Search Results for: implant

Ask The Doctor-What is your experience in reconstruction after radiation

pink-flower-1540614-1279x852This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: Hello, I am a Inflammatory Breast Cancer survivor. I live in Georgia, but I had all treatment and mastectomy atMD Anderson in Houston, TX. My doctors tell me I am ready to have reconstruction. They emphasized that the doctor I choose be experienced in reconstruction after radiation. I would like to know your experience in reconstruction after radiation. I had mastectomy July 10, 2014 and 36 rounds of radiation, some twice a day. Thank you.

Answer: I am glad to hear that you have completed your treatments and are ready to proceed with your reconstruction. First, I would suggest that you consider breast reconstruction options that avoid implants. Implants after mastectomy and radiation are not likely to be a good long term result in general under those circumstances.

Second, using your own tissue (fatty tissue from another area of your body) without sacrificing your body’s important muscles would be my recommendation in general under the circumstances you mentioned. Our practice has specialized in breast reconstruction using your body’s own tissue without sacrificing the  important muscles since 2002.

We frequently treat people who have had radiation prior to their breast reconstruction. I am aware of MD Andersons extensive research regarding inflammatory breast cancer and I agree with their recommendations in general regarding the care of patients who have had inflammatory breast cancer. If you would like more information please let me know. My staff or I could contact you for more specific information. Thanks for your question!

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

In Her Words- I am back to “me”

image-for-thank-you-and-tes

At the time I came to your office, I was unsure that I would ever feel normal again.  I had undergone a bilateral mastectomy in 2013 and had expanders put in at the same time to plan for my implants.  After waiting for about a year and a half, the surgery for the implants was performed.  Within three months, one of my breast implants had to be removed since the skin would not hold due to the radiation I had received.  My plastic surgeon told me it was possible that I might have to live with only one breast.  He told me I was not handling things right and sent me for counseling.  My counselor said my feelings were normal.

I decided to do some research and found you on the internet.  I liked the fact that in your website you said you used my own tissue and muscle.  I think what was most important was that your website said that you understood and saw my situation as a unique individual.  You actually cared about my feelings and that was something I did not feel my plastic surgeon cared about.  

You accepted my insurance and an appointment was set.  From our first meeting I felt very comfortable with you and your staff.  I felt I had been guided to your hands. 

Now after two surgeries I am back to “me”.  I have my body and my life back thanks to Dr. Craigie and The Center for Natural Breast Reconstruction.  If I had known about you and your procedure in the first place I would have been there sooner and saved myself several surgeries and disappointments.  My husband and I would both like to thank you so much for being there for me.  

D.S. – Myrtle Beach, S.C.

Ask The Doctor-What can I do about the pain in the expander?

16973190701_f97a90c094_zThis week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.
Question: What can I do about the pain in the expander?
Answer: Thanks for your question. Expanders can be painful, because they are stretching the soft tissues. If you had radiation, then it can be worse. You should definitely have your surgeon examine you to make sure. In general, there can be multiple reasons for painful expanders. Expanders are usually replaced at a second stage with either a permanent implant or your own fatty tissue. Both are softer and should not be  painful.
Have a question about breast reconstruction or post-surgical you’d like answered from our surgical team? Just ask!

Ask The Doctor-Will my breasts ever be symmetrical?

6868671738_8a02cc2447_zThis week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: I live in Florida. I had breast cancer 15 years ago and had lumpectomy (r) breast and radiation. My right breast is much smaller than the left and is scarred . I would like to make both breasts symmetrical even and lifted. I have been told because of radiation treatment the right breast would not heal properly?

Answer: Thank you for your question. You  are correct that after radiation the breast tissue will not heal normally following surgery to correct asymmetry. Because the radiation impairs healing attempts to lift or change the breast shape often don’t work. Using an implant to increase the breast size is high risk for implant related problems. If surgery is attempted and a healing complication occurs, then the scaring and the result is often worse.

Two possible options for someone in general include:

1) Fat grafting to the radiated breast 

2) Completion mastectomy to remove the radiated tissue and reconstruction of the entire breast with your own fatty tissue. Option 1 would only be helpful for mild to  moderate shape problems and option 2 would be more involved but in my opinion the most helpful approach.

Let me know if you would like more information about these approaches.

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

Ask The Doctor-Can my daughter do mastectomy and reconstruction at the same time?

1562198683_8cd8cb5876_zThis week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: My daughter was diagnosed with DCIS and Stage 2 in lymph nodes. She’s taking 6 rounds of chemo. She may need a mastectomy and then radiation. If she needs reconstruction, can she do mastectomy and reconstruction at same time?

