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 a 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 a lumpectomy. If the surgery results in a significant defect or radiation negatively impact 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, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I had a double mastectomy in January 2017. Expanders were placed at that time. I had radiation March-May. Postponed reconstruction until June 2018. Are implants still an option?

Answer: Implants may still be an option, but it’s going to depend on several things, probably the most important of which is how much you were expanded prior to radiation. It can be next to impossible to expand skin after it is radiated, although occasionally it seems to work. If you were expanded, and are tolerating the expanders well, then hopefully it would be straightforward to remove the expanders and place permanent implants. In addition to placing permanent implants, fat grafting can often significantly enhance the quality of your reconstruction.

If you end up not getting a reconstruction you like with implants, the good news is that none of what you have been through impacts your chances of getting a quality reconstruction with your own natural tissue. We have successfully reconstructed many, many hundreds of radiated patients with DIEP, sGAP, and other natural tissue flaps.

Hope this helps, please let us know if you would like additional information.

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 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!