Visible ripples in implants

ajones120961

I went yesterday to see my PS because of rippling and I'm flat on the outside of my breasts, he said he really couldn't do anything. I had my revision April 2010. Oh, by the way this was the 2nd PS I saw because the 1st PS did a horrible reconstruction job.  My nipples are not centered so I can't go without a bra because the are headed in the direction of my armpits not to mention I'm flat and look abnormal (my 1st PS was the one the didn't center the nips).  My PS said a new implant was coming out that that should help with the rippling etc. but is hasn't been FDA approved.  I would love any suggestions you might have. 

Anonymous

leeinfl- Do you know if Dr. Khouri's office will actually tell you who those other doctors are that he has trained?  Just wondering if there's one in my area.

ajones- The implant they are talking about is sometimes called a "gummy", "gummy bear", or anatomical silicone implant.  It is tear-dropped shaped so it's supposed to give a more natural shape and slope to the breast with less rippling.  The downside is it is pretty firm so it won't feel quite as soft as regular silicone implants.  It hasn't been FDA approved yet but there are LOTS of PS's participating in the clinical trial so if you can find one of them you can get these new implants.  Don't worry about the clinical trial part of it.  They have been used in Europe for over a decade with no problems.  It still has to be tested here in the U.S. so it has to go through all new clinical trials.  (So dumb, I know.)  I would call around in your area and see if anyone is using these and at least have a consultation.  Sorry about your recon.  I hope you can find someone to give you the results that you deserve.

leeinfl

Kate33 - I have no idea.  You can always call or email his office and ask.  I know it's an inconvenience to travel down to Miami, but he's the best.  Women come from all over the world to have him do their breasts.  I know every doctor and surgeon has to start somewhere and get experience, but I wasn't going to risk my revision with anyone but the best.

sweetie2040

Hi Ladies-well I guess we are all still on the fence then. I guess we all continue on the quest for how to resolve the ripples. I took a few days off from thinking about it because I've been so sick with a sinus infection all I could was sleep.

Kate did you get that job you were interviewing for? It sounds like you have been interested in Dr. Khouri's method for while. I'd go for it if I was you. If I had the means and there was a Dr in my area who did this method I'd definitely look into it. I'm hoping it becomes more the of the standard in the next 10 years. I'd definately look into when it's time to change out the implants.

Soccermom-keep us posted on what your Dr says.

Seafoobs-I saw him January. I scheduled the surgery for April but I'm having second thoughts so I want to see him again to review everything again. I may either not do it, or put it off until the fall, or maybe do it. Well see after Monday how I feel.

Ajones-sorry to hear your having such a hard time and your reconstruction did not come out as you hoped. You could still go for a revision. Kate gave you some good advice on the gummies. There is also a thread on here called "all about gummies" if you want to read what the ladies who have them say. My Dr. was in the gummy trial and I could have had them but chose the rounds. I do have a  lot rippling so I asked him if chose the gummies if I would still have had it. He said I probably would because of thin skin. It may have been less though. I didn't go for the gummy because of it's firmness and some other issues I considered but there are many girls on here who have them and love them. I haven't heard many of them complain of ripples either.

Anonymous

sweetie- Unfortunately, after an 8 hour interview I didn't get the job.  Made it all the way through until the last cut.  I heard 35,000 people applied!  I just applied for another job (flight attendant for a charter airline that is creating a new crew base in my home town, Mesa, AZ!).  I'm waiting to hear if I get called for an interview.  I think I've decided that if I get the job I'll put the revision on hold.  If I don't get the job it's a sign I'm supposed to move forward with the revision.  I have a call into Dr. Khouri's office to book an appointment in April so we'll see.  Anyway, it's either a new job or new boobs.  Win- win!!!!

soccermomofthree

sweetie I hope you feel better very soon!

Kate I like your win win attitude!

sweetie2040

Kate-an 8 hour interview, wow that's just crazy! Good luck with the next opportunity. It sounds very exciting. I agree if it's meant to be you'll get the job. If not no worries, then there's something else in store for you. That's great you made the appointment to see Dr. K. At least you can meet him and see how you feel about everything first hand. We will all definitely be waiting to see what you think after that appt. Good luck with everything.

Soccermom-thanks. I was supposed to go the gym this morning with my friend but my stomach was still yucky. I feel slightly better now so I guess it's off to my four mile walk. Good luck with your appt tomorrow.

