Search Results for: implant

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

Question: I had a bilateral mastectomy in February 2013. Since that time, I went through expansion and implant procedures. Because my skin was thin, they ended up having to remove everything on the left side. Even after adding donor skin, it did not work. After researching, it seems that I would be a candidate for a DIEP flap procedure. My plastic surgeon is recommending the TRAM flap, but I am worried about taking muscle from my back. Can you please advise?

Answer: I’m sorry to hear that you had some problems with your breast reconstruction. I’m wondering if you had radiation? Thank you for asking about the DIEP procedure. Unlike the TRAM procedure, the DIEP should not involve removing your muscles. The TRAM removes all or part of the tummy wall muscle known as the rectus abdominis muscle. The TRAM also uses the fatty tissue attached to the tummy muscle to rebuild the breast. The DIEP uses the lower tummy fat also but does not remove any muscle. It  also does not remove the back muscle. The back muscle is called the latissimus dorsi muscle and can be  used to help with implant problems.  In general, I would recommend the DIEP procedure for breast reconstruction because it should not sacrifice or remove the tummy wall (rectus abdominis )muscle. I would need more information about your situation to be more specific. Please let me know if you would like more information. Thanks for your question!

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

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

Question: I’ve already had transflap and gluteal flap surgeries. Both failed. What’s different about your methods? Would I be a candidate?

Answer: I’m sorry to hear that you have had problems with your reconstruction. I can’t tell you how our approaches are different than what you have already tried without knowing all the details. I will say that our specialty is using your own fatty tissue without ever sacrificing your important muscles. Our overall success rate for these procedures, in over 1,500 breast reconstructions, is 98.5%.

We do not do the tram procedure, but we prefer the DIEP procedure that uses your tummy fatty tissue without sacrificing the tummy muscle. We also use fatty tissue from the buttock and that approach is called the sGAP procedure.

For patients who have more fatty tissue in their thighs, we can perform the same type of reconstruction using the thigh tissue. If you have not had radiation, there are techniques that require implants and fat injections that could be an option. In that situation, small amounts of fat are taken from multiple areas using techniques similar to liposuction. The fat can then be combined, prepared, and then injected around an implant or alone to perform breast reconstruction. This approach requires multiple procedures with repeat injections of small amounts of fat and when used with an implant is best when no radiation is needed.

I would be interested to know more about your situation. Did you require one breast or two reconstructed? Did you need radiation? What were the circumstances that led to the previous surgeries failing? Were the blood vessels of your chest used to connect to the new breast tissue? Using the buttock tissue is not performed many places and is not always available. I would be interested to know where you had that procedure done. Please let me know if you have more questions.

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

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

Question: Should I have DIEP, after I had radation? I had it in 2013, and now I have non-invasive in same breast. My doctors are wanting to do this.

Answer: Thanks for the question. If you have already had radiation and are going to have a mastectomy, then DIEP breast reconstruction might be your best option. You do not want to have the DIEP breast treated with radiation. Make sure you ask your doctors if you may need radiation again after your mastectomy. Implants after radiation, in general, have higher complication rates and less favorable results.

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

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

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

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

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

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