Repeat surgeries? Please share your experience -
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Thanks again for the information, after googling I think I must have capsular contraction. When I went for checkup at PS she said "we will talk about it next year" but she has said that all the hardness I commented on was scar tissue. Now I am afraid that any other implant will have a scar tissue reaction. Further reading this forum, I see several people with shoulder problems that they attribute to breast surgery. That would explain my shoulder problem too (which is a disgression I guess) but I am really leery of getting another implant. How would it look without one? How hard is it to find a bra pad that would mimic the existing breast side? I also think I want to get a different PS.... any comments?
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I don't have first hand experience to answer your questions, but I think that just removing the implant will probably leave you with a less than satisfactory cosmetic result. Most insurers have coverage that includes bra fitting and prosthetics post mastectomy, but I'm not sure how difficult that is if you aren't left completely flat. There are certainly many prosthetic options to use with a mastectomy bra.
I would start with a consult with another PS and see where that leads. My opinion is that it's almost always worth it to get another perspective.
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Decatur, there is a thread regarding removing implants and going flat I looked at. I don't want to go flat, but rather remove my implants and fill with fat. That is probably not going to happen. Anyway, I am sorry I don't have the exact name of the thread, I found it when I searched for "remove implant". The women on the thread were saying you have to be adament with the ps to make you flat if that is what you want. A lot of the ps would give pushback, not want to do it. Their bread and butter is reconstruction. Some even said they woke up from surgery and still had a bit of breast mound or skin there the ps left "just in case" they changed their mind and wanted reconstruction. They also said it was so liberating to get rid of the implants. They would wear the prosthestis (if wanted) during the day and look totally natural. The uni ladies said it is important to have a weighted prosthesis for uni, or it would ride up and look weird.
Best wishes!
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Shore girl- just curious why you don’t think you could do the fat transfer and have implant removed
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Lula, when I had my initial consult with my new ps I told her if I had my way, that is what I would want. I explained that I had read about it on Dr Khouri's website. At 1st, he reduces the implant size by 50% and adds fat. Later he goes in and removes the smaller implant and adds more fat. I think it is to help collapse the capsule. I don't think it is really an option for me though because I really don't think I have enough fat to make 2 whole breasts, given that some dies. You are born with a certain amt of fat cells. The cells themselves gain and lose volume. Once they are gone, they are gone forever. I will get clarification from my ps on Jan 3rd when I see her for my 5 week post op exam. I really do want a definite answer. I am happier with the new softer, lower profile implants to be sure. But I just don't like the idea of possibly needing surgery down the road in my 60's and beyond if I were to get capsular contracture or need implants changed etc. I love how the fat was nice and warm and cushy!! I just want to be done!
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Maybe this is a crazy question....but...do any of you ever see your PS with clothes on, or at least in a bra? Especially for the UMX crowd, this is big.
I never am seen in clothes/bra which for me makes the discussion of happy with where I am or changing size more difficult. Of course without a bra my implant is high and tight and my native breast is 56 years old...so the difference is big and the immediate response is unless we do more surgery on my native breast there is nothing else for me.
Well, in a bra, I am close but clearly different and it seems like a smaller implant would make a huge difference of bringing the two closer together...like downsizing from 800 to 700.
Any comments???
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Hello all, First....Happy New Year!
I have skimmed this thread, and others, but have not found information about my issue, so am posting here in case anyone can offer any help. I had implants under the muscle 2 and a half years ago. For about 18 months, all was pretty good....a little rippling, but acceptable since I don't wear low cut clothes anyway. However, over the past several months, my right breast has gotten worse with the ripples and harder and flatter. My left breast has fallen as I guess it was supposed to.....not to a bad extent, but is now a good 1/4 inch or more lower than the other breast. And, I have a flatness in my left at the top and roundness in the hard, right one. It is like the left breast fell into place while the right just got flat and hard! The flatness makes it necessary to wear more of a padded bra because one protrudes more than the other. What is going on with the right breast that is hard and flat??? I am seeing my PS in a few months, but has this happened to anyone else.
I am disappointed since all was good for awhile. Any thoughts??
Lynn
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It sounds like you may have capsular contracture, Sunshine. Call your PS for an appt and have it checked.
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Had a similar problem-asymmetry with major discomfort from implants for many, many years. Finally had a redo-implants removed-total fatgrafting with Dr. Ahn-did the trick.
Dr. Khouri also does total fat Grafting-you could check out the website.