Anonymous

Hey guys!  Just got an email from a member on here that said her PS is also doing the fat grafting only reconstruction.  He is located in Dallas for those that are interested.  Here is the PM she sent me-

"I just had a follow-up appt with him a week ago and asked him about it.  He's now done several recons using only fat grafting, plus he was getting ready to do a mast with immediate recon using only fat grafting.  I'm just amazed by this - it's so exciting!  He says that these reconstructions are for women who want to be A & B cups so far.  He said it takes 2-3 separate fat grafting sessions to achieve recon.   He uses tissue expanders to stretch the skin for delayed recons or to hold the space after a mastectomy.  No external devices (like BRAVA) are necessary.His name is Dr. Michel Saint-Cyr at UT Southwestern Medical Center in Dallas.  He's an assistant professor at the medical school, as well.  His phone is 214-645-3115.  Call 214-645-2353 for appointments.  His email is michel.saint-cyr@utsouthwestern.edu.  You can also find his professional resume at www.utsouthwestern.edu under the Plastic Surgery dept.  The Plastic Surgery Clinic and staff are fantastic!  The medical center hospital is Zale Lipshy.  There is a separate hotel-type facility that's available for an additional charge, but I just stayed at Zale and it was very nice.  Dr. Saint-Cyr is very down-to-earth, kind, and personable, plus his practice is cutting edge." Kate33 "Yes, they're fake (@)(@) the real ones tried to kill me!" 

sweetie2040

Kate-thanks for the information. Hopefully this will be more widely available. I was wondering if we were happy with our implants but not the ripples and they can do a reconstruction with just the fat grafting, why can't they just do fat grafting around our implant? I mean more extensively like a whole layer covering the implant to hide the ripples. Maybe it just doesn't work that way, huh?

soccermomofthree

Hello my app went well today. I got the OK to not wear a bra 24/7 anymore which is so exciting and I also am feel to lift or do whatever.  So I will not have anything done until I hit my year mark then we will evaluate how things look.  I feel happy about this...I am just not ready for another surgery at this point.  I am happy to not think about it and enjoy the summer ripples divot and all lol.  My PS is willing to do the fat grafting if I wanted him to. I guess I should feel so thankful for that.  I don't like how the fat could get hard.  I would always wonder if it were really the fat or...anyway it is nice to have options for sure! 

bindola3

hi women... I made my second lipofilling 14 days ago, and wrinklins and rippling are disappearing...not at all, but the result is very satisfactory. Perhaps you say "liposculpture"? My surgeon took fat from my leg, and graft on my prothesy. The surgery is easy, I recommended you. bye, silvia  

Anonymous

sweetie- I think some surgeons will do the fat grafting over the implant.  Do you know a member named "MBJ"?  She just had another round of fat grafting to get rid of that step off which is basically the top of her implants so I don't know why they couldn't do it around the whole thing.  That is what leeinfl had done by Dr. Khouri except she had smaller implants put in first.  I don't think you would end up a whole lot bigger if you did the grafting over the top.

soccermom- Glad your appointment went well!

bindola3- Glad you are getting good results from your grafting!  It's nice to hear of a success story!  

sweetie2040

Soccermom-glad to hear you had a good appt. I think it's great to now let your body continue healing and just relax and enjoy the spring and summer. You may find after a while you'll be ok with everything. I see my Dr on Monday and I'm already having doubts about a revision again. I just feel like it's so hard to make a decision to go back into surgery for what seems like "cosmetic" reasons. I'll see how I feel after that appt. If I'm not ready I may wait til the end of the year to think about it again.

bindola-glad your getting great results! Your lucky to have a Dr who does those procedures!

Kate-Yes I've seen MBJ's photos and talked to her. She looks great. The problem is my Dr doesn't do the fat grafting. I asked another highly recommended Dr in my area and he doesn't do it either. It seems like it is not something widely done in my area. I would probably have to really search to find someone who did it and maybe have to go to NY or something. It seems to me like some of the best PS's are in NY, CA and FL.

Anonymous

Soccermom - glad your appointment went well and that you are at peace with enjoying the summer without surgery.

sweetie - good luck with your appointment Monday.  Hope you get information that is helpful with making your decision easier.

soccermomofthree

Thank you gals you are all so sweet.

