Ask The Doctor – I am not happy with the results of my DIEP Flap surgery – Should I get an implant?

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

QUESTION: Hi, in May 2013, I had my transfer done at the same time as my DIEP flap. In that surgery, I also had a reduction on my left breast. The doctor that did my surgery left and moved somewhere else, so I’ve seen another doctor since. My new doctor tried to fix it, but it’s still messed up. He said he really doesn’t know what to do. As far as the transfer is concerned, I’m not sure it worked. I had another procedure done that helped it at first, but my cancer came back again on my pelvis bone and the chemo has made it worse. I am no longer on chemo, but I will take Herceptin for the rest of my life. Is it possible to remove the fat and put an implant in my breast?

ANSWER: Hi, if you had radiation on the reconstructed side, an implant might not be the best option. It is possible to add an implant to a DIEP to increase the size in order to match the other breast. I personally prefer to perform fat grafting to add more volume when possible. It is harder to match a normal opposite breast with an implant breast reconstruction. Removing fat normally is not the answer to revising the shape unless the fat is not living. This is called fat necrosis and feels hard not soft like normal fat. Also, if you went with an implant on that side the results would be more natural if you had more of your own fat to cover the implant. Otherwise the new breast has no natural tissue to cover it and the end result looks less natural.

James E. Craigie MD

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!

How to Get Ready for Your 5K Race Day

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5K races are a great way to raise money and support causes you care about, like breast cancer research. Not only do you help non-profits financially, but you benefit from participating in a healthy and fun exercise.

If you’ve ever done a 5K, you know preparation is key to making sure the race goes smoothly and successfully. If you haven’t done a 5K before and you’re training for your first race, read below to get some helpful tips to run your best on race day.

 Prepare for your run the day before.

Before going to bed, prepare your 5K outfit and have it ready to go when you wake up. The last thing you want to have happen when you’re ready to leave for your race is to lose your lucky socks or find out that your favorite sports bra is still in the washing machine. When you wake up in the morning, you’ll likely feel some anxiety about the upcoming race. This is normal. Preparing in advance keeps you on time, even in a state of panic. The less you have to worry about, the more relaxed you’ll be.

Eat a healthy, balanced dinner the night before. It’s best to prepare something you’re used to eating so you can ensure you won’t get sick and your body will react normally. Don’t get too adventurous before your race. Make sure you’re eating substantial complex carbs in your meal so you can be properly fueled up and ready to run the next morning.

Use appropriate racing gear.

Similar to how you shouldn’t eat new food before your race – don’t do anything else that takes you out of your regular running routine. This means you don’t want to wear new shoes, new clothes, or anything else you’re not used to wearing while running.

Why?

Because running a 5K is just as much a mental activity as it is a physical one. The more you change your behaviors, the more your body won’t recognize how to optimize your peak performance. Plus – when you wear new gear for your race, you put yourself at higher risk for injury, chafing, skin irritation, and more.

Imagine you’re a racecar driver who practices the same track, day after day. After a while, you know every inch of the track, and you perform much better on it than you would a brand new track. This is how your body works. The more familiar you are with it and how it reacts to gear and your regular routine, the better.

Arrive early!

Get to your race very early so you get a good parking spot and have plenty of time to warm up before the 5K. It’s better to leave yourself enough time to run a light run than it is to arrive without free time, so you end up stretching cold muscles. Give yourself some room to jog around a little, stretch your legs, grab a snack and water, and mentally prepare for the race.

When the race starts, it’s okay to be nervous. It’s a natural reaction you’ll probably have, especially if it’s your first one. You probably also aren’t used to running around so many people at the same time. Just remember: it’s all in your head. Running is a mental race. As long as you have a great experience and get a good workout in, that’s all that matters. Relax!

Pace yourself, and have fun!

