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Ask the Doctor: Will Scar Tissue Buildup Be A Concern With The Gap Flap?

July 25, 2014 by

 

<alt="pink lotus flower"/>This week, Dr. James Craigie of The Center for Natural Breast Reconstruction answers your questions.

Question: My wife had a double mastectomy 10 years ago. At that time she had latissimus surgery to fill in her breasts. Since then, we’ve had numerous surgeries, about every 2 years, due to scar tissue building up in 1 of the 2 (or both) breasts that causes tightening and even pain. Will scar tissue buildup be a concern with the Gap Flap? 2. Regarding the Gap Flap procedure, what is the rate of failure that you experience with any of the 4 surgery sites (2 buttocks, 2 breasts)? Thanks.

Answer: Hi — I’m assuming your wife has implants under the latissimus flaps, which would explain the buildup of scar tissue. GAP flaps are generally large enough to make a breast by themselves (obviously, sizes differ among different people), so implants are not needed, and internal scar buildup would be a very rare event. We last calculated our statistics in October of last year. Over 10 years, we did 217 GAPs, 49 as unilateral, 168 as simultaneous bilateral. The GAP flap survival rate was 97% overall. All of the failures were in bilateral cases, but no patient lost both flaps, yielding a simultaneous bilateral flap survival rate of 96.4%. We have done quite a few GAPs since then with no failures (most recently a simultaneous bilateral last week), so the current statistics are actually a little better than that. We don’t bury flaps, and therefore can’t miss (or ignore) a failure, so these are ironclad statistics that could survive a GAO audit. To our knowledge, only Dr. Allen (who invented breast perforator flaps and trained the rest of us), his ex-partners in New Orleans, and ourselves actually do simultaneous bilateral GAP flaps on a routine basis. I’d be happy to discuss your situation further if you wish, just call or email.

Dr. James Craigie

Center for Natural Breast Reconstruction

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

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Ask the Doctor: What Are My Options for Natural Breast Reconstruction?

July 18, 2014 by

 

<alt="pink peony"/>This week, Dr. James Craigie of The Center for Natural Breast Reconstruction answers your question.

Question: I had right breast ductal carcinoma, Stage 2. Two out of 22 lymph nodes had cells. I did a gene test, and had both chemo and radiation. The expanded radiation destroyed it. I had a mastectomy in Charleston, and now I’m ready to have my breasts fixed. I don’t want to have implants. I’d rather have a reconstruction using my own body fat and tissue. What are my options?

Answer: Hi — I’m sorry you’ve had so much trouble, and hopefully things will continue to improve for you. Your history of radiation fortunately has no bearing on our ability to do a reconstruction using only your own tissue. Many of our patients initially had failed implant reconstructions elsewhere, only to be later successfully reconstructed with their own tissue. Please feel free to come by for a consultation if you live locally, or, if you’d rather, we can arrange a phone consultation. Thanks for your inquiry, have a great day!

Dr. James Craigie

Center for Natural Breast Reconstruction

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

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Ask the Doctor: What Are My Options For Post-Op Reconstruction Using Implants?

July 11, 2014 by

<alt="pink dahlia"/>This week, Dr. James Craigie of The Center for Natural Breast Reconstruction answers your question.

Question: I’m 42 years old, and I have a surgery this month for breast reconstruction. Due to my genetic history, a plastic surgeon will be performing a double mastectomy. I want to know what my options are for post-op reconstruction? Thanks.

Answer: Hi — Thanks for the information about your planned surgery. If you have requested using your own tissue and were told that was not a good option for you, then you certainly can get a second opinion. You stated that your mastectomies were for preventive reasons, which gives you the time to consider all possibilities. Before having surgery you should feel good about your decision and be confident you know all your options. You have excellent surgeons and I know you will do well.

One advantage of using an implant is that you don’t require an incision anywhere else on your body in order to donate the tissue to make the new breasts. Using your own tissue requires a longer recovery and more healing. The donor area ends up healing with a scar. If you don’t need a tummy tuck or have “excess” tissue in your thighs or buttocks then you may not want a scar in these areas. You should also know that it is not necessary to sacrifice any of your muscles in order to use your own tissue. Finally, it is important to know that if you have implant reconstruction and it does not work out you can still use your own tissue later–even years later! Most likely it will work out and you will have an excellent result and speedy recovery. I hope this has helped. Let us know if you have more unanswered questions. If you would like a second opinion, you could set up an appointment in our office, or we could also consult over the phone if you cannot make the trip to Charleston.

