Replacing breast implants
I have had textured implants since my double mastectomy 6 and a half years ago. I am concerned because of the recall on textured implants but they have also shifted and there is scar tissue that makes them uncomfortable. I have decided to have them replaced and am trying to decide between plain silicone vs saline. My PS also said he would do some liposuction to add fat to the implants for support. Any experience with this? Safety? I am a young 72 year old. Thank you.
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Silicone generally gives the most satisfactory results in reconstruction. The fat grafting will really help as well.
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There was a recently posted study on the topic of textured implants right here on BCO which you might be interested in: https://community.breastcancer.org/forum/73/topics/880210 Apparently textures and their health impact vary.
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I had to have a "redo" on my implants due to scar tissue buildup. I found the surgery recovery quite easy compared to the first go round except for the liposuction. That did hurt more than I expected. I think it depends where they harvest from. I am quite thin so the only place my PS felt was available was inner thighs. It took about five months for the soreness to go away. My sister had lipo on her arms and that wasn't nearly as sensitive. Just a heads up.
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veronica - there are several of us that have just done exactly what you posted about - here is a link to the recent thread that discusses:
https://community.breastcancer.org/forum/91/topics/879871?page=1#post_5674074
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Thank you. I read that the replacement was easy enough but some said that the liposuction could be painful and take a long time to heal. How useful is it to add fat to the new implants?
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I do have them and was worried myself originally but decided to wait after reading more about it here.
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veronica - is the plan to replace with the same size implants? Do your implants currently have a good aesthetic look? The fat grafting is used to soften the area around and above the implants to create a more natural appearance but you may not need it. I have had fat grafting done a number of times and it can be a bit uncomfortable for a few days to a week or so, then it has felt more like you did too many sit-ups (mine has been flank and abdomen) which I have found to be tolerable.
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Thank you for your input. I was thinking of going down a half size with the replaced implants. Some people said that the liposuction can be very painful for awhile. My PS mentioned he might want to do the lipo in the abdomen and maybe thighs. I didn't have that done with the original implants which have shifted, hardened and are the textured ones. He said I could leave the ones I have or replace them or just have them removed without replacement. Although I am 72 I don't think I'm ready to be flat yet.
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I had liposuction on my outer thighs, and it is not for the faint of heart. I think that the stomach lipo was not too bad, but the thighs! Imagine it hurting like the blazes, and you have to wear super tight compression garments. Every time you need a potty break, you have to drag the horribly tight pants down over the very painful bruises.
I'd do it again, but it does hurt a bit.
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I had inner thighs, outer thighs, abdomen and flanks lipo’d. The bruising was impressive, but I was secure in my “medical spanx” complete with a pee hole cut into them. After three days I no longer had to wear compression, but found that bike shorts felt good.
The pain wasn’t awful, and ibuprofen did a good job of relieving it. After 3-5 days I was just sore and that gradually faded, as did the bruises.
Good luck with your decision.
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i had mine replaced exactly 2years ago and love them. I went with silicone, smooth implants. They're much more comfortable and so far have not migrated. Best decision that I made, as the 410 gummies always felt cold and hard. The new implants feel lighter and more natural. I chickened out of fat grafting, after I was told about the pain factor. Good luck.
Nancy
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Thanks to everyone who has replied to my post. I decided to go with the smooth silicone implants but am still thinking about the fat grafting. My PS's office says it helps the implants stay in place and makes them smoother. I do not look forward to pain. My surgery is sceduled for Sept. so I have time to think about it but anyone else's experience with or without the fat grafting would be appreciated.
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Any feedback on replacing textured implants with smooth ones without using fat grafting.
I am a bit anxious about the liposuction after reading some of people's experiences. I'm wondering how to tell whether I need the fat graft or not. Thanks for any comments and support.
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I don't necessarily think the fat grafting is being recommended because you are changing from textured to smooth - the fat grafting is more to soften the aesthetic and possibly prevent rippling. You can choose smooth round implants with the firmest cohesive gel inside and get a good size fit for the pocket that your old implants were in and that might be enough. This is what my plastic surgeon did, she actually stepped up from the mid-range cohesiveness in my textured implants to the firmest in the smooth. While I did have fat grafting I think things would have looked acceptable without it, and for me it had more to do with the thin aspect of my skin - if that is not an issue for you you may not need it.
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In 2018 I decided to have my implant updated. I had it since 2007. The surgeon said we could also do a little nip tuck on my right breast. He did lipo on my stomach. He took from 3 areas to place some of it around the left implant. He took from my left and right side and also through my belly button. I only took pain meds the day of and the day after. I found the healing time was pretty quick. Now I'm scheduled for more reconstruction August 12th.
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I would say do the fat grafting. It makes things look so much better. I went back for second round and would go back for a third if needed. Worth the discomfort.
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I'll be having revision surgery for capsular contracture next week. I've left it up to my PS to do fat grafting if he feels it is necessary (very bony upper chest and some minor rippling with my current implants). I've been focused on the implants, but now that I've read the fat graftng info and consent forms I am a little concerned about the liposuction site. My PS will harvest from the abdomen and possibly flanks. I'm wondering how common it is for the donor site to end up looking lumpy or irregular after the liposuction. I know it will be important to wear the pressure garment.
