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Ask the Doctor – Would Reconstruction Be Successful For Me?

December 22, 2017 by

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

Question: I had implants put in 33 years ago, got breast cancer, had a lumpectomy, radiation, and got rock hard implants as a result. I just recently decided to have the implants removed and a great deal of scar tissue. They put in expanders that caused me to get an infection. I had to almost beg them to believe me as the pain was horrific. I had a 2nd doctor remove the expanders. I now have a very deformed left breast and a severely drooping right breast. I contacted the doctor who put my implants in years ago. He is no longer in the area but told me about this procedure.

I guess my question is if this procedure would be successful for me? I do not like the way I look, and it is painful as well. I am a teacher and would need to know the time frame this would entail. It has been a horrible summer with this ordeal. I almost wish I left the rock-hard implants in. Please let me know what you think. I am very much interested in hearing your thoughts. 

Answer: Thank you very much for your question. I’m sorry you have had so much difficulty. Your situation is unfortunately quite common, but the good news is that natural breast reconstruction with your own tissue can often help dramatically. Fortunately, a history of radiation (&/or multiple failed attempts at implant reconstruction) does not at all decrease the success rate of subsequent reconstruction using only your own tissue. We have successfully reconstructed hundreds of women in your situation.

Our first choice for a donor area, if you have some extra tummy tissue, is the DIEP flap. If you do not have adequate tummy tissue, the buttocks (sGAP flap) is also often an excellent donor area.

It is important to realize that natural tissue reconstruction is not just an operation, but a process. The first operation, the microsurgical transfer of the flaps, is by far the largest. It usually takes 6-8 hours, requires a 4-day hospital stay, and a total stay in Charleston of about a week. Recovery takes approximately 6-8 weeks.

After you have healed fully from the first surgery (usually 6 months if you have been radiated), 1-2 additional surgeries are required to achieve optimum results. These are much less involved, ordinarily requiring only one night in the hospital, and you can usually go back home as soon as you are discharged.

While the process can be lengthy, once you are done, you are REALLY done. Most women reconstructed with their own tissue come to regard their reconstructed breasts as their own, and are finally able to put the issue of breast cancer behind them.

I would be happy to call and discuss your situation in more detail if you wish, and thanks again 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- I’m Having Pain After My Last Latissimus Flap/Implant Reconstruction. What Can I Do Now?

November 10, 2017 by

This week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I was diagnosed with breast cancer in 2011, and had a mastectomy on my left side followed by chemo. In 2014, my mammogram began showing tumors and I would have an ultrasound every time. This caused panic attacks and I choose to have my right breast removed because the type of cancer I had was Stage 4 Aggressive. In April 2015, I had a bilateral latissimus flat and received implants. Now I am experiencing pain across my back where I was cut and my chest gets uncomfortably tight. The site of the drainage tube is swollen and doesn’t feel good. I stopped seeing my reconstruction doctor because he did things I was not informed of. I am worried because I do not know what is going on anymore. Could you please advise me as to what might be going on or what to do?

Answer: I’m sorry you are continuing to have problems, but you are not alone.

I can’t speak about your situation specifically because I haven’t examined you, but here are some thoughts in general about patients with symptoms like yours.

There is no question that many people with implants describe symptoms such as yours. Often, there is no discernible reason why they should feel discomfort, but they do. Nonetheless, many of them feel relief when the implants are removed. This does not mean that you would or should, it is just an observation.

The latissimus flap can be done with or without dividing the nerve that makes it contract. I have known some patients with latissimus flaps done without dividing the nerve to have discomfort associated with the muscle contracting. Some have experienced relief when the nerve was subsequently divided. Obviously, I don’t know if this is your situation or not.

Sometimes people have complex, persistent pain after surgery or injury which is out of all proportion to what would be expected. This can be difficult to treat but thankfully is rare.

When evaluating a patient with symptoms like yours, we usually start with a careful history and physical evaluation. Sometimes, especially if we have concerns about implant rupture, fluid collections, infection, etc., we then get an MRI and/or CT scan Following the complete evaluation, we then decide together how to proceed.

