Posts Comments

You are here: Home / Archives for breast reconstruction

July Q&A #1

August 19, 2019 by

Q.I’m waiting to have surgery to take a cancer lump from my left breast. Then I will be taking radiation treatment. Will my breast be disfigured from this and will I be suitable to build my breast appearance with reconstruction surgery?
Judi

A.Hi Judi, Sorry you’re having to go through this. Management of a lumpectomy defect can be more complicated than reconstructing an entire breast after mastectomy. If you are sure you want to have a lumpectomy instead of mastectomy, then it may be best to have a plastic surgeon do reconstructive surgery on your breast at the same time as your general surgeon does the lumpectomy, before radiation, as the radiation will make any subsequent surgery to improve the shape of the breast much, much riskier (particularly regarding wound healing problems). If you would like to discuss your situation in more detail by phone, I would be happy to speak with you.

Richard M. Kline, Jr., MD

Filed Under: Health and Wellness Tagged With: , , , , ,

Coping after surgery

August 19, 2019 by

Surgery is a common method of treating breast cancer, but it can be overwhelming. There is so much to think about and you might be feeling scared, especially about how you will handle recovery. Here are some tips that we hope will help to make your recovery easier:

Prepare: Recovering from breast surgery really begins before you even have your surgery. It will take you a few weeks to recover, at least, so take time to brainstorm everything you do on a daily and weekly basis. What can wait to do until after you’ve recovered? What do you need help with on a daily or weekly basis? You will need assistance, but before you make any arrangements, figure out exactly what those needs are. For example, do you need someone to drive the kids to activities? Take the garbage out? Cook or clean for you? Help with laundry or taking care of your bandages?

Find support: Once you know what you need, it is time to create a support system. You might need someone to help you dress, undress and bathe until your doctors remove your drain, if you’ve had a mastectomy. Ask what your spouse can help with and see where there are gaps. Perhaps your children, a few close friends or relatives can alternate times to help you. Neighbors might offer to take your children to their activities, while your mom offers to cook and do the housework for you.

Stock up: Make sure to cook and freeze a few days or weeks worth of meals before surgery, so you have easy-to-grab foods and snacks. Eating healthy is important for your recovery too, so choose low-fat, highly nutritious options. Keep fruit, vegetables and water on hand as well.

Don’t forget that you may have an issue putting on your current clothes, so consider purchasing several shirts that are a little larger than what you currently wear and that button up in the front so they are easier to get on and off and do not rub against your incision.

Don’t overdo it: Everybody wants to get back to their regular routine after surgery, but it’s important for your recovery that you don’t overdo it. Get plenty of rest and sleep, especially in the first few weeks.

Follow post-surgery care: You will be given exercises to do after surgery, information on how to care for your skin and directions on what you can and can’t do. For example, you may not be able to shower for a week or go in a pool for several weeks. Make sure to keep your follow-up appointments too. To heal properly, be sure to follow all directions that you’ve been given.

Be observant:If you have a drain, keep an eye out for any excess blood, signs of infection or other problems. If you see something that doesn’t seem right, contact your physician right away.

Filed Under: Health and Wellness Tagged With: , , , , ,

Breast Reconstruction: What Are My Options after an Unsuccessful Reconstructive Surgery?

July 10, 2018 by

Making the decision to undergo breast reconstruction surgery is a decision that is not taken lightly.

That’s why it breaks our hearts when we discover that there are women out there who are unhappy with their reconstructive results.

Over the past few months, we’ve heard from several ladies who want to know what their options are when their surgery doesn’t turn out as planned.

We thought our insight would be helpful to others who are facing the same problems as these courageous women.

Here are our answers to what your options are after an unsuccessful reconstructive surgery.

What Are My Reconstruction Options after a Failed Implant Reconstruction?

Question: Do you do reconstruction after ex-plants from a ruptured implant?

Answer: If you have had mastectomies, we will attempt to do reconstruction no matter what has happened, as long as you want it, and it’s medically safe to do so.

If your breast sustained damage from a ruptured implant placed for cosmetic reasons, we will still be happy to help you, but this might not be covered by your insurance.

I hope this helps.

See the full post here.

I’m Unhappy with My Reconstructive Result from Another Surgeon – Are You Able to Make It Look More Natural?

Question: Three years ago, I had a double mastectomy and am now cancer free.

My plastic surgeon did a terrible job with the reconstruction.

The left side implant is way off to the outer side and looks larger than the right side. The right side is way too far to the outside. There is zero cleavage.

Is there any way to reposition the implants more to the natural position of the breast?

