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Best of Ask the Doctor

February 8, 2013 by

charleston breast surgeonsAt The Center for Natural Breast Reconstruction, our mission is to help women everywhere make smart, informed decisions about breast reconstruction and overall healthcare.

Over the years, our surgeons, Dr. James Craigie and Dr. Richard M. Kline, Jr., have answered a wealth of questions about breast reconstructive surgery—from the different kinds of procedures to post-op healing tips.

If you’re searching for a thorough introduction to breast reconstructive surgery, here’s a sample of the invaluable advice our surgeons gave the past year:

Your Questions about Natural Breast Reconstruction and Implants Answered

Scarring After Breast Reconstruction Surgery

Tackling the Challenges of Breast Reconstruction After Lumpectomy and Radiation

The Benefits of DIEP Flap Breast Reconstruction Over Other Reconstructive Options

Is This Normal? Your Post Op Breast Reconstruction Question Answered 

Tips for Improving Recovery and Healing Time

If you are seeking advice about breast cancer, breast reconstruction, or healthcare options, please send your questions our way! We will address all of your questions with detailed and valuable insight straight from our surgeons.

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Wound Healing Post Breast Reconstruction Surgery

November 30, 2012 by

The below question is answered by the Charleston breast surgeon, Dr. James Craigie.

How do you determine when to use a wound vac in place of a traditional drain?

We have discussed the idea of using a wound vac in place of drains.  We have actually determined the use for combining the wound vac and drains under certain circumstances.  Some people have had radiation or have challenging wounds that result from wound healing problems combined with fluid collections caused seromas.  Sometimes drains are needed to evacuate seromas but unfortunately they are not always adequate.  Also, radiated tissues have difficulty healing and wounds developed in radiated tissue sometimes typical wound dressings may not be adequate as well.  We have used the wound vac combined with the drain in order to treat these complex wounds.  We have found that complex wounds are usually a combination of wound separation with fluid collections.  The drain actually passes through the wound vac sponge, the wound vac sponge is then covered with the steel dressing that is connected to a pump and the strong negative pressure generated is greater than the pressure of a normal drain.  This allows a deep pocket of fluid to be dressed with the drain tip and the open skin edge or wound edge to be treated with the sponge.  When the wound vac dressing is changed every 3-5 days, the drain can be backed out slowly and therefore as the wound edge heals, the fluid collection is controlled and the wound eventually heals quicker than other approaches.

-James Craigie, M.D.

Get answers to your questions about breast reconstruction and breast health straight from our surgical team! Submit your questions here today.

 

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Packing Guide: What to Pack in Your Hospital Bag for Breast Reconstruction Surgery

November 28, 2012 by

At The Center for Natural Breast Reconstruction, we know the key to a comfortable recovery begins with what you pack for your hospital stay. When preparing for your breast reconstruction surgery, pack the right things can give you some control over the upcoming experience, and can help you prepare mentally, physically, and emotionally. Consider what things may give you comfort and peace of mind, and take those items, along with an optimistic outlook.

Here’s our checklist for things you’ll need to bring along for breast reconstruction surgery, as well as some suggestions for items that will offer you comfort during your visit:

Prepare for Hospital Check-In. Get ready for your hospital stay, and make sure you bring everything you need for check-in paperwork. This includes:

  • Your identification
  • Your insurance card
  • Your checkbook
  • Admission papers (if applicable)

 Pack Relaxed, Easy Clothing. While packing for your return trip from the hospital, keep in mind that you may have surgical drains, dressings, and tender incisions. Make comfort your top priority when you choose your clothing to wear after your surgery, and bring along:

  • Loose tops that close in front. You may not feel like lifting your arms or pulling on anything over your head.
  • Elastic-waisted pants. Not only are these are easy to get into and out of, but also easy for someone to help you slip on.
  • Slip-on shoes with a good tread. If you don’t want to bend down and tie up shoelaces, have some slip-on shoes at the ready.
  • Post-surgical bra. Ask your surgeon which will be best for you—a supportive bra, or a sports bra. Look for a front-closure bra—it may have to fit over your dressings, and having the closure in front gives you more control over getting dressed.
  • Robe, slippers and warm, clean cotton socks. There’s nothing more comfortable than a soft bathrobe—and it’s easy to slip on and off without lifting your arms. And it’s always a good idea to keep your feet warm and covered!

