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In Her Words

August 13, 2018 by

I had my Stage 1 DIEP in Charleston with Drs. Kline and Craigie on May 25, 2018. On a scale of 1-10, I would rate my experience a 12! Before I go into more detail about my Charleston experience though, let me go back in time a little bit. I had my first unilateral mastectomy in 1998 (right side) with a reduction on the left side and immediate expanders.

A while later, I had the exchange for the permanent implants. This was all done in Atlanta, Georgia. The process was painful and inconvenient, took more than a year and was a complete flop. My right breast was half the size of the left, terribly scarred and deformed. The left breast was oddly shaped and had a very bad, fat scar underneath, and was hard.

The consequences of my low self-esteem led to intimacy problems with my husband, which resulted in divorce. Several attempts by different plastic surgeons only made the appearance of my breasts worse. The emotional consequences became compounded. In short, I felt like a freak. Dating was a concept I couldn’t even fathom – I was so self-conscious about my looks.

One day, 13 years after my first botched surgery, I saw a program on TV that discussed new procedures for reconstruction surgery after mastectomy. I immediately went online to research the DIEP procedure and decided to look into the facilities in Charleston. I was certain that Charleston was the right fit for me. Drs. Kline and Craigie are artists, and their highly trained staff made each and every step of the procedure flawless. Their attention to detail made me feel secure before, during and after. I’m about four months out from Stage 1 now. In those short months, my life has been transformed.

I haven’t had my stage 2 yet – that comes next month – but already I’m walking around with my head up and my shoulders back! My breasts look great. They are soft and warm, and it’s great to have those implants out. I would also like to add, if you are a single woman contemplating a location for reconstructive surgery, I highly recommend Charleston. The entire staff has a special sensitivity for those of us flying solo now.

–B.L., Thomasville, GA

Filed Under: In Her Words

4 Methods of Natural Breast Reconstruction

August 8, 2018 by

natural breast reconstruction methodsFor many women, a breast cancer diagnosis means a transformation, since both full and partial mastectomies are common as a way to rid the body of malignant tissues. These surgeries can leave a woman feeling uncertain or insecure about the changes.

Fortunately, there are options to help.

Perhaps you have heard the phrase “natural breast reconstruction” and wanted to know more about it. The term actually covers several different procedures, from improving the contour of scars left by mastectomies to even a natural alternative to breast implants. Natural breast reconstruction is a method of taking tissue from your own body to rebuild your breasts and the area around them. Tissue may be taken from a few different areas of the body. Here are a few methods of transferring tissue.

GAP Flap

In this procedure, also known as the gluteal artery perforator procedure, tissue is taken from the patient’s buttock area to create the breast mound. The muscles of the buttocks are left intact, and any extra tissue from either the upper or lower area (from “love handles” to “saddle bags”) can be considered. A GAP procedure is particularly useful for ladies who do not have excess body fat in other areas.

PAP Flap

Also known as the profunda artery perforator flap, this procedure takes tissue from the patient’s upper thigh to recreate the breast mound. Scars are hidden in the crease of the inner thigh, and only skin and fat are transferred.

DIEP Flap

Short for the deep inferior epigastric artery perforator flap, this popular procedure takes tissue from the patient’s abdomen to create the breast mound. Not only is the muscle of the abdomen left intact, many patients like the DIEP for the “bonus” result of having a tighter tummy.

SIEA Flap

Also known as the superficial inferior epigastric artery flap, this procedure is very similar to the DIEP flap (tissue is taken from the tummy); however, it is used only for a small percentage of women whose abdominal blood supply comes from the SIEA artery.

These procedures are not an exhaustive list of methods in which tissue can be obtained; other areas of the body, such as underneath the arm or even on the hip may also be reformed as breast tissue. Furthermore, surgeons are working daily to improve the art of natural breast reconstruction. Sensory improvement, for example, means reconstructing the nerves in the tissue used to build the breast, and repairing these nerves can mean better sensory response.

