Best of Ask the Doctor

charleston breast surgeonsAt The Center for Natural Breast Reconstruction, our mission is to help women everywhere make smart, informed decisions about breast reconstruction and overall healthcare.

Over the years, our surgeons, Dr. James Craigie and Dr. Richard M. Kline, Jr., have answered a wealth of questions about breast reconstructive surgery—from the different kinds of procedures to post-op healing tips.

If you’re searching for a thorough introduction to breast reconstructive surgery, here’s a sample of the invaluable advice our surgeons gave the past year:

Your Questions about Natural Breast Reconstruction and Implants Answered

Scarring After Breast Reconstruction Surgery

Tackling the Challenges of Breast Reconstruction After Lumpectomy and Radiation

The Benefits of DIEP Flap Breast Reconstruction Over Other Reconstructive Options

Is This Normal? Your Post Op Breast Reconstruction Question Answered 

Tips for Improving Recovery and Healing Time

If you are seeking advice about breast cancer, breast reconstruction, or healthcare options, please send your questions our way! We will address all of your questions with detailed and valuable insight straight from our surgeons.

If I Have Had Natural Breast Reconstruction Do I Need To Have A Yearly Mammogram?

diep and mammogramThe below question is answered by Charleston breast surgeonDr. James E. Craigie. of The Center for Natural Breast Reconstruction:

After having breast reconstruction using the DIEP method do I need to have yearly mammogram?  If so, can the pressure from the procedure cause any damage to the tissue or blood vessels used in the reconstruction?

First of all, following mastectomy and reconstruction with your own tissues, a mammogram is routinely not needed on a regular screening basis.  Screening mammograms are only helpful for normal breast tissue; therefore, in our patients we do not recommend that they have regular screening mammograms.  From time to time, people will be seen in follow up for examination and have areas of the breast feel firm or hard and sometimes the oncologist or other physicians will order mammograms to investigate a specific finding.  This would normally be performed after the first and second stages of the reconstruction process were completed and therefore should pose no risk of injury to the blood vessels that were connected to the breast.

-James E. Craigie, M.D.

Do you have a question about breast implants or natural breast reconstruction? Ask the doctor by submitting your questions here.


The Perfect Rainy Day in Charleston: What to Do for Fun

Charleston is one of those places that has so much to do and see that you can have fun even on a rainy day. From the South Carolina Aquarium to the Charleston City Market, here are our favorite dreary day activities.

South Carolina Aquarium

With a daily dive show and exhibits galore, the South Carolina Aquarium is the perfect rainy day activity for all ages. The exhibits take you from the mountains to the sea, and the first one you’ll see, the mountain forest exhibit, features majestic eagles and playful otters frolicking in the hilly forest. You’ll see the flora and fauna in the piedmont, coastal plain, and salt marsh areas before you hit the coast and ocean to have close encounters with sharks and pufferfish.

The Touch Tank allows you to see and touch water creatures such as stingrays and sea urchins. In February, the Aquarium will hold a birdhouse building workshop and a Love under the Sea Valentine’s Day dinner.

Tour the Yorktown

The focal point of the Patriots Point Naval and Maritime Museum is the World War II aircraft carrier USS Yorktown. The museum is home to a fleet of National Historic Landmark ships and the Cold War Memorial. Patriots Point also houses the Congressional Medal of Honor Society and Medal of Honor Museum.

Aboard the Yorktown, you can tour the flight deck and bridge, living quarters, brig, and engine room. The Charleston Navy Shipyard Museum and Medal of Honor Museum are on board, and individual memorials are scattered around the ship. The hangar bay holds vintage aircraft, and if you’d like to try flying yourself, you’ll want to try the flight simulator.

Kiln Time

If you’re artistically inclined and would like to paint your own pottery—or your kids would—Kiln Time is a great way to spend a rainy afternoon. You’ll find a large collection of pottery that you can decorate or paint, and then Kiln Time will fire them and have them ready in just a few days. What a fun way to spend some family time!

