Repeat surgeries? Please share your experience -
I had a nipple and skin sparing BMX with immediate reconstruction using pre-pectoral anatomical silicone implants in May. I am less than thrilled with the results and have tried to be patient. I realize that things have changed along the way and I'm grateful for that - swelling is gone, pain is negligible, and one side is more cone shaped so perhaps the other will join it! But ... I'm larger than I would like (went from B/C cup to DD), have lots of dents and ripples, don't like the general shape, and still have areas that are uncomfortable around the edges.
I've noticed many women on this site have had multiple surgeries and have a few questions for those of you who have:
Why did you decide to do another operation? How long did you wait to do it? Did insurance cover it? Did you use the same PS or go elsewhere? Are you glad you did it?
My PS stands by his decision to use the implants that he did. His only suggestion so far has been possible fat grafting down the road. Of course, my concern is whether or not that will actually help. I don't want to be bigger or end up with problems at the donor site.
I'm really not interested in doing any type of autologous surgery. I don't want the major surgery or the risks. I chose this original surgery so as to avoid further surgeries. Oh, well.
No one can give me back my breasts. Or sensation. And I look fine in clothes and even pretty good in a bathing suit. Maybe I'm being too picky about how I look naked. But I have to see myself a couple of times a day and am not all that happy with what I see.
Suggestions? Experiences? Help!
Comments
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You sound like me! I was unhappy with my anatomicals (Natrelle 410) when I woke up in recovery and it's never changed. In my case I find them to be wide, flat and somewhat ripply. The left one never dropped into the pocket and the right one was too loose and rotated a bit. I began seeking a revision at the 3 month appointment. My PS was incredulous, so I saw some other PS's.
My personal life got in the way as my mom went on hospice and eventually passed, so my plans for revision were delayed. I chose my new PS in April and after more delays, I am scheduled for a revision on 9/8. I will be getting round, smooth, smaller diameter implants placed above the muscle and fat grafting to enhance the contours. The right side will also have a bit of redundant skin removed. This revision will be 15 months after having the original exchange. Insurance is paying for every penny.
If you are not happy, there is no harm in seeking second opinions...or third opinions. Depending on what you learn in those appointments, you will perhaps know what to do next. Since I haven't had my surgery yet, I can't tell you if I made the right decision. I sure hope I have!
Good luck!
C
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Thanks, Carla. Sorry about your mother. Life goes along and I know this isn't nearly the concerns that some have to deal with.
I hope your surgery turns out great! Please let me know. :-)
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Hoping more people post in this. I am going in for reconstruction on left implant after recurrence with rads 2nd time around. Right implant looks, feels great. Left side that got roasted is hard as a rock and climbing up my chest towards my shoulder. Hoping to clean out scar tissue, replace and redo with just similar match to right side. I do NOT want to do a flap (from my poor back muscle or God knows where else). Dr is giving this 50 - 80% chance of matching or improvement. Oh hell, and I'm going to be 46 so happy birthday to me...I'm getting a chin / lower face lift to boot. Feel like the last 5 yrs show on my face bad and I'm getting the family jowls. Hell with this...you only live once!
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7of9 - Good for you! And happy birthday!
So it sounds like you were pretty happy with your results until rads did a number on the cancer side? When is your surgery? I hope everything gets solved!
Looks like you've been through too much already. Sorry.
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I had my exchange to subpec textured anatomicals 3 months ago. One is ok, one had moderate rippling. My PS dismissed my concern completely so I have decided not to continue following with him. When my schedule slacks off I'm planning to get a second opinion on whether this is a reasonable outcome, and what my options are. I do think they could look better but there's just been so much pain and surgery this year that I kind of want to put this on the back burner. You know?
