Ask the Doctor- Why Do Expanders Have To Be Used When a Breast is Removed?

This week, Richard M. Kline Jr. M.D., of The Center for Natural Breast Reconstruction, answers your question.

Question: Why do expanders have to be used when breast are removed and the pocket is empty and ready to be filled with an implant?

Answer:  It is not always necessary to place expanders at the time of mastectomies, but in many situations, it is a safer choice than immediately putting in an implant. Even if the breast surgeon leaves the nipples and removes no skin at all, the skin is not always healthy, as the blood flow is invariably at least somewhat compromised after mastectomy. Placing an implant under very poorly perfused skin would put additional pressure on the skin from within, and quite possibly cause the skin to die that otherwise would have lived. With an expander, we have the option of placing no fill at all at the initial surgery, thus minimizing additional pressure on the skin. In actual practice, sometimes the skin’s blood supply is so poor we don’t even put in an expander right away, but rather return to the operating room several weeks or months later to begin reconstruction.

Having said the above, I do agree it is nice if the final implant can be placed under healthy skin flaps immediately. However, it should only be done under ideal circumstances.

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


Ask the Doctor – I Was In An Accident And Now Have a Painful Knot On My Reconstructed Right Breast. Should I Be Worried About Long Term Damage?

This week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.

Question: I had reconstruction about 6 years ago after a double mastectomy. I had several surgeries for revisions. I had an SGAP on my right and stacked DIEP on left. Everything was fine until a month and a half ago when I was hit by a driver who ran a stop sign and t-boned me. My car was totalled. I had an impact on my right breast from the steering wheel and the airbags. For the past two months, I have had a large knot on my right breast. This is the SGAP one. It is painful and the knot is the same size. Could there be long-term damage to the reconstructed breast from the accident?

Answer:  If you are still having problems, you should see a plastic surgeon, and likely he or she will order some type of imaging (CT scan or MRI) to assess the situation. It is certainly possible that the flap could be damaged, or even other structures, such as your pectoralis muscle. While it might or might not be possible to do anything to improve any damage, I do recommend that you see someone to have it investigated.

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

Life after Mastectomy: Prosthetic Nipples

Being diagnosed with breast cancer and facing a cancer battle can be a long, draining, and scary experience.

While women who beat cancer find themselves overjoyed and grateful, there’s still a part of having breast cancer that tends to linger—especially if they’ve had to go through a mastectomy.

While we know women feel incredibly grateful that they’ve won their battle with cancer and feel they can begin life again, it’s also very common for them to long to feel like their old selves again.

At The Center for Natural Breast Reconstruction, we want all women to feel confident, radiant, and beautiful after a mastectomy, which is why we were so excited to find out about a new non-surgical solution to breast reconstruction—prosthetic nipples.

We love the product so much, we even carry demos in our office for women to try.

So, how exactly did this product come to be and how does it work?

I’m going to let breast cancer survivor and inventor Randi Johnson tell you in her own words.

Here’s her story…

After the shock of my IDC breast cancer diagnosis in 2007, I was hoping for the least invasive corrective surgery. The lump was too large for a lumpectomy, so a unilateral mastectomy was the choice I made. I had a new full-time job and didn’t want to take 6 weeks off for breast reconstruction.

The mastectomy was not very painful and I had a good recovery, but reality hit as bandages came off and I saw “my new normal” in the mirror. I’m not an especially vain person, but it was hard to feel “pretty” for my husband, even though I knew he loved me beyond the disfigurement.

I found myself wearing my prosthetic mastectomy bra to bed at night.

We happened to hear about Dr. Khouri in Miami, FL  who was doing a less invasive type of breast reconstruction surgery. There were no incisions, it was outpatient, and had a lower risk of complications. I only had to miss 3 days of work for each step (4 fat grafting sessions, for me).

Adding to the appeal, was the fact that they would take fat from tummy, thighs and anywhere else I didn’t want it and make a new breast out of it.

What’s not to love about that!

I was amazed to find that Dr. Khouri was in network for my insurance plan. There were still travel expenses etc., but somehow it all worked out.