While it is true that most surgeons are able to reconstruct a breast, only a few surgeons have had extensive experience with natural breast reconstruction. The procedures listed above all involve transferring body tissue without damaging surrounding tissues or sacrificing much needed muscle. Should a patient be interested in these procedures, proper research is the key to finding a surgeon who is credible and able to successfully perform natural breast reconstruction.

To learn more about natural breast reconstruction and find out if it might be the right choice for you, contact The Center for Natural Breast Reconstruction at NaturalBreastReconstruction.com or toll-free at 1-866-374-2627.

Filed Under: Uncategorized

Ask the Doctor- Why Do Expanders Have To Be Used When a Breast is Removed?

July 27, 2018 by

This week, Richard M. Kline Jr. M.D., of The Center for Natural Breast Reconstruction, answers your question.

Question: Why do expanders have to be used when breast are removed and the pocket is empty and ready to be filled with an implant?

Answer:  It is not always necessary to place expanders at the time of mastectomies, but in many situations, it is a safer choice than immediately putting in an implant. Even if the breast surgeon leaves the nipples and removes no skin at all, the skin is not always healthy, as the blood flow is invariably at least somewhat compromised after mastectomy. Placing an implant under very poorly perfused skin would put additional pressure on the skin from within, and quite possibly cause the skin to die that otherwise would have lived. With an expander, we have the option of placing no fill at all at the initial surgery, thus minimizing additional pressure on the skin. In actual practice, sometimes the skin’s blood supply is so poor we don’t even put in an expander right away, but rather return to the operating room several weeks or months later to begin reconstruction.

Having said the above, I do agree it is nice if the final implant can be placed under healthy skin flaps immediately. However, it should only be done under ideal circumstances.

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

 

Filed Under: Ask the Doctor Tagged With: , ,

Breast Reconstruction: What Are My Options after an Unsuccessful Reconstructive Surgery?

July 10, 2018 by

Making the decision to undergo breast reconstruction surgery is a decision that is not taken lightly.

That’s why it breaks our hearts when we discover that there are women out there who are unhappy with their reconstructive results.

Over the past few months, we’ve heard from several ladies who want to know what their options are when their surgery doesn’t turn out as planned.

We thought our insight would be helpful to others who are facing the same problems as these courageous women.

Here are our answers to what your options are after an unsuccessful reconstructive surgery.

What Are My Reconstruction Options after a Failed Implant Reconstruction?

Question: Do you do reconstruction after ex-plants from a ruptured implant?

Answer: If you have had mastectomies, we will attempt to do reconstruction no matter what has happened, as long as you want it, and it’s medically safe to do so.

If your breast sustained damage from a ruptured implant placed for cosmetic reasons, we will still be happy to help you, but this might not be covered by your insurance.

I hope this helps.

See the full post here.

I’m Unhappy with My Reconstructive Result from Another Surgeon – Are You Able to Make It Look More Natural?

Question: Three years ago, I had a double mastectomy and am now cancer free.

My plastic surgeon did a terrible job with the reconstruction.

The left side implant is way off to the outer side and looks larger than the right side. The right side is way too far to the outside. There is zero cleavage.

Is there any way to reposition the implants more to the natural position of the breast?

I do not expect perfect, but don’t like looking like a botched job. Thank you.

Answer:  I’m glad to hear you have been cancer free and have your treatment for breast cancer behind you.

At The Center for Natural Breast Reconstruction, it is part of our mission to help women move on with their lives after breast cancer. We focus our efforts on helping women get their bodies back together with permanent “natural results.”

I’m sorry you are disappointed with your reconstruction.

If you have had radiation, then it may be very hard to have your breasts match with implant reconstruction. If you have not had radiation, then perhaps your implants could be revised or adjusted for an improvement.

Unfortunately, these corrections are all too often temporary. It is possible that using your own fatty tissue would be a more permanent option without implants.

Sometimes it is hard to start over with another approach, but it may be necessary if you desire a more natural and permanent result.

If you would like more information about natural breast reconstruction with your own tissue, let me know.

See the full post here.

