Repeat surgeries? Please share your experience -
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So ... saw the PS yesterday for a 3 month follow up. I had some questions and concerns. And I'm not sure I like the answers.
I've had a small lump under the nipple on the cancer side for probably 2 months. Have had a CBE with OB/GYN as well as an exam by MO. I don't really think it's cancer since I had such a great response to chemo and am still on Herceptin. But the PS wants me to see the BS sooner than scheduled for her opinion. :-/
And then the flat area that has developed on the side of the other breast. He thinks the implant has rotated! They are anatomical ones and he thinks the top is now at the side! I didn't know that could even happen.
So he recommends fat grafting to fill a dent and some hollows as well as covering the rippling and edges. He says he can adjust the turned implant then as well. I'm five months since surgery and can have this done any time.
I don't know what I want. I'm afraid I'll go through all of this and still not look or feel better. I wonder sometimes about just getting different implants, but hate to treat it like "accessorizing" my body.
Have any of you had experience with PS that specialize in breasts? I think about the center in NOLA and wonder ...
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NotVeryBrave, et al -- I haven't been able to find the ID card for my current implants, so I finally just emailed my PS. Here is what I have: Natrelle Inspira cohesive round gels, SCX They're very new; only approved in the U.S. as of this year (or maybe late in 2016?)
Before this I had anatomicals which rotated, and left me with horrible rippling. I highly recommend that you talk to your surgeon about these new implants. The difference is unbelievable! No rippling! No rotating (they're round, so who cares if they rotate?!)
I've been thinking about posting pix. So if you have access to the picture forum and would like me to do so, please let me know. Then I will do it for sure. Only wish I had 'before" pics.
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I have the CX Inspria as well...I find the upper pole fullness very bothersome, especially as I am a UMX so it totally doesn't match the native R breast...have yours settled at all? I am 6 weeks post-op today and still swollen and bruised. TT
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@TrmTab - I'm sorry you're not pleased with your implant. I suppose there are many factors that go into deciding which type and style of implant to use. And it also seems like a near impossible task to match an implant on one side, to the breast nature gave, on the other side.
I don't know what "settled" looks or feels like. I've had them a little over 2 months, and they look great to me. Now, if I'd only had one of my breasts done, it would look ridiculous on me because my "natural" breasts were little sad sacks. A-B cups formed like baby ski-jumps.
I've never felt or looked swollen or bruised, but I assume I will always suffer discomfort around the incisions. Only time will tell.
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Swollen and bruised from pocket work as this was the initial exchange to implant from the TE.
I guess the "settled" is that the CX is very firm so far and the breast mound starts two inches below my collar bone, hoping it eventually sits lower in the pocket so the projection starts lower on my chest...
Currently DD/DDD on implant and only D on real...
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Perhaps, in this situation, size does matter. I do know that surgeons are forced to choose from a limited number of styles and projection types based on the size of your rib cage. It would be awesome if they'd custom make implants!
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Iwanna - Are your implants over or under the muscle? Mine are over and I think that's why it's more obvious with the "step off" at the top. It seems like round ones would be even more obvious?
TT - I still had swelling and fluid at 6 weeks, but I had everything done at once also. It seems like things were a lot better around 9-10 weeks
I don't have any pain at all at the incision lines - they're under my "breasts" - but have discomfort all around the edges of the implants. Sometimes it's barely noticeable and sometimes much worse. I wonder if that ever goes away?
Size is weird. I'm sure I was wearing the wrong size bra (36B - probably should have been 32/34C). I'm now wearing 32/34DD or DDD. They are mostly wide. Initially I was disappointed about the projection, but I think that has improved somewhat. I also didn't want to be bigger to begin with and don't want to look funny.
I don't know what I'll do. I see the BS on Monday to assess this lump. I may ask her opinion on PS's. She recommended the one I've had, but that was partly because of availability and location. Now that nothing is urgent, I could take my time deciding.
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not very brave, what kind of implant do you have? The Inspira SRX has great projection. Have you had fat grafting for the ‘shelf?