Wishing you the best-Eileen
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trmtab - 100ccs is 6 tablespoons - spread over the entirety of the implant, and may not make as much of a difference as you would think. At one point I had a 500cc in the left and a 650 cc in the right, you really couldn't tell. I think if you want a noticeably different look visually you would need to downsize more than 100ccs. I have 445ccs now in an Inspira (more projection) and can wear the same bras, with only a few exceptions, as when I had the 650/600cc implants.
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@mysunshine48. It sounds a lot like capsular contracture I would call your PS also ask if you need some extra fold work to keep them symmetrical. Revisions are usually covered by insurance.
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I'm wondering if I have some issues with capsular contracture, too. One feels tighter and higher and that was noted during my last exam by my MO. Mine are above the muscle.
SpecialK, are your Inspira implants textured? I'm wanting to change out my Natrelle 410s anatomicals to round smooth ones. I've had them for 4 years now and have always felt they are too big, plus I have pain on the cancer side where the tightness is compared to the other side. I have to wear a bra 24/7 because otherwise they feel too heavy.
When I went in to discuss revision, my PS who is new to me didn't discuss specific models, although their contract is with Allergan. She asked what bra size I wear and suggested to go down a cup size. I want to maintain the projection, if possible, but just have smaller and lighter bumps, if that makes any sense. They feel too wide and the left one feels bigger than the other. I'm going back in a few weeks to discuss again after having done PT to try and reduce the pain. I think the hardness I am feeling on that side isn't due to tight pecs and it isn't going to feel better by doing simple stretches. This is hard. I know what I want or don't want, yet she seems to be reluctant. Has anyone else had the feeling that you're PS is trying to talk you out of revision? Or maybe she just wants to be sure I'm doing it for the right reasons.
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My first PS was against a revision. I fired him, visited 3 more surgeons, picked #4, and had my successful revision. No regrets.
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I had delayed recon.(For a year after a BMX I wasn’t sure I wanted to) I had tissue expanders followed by cilicone implants. They look great with clothes on. I did have to have one replaced last year after I took a fall and it shifted...almost up to my chin.My PS never charges me anything although he does bill my insurance and they did pay for this second surgery
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bc101, to answer your question...yes my 1st ps was reluctant to do what I wanted. My take on it is some ps are simply not experienced with certain things. For instance, my 1st ps does not do nip recon, so tried to convince me I would be much better off with just 3D tats. He does not do extensive fg, only around the edge of implants. He did not want to downsize my implants. I promptly started researching and located my new ps who is much more forward thinking. I am very happy I didn't settle for what the 1st ps had to offer. I will just say that if you are considering revision, it is so important to have a doc who is in your corner and really listens to what you want. If there is any doubt in your mind that this doctor is willing or able to do what you want, by all means keep looking. You don't want any more surgeries than necessary. I hope you get to feeling better! Wishing you all the best, Shoregirl
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bc101 - yes, my Inspira's are textured and that choice was made because of the very thin skin I have on the left side after 16 surgeries, most of them for skin excisions and repairs. My cautious PS, with whom I have done 4 out of 16 of those surgeries, felt I would have less rippling and distortion with a textured implant because in addition I have some scar tissue and stuck skin that makes a flat indented area across the front. I do have very good projection even though I downsized by 200ccs, and can wear most of the same bras as with the previous implants. I am much more comfortable, but I also had a 3cm suture granuloma removed that had formed right in the same location as my original tumor and it was pushing against that 650cc implant.
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special K, are your implants over the muscle
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Thanks for all the helpful advice, ladies!
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birdoflight - no,they are sub-pectoral. Pre-pectoral for breast cancer recon is a relatively new concept, and I was diagnosed in 2010, so it was not something that was available. Pre-pectoral would not be advised for me now as I have exceedingly thin skin and have struggled with my allograft matrix perforating and not able to hold even sub-pectoral implants because of abnormally thin or absent pectoral muscles. That I currently have two implants in place is somewhat of a miracle, lol!
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Hi all.... Special K, I need to attend a Tampa luncheon so I can talk with you about my hardening breast issue. Here it is 1:30 in the morning and I am up because my boob hurts. In a previous post I said my right breast is definitely harder (implants 2 1/2 years ago) than the left. My surgeon does an ultrasound every six months because I also have a granuloma in the right breast. I made an appointment with my plastic surgeon then too so he a can evaluate this issue. If I need to exchange the right, I am wondering if I would also exchange the left for symmetry and especially if I went to a different kind of implant. ....?.. There is also quite a bit of rippling in my right breast. What to do? Are you happy with your implants? Textured, I think I read. Fort Myers is a lot farther for me to go than Tampa from The Villages. Is it a good idea to change surgeons? I just would like symmetry and get rid of the granuloma and the hardness. Your thoughts???
