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

Question:  I have an overwhelming history of breast cancer in my family (2aunts and grandmother ovarian cancer). My mother was diagnosed at age 50 before menopause and had to have chemo and radiation. I have BCBS of SC health insurance and it looks like the genetic testing is covered under medical necessity.

If I test positive I wanted to explore my options and know my coverage. Have you seen insurance cover a mastectomy and reconstruction under BCBS of SC for someone who has not been diagnosed but tests positive? Thanks for your help.

Answer: Thank you for your question. Yes we have had many patients who had negative genetic testing who have had preventive mastectomies and immediate breast reconstruction.

You should discuss your risks and history with a breast surgeon. They will let you know what the insurance company requires. If you are approved for a preventive mastectomy then reconstruction will be covered as well.

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 double lumpectomy on my right breast 16 years ago. I also had chemo and radiation. I never had reconstruction but was willing to live with it. But over the years I think the radiation has made my breast smaller and both breasts droop now.

Are there any surgeries being performed using stomach fat and how complicated for a 66 year old would this be? I am very healthy and exercise and workout a lot.

Answer: We routinely do reconstructive surgery on patients your age and older with good results (we did a bilateral DIEP reconstruction on a 74 year old lady a few weeks ago). Your overall medical condition is much more important than your chronological age.

You are correct to think that using your own tissue is usually preferable if you have had radiation, as the success rate in this situation is much higher using your own tissue than trying to use implants. The surgery is big, but we do it routinely, and it may well be your best option.

We would be happy to have our nurse Chris or P.A. Kim call you to discuss your situation further, and I will be happy to speak with you, if you wish. Thanks for your inquiry!

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:  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!

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!