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Ask The Doctor-How Many CC Would be Needed to Achieve the Size I Want?

April 22, 2016 by

 

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

Question:  After a bilateral mastectomy in December, I am in the process of having my expanders filled. I am looking for a ‘C’ cup size when finished but I can’t equate this to the amount of ‘cc’ that need to be injected. Right now I am at about 420 cc and my doctor tells me that we are just about done.

When I look at my breast it doesn’t appear to be very large. Would you be able to tell me how many cc would be needed to achieve the size I want? Thank you.

Answer: Thank you for your question. I’m sorry to say that there is no correlation between cc’s and bra size. The best place to start is to ask your surgeon how much your mastectomies each weighed.

Grams of breast compared to cc’s of saline and then extrapolate to your bra size you were before your mastectomy. It will not be exact but will give you a ballpark figure.

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

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Ask The Doctor-Is it Prudent to Remove the Expanders?

April 15, 2016 by

 

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

Question: I had bilateral nipple sparing mastectomies on 2/9/16 and developed a large necrotic area on the lower pole of my left breast. Air expanders and Alloderm were placed during the surgery and I have also developed redness over the area where the Alloderm is on my right breast. I have been on Keflex 250 mg qid since surgery and Levaquin was added yesterday, 2/26. My surgeon plans to debride the necrosis and perform a skin flap on Friday 3/4. Of course there is no staging of the area under the necrosis at this point. (It turned dusky the day after surgery.)

But I am keen to avoid two surgeries. My questions are these: In your opinion, is it prudent to remove the expanders, allow time for healing and then consider latissimus flap on the left? Under that circumstance, what options are there for healing the wound after debridement? Would closing good skin to good skin be best (I understand distortion is a given) and then flap it later? I will have to be referred for flap surgery and am trying to do diligence on who best to request for this. I am grateful for any advice you might be willing to offer.

Answer:  I’m sorry to hear that you are having a difficult time. From what I can gather from your question it sounds like you have had a difficult time with both breasts. On your left side the healing would be less complicated if you had the expander removed. On the right side if you have an infection then it is possible that the implant may have to be removed.

If the implants are removed then when you have healed you may consider using your own skin and fatty tissue instead of trying another expander. We specialize in breast reconstruction using your own fatty tissue without using implants and without sacrificing your important muscles. That includes the latissimus muscle. I suggest you ask your surgeons if you can consider that route as an option.

I’m sorry I can’t be more specific without more information from you about your situation, previous surgeries and medical history. If you would like more information I could have my office contact you for specifics. Just let me know. Thank you for your question.

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

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Ask The Doctor-Can You Help Me with My Implant Trouble?

April 8, 2016 by

 

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

Question:  After twice replacing implants due to scarring, I had them removed and a subsequent breast lift. The result since Nov.4 is necrosis of the nipple and breast tissue. Surgery was performed to remove the dead tissue and I am left with open wounds that have to be dressed twice a day.

My Dr. has a wait until it heals over the next 6 months and another Dr. in Atlanta recommends a mastectomy, skin grafts from the back and expanders followed by implants. I am scared to death of more implant trouble and psychologically I can’t bear these holes and open wounds any longer. Can you help me?

Answer: I’m sorry to hear you have had such a difficult time. I cannot give you specific advise without having more information from you. If you would like to send me photos I would be glad to look at them. It is possible I could then let you know if I agree with the options you have been given.

If you need to have breast reconstruction then I agree it seems that your body does not do well with implants. There are multiple options that do not include using implants and we specialize in using skin and fatty tissue to rebuild breasts. We do this without sacrificing your body’s important muscles. If you would like more information about these techniques let me know. Thank you for your question.

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

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Ask The Doctor-Would I Qualify for Further Reconstruction?

April 1, 2016 by

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

Question: Husband is retired Navy so we have Tricare. I’ve already had unilateral reconstruction with silicone implant. However, it is about 1/2 the size of real breast and scar tissue is drawing it up. I don’t want to go back to my surgeon since he left it that way. His option was to chop the real breast down to match the small implant. I said “No” and never heard from him again. No final tattoo was offered either.

My question is would I still qualify for further reconstruction? I’d be interested in having the implant removed and the DEIP procedure. Also, I have plenty of fat to offer but are there restrictions on how fat is too fat?

