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Ask The Doctor-Would I Qualify for Further Reconstruction?

April 1, 2016 by

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

Question: Husband is retired Navy so we have Tricare. I’ve already had unilateral reconstruction with silicone implant. However, it is about 1/2 the size of real breast and scar tissue is drawing it up. I don’t want to go back to my surgeon since he left it that way. His option was to chop the real breast down to match the small implant. I said “No” and never heard from him again. No final tattoo was offered either.

My question is would I still qualify for further reconstruction? I’d be interested in having the implant removed and the DEIP procedure. Also, I have plenty of fat to offer but are there restrictions on how fat is too fat?

Answer: Thank you for your question. I’m sorry things did not work out the way you wanted with your implant. It is possible to have your implant removed and replace it with your own fatty tissue. The DIEP may be a good option for you especially since you feel like you have extra fatty tissue in your tummy area. Also if your implant does not match your other breast then your own tissue would likely be a more natural match.

The restrictions have more to do with your overall health and your weight. If someone is too overweight then we would discuss losing weight before surgery to lower the risk of complications. In general if your weight is equal to or over 200lbs then we need to specifically evaluate your situation in detail. I would be glad to have our staff contact you for that information or set up a time that we could talk over the phone. If you would like to come for a consult that would be possible too. Just let us know if you would like more information.

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

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Ask The Doctor-Can You Do a Fat Transfer Without Muscle Movement?

March 25, 2016 by

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

Question: I am 57 years old and a 10 year BC survivor. I had bilateral mastectomy in 06 followed up with expander and implants. I am tired of the painful implants and want reconstruction with fat transfer. I would like to have transfer alone without muscle movement. Do any of your Doctors do this procedure?

Answer: Thank you for your question. I am sorry to hear that you are having problems with your implant breast reconstruction. We specialize in breast reconstruction using your own natural fatty tissue without sacrificing your important muscles. When patients are having implant type problems we can offer them an option that includes replacing their implants with their own fatty tissue and repairing the chest muscle that is now bothering you.

Since 2002 our practice has helped many women with problems similar to what you describe. I would be glad to give you more information about your specific situation. Let me know I could have my staff contact you for more specifics and set up a time we could talk over the phone. Just let me know what is most convenient for you.

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

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Ask The Doctor-What are Some Options After Bilateral Mastectomies?

March 18, 2016 by

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

Question: I had bi-lat mast in 2011…no attempt at reconstruction. My age is now 69. Do I have options other than implants of the ‘flap’ procedure? Fat transfer? Thanks you for your attention to this question.

Answer: Thank you for your question. Since you have had bilateral mastectomies you have multiple options for breast reconstruction. The options are independent of your age and if you are healthy then you can have breast reconstruction. Your possible options include: implants or your own tissue.

Results with implants may not be as natural and if you have had radiation then maybe implants would not be a good option. Also results with implants require more revisions. Using your own tissue without sacrificing your muscles is another option that does not include implants.

A flap procedure using your own fatty tissue usually requires two main procedures possibly three but then the results are permanent. Fat transfer or fat grafting is a possible option but that requires 4- 5 procedures. Please let me know if you need more information.

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

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Ask The Doctor-Am I a Candidate for the DIEP procedure?

March 11, 2016 by

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

Question: I am interested in the DIEP procedure after my mastectomy 2+ years ago, but wonder if I am a candidate. Would you accept pictures to review, before I would invest in a trip of that distance?

Answer: Thank you for your question. If you are healthy and recovered well from your mastectomies then chances are you could safely have breast reconstruction using your own natural fatty tissue. If you feel that you have extra tummy tissue and would benefit from a tummy tuck approach then the DIEP could be a very good option. The DIEP procedure uses the fatty tissue and skin of the lower tummy. We specialize in breast reconstruction using natural fatty tissue. If a patient does not have enough tummy fat, has already had a tummy tuck or if previous surgery makes the tummy unavailable, then we can still use another area of the body to get natural tissue for breast reconstruction.

We frequently evaluate patients from out of town by looking at photos and getting the important information from them. I can definitely let you know what option would be best for you without having to see you in person. If you want to come for a consult that would be great but we understand that may not be feasible when traveling from a distance.

When patients do travel from out of town we make arrangements in advance and if they are having surgery then I see them in person the day before surgery. I would be glad to have my office staff contact you to let you know how to do the photos. Just let me know. Thanks again for your interest.

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

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Ask The Doctor-Which is the best procedure for a natural looking breast?

March 4, 2016 by

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

Question:  A week ago I was diagnosed with invasive Mammary Carcinoma with Ductal & Lobular features, Intermediate and stage1. Since I have had a Lumpectomy and radiation 10yrs ago on same breast they said I would have to have a mastectomy. They have suggested I have the TRAM flap done.

I have been reading on your site about TRAM versus DIEP flap. I would really like I think to have the DIEP flap but not sure if the Plastic Surgeon that my Dr. uses does this. I’m really concerned and want the best results for a natural looking breast. He will have to later when recovered put a nipple on. Tell me your suggestions. Thank you.

Answer:  Thank you for your question. I’m sorry to hear that you need to have a mastectomy. I’m glad to hear it was detected early and is Stage 1.  Have they talked to you about needing chemotherapy? You have done some good research regarding breast reconstruction. Since you have had previous radiation then breast reconstruction using your own fatty tissue would give you the chance for the most natural result following your mastectomy.

