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

If you can, I would contact your original plastic surgeon, as he or she is probably in the best position to evaluate your symptoms. I would also be happy to discuss your situation with you further by phone, if you wish.

Thanks for your question.

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 about breast reconstruction.

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 re position 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.

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

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

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.

I would be happy to help you any way I can, but it would be best if you first returned to the surgeon who did your reduction and let her / him know of your concerns. If that doesn’t work, please let me know.

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

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

Question: It has been 30 years since my modified radical mastectomy and I am 65 years old. Am I still a candidate for DIEP.

Answer: If you are in reasonably good health, you may well be a wonderful candidate for natural breast reconstruction with a DIEP, sGAP, or other flap. We have restored many ladies’ breasts many, many years after their mastectomy(ies), and they usually do very well after surgery. It is actually advantageous to enter into the reconstructive operation fully healed, as this speeds operating time, as well as recovery. I would be delighted to speak with you about your options by phone, if you wish, or you are welcome to come for a consultation at any time.

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 about breast reconstruction.

Question: I am currently on a diet to lose weight. Will my breasts get smaller too?

Answer: Depending on how much  weight you lose you might notice a change. It should be minimal and proportional. You can’t “spot”reduce any one area  of the body. Therefore if you lose a moderate amount of weight you should have no problem.

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

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

Question: Are any of your doctors experienced with tuberous breast deformities and repair without breast implants?

Answer: We don’t have specific experience with tuberous breast deformities, but I am nonetheless optimistic that we can address your concerns. The cornerstone for tuberous breast deformity reconstruction is reduction of the nipple areolar complex.

This is straightforward, and the remaining part of the equation, enlargement of the breast mound, is also well defined. If you do not want to use implants, but also want to be larger, you may have to accept some additional scars associated with transfer of natural tissue.

Otherwise, there are no particular problems. I would be happy to discuss your situation in more detail, if you wish.

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

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

Question: I’ve had implants since a 2004 mastectomy following breast cancer diagnosis. I’m healthy, but feel that my implants have shifted and I’m considering a redo. I live in Colorado, and wonder how the system works for out of town patients. How many trips are required to have reconstruction with your docs?

Answer: By “considering a redo,” I’m assuming you mean replacing your implants with your own natural tissue.

Our P.A. Audrey and N.P. Lindsey spend a lot of time on the phone with out-of-town patients (and their local health care providers) before we ever see them, making sure that nothing important is overlooked before you make the trip. I recommend that at some point you and I also have a phone consultation, so that you will have an opportunity to directly ask me any questions you wish. We usually see you for the first time the day before surgery. On that morning, you get an MRI angiogram at Imaging Specialists of Charleston, then bring the disc to our office to help us plan your flap. We operate the next morning, and you usually spend 4 nights in the hospital. We recommend that you stay in town another 5 nights, if possible, although this is not absolutely required.

We actually discourage you coming back for follow-up visits, as travel is a significant risk factor for blood clots, which is a risk of the surgery (as it is for many other surgeries). If you have a local health care provider who can help with drain management (plastic surgeon, breast surgeon, primary care, etc.) that is helpful, but certainly not essential.  We stay in close contact with you via telephone and secure messaging to manage your post operative period.  You’ll send updates and photos on a routine basis and discuss your progress with our clinical staff.

Most of the time it will take at least 2-3 surgeries to complete the reconstructive process. If you are not radiated, these can be done as closely as 3 months apart (although they can be delayed as long as you wish). None of the subsequent surgeries are anywhere near as big as the initial surgery, and usually you can get by with just two nights in Charleston.

Hope this is helpful, and I hope I get the opportunity to meet you.

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

This week, Gail Lanter, CPC of The Center for Natural Breast Reconstruction answers your question.

Question: I am looking for a p.s. who specializes in microvas. breast recon. I had dcis in 2014 lumpectomy with 6 weeks rads followed by bilat mast. 2016 with immed. recon with expanders then implants in March. Then I got a serious infection in the left (rad) breast, had implant removed and refused to do have lat flap done.

I am thin and one ps said I might be able to do a bodylift type or one where they take from my backside and use an implant on both sides. I do not want the implant I have now. It is subpec and is painful. Can someone help? I have anthem bc/bs and you are out of network.

I do not have 8500 to have this done at another location. My insurance is agreeable to a pay if the it is in network. I can’t afford much out of pocket. We are low middle class, but don’t qualify for help.

Answer:  Hi and thanks for your inquiry. Glad you found us – you’ve definitely found a team that specializes in microvascular breast reconstruction. Regarding your insurance, does your card have a little suitcase on the lower corner of your card? If so, we’re actually in network for you utilizing the Blue Card program through our contract with BCBS of S.C.

I’m happy to check into that and assure that is the case if you would like. I’d only need a copy of the front and back of your card and some basic demographic information like – Name of insured on card and birthday if different from yours, your birthday, and address. I can run eligibility in a matter of minutes once I’ve received the information.

Also, I am sure that one of our physicians will be sending an answer to the remainder of your question very soon.

I look forward to your reply, we’d love to help you!

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

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

Question: I’m not happy with the results of my bilateral mastectomy with reconstruction using implants. Reaching out to see if it can be fixed.

Answer:  It is very likely that we could help you with your unsatisfactory reconstruction, either by using your own tissue, or by revising your implant reconstruction. I will be happy to discuss your situation in more detail by phone, if you wish.

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