July Q&A #2

I would like to learn more about liposuction or non-surgical liposuction around my abdomen and my thighs.
– Harmony

Hey Harmony,

Depending on your personal goals, both are great options for body contouring.

Trusculpt iD is a non-invasive option that offers fat dedication and skin tightening with minimal downtime. It’s Monopolar Radio-frequency platform tailors to patients’ individual needs and features Real-Time Temperature Control for clinically proven results, safety, and patient experience. In 15 minutes, truSculpt iD treats the entire fat layer, resulting in an average of 24% fat reduction.

Surgical liposuction is a more invasive method, with 1-2 weeks of downtime. It reshapes specific areas of the body by removing excess fat deposits and improving your body contours and proportion. Anesthesia is required for this procedure, but it is also safe and effective.

I would like to discuss this in more detail. If you’re interested please call 843-849-8418 to schedule a consultation. I am sure we can tailor a plan to meet your specific needs.

Thank you for reaching out. Hope to hear from you soon!

Dr. Lindsey Weaver, FNP-C

July Q&A #1

Q.I’m waiting to have surgery to take a cancer lump from my left breast. Then I will be taking radiation treatment. Will my breast be disfigured from this and will I be suitable to build my breast appearance with reconstruction surgery?
Judi

A.Hi Judi, Sorry you’re having to go through this. Management of a lumpectomy defect can be more complicated than reconstructing an entire breast after mastectomy. If you are sure you want to have a lumpectomy instead of mastectomy, then it may be best to have a plastic surgeon do reconstructive surgery on your breast at the same time as your general surgeon does the lumpectomy, before radiation, as the radiation will make any subsequent surgery to improve the shape of the breast much, much riskier (particularly regarding wound healing problems). If you would like to discuss your situation in more detail by phone, I would be happy to speak with you.

Richard M. Kline, Jr., MD

Coping after surgery

Surgery is a common method of treating breast cancer, but it can be overwhelming. There is so much to think about and you might be feeling scared, especially about how you will handle recovery. Here are some tips that we hope will help to make your recovery easier:

Prepare: Recovering from breast surgery really begins before you even have your surgery. It will take you a few weeks to recover, at least, so take time to brainstorm everything you do on a daily and weekly basis. What can wait to do until after you’ve recovered? What do you need help with on a daily or weekly basis? You will need assistance, but before you make any arrangements, figure out exactly what those needs are. For example, do you need someone to drive the kids to activities? Take the garbage out? Cook or clean for you? Help with laundry or taking care of your bandages?

Find support: Once you know what you need, it is time to create a support system. You might need someone to help you dress, undress and bathe until your doctors remove your drain, if you’ve had a mastectomy. Ask what your spouse can help with and see where there are gaps. Perhaps your children, a few close friends or relatives can alternate times to help you. Neighbors might offer to take your children to their activities, while your mom offers to cook and do the housework for you.

Stock up: Make sure to cook and freeze a few days or weeks worth of meals before surgery, so you have easy-to-grab foods and snacks. Eating healthy is important for your recovery too, so choose low-fat, highly nutritious options. Keep fruit, vegetables and water on hand as well.

Don’t forget that you may have an issue putting on your current clothes, so consider purchasing several shirts that are a little larger than what you currently wear and that button up in the front so they are easier to get on and off and do not rub against your incision.

Don’t overdo it: Everybody wants to get back to their regular routine after surgery, but it’s important for your recovery that you don’t overdo it. Get plenty of rest and sleep, especially in the first few weeks.

Follow post-surgery care: You will be given exercises to do after surgery, information on how to care for your skin and directions on what you can and can’t do. For example, you may not be able to shower for a week or go in a pool for several weeks. Make sure to keep your follow-up appointments too. To heal properly, be sure to follow all directions that you’ve been given.

Be observant:If you have a drain, keep an eye out for any excess blood, signs of infection or other problems. If you see something that doesn’t seem right, contact your physician right away.

