Dr. James Craigie Answers Your Questions About Natural Breast Reconstruction

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

Do you perform a stacked combination DIEP/SGAP using both to make a breast(s)?

We do on occasion. It may be needed when one area of the body does not have enough tissue to achieve the desired result. This is an unusual situation in our practice we can usually achieve our goals with one area of the body.

There is a lot of discussion about a maximum BMI what about a minimum?

BMI is a guide line that helps the surgeon determine who is at a higher risk for complications. It is not a strict guideline and the final decision is left to the surgeons judgment among other things. Safety is our first priority and studies have definitely linked high BMI to an increased rate of complications without a doubt. Unfortunately  BMI is not a perfect calculation and different doctors may use the information differently. A low BMI is not linked to complications if someone is otherwise fit for surgery. Someone with very little body fat will have a low BMI and possibly not enough tissue to make a very large breast. This does not mean they cannot have a good result. It  may mean they require and combined or stacked flap approach. We have seen many patients who have been told they “don’t have enough tissue” but after consultation can reassure them they can get a very proportional result.

Dr. James Craigie

The Center for Natural Breast Reconstruction

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  1. Ten months ago I had one surgery for double mastectomies followed by latissimus dorsi reconstruction using implants. I have scoliosis and suffer almost continuously with sometimes debilitating back pain. I also have spasms in my breast.

    My plastic surgeon focuses on the wonderful cosmetic effect, but does not want to discuss my side effects.

    I have been to physical therapy and am now in pool therapy. I am seeing a mental health therapist, and have tried massage therapy, which gives some temporary relief.

    Do I have any alternatives or hope?

    • Hi Donna,

      Thanks for reading our blog! The answer below comes from Dr. James Craigie.

      My question is: if your scoliosis was not causing you these problems before your reconstruction, then it is possible that your problems have been brought on by not having an intact back muscle. I could not confirm this without more information. I can tell you we have helped many women improve from problems they were having due to implants and having their back muscle taken to cover the implants. It would be assumed that while we could not correct or alleviate any problems you might have had prior to your reconstruction; removing the implants, reattaching the chest muscle back down to the chest wall and releasing the latissiumus may very well correct the problems that have occurred since your reconstruction. Replacing the implants with fatty tissue from another part of the body may restore breast fullness without the problems that resulted from re positioning the back muscle. A recent example was a person we were able to help. She had scoliosis and failed implant reconstruction covered with one of her back muscles. Surgery and radiation from her childhood made it impossible to use the fatty tissue from the tummy. Her scoliosis made one buttock more prominent and we were able to remove the fat on one side and use the tissue to reconstruct her breast without harming any important muscles! Her problems related to scoliosis and the implant covered by her back muscle greatly improved. She also had a natural breast reconstruction that is permanent and will not need to be redone in years to come.