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Natural Breast Reconstruction
naturalbreastrecon (Physician - Surgery - Plastic (Verified) )| Communities: Breast Cancer | Answers: 53 |
| Member Since: Mar. 2011 |
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Professional Statement
We are a team of microsurgeons dedicated to performing muscle sparing free flap breast reconstruction procedures.
Professional Info
Credential: MD
Primary specialty: Surgery - Plastic
State Licenses: SC, LA, NC
Board certifications: American Board of Surgery, American Board of Plastic Surgery
Areas of expertise: Microsurgical Breast Reconstruction, DIEP, GAP, SIEA, HIP, Stacked DIEP
Hospital affiliation: East Cooper Regional Medical Center
Practice name: The Center for Natural Breast Reconstruction
Practice address:
1300 Hospital Drive Ste 120
Mount Pleasant, SC
29464
Practice phone number: 866-374-2627
Webpage:
www.naturalbreastreconstruction.com
Personal Bio (My story)
James E. Craigie & Richard M. Kline, MD. Exclusively based in Charleston South Carolina.
naturalbreastrecon Activities
Our overall flap failure rate is about 1.6%. Once you get beyond a certain point, however, the chance of the flap failing gets much less than that.
See previous answer for more information -http://talkabouthealth.com/right-after-having-a-diep-flap-breast-reconstruction-is-there-a-risk-of-having-circulation-problems-what-should-i-be-watching-for
See previous answer for more information -http://talkabouthealth.com/right-after-having-a-diep-flap-breast-reconstruction-is-there-a-risk-of-having-circulation-problems-what-should-i-be-watching-for
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified))
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2 months ago
I'm assuming you mean circulation problems in the new flap. Yes, there is a risk, and that is the primary reason we keep you in the hospital for at least 4 days for careful observation. If a problem with circulation does develop after surgery, the success rate of fixing it is usually pretty good if the problem is caught early. The risk of having a problem decreases as time elapsed since surgery increases. In almost 100 flaps, we have had 2 flaps develop problems 3 days after surgery, 1 flap developed problems 4 days after surgery, and one developed problems 5 days after surgery. We have had a few problems with bleeding or wound healing later than that, but no problems which put a flap in jeopardy. Nonetheless, it could happen.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified))
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2 months ago
Eventually. We generally like people to sleep on their back for at least two months to avoid any chance of crushing the flap. After that, we transition to side sleeping if all is going well.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified))
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2 months ago
In all probablility, yes. Symptoms of tightness and discomfort can persist for months, and occasionally seromas (fluid collections) can persist for over a year, but most people eventually recover completely.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified))
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2 months ago
Theoretically possible if that someone is your identical twin, but probably not practical even then, as it is easier and generally more successful to reconstruct a nipple from ordinary skin.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified))
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2 months ago
Capsular contracture is commonly described using the four-grade Baker Scale.
• Grade I — the breast is normally soft and appears natural in size and shape
• Grade II — the breast is a little firm, but appears normal
• Grade III — the breast is firm and appears abnormal
• Grade IV — the breast is hard, painful to the touch, and appears abnormal
The symptoms can be varying from mild to severe. Mild capsular contracture may only be detectable by your surgeon. If the process worsens and becomes severe it may lead to changes in the breast that a person easily could tell themselves. In other words, the shape may change, the breast may become different in shape, and clothes may begin to fit differently. The breast may become hard and the skin and tissue over the implant can change in appearance and color. The most severe problem related to capsular contracture would be pain and discomfort that may eventually limit the range of motion and movement of the shoulder and upper body. Some patients relate symptoms that they describe as an “iron bra” across the chest when the scar is so thick and tight. The chest feels like it is wrapped in something as wrapped in an “iron bra” all the way around. Sometimes the process can worsen and actually press in, move the muscles away from the breast area, and change the shape of the ribs. This would be the most severe form of capsular contracture and at that point we would recommend removing the implant and replacing the reconstruction with a muscle-sparing procedure.
