Still Uncomfortable with Implants

PinkHeart

DocBabs,

I feel for you because I've had a TON of frustration with plastic surgeons who made BS remarks like "that's a very satisfactory outcome" when they don't want to fix another PS poorly performed reconstruction.

If you can trust your BS, can you ask your BS for a referral to someone more competent? 

Crescent5

Ronna, I don't want to speak too soon, and I have no explanation but since my revision (last week), my baubies feel soooo much better. It could be the fat grafting, or it could be that the pecs got stretched properly this time. I hope it works for you as well.

Anonymous

Ronna- I'm so glad you are finally getting your issues addressed but infuriated that it took this long for someone to take you seriously. Good for you for standing up and saying "I"M MAD AS HELL AND I'M NOT GOING TO TAKE IT ANYMORE!"  Think I'll call you Norma Jean from now on.  I hope the surgery can provide answers and a fix for all your pain.  Let us know how everything goes on Wednesday.  You're in my thoughts.

Tina337- I'm still around but have been dealing with some other stuff.  I was having some pain in my sternum so my GP sent me for testing.  X-ray was fine but bone scan and CT came back with some abnormalities so had to go to onco.  We just had a brand new Banner/MD Anderson Cancer Center open up about 20 minutes from my house so went there and was very impressed.  They ordered a pet scan to rule out mets so just did that this afternoon.  I get the results on Monday.  They said it's highly unlikely it's a recurrence since I just had DCIS but couldn't be certain based on the CT.  So it's been an emotional roller coaster the past several weeks to say the least.  Hopefully I'll be celebrating that it's all over in a few days.    How have you been?

DocBabs- Have you thought about fat grafting?  I just had one round of it with an implant swap for smaller ones and it really did help so much.  It especially helped with the divots and rippling.  I hope to have more rounds some day and get rid of these dang things all together.  I notice you're in NJ and there's a great fat grafting PS in the NY area- Dr. Christina Ahn (nycbreastreconstruction.com).  I know it's hard to think about putting ourselves through yet another surgery.  I think it's harder, though, to think about these stupid implants being inside my body for the rest of my life!

kriserts

Not sure if I've said this on this thread before ... I had fat grafting over a smaller implant (with Dr. Ahn) and it helped a LOT with the pain. There were 2-3 weeks where I thought the pain was back, but then it subsided again, and I'll say that I don't dwell on the pain and discomfort like I did before. I haven't touched my vicodin perscription, either. She was very aware of where I said I was in pain, and filled in extra fat there. The implant is still tight and uncomfortable and I plan on having it totally removed eventually. But it's about 60% better on the tighteness issue, and 95% better on the pain issue.

Anonymous

kriserts- That's about where I am, too, with one round of fat grafting.  I used to think that the fat was just good for aesthetics but it sounds like it also has therapuetic properties.  It's a win-win procedure for most of us!  I've heard such wonderful things about Dr. Ahn.  Just wish she were closer to me.  I'm having trouble finding anyone in AZ, who is a board certified PS, who does the total fat grafting.  The closest I've found so far is Los Angeles but just don't feel up to another out of state surgery at this point.  

tlew

Kriserts- Does Dr Ahn take insurance. I tried to schedule an appointment with her a few months ago when I was looking for a PS and was told by her receptionist that she does not take any insurance, but there's a chance she might if the patient has BC.I thought that was very confusing. She was completely booked and she had plans to take a really long vacation so I didn't end up using her.

Ginger48

Crescent- what did your revision involve? What is recovery like?

C-squared

Does anyone know of a good BS in the Denver area?  Someone with knowledge in (truncal) lymphedema (after mx & reconstruction) would be a big plus!!! 

Thanks for any referral(s) (for my sister).

 

Anonymous

Kate, that must be weighing heavily on your mind. I certainly hope all results are good and you are healthy. My goodness, as if implant pain and LE aren't enough to deal with. I am keeping my fingers crossed and doing everything to keep my LE at bay. For now, my body seems to be cooperating.

Anonymous

Thanks Tina! So far my LE seems to be doing ok too. One thing I noticed was when I massaged my implants to break up scar tissue my LE seemed to improve. I wonder if scar tissue and adhesions can interfere with lymphatic flow. Glad you're doing well.

