Ask the Doctor- Is It Too Late To Have Natural Breast Reconstruction?

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

Question: I had bilateral mastectomies and wanted to do the natural breast procedure but the surgeon wouldn’t even discuss it. Then he totally botched the reconstruction. I look deformed. I still avoid the mirror. A redo was set but was canceled day of surgery because b/p and bipod star were elevated. I want it redone. I would like to have the natural breasts. I have plenty of abdominal tissue. I am diabetic.

AnswerI’m sorry you have had so much trouble with your reconstruction.

Fortunately, previous attempts at implant reconstruction rarely impact our ability to successfully perform a reconstruction with your own tissue. Diabetes increases your risk of some complications, most notably wound healing problems and infections, but it rarely keeps us from doing the reconstruction at all.

If you wish, we can have one of our staff call you to discuss your situation further.

Thanks for your question, and look forward to meeting with you.

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

Ask the Doctor – Why Won’t Insurance Pay For Reconstruction?

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.

AnswerThat’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!

Ask the Doctor – Would Reconstruction Be Successful For Me?

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

Question: I had implants put in 33 years ago, got breast cancer, had a lumpectomy, radiation, and got rock hard implants as a result. I just recently decided to have the implants removed and a great deal of scar tissue. They put in expanders that caused me to get an infection. I had to almost beg them to believe me as the pain was horrific. I had a 2nd doctor remove the expanders. I now have a very deformed left breast and a severely drooping right breast. I contacted the doctor who put my implants in years ago. He is no longer in the area but told me about this procedure.

I guess my question is if this procedure would be successful for me? I do not like the way I look, and it is painful as well. I am a teacher and would need to know the time frame this would entail. It has been a horrible summer with this ordeal. I almost wish I left the rock-hard implants in. Please let me know what you think. I am very much interested in hearing your thoughts. 

AnswerThank you very much for your question. I’m sorry you have had so much difficulty. Your situation is unfortunately quite common, but the good news is that natural breast reconstruction with your own tissue can often help dramatically. Fortunately, a history of radiation (&/or multiple failed attempts at implant reconstruction) does not at all decrease the success rate of subsequent reconstruction using only your own tissue. We have successfully reconstructed hundreds of women in your situation.

Our first choice for a donor area, if you have some extra tummy tissue, is the DIEP flap. If you do not have adequate tummy tissue, the buttocks (sGAP flap) is also often an excellent donor area.

It is important to realize that natural tissue reconstruction is not just an operation, but a process. The first operation, the microsurgical transfer of the flaps, is by far the largest. It usually takes 6-8 hours, requires a 4-day hospital stay, and a total stay in Charleston of about a week. Recovery takes approximately 6-8 weeks.

After you have healed fully from the first surgery (usually 6 months if you have been radiated), 1-2 additional surgeries are required to achieve optimum results. These are much less involved, ordinarily requiring only one night in the hospital, and you can usually go back home as soon as you are discharged.

While the process can be lengthy, once you are done, you are REALLY done. Most women reconstructed with their own tissue come to regard their reconstructed breasts as their own, and are finally able to put the issue of breast cancer behind them.

I would be happy to call and discuss your situation in more detail if you wish, and thanks again for your question.

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

Ask the Doctor- Are Implants Still an Option after Radiation? I Have Expanders Now that Were Placed At the Time of Mastectomy.

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!

Ask the Doctor-What are Your Suggestions For Muscle Spasms After Breast Reconstruction?

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!

Ask the Doctor- I’m Unhappy With My Reconstructive Result from Another Surgeon – Are You Able to Make It Look More Natural?

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!

Ask the Doctor- Are These Normal Problems To Have 2 Years after a Breast Reduction?

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!

Ask the Doctor-It’s Been 30 Years Since My Modified Radical Mastectomy and I am 65 Years Old. Am I Still a Candidate for DIEP?

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!

Ask the Doctor- I am Currently on a Diet to Lose Weight. Will My Breasts Get Smaller Too?

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!

Ask the Doctor-Are Your Doctors Experienced with Tuberous Breast Deformities and Repair Without Breast Implants?

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!