Helping women make smart, informed choices about breast reconstruction.
Dr. Richard Kline answers Cheryl Harleston’s questions regarding breast reconstruction.
What this video covers:
To find out more about natural breast reconstruction and whether you or a loved one might be a good fit for this procedure, please watch this informational video.
At the time I came to your office, I was unsure that I would ever feel normal again. I had undergone a bilateral mastectomy in 2013 and had expanders put in at the same time to plan for my implants. After waiting for about a year and a half, the surgery for the implants was performed. Within three months, one of my breast implants had to be removed since the skin would not hold due to the radiation I had received. My plastic surgeon told me it was possible that I might have to live with only one breast. He told me I was not handling things right and sent me for counseling. My counselor said my feelings were normal.
I decided to do some research and found you on the internet. I liked the fact that in your website you said you used my own tissue and muscle. I think what was most important was that your website said that you understood and saw my situation as a unique individual. You actually cared about my feelings and that was something I did not feel my plastic surgeon cared about.
You accepted my insurance and an appointment was set. From our first meeting I felt very comfortable with you and your staff. I felt I had been guided to your hands.
Now after two surgeries I am back to “me”. I have my body and my life back thanks to Dr. Craigie and The Center for Natural Breast Reconstruction. If I had known about you and your procedure in the first place I would have been there sooner and saved myself several surgeries and disappointments. My husband and I would both like to thank you so much for being there for me.
D.S. – Myrtle Beach, S.C.
As you face the prospect of mastectomy and possibly reconstruction, it’s important that you feel you’re in good hands.
We suggest that patients look for these four characteristics in their ideal plastic surgeon: skill, compassion, rapport, and honesty.
When interviewing surgeons (something you should definitely do!) for microsurgical breast reconstruction, ask the following questions:
Question #1: Are you a microsurgeon? Where and by whom were you trained in this specialty?
You will want to know exactly what the doctor’s specialty is and where his training took place.
Question #2: How many microsurgeries have you performed? And how often do you perform them?
You want to know that your surgeon is very familiar and well versed with your particular surgery.
Question #3: What is your success rate?
Not only is this an important question to ask in regard to the surgeon’s skill level, but it’s also important to ask about the overall success rate of the surgery you’re looking into, by any surgeon.
Question #4: Can you arrange for me to speak with some of your patients who have had the procedure I am seeking?
This is a great way to communicate with others who can give you advice on what to expect, post op recovery, and information on their experience with the doctor. It’s important to note that candidates should speak with people of similar ages and lifestyles.
Question #5: How long do you anticipate I will be under anesthesia for the procedure?
It’s important for the surgeon to walk you through what to expect the day of the procedure—this way there will be no surprises, and you can also let your caregiver know the time commitment.
Question #6: How many board-certified physicians will be assisting with the first stage of the procedure? Will there be physicians in training (residents) involved with my surgery?
Be sure to know exactly who will be involved in the procedure and why your doctor has chosen them to participate in the surgery.
Question #7: Will I have to sign a consent form saying, if a physician is unable to complete the procedure, I will have to consent to a TRAM/Free TRAM?
Always know exactly what you’re signing and agreeing to, and make sure you’re comfortable with the contract.
Have a question for our doctors? Message them here.
Each week, we have women from all over the state, region, and country reaching out to us with questions on whether or not natural breast reconstruction is right for them. We understand there are a lot of factors to consider, and it’s important to find a resource you can trust.
Our doctors at The Center for Natural Breast Reconstruction—and our staff—do our very best to answer all questions we receive. Our team’s goal is to be as helpful as possible during this process and help you make the decision that’s right for you.
In the spirit of educating you and your loved ones, our doctors came up with this list of the most frequently asked questions just for our blog readers.
[Note: If you have a question you’d like answered, Click here to fill out our Ask the Doctor form!]
Breast reconstruction cannot be performed until 6 months after a patient’s final radiation treatment. However, chemotherapy varies. Some women have mastectomy and reconstruction immediately and do not start chemotherapy until after that is completed. Some women have to do chemotherapy first and then have mastectomy and reconstruction. Others have their mastectomy, have chemotherapy, and wait to have reconstruction. Planning and timing is based on the type of cancer, pathology, oncology recommendation, and the patient preference.
