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naturalbreastrecon
(Physician
- Surgery - Plastic
(Verified)
)
| Communities: Breast Cancer | Thank You's: 8 |
| Member Since: Mar. 2011 | Questions: 12 |
| Answers: 43 |
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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
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.
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 Conserving Surgery, Breast Cancer Surgery, Breast Cancer Surgery Options, Breast Reconstruction Options, Breast Surgery, Breast Cancer Treatment, Breast Reconstruction, Breast Conserving Surgery Scars, Breast Reconstruction Scars, Skin Sparing Mastectomy
1
Answer |
2 days ago
Once reconstruction is completed, no maintenance is required. Occasionally nipple/ areolar tattoos will need “freshening,” but that’s optional.
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) Autologous Breast Reconstruction Maintenance, Breast Cancer Treatment, Breast Reconstruction, Autologous Breast Reconstruction, Breast Reconstruction Maintenance, DIEP Flap, DIEP Flap Breast Reconstruction
1
Answer |
2 days ago
Absolutely not. That doesn’t mean they last forever, but they don’t have an expiration date.
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))
1
Answer |
2 days ago
Flap survival rate is 98-99%. Occasionally a flap will survive, but a patient will feel that their reconstruction was not successful for some reason (lots of necrosis being the most common reason), but that is unusual.
Flap survival rate is 98-99%. Occasionally a flap will survive, but a patient will feel that their reconstruction was not successful for some reason (lots of necrosis being the most common reason), but that is unusual.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified))
1
Answer |
2 days ago
Most surgeons recommend waiting 6 months, but we have successfully reconstructed women prior to then if they have minimal skin changes after radiation.
Most surgeons recommend waiting 6 months, but we have successfully reconstructed women prior to then if they have minimal skin changes after radiation.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified))
1
Answer |
2 days ago
This is a rare scenario, but in our practice we generally recommend waiting 3 months for the body to recover, then using another area of tissue, most commonly the buttock to perform the reconstruction. The failure of the first reconstructive attempt does not seem to adversely affect the success rate of the second reconstructive attempt. We have in the past sometimes attempted to perform the salvage reconstruction at an earlier date, but we have come to feel that the patients do better overall if they are allowed a period of healing before proceeding with the next surgery.
This is a rare scenario, but in our practice we generally recommend waiting 3 months for the body to recover, then using another area of tissue, most commonly the buttock to perform the reconstruction. The failure of the first reconstructive attempt does not seem to adversely affect the success rate of the second reconstructive attempt. We have in the past sometimes attempted to perform the salvage reconstruction at an earlier date, but we have come to feel that the patients do better overall if they are allowed a period of healing before proceeding with the next surgery.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified))
1
Answer |
29 days ago
Generally speaking, patients can sit in a chair the day after surgery, they are walking by 2 days after surgery, and they leave the hospital on the fourth day after surgery. We ask you to sleep on your back for a minimum of a month, sometimes longer (depending on the size of the flaps), and to avoid vigorous physical activity for at least 6-8 weeks. Most people seem to feel like they are well on their way to recovery within 2 months, although obviously healing goes on for a significantly longer. However, everyone is different, and some patients recover more rapidly, other seems to take a little more time. We feel that the optimal approach is to let you speak to other patients who have been through the process, so that they may share their experiences directly with you.
Generally speaking, patients can sit in a chair the day after surgery, they are walking by 2 days after surgery, and they leave the hospital on the fourth day after surgery. We ask you to sleep on your back for a minimum of a month, sometimes longer (depending on the size of the flaps), and to avoid vigorous physical activity for at least 6-8 weeks. Most people seem to feel like they are well on their way to recovery within 2 months, although obviously healing goes on for a significantly longer. However, everyone is different, and some patients recover more rapidly, other seems to take a little more time. We feel that the optimal approach is to let you speak to other patients who have been through the process, so that they may share their experiences directly with you.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified))
1
Answer |
29 days ago
I am going to break this question into two parts.
The first part is what are the benefits of the DIEP flap over reconstructive options using implants? Let us start with the benefits of implants. The primary benefit of implant is that the operations are shorter, they are potentially safer, and you do not need to operate on another part of the body.