I do not expect perfect, but don’t like looking like a botched job. Thank you.

Answer:  I’m glad to hear you have been cancer free and have your treatment for breast cancer behind you.

At The Center for Natural Breast Reconstruction, it is part of our mission to help women move on with their lives after breast cancer. We focus our efforts on helping women get their bodies back together with permanent “natural results.”

I’m sorry you are disappointed with your reconstruction.

If you have had radiation, then it may be very hard to have your breasts match with implant reconstruction. If you have not had radiation, then perhaps your implants could be revised or adjusted for an improvement.

Unfortunately, these corrections are all too often temporary. It is possible that using your own fatty tissue would be a more permanent option without implants.

Sometimes it is hard to start over with another approach, but it may be necessary if you desire a more natural and permanent result.

If you would like more information about natural breast reconstruction with your own tissue, let me know.

See the full post here.

I Have Implants But They Feel Horrible and My Reconstruction Looks Terrible. Is There Any Hope after Reconstruction?

Question:  I have implants. I do not like them, they feel horrible, and my reconstruction looks terrible.

Is there any hope after reconstruction?

Answer:  Fortunately, your previous experiences with implants in all probability do not affect our ability to get you a satisfactory reconstruction using only your own tissue.

See the full post here.

Do you have breast reconstruction questions? Send us your questions here! 

Filed Under: Health and Wellness Tagged With: , , , ,

3 Common Questions about Breast Reconstruction Pain and Discomfort

June 19, 2018 by

After breast reconstruction surgery, patients are bound to experience some sort of recovery pain or discomfort.

This mild pain often leads patients to ask questions such as…

  • How long will the pain last?
  • Is my pain normal?
  • Should I call my doctor?

At the time, a person’s pain or discomfort might seem unusual or scary…and the last thing we want is for patients to worry.

For that reason, we’ve decided to put together the answers to a few of our most common pain-related questions.

Find out what our surgeons and staff have to say about the following concerns…

What Are Your Suggestions for Muscle Spasms after Breast Reconstruction?

Question: I had breast reconstruction on my left breast in 2006. I have had muscle spasms in it ever since. Recently they have gotten bad again.

Any suggestions?

Answer: I’m sorry you are having problems with your reconstruction.

You didn’t mention if you were reconstructed with an implant or with your own tissue, so I will answer as if you are reconstructed with an implant. Please let me know if I have assumed wrongly.

There are several potential reasons why you could have spasms.

If the implant was placed under the pectoralis chest muscle, it can lead to pains in the pectoralis muscle or other muscles, as the muscle is no longer functioning in precisely the way it was designed to. Most people tolerate the implants well, but there is no question some have more problems than others.

The muscle can also sometimes separate from attachments to the chest wall over time, which could cause changes in symptoms.

Additionally, if you are radiated, this could potentially cause additional problems, as the muscle may be less flexible.

View the full post here.

I’m Having Pain after My Last Latissimus Flap/Implant Reconstruction. What Can I Do Now?

Question: I was diagnosed with breast cancer in 2011 and had a mastectomy on my left side followed by chemo.

In 2014, my mammogram began showing tumors and I would have an ultrasound every time. This caused panic attacks and I choose to have my right breast removed because the type of cancer I had was Stage 4 Aggressive.

In April 2015, I had a bilateral latissimus flat and received implants. Now I am experiencing pain across my back where I was cut and my chest gets uncomfortably tight.

The site of the drainage tube is swollen and doesn’t feel good. I stopped seeing my reconstruction doctor because he did things I was not informed of. I am worried because I do not know what is going on anymore.

Could you please advise me as to what might be going on or what to do?

Answer: I’m sorry you are continuing to have problems, but you are not alone.

I can’t speak about your situation specifically because I haven’t examined you, but here are some thoughts in general about patients with symptoms like yours.

There is no question that many people with implants describe symptoms such as yours. Often, there is no discernible reason why they should feel discomfort, but they do. Nonetheless, many of them feel relief when the implants are removed. This does not mean that you would or should, it is just an observation.

The latissimus flap can be done with or without dividing the nerve that makes it contract. I have known some patients with latissimus flaps done without dividing the nerve to have discomfort associated with the muscle contracting. Some have experienced relief when the nerve was subsequently divided. Obviously, I don’t know if this is your situation or not.

Sometimes people have complex, persistent pain after surgery or injury which is out of all proportion to what would be expected. This can be difficult to treat but thankfully is rare.

When evaluating a patient with symptoms like yours, we usually start with a careful history and physical evaluation.