It felt like I was growing a new breast and hardly had time to think about not having a nipple on that side, but when Dr. Khouri made an impression of my natural nipple and made up a silicone “rough draft” of a nipple for my recon side (for purpose of photos), my husband asked if he could tinker with the idea.

Dr. Khouri was very impressed with the prototype we brought back to show him a few months later. He invited us to display our Naturally Impressive nipple prosthetics as a vendor at a couple of his fat grafting conferences.

We received a great reception as well as some helpful ideas from the international breast surgeon attending.

I was part of an “MD Rounds” event at one of those Fat Graft Conferences and it was exciting to have MDs ask in disbelief (right after they heard my history). “Did you have a mastectomy?” We have heard countless similar stories from our clients about their Naturally Impressive nipples “fooling” others because they look so natural.

Now it’s become my new body image. If I have it off for a day or two, the asymmetrical image in the mirror doesn’t feel like it’s me.

We’ve been serving women through Naturally Impressive, LLC, since January 2010. As a “Mom and Pop” shop, we keep operating costs low and we also get to know many of our clients quite well. It’s an incredible joy! We love it!

No matter what option women choose regarding nipples, Naturally Impressive can be a way to “feel normal” again. For some, this is a great short-term option while waiting for tissue to settle before making a permanent choice. For others, it’s a wonderful non-surgical long-term solution.

If you or someone you care about is longing to feel normal again in the nipple department, check out our website to see the realism, variety and affordability of choices we offer.

Click here to visit the Naturally Impressive website.

You can also call Naturally Impressive, LLC, at 715-829-4488 if you have any questions.

Do you have a favorite post-mastectomy product that makes you feel confident and beautiful?

Share it with us in the comments below!

Gratitude: Why You Don’t Need to Find a Pot of Gold to Feel Lucky This Month

 During the month of March, people often think of lucky four-leaf clovers, chasing leprechauns, and finding a pot of gold at the end of a rainbow. It’s the month of luck after all!

Sure, finding a pot of treasure or stumbling upon a stash of golden horseshoes would be lucky, but the chances of that happening—unless you’re a treasure hunter–are slim to none.

That’s ok.

At The Center for Natural Breast Reconstruction, we believe it’s best to create your own luck, so that every day can be a great day!

Keep reading to discover some of our favorite ways you can remind yourself just how lucky you really are and show gratitude for everything you have.

Reflect on the Good Things in Life

It’s really easy to get caught reflecting on the bad things in life…like being diagnosed with cancer, losing a loved one, or being stressed out at work.

Yet, when we take a minute and begin to reflect on the good things in life, we realize there is often more good than bad happening in our lives.

Think about how lucky you are to have loving friends and family in your life that are there to support you whenever you need them. If you don’t have a lot of close friends or family, perhaps you have a pet that is always available for a snuggle.

Do you have a home, a warm bed to sleep in, and food to eat? Sadly, there are many people in the world that don’t. We consider ourselves lucky to have those things.

Chances are you’re reading this blog post from a computer or a smartphone. Just the fact that you have access to technology is very lucky! Not to mention other luxuries like electricity, a TV to watch, the ability to call friends and family via your cell phone, etc.

You see, when you start thinking about how many good things you have in your life, you don’t need “leprechaun magic” to realize just how good you have it!

Volunteer or Help Those in Need

Sometimes the best way to realize how lucky we are is put ourselves in the same room as those who aren’t as lucky.

The best way to do this is volunteering.

Working a soup kitchen is a great way to remind ourselves how lucky we are to have food in our stomach.

Volunteering at a homeless shelter is a wonderful way to remind ourselves how fortunate we are to have our own beds to sleep in.

And spending time with sick children or adults in a hospital is the best way to show us how lucky we are for our good health—regardless of the health issues you’ve faced in the past.

Volunteer for a cause that is close to your heart, and I promise you won’t need to find a pot of gold to feel rich in your blessings.

Create Your Own Luck

Good fortune is often the result of a lot of hard work.

Think about it…many millionaires who own thriving businesses started with nothing, working out of their garages. But, with hard work, they now live a very fortunate lifestyle.