Additionally, implants are readily available, and if you do not have enough extra body tissue somewhere to make a breast, implants may be the preferred choice for this reason. The advantage of the DIEP flap over implants is that it produces a much more natural feeling, warmer, and trouble free breast (after the reconstruction process is completed). There is data to suggest that women tend to accept the reconstructed breast as their own more readily if it is made using their own tissue, in comparison to women who have a reconstructed breast using implants. Additionally, many women feel that they have too much extra tissue in their abdominal area, and they may actually view removing this tissue to make a breast as an added bonus.
The second part of this answer is going to be why is the DIEP flap better than other reconstructive options using the patients own tissue, with the most commonly performed in our practice being the GAP or gluteal artery perforator flap, which is taking the buttock. The primarily advantage of the DIEP over the GAP is that it is faster, and no position changes are needed during surgery to harvest the flap. If the patient has adequate abdominal tissue to meet her reconstructive needs, we generally recommend using this as our first line option. Having said that, however, the buttock serves very well to make breast, although the process is a little more tedious and lengthy. I am going to break this question into two parts.
The first part is what are the benefits of the DIEP flap over reconstructive options using implants? Let us start with the benefits of implants. The primary benefit of implant is that the operations are shorter, they are potentially safer, and you do not need to operate on another part of the body.
Additionally, implants are readily available, and if you do not have enough extra body tissue somewhere to make a breast, implants may be the preferred choice for this reason. The advantage of the DIEP flap over implants is that it produces a much more natural feeling, warmer, and trouble free breast (after the reconstruction process is completed). There is data to suggest that women tend to accept the reconstructed breast as their own more readily if it is made using their own tissue, in comparison to women who have a reconstructed breast using implants. Additionally, many women feel that they have too much extra tissue in their abdominal area, and they may actually view removing this tissue to make a breast as an added bonus.
The second part of this answer is going to be why is the DIEP flap better than other reconstructive options using the patients own tissue, with the most commonly performed in our practice being the GAP or gluteal artery perforator flap, which is taking the buttock. The primarily advantage of the DIEP over the GAP is that it is faster, and no position changes are needed during surgery to harvest the flap. If the patient has adequate abdominal tissue to meet her reconstructive needs, we generally recommend using this as our first line option. Having said that, however, the buttock serves very well to make breast, although the process is a little more tedious and lengthy.
The first part is what are the benefits of the DIEP flap over reconstructive options using implants? Let us start with the benefits of implants. The primary benefit of implant is that the operations are shorter, they are potentially safer, and you do not need to operate on another part of the body.
Additionally, implants are readily available, and if you do not have enough extra body tissue somewhere to make a breast, implants may be the preferred choice for this reason. The advantage of the DIEP flap over implants is that it produces a much more natural feeling, warmer, and trouble free breast (after the reconstruction process is completed). There is data to suggest that women tend to accept the reconstructed breast as their own more readily if it is made using their own tissue, in comparison to women who have a reconstructed breast using implants. Additionally, many women feel that they have too much extra tissue in their abdominal area, and they may actually view removing this tissue to make a breast as an added bonus.
The second part of this answer is going to be why is the DIEP flap better than other reconstructive options using the patients own tissue, with the most commonly performed in our practice being the GAP or gluteal artery perforator flap, which is taking the buttock. The primarily advantage of the DIEP over the GAP is that it is faster, and no position changes are needed during surgery to harvest the flap. If the patient has adequate abdominal tissue to meet her reconstructive needs, we generally recommend using this as our first line option. Having said that, however, the buttock serves very well to make breast, although the process is a little more tedious and lengthy. I am going to break this question into two parts.
The first part is what are the benefits of the DIEP flap over reconstructive options using implants? Let us start with the benefits of implants. The primary benefit of implant is that the operations are shorter, they are potentially safer, and you do not need to operate on another part of the body.
