Breast Reconstruction Clubhouse Discussion

This past week, I was fortunate to have Roberta Albany and Dr. Minas Chrysopoulo join me as moderators for a breast reconstruction clubhouse discussion.

Clubhouse is a fairly new app for iPhone users. The sessions generally last an hour in length. Think of it as a casual phone conversation with the members who join. It is not recorded, or at least does not have that feature yet. There are moderators who can invite those who “raise their hand” using an icon on the app to come “up to the stage”. They are invited to speak by a moderator when they raise their hand. Once invited to speak, they unmute their microphone to begin their question, comment, or thoughts.

The topic I chose was “Breast Reconstruction Concerns and Questions Answered”. The discussion and information provided by Roberta and Dr. C was both enlightening and informative. I want to provide some of the concerns presented by patients, questions answered, but more importantly, provide the resources that may further provide insight for the readers of this blog who may have similar breast reconstruction concerns.

Breast Reconstruction Recovery and Pain Management

DIEP flap breast reconstruction involves incisions at the abdominal area to harvest the flap to create a new breast after mastectomy. With incisions at the breast and tummy patients are often concerned about length of stay in hospital, recovery, and pain management. It is a valid and understandable fear. Dr. C spoke at length about ERAS (Enhanced Recovery After Surgery) protocol. Roberta and I both shared that we did not have this protocol in place at the time of our DIEP flap and how much difference we see in patient recovery and length of time in hospital compared to now and patients who experience the advantages of ERAS. Key take away provided by Dr. C: Change is driven by patients so please mention ERAS to your plastic surgeon at your breast reconstruction consult. I will provide links to resources where you can watch and read more:

Real patient stories who had ERAS protocol.

Episode 104: Understanding Risk-Reducing Mastectomy & Reconstruction – DiepCJourney Podcast

In this episode of the DiepCJourney® podcast, Terri sits down with Dr. James Craigie of The Center for Natural Breast Reconstruction for an important and compassionate conversation about risk‑reducing mastectomy, genetic mutations, and the reconstructive options available to those navigating increased breast cancer risk. Dr. Craigie brings years of microsurgical expertise and a deeply patient‑centered approach to help listeners understand when and why risk‑reducing surgery may be considered, what the process looks like, and how women can make informed decisions that support long‑term survivorship. Episode Highlights • What BRCA Genetic Mutations Mean for Risk Dr. Craigie explains what the BRCA1 and BRCA2 genetic mutations are, how they increase lifetime breast cancer risk, and why individuals who test positive may choose to explore risk‑reducing mastectomy with reconstruction as a proactive option. • When There's No BRCA Mutation but Family Risk Is High Not everyone with elevated breast cancer risk carries a BRCA mutation. Dr. Craigie discusses how strong family history can still warrant enhanced surveillance or consideration of prophylactic surgery, depending on individual circumstances. • Recommended Screening Before Surgery For those considering risk‑reducing mastectomy, Dr. Craigie outlines the surveillance tools typically recommended beforehand, including mammography, MRI, and clinical breast exams, to ensure comprehensive monitoring during the decision‑making process. • Other Genetic Mutations That Increase Risk Beyond BRCA, Dr. Craigie touches on additional genetic mutations associated with higher breast cancer risk and how they factor into decisions about prophylactic mastectomy and reconstruction. • Steps to Begin the Risk‑Reducing Surgery Journey Dr. Craigie walks listeners through the consultation process, including what to expect, how to prepare, and the importance of meeting with a reconstructive surgeon early to understand all available options. • Common Fears and Concerns About DIEP Flap Reconstruction From recovery time to surgical complexity, Dr. Craigie shares the most frequent concerns patients bring to their consults when exploring prophylactic DIEP flap or other reconstruction methods and how these fears can be addressed with education and support. • How Much Risk Is Reduced After Prophylactic Surgery Dr. Craigie explains the percentage of breast cancer risk reduction achieved through prophylactic mastectomy and why this option can be life‑changing for individuals with significantly elevated risk. Why This Conversation Matters Risk‑reducing mastectomy is a deeply personal decision. This episode offers clarity, compassion, and credible information for anyone navigating genetic risk, family history, or the emotional weight of preventive surgery. Dr. Craigie's insights help empower listeners to make choices aligned with their values, health needs, and long‑term survivorship goals. Listen, Learn, and Share If you or someone you love is exploring genetic testing, elevated breast cancer risk, or reconstruction options, this episode is a powerful resource. Share it with your community because at DiepCFoundation we belive education can help saves lives. Connect with Dr. Cragie and his practice. Instagram: https://www.instagram.com/natural.breast.reconstruction/ Facebook: https://www.facebook.com/naturalbreastreconstruction LinkedIn: https://www.linkedin.com/company/the-center-for-natural-breast-reconstruction/posts/?feedView=all

1. Episode 104: Understanding Risk-Reducing Mastectomy & Reconstruction 25:15
2. Episode 103: Hormone Replacement Therapy: A Conversation with Dr. Ann Chuang 13:04
3. Episode 102: A Better Decsion Through Self-Advocacy 39:11
4. Episode 101: Fertility Preservation, Legislative Advocacy, and Patient‑Centered Breast Cancer Care 22:38
5. Episode 100: Lymphatic Drainage Massage and Acupuncture 44:54

Breast Reconstruction Wound Healing and Seromas

Patients present with a variety of medical history and prior surgeries that can compromise or make wound healing more challenging for some. One participant shares her experience with prior seromas and healing after being brought to the stage. Dr. C listens carefully to the details and advises her accordingly. Resources discussing these to concerns can be found in the links below for further information and details.

Blog discussing breast reconstruction wounds and management can be found in this link.

Breast Reconstruction Clubhouse Discussion on Sensation

Unfortunately, women are not always aware or told their breasts will have numbness after mastectomy. There is hope restoring some of the sensation lost during mastectomy. If a woman is considering autologous reconstruction sensation can be performed with or without the use of a nerve graft. Resources to understand this process further are provided in the links below:

Sensory Nerve Reconstruction During DIEP flap Breast Reconstruction

Nerve Graft and Restoring Sensation to the Breast

Sensation can also be restored during implant-based reconstruction. Dr. C mentioned the two surgeons who pioneered this work, Drs. Anne Peled and Ziv Peled. You can listen to the podcast and watch the video interviews with these two surgeons in the links below:

Breast Reconstruction and Breast Sensation with the DiepCJourney Podcast in this blog.

Nipple Sparing Mastectomy in Breast Reconstruction

There was also a detailed discussion about nipple sparing mastectomy and why or why not women chose this at the time of breast surgery or breast reconstruction based on choice and oncologic safety. More details are in the links below. Thank you to PRMA for providing the link to the video.

From Nipple Sparing Mastectomy to DIEP flap Breast Reconstruction

Breast Reconstruction Clubhouse

I was grateful to those who participated and joined us that evening. There is a “Club” on Clubhouse titled, “Breast Reconstruction” I set up with the intention of having further discussions for interested participants. I encourage you to give Clubhouse a try and follow me by searching Terri Coutee and my moderators by searching Roberta Albany and Minas Chrysopoulo. I hope you will join me for the next breast reconstruction Clubhouse discussion.

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