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Wow! The breadth of my ignorance stuns me! I don't know whether my implants are over or under my muscles. Is there a way to tell (besides contacting my PS)?
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Hi Ladies! Just reading some of your posts as I saw a new PS yesterday. I loved the first. He was very positive and reassuring from the start. I had BMX with immediate expanders filled to 250cc. Oh, I had sub-pec implants prior to BC, so a pocket existed and all was fairly easy. Expanders were exchanged with implants and then I had radiation. Yes, the challenge of reconstruction with radiation. All things considered, I was pleased with the result, knowing of some options to improve. That was late 2015. Fast forward to February 2017, I go for some improvement. On radiated breast, changed implant, removed scar tissue, some fat grafting, aligned nipples. Woke up to nurses RAVING about how good they looked! I was stoked!! A few days later, I get my first look and wonder WTH did they see that I’m not seeing :-(. I’m thinking the swelling had them looking good, but as that swelling went down... uhh, not so good.
I’m am so disappointed and to add to my frustration; I was out of pocket (insurance deductable) about $5000. Went for a follow-up in early September. PS didn’t give me any specific options to further improve, but said “he wasn’t going anywhere as we can keep trying”. At that point, I decided to get a second opinion. If there was no hope, I was going to get a tattoo over this biotch, lol
So... I met a female PS that is in high demand as she is the only one in the area that also does pre-pec implant reconstructions. LOVE her!!! And yes, she knows the other PS AND the PS that did my augmentation before BC! I had pics of my augmentation results which were friggin PERFECT! I never expected to get back to that point, but today, I am NO where near there. She totally got and agreed with my dislikes and desires and feels the best option for significant results is a Lat dorsi flap. She explained it was a much bigger surgery (hospital stay, recovery time, potential pain), but I’m going for it! The earliest she can get me in is January. That means another $5000 deductible, but I’m feeling hopeful. Will be two surgeries over time. 1) Lat dorsi flap + expander on left radiated side 2) exchange TE and right side implant for new implants. Right side may be changed to pre-pec.
I’m excited. Would go tomorrow if she had an opening!!!
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NotVeryBrave--My breasts are also substantially larger than my pre BMX. I think they do that to ensure that the skin is taught.
SugarCakes--Great that you found a new PS that you feel so enthusiastic about! But it really sucks that you have to pay the deductable for what is essentially corrective surgery. As for the nurses raving about the results after your last surgery, my PS was likewise very pleased after all of my revisions. But I remember looking at my breast right after my 2nd revision and knowing immediately that I would be going back for another surgery. If you really are ready to go in as soon as "tomorrow", you could let the scheduling staff or your surgeon know that you'd like to come in sooner if there's a cancellation. I also was meant to wait until next year, but a cancellation made room for me to go in within a week. Short notice, but it was enough time to get all my ducks in a row.
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Bird - The implants that I have are Mentor MemoryShape, medium height and moderate profile, 355cc and 395 cc. I guess I'm not going to be pursuing fat grafting or any changes probably for a while.
Iwanna - I'm really not sure if you could tell about placement. Most are done under the muscle, but more and more are being done above. Under can be more painful and can cause some problems with chest muscle use. Above leaves only skin basically over the implant and can have more problems with rippling. You can probably feel the implants externally more with above the muscle.
The BS visit yesterday resulted in me now going for US to examine this lump. I wasn't really worried about it before. I guess I'm glad that she is - in her words - performing her "due diligence" in figuring it out. Interesting - she would really prefer if I wait a couple of years before doing any fat grafting. Her concern is that it could lead to more lumps and bumps that would need to be evaluated and the risk of recurrence is highest in the first few years.
She did agree that the implants are a bit wide for my frame but said that was probably in part because of the amount of tissue that is removed from the side. IDK. It's not like they fill that void. Or that I would want them to, either.
I don't understand how round implants can have upper pole fullness. I thought that was the whole point of shaped implants - adding that piece at the top so that the breasts don't just look like circles? Although, as a 50 year old woman, it wasn't like I had a lot of fullness above!