It’s important to pace yourself throughout the run. Don’t worry about being first or letting your adrenaline take over. A 5K is about stamina. You may even want to think of the first 10-15 minutes of your 5K as a warm-up. It’ll help the race go by more quickly!

As you run, breathe from your inner stomach. Doing so allows you to have deeper breaths and sustained energy. It’s important to conserve your energy for the final mile, because that’s when you will get your second wind. The finish line is your goal. When you see it, keep your eyes on it and run like a cheetah!

5K runs are both fun and beneficial to your community. Be sure to replenish your workout with a healthy carb and protein-based meal, so you can stay healthy for your next 5K – and be sure to keep spreading the word about the 5K charity, foundation, or cause you supported.

Photo Credit: jacsonquerubin

Ask the Doctor – Will Insurance Cover the Reconstruction of My Breasts?

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

QUESTION: When I had breast cancer in 2010, I didn’t have any insurance. Now, I have great insurance and I want to undergo breast reconstruction. Will insurance cover the reconstruction of my breasts?

ANSWER:  Hi there. Thank you for your question. If you have had a mastectomy for breast cancer reasons and now have insurance, then you should be covered. There is no time limit between having a mastectomy and undergoing breast reconstruction. You should be covered, but make sure you call your insurance company and check what procedures your insurance will take care of.

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!

Five Irresistible Books for Your Summer Beach Bag

What better way to soak up a little sun than with a riveting new read? At The Center for Natural Breast Reconstruction, we’ve pooled together a list of hot summer books for you to enjoy at your favorite Charleston beach!

1. Wild by Cheryl Strayed: One of the hottest memoirs to hit the shelves, Strayed’s story is a heartening and harrowing one. After losing her mother to cancer, reeling from the ruin of her marriage, and recovering from drug addiction, Strayed made a life-changing decision to hike the Pacific Crest Trail solo in the hopes of salvaging her life and herself. If you need more convincing, Oprah selected this memoir to kick-off Oprah’s Book Club 2.0.

2. Fifty Shades of Grey by E. L. James: If you’ve yet to dive into the naughty world of Grey, we recommend you start at the very beginning, where Ana Steele and Christian Grey first fell headlong into their steamy, erotically dark affair. This book is sure to fuel your appetite for the other two novels in this trilogy: Fifty Shades Darker and Fifty Shades Freed.

3. The Chaperone by Laura Moriarty: A story of tangled trajectories, this novel tracks the journey of fifteen-year-old Louise Brooks before she became the silent-film icon, and her thirty-six year old chaperone Cora Carlisle. Set in the roaring 1920’s, this novel is rich both in its cultural depiction, and in its exploration of each character’s destiny during this era of possibility.

4. The Odditorium by Melissa Pritchard: This short-story collection is the imaginative transport your summer’s been missing. Weirdly enchanting, beautifully haunting, Pritchard bends the conventions of westerns, horror, and historical fiction to create a menagerie of pure enthrallment. Good luck putting this one down!

5. We Only Know So Much by Elizabeth Crane: With whimsy, wit, and unrelenting insight, Crane reveals the story of the Copelands, a family torn and entwined by the secrets they keep and the lives they lead. Sharp and voice-driven, this novel will make you laugh and cringe, but most of all, you’ll simply be happy to be reading it.

What books are on your reading list this summer?

 

 

How to Eat Out without Blowing Your Healthy Eating Plan

Eating out doesn’t have to mean watching every morsel you put in your mouth for fear of blowing your eating plan. With just a few tweaks, you can enjoy eating out and still stick to your program.

Say no to the bread, or have just one slice with your meal.

Many restaurants bring out a big basket of bread the moment you sit down, and this bread can wreck your healthy eating plans. If you can’t say no, at least have the bread with your entrée to minimize the damage. Spread real butter on it or dip it in olive oil. If you love bread, ask for darker breads like rye instead of the typical white bread.

Ask for low-starch veggies in place of potatoes or rice.