Sometimes, especially if we have concerns about implant rupture, fluid collections, infection, etc., we then get an MRI and/or CT scan. Following the complete evaluation, we then decide together how to proceed.

View the full post here.

Are These Normal Problems to Have 2 Years after a Breast Reduction?

Question: I had a breast reduction over two years ago. It still feels like I have scar tissue in some areas and nipple tends to be a little sore at times.

Is that normal?

Answer: No, that’s not normal, and I’m sorry you’re having to endure it.

I can’t tell what is going on by your description, but it’s possible that you have some residual dead fat in your breasts which has not been resorbed.

An MRI scan would be the best way to determine this.

It’s also possible that you have pain for no discernible reason, which is unusual, but it happens from time to time. That doesn’t mean it can’t be treated, however, as pain therapists can be very effective in helping manage that type of pain.

View the full post here.

Do you have breast reconstruction questions? Send us your questions here!

Filed Under: Health and Wellness Tagged With: , , , , ,

Ask The Doctor: I Had A Breast Expander Removed and Can’t Re-start Breast Reconstruction For 6 Months. What Are My Best Options?

June 8, 2018 by

Daliahs

This week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I have started my reconstruction, but had to have one side removed and can’t start on that side for 6 more months. My one side has 80 ml saline in it. What are my best options?

Answer #1: Can you tell me why you had to have one side removed?

Richard M. Kline, Jr., MD

Answer from the patient: It started with a blood clot and just kept getting infecting.  So my surgeon removed it so I could start my chemo and to get the infection cleared up, which it has cleared up completely.  I have started my chemo, which I have 4 to 5 treatments. Then after 6 months from have inflated removed I can start the reconstruction procedure.

Answer #2:  Sorry you’re having trouble. I think your surgeon was wise to remove the expander, you certainly don’t want to delay chemo.

If you weren’t radiated, it may be reasonable to try another expander after finishing chemo. I think the chances of it working may be less than usual since you’ve had trouble before, but nonetheless, it may work next time.

If you would like to forego expanders/implants and have reconstruction with your own tissue, the chance of getting an infection will be much less, and the quality of the reconstructed breasts will be much more natural. The surgery involved is larger, and it’s not for everyone, but once you are done there is essentially nothing to ever go wrong later. Previous unsuccessful reconstruction attempts with implants generally don’t affect our ability to reconstruct you with your own tissue, so if you want to try implants again after chemo, the natural tissue option will still potentially be there if implants don’t work again.

I would be happy to chat with you more about your situation at any time if you wish.

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

Filed Under: Ask the Doctor Tagged With: , , , ,

Ask the Doctor – What Are the Pros & Cons of Reconstructive Breast Surgery?

June 1, 2018 by

yellow flowers

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

Question:  What are the pros & cons of reconstructive breast surgery?

Answer: Thanks for your question. Ultimately the pros for breast reconstruction include restoration of a woman’s body following surgical removal of part or all of her breast/breasts. Surgery to remove the breast is performed to prevent or treat breast cancer. The ultimate goal of reconstruction is to restore physical well being and quality of life. Breast reconstruction using your own natural tissue provides the opportunity to achieve the most natural results. Even restoring breast sensation is possible (not guaranteed and not necessarily complete) using your own natural tissue. The cons of natural tissue are that the patient must donate the natural tissue from another part of the body. That means scars and healing in more than one area of the body. Surgery always requires down time, recovery and time away from working etc.. Also reconstruction almost always requires more than one surgery.

Breast reconstruction using implants is generally less natural than using natural fatty tissue that contains healthy blood vessels and nerves. The advantage of implant reconstruction is that surgery is not required in another area of the body and there are fewer scars in areas of the body other than the breast. Long-term, reconstructions with implants require more revisions due to implant problems and are generally less permanent than using your own tissue.

There are always individual factors and expectations that may change the pros and cons. Hopefully, this brief synopsis has answered your question. Please 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!

Filed Under: Ask the Doctor Tagged With: , , ,

Ask the Doctor -After Two Different Types Of Reconstruction Over The Years, What Can I Do To Regain Some Symmetry?

May 18, 2018 by

Wild RoseThis week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I had my first mastectomy in 1991 with a tram flap reconstruction. My second mastectomy was in 2004 with an s-gap reconstruction. In the last few years, my breasts have become increasingly uneven and have shifted on my chest. Is there something I can do to my reconstructed breasts to regain some sort of symmetry?