Lynn
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mysunshine -sorry you are experiencing capsular contracture, I have heard that it is indeed painful. That is on the same side as the granuloma? I developed a suture granuloma on the cancer side that eventually got to 3cm, pushing against the implant. It was uncomfortable, but can’t imagine it combined with CC also. I would look into having that side replaced and the granuloma removed - that is what I did, I can recommend my Tampa PS wholeheartedly, she is awesome. There are a number of the Tampa ladies who have seen her, and I wish I had changed to her sooner in the process. I am as happy as I can be with my implants - but I have had a lot of surgical intervention, so success to me is different than it is for most. I have spent long periods of time without an expander or implant in place, so half flat but not with a natural breast on the other side - which made matching a prosthetic problematic. Because my left side has been incised 16 different times it does not look good compared with other’s recon, I can’t wear clothing that is cut low at all, or a regular bathing suit, but I am thrilled to have an implant in there!!! My implants are very comfortable and a much better choice for me than the previous ones. Also, I can always meet you for a lunch anytime to discuss
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In 2003 I had DCIS on my R-breast. Stage 2 with lymph node involvement. Had the lumpectomy and that margin was positive. Went in for the second margin and that was negative. The pathologist missed the cancer in the lymph node tissue. Went through 4 rounds of chemo which was call the Kool Aid mix, using two different kind and 8 weeks of radiation which was intense because they needed to get the breast tissue plus the lymph node area.
Fast forward 14 years (BLM 1-31-2017), the cancer came back in the same breast but, I caught it early enough that I didn't need treatment. I knew that after the radiation that the breast would have to be removed to I decided for them to take both plus the nipples.
The PS went through the different types of reconstruction ideas and he decided that implants would be best for me. Since I had augmentation done before breast cancer #1 I didn't need the expanders. My breast size was a full C which is basically a D cup. I was extremely unhappy with the look and feel. I thought it was because I had saline and now silicone. He told me that they would get better with time and they just got worse. The left was high and the right was low. Both were spread apart to the point where if I was laying on my back they were near my armpits. After he told me that is was all because of the radiated breast I got MAD. I had both removed so that I could receive the symmetry possible.
Went to four other PS for advise. Most don't want to get involved with another doctors errors. Found a doctor that said Fat Grafting was the way to go. Been through that twice and now I have nerve damage in my abdomen. I have a few binders so I always have a clean one to wear.
Being the first among all my friends to develop breast cancer, plus the only one who had radiation, I can't compare my reconstruction with theirs. All I know is that my breasts are lumpy and getting smaller. All the new bras are starting to fold over where the nipples would be (haven't had time to even think about getting them done). None of my swim suits fit or tops. They hang off my shoulders.
I'm looking to talk to someone who has went through this. This has gotten to the point where I'm obsessing over it. After all it's been over a year along with other physical problems, I've been under anesthesia at least 8 times this past year. Four were on my breasts. I developed an infection after the first fat grafting, which could have been prevented by the emergency room doctors the night I went in due to my one breast that was bleeding. They never even took off the surgical bra or sent me home with antibiotics. They said that some bleeding was normal. I had a towel with blood on it.
I'm tired and feeling somewhat depressed. Certainly not the same person I was after battling cancer #1. That was a walk in the park.
Anita
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Hi, Anita, you poor girl....sounds awful. I have not had the problems you have, but some of my own...mentioned above. I am no expert on this as I have asked for advice too, but I know there is a breast reconstruction center in New Orleans.....that is all they do. Just passing on this information.
Special K, Yes, I would love to meet and talk with you in the next month or so. I will PM you about possibilities. Thank you! I know you know a lot!
Lynn
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Thanks Lynn. I'd love to talk to you about my options. Just made an appointment with and PS. This time a woman. It's later in March. Just the driving back and forth to doctor appointments is making me crazy.
Anita
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Just had 6month follow up with PS. after DMX with nipple sparing. Said I could do a revision if I was interested in going up a size. Mine are baby ones,,barely a B. Its not that I'm dissatisfied with the size, i wish the rippling wasnt there. I just don't like looking at myself in the mirror on the sides. They have fallen a bit too. For me its on the sides and I can feel it under the boobs but dont see it. My PS had said prior to my surgery that my skin was tight, I did not have enough fat anywhere to do grafting so I went direct to implants and could just about be what I was before. Now he said my skin has loosened a bit but still no guarantee of how much bigger(not a big deal) or if the rippling would be less noticeable(big deal). I don't want a bigger boob with even more pronounced rippling. Worrying now about my nipples looking like they are migrating to my armpit lol.