Cool For Summer

Healthy lifestyle concept, clean food good health dietary in heart dish with sporty gym aerobic body exercise workout training class equipment, weight scale and sports shoes in fitness center

Making healthy changes at any point in your life can help you reduce your risk of a recurrence or new cancer, prevent additional health issues and keep your body strong as it recovers from treatment and surgery.

Consider these important 6 healthy living choices:

  1. Drop Excess Weight
    Those love handles might sound cute, but carrying around excess pounds can increase your risks for a variety of health issues, including heart disease and high blood pressure, high cholesterol, and Type 2 diabetes.

According to the Centers for Disease Control, the good news is that even a modest weight loss, such as 5 to 10 percent of your total body weight, can produce health benefits, such as improvements in blood pressure, blood cholesterol, and blood sugars.

Losing weight prior to your breast reconstruction might also help to prevent surgical complications. One study published in the Journal of Reconstructive Microsurgery found that obese women were 2.29 times more likely to experience surgical complications.

Dropping pounds should be done gradually at a rate of 1 to 2 pounds per week.

  1. Eat Healthier
    If you skip breakfast, love sweets, douse your popcorn in a salt and butter, enjoy a double cheeseburger every day for lunch, and haven’t had a veggie pass your lips in years, you might want to consider a diet overhaul. Eating a healthy, balanced diet can prevent heart disease, diabetes, and certain cancers, keep your bones and muscles strong and help keep your weight down.

Start eating healthier by making small changes. According to the U.S. Department of Health & Human Services, you should incorporate at least six of these eight goals into your diet:

  • Make half your plate fruits and vegetables.
  • Make half your grains whole grains.
  • Switch to fat-free or low-fat milk.
  • Choose a variety of lean protein foods.
  • Compare sodium in foods.
  • Drink water instead of sugary drinks.
  • Eat some seafood.
  1. Get Moving
    Cancer treatment can tire out your body, but it’s important to get off that couch and get moving! It doesn’t matter how you do it either — whether it’s dancing to Usher’s latest tunes, walking a treadmill, hiking, or joining a weekly Zumba class, find something you enjoy and do it. The American Heart Association recommends at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week. Add moderate- to high-intensity muscle-strengthening activity (such as resistance or weights) at least 2 days per week.

Exercise helps to lower your risk of heart disease, stroke, type 2 diabetes, high blood pressure, dementia and Alzheimer’s and several types of cancer. It also helps with depression and anxiety.

  1. Stop Smoking
    According to the American Cancer Society, about half of all Americans who keep smoking will die because of the habit. Each year more than 480,000 people in the United States die from illnesses related to tobacco use. This means each year smoking causes about 1 out of 5 deaths in the US More importantly, research shows that smokers have higher rates of wound complications after surgery, including healing after plastic surgery and breast reconstruction.

It’s hard to do, but quitting smoking can improve your health almost immediately. Quitting lowers your blood pressure and heart rate almost immediately and your risk of a heart attack declines within 24 hours.

  1. See Your Doctor
    You’re already seeing your doctor to treat your breast cancer, but have you had a general physical or other annual tests such as a colonoscopy or bloodwork? Staying on top of your health will help reduce the risks of getting sick and prevent other illnesses.

Overcoming ‘Scanxiety’: 5 Tips to Keep Your Wits for Your Next Breast Scan

Even though you won’t find the word in any dictionary — yet — scanxiety is real. Just ask any breast cancer patient. Scanxiety is the anxiety you feel when your next scan — mammography, ultrasound, PET scan or other major test — approaches. You’re nervous, restless and tense, your heart is pounding and you may have trouble sleeping or eating. You’re constantly worried about what the test will find.

These tests can determine if your cancer is in remission or if you still need additional treatment. For some, the scanxiety over these tests can start days, weeks and even months before the actual test occurs and continue while you take and wait for the results. And even those who have received good news from scans in the past still suffer from scanxiety leading up to their next one, hoping that they will hear those same results again.