Historical Charleston City Market

The Charleston City Market has been part of Charleston’s history for over two centuries. The majestic Market Hall building houses the Daughters of the Confederacy museum. Grab your umbrella and head to this amazing open-air market that sells everything from jewelry to food to sweetgrass baskets. With over 100 vendors, the market has something for everyone, and is the perfect place to have a coffee and watch people. Take a carriage ride, relax, and enjoy Charleston.

Do you have any suggestions for a perfect way to spend a rainy day in Charleston?



Your Questions about DIEP Flap Breast Reconstruction Answered

The below questions are answered by Charleston breast surgeon, Dr. Richard M. Kline, Jr. of The Center for Natural Breast Reconstruction:

What are the most common reasons a diep flap will fail?

Specifics may vary from case to case and practice to practice, but all failures involve interruption of the blood supply. This can be caused from a clot forming at the arterial or venous anastomosis, or from a conformational change in the blood vessel which produces “kinking” and subsequent interruption of blood supply. Most surgical teams experience dramatically lower failure rates as their experience expands, and it can get very difficult to determine precise reasons for failure (and ways to prevent it) when failure is a very rare event, i.e., success rates of 98-99%, which is typical for experienced surgeons. The best teams will nonetheless strive, whenever they have a failure, to find some “take home message” which they can use to hopefully further minimize their failure rate.

If you had a failure with Diep on one side does that increase your chances of failing again if another flap procedure were done in the future?

In our experience, no, although in a large enough series it may. We have always been able to use the internal mammary vessels, supplied through collaterals, to successfully supply blood to a second flap after an initial flap failed. Generally speaking, the collateral supply to the internal mammary from one intercostal artery is probably sufficient to supply a new flap. I do think that it is advisable, however, to wait at least 3 months following an initial flap failure before attempting a second flap, as this gives time for tissue edema to resolve, and serum protein levels to return to normal.

My Diep Flap failed on one side. I wound up with a silicone implant on the right side, and it is not healing quickly. What should I be watching for ?

That depends on what you mean by “not healing quickly.” If you have an unhealed wound, then something is really wrong, and you should see your surgeon. If it simply hurts or “doesn’t feel right,” then it may improve with time, or you may be developing capsular contracture (a common problem with implants), which may not go away. If you still want a flap, you may well still be able to have one from your buttock or elsewhere.

Do you have a question for the Charleston breast surgeons at The Center for Natural Breast Reconstruction? We’d love to hear from you.


Top Fitness Equipment to Help Increase Strength

We’ve found so many different types of great fitness equipment that we had to share them with you. All of them will help you increase strength, get in shape, and feel better. Any sporting goods store or website will have a range of equipment. Pick your favorite and start!

Fitness balls

These fun PVC plastic balls give you a total body workout, and simply sitting on them while working and watching TV will strengthen your core (abdominals and lower back) and stretch your muscles. Look for a burst-resistant ball that comes with its own pump and a DVD or booklet outlining exercises.

Fitness balls come in different sizes and are gauged by the user’s height, so be sure to read the packaging or website information before buying. When you sit on the fully inflated ball, your knees should be bent at a 90-degree angle—if they aren’t, move up or down one size. If you’re heavy for your height, you may need to go one ball size bigger, or if you’re very light, you may need one size smaller.

Medicine balls

Medicine balls are smaller than fitness balls, and they’re weighted to help you improve strength in your hands, arms, core, and legs. Use them as an alternative to weights, or simply play catch with them. These bouncy balls come in a wide variety of sizes and are typically made of rubber for easy grip.

Resistance cables

Also known as toning cables, toning tubes, or resistance tubes, resistance cables are a convenient, inexpensive alternative to free weights or machines. Typically made of latex or rubber, they have handle grips, and you can use more than one to increase the resistance. Many are versatile enough to strengthen any area of your body, depending on how they’re used.