Although immediate reconstruction has advantages, procedures can also be done years after a mastectomy.
Although scars will be present, the shape may be improved. Many of our “flap” procedures involve the removal of tissue from other parts of the body. The resulting “tummy tuck” or “buttocks lift” can re-contour these areas for a more youthful, attractive appearance.
The Women’s Health and Cancer Rights Act of 1998 provides protection to patients who choose to have breast reconstruction in connection with a mastectomy. The federal law applies to those covered under group health insurance plans and those with individual health insurance coverage. You should check with your insurance provider for coverage details. Our administrative staff can also help you with reimbursement questions.
To learn more, click here.
Always consult with your doctor if you have any questions or concerns. Make an appointment with one of our physicians today.
Hamed Saber
On average, 1 out of 8 women will get diagnosed with breast cancer. This statistic puts the harsh reality of this disease into perspective. Because you might not know how to react to a friend who says she has breast cancer, we put together some suggestions for you should this unfortunate situation happen.
Having breast cancer means making a lot of decisions, and a lot of stress. For example, she may have to decide if she will get a lumpectomy, radiation treatment, or mastectomy. All of these things require research and an investment of time and energy.
In this scenario, you have to remind yourself that unless you’re a qualified medical expert, you are not in the best position to determine someone else’s life.
Instead, you can be of greater help by simply listening. Listen to her without judgement and let her share her ideas with you. Whatever she says, let her know you’re behind her all the way.
If you notice any strong emotional undertones to her words, support those too.
One of the worst feelings to have when going through something difficult is feeling like you’re alone. Don’t let your friend go to appointments or meetings by herself. Simply being with her means a lot. If she says she wants to go alone, you could offer to drive her to and from the location. That’s a start, and it will help.
Questions like “how are you?” and “let me know if you need help” are not as helpful as you think for a few reasons. First, she’s getting asked those questions by mostly everyone she knows.
Secondly, she might not know the right way to answer.
For example, if you ask her “How are you?” she might say, “I’m fine, thanks.” But the reality is she doesn’t want to talk about how she’s really feeling: sad, sick, and low on energy.
Instead, ask specific questions and make specific inquiries, like:
Be a positive action-taker who goes beyond asking general questions. It will mean more to her than you know.
If you follow these 3 general rules, you will be a better supporter.
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!
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!
This week, Dr. James Craigie of The Center for Natural Breast Reconstruction answers a special two-part question.
Q: Do you know of surgeons in northwest Ohio who can do natural breast reconstruction? I was diagnosed with DCIS and had a lumpectomy done and now am considering a bilateral mastectomy instead of radiation. I was a AA cup size and don’t have much breast tissue left, so I feel like I could use the reconstruction, which is why I am considering the mastectomy.
A: Thank you for your question. I’m sorry I don’t know anyone in that area. Based on your situation you are asking a very good question!
If you have little breast tissue remaining after your lumpectomy then if you went through radiation the breast may develop more abnormal shape. When that occurs, it is difficult to fix that breast because of the radiation effects. If you instead remove the remaining breast tissue you could rebuild the breast to the size you wanted based on how much of your own tissue you have to use. Also you would not need radiation. Remember that implants after radiation are more likely to have complications than without radiation.
Q: If the DCIS is in one breast, would a double mastectomy make sense, so I could even out the “new” size I choose? Also, do you have information on recurrence rates if I try a nipple-sparing or skin sparing mastectomy? Is that wise at all?
A: Questions regarding recurrence rates are best answered by the surgeon who performs the mastectomy. We work closely with them as a team and perform the reconstruction immediately after the mastectomy. I’ll be glad to forward your question to the expert. In general, recurrence rates should be the same or lower for mastectomy vs. lumpectomy and radiation. Skin and nipple sparing mastectomy should be the same as well. For your situation we would get the cancer specialists we work with to give us their opinion before we could give you specific recommendations.