If you feel as if you’ve been stuck in a rut without any good luck, it’s time to roll up your sleeves, follow your dreams, and create your own good luck for the future.

Have the tools and resources you need to start your dream business? Do it!

Need to finish your college degree to help make a comfortable life for you and your family? Hit the books!

Do you dream of traveling the world? Start saving a little money each month to make that dream a reality.

With a little hard work and planning, you’ll have the potential to do whatever you set your mind to—how lucky is that!

How do you make your own luck? Let us know in the comments below!

Give Yourself the Gift of Health This New Year

With the holidays behind us, it’s time to get excited and look forward to the new year ahead of us. Before we officially close out the season of giving, there is one more gift we want to talk about.

And that gift is the gift of health.

We believe that taking care of your body and being aware of your health are the keys to living a happy and healthy life. There’s no better time than right now to put yourself on the path to health and happiness as we begin a new year.

It doesn’t matter how good or poor your health currently is. There are many small lifestyle changes you can make to help ensure you’re giving your body the things it needs while also getting the medical care you need to stay happy and healthy.

The new year means starting fresh. We hope you’ll take advantage of this time to put in place a plan for the year that promotes your health and happiness.

Not sure where to start? No worries, we have a few suggestions!

Keep reading to discover a few things you can do to give yourself the gift of health this year.

Eat Healthy

Your health begins with what you put in your body.

Of course, there’s nothing wrong with indulging in a tasty treat every once in a while. But it’s also important to ensure that you are getting the nutrients from fresh meats (if you’re not a vegetarian), vegetables, and fruits.

Here are a few of our favorite recipes you can add to your weekly meal plan.

Go for Regular Physicals

Visiting your doctor for a yearly exam is a great way to make sure you’re in tip-top shape.
Most important, your doctor might be able to detect health problems before you notice them. And that’s important because early detection is the key to saving lives, especially for cancer patients.

You can’t go wrong with a yearly exam to make sure you’re in good health.

Get Exercise

Exercise is an important part of staying healthy. It helps you build muscles, burn excess fat, and keep your heart strong.

If you’re someone who feels as if you can’t exercise, don’t worry. It’s ok to start slow. Something as simple as a walk around the block is a great place to get started.

Check out some of our favorite ways to get into an exercise routine.

Perform At-Home Breast Exams

Ladies, this one is super important!

As we mentioned before, early detection saves lives. Which is why at-home breast exams are so important, even if you don’t have a family history of breast cancer. gives a great overview on how to do an at-home breast exam. Check it out here.

Your doctor can also teach you how to do a self-exam. Ask your doctor to show you at your next appointment.

Take Note of Changes in Your Body

Nobody knows your body better than you do.

If you notice any changes—including lumps, spots, marks, bumps, rashes, or even less visible changes like unusual headaches or pains—be sure to report those changes to your doctor.

Your doctor can diagnose any health concerns and put you on the path to health and happiness.

What do you do to live a healthy life? Share with us below!

5 Simple Ways to Brighten Someone’s Day

At The Center for Natural Breast Reconstruction, we believe that spreading cheer is something we should be doing year-round, not just during the holiday season.

There is truly no better feeling than knowing you’re making someone happy. When you spread joy, you’re bound to get some in return.

After all, you tend get in return what you give.

For many of us, spreading cheer is something that’s easy to do. Especially if we are surrounded by people who radiate generosity, kindness, and warmth.

Yet, unfortunately, many people do not experience the warmth and happiness we do during this season. In fact, this is a time of year when many people struggle and are sad.

Some families will be celebrating the holidays for the first time without a loved one. Many people will be feeling the effects of isolation and loneliness at much deeper level over the new few weeks. And we can’t forget that this time of year can also be difficult with the grey and gloom of winter that can bring on the winter blues and depression.

For that reason, it’s vital to remember the importance of making each other’s days as merry and bright as we possibly can.

And it’s not hard to do…

Even the smallest act of kindness and love can have a major impact on brightening someone’s day. So, this season, as well as all year round, we encourage you to think about what you can do to lift the spirits of those you love.

We already have a few ideas of things we love to do to spread some cheer! Keep reading to discover 5 of our favorite ways to make someone’s day merry and bright.