There have not been many medical studies done on the impact of scanxiety, but one small study done on lung cancer patients was published in the October 2016 edition of Lung Cancer. It showed that scanxiety can mimic the symptoms of post-traumatic stress disorder (PTSD), including distressing thoughts, difficulty concentrating, anxiety, insomnia and irritability. The study showed that scanxiety can actually impair your quality of life.

Fortunately, there are steps you can take to help reduce or even eliminate the symptoms of scanxiety:

  1. Meditation: Whether you do it in a group or by yourself, meditation has been found to settle thoughts and help reduce stress and improve concentration. According to the Mayo Clinic, there are several ways that you can meditate:
  • Guided meditation: Led by a teacher, you are guided to conjure mental images that you find relaxing.
  • Mantra meditation: repeating a calming word or phrase that will be used to prevent distracting thoughts from entering your mind.
  • Mindfulness meditation: This is increased awareness and acceptance of living in the present moment. “I took a mindfulness course which I firmly believe kept me from completely going off the rails,” said one triple negative breast cancer patient in an online support group.
  1. Support Groups: Speaking of support groups, there are many in-person and online support groups that you can join to help you get through these difficult times. Your cancer center may have a supportive care department that is staffed with doctors, social workers and psychiatrists or psychologists. Here you can express your concerns about your upcoming scans. Others who may have also experienced the same symptoms can share additional coping mechanisms. Sometimes, just letting it out can help.

There are Facebook groups for breast cancer patients as well as patients with specific conditions, such as Triple Negative Breast Cancer. The best thing about online support groups is that they are available 24/7, so you can let people know what you’re going through even if it’s the middle of the night.

  1. Support System: Often scanxiety gets worse if you feel like you’re going through the tests alone. Will someone be with you when you go to the test or get the results? Having that person to hold or talk to can often reduce scanxiety.
  2. Fun Things: It might sound simple, but distracting yourself with some fun activities may help to reduce your scanxiety. A good book or a good movie, dinner with friends, or a weekend getaway can keep your mind occupied.
  3. Medication: Sometimes, patients need help keeping anxiety under control. Before taking anti-anxiety medication, such as Lorazepam, discuss these options with your physician to find the right one for you.

Most importantly, don’t ignore your scanxiety symptoms. Treating them allows you to live a better quality of life while you’re going through these very important tests.

Why Keeping a Breast Cancer Journal Is Good for Recovery


For many young girls, it’s a rite of passage to keep a diary filled with secrets, hopes and dreams. It feels good to have a private place to write down those things that are too difficult to share with another living soul. Looking back at it later in life, it allows you to discover details that have long since been forgotten. Unfortunately most of us stopped writing in those diaries that were locked away when we hit our teen or adult years.

For women who find themselves on the emotional journey that is breast cancer, it might be time to start journaling again. Studies have shown there are mental and health benefits to journaling. After all, journaling has been shown to improve your mental health, reduce stress and make you feel better physically. It’s also just a great way to document your recovery.

Although not many studies exist on the effects of journaling, WebMD.com suggests that writing can improve sleep, help fight feelings of fatigue, and provide an outlet for positivity.
Before starting a journal, here are five ideas to guide you:

1. Rule #1: No Rules

The only rule to keeping a breast cancer journal is that there are no rules. Treat yourself to a new notebook or pretty journal or download one of the many journaling apps that are available. Write for a few minutes or several times a day. You can draw, write your thoughts in poetry or take pictures and write captions about what you see. Anything goes.

2. Start Anywhere

It doesn’t matter where you are in your breast cancer journey, you can start a journal today. You can work backward on the path you’ve already walked and write down as much as you can remember or write going forward only.