Answer: Thank you for your question; I’m sorry to hear your daughter is going through treatment for DCIS. If she needs to have radiation after her mastectomies, then it is possible to start the reconstruction process at the time of the mastectomies. In general, most would recommend immediate reconstruction with an implant or expander. After the radiation, the reconstruction can be continued with a permanent implant, or her own tissue depending on what option is best for her.

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

Ask the Doctor-When should a patient should have a flap procedure to rebuild a breast?

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

Question: I have been undergoing reconstruction with implants for the last couple of years. My last surgery was January 26, 2015. I have a z-plasty across the breast under the nipple reconstruction scar, not very aesthetically pleasing. Also left with a left small B, right D and pain when I sneeze in the right implant rib cage area. The small B is fine with me. One other issue that has come up is the outbreak of skin blistering which my doctor cannot account for and is ongoing. My question is how do you determine when a patient should have a flap procedure to rebuild a breast given previous medical history?

Answer:  I’m sorry you are having problems with your reconstruction. The issue of when to abandon implant reconstruction and pursue natural tissue reconstruction is sometimes very straightforward (for instance, if you put a tissue expander in a radiated mastectomy wound, and it falls out during expansion), and sometimes less obvious. Although the majority of non-radiated patients reconstructed with implants do well, a significant minority have problems, some such as you have described, and ultimately pursue reconstruction with their own tissue. The decision is often not just a straightforward medical one, but often is very dependent on what your specific goals are for your reconstructed breasts. We would be happy to talk with you more about the specifics of your specific situation, if you wish. Thanks for your inquiry.

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

Ask The Doctor-What can I do about my painful scar tissue?

501787321_335f8e09c7_zThis week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: I have implants over the muscle. One has extreme scar tissue around it that has made it hard and very painful. If I remove them and go under the muscle, is there less chance that this will happen again, and would I need a mesh material to have that procedure performed?

Answer: Thank you for your question. I am thinking that your implants were placed for breast augmentation, please correct me if I’m wrong. In general releasing the scar and repositioning the implants under the muscle may help the problem. Placing the implant under the muscle mainly provides more of your own tissue to cover the implant, which can be helpful for some people. Unfortunately it does not guarantee the problem wont recur. Depending on the cause of the problem this approach may be successful 50% of the time. The use of any type of mesh is not a recommended treatment specifically for scarring around an implant but there are some types of mesh like materials that can help for other types of implant problems. I would need more information about your situation to be more specific. Let me know if you would like to give me some more details. Thanks again.

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

Ask The Doctor-Should I have a 2nd surgery to remove the scar tissue/neuroma

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

Question: I had a direct implant after a mastectomy, and I have had pain from under my arm to the implant along the scar tissue for 4 months. Should I have a 2nd surgery to remove the scar tissue/neuroma?

Answer: Thank you for your question. It is important for the doctor who did your reconstruction to examine you for any specific causes of the pain. If there is no other reason for you to have surgery on the breast, you could consider a nerve block to see if it is a neuroma. If the block did not last, then considering surgery would be next. If you had any other reason for surgery on the breast (capsular contraction for example), then you might skip the block and ask your surgeon if the scar could be removed during the surgery.

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

Ask The Doctor-Should I have a 2nd surgery to remove the scar tissue?

2807332883_cd9104dded_m (1)This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: I had a direct implant after a mastectomy and have had pain from under my arm to the implant along the scar tissue for 4 months. Should I have a 2nd surgery to remove the scar tissue/neuroma?

Answer: Thank you for your question. It is important for the doctor who did your reconstruction to examine you for any specific causes of the pain. If there is no other reason for you to have surgery on the breast, you could consider a nerve block to see if it is a neuroma. If the block did not last, then considering surgery would be next. If you had any other reason for surgery on the breast (capsular contraction for example), then you might skip the block and ask your surgeon if the scar could be removed during the surgery.

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

Ask The Doctor-What does this mean on my billing statement?

2900257491_bae8f6e366_mThis week, Gail Lanter, CPC, of The Center for Natural Breast Reconstruction answers your question.

Question: My recent replacement implant surgery was last week. The billing states “Reconstruction of the Breast Prothesis.” What does that mean?

Answer: Thanks for your question.  The narrative reflected within the billing process of most practice management systems is abbreviated and sometimes determined by the staff of the practice (could be the reason for prosthesis to be spelled incorrectly).  This narrative would normally be taken from the content of the CPT (Current Procedural Terminology) book utilized to assign a 5 digit code to a procedure to send via electronic claim to an insurance company. If you happen to see a 5 digit code on your billing statement that begins with 193XX, I could send you the specific narrative of the procedure billed. Hope this helps!

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