Ask The Doctor-I’m having implant difficulties. Can you help?

lotus flowerThis week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: I was diagnosed with triple negative breast cancer in my left breast in December of 2010. I had a lumpectomy in January 2011 followed by chemotherapy, a bilateral mastectomy and radiation. I have implants now. The right implant has dropped and the left is hard and contracted. I need help. My 36d has been replaced by 38b and the cups are too big. Please help.

Answer: I’m sorry you’re having problems with your breast reconstruction. Our practice specializes in breast reconstruction using your own tissue and preserving your body’s muscles.  Approximately 30% of our patients have already had implants and we remove them and complete their reconstruction without implants. You may already know that after radiation the chance for complications with implants increases. We have helped many women having similar problems to what you described. I would be glad to give you more specific information about your situation but I would need more information from you. I could talk to you over the phone or you could come for a consult depending on what is most convenient and where you live. Let me know.

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

Charleston Breast Surgeon Answers Your Implant and Insurance Questions

charleston breast surgeonsThe below questions are answered by Dr. James Craigie of The Center for Natural Breast Reconstruction

Should a woman have an MRI follow up every two years after implants to check on things? I’ve been told this.

Let’s go to the source of that information for the best answer . . .

This is from the product insert data sheet included with Mentor Corporation Memory Gel Implants . . .

“Rupture of a silicone gel-filled breast implant is most often silent (i.e., there are no symptoms experienced by the patient and no physical sign of changes with the implant) rather than symptomatic.  Therefore, you should advise your patient that she will need to have regular MRIs over her lifetime to screen for silent rupture even if she is having no problems. The first MRI should be performed at 3 years postoperatively, then every 2 years, thereafter. The importance of these MRI evaluations should be emphasized. If rupture is noted on MRI, then you should advise your patient to have her implant removed. You should provide her with a list of MRI facilities in her area that have at least a 1.5 Tesla magnet, a dedicated breast coil, and a radiologist experienced with breast implant MRI films for signs of rupture.”

You can read the entire product insert data sheet here:

Does insurance generally cover redoing of nipples and tattooing?  I’m not completely satisfied with the result of my nipple reconstruction procedure.

Great question . . . Let’s address the insurance portion first. If your health insurance covers mastectomy, it must cover reconstruction throughout all phases. There are some that do not have to abide by this rule, (WHCRA 1998) but they are few and far between. Some may limit the number of times you can undergo a procedure at their expense. The best way to assure they will pay for your procedure is to call the insurance company each time and make sure you have benefits available for the procedure you desire.

Nipple reconstructions can deteriorate over time. Those that seem a little too prominent at first tend to flatten out after a while and may no longer project enough to suit a patient.  Tattoos fade, especially when applied to skin that has a large amount of scar. This being said, repeat nipple reconstructions are a quick procedure routinely performed with local anesthesia and it’s not unusual to require a touch up tattoo.

—James E. Craigie, M.D.