3. Be Prepared for the Emotions

One breast cancer patient had big aspirations of writing in a journal throughout her journey. Unfortunately, writing about her tests and treatment brought out too many emotions and she put the journaling aside. Journaling can be emotional, but it can be therapeutic too. If it gets to be too much, stop for the time being, but make a date to pick it back up again and perhaps write in smaller chunks or skip a few days in between. Find what works best for you.

4. Make a Caring Bridge Journal

There are online websites that allow you to journal and share it with family and friends who want to keep up with your journey but who may not be able to see you. “Anne-Marie” started a CaringBridge account to share her journey. She wasn’t posting every day, but often enough that when she goes back now and re-reads the entries, she remembers details about things that she started to forget.

5. Use Your Phone

Maybe you prefer to use your phone to journal, which is probably with you all the time. If so, try a journaling app, such as Dabble.me, Day One, or Five Minute Journal. Some charge a fee for the download but can provide prompts to remind you to write.
Whatever you do, and however you do it, make sure it works for you. That’s really the ultimate test of any effort to deal with your breast cancer journey.

When is the Ideal Time for Reconstruction Surgery?

Some breast cancer patients require a mastectomy, the removal of a breast affected with cancer. Many choose to then have reconstruction surgery in an attempt to rebuild the breasts back to a normal look and shape. But when is the best time to have this surgery – at the same time you are having your mastectomy or at a later time?

Well, it depends on a variety of factors.

During the Mastectomy

Ideally, reconstruction begins at the same time that you have the mastectomy. This is especially important for earlier stage breast cancers. There is an advantage to having immediate reconstruction: Breast cancer patients do not have to wake up to the stark change of a removed breast. Instead, the reconstructed breast is already in place. This often helps with the breast cancer patient’s self-esteem and recovery.

Months After the Mastectomy

However, breast cancer patients who must undergo chemotherapy or radiation may choose to delay their breast reconstruction. Breast reconstruction cannot be performed until around six months after a patient’s final radiation treatment. However, chemotherapy varies. Some women have mastectomy and reconstruction immediately and do not start chemotherapy until after that is completed. Some women have to do chemotherapy first and then have mastectomy and reconstruction. Others have their mastectomy, have chemotherapy and wait to have reconstruction. Planning and timing is based on the type of cancer, pathology, oncology recommendation and the patient preference.

You might also decide to have reconstruction at a later time because, as a breast cancer patient, you are also dealing with a lot and may just want some time to make this decision and prepare for the surgeries.

Preparing for a Delayed Reconstruction

For those who do choose delayed reconstruction, the surgeon can put expanders in during the mastectomy that will help to keep the skin preserved to accommodate an implant or autologeous breast flap at a later time.

There are many decisions to make when you are undergoing breast cancer treatment and possible reconstruction. Patients and their team must consider timing and which reconstruction procedure is best. The patient can choose from implants or autologous breast procedures. Autologous breast reconstruction uses the patient’s own body tissue to recreate the breast. The tissue can come from the belly, buttocks or thigh.

It is important to note that if radiation therapy is indicated it’s best that occur before undergoing autologous breast reconstruction. Whether you decide to have autologous breast reconstruction or implant reconstruction will also depend on several factors, including your age, health status, location of the tumor, previous surgeries and the availability of extra tissue in your body. There are pros and cons of each procedure, so it’s important to talk to your doctor about which one is best for you.

The Center for Natural Breast Reconstruction believes in good health for everyone. If you or someone you know is in need of breast reconstruction, contact them at NaturalBreastReconstruction.com or toll-free at 866-374-2627.

Know the 5 Steps of Breast Reconstruction Before Your Mastectomy

 

If you’ve been diagnosed with breast cancer and will have a mastectomy, your doctor has probably discussed what comes next. Often, if you choose breast reconstruction, the process starts at the time of your mastectomy, but it can also be done at a later time – even years later.

Once the reconstruction process starts, it’s typically two or three stages – restoring the breast, refining the shape of the reconstructed breast and then reconstructing the nipples if desired. But every breast reconstruction procedure should start with a consultation with your physician.