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Each surgery option has pros and cons. I struggle with my implants distorting while my girlfriend with one foob an implant and the other a lat dorsi fap struggles with when she gains weight, one boob grows while the other stays the same. None of these choices are easy.
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Thanks NVBrave--I'm guessing my implants are under the muscle then, because from my pects to my nipples feels seamless. I would be totally freaked out if there was even the slightest hint of concern about a lump or other suspicious marker. So, I'd call you "Brave". Please do keep us posted about that. Regarding the upper-pole fullness of the rounds--they are "high slung", but somehow they don't look totally unnatural. (Well--on me they probably do because I'm 48) But as breasts go, they are in the realm of possibility. Funny though, even my PS said that they might not be "appropriate" for me. She didn't explain that comment, so I asked her--"Do you mean because of my age?", to which she said "yes". I'm not trying to fool anyone with my new cleavage, but my husband loves my boobs now, so it's fine with me. (Besides--something had to compensate for the raised horizontal keloid scars I have from my nipples to my sides. Keloids don't fade and generally get bigger over time. Thankfully, I have no sensation there because they can itch like crazy.)
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iwannacookie, actually got that call this morning! Opening on November 1. Ended up declining as I have way too much fun lined up the weekend of the November 4th, lol. Told them if something opens up after the November 6th, i’m All over it!!
November 1st is my birthday. Hmmm... maybe that was a sign of good things to come
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oh my! Never thought of that, Bird. One breast growing with weight gainand the other not!
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Last night where the cancer was itched like crazy. Scared the shit out of me. Made me less concerned about my boobs and more concerned about remaining NED. I’m one year out from Taxol and only a few months out from Herceptin. I don’t want to worry, but the fear of it returning is real
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I totally get that. I wasn't worried about this lump until the PS wanted me to move my appt with the BS up. Now I want to hurry up and get the US done. Waiting (as usual) is making me anxious.
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I’m sorry you have to wait. That sucks! I’ll send positive thoughts your way. Keep us posted
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Hi all,
I was so happy to find this thread! I'm almost 4 years out from my BMX and just recently decided enough is enough - I want my implants removed. They are too big, too heavy, too wide, too low, and most of all, they hurt. I've been struggling with breast pain to some degree since the surgery. I have the Natrelle 410 MF 640's.
At my last fill before surgery I had my TE's expanded bigger than I had originally planned - who knows what I was thinking at the time! During the exchange my PS put in bigger implants despite what we had discussed. Surprise! Not sure why, but my recovery was horrendous. It just seemed like I was in a lot more pain than expected. I also had fat grafting, which was horribly painful. Not sure I could ever go through that nightmare again. I have burning pain along the top and side of my left implant, including painful scar tissue in my armpit on the cancer side.
The right side shows rippling and I have some really bad sore spots along the edge ear the armpit. From the start, the left side looked and felt like it in my armpit. At night both implants seem to slide into my armpits (they are above the muscle). I have to wear a bra ALL THE TIME. All I wanted was a little cleavage and I don't even have that. I've decided to switch out for something smaller - maybe saline, but the new implant others have talked about here sound like a great option. I'm hesitant, though, because just a few years ago, the cohesive silicone 'gummies' were considered the latest and greatest. On top of al that, I'm also concerned about the risks of ALCL and the safety concerns of Natrelle's textured shell.
I have an appt. scheduled with a new PS next week. My original PS has since left the clinic and all my other providers have moved on to new horizons. I feel so alone in this, so I welcome any insights. I'm not even sure what questions to ask???
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bc - I certainly don't have many answers! I'm still trying to figure a lot of this out myself.
I think I would start with writing down all the things that you are currently unhappy about as well as anything that you like. See what they recommend and what they think they can do. And ask to look at pictures of their reconstruction work.
I'm thinking that there seems to be a frequent disconnect between what women want and what they end up with. Maybe more communication is key. I know we can't have real breasts back, but ...
