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

Question: I am trying to find a surgeon that can repair an already breast reconstructed breast that was done 5 years ago.

Answer:  Thank you for your question. The answer is yes, I frequently revise breast reconstruction that was performed elsewhere. Whether your previous surgeon is no longer available or if you would like a second opinion I would be glad to help.

My practice specializes in breast reconstruction of all types and we frequently see patients who have failed a previous attempt at breast reconstruction. If it would be convenient for you to come for a consultation let me know and someone from my office will contact you for more details. If not convenient for you to come for a consult we could talk over the phone. Let me know if I can help.

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 am 19 years old and 13 months ago I had a benign lump removed from my right breast. Since then, my right breast has increased in size significantly but my left one has not. My left breast is a full size smaller than my right breast and I’m very self-conscious about it.

I want to get a procedure done that will even them out. I’m just having a hard time finding the right doctor to do it, and I’m unsure how much the insurance will cover. If you could help me with the insurance policies and what your surgeons could do for me, I would greatly appreciate it. Thank you so much.

Answer:  Thanks for your question!

It is difficult to sort out exactly what is going on and what would need to be done based on your brief description, but we would be more than happy to see you in the office and evaluate your situation (medical and insurance).

While your insurance company may not be obligated to cover any treatment without the diagnosis of breast cancer, that does not automatically mean that they won’t.

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 have breast cancer Stage 1 grade2 in my right breast. The surgeons here want to use my latissimus dorsi muscle for reconstruction. This is unacceptable to me because I am very active and snow ski and garden etc.

I think this method runs too much of a risk to my future ability to do things I like to do. I had lipo on my lower abdomen years ago. I do have more than enough fat on my upper abdomen. Can that be used? I am not comfortable with what I have been told so far.

Answer: Thank you for your excellent question! I’m sorry you are having to go through breast reconstruction and breast cancer treatment. You make a very good point and I agree that you should not need to sacrifice your bodies important muscles in order to restore your body after having mastectomy.

In some circumstances it may be necessary but you should know that there are options that use your own natural fatty tissue without sacrificing your important muscles. You should also anticipate that you can continue to be active as before surgery. In our practice we frequently help patients who have had tummy lipo or other surgeries that make the tummy fat inadequate.

We can also use fatty tissue from the buttock or thigh area without sacrificing muscles or using silicone breast implants. Let me know if you would like more information.

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 don’t understand why insurance company doesn’t pay for reconstruction if you’ve had lumpectomy. With radiation your breasts shrink a lot and you are all out of proportion. I finally did get them to pay for prosthesis and bra.

Answer: That’s not always the case with lumpectomy. If the surgery results in a significant defect or radiation negatively impacts the tissue, most times we can submit your case to your insurance company along with photos of the affected area and they will indeed cover a reconstruction surgery for you.

We’re happy to chat with you about your specific situation and see what we can do to help you through that process.

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 wanted to know if you accept patients that are considering implant removal and reconstruction (with no history of mastectomy). If so, I’d like an idea of costs involved. Thank you!

Answer: Thank you for your question. Yes we do surgery to reconstruct and re shape the breasts after implants are removed. The cost is determined by what procedure is necessary to help restore the breast shape.

If your implants were put in for cosmetic reasons then the surgery to restore the breasts is usually cosmetic as well. If you would like to come for a consultation I could give you more specific details regarding the fees.

Alternatively if you can not come for a consult I could get more information from you about your situation. A call from.my staff for more details may be needed. Just let me know if either option is good for you.

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 bilateral mastectomies and wanted to do the natural breast procedure but the surgeon wouldn’t even discuss it. Then he totally botched the reconstruction. I look deformed. I still avoid the mirror. A redo was set but was canceled day of surgery because b/p and bipod star were elevated. I want it redone. I would like to have the natural breasts. I have plenty of abdominal tissue. I am diabetic.

Answer: I’m sorry you have had so much trouble with your reconstruction.

Fortunately, previous attempts at implant reconstruction rarely impact our ability to successfully perform a reconstruction with your own tissue. Diabetes increases your risk of some complications, most notably wound healing problems and infections, but it rarely keeps us from doing the reconstruction at all.

If you wish, we can have one of our staff call you to discuss your situation further.

Thanks for your question, and look forward to meeting with you.

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 tram flap done back in 2012. Didn’t like the results so I didn’t go back to get it finished. I was to receive a breast reduction on my left breast because I was heavy. My left breast is still larger than my right. Can it be re-fixed to how I want so that I can be happy with my body?

Answer: Thanks for your question. Yes you can still have a procedure to adjust your other breast. There is a good chance that adjusting your “heavy” breast will improve the match or symmetry between the two and improve your overall result.

It is also possible that your TRAM breast could be adjusted so that the result is better. If you never went back to have it revised then there is a good chance that improvements could be made. If you would like more information then let me know I can have someone from my office contact you for more information.

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 need a redo of reconstructed breast. It is very high on my chest and it is showing in my clothing.

Answer: Thank you for your question. Sorry you are having problems with your breast reconstruction. If you do not want your surgeon who performed your reconstruction to revise your results then I would be willing to let you know what possible options you have.

We specialize in breast reconstruction and after getting all the details of your surgery I can let you know what my opinion is. My staff will need to contact you for all the details but until then can you tell me if you had implant reconstruction or another type? Also did you require radiation?

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: Diagnosed with breast cancer in Dec. 2013. Had Mastectomy Feb 2014. Reconstruction of left breast Feb. 2015 using TRAM flap procedure. Developed bulge which abscessed/infection (hospitalized 2 weeks). Bulge got bigger (right lower abdomen). Hernia repair Nov. 2015…unsuccessful.

Went to have follow-up laparoscopic hernia repair this week…couldn’t do procedure. Dr. said it wasn’t a hernia….abdominal wall defect….abdominal muscle has protruded into abdomen!

I have no idea what to do next. Having mobility problems because of all this, plus the deformity. I am a 72 year old woman. Any suggestions/information would be appreciated. All procedures carried out at MUSC.

Answer: I’m sorry you are having problems.I can’t say with certainty whether we can help, but I would be delighted to see you and evaluate your situation. If you could bring a disc with your latest CAT scan, and any operative reports, that would be helpful, but we can get that stuff later if you don’t have it.

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 the same physician do the mastectomy as does the reconstruction? Your thoughts?? I am undergoing chemo, will have bilateral mastectomy, radiation then reconstruction?

Answer: Generally speaking, the mastectomy should be done by a general surgeon, and the reconstruction should be done by a plastic surgeon. Often, the mastectomy and stage I of the reconstruction can be done at the same time, but not always. It is done this way for several reasons:

1) It would be difficult for one surgeon to stay up-to-date and proficient at both breast cancer management and breast reconstruction

2) There may be subtle unwanted bias when doing the mastectomy (i.e., extent of tissue removal) if the surgeon knows he also has to do the reconstruction

3) It is more fatiguing for one surgeon to do both procedures, and this could have undesirable consequences.

If you know that you are going to have radiation, then most likely the plastic surgeon will either do nothing, or place a tissue expander at the time of surgery. If you are going to attempt permanent implant reconstruction, the plastic surgeon may try to place the permanent implant before the initiation of radiation, or may leave the inflated tissue expander in place until after you have healed from radiation (usually about 6 months).

If you are planning to have natural tissue reconstruction, the expanders can be removed and flap transfers done after healing from radiation. Natural tissue reconstruction is usually not done at the same time as the reconstruction if radiation is planned, as the radiation can severely damage the transferred tissue.

Hope this helps, please let us know if we can answer any more questions.

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