I Have Implants But They Feel Horrible and My Reconstruction Looks Terrible. Is There Any Hope after Reconstruction?

Question:  I have implants. I do not like them, they feel horrible, and my reconstruction looks terrible.

Is there any hope after reconstruction?

Answer:  Fortunately, your previous experiences with implants in all probability do not affect our ability to get you a satisfactory reconstruction using only your own tissue.

See the full post here.

Do you have breast reconstruction questions? Send us your questions here! 

Filed Under: Health and Wellness Tagged With: , , , ,

Ask the Doctor – How Long Should You Have a Breast Expander In?

June 22, 2018 by

Lymphedema after mastectomy

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

Question: How long should you have a breast expander in?

Answer: There is no “one size fits all” answer to your question.

In many cases, expansion can be achieved, and the permanent implant placed, in 2-3 months (more commonly 3).

In other cases, expansion may take longer, or sometimes other factors such as radiation may cause delays in removing the expander and placing the permanent implant. Whenever possible, however, expansion should be completed before the beginning of radiation, because the expansion of radiated skin ranges from difficult to impossible.

I do not think that having expanders in for long periods is likely to cause any lasting problem, although the chance of them deflating goes up. I met a patient recently who, for various reasons, had had an expander placed by another surgeon in place for 15 years. She appeared none the worse for it, we placed a permanent implant, and she is doing well.

Hope this helps, I’d be happy to chat with you if you wish.

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

Filed Under: Ask the Doctor Tagged With: , ,

3 Common Questions about Breast Reconstruction Pain and Discomfort

June 19, 2018 by

After breast reconstruction surgery, patients are bound to experience some sort of recovery pain or discomfort.

This mild pain often leads patients to ask questions such as…

  • How long will the pain last?
  • Is my pain normal?
  • Should I call my doctor?

At the time, a person’s pain or discomfort might seem unusual or scary…and the last thing we want is for patients to worry.

For that reason, we’ve decided to put together the answers to a few of our most common pain-related questions.

Find out what our surgeons and staff have to say about the following concerns…

What Are Your Suggestions for Muscle Spasms after Breast Reconstruction?

Question: I had breast reconstruction on my left breast in 2006. I have had muscle spasms in it ever since. Recently they have gotten bad again.

Any suggestions?

Answer: I’m sorry you are having problems with your reconstruction.

You didn’t mention if you were reconstructed with an implant or with your own tissue, so I will answer as if you are reconstructed with an implant. Please let me know if I have assumed wrongly.

There are several potential reasons why you could have spasms.

If the implant was placed under the pectoralis chest muscle, it can lead to pains in the pectoralis muscle or other muscles, as the muscle is no longer functioning in precisely the way it was designed to. Most people tolerate the implants well, but there is no question some have more problems than others.

The muscle can also sometimes separate from attachments to the chest wall over time, which could cause changes in symptoms.

Additionally, if you are radiated, this could potentially cause additional problems, as the muscle may be less flexible.

View the full post here.

I’m Having Pain after My Last Latissimus Flap/Implant Reconstruction. What Can I Do Now?

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.

View the full post here.

Are These Normal Problems to Have 2 Years after a Breast Reduction?

Question: I had a breast reduction over two years ago. It still feels like I have scar tissue in some areas and nipple tends to be a little sore at times.

Is that normal?

Answer: No, that’s not normal, and I’m sorry you’re having to endure it.

I can’t tell what is going on by your description, but it’s possible that you have some residual dead fat in your breasts which has not been resorbed.

An MRI scan would be the best way to determine this.

It’s also possible that you have pain for no discernible reason, which is unusual, but it happens from time to time. That doesn’t mean it can’t be treated, however, as pain therapists can be very effective in helping manage that type of pain.

View the full post here.

Do you have breast reconstruction questions? Send us your questions here!

Filed Under: Health and Wellness Tagged With: , , , , ,

Ask The Doctor: I Had A Breast Expander Removed and Can’t Re-start Breast Reconstruction For 6 Months. What Are My Best Options?