• Grade I — the breast is normally soft and appears natural in size and shape
• Grade II — the breast is a little firm, but appears normal
• Grade III — the breast is firm and appears abnormal
• Grade IV — the breast is hard, painful to the touch, and appears abnormal
The symptoms can be varying from mild to severe. Mild capsular contracture may only be detectable by your surgeon. If the process worsens and becomes severe it may lead to changes in the breast that a person easily could tell themselves. In other words, the shape may change, the breast may become different in shape, and clothes may begin to fit differently. The breast may become hard and the skin and tissue over the implant can change in appearance and color. The most severe problem related to capsular contracture would be pain and discomfort that may eventually limit the range of motion and movement of the shoulder and upper body. Some patients relate symptoms that they describe as an “iron bra” across the chest when the scar is so thick and tight. The chest feels like it is wrapped in something as wrapped in an “iron bra” all the way around. Sometimes the process can worsen and actually press in, move the muscles away from the breast area, and change the shape of the ribs. This would be the most severe form of capsular contracture and at that point we would recommend removing the implant and replacing the reconstruction with a muscle-sparing procedure.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) Breast Implant Rejection, Breast Surgery Side Effects, Breast Cancer, Capsular Contracture, Post-surgery Complications, Breast Cancer Treatment Side Effects, Breast Implant, Breast Surgery Complications, Breast Implant Experiences, Side Effects, Breast Reconstruction Side Effects
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1 year ago
naturalbreastrecon (Physician - Surgery - Plastic (Verified)) asked the question in topic(s) Breast Implant Rejection, Breast Surgery Side Effects, Breast Cancer, Capsular Contracture, Post-surgery Complications, Breast Cancer Treatment Side Effects, Breast Implant, Breast Surgery Complications, Breast Implant Experiences, Side Effects, Breast Reconstruction Side Effects
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1 year ago
The next step would depend on how severe the capsular contracture is. All implants will develop a capsule and this may slowly lead to changes in the shape or in the most severe cases painful scarring and hardness. When symptoms develop it may be necessary to surgically intervene. The next step would depend on whether the patient has had radiation and the available options for reconstruction. The first step and the least involved regarding surgery would be capsulotomy or release of the scar. Sometimes the healing process, whether there was an infection or a bruise around the breast, could have increased the risk for capsular contracture. Other times it may simply be the body’s reaction to an implant. If after capsulotomy or capsulectomy the contracture has not resolved, the next step would be to consider moving additional healthy tissue to cover the implant or to remove the implant and replace it with your own tissue. 30% of our patients who choose to undergo autologeous reconstruction have had prior implant reconstruction and their bodies have developed severe capsular contracture. If someone has had radiation, the capsular contracture will be more severe and most likely once problems develop the problems will continue. Therefore, when multiple capsular contracture procedures have been necessary; our recommendation would be to consider removing the implant and replacing it with your own tissue using a muscle-sparing procedure. Your own tissue would not develop capsular contracture and it is the most successful way to solve problems resulting from implant reconstruction.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) Breast Implant Rejection, Breast Implant , Capsular Contracture, Breast Cancer Treatment Side Effects, Cancer Next Steps, What To Expect, Breast Implant Rejection What To Expect, Breast Implant Rejection Next Steps, Breast Surgery Side Effects, Breast Cancer, Next Steps, Post-surgery Complications, Capsular Contracture What To Expect, Breast Implant Experiences, Capsular Contracture Next Steps, Breast Reconstruction Side Effects, Breast Reconstruction Complications
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1 year ago
naturalbreastrecon (Physician - Surgery - Plastic (Verified)) asked the question in topic(s) Breast Implant Rejection, Breast Implant , Capsular Contracture, Breast Cancer Treatment Side Effects, Cancer Next Steps, What To Expect, Breast Implant Rejection What To Expect, Breast Implant Rejection Next Steps, Breast Surgery Side Effects, Breast Cancer, Next Steps, Post-surgery Complications, Capsular Contracture What To Expect, Breast Implant Experiences, Capsular Contracture Next Steps, Breast Reconstruction Side Effects, Breast Reconstruction Complications
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1 year ago
Breast reconstruction requires detailed planning before surgery. One of the most important considerations is the desire of the patient to either be the same as she was before mastectomy or to change some aspect of the breast. When there is adequate donor tissue (in the case of a DIEP excess tummy tissue) we may have the opportunity to increase the patient’s bra cup size given adequate planning and adequate donor tissue. The desire of the outcome is always to be proportional and if someone has more tissue on the tummy we can usually achieve this. In ideal circumstances, we plan to make the reconstructed breast approximately 20% larger at the first stage than the end goal after the reconstruction process is complete. During the first stage of surgery, the tissue from the tummy is transferred and the primary goal is to have adequate blood supply and healthy nourished tissue. The shaping of the breast is secondary to the functioning of the blood vessels during this stage. At the second stage of surgery, in order to create a more natural shape, some tissue may need to be removed or any tissue that did not survive the initial transfer (fat necrosis) removed.
