Your Questions about Natural Breast Reconstruction and Implants Answered

implantsThe following submission below is answered by Dr. James E. Craigie, of The Center for Natural Breast Reconstruction.

I had breast reconstruction in 2009 with implants and am unhappy with the result.  How hard is it to go back and do reconstruction with your own tissue?  What is the recovery time and does insurance give you a hard time if you need to do this?

Sorry that you are having so many problems with your implants, here are several things you need to know.  First of all, if someone required a mastectomy and their insurance company offers coverage for mastectomy; there is a federal law that mandates that insurance company to cover breast reconstruction.  If one technique did not work for you or failed, you are still eligible for another technique.  In our practice, 30% of our patients who undergo reconstruction with their own tissue have had failed implants.  Implant failure can be many different things.  Some people lose their implants because of infection; some have had radiation effects that contributed to rejection of the implant or hardness, while others simply have a result that is not satisfactory to them.  Other factors such as problems with implant itself or leakage can be reasons for implant failure as well.  Depending on exactly what your situation and original surgery was, the challenges of reconstruction following implants can include repair of the chest muscle, removal of leaking silicone, or removal of Alloderm if that product had been used during the initial reconstruction.  All of these things do make the reconstruction more challenging, but certainly our most successful technique to solve this problem is to remove the implants, any leaking implant material, the Alloderm, and the hard capsule that had formed around the implant and replace all of this with your own healthy living tissue.   Our preferred way to do this utilizes muscle-sparing techniques such as the DIEP or GAP, using just your fatty tissue to replace the implants.  Compared to someone who has not had failed implants, you may require an additional one or two revision stages of surgery and may require more time to allow the results to settle and overcome the effects of the previous surgeries.  These issues do make the process more complex, but the success rate among our patients is very high and the completed result is permanent and natural feeling which our patients who have had implant failures report to be their main goal. The recovery time for these types of surgeries is always patient dependent and generally longer than surgeries utilizing implants but our patients are usually back to work anywhere between 4 to 6 weeks.  I hope this has answered your questions and if you have any others I can answer, please feel free to forward them to us.

Do you have a question about breast implants or natural breast reconstruction? Submit your questions here to be answered by our team!



How One Woman Discovered the Positive Outcomes of Reconstruction Surgery and Cancer

Today’s In Her Words post comes to us from a past patient of The Center for Natural Breast Reconstruction, Jakki Grimball. Jakki is a breast cancer survivor who lived in Columbia, SC and traveled to Charleston to receive her DIEP reconstructive surgery. Today, her and her husband live in Charleston where her husband is the director of The Neighborhood House, an organization providing services for people in need, including food pantry, soup kitchen, emergency assistance, sewing classes, resume writing, and more.

See below for our interview with Jakki:

What type of reconstruction surgery did you have and how do you feel about the results?

I had the DIEP flap procedure done October 2007 by Dr. Craigie. The outcome far outweighs the surgery and recovery time. I am very pleased with the results and having a tummy tuck as an added benefit!

Would you make the same decision again if you could go back?

I would definitely make the same decision. I had a friend who had implants and she now wishes she had done the DIEP flap procedure. She’s had several complications. Of course, I believe I had the best plastic surgeon in South Carolina perform my surgery.

What advice would you give to women who have undergone a mastectomy or double mastectomy and are unsure about natural breast reconstruction?

I would and have advised women to have the DIEP flap surgery. It is far better to have natural breast reconstruction than to have a foreign substance placed in the body. I realize advances have been made in breast implants and there are fewer adverse effects; however, I believe that using my own tissue left little opportunity for infections and other complications. I have never regretted having the surgery or choosing Dr. Craigie as my surgeon.

In what ways has breast cancer both negatively and positively affected your life?

The only negative affect breast cancer had in my life was the mastectomy and the chemotherapy. I firmly believe God has a purpose for everything and having breast cancer made me more aware of how fragile life can be. Breast cancer brought my family and friends closer and I hate to say it, but it weeded out those who were truly not my friends. I found out I had breast cancer three days before my wedding and I gave my fiancé the chance to cancel the wedding. He told me he would marry me at my bedside if necessary. So the diagnosis also brought us closer together. I now cherish every moment and I don’t sweat the small stuff (sometimes not even the big stuff).

You and your husband recently relocated from Columbia, SC to Charleston, SC where your husband is the Executive Director of Neighborhood House. Tell us a little bit about this non-profit organization and how it helps the community.

Click here to view a document from The Neighborhood House, outlining their mission and daily services to the community.

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Answering Your Breast Implant Questions

dr. richard klineThe question below is answered by Dr. Richard M. Kline, Jr., of The Center for Natural Breast Reconstruction

I had cancer in my left breast 15 yrs. ago, had the lump taken out, then developed a rather large cyst in the same breast. I had the cyst removed, which left me with only half a breast. I also had 8 weeks of radiation. I wanted a breast implant but the doctor said I couldn’t get one. Since it has been so long, could I now get one? I am 75 but still don’t feel good about my breast. I wear a breast form, but it’s not the same.

It is sometimes possible to reconstruct a lumpectomy defect with an implant, but your history of radiation makes success less likely. To some extent, the size of the implant you would require, and the amount of radiation injury you have sustained, influence the chances for success. Flap surgery, while significantly more involved, is ideal for use in radiated tissues, as it allows us to use healthy, non-radiated tissue to replace what is missing. Age, in and of itself, does not affect the success of either surgery, as long as you are generally healthy.

—Dr. Richard M. Kline, Jr.

Do you have a question about breast implants or natural breast reconstruction? Ask the doctor by emailing us at

What is Capsular Contracture?

breast reconstruction

The below question is answered by The Center For Natural Breast Reconstruction team:

I’m considering implant-based breast reconstruction. My surgeon mentioned a “risk of capsular contracture.” What exactly is that?

Capsular contracture is an abnormal response of the immune system to foreign materials in the human body. Medically, it occurs mostly in context of the complications from breast implants and artificial joint prosthetics.
The occurrence of capsular contraction follows the formation of capsules of tightly-woven collagen fibers, created by the immune response to the presence of foreign objects surgically installed to the human body, e.g. breast implants, artificial pacemakers, orthopedic prostheses; biological protection by isolation and toleration. Capsular contracture occurs when the collagen-fiber capsule tightens and squeezes the breast implant; as such, it is a medical complication that can be very painful and discomforting, and might distort the aesthetics of the breast implant and the breast.

Although the cause of capsular contracture is unknown, factors common to its incidence include bacterial contamination, rupture of the breast-implant shell, leakage of the silicone-gel filling, and hematoma.
Moreover, because capsular contracture is a consequence of the immune system defending the patient’s bodily integrity and health, it might reoccur, even after the requisite corrective surgery for the initial incidence.

The degree of an incidence of capsular contracture is graded using the four-grade Baker scale:

• Grade I — the breast is normally soft and appears natural in size and shape
• Grade II — the breast is a little firm, but appears normal
• Grade III — the breast is firm and appears abnormal
• Grade IV — the breast is hard, painful to the touch, and appears abnormal

–The Center for Natural Breast Reconstruction team

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