Hope this helps at least a little. I would be happy to chat with you further by phone about your specific problem or see you in person if you can come for a visit.

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

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Flap Reconstruction Surgery: Important Stats and Abstract Information

August 8, 2017 by

If you’ve had breast cancer and are considering reconstruction surgery, it’s possible that one of the options you may be looking into is flap reconstruction surgery.

Breast reconstruction utilizing “flap” techniques are procedures where body tissue is used to reconstruct the shape of your breast after surgery. While it’s a relatively common type of reconstructive surgery these days, we feel it’s important that you should learn as much as possible about the benefits and risks, and discuss them with your doctor before you have the procedure.

That’s why we at The Center for Natural Breast Reconstruction are always looking for better ways to educate and inform our patients before a decision.

One way we ensure our patients have access to the latest in medicine and medical technology is to have our surgeons and staff constantly learning, researching, and writing about their findings.

In fact, some of our latest research on reconstructive flap surgery was recently submitted to the American Association of Plastic Surgeons by our Dr. Kline. This specific abstract documented the success rate of our reconstructive flap surgeries with regard to the role of autogenous microvascular breast reconstruction in the community.

Check it out…

Abstract

PURPOSE: To present the continuing role of autogenous microvascular breast reconstruction in the community

METHODS: 1393 free perforator flaps for breast reconstruction were performed by two surgeons from October, 2003 to October, 2016. All flaps were performed in two community hospitals. Types of flaps included DIEP unilateral (122 flaps), DIEP simultaneous bilateral (866 flaps), DIEP bipedicle (106 flaps), sGAP unilateral (55 flaps), sGAP simultaneous bilateral (202 flaps), iGAP unilateral (2 flaps), iGAP simultaneous bilateral (18 flaps), PAP unilateral (5 flaps), PAP bilateral (10 flaps), SIEA unilateral (3 flaps), SIEA simultaneous bilateral (2 flaps), and TFL perforator (1 flap). The series includes a large number of both immediate and delayed reconstructions, prior failed reconstructions, and patients with a history of radiation.

RESULTS: Overall flap survival rate was 98.2%. DIEP survival rate was 99.1%. sGAP survival rate was 95.7%. No primary unilateral flaps were lost, and no bilateral losses occurred. Including those patients whose initial flaps failed, 99% of patients were ultimately successfully reconstructed with autogenous tissue.

CONCLUSION: Implant-based reconstruction is an appropriate initial choice for many patients, but autogenous microsurgical reconstruction still remains an excellent option, whether as an initial choice, or for patients with a prior history of failed reconstruction. With proper preparation and institutional support, perforator flap breast reconstruction can be performed with a high degree of success in a community hospital setting.

On top of the abstract, our physicians—Richard M. Kline Jr., M.D. and James E. Craigie MD—also wrote the chapter on GAP (buttock) flaps for the book Perforator Flaps for Breast Reconstruction.

Check out the book chapter here.

As we mentioned earlier, we are passionate about continuing to learn, receive training, and interact with the scientific community to ensure we provide our patients with the safest, most advanced care.

And, while we’re doing our job to make sure we’re properly training our staff and staying up-to-date with the latest in medical technology, there’s one thing we encourage you to do as well—always ask for medical procedure stats.

Much like the abstract we provided above, your doctor should be able to provide you with stats on the procedures he or she conducts.

When patients come to us and ask questions on success rates, we can happily tell them the different percentage rates of success for the various procedures we provide. Equipping our patients with this information empowers them to make wise, educated decisions about their own health.

So, please, before you move ahead with a specific procedure, ask your doctor for the stats. If they have a high success rate with their surgeries, then you’re in the right place. If they don’t, it’s time for you to find another doctor.

We wish you the best as you move forward with any new procedure you may need!

Did you find the book chapter insightful? Let us know what you learned and what you thought was helpful to know in the comments below!