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Hi ladies, I’m 8 years post diagnosis. In my first 3 years, I had nine surgeries due to some complications. I also struggled tremendously with my outcome. My PS was very proud of the end result. There were always things that bothered me. I have a step off on one side, a little rippling and I hated my nipple recon. In retrospect, I now understand that much of what I disliked was part of a commom adjustment to a new normal. In my group of good friends, many of us took about five years to recognize our good results and even longer to feel like these are a part of us.
I now have a rupture and an opportunity to fix some things but this means changing what I have come to know as my body. I do have continued pain when I exercise or lift too much and I’ve never quite gotten over the distortion I have on one side when I flex my pec so I will move my implant from under the muscle to over but it’s a hard decision because the aesthetic result could end up less aesthetic. You do deserve good results but I think that doctors often recognize that there is a huge mental adjustment that you simply don’t comprehend when you’re going through reconstruction and more surgery means risk of infection and unexpected changes to other aesthetics. In the end we must all make the decision that makes us feel whole. These are individual decisions. I’m just suggesting that you also honor the emotional adjustment you’re going through. Best of luck
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Thanks, Julie. I agree that so much of this is an emotional toll. There's the fear related to a cancer diagnosis and the concerns about treatments. And then there's the changes to your body to adjust to as well. I was an emotional trainwreck after surgery - second guessing my decision and worrying I would never look "normal" or be okay with it.
I can see where eventually (hopefully) you do adjust enough to feel like yourself. I can say that after only close 6 months - I'm forgetting what my body was really like before. I worry that any further surgery could leave me less pleased or result in complications. I had an infection 5 weeks after the BMX and there was the threat of losing the implant on one side. Very scary.
There are a number of things that I'm not happy with, but I appreciate that I'm currently pretty stable. I'm waiting for a sono to evaluate a lump and I wish the one side hadn't rotated, but nothing has to be done. That's a good feeling.
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Wow, this thread has been very active! TrmTab, regarding swelling and implant settling downward, mine are SCX as well, installed 4/25/17. They are a bit too firm for my liking even now, 6 months post op. The swelling was gone by 3 months post op, and the implants dropped lower about 4 months post op. Of course everyone is different. My skin is a bit lax as I had 4 babies and a 50lb weight loss. At my upcoming revision, my ps is actually LIFTING mine back up a bit along w/downsizing from 470 to 450cc and FG to cushion the edges and hide ripples.
Cookie, my incisions hurt for several months. They are big though, from IMF all the way around to my shoulder blades. There was a lot of extra skin on my sides the doc had to resect since I had the weight loss. He called the redundant skin "dog ears" that remained from bmx surgery till exchange surgery. I started massaging them with an essential oil blend and they started feeling better about 5 months post op. Still tender if I neglect massaging at night, and I can't wear a bra all day AND all night, the scars get irritated.
Brave, the edges of my implants hurt for months post exchange, I didn't think it would ever get better but it has. I think around month 5 is when I noticed a big improvement/pain relief. I pray all is well and you get a benign result from your US.
SugarCakes, congrats on the new female ps! It is a great feeling to connect with a doc that is on the same page!! I too switched from a male ps to a female, and although I liked my male doc, I felt much more compassion with the new doc, and the feeling that she understands a woman's body much more. I am super excited for my revision as I can tell you are too!!