Step One: Consultation with Your Team
Not every woman chooses to have reconstruction after mastectomy, so it’s important to weigh your options with your team, which should include your breast surgeon, plastic surgeon, radiation oncologist, medical oncologist and anyone else who is part of your treatment.

If you do choose reconstruction, your physician should discuss whether you will have your procedure at the same time you are having your mastectomy or at a later time. Your physician may recommend delaying your breast reconstruction based on the course of your treatment. Sometimes chemotherapy and radiation can delay the ability to have immediate reconstruction. Your surgeons should discuss the risks and benefits associated with all breast reconstruction procedures to allow you to make the choice that is best for you as well as helping you understand when the right time is for you to successfully complete the procedure of your choice.

Step Two: Mastectomy and Reconstruction

Choosing immediate reconstruction, at the time of mastectomy, is a great choice if it’s possible for the patient to do so. Those who opt to have breast reconstruction at a later time and have their mastectomy completed first can still choose from the wide variety of breast reconstruction procedures offered to all patients. At the time of mastectomy, tissue expanders can be inserted to help preserve the shape of the breast and conserve breast skin should definitive reconstructive surgery be scheduled for the future.   

Step Three: Restoring the Breast

Now it’s time to rebuild your breast. The two most common reconstruction procedures are autologous breast reconstruction and implant reconstruction. During autologous reconstruction, a plastic surgeon uses your own tissue, skin and fat from another place on your body – typically from your buttock, abdomen or thigh – to recreate your breast mound. Should you choose implant reconstruction, our surgeons at The Center for Natural Breast Reconstruction utilize the most state of the art techniques to achieve the most natural result. Direct to implant and above the muscle implant reconstruction with acellular dermal matrix are examples of the procedures we offer. 

Step Four: Refinement
Sometimes the shape of the reconstructed breasts need to be refined a bit, so another surgical procedure might be necessary. Some patients also choose to have the unaffected breast modified to achieve even closer symmetry, and that can be done at this stage.

Step Five: Nipple Reconstruction

If you have chosen to have a nipple-preserving mastectomy, you may only need one or two stages of surgery to complete the restoration process. However, if you need nipple reconstruction, it can be done either during Stage Two or Three. We typically like to wait at least three months between all procedures if possible to allow for healing before making further modifications. A few months after the nipples are reconstructed, you may also undergo a tattooing procedure to add more natural coloring to the nipple. Some women choose only 3-D tattooing as their definitive choice for nipple reconstruction.

Recovery time will vary from patient to patient. Your individual surgery timeline may also differ depending on your particular needs.

The Center for Natural Breast Reconstruction believes in good health for everyone. If you or someone you know is in need of breast reconstruction, contact them at NaturalBreastReconstruction.com or toll-free at 866-374-2627.

Finding the Right Surgeon

5 Key Attributes to Look for in a Plastic Surgeon

 

You’ve been diagnosed with breast cancer and had a mastectomy. Now you’ve made the important decision to have reconstructive surgery to rebuild your breast. Your next important decision is to make sure you have the right plastic surgeon to do the job.

Finding the right surgeon isn’t always easy. But you need to put the same time and effort into it that you would put into hiring a real estate agent to find you a home or finding the right school for your children. After all this is your health we’re talking about and you deserve the best.

So what should you look for when choosing a surgeon?

1. Make Sure the Plastic Surgeon Specializes in Your Procedure

Some plastic surgeons specialize in implants, while others do tissue flap procedures, such as TRAM or the newer microsurgical procedure, the DIEP flap. Perhaps you already had a reconstruction procedure and need it revised. You need someone who has extensive experience with revision surgery.  Ask how many procedures the surgeon has performed and the success rate for the specific procedure you are considering.

