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Is There a Time Limit on my Breast Reconstruction Options?

May 9, 2014 by

1418214_blue_flowerThis week, Dr. James Craigie of The Center for Natural Breast Reconstruction answers your questions.

Q: I had a right mastectomy in May 1995 with 12 nodes removed at age 42. Then I received chemo for 3 months. Can I still have a reconstruction done at this point? How long is the recovery time? I work as a nurse on a cruise ship and am often 3-4 months away from home with varying times home (anywhere from 10 days to 3 months).

A: Thank you for your question. There is no time limit for breast reconstruction after having a mastectomy. The recovery depends in general on what type of reconstruction you had. If you did not have radiation you may have the option of implant reconstruction or reconstruction with your own tissue. Recovery from using your own tissue in general in longer and for our patients 8 weeks after stage one is typical. With more info I could be more specific. Let us know we could contact you for more details.

Q: I had a flap with reconstruction about 17 years ago. The right side is smaller than the left, and I would like to get them back to the same size, as well as get my nipple finished on the reconstruction. Is this still possible?

A: You can always have your reconstruction completed. There is no time limit in general. In order to proceed, we need to know what type of breast reconstruction you received 17 years ago (for instance, implant or using your own tissue). If you contact our office with more details, but we’re happy to discuss your options.  Thanks for 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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Will Reconstruction Improve the Shape and Size After My Lumpectomy?

May 2, 2014 by

1426157_white_rose_1This week, Dr. Richard Kline of The Center for Natural Breast Reconstruction answers your questions.

Q: I had a lumpectomy and radiation in 2004. The defect in my breast is increasingly more noticeable (clothed) than in the past. Now, I’m interested in reconstruction to improve shape & size of my breast. Do you have any advice?

A: Lumpectomy defects can be challenging, for several reasons. Firstly, the tissue is radiated, which of course makes ANYTHING less likely to work. Secondly, there is no really satisfactory way to reliably replace the volume that was lost, precisely where you want it. Sometimes a small implant can be helpful, but not always. If the defect is large enough,  a microvascular flap of the type we do can be used, but often this seems like overkill for the size of the defect. Free fat grafting (sucking fat from elsewhere and injecting it into the breast) might be as close to an ideal solution as possible, and some surgeons do it currently, but it has not been established with certainty that this does not increase the chance of cancer recurrence, so we are holding off on that procedure until more evidence is in.

In many lumpectomy / radiation breasts the entire breast envelope, including the skin, has shrunken significantly. This often presents the option of re-arranging (with surgery) the remaining breast tissue to improve the shape, then subsequently lifting or reducing the other side to match as closely as possible.

Hope this helps. If you’d like to send pictures, I can possibly give you more specific suggestions. If you’d to speak with our nurse Chris or PA Kim to give them more information, they’d be happy to give you a call.

Dr. Richard Kline

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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Tram Reconstruction and Recurring Cancer in Breasts–How Should I Proceed?

April 18, 2014 by

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

Ask the DoctorQ: I had a mastectomy on my left breast with the tram–which partially failed–then Latisimis Dorsi surgery. I now have breast cancer in my right breast. What is the likelihood of decent symmetry and matching both breast shapes during this procedure?

A: I’m sorry to hear about your new diagnosis. In our practice, we have treated quite a few people referred to us with similar situations. We do not perform tram reconstruction but instead use the skin and fat of the lower tummy without taking the tummy muscle. If we have a patient that later develops a second breast cancer we would use skin and fat from either the upper buttock or the back of the upper thigh below the buttock. This can create a very good match for the tummy fat or a tram reconstruction. I would be glad to give you a more detailed answer with more specific information about your situation, let me know. I do think you most likely have good options without needing to give up any other important muscles. For more specific answers I will need to have my staff contact you for more details about your medical history.

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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After Radiation, Mastectomy and Reconstruction, I’m Having Extreme Back Pain…Solutions?

October 11, 2013 by

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

Q:  About 6 years ago, I had a bilateral mastectomy with reconstruction. The plastic surgeon took one muscle from each side of my back to reconstruct each breast. Now I am experiencing extreme back pain on the right side. This is the side where the tumor was. This was a second occurrence.

In 1993, I had a lumpectomy with chemo and radiation to this right breast/side. The extreme pain feels like it is muscular in nature on the right side. Is this normal and something I just have to live with, or might there be some other treatment for muscle pain? Should I have it checked out for a possible disc problem causing the radiating pain in my back? Should I check out physical therapy or is it too late for this therapy? I am at a loss and hate enduring this constant pain.

A: Thank you for your question, I am sorry you are experiencing pain.

When the pain first developed and exactly where it is located could help determine what the cause is and how to treat it. If it is your back in the area where your back muscle was removed it could possibly be related to your spine discs or from your body compensating for not having the muscle. If you have an implant and the discomfort is in the breast area it is possible that scarring around the implant is the cause.  Most importantly you should let your plastic surgeon,  breast surgeon and oncologist know so they determine the cause and treatment.

Your oncologist should determine if you need any special scans or tests with regard to your breast cancer history and your plastic surgeon can determine if it has to do with the reconstruction and if there is a fix.