Would anyone comment on how satisfied you are with fat grafting overall and how the donor site turned out?
Thank you!
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TinaT - my fat grafting was along inner thighs - word of warning that site hurts a bit. I have had to stay on top of deep tissue massage with a special little weird plastic device with rigid fingers I bought to help (I think the name was a fat blaster or some other ridiculous moniker) once I had healed enough to tolerate. Otherwise I was getting a clear delineation between where she took the fat and where she didn't . Maybe some others can speak to your potential sites, the stomach and the flanks. I would also speak with your PS for suggestions.
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tina - I have had fat grafting six times, for a variety of different reasons, including several to a temporarily flat side from implant loss (long story) to help prepare for another try at implant recon which was ultimately successful. My flanks and abdomen have been used, abdomen more than once despite not having a great deal of fat in any particular spot. If your PS is experienced you should not end up with lumps, but even if you are told that compression is optional, wear it anyway. My first PS advised at least 8 weeks in some level of compression, I used a less restrictive garment as time went on. Those tunnels made with the cannula during the fat harvestcan fill with fluid and become firm and it takes a long time to dissipate. My abdomen is perfectly normal looking despite repeated grafts taken. Good luck!
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Thanks so much for sharing your experiences. I appreciate it!
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Thanks for sharing. I am due to have my textured implants replaced in Sept. I am reluctant to have fat grafting. Has anyone had textured implants replaced by smooth ones without fat grafting and if so how do they come out?
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I haven't been on here in a long time and I'm so glad I found this thread as I am having my textured implants replaced for smooth in October. They have been in for 12 years and I have had ALND surgery since then. I'm concerned about the lymphedema risk.
SpecialK, it is so good to see you still on these Forums! Since you have also had ALND surgery, did you find that you had any extra fluid in your arm or torso after exchange surgery? My PS is totally downplaying the risk.
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bren - good to see you! I have lymphedema on my ALND side, so I always worry about whether surgery will aggravate it. I did not have any issues with any extra fluid or swelling after surgery, other than generally feeling puffy everywhere from the amount of IV fluids - takes a few days to work through my system. I had fat grafting also and my surgeon took from a number of locations, including over the ribs on both sides and I did not have any swelling in the torso either. Good luck with your surgery - I had a silent rupture on the right side, which necessitated the surgery as a primary reason but my surgeon also wanted to get both of the textured implants out since I would already be under. I am relieved they are out - i downsized very slightly, by 45ccs, as I needed some skin remediation on the non-cancer side. I don’t notice any difference in size and have Inspira cohesives which have the greatest forward projection of that line, to compensate for the slight downsize
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Thank you SpecialK for your input! The risk of LE has been my biggest concern. So far I have been fortunate that I have not had much in the way of LE since the ALND surgery and I don't want this to be the thing that sets it off.
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Hi everyone. These posts are very helpful. My surgery to replace textured implants is scheduled for mid Sept. I have pretty much decided that I don't want liposuction. I'm 72 yrs old; altho I look and feel younger I am less concerned with appearance under my clothes as I am with comfort and health. I was frightened by the announcement of the textured implant re-call and altho I'm not experiencing problems other that hardening and a bit mis-shaping I thought I should have them replaced before I get much older. I have had the textured ones for six and a half years. I'm wondering now if waiting it out a couple of years more, especially with covid increasing, would be wise or to just bite the bullet and do it. I don't know if the smooth implants, without lipo, would look or feel better. Thanks for any input.
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Veronica - I think you've gotten lots of very good feed back & answers to all your questions.
As for waiting due to Covid - it's such a personal decision. I have Allergan 410 implants and haven't had any problems. It's 10 years and I don't plan to replace anytime soon - and I'm 77. That said - personally I would put off any surgery that I could in the middle of this epidemic. The medical community is working at capacity and exhausted - not to mention potential exposure if you're out & about. BUt like said - it's a personal decision
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Thank you Minus Two. I had decided not to have a replacement last year because of covid and thought waiting and being vaccinated would make things safer this year. I also thought that to have any surgery at age 72 would be safer and easier than waiting until I'm 80 plus. Since I'm not having major problems right now, other than a few hard spots and uneven shaping which doesn't show under clothes, that maybe I can hold off and see what the environment is like down the road. I had a slight panic when my gyno told me last year to "get the textured implants out immediately". My oncologist and PS did not agree with the need for that but are leaving it up to me.
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I am in the same situation, - "young" 70 years old , with textured implants, putting off the removal/switch. My PS has made me feel that it isnt urgent to do. He said the risks are greater for complications from surgery than from having textured implants.
I am reluctant to have any procedure that is not essential, especially now with covid numbers raising.
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Thanks so much for your input. I called PS and they said to keep my pre surgery appointment and discuss further with the surgeon. I'm pretty much deciding to hold off on on the surgery. It helps to hear from others who have textured implants and are waiting.
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Veronica,
I go to a top cancer institution and I have been recommended to get my textured implants switched. I also believe if your implant has been in for a long time, your risk may increase slightly. The incidence of BIA-ALCL may be under reported - refer to research with a smaller group sample - Pubmed article "Risk of breast implant associated anaplastic large cell lymphoma(BIA- ALCL)".
For me, it is peace of mind. Planned surgery in October.
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