2. Make Sure They are Board Certified and Well Trained.

Plastic surgeons are certified by the American Board of Plastic Surgery (ABPS)  which means that they have completed residency training specifically in Plastic and Reconstructive Surgery at an accredited institution.  They have passed comprehensive written and oral examinations covering all plastic surgery procedures. You can visit the ABPS website to find out if your plastic surgeon is an up-to-date certified member.  Fellowship training in a specialized field such as Breast Microsurgery is desirable if you are considering muscle sparing autologeous reconstruction procedures such as DIEP, GAP, PAP etc.

3. Make Sure the Surgeon’s Record is Clean

There are licensing boards for each state where you can check a surgeon’s background for any malpractice judgments or disciplinary actions. Visit the Federation of State Medical Boards’ website for more information.

4. Make Sure You are Comfortable

Once you find a plastic surgeon that specializes in your chosen breast reconstruction procedure, make sure to meet and ask a variety of questions. For example, how many procedures have you performed? What is your success rate? What is your background? What will the surgery entail and what is recovery going to be like?

Even if you have done your research and know the answers, see if you are comfortable with how the doctor communicates with you during this meeting. Does the surgeon answer your questions thoroughly and address your concerns?  If the answers are off-putting or you feel uncomfortable in any way, that surgeon may not be the one for you.

5. Make Sure They Take Your Insurance

It might sound like an obvious thing to ask, but some surgeons will require that you pay out-of-network fees. You don’t want to be surprised with a big bill at the end of the procedure, so make sure that your plastic surgery procedure and the surgeon’s fees are covered at in-network rates by your insurance plan. Work with the surgeon and their staff to make sure everything is covered and you know all of the out-of-pocket costs prior to the procedure.

The Center for Natural Breast Reconstruction believes in good health for everyone. If you or someone you know is in need of breast reconstruction, contact them at NaturalBreastReconstruction.com or toll-free at 866- 374-2627.

Autologous vs. Implant

Benefits of Autologous Breast Reconstruction vs. Implants

 

If you had a mastectomy as part of your breast cancer treatment, you may be considering reconstruction to get back the look and feel of your natural breast. The two reconstruction options that patients normally choose between are autologous breast reconstruction and implant reconstruction.

Autologous breast reconstruction involves using your own tissue to recreate your breasts and can be done either when you have your mastectomy (immediate reconstruction) or at a later time (delayed reconstruction). Autologous breast reconstruction typically involves multiple stages; however, implant reconstruction often requires several stages as well.

With autologous reconstruction, a plastic surgeon uses the tissue from another place on your body (called a donor site) — typically from your abdomen, buttocks, or thighs – to recreate natural looking (and feeling) breasts. Using microsurgery, the surgeons attach vessels from the donor site to vessels in your chest to provide adequate blood flow to your new breasts.

Many patients who undergo autologous reconstruction, after having implants placed previously, state that their new breasts look and feel more like their old breasts compared to when they had implants.

Women who need radiation therapy before or after their mastectomy may also want to consider autologous breast reconstruction instead of implants because of the higher rate of failure associated with placing an implant under radiated skin and tissue. However, it is important to note that radiation must occur before undergoing autologous breast reconstruction.

Whether you decide to have autologous breast reconstruction or implant reconstruction depends on several factors, including your age, health status, location of the tumor, previous surgeries, and the availability of extra tissue in your body. There are pros and cons of each procedure, so it’s important to talk to your doctor about which one is best for you.

Implant reconstruction carries its own unique set of risks. Risks include inflammatory reaction, leaks, and mechanical implant failures.  There is also a chance that excessive scar tissue can form around the implants (capsular contracture) and cause pain and malposition necessitating removal or revision of the reconstructed breast. Due to these possibilities, implants may have to be surgically replaced or exchanged at a later time.

The Center for Natural Breast Reconstruction believes in good health for everyone. If you or someone you know is in need of breast reconstruction, contact them at NaturalBreastReconstruction.com or toll-free at 866- 374-2627.