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Not sure what I want to do. Ideas?

nns121317 Member Posts: 113
edited January 2023 in Breast Reconstruction

I had a BMX with direct to implant reconstruction in October 2021. Implants were the only option for reconstruction at the time because I wanted to save my skin, and COVID meant I couldn't get a DIEP - no hospital bed available, and I didn't really have enough fat anyway. Then pathology found a tumor in one of the sentinel nodes removed during surgery, and I had a high Oncotype so did chemo, then rads on my left side.

I finished rads in June 2022. When I saw my reconstructive surgeon in September 2022, my left implant was okay - not quite as symmetrical as before rads, but fine. I was scheduled for fat grafting in February 2023 to smooth some rippling and add a little volume.

However, by December the whole left chest area was quite uncomfortable, and the left implant was becoming increasingly distorted. I'm short of breath (but we've ruled out a lung issue), everything is tight, it constantly feels like someone is poking me in the chest and the implant is on fire. Most days I want to just rip it out. The implant is higher and tighter, more like a ball, and it doesn't move like the right implant.

Also, my blood work shows inflammation almost like lupus, but rheumatology didn't find any connective tissue disorder. I'm wondering if my body just doesn't love my implants.

I saw the surgeon's PA today, who agreed there's an issue on the left side. I expressed interest in exchanging my implants for DIEP, and she thought I'd be a good candidate but my surgeon is already booked out for DIEP procedures until 2024. I can't live with the pain that long. She said fat grafting might help with some of the pain, but it would be tough to do fat grafting and have enough left over for a DIEP later. We could also consider removing the left implant and some scar tissue, then putting in a new implant to keep the skin in good position until the DIEP next year, but no guarantee that would fix the pain. This doc is the only one in my area who does DIEP. The other issue with waiting to do the DIEP is that at my typical weight, I don't have enough tissue to make that happen. I've gained nearly 50 pounds since I was diagnosed, so now I have enough belly fat for the DIEP but I'd prefer not to carry this extra weight for another year...

I'm just not sure what to do, and I think the pain is clouding my judgment. Just about every aspect of my treatment has been a dumpster fire, unfortunately, and I'm starting to lose confidence in my treatment choices. I think I would regret going flat, though.

Any suggestions?