June 8, 2018 by

Daliahs

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

Question: I have started my reconstruction, but had to have one side removed and can’t start on that side for 6 more months. My one side has 80 ml saline in it. What are my best options?

Answer #1: Can you tell me why you had to have one side removed?

Richard M. Kline, Jr., MD

Answer from the patient: It started with a blood clot and just kept getting infecting.  So my surgeon removed it so I could start my chemo and to get the infection cleared up, which it has cleared up completely.  I have started my chemo, which I have 4 to 5 treatments. Then after 6 months from have inflated removed I can start the reconstruction procedure.

Answer #2:  Sorry you’re having trouble. I think your surgeon was wise to remove the expander, you certainly don’t want to delay chemo.

If you weren’t radiated, it may be reasonable to try another expander after finishing chemo. I think the chances of it working may be less than usual since you’ve had trouble before, but nonetheless, it may work next time.

If you would like to forego expanders/implants and have reconstruction with your own tissue, the chance of getting an infection will be much less, and the quality of the reconstructed breasts will be much more natural. The surgery involved is larger, and it’s not for everyone, but once you are done there is essentially nothing to ever go wrong later. Previous unsuccessful reconstruction attempts with implants generally don’t affect our ability to reconstruct you with your own tissue, so if you want to try implants again after chemo, the natural tissue option will still potentially be there if implants don’t work again.

I would be happy to chat with you more about your situation at any time if you wish.

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

Filed Under: Ask the Doctor Tagged With: , , , ,

Ask the Doctor – What Are the Pros & Cons of Reconstructive Breast Surgery?

June 1, 2018 by

yellow flowers

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

Question:  What are the pros & cons of reconstructive breast surgery?

Answer: Thanks for your question. Ultimately the pros for breast reconstruction include restoration of a woman’s body following surgical removal of part or all of her breast/breasts. Surgery to remove the breast is performed to prevent or treat breast cancer. The ultimate goal of reconstruction is to restore physical well being and quality of life. Breast reconstruction using your own natural tissue provides the opportunity to achieve the most natural results. Even restoring breast sensation is possible (not guaranteed and not necessarily complete) using your own natural tissue. The cons of natural tissue are that the patient must donate the natural tissue from another part of the body. That means scars and healing in more than one area of the body. Surgery always requires down time, recovery and time away from working etc.. Also reconstruction almost always requires more than one surgery.

Breast reconstruction using implants is generally less natural than using natural fatty tissue that contains healthy blood vessels and nerves. The advantage of implant reconstruction is that surgery is not required in another area of the body and there are fewer scars in areas of the body other than the breast. Long-term, reconstructions with implants require more revisions due to implant problems and are generally less permanent than using your own tissue.

There are always individual factors and expectations that may change the pros and cons. Hopefully, this brief synopsis has answered your question. Please let me 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!

Filed Under: Ask the Doctor Tagged With: , , ,

Ask the Doctor – How Long Should You Have a Breast Expander In?

May 25, 2018 by

pink and white flowers

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

Question: How long should you have a breast expander in?

Answer: There is no “one size fits all” answer to your question.

In many cases, expansion can be achieved, and the permanent implant placed, in 2-3 months (more commonly 3).

In other cases, expansion may take longer, or sometimes other factors such as radiation may cause delays in removing the expander and placing the permanent implant. Whenever possible, however, expansion should be completed before the beginning of radiation, because the expansion of radiated skin ranges from difficult to impossible.

I do not think that having expanders in for long periods is likely to cause any lasting problem, although the chance of them deflating goes up. I met a patient recently who, for various reasons, had had an expander placed by another surgeon in place for 15 years. She appeared none the worse for it, we placed a permanent implant, and she is doing well.

Hope this helps, I’d be happy to chat with you if you wish.

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

Filed Under: Ask the Doctor Tagged With: , ,

The Ultimate Guide to Breast Reconstruction Insurance Questions

April 24, 2018 by

There are a lot of questions out there regarding insurance costs for reconstructive surgery.