Dr. James Craigie
Center for Natural Breast Reconstruction

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

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Ask the Doctor: Do you have a recommendation for a topical that will help scars heal or fade?

July 4, 2014 by

<img src="pink flower" alt=" " />

This week, Dr. James Craigie of The Center for Natural Breast Reconstruction answers your questions.

Q: Do you have a recommendation for a topical that will help scars heal or fade?

A: Unfortunately, nothing of which we are aware does this reliably. Avoidance of sun exposure is critically important to give scars their best chance of fading, but no topical preparations routinely make scars better. If scars are heavy or raised, Mederma can help, but it should not be used on scars which are already flat.

 

Dr. James Craigie

Center for Natural Breast Reconstruction

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

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Ask the Doctor: Is there any surgery for a Tram flap patient with a belly bulge, no hernia?

June 20, 2014 by

<img src="image.gif" alt="Pink Flowers" />This week, Dr. James Craigie of The Center for Natural Breast Reconstruction answers your questions.

Q. Is there any surgery for a Tram flap patient with a belly bulge, no hernia? Breast reconstruction was great and there were no complications. I have heard that mesh can be used, does this flatten the belly, or would I be at risk for complications such as a hernia?

A. Hi Karen, Thank you for your question. If your tummy bulge is due to the TRAM flap procedure then it is possible that repair of the bulge using mesh could help flatten your tummy or repair the bulge. We normally check for a possible hernia by ordering a CT Scan of the tummy wall before planning this type of procedure. The findings help us determine what is the best approach and if we need to use permanent mesh or some other type. If there is no hernia then repairing the bulge should not risk creating a hernia. Depending on the situation, it is possible that the bulge could come back. Prior to this type of repair you should make sure you do all you can to avoid being overweight, as your weight can impact the success of the repair. I hope this answered your question.

Dr. James Craigie

Center for Natural Breast Reconstruction

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

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Happy Holidays From All of Us!

December 25, 2013 by

Our doctors and staff at the Center for Natural Breast Reconstruction wish you a merry Christmas and holiday season!

It is such a joy to have friends, former patients, and current clients reaching out to us during this time. We hope your week is filled with warmth and cheer for a healthy new year!

 

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National Women’s Survivors Convention in Nashville, TN

July 24, 2013 by

 

“To transform survivorship from a mood into a movement by empowering, educating, and connecting women whose lives have been touched by cancer.”

~ Vision of the Women Survivors Alliance

The 2013 National Women’s Survivors Convention (NWSC) celebrates women who have conquered cancer, and its founding group is the all-volunteer Women Survivors Alliance. Their mission is “to establish a network where women affected by cancer can find their voice, improve their quality of life, and embrace their new normal.”

The conference will be held at the Gaylord Opryland Resort in Nashville, TN from August 22–24, 2013. The convention fee of $139 includes Empowerment sessions, the main stage presentations, the Survivor Chef Challenge panels, “Heeling” for Survivors Fashion Show, and the Red Carpet Live! Pajama Party.

Transportation to and from the convention, hotel, and meals are not included in the registration fee. The Saturday night Salute to Survivors All Star Concert will be held at the Grand Ole Opry and is $36 per person. Hosted by Scott Hamilton, the concert will feature Martina McBride and other Nashville stars.

The Empowerment sessions during the convention will focus on a wide variety of topics related to cancer.

Our own Dr. Craigie will host a session called Know Your Options: Making Smart, Informed Choices Between Breast Reconstruction Procedures.

From the session description: “A well-informed patient who actively participates in decision-making is an essential ingredient of successful outcome in breast reconstruction. Participants will understand the patient-centered approach to choosing breast reconstruction procedures and be introduced to all available options . . . this discussion will be centered around the patient education process, making choices based on that information, and will provide tools and resources giving the participant ideas to organize and assess information proven effective for women facing the decision to have breast reconstruction.”

Other Empowerment sessions include topics such as: stress reduction, sexuality, nutrition, and physical fitness. Guest speakers include Shannon Miller, Olympic gold medal-winning gymnast and ovarian cancer survivor; Tabatha Coffey, TV personality; Diem Brown, MTV personality and cancer survivor; and Scott Hamilton, Olympic gold medalist and World Champion figure skater and cancer survivor.