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June Charleston Activities You Don’t Want to Miss

May 30, 2017 by

 

Between the beaches and historic sites, world-class restaurants and shopping galore, Charleston has a lot to offer. With so much constantly going on in this city, it’s easy to miss some of the best Charleston activities when they pop up on the calendar.
For that reason, we decided to share some of our favorite Charleston events that happen in the month of June. Regardless of whether you live here full-time, or are planning to visit, we hope you’ll add some of these suggestions to your itinerary if you’ll be around in the month of June.
Enjoy!

Carolina Lady Anglers Fishing for the Cure Tournament – May 31 through June 4

The Carolina Lady Anglers raise funds for breast cancer every year with a Fishing for the Cure Tournament. This year, we are honored to be a Species Sponsor for the event.

This fun, family-friendly tournament is a great way to help an important cause while making many memories along the way. If you’re in the area, we encourage you to grab a fishing rod and sign up!
Each team that participates must select a captain to attend the Captain’s meeting on May 31, at 6:00 p.m. at Charleston Maritime Center. The fish weigh-in is on June 4, from 4 to 6 p.m. at the same location.
For registrations costs, prize details, and other info, please visit the Carolina Lady Anglers website.
Spoleto Festival USA – Runs through June 11
If you love art, music, and theater, the Spoleto Festival is an event you’ll want to put on your calendar.
Technically this festival started at the end of May, but it’s still in full swing. Live events for this festival will continue on through June 11, so be sure to find a day to enjoy the festival with your family.
Between art galleries, dance shows, theater performances, and more, there’s bound to be something at this festival for every member of your family—kids included!
Check out the Spoleto Festival calendar here.
Blues & BBQ Harbor Cruise – June 8, 15, 22, or 29
If you love ocean views and Lowcountry blues, you definitely need to get yourself signed up for a Blues & BBQ Harbor Cruise.
This dinner cruise is a wonderful way to experience Charleston while listening to the musical stylings of well-known blues pianist Shrimp City Slim and his band.
On this 2-hour cruise, you’ll enjoy a full all-you-can-eat BBQ buffet with access to a cash bar. Yum!
Find out more about tickets and pricing here. 
Sunset at Fort Sumter – June 9, 16, 23, and 30
Charleston is rich in history. So, if you’re here for a visit or live in town, we highly recommend spending an evening taking a step back in time with a Sunset at Fort Sumter tour.
On this tour, you will interact with period-dressed Civil War historians and learn about the Civil War. Once at the fort, enjoy the rich history provided by the National Park Service Rangers and spectacular views of the city, harbor, and Atlantic Ocean from the top of the fort.
This tour also includes a return cruise where you will relax and take in the spectacular views of the harbor and the marine life while dining on southern BBQ cuisine. Beer, wine, and cocktails are available for purchase at the fort and during the cruise.
Advance reservations are recommended. Call 843-722-BOAT to purchase tickets.
Moonlight Mixers – June 16
Moonlight Mixers is a family-friendly event that’s fun for both adults and children. All ages are invited to celebrate the arrival of summertime weather with some shag dancing on the Folly Beach Pier.
During this event, DJ Jim Bowers will keep your feet moving with the hottest oldies and beach music. This even runs from 7:00 p.m. – 11:00 p.m.
Admission is $8 per person when tickets are purchased in advanced online. On-site tickets cost $10 per person.
Purchase your ticket now!

 

Charleston Carifest – June 22, 23, 24, and 25

Charleston Carifest is a Caribbean Carnival celebration in honor of Caribbean American Heritage Month.
This festival is four days long and is full of food, fun, music, and costumes. When you attend this event, you will instantly be submerged in education and culture.
Join in on the festivities and embrace Unity in Diversity.
Visit the website for more information.

Do you have a favorite Charleston event you attend in June?

Comment below and let us know what it is!

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Life after Mastectomy: Prosthetic Nipples

March 28, 2017 by

Being diagnosed with breast cancer and facing a cancer battle can be a long, draining, and scary experience.

While women who beat cancer find themselves overjoyed and grateful, there’s still a part of having breast cancer that tends to linger—especially if they’ve had to go through a mastectomy.