Answer: Thank you for your question. I’m sorry things did not work out the way you wanted with your implant. It is possible to have your implant removed and replace it with your own fatty tissue. The DIEP may be a good option for you especially since you feel like you have extra fatty tissue in your tummy area. Also if your implant does not match your other breast then your own tissue would likely be a more natural match.

The restrictions have more to do with your overall health and your weight. If someone is too overweight then we would discuss losing weight before surgery to lower the risk of complications. In general if your weight is equal to or over 200lbs then we need to specifically evaluate your situation in detail. I would be glad to have our staff contact you for that information or set up a time that we could talk over the phone. If you would like to come for a consult that would be possible too. Just let us 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!

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Ask The Doctor-Can You Do a Fat Transfer Without Muscle Movement?

March 25, 2016 by

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

Question: I am 57 years old and a 10 year BC survivor. I had bilateral mastectomy in 06 followed up with expander and implants. I am tired of the painful implants and want reconstruction with fat transfer. I would like to have transfer alone without muscle movement. Do any of your Doctors do this procedure?

Answer: Thank you for your question. I am sorry to hear that you are having problems with your implant breast reconstruction. We specialize in breast reconstruction using your own natural fatty tissue without sacrificing your important muscles. When patients are having implant type problems we can offer them an option that includes replacing their implants with their own fatty tissue and repairing the chest muscle that is now bothering you.

Since 2002 our practice has helped many women with problems similar to what you describe. I would be glad to give you more information about your specific situation. Let me know I could have my staff contact you for more specifics and set up a time we could talk over the phone. Just let me know what is most convenient for you.

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

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Ask The Doctor-What are Some Options After Bilateral Mastectomies?

March 18, 2016 by

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

Question: I had bi-lat mast in 2011…no attempt at reconstruction. My age is now 69. Do I have options other than implants of the ‘flap’ procedure? Fat transfer? Thanks you for your attention to this question.

Answer: Thank you for your question. Since you have had bilateral mastectomies you have multiple options for breast reconstruction. The options are independent of your age and if you are healthy then you can have breast reconstruction. Your possible options include: implants or your own tissue.

Results with implants may not be as natural and if you have had radiation then maybe implants would not be a good option. Also results with implants require more revisions. Using your own tissue without sacrificing your muscles is another option that does not include implants.

A flap procedure using your own fatty tissue usually requires two main procedures possibly three but then the results are permanent. Fat transfer or fat grafting is a possible option but that requires 4- 5 procedures. Please let me know if you need more information.

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

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Ask The Doctor-Am I a Candidate for the DIEP procedure?

March 11, 2016 by

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

Question: I am interested in the DIEP procedure after my mastectomy 2+ years ago, but wonder if I am a candidate. Would you accept pictures to review, before I would invest in a trip of that distance?

Answer: Thank you for your question. If you are healthy and recovered well from your mastectomies then chances are you could safely have breast reconstruction using your own natural fatty tissue. If you feel that you have extra tummy tissue and would benefit from a tummy tuck approach then the DIEP could be a very good option. The DIEP procedure uses the fatty tissue and skin of the lower tummy. We specialize in breast reconstruction using natural fatty tissue. If a patient does not have enough tummy fat, has already had a tummy tuck or if previous surgery makes the tummy unavailable, then we can still use another area of the body to get natural tissue for breast reconstruction.

We frequently evaluate patients from out of town by looking at photos and getting the important information from them. I can definitely let you know what option would be best for you without having to see you in person. If you want to come for a consult that would be great but we understand that may not be feasible when traveling from a distance.

When patients do travel from out of town we make arrangements in advance and if they are having surgery then I see them in person the day before surgery. I would be glad to have my office staff contact you to let you know how to do the photos. Just let me know. Thanks again for your interest.

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

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Ask The Doctor-Which is the best procedure for a natural looking breast?

March 4, 2016 by

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

Question:  A week ago I was diagnosed with invasive Mammary Carcinoma with Ductal & Lobular features, Intermediate and stage1. Since I have had a Lumpectomy and radiation 10yrs ago on same breast they said I would have to have a mastectomy. They have suggested I have the TRAM flap done.

I have been reading on your site about TRAM versus DIEP flap. I would really like I think to have the DIEP flap but not sure if the Plastic Surgeon that my Dr. uses does this. I’m really concerned and want the best results for a natural looking breast. He will have to later when recovered put a nipple on. Tell me your suggestions. Thank you.