Sponsors and exhibitors include The Center for Natural Breast Reconstruction, Cleveland Clinic Taussig Cancer Institute, Meals-To-Heal, Eucerin, Nashville Convention and Visitors Bureau, and A Silver Lining Foundation.

 

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Ask the Experts: Dr. James Craigie

June 14, 2013 by

Dr. Craigie  of the Center for Natural Breast Reconstruction was recently featured on Channel 4, representing East Cooper Medical Center. Check out his video here!


Ask the Experts: Dr. James Craigie

 

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

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Can I Have an Autologous Fat Transfer After a Lumpectomy?

May 10, 2013 by

Ask the doctor May 9

This week, Dr. James Craigie of The Center for Natural Breast Reconstruction answers your questions.

Q: I am a stage IV breast cancer patient looking for autologous fat transfer to fill in my left breast after a lumpectomy in 2008. Can you please let me know how to proceed regarding consultation and such?

A: I would be glad to have our PA call you for more information or phone consultation. I would also be glad to see you in person if you want to come for an office visit to Charleston. I frequently see patients with similar requests.  In my opinion,  fat injections to repair lumpectomy and radiation deformities is usually not the most effective approach. There are also concerns by experts in this specialty regarding fat injections of the breast after that breast has already developed breast cancer once.

As long as the breast tissue remains then there is a risk–although very small–for the cancer to recur. That is why you still need to monitor that breast for any suspicious changes. The fat injections could make monitoring the breast more difficult and most importantly there could possibly be (not proven definitely yet ) an increase in the risk for recurrence after fat grafting. No one knows this for sure yet, but we are always careful regarding this type of safety issue. I could be more specific and talk to you about alternatives if I had more information and especially if I saw you in person. I hope this helps! Please let us know.

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Q: I have BRCA mutation. I am 25 years old. I want to have mastectomies with reconstruction but don’t really know which would be the right way to go.

A:  I am sorry you are facing such a difficult decision. Fortunately, breast reconstruction after preventive mastectomies allows for more planning before surgery and usually sets the stage for the best possible breast reconstruction result.  There are several reasons for this.

One reason is more of your natural tissue can be saved. It is usually possible to keep your natural nipple and all of the normal breast skin. Other problems related to possible treatments like chemo and radiation are eliminated because the mastectomies are done to remove breast tissue and prevent breast cancer.

The techniques for breast reconstruction are generally the same following preventive mastectomy and mastectomy for cancer.  Implants are used most frequently because of availability and more rapid recovery from the initial surgery. The end results with implants tend to be less natural than with your own tissue and after the process is complete there is a tendency for the results to deteriorate with implants because they are not living tissue. Your body may reject the implants or they may leak or deflate. The results with using your own tissue are generally more natural and more permanent. We specialize in breast reconstruction using your own tissue but without sacrificing your body’s important muscles.  To be more specific about recommendations for you I would need more information. I will be glad to have our office contact you for this information, just let me know.

James Craigie, MD

Center for Natural Breast Reconstruction

 

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

 

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Join Us for We Know Women!

May 8, 2013 by

We Know Women Event garden partyFor the fourth year, East Cooper Medical Center is hosting an amazing event for women of all ages, the “We Know Women Event: Garden Party” on Thursday, May 9, starting at 5:30 p.m.

This fun event features live music, health demonstrations and screenings, local vendors with products women love, and wellness discussions with doctors including a question-and-answer panel. Wine tasting and delicious food will be provided, and Babies-R-Us will host a car seat installation demonstration.

Vendors include Grill Charms, Relax the Back, Abide-While, Silpada Designs, The Foot Store, HandPicked, Jonathan Green Prints, Miche Bag, No Wheat Treats, and Whaley’s Photos. The vendors will offer discounts and a variety of giveaways.

The physicians in attendance include Dr. James Craigie and Dr. Richard Kline from The Center for Natural Breast Reconstruction, Dr. Terrence O’Brien, Dr. Ross Rames, and Dr. Lynn Crymes. Topics include breast cancer, natural breast reconstruction, heart disease, cosmetic surgery, hormone therapy for women, and bladder concerns.

 

The “We Know Women Event” is free, but please register by calling 843-884-7031 or by visiting http://www.eastcoopermedctr.com/en-us/cwsapps/findanevent.aspx.

East Cooper Medical Center is located at 2000 Hospital Drive in Mount Pleasant. 

 

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