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

Question: I had a left mastectomy in 2010 and was thinking about different options for breast reconstruction! I want something that I get done one time and don’t have to keep coming back for different procedures.

Answer: Thanks for your great question. Breast reconstruction can be performed using different techniques. Each approach has its advantages and disadvantages. Also each person’s situation is different and factors related to whether the reconstruction is started at the time of mastectomy or later may play a part in determining what technique is best for each person.

Unfortunately, there is no one option that can routinely be performed in only one surgery. In general, breast reconstruction with your own natural tissue (fatty tissue and skin) gives results that when complete are more likely permanent and as time goes by tend to get more natural and don’t deteriorate. Reconstruction with implants may require less time to recover but as time goes by the results tend to deteriorate and more often require revisions from year to year. Unfortunately, both approaches may require (almost always) more than one step. If you have had radiation, then using your own tissue is usually the best option. Therefore if you are looking for a permanent result that does not need to be redone later, then using your own tissue without sacrificing important muscles may be a good option for you. Let me know if you have more questions.

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

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

Question: Hello, I am a Inflammatory Breast Cancer survivor. I live in Georgia, but I had all treatment and mastectomy atMD Anderson in Houston, TX. My doctors tell me I am ready to have reconstruction. They emphasized that the doctor I choose be experienced in reconstruction after radiation. I would like to know your experience in reconstruction after radiation. I had mastectomy July 10, 2014 and 36 rounds of radiation, some twice a day. Thank you.

Answer: I am glad to hear that you have completed your treatments and are ready to proceed with your reconstruction. First, I would suggest that you consider breast reconstruction options that avoid implants. Implants after mastectomy and radiation are not likely to be a good long term result in general under those circumstances.

Second, using your own tissue (fatty tissue from another area of your body) without sacrificing your body’s important muscles would be my recommendation in general under the circumstances you mentioned. Our practice has specialized in breast reconstruction using your body’s own tissue without sacrificing the  important muscles since 2002.

We frequently treat people who have had radiation prior to their breast reconstruction. I am aware of MD Andersons extensive research regarding inflammatory breast cancer and I agree with their recommendations in general regarding the care of patients who have had inflammatory breast cancer. If you would like more information please let me know. My staff or I could contact you for more specific information. Thanks for your question!

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

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

Question: I had mastectomy & silicone implants in late ’92. I was never happy with them. My concern is the years I’ve had my implants, and I won’t go back to my plastic surgeon who did them. Should I have any concerns about their age? I do have other issues with the appearance. Thank you in advance.

Answer: In general, implants don’t need to be replaced after any certain time following surgery. As time goes by, there is a chance that the implants could leak. In that situation, they would likely change by getting more firm. If the implants are not causing problems, there is probably nothing wrong. If you are unhappy with the results, then you should have a plastic surgeon see you and give an opinion. If you don’t want to go back to the surgeon who did the surgery, then you should get a second opinion from another plastic surgeon in your area. We see patients who have had problems with their implants frequently and if you would like to be seen we could make arrangements. If you are not in the area, I would be glad to make arrangements  for a phone consult. Just let me know. Thank you for your question.

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

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

Question: I live in Florida. I had breast cancer 15 years ago and had lumpectomy (r) breast and radiation. My right breast is much smaller than the left and is scarred . I would like to make both breasts symmetrical even and lifted. I have been told because of radiation treatment the right breast would not heal properly?

Answer: Thank you for your question. You  are correct that after radiation the breast tissue will not heal normally following surgery to correct asymmetry. Because the radiation impairs healing attempts to lift or change the breast shape often don’t work. Using an implant to increase the breast size is high risk for implant related problems. If surgery is attempted and a healing complication occurs, then the scaring and the result is often worse.

Two possible options for someone in general include:

1) Fat grafting to the radiated breast 

2) Completion mastectomy to remove the radiated tissue and reconstruction of the entire breast with your own fatty tissue. Option 1 would only be helpful for mild to  moderate shape problems and option 2 would be more involved but in my opinion the most helpful approach.

Let me know if you would like more information about these approaches.

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

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

Question: I have implants over the muscle. One has extreme scar tissue around it that has made it hard and very painful. If I remove them and go under the muscle, is there less chance that this will happen again, and would I need a mesh material to have that procedure performed?

Answer: Thank you for your question. I am thinking that your implants were placed for breast augmentation, please correct me if I’m wrong. In general releasing the scar and repositioning the implants under the muscle may help the problem. Placing the implant under the muscle mainly provides more of your own tissue to cover the implant, which can be helpful for some people. Unfortunately it does not guarantee the problem wont recur. Depending on the cause of the problem this approach may be successful 50% of the time. The use of any type of mesh is not a recommended treatment specifically for scarring around an implant but there are some types of mesh like materials that can help for other types of implant problems. I would need more information about your situation to be more specific. Let me know if you would like to give me some more details. Thanks again.

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