Not considering to do anything at this time anyway. Last summer was a wash with being diagnosed and surgery/recovery. I'm not willing to give up going in water for 6weeks or more again after surgery. I want this summer for me! I may consider it later on.
I had the Natrelle Inspira with Alloderm graft.
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I went through last summer not being able to go into the ocean with family and friends too. If it wasn't due to the breast surgeries then it was due to the cataract surgeries. I'm trying to get the flap done before it gets too hot but that has to wait because I'm getting a Spinal Cord Stimulator taken out next month.
My skin on the right breast is thin due to the radiation. In fact, at the end of last summer that breast started losing it's size. That was due to the radiation done over 13 years ago. I couldn't believe it. It was true. It doesn't matter how many years it has been. Just like breast cancer itself. November 2016 I felt that same lump as the first time. Maybe, my breast getting smaller was a part of the cancer coming back but, one thing for sure, it made me pay more attention to that breast which let me find it early.
I have the rippling skin, pockets and especially around the silicone implants. If and when I finally get better results, then I can finally look into tattooing. Just hope when that time comes that my breasts still are numb.
Should have done my research before going with the first PS. My fault because when it comes to anything else in life, I do my research. My PS also told me that there wasn't enough fat on me to do the flap and he refused to use any from any other area. Instead of going through the healing with the all the tubes once, I'll have those horrible drainage tubes to deal with again.
Wish you the best and enjoy the water. My bathing suits don't fit right.
Anita
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Beach2Beach, have you considered getting a second opinion, just to see what's out there? I have Inspira's, too, and with fat grafting I have no rippling.
Good luck with your revision.
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Hi Shoregirl, I was wondering if you went back to your PS and inquired about switching your implants for fat? I too am wondering if I can possibly do that. I got my implants Nov 1st and really just do not like them. It may be because I feel them so much (since they are under the muscle) and they just look like mounds sitting on my chest ha. They are also much smaller than I was originally and when I asked my new PS about them (because I did not go to my original PS after my exchange surgery because he does not listen and does what he wants) so I asked my new lady PS and she said I have large implants in but that because they are under the muscle and I do not have breast tissue around them (just some fat grafting) that I will most likely always feel the implants in my chest since they are under my muscle. Any of you get annoyed with feeling them 24/7 or is it just me? ha. I am thinking of asking to remove them and putting fat in both breasts instead but not sure if my insurance will pay for that or if I really want to go back through another hard surgery. My other option is to keep my implants and do more fat grafting and also add my nipples and tattoo areolas. I am just not sure what to do. So curious what your PS said. If any of you other ladies have this same experience please let me know
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I have large implants under my muscle and have had two fat graftings. As far as I'm concerned, I wasted my time with two PS. At the time of my mastectomies, after reading just recently about the Flap, that is what I should have had done. Like I said, wasted time. Fat grafting has come a long way but, it still needs to go a longer way in order to keep the fat where they place it.
The PS may say that it's a great choice but, get a few different opinions. Ask to look at before and after pictures. They all have them and if they tell you they don't when you are making your appointment, then don't bother or waste your time.
Before I went through my first BC I had breast augmentation. The doctor had a large book of before and after, with different results and sizes.
My last appointment to my PS was a disaster. I went to the wrong location, had a fight with the office, even though I was only 15 minutes late. They told me that the doctor couldn't see me. The office is not close to my home and the traffic is always a mess. I told them that the doctor would see me and I waited. Since they were upset with me of course I was the last in the waiting room. So I took it upon myself after seeing one by one of the office staff leaving for the day, to walk back and find him before he slipped out the back door. That is when I walked into the room with the big blue screen. That is the screen where they take the before an after pictures. The same when I had augmentation. After looking around the room while I was waiting, there was the 3 ring binder with all the pictures.
From what I have been reading, it seems that most of the problems is from fat grafting. We have at least 8 friends who have had bilateral mastectomies and not one of them have had fat grafting. Sure the lap surgery is more intense and so is the recovery time. If I had it done the first time then I would not still be going through this crap over a year now. DO YOUR HOMEWORK! It's you body not the doctors.
Sounds like I'm mad because I AM. All of this takes a toll on you mind and body, not including who has to take off from work to drive you and pick you up. I have become a problem to everyone. They may try to hide it but, it's the truth.
Good luck,
Anita
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I think the rippling that occurs with the fat grafting is either related to going from large breasts to smaller or if you had previous radiation. These are the only two factors that 4 different PS have told me, especially the radiation because the skin has been destroyed.
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