While we know women feel incredibly grateful that they’ve won their battle with cancer and feel they can begin life again, it’s also very common for them to long to feel like their old selves again.

At The Center for Natural Breast Reconstruction, we want all women to feel confident, radiant, and beautiful after a mastectomy, which is why we were so excited to find out about a new non-surgical solution to breast reconstruction—prosthetic nipples.

We love the product so much, we even carry demos in our office for women to try.

So, how exactly did this product come to be and how does it work?

I’m going to let breast cancer survivor and inventor Randi Johnson tell you in her own words.

Here’s her story…

After the shock of my IDC breast cancer diagnosis in 2007, I was hoping for the least invasive corrective surgery. The lump was too large for a lumpectomy, so a unilateral mastectomy was the choice I made. I had a new full-time job and didn’t want to take 6 weeks off for breast reconstruction.

The mastectomy was not very painful and I had a good recovery, but reality hit as bandages came off and I saw “my new normal” in the mirror. I’m not an especially vain person, but it was hard to feel “pretty” for my husband, even though I knew he loved me beyond the disfigurement.

I found myself wearing my prosthetic mastectomy bra to bed at night.

We happened to hear about Dr. Khouri in Miami, FL  who was doing a less invasive type of breast reconstruction surgery. There were no incisions, it was outpatient, and had a lower risk of complications. I only had to miss 3 days of work for each step (4 fat grafting sessions, for me).

Adding to the appeal, was the fact that they would take fat from tummy, thighs and anywhere else I didn’t want it and make a new breast out of it.

What’s not to love about that!

I was amazed to find that Dr. Khouri was in network for my insurance plan. There were still travel expenses etc., but somehow it all worked out.

It felt like I was growing a new breast and hardly had time to think about not having a nipple on that side, but when Dr. Khouri made an impression of my natural nipple and made up a silicone “rough draft” of a nipple for my recon side (for purpose of photos), my husband asked if he could tinker with the idea.

Dr. Khouri was very impressed with the prototype we brought back to show him a few months later. He invited us to display our Naturally Impressive nipple prosthetics as a vendor at a couple of his fat grafting conferences.

We received a great reception as well as some helpful ideas from the international breast surgeon attending.

I was part of an “MD Rounds” event at one of those Fat Graft Conferences and it was exciting to have MDs ask in disbelief (right after they heard my history). “Did you have a mastectomy?” We have heard countless similar stories from our clients about their Naturally Impressive nipples “fooling” others because they look so natural.

Now it’s become my new body image. If I have it off for a day or two, the asymmetrical image in the mirror doesn’t feel like it’s me.

We’ve been serving women through Naturally Impressive, LLC, since January 2010. As a “Mom and Pop” shop, we keep operating costs low and we also get to know many of our clients quite well. It’s an incredible joy! We love it!

No matter what option women choose regarding nipples, Naturally Impressive can be a way to “feel normal” again. For some, this is a great short-term option while waiting for tissue to settle before making a permanent choice. For others, it’s a wonderful non-surgical long-term solution.

If you or someone you care about is longing to feel normal again in the nipple department, check out our website to see the realism, variety and affordability of choices we offer.

Click here to visit the Naturally Impressive website.

You can also call Naturally Impressive, LLC, at 715-829-4488 if you have any questions.

Do you have a favorite post-mastectomy product that makes you feel confident and beautiful?

Share it with us in the comments below!

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5 Classic Books You Should Read This Year

January 10, 2017 by

As the new year begins, most of us make lists of things we’d like to do differently this year.

For you, it may be going to the gym, eating healthier, or volunteering more often. Or maybe you want to travel more, finally sign up for yoga, or not work weekends. While these are all wonderful goals, we suggest you also add exercising your brain to the list.

Instead of sitting in front of the TV this year, we encourage you to pick up a book. What better way to exercise your brain than to sit down and read a few classics.

To make it easy for you to get started, below are our top 5 recommendations.

Book #1 – Great Expectations

Great Expectations is Charles Dickens’ 1861 classic novel about an orphan named Pip and his journey from poor orphan to power and wealth, the friends he gains and loses, and his eventual humbling.