If your meal comes with potatoes or rice, ask to substitute something else. Low-starch veggies such as green beans, spinach, or broccoli are good choices.

Enjoy plenty of salad with healthy dressing.

Ask the server about your dressing choices. Chances are you can enjoy a healthy, homemade vinaigrette or oil and vinegar. If you have access to a salad bar, don’t be afraid to load up on the greens and veggies, but go easy on the cheese, croutons, and creamy dressing.

If you must have creamy dressing, have it on the side, dip your fork in it, and then take a bite of salad. If you want creamy dressing on a house salad, ask for it on the side.

Put half in a to-go box.

Ask for a to-go box when you order, and put half your meal in it before you start eating. That way you don’t blow your diet, and you can enjoy the rest of the meal the next day. If you’d rather not take anything home, split a meal with your dining companion, or give the leftovers to a friend.

When it comes to dessert, have anything you wish—just take a few bites.

You’ve probably noticed that when you eat a rich, luscious dessert, there comes a point at which it’s too much and you’ve had enough. Why not order any dessert you want and then savor only two or three bites? Again, you can share or take the rest home.

What’s your favorite tip for healthy eating out?

Healthier Ways to Make Your Favorite Winter Comfort Foods

comfort foodsAh, winter comfort foods—is anything better than curling up in a blanket and eating your favorite?

However, many comfort foods, such as macaroni and cheese, fried chicken, and creamy stews and soups, are full of fat and calories we don’t need. Following are a few tips to reduce the fat and calories without sacrificing the taste and comfort you want.

Cut down the butter.

If a recipe calls for three tablespoons of butter, try using only two tablespoons (or less). Chances are you won’t notice a difference in taste. Using margarine presents its own problems, as most of them have hydrogenated oil you need to completely stay away from.

Try using lower-fat dairy products.

Instead of heavy cream, try using half-and-half, or use 2% milk instead of full-fat milk. Sour cream and cottage cheese come in low-fat varieties. You can find lower-fat cheeses, or use a smaller amount of high-quality cheese.

For some recipes, a lower-fat substitution might not work, but it’s certainly worth a try.

Reduce sugar by half.

While sugar doesn’t have that many calories, reducing it is always a good idea when trying to eat healthier. If you don’t like the taste with less sugar, try adding a little bit of honey.

Add more lean protein, fruit, and vegetables.

If you’re making a chicken potpie, use the leanest cuts of the chicken and add more vegetables. Try some broccoli, cauliflower, and beans.

Try pan-frying instead of deep-frying.

You’ll use less oil and have fewer calories. Try frying in olive oil or coconut oil for a change of taste. Taking the skin off will reduce fat, as will baking or oven-frying.

If all else fails, simply eat smaller portions, or make adjustments elsewhere in your diet.

If you can’t stand the way your mac ‘n cheese tastes with lower-fat substitutions, by all means, cook it the right way—just eat from a smaller bowl or plate. If you don’t want to do that, then plan your mac feast and eat less during the other meals of the day.

What do you do to reduce the fat and calories in your comfort foods?

5 Things You Wish You Were Told About Menopause

menopause symptomsEven though the majority of women experience menopausal symptoms, and menopause is regularly discussed on talk shows and in magazines, the symptoms still take women by surprise. This can be a very stressful time for all your personal relationships, especially your marriage. Do not hesitate to get professional help if relationships become strained.

Following are a few things our patients wish they had been told about menopause.

You may start having symptoms 10 years before you actually enter menopause.

Beginning in your mid-forties or even earlier, you may begin experiencing menstrual irregularity, mood swings, hot flashes, and sleep problems. This stage, called perimenopause, can last several years.

According to the Mayo Clinic, once you have gone 12 consecutive months without a period, perimenopause is over, and you have reached menopause. You can find more information on perimenopause by clicking here.

You won’t feel like yourself.