Here's another thought I've had: my copay is $60. So if both the general surgeon and the plastic surgeon want to see me multiple times a year basically to examine me for 20 seconds and then say everything looks great despite my concerns, that adds up. I don't mind paying my share for care I need, but I really feel these visits are redundant
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Hi-
I just had my 3rd revision surgery about 10 days ago. Quick history--had TEs at time of BMX, followed by exchange with anatomicals about 6 months later, then after another 4-6 months had replacement of right implant due to rotation, then another surgery last September for the same thing in the same breast, and then my most recent (and hopefully my last) surgery a week and a half ago, to replace both implants with latest round gummy bear implants, because my right implant had rotated yet again. (I'm sorry I'm not recalling the exact make and model of the implants off the top of my head). Anyway, I went in yesterday for my follow-up appointment and was fortunate to get my drains out. The PA with whom I had my appointment told me that she had assisted in my last surgery and that when they removed my anatomicals they discovered that both of them were all "dented" with scar tissue surrounding the dents. I had been very unhappy with what I was seeing when I looked down at my breasts, and especially when I leaned over with or without a bra on--they both looked so wrinkly and ugly. But it didn't occur to me that I was "entitled" to complain about them, and certainly couldn't expect another surgery to correct them. Luckily, it was my PS who decided without my asking, to do all of my surgeries. But I realize now that I could've and should have pursued these corrections. I don't feel entitled to have "perfect" boobs (I certainly didn't have them before the mastectomy), but I think it's reasonable to expect your PS to give you the best breasts possible with what they have to work with. If you have thin skin, like I do, a certain amount of rippling is to be expected, but I don't agree with your doctor standing so rigidly with his decision about the type of implants he used. That sounds like pride to me; not necessarily what's in your best interest. Perhaps you should seek a second opinion.
In answer to your specific questions--I belong to an HMO so I did my surgery at the same hospital that I always go to, my insurance has covered all of my surgeries minus my $30 copays, I had the same PS, and yes--so far I'm glad I did it.
As for the look of the new round implants--so far I see a big improvement. As you can imagine, they give you more upper pole fullness. Aesthetically, I don't really care one way or another about that, but the real benefit is that it causes less rippling! My breasts still aren't perfect, but if they stay looking more or less the way they do now, I will be content with them.
I hope you pursue and get what's best for you.
Best wishes!
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Hercules - Yes, too much of lots of stuff this last year. It gets really old. And I worry about possibly being LESS happy with another surgery!
I'd be a bit worried with copays that high as well. Seems like you shouldn't need to see both. Why does the general surgeon want to see you? I haven't seen any bills from my PS since the surgery - weird. I keep expecting them to all come through at once. I've certainly been there a bit.
Iwanna - Did they use Alloderm or something similar with your surgeries? I thought that was supposed to help prevent rotation. Something else to concern myself with! And drains again, huh?
I get your comment about perfect boobs! The originals definitely weren't perfect, but I asked for as close to original as possible and don't feel that I've gotten that. The ripples look better or worse at will, it seems. Mostly I just don't like them when they're looking worse and I really don't like the sideways view - it's a very strange, humped shape. I was expecting anatomicals to look more natural.
Not sure what I'll do about PS. Probably wouldn't do anything for quite a while anyway. But it does feel like pride on his part to me as well.
Thank you both for your honest responses.
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No Alloderm or other substance besides my implants. Actually you reminded me that my first revision was supposed to be the addition of Alloderm for rippling, but then it became obvious that my right implant had rotated, so my PS replaced that instead and seemed to forget about doing the alloderm...at least that's how I remember it. When I asked her about adding alloderm a few months ago, she wasn't convinced that it would really help enough to merit opening me up again. It's not that she was trying to cheat me out of the improvement, it was more that she doesn't think that the results are reliable; the risk outweighs the possible benefits. I defer to her because what she lacks in bedside manner, she makes up for in her perfectionism.
Please don't despair. When you're ready, I hope you will seek out a PS that respects you and understands how important this is.
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Sorry to hear of the less than satisfactory results on this thread. I popped in hoping to find more women that are on the other side of revision, but I see the thread is very new. It seems the anatomicals are giving the most trouble. I however, have Inspira smooth rounds, above the muscle with Alloderm, surgery was 4/25/17. They look good, but there is quite a bit of rippling, especially when I lean forward. And they are uncomfortable, painful when I wake in the night to use the restroom. Kind of feels like the inside of my skin is peeling away from the implant when I stand up, and full and heavy feeling. My other problem is both of them on separate occasions flipped over backwards. The pockets are apparently too loose. I had a 50lb weight gain and loss from the drug Lyrica back in 2012 so my skin is not very resilient. My PS suggested I revise and put anatomicals in, as the texture will act like Velcro with my tissue, and he would tighten the pockets and fat graft. I don't want the anatomicals, mainly due to the slight risk of lymphoma associated with the textured implants, but also the lack of upper pole fullness I saw described here. I got a 2nd opinion, was seriously considering removing the implants altogether and doing an SGAP. My ps doesn't do SGAP, only DIEP which I can't have. He referred me to a ps at Johns Hopkins to talk about the flap surgery. The Hopkins ps said while he would be honored to be involved in my care, I have a great aesthetic result with my current implants in his opinion. He advised I have my ps just tighten the pockets, remove a small interal stitch granuloma, and do some fat grafting. He actually got his fellowship in peripheral nerves, and told me if I give it a YEAR or TWO, they should become much more comfortable. The discomfort I am experiencing is the nerves trying to regenerate. He did manually flip my implant back right side up during our consult (YAY!!!).