The stories and lessons you’ll learn in this book will last you a lifetime.

Book #2 – Treasure Island

Treasure Island was written by Robert Louis Stevenson in 1883.

This book tells the story of Jim Hawkins, a boy living with his parents at their inn, whose life is changed when he encounters a sunburned sailor singing, “Yo-ho-ho and a bottle of rum!” at his family’s establishment.

If you like stories about adventure, pirates, treasure, and sailing the Seven Seas, this book is certainly for you.

Book #3 – Little Women

Little Women is Louisa May Alcott’s 1868 “coming of age” novel set during the American Civil War and follows the lives of four sisters: Meg, Jo, Beth, and Amy.

If you’re a bold, fierce, and courageous woman, you will get a kick out of everything these girls, and their mother, Marmee, encounter throughout this heartwarming book.

Book #4 –  The Great Gatsby

The Great Gatsby was written by F. Scott Fitzgerald in 1925.

This novel takes place in the midst of the glitz and glam of the Roaring Twenties and is narrated by a character named Nick Carraway—Gatsby’s neighbor. Nick tells the story of the many incidents that take place in the home of the rich and famous Mr. Gatsby.

If you love history, this book will easily transport you back into the early 1920s and give you a firsthand look at all crazy things that went on during parties and other social events that were hosted by the wealthy upper class.

Book #5 – Gone with the Wind

Gone with the Wind, written by Margaret Mitchell in 1936, is by far one of the more classic pieces of literature around. Chances are you’ve seen the movie. If you haven’t read the book, it’s a must!

This book details the life of Scarlett O’Hara, a wealthy Southern belle, who lives on a large plantation in Georgia. The plot twists when Scarlett’s family loses all of their wealth, and she is forced to make a decision between marrying for love or for wealth.

This book contains a little bit of everything and includes storylines rich in history, romance, and life lessons.

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Ask the Doctor-Would reconstruction be successful for me?

November 18, 2016 by

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

Question: I had implants put in 33 years ago, got breast cancer, had a lumpectomy, radiation, and got rock hard implants as a result. I just recently decided to have the implants removed and a great deal of scar tissue. They put in expanders that caused me to get an infection. I had to almost beg them to believe me as the pain was horrific. I had a 2nd doctor remove the expanders. I now have a very deformed left breast and a severely drooping right breast. I contacted the doctor who put my implants in years ago. He is no longer in the area, but told me about this procedure.

I guess my question is if this procedure would be successful for me? I do not like the way I look, and it is painful as well. I am a teacher, and would need to know the time frame this would entail. It has been a horrible summer with this ordeal. I almost wish I left the rock-hard implants in. Please let me know what you think. I am very much interested in hearing your thoughts. 

Answer: Thank you very much for your question. I’m sorry you have had so much difficulty. Your situation is unfortunately quite common, but the good news is that natural breast reconstruction with you own tissue can often help dramatically. Fortunately, a history of radiation (&/or multiple failed attempts at implant reconstruction) does not at all decrease the success rate of subsequent reconstruction using only your own tissue. We have successfully reconstructed hundreds of women in your situation.

Our first choice for a donor area, if you have some extra tummy tissue, is the DIEP flap. If you do not have adequate tummy tissue, the buttocks (sGAP flap) is also often an excellent donor area.

It is important to realize that natural tissue reconstruction is not just an operation, but a process. The first operation, the microsurgical transfer of the flaps, is by far the largest. It usually takes 6-8 hours, requires a 4 day hospital stay, and a total stay in Charleston of about a week. Recovery takes approximately 6-8 weeks.

After you have healed fully from the first surgery (usually 6 months if you have been radiated), 1-2 additional surgeries are required to achieve optimum results. These are much less involved, ordinarily requiring only one night in the hospital, and you can usually go back home as soon as you are discharged.

While the process can be lengthy, once you are done, you are REALLY done. Most women reconstructed with their own tissue come to regard their reconstructed breasts as their own, and are finally able to put the issue of breast cancer behind them.