The symptoms of menopause include hot flashes and cold flushes, night sweats, irregular periods, hair loss, facial hair, memory lapses, and inability to concentrate. You won’t feel like yourself, and you may not act like yourself either. It will pass, but it will take time. Talk to your doctor about your symptoms; he or she may be able to help you get some relief.

Your sex drive may go down.

Fluctuating hormone levels, mood swings, and vaginal dryness may make you less desirous of sex. Make the effort to stay connected with your spouse or significant other, even if you don’t want to have intercourse, and consider other ways to please each other.

You may have severe mood swings and outbursts.

Many of our patients have been surprised at the speed and severity of their mood swings. Understandably, their families feel confused about the sudden changes in mood. Talk to your doctor if your mood swings are severe, and consider other ways of relieving stress, such as yoga or exercise. Don’t be afraid to let your family know when you need time alone to work through your moods.

You won’t want to hear any advice.

It’s human nature to try to come up with solutions for problems, and your family may feel your menopausal symptoms are an issue they can solve. If their well-intended advice grates on your nerves, lovingly tell them that you appreciate their concern, but that you need them to listen and just be there for you.

For more information on possible symptoms of menopause, click here.

If you have been through this, what advice do you have for other women?

How to Spark Creativity and Find More Joy in Each Day

creativityWhen you feel creative, you feel more happiness in your life because you’re living more consciously and seeking beauty. Following are several ways to spark your innate creativity and live a more joy filled life.

Explore the world of art.

Sculpting, painting, drawing—all are creative pursuits, and all unlock your creative mind. The satisfaction of creating something new is fulfilling, and you’ll find joy every time you pick up a brush or pen. Experiment with colors, details, textures, and dimensions. You should feel free as air while you’re creating.

Even if no one else ever sees your work, you’ll know it’s there and that you did it.

Learn a musical instrument.

Much like creating art, creating music elevates your mood and happiness. Learn the instrument you really wanted to take up when you were in fifth grade and didn’t. As you go down the path of learning to play it, you become one with it and raise your joy factor significantly. You’ll feel happy and joyful every time you pick up the instrument and begin to play.

And no one ever said you had to play only songs that have already been written.

Work with your hands.

Whether you like woodworking, knitting, embroidery, or origami, create something. Anything. Use your hands to form what’s in your mind. The simple act of creating raises your level of joy, no matter what you create or how you do it.

Journal.

Putting your thoughts, hopes, dreams, and desires on paper creates a record of you—what better way to spend your time? When you journal, don’t hold back. Often, you can break through barriers in your life by simply writing them down. Once they are on paper, they have no hold over you anymore. The power of journaling is, in a word, amazing.

Write that book you’ve always contemplated.

Whether you want to share 101 ways to decorate your home or a new biography of Eleanor Roosevelt, it’s time to write that book you’ve thought about for years. It doesn’t matter if you prefer fiction or nonfiction—it’s the creation of the book, the words flowing on the paper or computer screen, that matter. If you choose, you can even publish your journal.

One major barrier for up-and-coming authors is now gone: you can self-publish now, both paperback and electronically, so you don’t need a publishing house or an editor. Your options are wide open; take advantage of them to create the newest book the world needs.

Do what your heart wants you to do. Start today.

We’d love to hear from you, so please feel free to contact us or leave a comment for us on Facebook!

The Importance of Taking Time to Reflect on Your Year

new yearEvery year, we take time not only to reflect on how thankful we are for our families, freedoms, and lives, but we also reflect on what we’ve accomplished during the year. We celebrate our successes and learn from our mistakes, and we decide what we’d like to achieve in the New Year. Here are a few ways to commemorate 2011 and plan 2012.

Make a list of your accomplishments.

What have you done in 2011? What were your successes and your leaps forward? No matter how small your wins may seem, they are still wins and should be celebrated. List them all so you can see what a tremendous year you’ve had. You may want to list them in categories, such as financial, health, family, etc. Rejoice in how long your list is.