The TRAM procedure uses your own fatty tissue from the tummy but unfortunately it sacrifices your tummy wall muscle in the process. The DIEP is another way to use your own natural tummy fatty tissue and does not sacrifice your tummy muscle. You don’t need muscle to rebuild your breast.  You do need your tummy wall muscle located where it naturally is.  After a TRAM, patients can have problems related to removing the muscle. Therefore you should request a plastic surgeon who has experience with the DIEP procedure to see you in advance of your mastectomy. If there are none in your area then you may have the option to travel to a practice that does specialize in the DIEP procedure.

In our practice we have had patients from almost every state in the U.S travel to us because of our expertise in breast reconstruction using natural fatty tissue. It is not easy to travel for surgery but unfortunately for this specialized type of procedure it is sometimes necessary. If you need more information about how that works or the things we can do to help our traveling patients just let me know.

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

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Ask The Doctor-Does Medicare Cover the Cost of Surgery?

February 26, 2016 by

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

Question: I had breast surgery in 2014- one breast removed but the Dr. left enough flesh to reconstruct. I hate surgery and afraid of the length first of all. Second, I have heard there are SEVERAL operations and most of all does Medicare cover the cost. I pay for the best you can get and I am 66 yr old. Thanks.

Answer: Thanks for your question. You are correct that breast reconstruction does require more than one surgery. Depending on several factors such as what technique is used the surgery can also take a long time. Using your own tissue to remake a natural permanent new breast is what we specialize in but we also use implants if our patients choose that option.

Medicare does cover breast reconstruction but no matter how much you are willing to pay for the expertise Medicare will only pay the surgeons a set, very low fee. Fortunately that’s ok because we are physicians and our mission is to provide the best for all our patients. At this time we do accept Medicare and will as long as we can continue to fulfill our mission. Please let us know if you have any other specific questions.

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

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Ask The Doctor-Will My Wife Have Her Reconstruction Along With Her Double Mastectomy?

February 19, 2016 by

 

 

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

Question:  My wife is currently taking chemo for breast cancer and will be done in March. Then she will have a double mastectomy.  Will she have her reconstruction at the same time or will she have to wait until after radiation. We are hoping for it to all be done at one time. What is the best recommendation? We are look for her best options and best doctors we live in North Carolina. Thanks.

Answer:  The questions you have are very good questions but I feel they should be directed to her breast doctors (surgeon, oncologists). As a plastic surgeon I rebuild the breasts after the mastectomy and do not perform the cancer surgery or other treatments.

Because my expertise is in breast reconstruction I work closely with the breast surgeons and oncologists in the treatment of my patients but defer the questions about the cancer treatments to them. In general the treatment of breast cancer requires removing the cancer from the body and breast (mastectomy) and the chemotherapy and hormonal manipulation addresses the possible spread of cancer from the breast to elsewhere.

The radiation is used to help treat the breast after the cancer has been removed and is necessary to keep the cancer from returning in the breast after surgery has been performed to remove the cancer. Chemo therapy and hormone treatment/blocking can shrink breast cancer but in my non expert knowledge the chemo cannot completely treat the cancer without it being removed with surgery. I hope I have helped point you in the right direction to get your questions answered.

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

 

 

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Ask the Doctor- Are My Symptoms From My Saline Implants?

February 12, 2016 by

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

Question: Hello I am from NY and am having a very difficult time and I believe it is from my Saline Implants. I came across your site and am hoping you can advise. Since my implants in 1998, I’ve had severe hives, and now chronic eczema. Over the last 2 years I’ve had severe skin rashes, non-stop and an elevated white blood count for approx 15 years. I have always felt sick etc. Dr’s are not sure why, and chalk up to allergies etc.

I believe I am having low grade infection and sensitive to the implant and the chemicals attached to the silicone shell. I cannot find a Dr who is experienced with an explanation with an En Bloc in my area (I live far from city etc) My question is, is there any symptoms or literature that you know of that could correlate with what I am experiencing. Or is there any test to pinpoint that it could be from a mold or bacterial infection coming from implant.

I do not have any fevers…just feeling generally unwell, high IGE count, and ALWAYS elevated WBC. I am desperate for any help. Thank you.

Answer:  I’m sorry you are having problems. If your symptoms began when your implants were placed the best option may be to have your implants removed. If you begin to feel better then you know. Taking your implants out doesn’t mean you couldn’t have them placed again later if your problems are found to not be related.

Many women need to have their implants removed and are pleasantly surprised that their breasts look better than they thought after the implants are removed. Thanks for your question.

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

 

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Ask The Doctor- Can a diabetic have reconstructive surgery?

February 5, 2016 by

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

Question: Can a diabetic have reconstructive surgery?

Answer: Thank you for your question. Yes, a diabetic can have breast reconstruction. They need to have their blood sugars well controlled and not be too overweight. If there are no other medical problems to address, then diabetics can have breast reconstruction.

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

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Ask The Doctor- What are the chances of new cancer in my right breast?

January 29, 2016 by

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

Question: In 2007, I was diagnosed with stage 3 metaplastic breast cancer that had not spread to the lymph nodes. I had a lumpectomy followed by 5 different chemotherapys and a month of radiation. In 2011, I had a very small {encapsulated} ductal cancer, followed by a double mastectomy and reconstructive surgery. The cancer was in the left breast both times. I have just discovered a lump about the size of a quarter in my right breast.

Answer: Since you have had a right mastectomy and reconstruction the chances for a new cancer in that breast are low. However, you should have your breast surgeon examine you right away to rule that out. Since you had reconstruction, the lump could also be scar from the surgery but you should definitely let your breast surgeon and plastic surgeon check it out soon.

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

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