Call a Friend or Loved One

For many of us, our lives are so busy that we neglect to check in with the people we love. We certainly don’t mean to, but between work, taking care of families, and everything else we have on our plate, it’s easy to forget to give our friends and family members a call.

And with social media at our finger tips, it’s even easier to keep tabs on people without actually having to talk to them.

This season, and for the rest of the year, make a commitment to staying in touch more frequently with those you love.

The sooner you start, the better!

Pick a time this week to call a friend or family member and catch up. It’s such a nice thing to be able to hear a person’s voice on the phone. A call will certainly spread some joy to whoever is on the receiving end of it.

Send Handmade Cards

Once again, technology has put a damper on a lot of the communication we have with the ones we love.

Sure, it’s wonderful to be able to send someone an email, a Facebook message, an eCard, or a text message, but sometimes those digital messages come across as a little impersonal.

This year, spend some time making handmade cards for your friends and family members.

Not only will these cards bring a smile to your loved one’s face, but the time you took to make the cards will also show them how much you care.

Make Dinner for Someone

Life is busy, and people often feel overwhelmed in the hustle and bustle of working, raising families, getting chores done, and finding time to relax.

For that reason, bringing a friend or family member dinner one night is a great way to spread some cheer, as well as give someone a much-needed break from the cooking chores.

This meal doesn’t have to be expensive or extravagant. A simple spaghetti dinner, or even pizza from your local pizza place would make just about anyone happy!

We do have one tip before you do this though.

Talk with the person you’re bringing dinner to beforehand. This way they can tell you what they like to eat, can warn you of any allergies, and will be prepared when you arrive with the meal.

Treat Someone to a Free Coffee

It’s nice to go out and treat yourself to a cup of coffee every once in a while. It’s even nicer when you discover the person in front of you is paying for your drink as a random act of kindness.

This month, if you are financially able, try surprising someone in line with a free coffee. This small act of kindness will surely light up someone’s day.

If you’re not comfortable with buying a stranger a cup of coffee, you can always invite a close friend or family member out for a cup of coffee on you.

Bake a Delicious Treat to Share

Everyone loves a tasty treat every once in a while.

If you enjoying baking, make one of your favorite treats to share with those you love.

For those of you that are stay-at-home parents or work from home, bring the treats you make to your neighbors. Or, if you work outside your home, put together a tray of goodies to take with you.

It’s amazing that something as simple as a homemade cookie can brighten a person’s day.

What have you done to make someone’s day merry and bright? Share below!

The Center for Natural Breast Reconstruction Gives Thanks

In a few short days, we will be celebrating Thanksgiving—a time of year in which many of us stop and reflect on everything we have to be grateful for.

This year we made sure to stop and think about the many things we are grateful for at The Center for Natural Breast Reconstruction.

We’d love to share with you a few of the things we are thankful for. Check it out!

We are thankful for…

  • The opportunity to work with so many strong and courageous women who have battled breast cancer. You are an inspiration.
  • Our team of highly skilled staff and medical professionals that provide such amazing care to all of our patients.
  • The incredible breast cancer fundraising events, like the Susan G. Komen Race for a Cure, that raise money for new cancer research and treatment options.
  • The friends and family that stand by our side no matter what challenges we are facing.
  • All of the technology and medical advances that help keep women healthy and thriving.
  • Our pets, for those of us that have them, that are always available for a stress-relieving and calming cuddle on the couch.
  • The fall weather and the beauty that comes with this season.
  • All of the amazing success stories that we get to hear from our patients. It is a joy to celebrate you and your health!

We could go on for days about the many things we are grateful for all year round!

The Center for Natural Breast Reconstruction wishes you a happy and wonderful Thanksgiving celebration. And we hope you’ll take some time this week to think about everything you are thankful for.

We’d love to hear what you’re thankful for this Thanksgiving!

Comment below!

All Things Charleston: Hiking in the Lowcountry


Here at The Center for Natural Breast Reconstruction, we’re always brainstorming strategies to help women reduce stress and promote wellness.

Sometimes we feel the need to revert to a classic approach.