Additionally, implants are readily available, and if you do not have enough extra body tissue somewhere to make a breast, implants may be the preferred choice for this reason. The advantage of the DIEP flap over implants is that it produces a much more natural feeling, warmer, and trouble free breast (after the reconstruction process is completed). There is data to suggest that women tend to accept the reconstructed breast as their own more readily if it is made using their own tissue, in comparison to women who have a reconstructed breast using implants. Additionally, many women feel that they have too much extra tissue in their abdominal area, and they may actually view removing this tissue to make a breast as an added bonus.
The second part of this answer is going to be why is the DIEP flap better than other reconstructive options using the patients own tissue, with the most commonly performed in our practice being the GAP or gluteal artery perforator flap, which is taking the buttock. The primarily advantage of the DIEP over the GAP is that it is faster, and no position changes are needed during surgery to harvest the flap. If the patient has adequate abdominal tissue to meet her reconstructive needs, we generally recommend using this as our first line option. Having said that, however, the buttock serves very well to make breast, although the process is a little more tedious and lengthy.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified))
1
Answer |
29 days ago
Opinions on this vary, but I think the prevailing opinion is the sooner the better. Ideally, the patient would see the reconstructive surgeon even before plans were finalized for treating her cancer. This is because many times several options are available to the patient, and she may not fully understand the implications of the various options available to her unless she understands what reconstructive options are available in each setting.
Opinions on this vary, but I think the prevailing opinion is the sooner the better. Ideally, the patient would see the reconstructive surgeon even before plans were finalized for treating her cancer. This is because many times several options are available to the patient, and she may not fully understand the implications of the various options available to her unless she understands what reconstructive options are available in each setting.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified))
1
Answer |
29 days ago
I am going to split the answer for this into two parts. First, what you should watch for while you are in the hospital (at which time you will, of course, have lots of help watching for things). Second, what should you watch for when you go home?
When you are in the hospital, we primarily look for changes in the vascular status of the flap. There are monitors attached to the flap which will within seconds pick up any change in the blood flow to the flap. If on further evaluation by the nurses, it shows that there is a problem, we will take you back to surgery immediately and attempt to correct the problem. Fortunately, incidents such as these are rare, but if they do occur. We have learned that the most important factor is to get to the operating room quickly, in which case we can almost always fix whatever might be wrong.
Thankfully, it is unbelievably rare to have a problem with the blood flow to the flap after going home, although it is not impossible. Your primary concern should be to follow the specific directions which we have given in terms of positioning and brassiere support. Most patients still have temperature monitoring strips attach to the flap, and this can serve as useful reassurance to let you know that your flap is fine. Infections are extremely rare after DIEP flap surgery, but they can occur either at the reconstruction site or at the abdominal donor site. Wound healing problems are not as rare as infections but may occur. If you are not radiated, the most likely place to have a wound healing problem is your abdomen. If you are radiated, it is very common to have a little bit of a wound healing problem where the healthy flap tissue meets the radiated breast skin. Essentially all wound healing problems can be managed very effectively, so it is not something you need to worry about. I am going to split the answer for this into two parts. First, what you should watch for while you are in the hospital (at which time you will, of course, have lots of help watching for things). Second, what should you watch for when you go home?
When you are in the hospital, we primarily look for changes in the vascular status of the flap. There are monitors attached to the flap which will within seconds pick up any change in the blood flow to the flap. If on further evaluation by the nurses, it shows that there is a problem, we will take you back to surgery immediately and attempt to correct the problem. Fortunately, incidents such as these are rare, but if they do occur. We have learned that the most important factor is to get to the operating room quickly, in which case we can almost always fix whatever might be wrong.
Thankfully, it is unbelievably rare to have a problem with the blood flow to the flap after going home, although it is not impossible. Your primary concern should be to follow the specific directions which we have given in terms of positioning and brassiere support. Most patients still have temperature monitoring strips attach to the flap, and this can serve as useful reassurance to let you know that your flap is fine. Infections are extremely rare after DIEP flap surgery, but they can occur either at the reconstruction site or at the abdominal donor site. Wound healing problems are not as rare as infections but may occur. If you are not radiated, the most likely place to have a wound healing problem is your abdomen. If you are radiated, it is very common to have a little bit of a wound healing problem where the healthy flap tissue meets the radiated breast skin. Essentially all wound healing problems can be managed very effectively, so it is not something you need to worry about.