We do have patients choose to do what you mentioned frequently, for the same reasons. Preventive mastectomies are done to reduce the chances of getting breast cancer. If someone is high risk, then they might decide to reduce the risk of DCIS on the other side. When someone has enough donor tissue we try to give them the best result possible based on each person’s expectations. If you had a bilateral mastectomy we would try to make the new breasts fuller and uplifted as long as there was enough donor tissue to work with. I hope this answers your questions. Let me know.
Dr. James Craigie
Center for Natural Breast Reconstruction
Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!
At the Center for Natural Breast Reconstruction, we know that women’s bodies and emotional selves are inextricably linked. There isn’t a question we haven’t been asked, or a concern we haven’t helped women and their loved ones manage.
We’re here to help you navigate the sometimes-confusing world of natural breast reconstruction, in a live phone call with our doctors tomorrow!
After the news about Angelina Jolie’s preventative double mastectomy, we’ve had a flood of questions about options in reconstructive surgery, and now we want to answer as many questions as we can at once.
Because part of our mission is to help you make informed decisions about breast reconstruction, our Drs. Craigie and Kline are going to answer questions on a free, live call!
Ask the Doctors LIVE
Click Here to Register and Listen
Join us tomorrow, August 6 at 7 p.m. Eastern / 4 p.m. Pacific.
You’ll hear from the doctors about several different topics, such as how to choose a breast reconstruction surgeon, reconstruction surgery options, financial issues, differences among procedures, post-surgery care, intimacy issues, and anything else you may have been wondering about.
Don’t miss this opportunity to hear from the doctors about your breast reconstruction options. Register now for the call, as space is limited. Hope to see you there!
This week, Dr. Richard Kline and Dr. James Craigie of The Center for Natural Breast Reconstruction answer your questions.
Q: I was diagnosed with stage 3 breast cancer about 3 years ago. I underwent all the usual treatments since then; however my oncologist has moved to another state, leaving me without one! I have not been able to get the reconstruction process completed.The last time I spoke with my oncologist, I was informed that it couldn’t be done. Do you think you can help?
A: Thanks for your inquiry!
Without knowing more details I can’t answer your question with certainty, but only rarely do we encounter a patient who can’t be reconstructed by any means. If you would like, we can have our nurse or PA call you to get more details.
Dr. Richard M. Kline, Jr.
Q: My doctor recently told me that based on my family history–mom with a bilateral mastectomy, aunt (on mom’s side) with bilateral mastectomy, and another aunt (on mom’s side) with partial mastectomy–and combined with my PTEN mutation, thyroid issue, and other auto immune illnesses, that my chances of getting breast cancer in the next three years is 1 in 3. Should I seriously consider getting a preventive mastectomy?
A: A preventive mastectomy is the most effective way women can reduce their risk for breast cancer.
Close screenings with exams and x-rays or MRI, will only help with early detection and do not lower the chances of getting breast cancer. Women who are at high risk for breast cancer because of many different factors, family history or known genetic mutations do have preventive mastectomies to lower their chances. Before considering this big step you should review your risks with someone familiar with preventive mastectomies or a specialists in genetics.
It sounds like you have a doctor helping you through this decision. When it comes to proceeding further you should look for a team with a surgeon specializing in the breast removal and one specializing in rebuilding the breast at the same time as the mastectomy. Preventive mastectomies can preserve the breast skin and nipple, and are very different from most other types of mastectomy. Also the reconstructive procedures are specific for preventive mastectomies and have the chance to be the most natural results.
Our practice specializes in this type of breast reconstruction and we work with specialists who regularly perform nipple-sparing mastectomy. If you want more information we can contact you with a few more questions. Regarding my recommendation about when or if to do it I would say it is a very individualized decision to make, and the process is major surgery. You should know about all the risks and know what to expect regarding possible results.
We would be glad to review the details with you if you like. If so just let us know and I will have our PA or RN give you a call to discuss the details. I hope this helps.
Dr. James Craigie
Center for Natural Breast Reconstruction
Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!