Bc101, sorry to hear of your struggles with pain 4 yrs post op. That is terrible! As for the concern w/Natrelle textured shell, you can get Natrelle smooth shell in the round style. I have Natrelle Inspira SCX which is the smooth round high cohesive xtra full projection. Honestly, they are a bit too firm for me. I will ask my new ps at my pre-op on the 16th about the Natrelle SRX which is a Responsive gel, a bit softer. I don't know if that would be more prone to ripples, but my SCX are pretty rippled anyway. I would definitely ask about the various styles of smooth round implants, and consider over the muscle placement (less pain in recovery and no implant distortion when flexing vs under the muscle) if you are a candidate. There is a good thread on pre pec (over the muscle), if you need the link let me know. Best wishes to you as you seek clarity with all this. I know it is tough!! (Hugs)
Julie, what you said about the mental component and the "new normal" in all this was so well put! These ARE deeply personal decisions as you said and I am so grateful to have this forum to discuss everything with sisters who get it. I can't imagine going through all this without being able to research, compare notes and get the abundant compassion and support found on these threads!! Best wishes to ALL
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Shoregirl...I am 7+ weeks post-op and swelling still coming down. Too soon to tell where I will be but have pushed back on a Dec revision, so I can see where I am at at 4 months, 6 months, etc. Are you staying with the CX style or going to another inspira, RX or SX? My understanding is SRX is softest, SSX middle and SCX firmest. With the SX and CX being the new additions to the line.
I wonder if I move to a softer and smaller implant...will I lose more than expected just from the size difference...being, will the softer implant be more squished and thus not provide the same projection???
Moving two variables is difficult to forecast! TT
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SugarCakes--Lest I forget in 2 days, Happy Birthday to you! I wish you much joy, health, and laughter.
Bird--Is the itching inside your breast, or near the incision? Itching is a normal part of external wound healing. If it feels like it's inside, maybe it's a nerve thing? Are you seeing your doc about it?
(not)NotVeryBrave--We all feel your anguish. Truly one of the worst parts of the entire cancer ordeal is the "waiting" for results/info. Hopefully one gets stronger with each "waiting" hurdle we jump over.
bc101--You have a lot to bring up with your PS--just make bullet points of all the things you brought up here. All totally valid issues. I hope your doc is a good listener. You won't have to convince a good doc to help you, they'll just want to do it. Please let us know how it goes at your appointment.
Julie--You're so right about the mental/emotional adjustment with each surgery. I sort of disagree with you about the wisdom of doctors concerning this though. I feel like more often than not, they don't do anything to prepare us mentally. Fortunately, we have this website!
TrmTab--Going smaller will mean either removing skin, making surgery a bit more traumatic on the body, or else the bigger skin is looser around the smaller implant. In any case, I think going softer can be more problematic in terms of rippling. But maybe that's only if you have thin skin like mine. (It was all stretched and thin to begin with, so rippling was pretty much inevitable...until I got these new round (but firm) implants.)
Sigh...another Monday has arrived. Must get to work.
Have a good week everyone!
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Cookie - I currently have TCX 800, so the new cohesive in the firmest form... it is too big as it is fully at the cleavage/breast bone, but also in my armpit, so hope something smaller/smaller radius (750/700) can be pushed center by tightening up the "dog ear" so my arm doesn't swing on the implant with every step.
The idea of going softer is more for the implant to settle more in the pocket and have less upper pole fullness. I was not expecting the CX at time of exchange, we had only talked about the RX. Not sure why the PS changed his mind, but in doing research on the CX its main advantage is the firmness that assures/maintains upper pole fullness...exactly what I don't want! In one article it says the CX is best for someone who wants a 20 year olds breast and the RX for a 40 year old breasts...well at 56 y.o. I'm thinking getting an implant to look like a 20 y.o. is ridiculous...plus as a UMX, it is very difficult for my poor native right breast to keep up, literally keep up, with the CX implant! TT
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I have Natrelle SCM. What is the inside scoop on those? I don't even know! LOL
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TrmTab, here is a link to the size chart for the SRX/SSX with specs including projection. Now you have me wondering why my ps would give me 20 yr old boobs too lol!! As to what I am leaning toward, I will wait and see what my ps recommends. These SCX are just slightly softer than my TEs, I feel like I will knock someone over if I bump into them. Cookie raises a good point, wonder of the softer feel means more ripples...
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I love my SCX's and I would not say I look ridiculous or 20-something at all. The upper pole fullness was eased with some fat grafting.
Yes, the softer the implant the more ripples you get. I was offered the SSX and SCX and allowed to choose and just holding them side by side I could see the "ripple-proneness" of the SSX.
Seven weeks in, the SCX's seem to be getting softer.
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