When you are in the hospital, we primarily look for changes in the vascular status of the flap. There are monitors attached to the flap which will within seconds pick up any change in the blood flow to the flap. If on further evaluation by the nurses, it shows that there is a problem, we will take you back to surgery immediately and attempt to correct the problem. Fortunately, incidents such as these are rare, but if they do occur. We have learned that the most important factor is to get to the operating room quickly, in which case we can almost always fix whatever might be wrong.
Thankfully, it is unbelievably rare to have a problem with the blood flow to the flap after going home, although it is not impossible. Your primary concern should be to follow the specific directions which we have given in terms of positioning and brassiere support. Most patients still have temperature monitoring strips attach to the flap, and this can serve as useful reassurance to let you know that your flap is fine. Infections are extremely rare after DIEP flap surgery, but they can occur either at the reconstruction site or at the abdominal donor site. Wound healing problems are not as rare as infections but may occur. If you are not radiated, the most likely place to have a wound healing problem is your abdomen. If you are radiated, it is very common to have a little bit of a wound healing problem where the healthy flap tissue meets the radiated breast skin. Essentially all wound healing problems can be managed very effectively, so it is not something you need to worry about. I am going to split the answer for this into two parts. First, what you should watch for while you are in the hospital (at which time you will, of course, have lots of help watching for things). Second, what should you watch for when you go home?
When you are in the hospital, we primarily look for changes in the vascular status of the flap. There are monitors attached to the flap which will within seconds pick up any change in the blood flow to the flap. If on further evaluation by the nurses, it shows that there is a problem, we will take you back to surgery immediately and attempt to correct the problem. Fortunately, incidents such as these are rare, but if they do occur. We have learned that the most important factor is to get to the operating room quickly, in which case we can almost always fix whatever might be wrong.
Thankfully, it is unbelievably rare to have a problem with the blood flow to the flap after going home, although it is not impossible. Your primary concern should be to follow the specific directions which we have given in terms of positioning and brassiere support. Most patients still have temperature monitoring strips attach to the flap, and this can serve as useful reassurance to let you know that your flap is fine. Infections are extremely rare after DIEP flap surgery, but they can occur either at the reconstruction site or at the abdominal donor site. Wound healing problems are not as rare as infections but may occur. If you are not radiated, the most likely place to have a wound healing problem is your abdomen. If you are radiated, it is very common to have a little bit of a wound healing problem where the healthy flap tissue meets the radiated breast skin. Essentially all wound healing problems can be managed very effectively, so it is not something you need to worry about.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified))
1
Answer |
29 days ago
naturalbreastrecon (Physician - Surgery - Plastic (Verified)) asked the question in topic(s) Breast Surgery, Breast Reconstruction, DIEP Flap, Surgery, DIEP Flap Breast Reconstruction
1
Answer |
4 months ago
Implants are not actually “rejected” in the medical sense, but some people tolerate them poorly due to complications, the most common being capsular contracture, or heavy, sometimes painful, internal scarring around the implant. It is strange, but true, that no one really understands what causes capsular contracture, or knows precisely how to prevent it. While the exact same implants used for breast reconstruction are also used to augment healthy breasts, contracture may be more of a problem after reconstruction, due to the paucity of normal tissue around the implant (relative to a normal breast). Additionally, radiation seems to sometimes make contracture worse.
Infection will be almost invariably be accompanied by pain, redness, and, if it progresses sufficiently, fever and possibly spontaneous drainage. If your implant is infected, your symptoms will progress rapidly over a period of a few days, and you should seek help at once if you suspect it.
Richard M. Kline Jr., M.D. Implants are not actually “rejected” in the medical sense, but some people tolerate them poorly due to complications, the most common being capsular contracture, or heavy, sometimes painful, internal scarring around the implant. It is strange, but true, that no one really understands what causes capsular contracture, or knows precisely how to prevent it. While the exact same implants used for breast reconstruction are also used to augment healthy breasts, contracture may be more of a problem after reconstruction, due to the paucity of normal tissue around the implant (relative to a normal breast). Additionally, radiation seems to sometimes make contracture worse.