Sweetie I hope you have a clear feeling after your app. Monday.  It is so hard and so easy to go back and fourth.  I really get what your saying about cosmetic reasons.  I feel that way too because I am not totally messed up and what if the revision makes things worse or I get an infection...endless what ifs...what if its easy and I say why didn't I do this sooner.lol   I feel better just saying I can make my decision next year. So I can have so time off from dwelling on it.  It is such a personal decision for sure.

SeaFoobs how are things coming along with you?

Silvia I am really glad the procedure went so well for you.

deekaay

Does insurance cover the Dr. Khouri and other similar methods that include only fat grafts for the whole breast?  It does sounds like a great hope for future breast recon.  Lee, I'll check on the forum for your pictures.  You sound like you really have a great result.  I would have been happy with a B which is what I was.  Now I'm a C and it's ok, still feels a little big to me.

I am not up for doing the Dr. K redo now.  I have a lat d on one side and have had radiation so I don't want to do big surgeries if I can avoid, I just don't want to mess with that tender skin when I've had such good luck so far.  When it's time to replace these implants, I would look into it.

I decided to take a few months off from worrying about ripples and I have to say it has been a major relief to not obsess on them.  And, I don't see the ripples as so annoying now.  I would like them to be gone, but I am on the fence about more fat grafting.  I have a surgery date for end of April so I'll decide soon if I'll go ahead.  If not, I can do it in the future.

Anonymous

soccermom - I finally got rid of a chord at the lower left side of my left implant.  It was causing pain so that is a relief. I still have one major chord at the top of the left implant.  If I could work that out it would be a major step in that it would let the implant move more freely. I'll keep plugging away at it.

soccermomofthree

deekaay-I think that taking a few months off from worrying about ripples does help to not get so bothered about them.  It has helped me also.

SeaFoobs-I am glad you got rid of the one chord and done with that pain.  I am glad you know that the work you put into working them out pays off.  Hope the other will loosen up soon!  My PS wants me to move my implants around everyday.  I think so capsular contracture does not set in.

Anonymous

deekaay- I do know that leeinfl has the implant exchange/fat grafting and then I think two more rounds of fat grafting and her insurance covered it all.  And I thiink MBJ said her insurance covered her fat grafting as well.  I know what  you mean about C feeling too big.  I feel the same way.  It just makes me feel bigger all around and I feel out of proportion.  I know I don't look it to most people but I guess I was just used to my body being a certain way.  I miss it so if I do go with Dr. Khouri I'm going to tell him I want to end up smaller.

deekaay

Kate, re insurance, my PS told me he either does the fat grafting while he's doing other procedures and just doesn't get reimbursement for it OR if he does fat grafting alone, insurance will pay but it takes more documentation because of the lipo aspect of it (makes ins. co. suspicious of the medical need.)

In earlier email I was wondering if insurance pays for the full breast recon w/ Dr. Khouri using only fat grafting?  Just curious if that is approved as yet as covered expense. So, Lee had fat grafting in addition to implants by Dr. Khouri? I missed that...   

If Dr. K does A's and B's you will get just what you want.  That would be nice, wouldn't it? 

hopefulhealing

Hi Ladies,

Haven't been on in awhile. I have to make a decision. I have rippling as we all seem to have. My implants are textured. My PS is telling me the smooth have more problems with capsular contracture. I was scheduled for 3/31/11 for revision. He is saying I should wait till the gummies have been approved as this would help.  Had multiple complications so he is nervous about more surgeries. He does not do fat grafting as he feels it has not been around long enough to know where is the best place to use etc.  Have your PS told you not to go smooth due to increased chance of capsular contraction?  Thanks for your help. I see him at 2:30 today!

Anonymous

deekaay- As far as I know if you do total fat grafting with Dr. K it is covered but I have heard some women talk about having to pay for the BRAVA system that he needs to do the procedure.  (Not sure how much that costs.)

Determined- Hi!  Nice to see you on here, again!  I was wondering where you had gone to.  My PS never said anything about smooths and c.c.  I do know the gummies are much firmer and women have said they don't feel as natural as the regular silicones.  I would think there would be less, or no, rippling, though.  There are a lot of PS participating in the clinical trials so if you wanted gummies now you could probably find a new PS that could put them in.  They've been used in the UK and Canada for about 10 years I think.  Good luck with your appointment today! 