Create a second list of your attempted successes that didn’t quite reach the mark. Those are worth celebrating too, even if the outcome wasn’t quite what you had anticipated or wanted. Simply attempting them is a win, and you can always try again.

Pat yourself on the back.

Look over your lists, and ensure you’ve included everything you’ve accomplished and attempted. You probably didn’t realize you made so many strides in 2011. Spend a little while remembering each accomplishment and how it made you feel. Re-create that feeling. Celebrate you and your success!

Use the lists to set your goals for 2012.

With the future in mind, decide what you want to try for next year. For each accomplishment, there is probably a natural next step. For example, if you lost 15 pounds, perhaps you would like to lose 10 more—or maybe you’d like to make sure you keep those pounds off by starting an exercise program.

If you attempted a goal and didn’t reach it this year, do you want to try again? Chances are that you learned something from trying it this year, and your odds of succeeding are even higher now. Give it another shot!

Finally, treat yourself to something special.

You deserve it for all your hard work, and this is the perfect time to treat yourself. Whether you book a spa day, take a trip during the holidays, or buy something you’ve had your eye on, celebrate yourself!

Tell us what you’ve accomplished this year so we can rejoice with you!

How to Reduce Exposure to Hazardous Chemicals That Have Been Linked to Breast Cancer

chemicalsOver 400 women are diagnosed with breast cancer each day, and several hazardous chemicals have been linked with breast cancer. While it might not be possible to completely avoid these toxins, here are some ways to reduce your exposure to them.

Eat as naturally as possible.

Our food supply is loaded with artificial ingredients, dyes, hormones, chemicals, additives, and preservatives. Keep your diet as close to its natural state as possible. Shop the perimeter of the store, as much of the chemical-laden “food” is in the center of the store.

When you arrive home with produce, wash it thoroughly. Buy free-range or organic eggs and poultry, grass-fed beef, and wild fish (not farmed).

Buy BPA-free products.

The less plastic you have in your life, the better, but at a minimum, you should avoid bisphenol-A (BPA). BPA is a hormone disruptor found in plastic food and drink containers, as well as in canned food, including infant formula cans. BPA leaches from the plastic or can into the food. Look at the bottom of your plastic containers. Throw away any with the number 7. Plastics with the numbers 1, 2, and 4 do not contain BPA.

Use glass for food storage and cooking when possible, and never microwave food in plastic or Styrofoam.

Avoid furniture made with the flame retardant PBDE.

While flame retardants have a purpose and have saved lives, one type of flame retardant, polybrominated diphenyl ether, or PBDE, has been linked to breast cancer. When buying furniture, look for items with a different flame retardant, or buy organically manufactured when possible.

Use solvent-free cleaning products.

Antibacterial and harsh chemical cleansers are not necessary. The more natural you can go when you clean, the better. Ammonia, bleach, and any cleanser containing a solvent are hazardous to everyone in the home. Hydrogen peroxide, vinegar, lemon juice, and baking soda make excellent cleansers, and a quick Google search will yield plenty of recipes and ideas to use them.

If you prefer other cleansers, buy green cleaners made with safer ingredients, which can be found in any health food store or online.

Clean out your cosmetics.

Makeup is full of additives, chemicals, and synthetic hormones that no one needs. Toss out your liquid or cream foundation and use mineral makeup. It’s better for your skin and covers just as well as the pore-cloggers you’re used to. Mineral makeup companies also sell eyeshadow, mascara, blush, lipstick, and lip gloss.

Stop the antibacterial foolishness.

Contrary to popular belief and TV commercials, antibacterial soap is not necessary and does more harm than good. The truth is that any soap is antibacterial, and you can find natural or organic soap at health food stores or online.

Know the ingredients of everything you buy, no matter who you’re buying from, as marketing pros often give you the illusion that something is natural or organic when it isn’t.

What tips do you have for reducing chemicals and toxins?