Do You Provide the BRAVA and AFT Procedure?

This week, Dr. Richard Kline of The Center for Natural Breast Reconstruction answers your questions.

Q: I am a breast cancer patient who has recently finished chemotherapy. I am looking now into reconstruction, but I was wondering if you performed the BRAVA+AFT procedure?

A: We are actively looking into BRAVA and AFT, but not doing it yet. I would suggest you contact Dr. Khouri, he’s certainly the expert at this point. If you should need GAPs, PAPs, or DIEPs, we would be happy to help you.

 

Q: I recently finished 8 weeks of chemotherapy. I did not have radiation. I still have Herceptin until next May. I understand you do not currently offer BRAVA, but I’m interested in a fat transfer. Do you use expanders or something? I really want to have something done sooner than later but am willing to wait if it’s necessary. Could you explain to me the procedures you recommend?

A: I would not recommend fat transfer alone as a breast reconstruction technique without BRAVA. Even with BRAVA, it will probably take several sessions to get to the size you want, and there is still no guarantee that it will ultimately be successful, as fat survival is not strictly predictable.

We primarily offer microsurgical breast reconstruction (DIEP, sGAP, PAP), we do it on an almost daily basis, and our flap survival rate over the last 10 years (98.4 %) is realistically probably as high as anyone’s. However, we realize that this is not for everyone. If you have not had radiation, implants may well be a good option for you, and there is likely no need for you to travel a long distance for this, as most communities of any size have plastic surgeons skilled in this area.

Any type of reconstruction can usually be done in between Herceptin treatments, although we ultimately defer to your oncologist’s advice on this.  If you live near us and want an opinion, we’ll be happy to see you in consultation at any time.

Hope this helps!

Dr. Richard M. Kline

Center for Natural Breast Reconstruction

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

What Is PAP Flap Reconstruction? Am I Suitable Candidate for It?

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

Q:  I just heard about a PAP flap breast reconstruction?  Is it new?  How do I know if I am a suitable candidate for it?

A: The “PAP” (profunda artery perforator) is another type of muscle sparing technique to reconstruct the breast utilizing extra skin and fat taken from the back of the thigh. Dr Allen called this the “banana roll” flap. The concept is the same as the DIEP, sGAP, SIEA and others sometimes referred to as perforator flaps. There are situations when someone has extra tissue in this area but unlike the TUG flap it does not remove any important leg muscles.  Since lymphedema has been associated with the TUG flap in some published papers, the PAP breast reconstruction procedure is performed carefully and specifically to not disrupt the delicate lymph channels and nodes that if removed or damaged might lead to an increased risk for lymphedema.

James E. Craigie, MD

Read more about the “PAP” reconstruction technique here: Breast_Reconstruction_with_the_Profunda_Artery

 

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