Bring the Comforts of Home. Since you will be staying overnight in the hospital, bag up some soothing items that help you pass the time and give you a sense of reassurance, such as:

  • Your regular medications.
  • Your toothbrush, toothpaste, and deodorant.
  • A makeup kit and some skin lotion to help lift your spirits.
  • iPod with earphones so you can listen to your favorite calming music.
  • Novels or magazines to occupy your mind while you recover.
  • A journal, needlework or other items to keep you comfortable and busy as you rest in the hospital.
  • A small comfort pillow for keeping a seatbelt from pressing on your chest during the ride home.

Do you have other questions about how to prepare for breast reconstruction surgery ? Let us know in the comments section below!

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Can I Use Vitamin E on Incisions Resulting from Breast Reconstruction Surgery?

October 19, 2012 by

vitamin e on incisionsThe below question is answered by Charleston breast surgeon, Dr. James Craigie, of The Center for Natural Breast Reconstruction.

Is Vitamin E of any use on incisions? 

Scarguard or silicone sheeting may be a better alternative.  There are several things, scientific improvements, which helps the appearance of scars. Silicone is probably the most effective.  Silicone works by an unknown mechanism to help soften raised or severe scars regardless of how old they are.  The other technique proven to work is massage.  Topical massage can help the scars whether they are new or old and combined with silicone is probably the most useful combination treatment for difficult scars.  Scarguard is a product that contains silicone, comes in a liquid form is painted on like fingernail polish, and because of the silicone component it is effective for some scars.  Regarding Vitamin E, there have been some studies to hint that it may help with scar formation and some people find a benefit in taking vitamin E orally from a capsule or rubbing it into a scar.  However, it may be that massage is more effective than the Vitamin E.  In summary, the best answer is that all of these techniques can help.  They must be used at the appropriate time so it is always best to ask your surgeon for guidance as to when the best time to begin scar therapy would is.  Also, it is important to know that no technique will make scars disappear completely.  The goal with these treatments is either to minimize the severity of the scar or to improve its appearance.

-James E. Craigie, M.D.

Have questions about breast reconstruction options? Submit them here and get answers straight from our surgical team!

 

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The Advantages of ICAP Flap Breast Reconstruction and When to Use This Procedure

July 13, 2012 by

The below question is answered by Charleston breast surgeon, Dr. James Craigie of The Center for Natural Breast Reconstruction.

When would we use the ICAP flap for breast reconstruction and what are the advantages of this procedure?

The TCAP flap is a procedure for reconstructing the breast or partial breast reconstruction and is another of the muscle-sparing flaps. The ICAP does not require microsurgery or reattachment of the blood vessels, but usually the amount of tissue available is small.  In our experience it is most frequently used to perform partial breast reconstruction of mainly the outer side of the breast or to add volume to a previously reconstructed breast or when the resulting size is not as quite as large as desired from the original planned procedure.  An advantage of the ICAP flap is that it removes tissue from the side of the body that is usually in excess and sometimes bothersome following a mastectomy.  It is just above the bra line and the scar, and although it extends to the back, can almost always be covered in a bathing suit or a support type bra.  Again, the ICAP’s best use is in adding additional tissue to an already reconstructed breast or providing small amounts of tissue for partial breast reconstruction.  It typically does not involve microsurgery to reconnect the blood vessels and the blood vessel that nourishes the tissue is conveniently located on the side of the body near the breast just above the bra line.

For more answers to your breast reconstruction questions, visit our Ask the Doctor section of this blog or submit your questions here.

 

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The Benefits of DIEP Flap Breast Reconstruction Over Other Reconstructive Options

May 11, 2012 by

diep reconstructionThe below question is answered by Charleston breast surgeon, Dr. Richard M. Kline, Jr. of The Center for Natural Breast Reconstruction:

What are the benefits of the DIEP flap breast reconstruction over other options?

I am going to break this question into two parts.