Answer:  Without knowing any more specifics of your situation, I can state in general terms that asymmetry after reconstruction is very, very common and that there are a host of techniques which we routinely use to minimize asymmetry as much as possible. Some of these techniques are fat grafting, reduction, contour alteration, and position changing. We have currently performed almost 1700 perforator flap reconstructions, and we likely have significant experience dealing with situations very similar to yours. I would be happy to see you in consultation any time or chat on the phone if you wish.

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

Filed Under: Ask the Doctor Tagged With: , , , , ,

Ask the Doctor – Would I Be A Candidate For DIEP Flap Surgery After Previous Expanders Are Removed And Will You Accept VA Insurance?

May 11, 2018 by

This week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I had a bilateral mastectomy with reconstruction and I am terribly dissatisfied with my care so far. 11 Months later, the expanders are still painful. I will be asking to have them removed this week.

I have 2 questions for you. After I  have the expanders removed would I still be a candidate for the DIEP flap? I am still going to chemo (Herceptin) which will run until the end of November, provided there are no more setbacks. My second question is, do you accept VA insurance? One form of payment is through the VA another is Veteran’s Choice. I am not sure which would cover outside care. I look forward to your response.

Answer: I’m sorry you have had so much trouble, but there is a very good chance that we can help you.

Your previous unfortunate experience with expanders does not in any way decrease our ability to successfully reconstruct you with DIEP flaps. The blood vessels which we use to vascularize your flaps are well below the area where tissue expanders are placed, and we have successfully reconstructed literally hundreds of patients in your situation. One potential advantage to having the expanders removed sooner rather than later is that we get an MRI angiogram on all patients who are scheduled for perforator flap breast reconstruction, and most breast tissue expanders are not MRI-compatible. If they use a little magnet to find the port before they fill your expanders, then you can’t get an MRI with those expanders in place.

We have worked with the VA many times in the past, and Gail, our insurance expert, will contact you to investigate your situation further.

Thank you very much for your inquiry, and I look forward to meeting you.

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

Filed Under: Ask the Doctor Tagged With: , , , , ,

Ask the Doctor – Could Odd Pains In My Body Be The Consequence Of an Old Abdominal Flap Surgery Following A Halstead Radical Mastectomy?

April 27, 2018 by

Poppy in a feild

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

Question:  In 1987, I had abdominal flap surgery following a Halstead radical mastectomy. I keep wondering what is NOW going on in my body! When I feel odd pains I wonder if it could be repercussions of that surgery so long ago.

Answer:  Thank you for your question. If you had your surgery in 1987 and you had reconstruction using your abdominal tissue then I will assume that you had a Tram procedure. That surgery relies on partially removing the muscle from the abdominal wall. Not having the muscle in place can cause problems later in life. People can have pain or bulging of the tummy and even hernias. Of course not all patients have those problems. If your problems are in the tummy area then that is a possibility. If your problems are in the area of your breast or mastectomy then you should consider seeing a breast surgeon that specializes in doing mastectomies to make sure all is well with regard to your breast area. You could also see the doctor who follows you regarding your breast cancer history. Scaring from a “Halstead” mastectomy especially after radiation could cause aches and pains later in life. Regardless of what it might be you should definitely be seen by your doctor so they could do a complete evaluation of your symptoms. After an evaluation they could make more specific recommendations. I hope his information helps. Let me know if you have further questions.

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

 

Filed Under: Ask the Doctor Tagged With: , , , , ,

Ask the Doctor – What Are My Chances With DIEP Flap Surgery After Several Failed Reconstructions With Tissue Expanders and Implants?

April 13, 2018 by

Sunflowers

This week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I have had several failed reconstructions with tissue expanders and implant. I have also been put on IV antibiotics due to a staph Infection. I am wondering what my chances are with the DIEP Flap.

Answer:  Great news! Your prior failures with implants does not in any way decrease your ability to get soft, warm breasts with DIEP flaps. Many, many, many of our patients have histories of prior failures with implants, some with (10-20) prior failed surgeries, and we have been able to successfully 99+ % of them with only their own tissue. Once the infection from prior implants is eradicated from your body (if you have been healed for at least 6 months, you can generally assume that all the prior infection is gone), then subsequent reconstruction with your own tissue carries only a minuscule fraction of the infection risk of reconstruction with implants. You didn’t mention if you were radiated, but it makes no difference, breasts reconstructed with your own tissue are still extraordinarily unlikely to have problems with infection.

We would love to chat with you and discuss your options further. Looking forward to speaking with you, and thanks for your inquiry.

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

Filed Under: Ask the Doctor Tagged With: , , , , ,
Next Page »