Infection will be almost invariably be accompanied by pain, redness, and, if it progresses sufficiently, fever and possibly spontaneous drainage. If your implant is infected, your symptoms will progress rapidly over a period of a few days, and you should seek help at once if you suspect it.
Richard M. Kline Jr., M.D.
Infection will be almost invariably be accompanied by pain, redness, and, if it progresses sufficiently, fever and possibly spontaneous drainage. If your implant is infected, your symptoms will progress rapidly over a period of a few days, and you should seek help at once if you suspect it.
Richard M. Kline Jr., M.D. Implants are not actually “rejected” in the medical sense, but some people tolerate them poorly due to complications, the most common being capsular contracture, or heavy, sometimes painful, internal scarring around the implant. It is strange, but true, that no one really understands what causes capsular contracture, or knows precisely how to prevent it. While the exact same implants used for breast reconstruction are also used to augment healthy breasts, contracture may be more of a problem after reconstruction, due to the paucity of normal tissue around the implant (relative to a normal breast). Additionally, radiation seems to sometimes make contracture worse.
Infection will be almost invariably be accompanied by pain, redness, and, if it progresses sufficiently, fever and possibly spontaneous drainage. If your implant is infected, your symptoms will progress rapidly over a period of a few days, and you should seek help at once if you suspect it.
Richard M. Kline Jr., M.D.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) Surgery Complications, Infection, Breast Surgery, Breast Surgery Complications, Breast Reconstruction, Breast Reconstruction Complications
1
Answer |
4 months ago
What are some possible side effects can I expect from breast reconstruction with a silicone implant?
One of the most common complications marring the reconstructive outcome is capsular contracture, or heavy, sometimes painful scarring around the implant, which can be seen with either saline or silicone implants. Other common problems include implant malposition, and asymmetry. While not really a side effect, implants are only made up to about 800 cc volume, which is not large enough to reconstruct many large breasts (in which case flap reconstruction with your own tissue may potentially provide more material). Other possible complications include infection, wound healing problems, skin loss, and chest wall deformities.
Richard M. Kline Jr., M.D. The most bothersome side effects I have experienced are numbness along the scar and coldness of the skin on the breasts. The surgery itself can have a long recovery period. Be sure to exercise as much as they will let you.
Richard M. Kline Jr., M.D. The most bothersome side effects I have experienced are numbness along the scar and coldness of the skin on the breasts. The surgery itself can have a long recovery period. Be sure to exercise as much as they will let you.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) Silicone Implants, Breast Surgery Side Effects, Breast Reconstruction, Side Effects, Breast Reconstruction Side Effects
4
Answers |
4 months ago
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.
Richard M. Kline Jr., M.D. 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.
Richard M. Kline Jr., M.D.
Richard M. Kline Jr., M.D. 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.
Richard M. Kline Jr., M.D.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) Breast Surgery, Breast Reconstruction, DIEP Flap, Breast Reconstuction Complications, Surgery, DIEP Flap Breast Reconstruction
1
Answer |
5 months ago
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.
Richard M. Kline Jr., M.D. 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.
Richard M. Kline Jr., M.D.
Richard M. Kline Jr., M.D. 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.
Richard M. Kline Jr., M.D.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) Breast Surgery, DIEP Flap, Surgery, DIEP Flap Breast Reconstruction, Breast Reconstruction Complications
1
Answer |
5 months ago
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.
Richard M. Kline Jr., M.D. 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.
Richard M. Kline Jr., M.D.
Richard M. Kline Jr., M.D. 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.