The first part is what are the benefits of the DIEP flap over reconstructive options using implants?  Let us start with the benefits of implants.  The primary benefit of implant is that the operations are shorter, they are potentially safer, and you do not need to operate on another part of the body. Additionally, implants are readily available, and if you do not have enough extra body tissue somewhere to make a breast, implants may be the preferred choice for this reason.  The advantage of the DIEP flap over implants is that it produces a much more natural feeling, warmer, and trouble free breast (after the reconstruction process is completed).  There is data to suggest that women tend to accept the reconstructed breast as their own more readily if it is made using their own tissue, in comparison to women who have a reconstructed breast using implants.  Additionally, many women feel that they have too much extra tissue in their abdominal area, and they may actually view removing this tissue to make a breast as an added bonus.

The second part of this answer is going to be why is the DIEP flap better than other reconstructive options using the patients own tissue, with the most commonly performed in our practice being the GAP or gluteal artery perforator flap, which is taking the buttock.  The primarily advantage of the DIEP over the GAP is that it is faster, and no position changes are needed during surgery to harvest the flap.  If the patient has adequate abdominal tissue to meet her reconstructive needs, we generally recommend using this as our first line option.  Having said that, however, the buttock serves very well to make breast, although the process is a little more tedious and lengthy.

Would you like your breast reconstruction question answered? Just ask us!

 

 


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Water Soluble Vitamins: What Do They Do and How Do You Get Them?

April 30, 2012 by

vitaminsVitamins are either fat soluble (stored in fat) or water soluble, which means they dissolve in water and must be replenished daily. The fat-soluble vitamins are A, D, E, and K, and the B complex and C vitamins are water soluble.

Vitamin B Complex

The B vitamins, also known as the B complex, are a group of eight vitamins that perform a variety of functions in the body. They help your body’s cell division and metabolism perform at peak efficiency, aid your immune system’s function, and promote healthy hair and skin.

The main sources of the B vitamins are whole grains, beans and legumes (including peanuts), animal products, yeast, and green or cruciferous vegetables. The vitamins are listed below along with their common names and prime sources:

B1: Also known as thiamine, B1 is found in whole grains, cruciferous vegetables, and animal products.

B2: Called riboflavin, this B vitamin is found in dairy products and green vegetables.

B3: Food sources high in niacin include meat, fish, and vegetables.

B5: Find pantothenic acid in animal products and green vegetables. Women may recognize this as an ingredient in beauty products.

B6: Also called pyridoxine, eat plenty of veggies and meat to get your B6.

B7: Biotin (also an ingredient you might recognize from beauty products) is found in animal products and peanuts.

B9: Folic acid is a vital nutrient for a healthy pregnancy and is found in grains and leafy vegetables.

B12: This vitamin, cyanocobalamin, presents challenges to vegetarians and vegans because it is found only in animal products.

Vitamin C

Known as ascorbic acid, vitamin C aids metabolism, fights infections and acts as an antioxidant. It also promotes healing, such as from breast reconstruction surgery,  so we always suggest you ensure you’re getting enough. It’s found primarily in fruits and vegetables, as well as some meats such as liver. Sources high in vitamin C include peppers, berries, rose hips, and parsley.

The water-soluble vitamins are easily supplemented if the diet is deficient, though natural sources are always the best way to ingest them. These vitamins degrade when cooked, so raw foods are preferred. The important thing is that you’re receiving at least the reference daily intake (RDA) each day, as excess B and C vitamins are excreted in the urine.

 

 

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Potential Issues to Watch for After DIEP Flap Breast Reconstruction

April 27, 2012 by

The below question is answered by Charleston breast surgeon, Dr. Richard M. Kline, Jr. of The Center for Natural Breast Reconstruction:

What potential issues should I be watching for right after having DIEP flap breast reconstruction?

I am going to split the answer for this into two parts.  First, what you should watch for while you are in the hospital (at which time you will, of course, have lots of help watching for things). Second, what should you watch for when you go home?

When you are in the hospital, we primarily look for changes in the vascular status of the flap.  There are monitors attached to the flap which will within seconds pick up any change in the blood flow to the flap.  If on further evaluation by the nurses, it shows that there is a problem, we will take you back to surgery immediately and attempt to correct the problem.  Fortunately, incidents such as these are rare, but if they do occur.  We have learned that the most important factor is to get to the operating room quickly, in which case we can almost always fix whatever might be wrong.