Answer:  Thank you for your question. I’m sorry to hear that you need to have a mastectomy. I’m glad to hear it was detected early and is Stage 1.  Have they talked to you about needing chemotherapy? You have done some good research regarding breast reconstruction. Since you have had previous radiation then breast reconstruction using your own fatty tissue would give you the chance for the most natural result following your mastectomy.

The TRAM procedure uses your own fatty tissue from the tummy but unfortunately it sacrifices your tummy wall muscle in the process. The DIEP is another way to use your own natural tummy fatty tissue and does not sacrifice your tummy muscle. You don’t need muscle to rebuild your breast.  You do need your tummy wall muscle located where it naturally is.  After a TRAM, patients can have problems related to removing the muscle. Therefore you should request a plastic surgeon who has experience with the DIEP procedure to see you in advance of your mastectomy. If there are none in your area then you may have the option to travel to a practice that does specialize in the DIEP procedure.

In our practice we have had patients from almost every state in the U.S travel to us because of our expertise in breast reconstruction using natural fatty tissue. It is not easy to travel for surgery but unfortunately for this specialized type of procedure it is sometimes necessary. If you need more information about how that works or the things we can do to help our traveling patients just let me know.

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

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Ask The Doctor-Does Medicare Cover the Cost of Surgery?

February 26, 2016 by

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

Question: I had breast surgery in 2014- one breast removed but the Dr. left enough flesh to reconstruct. I hate surgery and afraid of the length first of all. Second, I have heard there are SEVERAL operations and most of all does Medicare cover the cost. I pay for the best you can get and I am 66 yr old. Thanks.

Answer: Thanks for your question. You are correct that breast reconstruction does require more than one surgery. Depending on several factors such as what technique is used the surgery can also take a long time. Using your own tissue to remake a natural permanent new breast is what we specialize in but we also use implants if our patients choose that option.

Medicare does cover breast reconstruction but no matter how much you are willing to pay for the expertise Medicare will only pay the surgeons a set, very low fee. Fortunately that’s ok because we are physicians and our mission is to provide the best for all our patients. At this time we do accept Medicare and will as long as we can continue to fulfill our mission. Please let us know if you have any other specific questions.

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

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Simple Charleston-Area Recipes

February 23, 2016 by

 

Lowcountry cuisine is one of the many things that make Charleston, South Carolina, one of the most wonderful places to live (and visit).

If you’re new to cooking Lowcountry food (or to cooking in general) and have wanted to try it out, you’re in luck! The Center for Natural Breast Reconstruction has compiled a list of easy and authentic Low Country recipes that cooks of any skill level will be comfortable taking on.

Enjoy!

Shrimp and Grits

Shrimp and Grits is a Lowcountry staple that is much easier than you might think to pull off. This recipe calls for some simple ingredients that you can easily find at the grocery store, and takes just 30 minutes of prep time. Simply cook your grits, fry your bacon and sausage, then cook the vegetables and shrimp together. Serve on a bed of cheesy grits, and enjoy.

Red Rice

Red Rice is another delicious Lowcountry dish that requires very little culinary expertise to make, and all of the ingredients are probably already in your pantry. To make Red Rice, boil 2 cups of long grain white rice until tender, then cook your bacon in a skillet until browned. Cook your onion and tomatoes in the bacon drippings, and mix in the rice. That’s it!

Seafood Muddle

The Seafood Muddle is a hearty seafood stew that calls for clams, fish, shrimp, and mussels cooked together with potatoes and other vegetables in a fish stock broth. This is a must-try for seafood lovers! The recipe should only take 15 minutes to prep, but you’ll want to make sure that your shellfish are properly scrubbed, shelled, and de-veined ahead of time.

Frogmore Stew

Frogmore Stew is a traditional Lowcountry seafood boil that is perfect for serving at large gatherings. The amount of ingredients can easily be adjusted for more or fewer servings. So get some of your favorite people together, and get your largest pot ready. To make Frogmore Stew, boil 5 quarts of water with some Old Bay seasoning, and add potatoes, sausage, corn, and shrimp. Simply boil everything together, and drain before serving. Add more seasoning and cocktail sauce to taste.

African Peanut Soup

This recipe combines some very unlikely ingredients, including peanut butter, rice, and chili powder, into an irresistible dish that will have you coming back for seconds. It requires little prep time, and surprisingly little effort—if you can chop vegetables, you can make this recipe!

We hope you have fun in the kitchen cooking up one of these delicious Lowcountry recipes. Do you have a classic Charleston area staple that we missed? Share it with us in the comments!

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