Therefore, when planning the first stage procedure, we try to end up with slightly more than desired. That gives us the ability to shape the breast and we can always make it slightly smaller at the second procedure; which is a much easier adjustment than making it larger. So, it is possible to increase the current breast size with the DIEP, but it would depend on the size of the breast prior to the mastectomy and how much donor tissue is available for reconstruction.
Therefore, when planning the first stage procedure, we try to end up with slightly more than desired. That gives us the ability to shape the breast and we can always make it slightly smaller at the second procedure; which is a much easier adjustment than making it larger. So, it is possible to increase the current breast size with the DIEP, but it would depend on the size of the breast prior to the mastectomy and how much donor tissue is available for reconstruction.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) DIEP Flap Reconstruction Experiences, Breast Cancer, DIEP Flap Reconstruction Treatment Process, Breast Cancer Treatment Options, Breast Reconstruction Options, Breast Reconstruction, Breast Size Changes, Breast Reconstruction Treatment Options, DIEP Flap Reconstruction Treatment Options, DIEP Flap Breast Reconstruction
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1 year ago
naturalbreastrecon (Physician - Surgery - Plastic (Verified)) asked the question in topic(s) DIEP Flap Reconstruction Experiences, Breast Cancer, DIEP Flap Reconstruction Treatment Process, Breast Cancer Treatment Options, Breast Reconstruction Options, Breast Reconstruction, Breast Size Changes, Breast Reconstruction Treatment Options, DIEP Flap Reconstruction Treatment Options, DIEP Flap Breast Reconstruction
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1 year ago
The TCAP flap is a procedure for reconstructing the breast or partial breast reconstruction and is another of the muscle-sparing flaps. The ICAP does not require microsurgery or reattachment of the blood vessels, but usually the amount of tissue available is small. In our experience it is most frequently used to perform partial breast reconstruction of mainly the outer side of the breast or to add volume to a previously reconstructed breast or when the resulting size is not as quite as large as desired from the original planned procedure. An advantage is the ICAP flap is that it removes tissue from the side of the body that is usually in excess and sometimes bothersome following mastectomy. It is just above the bra line and the scar, and although it extends to the back, can almost always be covered in a bathing suit or a support type bra. Again, the ICAP’s best use is in adding additional tissue to an already reconstructed breast or providing small amounts of tissue for partial breast reconstruction. It typically does not involve microsurgery to reconnect the blood vessels and the blood vessel that nourishes the tissue is conveniently located on the side of the body near the breast just above the bra line.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) Intercostal Artery Perforator (ICAP) Flap Breast Reconstruction, Post Mastectomy Reconstruction, Flap Reconstruction, Breast Reconstruction, ICAP Flap Reconstruction Uses, Post Mastectomy Treatments, ICAP Flap Reconstruction Eligibility, Post Surgery Treatments, Post Surgery, Muscle Sparing Breast Reconstruction, Muscle Sparing Flap Reconstruction, Post Mastectomy
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1 year ago
naturalbreastrecon (Physician - Surgery - Plastic (Verified)) asked the question in topic(s) Intercostal Artery Perforator (ICAP) Flap Breast Reconstruction, Post Mastectomy Reconstruction, Flap Reconstruction, Breast Reconstruction, ICAP Flap Reconstruction Uses, Post Mastectomy Treatments, ICAP Flap Reconstruction Eligibility, Post Surgery Treatments, Post Surgery, Muscle Sparing Breast Reconstruction, Muscle Sparing Flap Reconstruction, Post Mastectomy
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1 year ago
What is the TDAP flap breast reconstruction procedure and what are its advantages and disadvantages?