So here’s a not-so-off-the-wall idea…

Go for a walk.

Call us biased, but there’s no better place to go for a walk or hike (or bike!) than Charleston, S.C., and the surrounding Lowcountry. This area provides countless opportunities to enjoy breathtaking natural beauty, historic sites, and gorgeous antebellum homes and mansions.

While walking or hiking in Charleston and the surrounding area is a great way to unwind, it also provides a simple but effective exercise. (Let’s call that a win-win.)

That said…

If you’re a person who cares about a breast cancer survivor or somebody who’s recently gone through a mastectomy, take her hiking in this beautiful part of the country.

Here are a handful of our favorite places to calm the mind, appreciate this incredible corner of the world, and spend time with the important people in your life.

Awendaw Passage

As part of the Francis Marion National Forest, Awendaw Passage of the Palmetto Trail offers both mountain and sea views. As you take the 7-mile trek, you will cross through pines and palmettos.

When you reach the terminus, you’ll be treated to a tropical view. Oh, and to gain an up-close look at wildlife and natural details, don’t forget your binoculars.

I’on Swamp Trail

Also a part of the Francis Marion National Forest, the I’on Swamp trail is an easy, 2-mile loop that follows the abandoned rice fields that once made up the Witheywood Plantation.

As you take this gorgeous walk, you’ll pass through bald cypress wetlands that allow you to observe migrating songbirds.

Swamp Fox Passage

One of the Lowcountry’s oldest trails, the Swamp Fox Passage offers a long, flat, one-way journey through coastal pine forests and wetlands. Located in the Francis Marion National Forest, this trail is the longest option of the refuge.

However, if you’re not into the idea of hiking 40+ miles, you can walk until you feel like turning around.

Bull Island

Touted as an easy two-mile loop trail, Bull Island is part of the Cape Romain National Wildlife Refuge. Keep in mind: this is an island, so you’ll need to catch a ferry in order to check it out.

When you walk this trail, you’ll see a variety of Lowcountry topography—including forests, wetlands, and beaches.

West Ashley Bikeway

If you and your friends are more cyclists than walkers, the West Ashley Bikeway is the perfect place for you to be. What’s particularly spectacular about this trail is not its beauty, but its story.

Once a dumping ground for torn-up mattresses, discarded appliances, and other trash, this path has experienced a transformation as Charleston locals sought to create something beautiful and replace litter with lush scenery.

Downtown Charleston

Maybe you’re not a nature person. Or perhaps you simply want to take in all the historic sights, architecture, and breathtaking homes Charleston has to offer. You’re in luck, because downtown has been called a “living museum.”

Rightfully so. When you stroll along the peninsula, you’ll see shops, beautiful churches, plantations, museums, and historic landmarks.

What’s your favorite place to walk or hike in Charleston?

Tell our Facebook community all about it!


All Things Charleston: Music Therapy



We might be a tad bit biased, but there’s never a dull moment in our beautiful and charming hometown of Charleston, South Carolina.

From gorgeous beaches and historic attractions to incredible cuisine and the most hospitable people in the country, you will never run short on activities.

Music therapy is one of the many choices you have.

At The Center for Natural Breast Reconstruction, we like to celebrate Charleston and life itself, and there’s no better way to do that than music. As Billy Joel put it, “I think music in itself is healing. It’s an explosive expression of humanity. It’s something we are all touched by.”

To add to his point, music provides a wonderful therapy, no matter if you’re coping with breast cancer or simply looking for a cathartic release. In fact, there’s a science behind the healing power of music.

According to a University of Florida article, music has a profound effect on the human brain. Specifically, listening to music regularly will…

  • Decrease anxiety.
  • Promote healing.
  • Increase optimism.
  • Decrease pain.
  • Improve language skills.
  • Spark creativity.
  • Cause happiness.

You can read the article here, but suffice it to say, music therapy is an ideal healing strategy for breast cancer survivors and the people who love and support them.

Since we’re here to be your resource for all things therapeutic, in this article you’ll learn about some upcoming concerts in Charleston, South Carolina, that you may enjoy.