I would be happy to call and discuss your situation in more detail, if you wish, and thanks again 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- Do you do 3T MRI of both the abdomen and the chest before a DIEP flap?

February 6, 2015 by

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

orange flowerQuestion: Hello, I was wondering if you do a 3T MRI of both the abdomen and the chest before a DIEP flap? I would rather not have more radiation, because I had mantle radiation when I had Hodgkin’s 20 years ago and developed breast cancer as a result. Also have you heard of an APEX flap? Thank you for your time.

Answer: Thanks for your great question! We perform preoperative MR Angiograms with an open 3T MRI protocol on all possible patients we have who are undergoing breast reconstruction with a DIEP procedure. We do the same for any of the multiple muscle sparing natural tissue reconstruction procedures we regularly perform. We do not perform MR angiogram of the chest. That would not provide us with any useful preoperative planning information. There are quite a few people who cannot have a MRI. People who have metal knee replacements or breast expanders with metal parts are examples of reasons some of our patients cannot have an MRI. In our practice we have found CT angiograms are not as useful and avoid them if we can because of the increased radiation. As you may be aware, your history of previous mantle radiation may also increase your chances for problems with implant breast reconstruction. I agree that a DIEP may be a very good option for you. I hope I answered your question. If you would like more information please 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- What Can Be Done for Inflammation of Scar Tissue?

December 19, 2014 by

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

Question: I have chronic inflammation of scar tissue after having breast cancer surgery and reconstructed surgery. I have been in pain now for over a year. What if anything can been done to for this?

Answer: Thank you for your question. We cannot specifically give you medical advice by email because we would need more information.  You should make sure your surgeons (plastic surgeon and breast) and oncologists know you are having problems right away if you have not already.  They will be familiar with your history and can make sure you have been checked thoroughly.

We specialize in breast reconstruction and frequently help patients having problems with their reconstruction. The effects of radiation and scaring can lead to problems and pain. We help patients with implant problems by replacing their implants with their own fatty tissue. If you would like more information I would need to have my office contact you regarding your specific situation.

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

Just ask!

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Events to Raise Awareness

October 8, 2014 by

Whew!  Breast Cancer Awareness month is off to a running start here in Charleston!  Just a few events we’re going to mention where we’ve lent our support – there are so many that I hope you can find your way to one of them to show your support of our sisters (and brothers) who have been affected by breast cancer.

 

warriors pink approved-signed

 

 

 

Tonight! October 8, 2014 – 2nd Annual Warriors Wear Pink Event at ALOFT Charleston Hotel & Convention Center from 6:00 to 8:00 p.m.   Click the event flyer thumbnail for more details.

 

October 15, 2014 – BRA Day USA!!  Learn more……

October 18, 2014 – Komen Lowcountry Race for the Cure –  Family Circle Cup Stadium – Daniel Island, S.C.

Shana Brown Event Flyer

October 19, 2014 – A Tickled Pink Reception:  T-shirts & Stillettos –  Presented by the Folly Road Church of Christ.  3:30 p.m.  Experience a fun filled afternoon celebrating breast cancer survivors.  Click the event flyer for more details.

 

 

 

Columbia Friends – SC FORCE Support Group Gathering – October 26, 2014, 3:00 to 5:00 p.m. at the Richland country Main Library – Irwin Kahn Conference Room – 1431 Assembly Street – Columbia, S.C. 29201.   Do you have a family history of breast and/or ovarian cancer?  Have you tested positive for a BRCA mutation or are you considering genetic testing?  You are not alone and we invite you to join us to find out more.  http://www.facingourrisk.org/get-support/local-groups/south-carolina.php

Worship in Pink – Worship in Pink is a breast health education initiative for the Affiliate’s faith-based communities in an effort to reduce disparities seen in African-American, Hispanic and rural communities.  The Center for Natural Breast Reconstruction is thrilled to be the Promise Partner for the Komen Lowcountry initiative again this year.   Find out more….

What events do you plan to attend?  We’d love to feature them on our next “Upcoming Events” or “All Things Charleston”  post.

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