 

Q: I had nipple reconstruction a month ago. After a summer with not having to wear a bra, I’m now having remorse that I didn’t go for 3-D tattoos. Two questions:

Can one have the reconstructed nipples removed?

Is there a way to flatten the nipples over time?

I understand that some nipples flatten naturally but others don’t. I wish I had thought all this through the way I did for every other decision I made during the breast cancer journey. Is there any thing else you would suggest for someone with buyer’s remorse regarding nipple reconstruction? 

A: Thank you for your question.

I suggest you ask your surgeon as it may depend on how the reconstruction was done. Otherwise I would also expect over time the nipple will flatten. It takes about 9 months. It can always be made smaller easily in the office with only numbing medicine.

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!

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Can I Have Reconstruction After Recurrence of Cancer? Should I Go to My Local Surgeon or Elsewhere?

September 27, 2013 by

This week, Dr. Richard Kline and Dr. James Craigie of The Center for Natural Breast Reconstruction answer your questions.

Q: I have been diagnosed with a second primary breast cancer in the right breast. 13 years ago it was IDC now DCIS. What are my reconstruction options? 

A: I’m sorry you are having to deal with a recurrence. Glad to hear it is DCIS. I imagine you had radiation before and could have mastectomy with immediate reconstruction. If you like I will have my office contact you for a few more details.  I would be glad to set up a phone consult so you could get my opinion right away.

Dr. James Craigie

 

Q: I was referred by a coworker who was a patient. I’ve had a bilateral mastectomy, expanders and two sets of implants (taken out due to capsular contracture). My plastic surgeon said my body just isn’t taking to the implants and suggests I try DIEP flap reconstruction. My plastic surgeon does them, but my coworker said she recommends more experience. At this point I am torn. She suggested I contact you. I live in Florida and I am very comfortable with my surgeon, but understand the more you do, the better you are. I’ve also had a gastric bypass 10 years ago and I am scheduled for a hysterectomy (via DaVinci robot) Oct 2nd.

A: Thanks for your inquiry, and sorry for the trouble you’ve had.

Having said that, more surgeon experience, having two microsurgeons involved, and using a hospital with a dedicated flap team does potentially provide benefits, probably most so in terms of shorter operating times and increased flap survival rates. We have presently done about 1030 DIEP and GAP flaps, with a 98.4% survival rate, and we would be happy to see you at any time.

However, I would suggest that you consider discussing your concerns with your plastic surgeon, and if he still feels confident he can do it, I think I would give him the benefit of the doubt. Even if you ultimately decide to have your surgery elsewhere, it would be very helpful to have him on board with your decision.

Dr. Richard M. Kline, Jr.

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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BRAdayUSA 2012: A Photo Journey Recap

October 24, 2012 by

We are thrilled with the turn out and success of our BRAdayUSA event held last week aboard the Carolina Belle in Downtown Charleston! The night was filled with great people, food, a little retail therapy and outstanding raffle prizes. The Center for Natural Breast Reconstruction team couldn’t be prouder to have hosted our own BRA Day event for the first time this year, or to raise awareness of a cause we so firmly believe in.

If you couldn’t make it this year, or just want to relive the great moments, we’d like to share some of our favorite pictures from the night with you below!

Guest enjoying the hors d’oeuvres and mingling on the top deck!

What a beautiful night spent in the Charleston harbor.

The Premier Design Jewelry booth featuring fabulous baubles.

Some of our guest enjoying a little retail therapy in the cabin.

The Radberry Nails with nail creations to match any mood!

We cannot say thank you enough to all of the wonderful businesses that donated beautiful raffle items for this year’s event. Without you, this event would not have been the success it was! For a complete list of the participating vendors click here

For more pictures from this year’s event make sure to visit our facebook page!

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Join Us for BRA Day USA

October 8, 2012 by

bra dayCome celebrate our first BRA Day USA on Wednesday, October 17, 2012 aboard the dockside Carolina Belle on 10 Wharfside Street, Charleston, SC ! We’re happy to promote Breast Reconstruction Awareness Day, or BRA Day, which is an initiative designed to increase education, awareness, and access regarding post-mastectomy breast reconstruction.

Created to inform women of their choices and options for breast reconstruction, the campaign also strives to make reconstructive education and services available to all women, regardless of age, financial status, or race. Studies show that 7 out of 10 women are never informed about post-mastectomy reconstructive surgery, and the statistics are even lower for minorities. However, with BRA Day events appearing all over the world, hopefully those numbers will soon be a thing of the past.

Though BRA Day initially launched in Canada, it quickly became an international campaign and grassroots collaboration between plastic surgeons specializing in breast surgery, nurse navigators, medical device industry representatives, breast cancer patients and families, and breast cancer support groups. Together, these participants coordinate BRA Day events that include question and answer sessions, lectures, flash mobs, fundraising parties, advertising campaigns, and community events.

The Center for Natural Breast Reconstruction team couldn’t be prouder to host our own BRA Day event for the first time this year, or to raise awareness of a cause we so firmly believe in. Help spread the word about reconstruction options, and join us for a little retail therapy, some great food, and outstanding prizes. Admission is free but limited to the venue capacity of 250.

To secure your spot, be sure to RSVP to info@naturalbreastreconstruction.com. We’ll see you on the Carolina Belle Wednesday, October 17th!

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