So, I am trying to find women who have had pocket tightening, downsized their implants (I am thinking about going down a little), and fat grafting.
Notverybrave, I wish you all the best as you move forward. I would absolutely seek out some other ps. You have every right to get what YOU want, this is your life, your body and your doctor needs to do whatever it takes to make you happy with your results. Please don't give up and settle. I am fortunate that my ps will ultimately do what I want. He may need a little nudging once in a while, but he is in no way arrogant and I couldn't work with him if he was. We are already sort of fragile in this, don't need to be talked down to!! Mine are a little bigger than I wanted too but they are the same size as my originals so maybe it was meant to be! Also the edges of my implants hurt for about 3 months, I am 4 months post op now and they are getting less painful, I really only notice it at night for some reason.
VegGal, so sorry to hear about your mother's passing. God bless you as you adjust to life with her on the other side. Best wishes for a great outcome with your revision!
Iwannacookie, I hope you are healing nicely. I agree with you on the thin skin and rippling. I hope the fg helps!! I loved your comment, I don't feel entitled to have "perfect" boobs (I certainly didn't have them before the mastectomy), but I think it's reasonable to expect your PS to give you the best breasts possible with what they have to work with. That is great advice!
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Thank you for the condolences NotVeryBrave and Shoregirl. And thanks for the good wishes for my upcoming revision. My new PS seems SO sure of what the outcome will be (fabulous) and I am hoping it is. Sixteen days and I'll be done!
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Shoregirl - Thanks for your info and support. You're a couple weeks further along than me. I kind of dread getting out of bed because of that initial heaviness and "pulling" feeling. Darn gravity!
I'm probably much too afraid to have one of those big flap surgeries. I worry about even having fat grafting: Will it take? What if it just adds lumps? What if the donor site ends up being another problem? And so on. But my PS described the rippling problem as equivant to "not enough fill in a comforter" due to the lack of much covering the implant. There's only skin and a thin layer of fat.
And I don't want to sound like my PS is a jerk or anything. He's actually very kind and was super understanding about a lot of things. And he doesn't even want to do fat grafting soon. I guess he just wants me to be fully healed and stable. But I'm not going to add fat to a shape I don't think is the best!
We are vulnerable through all of this. I hope we all end up with a good level of satisfaction and can move on. There should be some hope for that.
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If you're willing to sleep with a bra on, you won't have to fear gravity so much when you get out of bed. I wear a maximum-support sports bra 24/7 (minus bathing and nookie time). I have been doing so since my first implant surgery. I feel more secure with one on. Right now, since I can't reach behind, I'm wearing a zipper-front bra. I just ordered 5 more of the same brand/style from Target. It fits me absolutely perfectly, so while it totally holds me in, it doesn't cut into my breasts at all. Of course, we're not all sized and shaped the same, so what works for me might not work for you, but I'm sure there are plenty of brands/cuts to choose from. I figure this is going to be a way of life as long as I have implants. It's not the most comfortable thing, but neither have my implants ever been. At least I have more peace of mind to help mitigate the physical discomfort.
Shoregirl - It sounds like you have a great PS. What do you mean by "edges" hurting? Do you mean where your incision is? 'Cause I'm so surprised by how much mine hurt. I didn't think I had any more functioning nerve endings left to feel pain.
VegGal - I'm so sorry about your mom. I hope you have plenty of love and support--going thru all this BC stuff and the passing of your dear mom is a lot to deal with.
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Thank you, Iwannacookie. Mom's decline was a long, slow process. She'd had BC 7 years previously, but ultimately it was congestive heart failure that caused her death. In the end it was actually a relief to witness her pain free and peaceful passing after all the struggles that came before. In a way it's a good thing that I no longer have to see the pain in HER eyes as she watched me go through the BC process. I have a very good support system now.