Because breast reconstruction surgery can be expensive, it’s important that you know as much as you can about whether the procedure will be affordable for you, and what your insurance coverage options are.

Keep reading to check out some of the most common breast reconstruction insurance questions we receive.

Why Won’t Insurance Pay for Reconstruction?

Yellow Lily
Question: I don’t understand why insurance company doesn’t pay for reconstruction if you’ve had a lumpectomy. With radiation, your breasts shrink a lot and you are all out of proportion. I finally did get them to pay for prosthesis and bra.

Answer: That’s not always the case with a lumpectomy. If the surgery results in a significant defect or radiation negatively impacts the tissue, most times we can submit your case to your insurance company along with photos of the affected area, and they will indeed cover a reconstruction surgery for you.

Read the full post here.

I’m Looking for a Plastic Surgeon That Specializes in Microvascular Breast Reconstruction. Are You in My Insurance Network, and Do I Have to Make a Huge Down Payment before Surgery?

Question: I am looking for a p.s. who specializes in microvas. breast recon. I had dcis in 2014 lumpectomy with 6 weeks rads followed by bilat mast. 2016 with immed. recon with expanders then implants in March. Then I got a serious infection in the left (rad) breast, had implant removed and refused to do have lat flap done.

I am thin and one PS said I might be able to do a body lift type or one where they take from my backside and use an implant on both sides. I do not want the implant I have now. It is subpec and is painful. Can someone help? I have anthem BC/BS and you are out of network.

I do not have 8500 to have this done at another location. My insurance is agreeable to a pay if it is in network. I can’t afford much out of pocket. We are low -middle class, but don’t qualify for help.

Answer: Hi, and thanks for your inquiry. Glad you found us – you’ve definitely found a team that specializes in microvascular breast reconstruction. Regarding your insurance, does your card have a little suitcase on the lower corner of your card? If so, we’re actually in network for your, utilizing the Blue Card program through our contract with BCBS of S.C.

Read the full post here.

Does Insurance Cover Breast Reconstruction for Poland Syndrome?

Purple flower in a green field
Question: I was wondering what insurance would cover breast reconstructive surgery that’s due to having Poland Syndrome? My case I where I was born without having my right breast muscle and a smaller areola.

Answer: The good news is that we’ve been able to get breast reconstruction for Poland syndrome covered for past patients and certainly know how to navigate the process to make that happen for you.

Read the full post here.

Will My Insurance Cover a Prophylactic Mastectomy If I’ve Had Gene Testing?

Bright pink lily on water

Question: I did the gene testing in February; tested positive for BRCA 2. I want to go full steam ahead and be proactive with prophylactic mastectomy. I am a 31-year-old single mom.

However, in regards to insurance, I am in a pickle. I just switched jobs and will be obtaining new/different insurance with a new company. Will the new insurance I am obtaining most be okay with the gene testing from the prior company and proceed to pay for the mastectomy/reconstruction? I can provide all the results and positive test results as well to them to suffice.

Answer: Most insurances do pay for prophylactic mastectomies when you have a gene conferring increased risk. While I cannot tell you with certainty, the companies that offer the tests are pretty standardized, and there is no logical reason not to accept the results of a prior test.

Read the full post here.

How Much Will Insurance Cover?

Question: Hi, I am 19 years old and 13 months ago I had a benign lump removed from my right breast. Since then, my right breast has increased in size significantly but my left one has not. My left breast is a full size smaller than my right breast and I’m very self-conscious about it.

I want to get a procedure done that will even them out. I’m just having a hard time finding the right doctor to do it, and I’m unsure how much the insurance will cover. If you could help me with the insurance policies and what your surgeons could do for me, I would greatly appreciate it. Thank you so much.

Answer:  Thanks for your question!

It is difficult to sort out exactly what is going on and what would need to be done based on your brief description. While your insurance company may not be obligated to cover any treatment without the diagnosis of breast cancer, that does not automatically mean that they won’t.

Read the full post here.

Filed Under: Health and Wellness
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