Anonymous

This is an old article (2008) about fat grafting but thought it was kind of interesting.

http://www.medscape.com/viewarticle/583239 

orchidgal

Sweetie, My PS told me that he recently used all around the implant fat grafting on the recon of a patient who had radiated skin, and that it worked out really well. He was suggesting to me that he could do more extensive fat grafting if need be after this revision I just had, but he thinks now that he put in slightly larger implants that he will do the regular fat grafting, as he does it with nips/areolas, in the upper pole areas, but can do more extensive if need be. I know what you mean about thinking that the cosmetic part is too much, but I'm happy now that I've gone through, although I'm still swollen and bandaged w/ drains, I have confidence that I will end up with something I feel good about, expecially due to my active, outdoor lifestyle.

Whatever I have done must be this year as I have a PPO individual policy and my decuctible is 5k, and out of pocket in network 10k, in network 7k, and my PS is out of network. Must get everything done this  year!! Insurance will cover everything until I am completed.

I think what MBJ did was wise in waiting to get her nips for so many months, as things really started changing for me at around ten weeks. And kept changing, day by day even, and getting better. So interesting how the body adapts to these foreign objects, as well as how you use your body and move it. The more I worked out, stretched, danced, walked, hiked, the more they became a part of my body. Have also been sleeping on a 30 degree wedge pillow that has a top layer of memory foam ever since my BMX, which was July. I think these things help out a lot. Never actually started sleeping on my stomach since the BMX in July. Glad to know this in advance this time around the old implant merry go round!

Anonymous

orchidgal- I never really thought about the implants feeling better with more activity but it makes sense.  Sorry about the dreaded drains but hope it will all be worth it and you'll get the results you want.  Guess you're an inspiration to all of us "fence sitters" trying to decide if we can muster up enough energy to go through a revision!

sweetie2040

Hi ladies-Wow I was off for two days and this thread is moving along! I had a great appt with my Dr today and we went over everything. He said he would not recommend surgery to me or do the surgery if he didn't think it was worth it and would improve my problems. He thinks he will get a better look and improvement of ripples with some stitching and a slightly larger implant. I told him how I was worried about pain and ruining what I had. He assured me things will get better and not worse in anyway. He did say there will be pain for a few weeks though as this is not as easy as the first exchange. I felt pretty good about everything after I left, but I still go back in forth in my mind. I think the choice would have to be like some of you to just put it off and not think about it, or to just go ahead and do like Orchidgal.

Orchidgal-I'm glad to hear you are happy you made a decision. I know your going to look great and be greatly improved. I agree with with your saying about the implants feeling more like a part of us. After six months these really started feeling much more normal and I didn't notice them. They seem to fit in well with my body. I just feel bummed I have to start all over. I wish he did the fat grafting but he doesn't.  We'll see how the revision goes, hopefully it will be good enough where I don't need it. By the way do you know why you needed drains? My Dr didn't say anything about using them on my revision. I would think he would tell me if I need them. Maybe I should ask.

soccermomofthree

Sweetie I am so glad your app went well.  It is great that your PS is so confident.  It is hard to think about all the healing again but great to know he can make the problems better!  At least you have choices  

Orchidgal so glad things with well with your revision!  You give us hope

ajones120961

Kate 33, Thanks for the info I'm going to call him.... Tell me I'm not crazy! I just would like to look some what normal and I hate this is will be the 3rd PS. 

sweetie2040

Soccermom-thanks for encouragement. Of course I couldn't sleep all last night thinking about it. I kept worrying about the pain mostly. I had an appt with with GYN and showed her the implants for the first time (she found the lump last year) She thought there were good but agreed I had lots of ripples. She thought it was up to me if I thought would be worth or not to do the revision because she said it depends on how you feel about it.  I showed her nurse and she thought the results were great. They both wanted the names of my BS and PS since they are in another city and said they would recommended them to patients. She says she gets about 5-6 breast cancer dx a year.

Anonymous

ajones- It would be nice to feel like you look good and not just good from someone who has had a MX.  That's my goal!

sweetie- It sounds like your doctor is pretty encouraging as far as worrying you'll mess things up further.  I guess that's what's holding me back.  Just curious- what kind of "stitching" would he do and where?