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Deciding to go flat: What questions do I need to ask surgeon?

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2008 BMX, with right rupture now: I need to decide asap what surgery to get: replacement of silicone implant or no replacement but go flat. My brief overview of prior posts indicates that even with going flat there is much to learn about: proper incisions, ensuring proper mobility, fat grafting? ...

Any advise or and extensive list of questions to ask and issues to think about would be much appreciated.

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  • exbrnxgrl
    exbrnxgrl Member Posts: 4,952
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    ailenroc,

    I have no experience with flat closures but I thought you might find some help on this thread.

    https://community.breastcancer.org/forum/82/topics/882994?page=2#post_5760564

  • ailenroc
    ailenroc Member Posts: 21
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    exbrnxgrl: Thank you for that information; it helped to get me a step further: after looking at that forum and another website referenced there: https://notputtingonashirt.org/goingflat/#question...

    ... and reviewing that website, I was able to quickly decide that ‘going flat’ is not an option for me. Going flat sounds so simple but from what as the site states “one overestimates the benefits”. There are numerous drawbacks, finding the right surgeon, figuring out type of surgery / incision to have a decent flat closure that does not impede mobility, being aware of numerous risks beyond the typical surgery risks ... I had no idea that I would be at risk for a pneumothorax and that because I had a long time ago expanders and then implants that I likely would have a concave chest after years of compression. Not good.

    So back to implants, provided I don’t have the silicone from the ruptured implant already in my lymph system. I am considerable swelling and a fluid aspiration is scheduled to determine if I might now have BIA-ALCL - implant associated lymph cancer. Pray for me please that this is not the case.

    Any advice on what else I need to pay attention to and ask at this time?

    One more obstacle is: the original surgeon from 2008 no longer takes insurance: his cost is $8000 out of pocket. I have faith in his expertise but can’t get an answer from the insurance what of that, if any they would cover. In addition there will be surgery center, anesthesia, etc all of which supposedly will bill insurance but I will have to pay 20% coinsurance. Does the insurance have to pay for bilateral replacement although only one is ruptured? Surgeon says yes, because the implants are 13 years old. Please, all advise is much appreciated!

  • ailenroc
    ailenroc Member Posts: 21
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    I am starting to reconsider going flat after reading that the newer studies do link implants to autoimmune disorders. I am really torn; I would like to replace the ruptured implants with new ones to maintain my body image and not look mutilated, but I did develop Dermatomyositis since i have them.

    Seeing surgeon on Monday; what questions regarding explants do I need to ask? I had expanders and 500 cc (36c cup) and am under the impression that explants would leave me with concave holes in the chest. Is that repairable? I don’t have any extra fat for grafting.

  • ailenroc
    ailenroc Member Posts: 21
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    I am starting to reconsider going flat after all - after reading that the newer studies do link implants to autoimmune disorders.

    https://www.mdanderson.org/newsroom/largest-ever-study-shows-silicone-breast-implants-associated-with-rare-diseases.h00-159227301.html

    I am really torn; I would like to replace the ruptured implants with new ones to maintain my body image and not look mutilated, but I did develop Dermatomyositis since i have them.

    Seeing surgeon on Monday; what questions regarding explants do I need to ask? I had expanders and 500 cc (36c cup) and am under the impression that explants would leave me with concave holes in the chest. Is that repairable? I don't have any extra fat for grafting.

  • ailenroc
    ailenroc Member Posts: 21
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    I am reading that the dreaded concavity that implant removal after expanders could be repaired with excess skin - has anyone done that? What are the results?