Hope everyone has a good end to the week!
C
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VegGal - I'm glad you have a good support system. And, of course, you have this website, which I find to be a great source of comfort, as well as knowledge.
NotVeryBrave et al - I just wanted to update my situation. I had my second follow-up appointment yesterday. My PS and I are quite pleased with the results of these new implants. I had barely looked at myself until then. My breasts are a bit "high" for my age (47), but so far, I see no rippling! That's a HUGE improvement. On the down side, my doc confirmed that I basically have to wear a bra all the time (including when I sleep) for as long as I have these implants; she says my skin just isn't strong enough to keep these babies in place. I don't know if that applies to everyone who gets this type of implant, or if it's just those of us with the thin skin. I was also told to massage the implants several times a day, but I don't really understand how to do it. I'll poke around this site for info about it.
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iwannacookie - my massage instruction were to begin when I am fully healed, and to push at the clock hands noon, 3, 6 and 9 toward the middle of the breast - i.e., at the noon position push down, 6 push up, and 3 and 9 push to the inside or outside respectively. Hold for a count of 20, and repeat several times a day. My first PS told me if I was driving to do this at each red light - he's a funny man...
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SpecialK--Thank you for that description!
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VegGal, did you have your revision yet? I hope all is well!! Cookie, congrats on your great results!! When was your revision? When referring to the "edges hurting" I meant the edges of the implants. When I lay down on my side the weight of the implants along with gravity pulls the top implant down to the midline of my chest where the edge of the implant then digs into the backside of my skin. Sleeping is the worst part of my day
I didn't get any guidance regarding wearing a bra to bed after the 1st month, was told I could wear one or not, whatever was comfortable.Yes my ps is a good man and a talented ps. But I won't be continuing in his care. There were a few glimmers that he may not be a good fit early on, but I went ahead and let him do my initial surgery to place expanders at msx time and also do my exchange. He does not do surgical nip recon, tried to talk me into just getting 3D tats and will only fg the edges of the implants and the upper pole, isn't experienced with fg over the entire implant like I want.
I determined to find a female ps that would do the extensive fg, this is what I really want. I found her in the same town and met with her Tuesday. My mom came with me. We were both super impressed with this dear woman. She not only does the fg over the entire implant, but also under the muscle. She plans to downsize my implant just slightly from 470 to 450, add more alloderm, tighten the pockets, tighten the outside skin so the implants are more firmly attached to my chest wall and lifted a bit. Let all that settle a few months, then most likely go in with more fg. She said to look at it as a staged revision, with 2-4 surgeries. She really listened to my wants, my reasons for wanting and offered solutions that I am super excited about. Also, she mentioned the fact that after my bmx, my pain was not well managed and as a result I had to spend 4 nights instead of just 1 in the hospital. She wants to avoid me going through that again, and gave me the option of driving a little further to another hospital she uses that offers a long acting (72 hour) numbing medicine. So I thought that was so compassionate of her. She makes you feel like you are with your best friend. I really like her! She does nip recon all the time with no problems, which I am also happy about!! She is very pregnant, due in 2 weeks with her 3rd girl. So I am scheduled for revision on Nov 29.
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shoregirl I never thought I'd say this but I think I'm jealous of your plastic surgeon. That's what I'm looking for.... someone to listen and offer suggestions.
I called some plastic surgeons in our mid sized city this week. One told me he doesn't like to get involved in any cases that another local surgeon has worked on. I guess I get that but it's sure not putting the patients needs first. Another has agreed to see me later this month. Fingers crossed maybe we'll be a good match.
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Yes, Shoregirl, I'm all done. Things are going well and I am hoping to have my drains pulled tomorrow. If I have to keep them another 8 days I will not be happy!
I'm swollen and bruised but I think I kind of love the new implants! They are "front and center" just like the PS said I needed, which is a far cry from the flat burger buns I carried around for over a year!
I think you will be very happy with extensive fat grafting. The grafted areas remind me of real breast tissue!
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Shoregirl - Congrats on finding a PS that you like! Having that level of comfort is really worth a lot. To speak and really be heard ...
VegGal - Yay on surgery done! It's exciting to hear good news around here. I'll wait a while and ask you more about the FG. ;-)
To all of those who've had multiple surgeries - how does the post-op pain compare? And how is your sensation later?