Richard M. Kline Jr., M.D.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) Silicone Implants, Breast Reconstruction Experiences, DIEP Flap, DIEP Flap Breast Reconstruction, Breast Reconstruction Complications
2
Answers |
5 months ago
So sorry to hear of your troubles with tissue expanders. Unfortunately 30% of the women we perform DIEP flaps for have had failed attempts at implant/expander reconstruction. It is possible that the infection could be treated and then later re-try an implant but it may very well happen again. The benefit of the DIEP is that no implants are use and the risk for infection is minimal. It also preserves the muscles of your tummy wall while producing a natural, soft, warm breast that is meant to last a lifetime. (We don't perform TRAM flaps any longer since the DIEP preserves the muscle)
James E. Craigie, M.D. So sorry to hear of your troubles with tissue expanders. Unfortunately 30% of the women we perform DIEP flaps for have had failed attempts at implant/expander reconstruction. It is possible that the infection could be treated and then later re-try an implant but it may very well happen again. The benefit of the DIEP is that no implants are use and the risk for infection is minimal. It also preserves the muscles of your tummy wall while producing a natural, soft, warm breast that is meant to last a lifetime. (We don't perform TRAM flaps any longer since the DIEP preserves the muscle)
James E. Craigie, M.D.
James E. Craigie, M.D. So sorry to hear of your troubles with tissue expanders. Unfortunately 30% of the women we perform DIEP flaps for have had failed attempts at implant/expander reconstruction. It is possible that the infection could be treated and then later re-try an implant but it may very well happen again. The benefit of the DIEP is that no implants are use and the risk for infection is minimal. It also preserves the muscles of your tummy wall while producing a natural, soft, warm breast that is meant to last a lifetime. (We don't perform TRAM flaps any longer since the DIEP preserves the muscle)
James E. Craigie, M.D.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) Tissue Expander, Infection, Breast Reconstruction, DIEP Flap, Breast Reconstruction Side Effects, DIEP Flap Breast Reconstruction, Surgery Side Effects
3
Answers |
5 months ago
We think you are talking about either the latissimus dorsi flap or a TRAM flap reconstruction. Both of those muscle flap procedures mean the muscle is turned and moved with the tissue in order to give the tissue blood supply. Whenever the muscle is divided at one end in order to do that the muscle will no longer function and will actually waste away and become very small. There are plenty of other procedures you can have that are muscle sparing and produce a successful breast reconstruction.
James E. Craigie, M.D.
We think you are talking about either the latissimus dorsi flap or a TRAM flap reconstruction. Both of those muscle flap procedures mean the muscle is turned and moved with the tissue in order to give the tissue blood supply. Whenever the muscle is divided at one end in order to do that the muscle will no longer function and will actually waste away and become very small. There are plenty of other procedures you can have that are muscle sparing and produce a successful breast reconstruction.
James E. Craigie, M.D.
James E. Craigie, M.D.
We think you are talking about either the latissimus dorsi flap or a TRAM flap reconstruction. Both of those muscle flap procedures mean the muscle is turned and moved with the tissue in order to give the tissue blood supply. Whenever the muscle is divided at one end in order to do that the muscle will no longer function and will actually waste away and become very small. There are plenty of other procedures you can have that are muscle sparing and produce a successful breast reconstruction.
James E. Craigie, M.D.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) TRAM Flap Breast Reconstruction, Latissimus Dorsi Flap, Breast Surgery, Breast Reconstruction, Surgery, TRAM Flap
2
Answers |
5 months ago
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 to your areolar tattoo.
James E. Craigie, M.D. 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 to your areolar tattoo.
James E. Craigie, M.D.
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 to your areolar tattoo.
James E. Craigie, M.D. 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 to your areolar tattoo.
James E. Craigie, M.D.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) Nipple Reconstruction, Tattoing, Nipples, Breast Reconstruction, Nipple Reconstruction Surgery
1
Answer |
5 months ago
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: http://www.mentorwwllc.com/Documents/gel-PIDS.pdf
James E. Craigie, M.D. 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: http://www.mentorwwllc.com/Documents/gel-PIDS.pdf
James E. Craigie, M.D.
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: http://www.mentorwwllc.com/Documents/gel-PIDS.pdf
James E. Craigie, M.D. 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: http://www.mentorwwllc.com/Documents/gel-PIDS.pdf
James E. Craigie, M.D.
New answer by naturalbreastrecon (Physician - Surgery - Plastic (Verified)) in topic(s) Breast Implants, MRI (Magnetic Resonance Imaging), Breast Implants Follow Up
1
Answer |
5 months ago
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