Jump rope

Still as fun as they were when you were a kid, a jump rope gives you a cardio workout with a twist: the handles hold weights to help you strengthen and tone your arms, shoulders, and back.

Wobble boards and stability discs

Much like the fitness balls, these flat boards and rounded discs help you strengthen your upper and lower body while improving your stamina, stability, and balance. Wobble boards are typically used during yoga or Pilates work to strengthen your core and legs. Stability discs can be used sitting, kneeling, lying, or standing, and you have the option of inflating them to your desired size.

Have you tried any of these fitness helpers, and how did you like them?


Top 3 Holiday Related Activities to Enjoy in Charleston

festival of lightsImage to the left taken from the Charleston County Park & Recreation Commission website.


Charleston comes alive during the holidays, and enchanting activities for all ages abound. Here are just a few of the festive holiday celebrations to enjoy right now.

Holiday Festival of Lights
James Island County Park, November 10, 2011–January 1, 2012

With over 2 million lights, the Holiday Festival of Lights is a must-see event. Set up as a 3-mile driving tour or a fun-filled train ride, the Festival of Lights also offers several activities besides twinkling lights, such as marshmallow roasts, gift shops, carousel rides, life-size greeting cards, and a tree lighting.

The driving tour is $12 per car, and the train ride is $3 per person. Children under 2 are admitted free.

Charleston Christmas Sleigh Ride 2011
Charleston Harbor, December 1–31, 2011

Every night in December excluding Christmas, Thriller Charleston hosts sleigh rides by boat to look at the Christmas lights and decorations. You’ll depart from Shem Creek in Mt. Pleasant and see the sights in Charleston, James Island, and Mt. Pleasant. As you drink hot cocoa, you’ll hear charming stories of Charleston’s Christmas customs. You keep your travel mug and rain poncho.

Sleigh rides are $45 for adults and $35 for children ages 5–12. Children under 5 are admitted free, but do not receive the hot chocolate or rain poncho.

What’s your favorite Charleston holiday tradition?

What Does It Mean to Eat Healthier?

healthy eatingWhat does healthy eating mean to you, personally?

Eating healthier means different things to all of us. For one person, it might mean cutting out animal products and eating strictly organic vegan food. For another, it might mean eating out no more than a couple times a week and learning to cook.

Transforming your eating habits is a process, and you can’t expect to be perfect overnight. Eating healthier means striving to avoid unhealthy food most of the time. Only you can decide what it means to decrease unhealthy food and add healthy food. Your doctor or nutritionist can help, but you must live with your new eating habits, so your plan must be realistic.

We’ve seen people stop eating certain foods cold turkey, and while it works for some, for others it’s a recipe for disaster. When you deprive yourself of foods you love, you may reach a point where you have an overwhelming craving for that food, and then you’re likely to binge, or eat a large amount at one sitting.

We recommend that instead of cutting out favorite foods completely, allow small portions occasionally, or find an acceptable substitute. One example is moving from eating large amounts of milk chocolate daily to small amounts of dark chocolate a few times a week. Another example is limiting yourself to one soda a day.

When you’re ready to change your diet for the better, you can start with these tips:

  • Think about how you eat now. Look at how often you eat processed food, such as frozen pizza, versus food in its natural state, such as fruit. Generally, the less often you eat processed food, the better.
  • Keep a food diary for two weeks. You’ll see where you can improve, and you’ll have a good idea of exactly what you’re eating.
  • Visit,, and for more information on healthy eating and ways to change your eating habits.
  • Decide what you can and cannot live with when it comes to healthy eating, and start with small steps such as reducing sugar intake. Once you’re comfortable with that, add another small change to your diet.

Remember, this is a marathon, not a sprint. Make minor changes gradually, and you’ll still enjoy eating while you work toward your goals. Use your doctor and nutritionist for help and guidance.

What steps to improve your diet are you considering? If you’ve already taken steps to change your eating, please share in our comments section.