The TDAP flap or thoracodorsal artery perforator flap is a procedure for reconstructing the breast or partial breast reconstruction and is another of the muscle-sparing flaps. The procedure allows for the fatty tissue from the side and back to be mobilized and then transferred to the breast without disconnecting its blood supply and performing re anastomosis of the small blood vessels. The tissue that is used is in the area above the latissimus dorsi muscle, which is the largest muscle in the body; however, the procedure does not involve transferring the muscle or destroying the muscle. The advantages of this procedure are that the tissue can be used for breast reconstruction without performing the microsurgery and without damaging or removing the muscle. The disadvantages of the procedure are that there is a limited amount of tissue available to use for breast reconstruction and because the blood vessel remains attached and is not divided, there is a limit to the shaping and positioning of the new tissue. It is most frequently used for reconstruction of a part of a breast, mainly the outside, but in some circumstances can be used for reconstructing the entire breast. However, this is usually a smaller reconstruction and the amount of skin available is typically limited as well. The TDAP can be used for transferring fat to the breast at the time of mastectomy or can be used later after mastectomy and the body has healed.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified))
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1 year ago
What is the TDAP flap breast reconstruction procedure and what are its advantages and disadvantages?
naturalbreastrecon (Physician - Surgery - Plastic (Verified)) asked the question
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1 year ago
A skin-sparing mastectomy will set the stage for an optimal scar pattern when reconstruction is completed. Typically, even though the nipple must be reconstructed, patients will have the same scars as if they had just had a breast lift or breast reduction.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) Breast Surgery Scars, Breast Cancer Surgery, Breast Cancer Surgery Options, Breast Surgery, Breast Reconstruction, Mastectomy, Breast Cancer Treatments, Breast Conserving Surgery, Breast Cancer, Breast Reconstruction Options, Breast Surgery Options, Breast Reconstruction Scars, Skin Sparing Mastectomy
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1 year ago
naturalbreastrecon (Physician - Surgery - Plastic (Verified)) asked the question in topic(s) Breast Surgery Scars, Breast Cancer Surgery, Breast Cancer Surgery Options, Breast Surgery, Breast Reconstruction, Mastectomy, Breast Cancer Treatments, Breast Conserving Surgery, Breast Cancer, Breast Reconstruction Options, Breast Surgery Options, Breast Reconstruction Scars, Skin Sparing Mastectomy
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1 year ago
Once reconstruction is completed, no maintenance is required. Occasionally nipple/ areolar tattoos will need “freshening,” but that’s optional.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) Breast Cancer Treatments, Breast Cancer, Autologous Breast Reconstruction Maintenance, Autologous Breast Reconstruction, Breast Reconstruction, DIEP Flap, Breast Reconstruction Maintenance, DIEP Flap Breast Reconstruction
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1 year ago
naturalbreastrecon (Physician - Surgery - Plastic (Verified)) asked the question in topic(s) Breast Cancer Treatments, Breast Cancer, Autologous Breast Reconstruction Maintenance, Autologous Breast Reconstruction, Breast Reconstruction, DIEP Flap, Breast Reconstruction Maintenance, DIEP Flap Breast Reconstruction
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1 year ago
Absolutely not. That doesn’t mean they last forever, but they don’t have an expiration date.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified))
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1 year ago
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