Thankfully, it is unbelievably rare to have a problem with the blood flow to the flap after going home, although it is not impossible.  Your primary concern should be to follow the specific directions which we have given in terms of positioning and brassiere support.  Most patients still have temperature monitoring strips attach to the flap, and this can serve as useful reassurance to let you know that your flap is fine.  Infections are extremely rare after DIEP flap surgery, but they can occur either at the reconstruction site or at the abdominal donor site.  Wound healing problems are not as rare as infections but may occur.  If you are not radiated, the most likely place to have a wound healing problem is your abdomen.  If you are radiated, it is very common to have a little bit of a wound healing problem where the healthy flap tissue meets the radiated breast skin.  Essentially all wound healing problems can be managed very effectively, so it is not something you need to worry about.

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Upcoming Webinar: “Is Natural Breast Reconstruction Right for Me?”

April 2, 2012 by

NBR WebinarWe at The Center for Natural Breast Reconstruction are excited to announce our upcoming webinar, Is Natural Breast Reconstruction Right for Me?, happening Thursday, April 12, at 7:00 p.m. Eastern / 4:00 p.m. Pacific.

Intended for anyone who has been affected by breast cancer (including those who have been recently diagnosed, those currently in treatment, those currently in remission, and family and friends of those with cancer), the no-cost webinar will provide information about women’s options for natural breast reconstruction

Unlike other types of post-mastectomy breast reconstruction, natural breast reconstruction uses tissues from a woman’s body to create natural looking and feeling breasts. The webinar will be hosted by The Center for Natural Breast Reconstruction’s Dr. James Craigie and Dr. Richard M. Kline, Jr.,MD, both of whom specialize in natural breast reconstruction surgery.

During the hour-long event, the surgeons will educate attendees about…

  • Exactly what natural breast reconstruction entails and who is eligible for this type of surgery.
  • The language and shorthand of natural breast reconstruction, defining and explaining what all the natural reconstruction acronyms (including DIEP, GAP, TUG, and SIEA) mean.
  • What patients can expect in terms of hospital stays, recovery time, and scarring.
  • How The Center for Natural Breast Reconstruction handles insurance and what types of insurance we accept.

We’ll also open the phone lines to a live Q&A session with the surgeons and our insurance specialist so attendees can get answers to all their questions related to natural breast reconstruction.

To join us for the webinar, register here.

Note: if you are busy on April 12, register today, and we’ll send you a link to the replay, which you can watch at your convenience.

 

 

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The Best Tours of Charleston

March 21, 2012 by

Charleston ToursCharleston, South Carolina, is commonly cited as one of the nation’s most historical cities. Many of our patients who come for breast reconstruction surgery stay long enough to enjoy the eclectic sights Charleston has to offer.

The next time you’re in town, consider making time to visit one of these excellent Charleston tours.

Historic Charleston Tour

Founded in 1670, Charleston boasts more than three centuries of fascinating history. Join the historic tour to learn about Charleston’s role in the Revolutionary and Civil Wars, as well as the natural disasters that the city has withstood through the years. Your licensed tour guide will draw your attention to more than 100 points of interest. Hotel pick-up and drop-off service may be available.

Old Charleston Walking Ghost Tour

Keep your mind sharp and your body healthy with a walking tour of Charleston’s most haunted places. Tour guide Mike Brown offers more than a decade’s worth of research about the city’s spookiest alleys, graveyards, and other locations. Offered at 7:30 and 9:30 p.m. daily, these tours are sure to get your heart thumping and can act as either a main attraction or the opening for an exciting night on the town.

Historic Harbor Boat Tour of Charleston

Relax aboard a boat for a nonstop tour from the water. During your 90-minute sea adventure, you’ll learn about the historically significant Charleston Harbor and get to view three major forts (Moultrie, Sumter, and Johnson). The tour also includes views of Charleston’s best-known landmarks, including St. Michael’s Episcopal Church. If you keep your eyes on the water, you may even spot dolphins, pelicans, or other Low Country sea life.

Gone with the Wind City & Mansion Tour

Relive the beauty and drama of Margaret Mitchell’s iconic novel on Charleston’s Gone with the Wind City & Mansion Tour. You’ll see the French Quarter, the Market, Old Citadel, and the Rainbow Row of homes in pastel colors. The tour concludes inside the historic Manigault House, complete with antique furniture and architecture.

 

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