how you may benefit from nutritional supplements. For example, if you’re a vegetarian, it’s important to make sure you get plenty of vitamin B12. You may find a daily multivitamin can help fill in the nutritional gaps within your diet.

What are your New Year’s resolutions for 2013? Share your aspirations in the comments section below!

 

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What Would Disqualify a Patient for Breast Reconstruction?

December 28, 2012 by

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

What are some circumstances that may disqualify a patient for breast reconstruction?

Any serious medical conditions which would prevent a patient from tolerating 4-8 hours of general anesthesia would prevent her from having flap reconstruction. Some medical conditions, such as diabetes, increase various risks (in particular, risks of wound healing problems), but do not disqualify the patient from having reconstruction. We do not perform reconstruction on patients who are currently cigarette smokers (or use nicotine in any form) because nicotine’s effects on wound healing after flap surgery is frequently catastrophic. However, most patients will clear all nicotine form their system after a month’s abstinence. Some very slender patients do not have enough donor tissue anywhere on their bodies for flap reconstruction, but this is quite uncommon.

Have a question about breast reconstruction question you’d like answered? Just ask us!

 

 

 

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