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I have to admit, I too am a bit envious of you, Shoregirl. I have a ton of faith in my PS, but it sounds like you found the cream of the crop!
My last revision was on August 11th. I'm still pleased with the results...at least visually. In response to your question, NotVeryBrave--I'm less than pleased with the feeling. I've had 5 different implant surgeries, from TEs to my current implants, and I've been pretty much in some state of discomfort the whole time. But I feel like this time it's the worst. I think that's because my PS really had to stretch my skin around these implants. They're a bit larger than the previous ones. So far this tightness has smoothed out the rippling I had before, but I feel (and look a bit) like a stuffed sausage. My skin is stretched as far as possible. Most of my pain is around my incisions, but then there's just that icky feeling of having these massive foreign objects pressing against your chest. I wear a bra 23/7, but that does nothing to alleviate the discomfort. ( TMI alert--This is a bit of a disappointment for my husband because he loves what he sees, but let's just say, he's not allowed to "handle" them the way he'd like too.)
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7of9, good luck w/your revision and facelift. That is a great birthday gift!! Keep us posted!!
Hercules, I hope you find a good match soon!! I just read an article about "breaking up" with your dr. It was a generic article, not specific to plastics. The gist of it was you should let them know you are leaving and ask for your records, you don't have to give a reason but can if you feel it would be constructive, and not to burn bridges in case you have to go back for some reason. Also it said the pool of doctors is relatively small in communities, even big cities. Therefore the docs likely know each other, may even socialize. So I am not really surprised at the ps not wanting to get involved, but I don't think its right!! I always research docs on Healthgrades.com and Realself.com. Keeping in mind a couple negative reviews do not scare me away. I like to see what med school they attended, board certifications and if any sanctions filed against them etc. Is it feasible for you to travel to a neighboring city to broaden your options? I drove 80 miles to consult at Johns Hopkins, and my original and new ps are 50 miles from my home.
Notverybrave, great thread idea btw!! I am with you on the big flap surgery. I had considered it, but when the Hopkins ps explained it was a 14 hour ordeal, and then as you say you have donor sites to worry about, I changed my mind quick!
Veg, congrats!! Happy w/results already and drains out! Fantastic!! I was surprise at your description of the 410s looking like burger buns. Did you get Inspiras to replace them? Thats what I have and they are def "front and center!" I am so excited about the fg, and to hear you say it feels more like breast tissue is just wonderful! I hope it helps reduce the cold clammy feeling of my skin over the implants. Do you mind sharing what area(s) the fat was taken from? Would you say your donor sites are more painful than the implant revision?
Cookie, I have a long road ahead as you have had. Best wishes for continued healing and happiness. I don't look fwd to basically starting over with recovery again but I think I will be happy in the long run. My huge "dog ear" incisions still hurt, and they are nearly 5 months old. I think my orig ps took too much tissue when he got rid of the dog ears. New ps said she can put a little fat beneath the scars and that may help. I know what you mean re the husband. Mine also wants to grab and squeeze and I am just NOT having it! But that's a whole nother thread lol!
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veg and cookie, are your implants pre-pectoral
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Bird-of-Light -- I'm astounded by my own ignorance! I actually don't know the answer to your question, but I should. Is there something that would make it obvious--like the way my breasts move when I flex my pects?
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Shoregirl, I had FG from my inner and outer thighs. It was SORE but it was not really painful. All the discomfort was easily managed with meds. I also used Arnica pellets and took a lot of liposomal Vit C and I think they helped.
Yes I replaced the icky 410's. Now 4.5 weeks in, the Inspiras are nice and soft. My fat survived for the most part, so far. I saw my BS for my yearly check last week and she was astounded by the results and was surprised to hear I had round implants as my PS had done such a great job with contouring the upper poles. I do think these implants feel a little less cold.
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Cookie, under the pecs causes distortion when the pecs are flexed
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Is that what I'm feeling when I shift gears? (Have been trying to do nothing to flex the pecs since Exchange 4.5 weeks ago but drove a stick today.) Feels weird and not terribly comfortable yet. I had a lot of pocket work, so babying everything.
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Bird -- I've had so many revisions for my funky boobs, that I don't know "distortion" from "normal" any more!
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I’m sorry Cookie. Cancer sucks
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amen to that
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