Saturday, April 2-The Phantom of the Opera

The Phantom of the Opera is a 1976 musical with book and lyrics by Ken Hill. It is the first musical adaptation of the novel The Phantom of the Opera by Gaston Leroux, about the hideously disfigured Phantom’s amorous obsession with the magnificent, naive singer, Christine. Hill wrote the original English lyrics to the music of Verdi, Gounod, Offenbach, Mozart, Weber, Donizetti, and Boito.

Grab your tickets.

Wednesday, April 13-The Sound of Charleston

For over three centuries, Charleston’s musical heritage has been as diverse as the people who’ve lived here–haunting spirituals of slaves first arriving in America through our port, Civil War camp songs from both sides in this place where the first shots were fired, and more…

Grab your tickets.

Saturday, April 23- Alabama Shakes

Alabama Shakes is an American rock band formed in Athens, Alabama, in 2009. The band currently consists of lead singer and guitarist Brittany Howard, guitarist Heath Fogg, bassist Zac Cockrell, keyboard player Ben Tanner, and drummer Steve Johnson.

Grab your tickets. 

Wednesday, August 10-Ray Lamontagne

Raymond “Ray” Charles Jack LaMontagne is an American singer-songwriter. LaMontagne has released five studio albums, Trouble, Till the Sun Turns Black, Gossip in the Grain, God Willin’ & the Creek Don’t Rise, and Supernova.

Grab your tickets.

Why we recommend music therapy.

When it comes to breast reconstruction and surviving cancer in general, it’s all about celebration…and there’s no better way to express gratitude and feel more alive than listening to music that moves you.  

Though we can’t teach you how to play an instrument, we can help you make healthcare decisions. If you have any questions about our breast reconstruction procedures, click here to ask a doctor.

5 Ways to Stay on Track with Your New Year’s Resolution

The start of a New Year is a great time to think about what you would like to accomplish over the next 12 months.

But often, we make New Year’s Resolutions with the best of intentions, but forget about them by mid-February.

This year, let’s break that pattern! Follow these 5 steps to keep your New Year’s Resolutions, and you’ll be well on your way to a new you.

Remember Why You Set the Goal

A good place to start is remembering why you set your goal in the first place. If you resolved to get into better shape, for example, try writing down exactly why. Maybe you want to be able to get around more easily, or maybe you want to be ready to take that hiking trip this summer. Focusing on the reasons behind your goal is a great source of motivation. For a daily reminder, try keeping sticky notes around the house, or set an inspirational photo as the background on your phone.

Assess Where You Could Improve

After setting your goals, identify ways in which you can improve. Where have you stumbled or given up in the past? What modifications can you make to your schedule or lifestyle that will make your journey easier? When you come up with your list, take proactive steps to make the needed changes. Vary your workout routine so you don’t get bored. Cut back on your unnecessary spending. Set aside one day a week to catch up with friends. If you are conscious about making improvements every day, you’ll reach your goal in no time.

Define What Makes You Want to Quit

When making life changes, it’s normal to feel like quitting from time to time. Don’t ignore these feelings—identify what’s causing them. Are you working yourself too hard? Are you completely depriving yourself of something you enjoy? Are you trying to achieve your goals in an unhealthy way? Make adjustments to your plan when necessary, and reward your progress. Don’t be discouraged by setbacks!

Identify the Stressors That Distract You

Living a busy life and juggling work and family schedules can make it hard to always stay on track of your goals. Pinpoint the major stressors that prevent you from keeping your resolutions. Then, find realistic ways of dealing with them. This can be as easy as finding a way to unwind during your lunch break, or as drastic as cutting back on the responsibilities you choose to take on. Every small change makes it easier to focus on bettering yourself.

Accept That You’re Not Perfect

Finally, you have to accept the fact that you’re not perfect… and that’s OK! Making positive changes and sticking to your goals takes time and dedication. Don’t be too hard on yourself when you fall short. Congratulate yourself for making the effort, and keep on trying.

This New Year, add one more resolution to your list: to actually follow through with your New Year’s Resolutions for 2016. Just focus on why you set your goals, find ways to improve, deal with distractions, and forgive yourself when you fall short. With a little patience, you will be able to achieve your goals.

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