Search Results for: implant

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

If you can, I would contact your original plastic surgeon, as he or she is probably in the best position to evaluate your symptoms. I would also be happy to discuss your situation with you further by phone, if you wish.

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 about breast reconstruction.

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 re position 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.

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

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

Question: I’ve had implants since a 2004 mastectomy following breast cancer diagnosis. I’m healthy, but feel that my implants have shifted and I’m considering a redo. I live in Colorado, and wonder how the system works for out of town patients. How many trips are required to have reconstruction with your docs?

Answer: By “considering a redo,” I’m assuming you mean replacing your implants with your own natural tissue.

Our P.A. Audrey and N.P. Lindsey spend a lot of time on the phone with out-of-town patients (and their local health care providers) before we ever see them, making sure that nothing important is overlooked before you make the trip. I recommend that at some point you and I also have a phone consultation, so that you will have an opportunity to directly ask me any questions you wish. We usually see you for the first time the day before surgery. On that morning, you get an MRI angiogram at Imaging Specialists of Charleston, then bring the disc to our office to help us plan your flap. We operate the next morning, and you usually spend 4 nights in the hospital. We recommend that you stay in town another 5 nights, if possible, although this is not absolutely required.

We actually discourage you coming back for follow-up visits, as travel is a significant risk factor for blood clots, which is a risk of the surgery (as it is for many other surgeries). If you have a local health care provider who can help with drain management (plastic surgeon, breast surgeon, primary care, etc.) that is helpful, but certainly not essential.  We stay in close contact with you via telephone and secure messaging to manage your post operative period.  You’ll send updates and photos on a routine basis and discuss your progress with our clinical staff.

Most of the time it will take at least 2-3 surgeries to complete the reconstructive process. If you are not radiated, these can be done as closely as 3 months apart (although they can be delayed as long as you wish). None of the subsequent surgeries are anywhere near as big as the initial surgery, and usually you can get by with just two nights in Charleston.

Hope this is helpful, and I hope I get the opportunity to meet you.

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

This week, Gail Lanter, CPC of The Center for Natural Breast Reconstruction answers your question.

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 bodylift 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 the 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 you utilizing the Blue Card program through our contract with BCBS of S.C.

I’m happy to check into that and assure that is the case if you would like. I’d only need a copy of the front and back of your card and some basic demographic information like – Name of insured on card and birthday if different from yours, your birthday, and address. I can run eligibility in a matter of minutes once I’ve received the information.

Also, I am sure that one of our physicians will be sending an answer to the remainder of your question very soon.

I look forward to your reply, we’d love to help you!

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

This week, Richard M. Kline, Jr., MD and James Craigie, MD of The Center for Natural Breast Reconstruction answers your question.

Question: I had left implant removed due to contracture. ( double mastectomy and left radiation) Just had DIEP surgery that failed so now have no left breast. I am thin , especially now with little belly removed. What are my options for reconstruction now?

Answer:  I’m sorry you are having such difficulty getting a satisfactory reconstruction. As you know, given your history of radiation and prior problems, you are unlikely to ever get a successful reconstruction of the left breast with an implant.

When the DIEP is not available, the next option is often the sGAP flap (from the buttocks). This is far less widely available than the DIEP flap, but we have performed about 300, with a 95.7% success rate (our DIEP success rate is a little higher, at 99.08%). Other options include the PAP flap, from the posterior upper thigh, the anterolateral thigh flap, and the latissimus flap. The latissimus is rarely large enough to use by itself, and is usually combined with an implant; unfortunately, in a radiated tissue bed, the implant still often does not work well, even with a latissimus covering it.

Sometimes we can do two smaller flaps at the same time to reconstruct one breast. This is more difficult with a previous flap failure, as the recipient vessels are a little harder to reach, but we have done it successfully in some cases.

Over the last few years we have gained extensive experience augmenting the size of natural tissue flaps with fat grafting. This basically means we first do a natural tissue flap, then come back a few months later and do liposuction (yes, it can be a problem getting fat in some people), then inject the fat with specially designed needles into the flap. On some occasions, we have essentially doubled the size of flaps, although our ability to do this obviously varies with different patients’ body types. We have successfully made small “C” breast mounds even with latissimus alone + fat grafting, however.

I would be happy to chat with you by phone, or see you in person and discuss your options further, if you wish.

Thanks for your question!

Answer #2:  I’m sorry to hear you have had a difficult time. I’m sure you still have options. If I had additional information about the size of your natural breast and your body weight I could perhaps be more specific. In our practice we use your own fatty tissue without muscle sacrifice. If the DIEP did not work out then possibly thigh, or buttock fat or a combination of the two would be an option.

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

This week, Gail Lanter, CPC of The Center for Natural Breast Reconstruction answers your question.

Question: Can I see a picture of the expander before it goes into the body?

Answer:  Absolutely! Thanks for your question Mary Lou. Tissue expanders come from a myriad of manufacturers in a wide variety of sizes; each with different shell styles and features. This photo shows two that we have on hand now as samples.

The one on the right with the tabs is by Natrelle and the smaller on the left with no tabs is from Mentor.   The magnetic disc in the middle of each is the fill area.   Are there specific questions you would like answered about breast reconstruction with tissue expanders.  We’re happy to help!

Question: Thank you for the picture of the two different tissue expanders. The expander that is on the left, that comes to a point- is there metal in the frame of it to keep it’s shape? Thank you again for the information.

Answer: No ma’am, there is no support system. Just a shell. Expanders like these start empty and are made to be replaced with permanent implants. The expansion process and saline within is what gives the shape. The only metal is in the magnetic disc used to locate the port during that process.
Hope that helps!

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

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 necessarily 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 very poorly perfused skin would put additional pressure on the skin from within, and quite possibly cause 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 from our surgical team? Just ask!

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

Question: Hi. I was wondering if you could answer a couple of questions. My first question is what would deem breast reconstruction medically necessary? My second question is how much would breast reconstruction and nipple reconstruction cost? I am a size B and have collapsed breasts. I used to be a double D. My nipples are also partially inverted.

Answer:  Breast reconstruction is generally regarded as being medically necessary if the breast is removed for cancer, or to prevent cancer in certain high-risk individuals. It sounds like what you are asking about would be considered cosmetic breast surgery. The most common cosmetic breast surgeries are breast augmentation (with saline or silicone filled implants), breast reduction, or breast lifting. What you describe as “collapsed breasts” could potentially be improved with a breast lift, breast augmentation, or a combination of the two.

Inverted nipples are caused by shortened ducts leading to the nipples. They are fixed by making a small incision adjacent to the nipple and dividing the ducts.

Gail in our office can give you prices for these procedures.

Thanks for your question.

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