Crescent5

Ginger, I had a few things going on. Had NSM in January and had decent results, but not great and always felt discomfort in pecs. For revision, 1 breast had some loose skin at the bottom and new PS was able to tighten that up by opening original incision and pulling up the skin. 2 PS here suggested new incision at IMF to deal with that, but I was concerned about losing any more sensation. I thought this was a great approach. I had lateral displacement on the other breast, and you could clearly see the pec clamped down tightly across the top. I thought that was gross. Dr Colwell repositioned that implant and put a few stitches in the pocket. I had fat grafting at the top of both breasts to conceal rippling and that gross line (which I suspect is gone now). I did not expect to feel all this relief. Of course, that may be from wearing the surgical bra 24/7 (but that made the pain worse earlier this year), or it could be the fact that I'm taking it easy physically. Dr seemed a little surprised that I had this benefit, but said sometimes that happens when things get moved around. My gut has told me all along that moving that implant and getting FG was exactly what I needed.

Kate, I didn't realize you were going through all this . {{{hugs}}} As far as massage goes, I am a strong proponent of massaging scars as well as implants. There are huge benefits. I noticed very early in the year that after massaging ALND  scar in the armpit for a few weeks, my arm was able to move back like a ballet dancer. I remember my PT saying at that point, I had better ROM than most people. There is no doubt that massaging the pit area made that possible. I'm always cautious to make sure to use strokes that move away from the arm, so perhaps that helps with drainage too. My PT had given me drainage massage techniques a while back. Has your PT given you that?

For those uncomfortable with implants, if you haven't tried massage (implant displacement exercises), please try. It may not get rid of the pain entirely, but it can help. Please check with your PS to make sure you can do the massage as some implants should not be displaced (ie: textured or anatomicals).

edit to add: I just realized Ginger asked what recovery was like. The breasts are totally fine and have been since day 2 post op. The donor sites for FG have been very sore though they are much better now. I don't think most people have the intense pain that Kate & I have had at the donor sites. The most annoying thing is being back to sleeping on my back. I just can't this time around, but I need to while the pockets heal. My boobies feel so good, I am soooo ready to flip over in bed and slip my arms under my pillow ..... mmmmmmmmm

Ginger48

Crescent-Thanks for the info. I had fat grafting at my exchange and the donor sites were pretty painful. I have a great cosmetic look but still have muscle tightness and am always aware of the implants. Also have some truncal LE. Not sure yet if I will pursue anything more. I really do not want another surgery to heal from. Did PS say anything about monitoring implants with scans?

Anonymous

Crescent- I did LE PT for 6 weeks when initially dx with it and she did show me all the drainage techniques.  It helps with the arms but I also have truncal which can be more challenging to drain.  (I've heard some have used a fluffy paint roller- lol!)  I have heard of a few people on here having their implants removed and their LE resolves.  Of course, no guarantees but one more reason to get these babies out some day.  Worst case if my LE gets worse I have been researching the lymph node transfer surgery- very interesting.  

Wish I knew the true complication rate of recon with implants.  I'm guessing it's much higher than anyone realizes or our surgeons acknowledge.  They should be sending out 6 month, 1 year, 18 month and 2 year questionaires for follow up.  That would be easy enough to do.  If anyone hears of any studies we can participate in would they post them here?  

PinkHeart

CSquared~

A BS surgeon does not treat lymphedema, and half of them don't even inform their patients about the risk of lymphedema as a result of their surgery.

She needs a physical therapist who is fully certified in lymphedema treatment.  Who diagnosed her with truncal lymphedema? 

I hope she finds help soon as those of us who suffer from chest wall/truncal and arm LE know her pain and suffering.

She could call around to local hospitals to their physical therapy departments and ask questions and even ask to talk to the PT to confirm their credentials. 

PinkHeart

Kate & Crescent~

What donor sites did the PS use for fat grafting?  Did you need to wear any type of compression garments on donor sites?

C-squared

Yes, pinkheart, she does have a LE therapist working with her.  I am just seeking a PS/BS that can be a little more sensitive to the situation and actually acknowledge LE as many of them won't.  As you said, "half of them don't even inform their patients about the risk of lymphedema as a result of their surgery."  As a former certified LE therapist myself, I am all too familiar with the surgeons (& other physicians) that don't acknowledge LE. 

Anonymous

PinkHeart- The majority of mine was taken from my stomach as that's the hardest fat for me to lose. I only weighed 115 at the time (my, how much has changed in the past 18 months- lol!) so he also had to take some from thighs and hips (love handles). I would think it would be a good thing to have a little taken from different areas so if weight is gained back it will still look proportionate.



Forgot to mention earlier but if anyone is doing implants + fat grafting I was told by my PS not to massage implants for 6-9 months. He said it can cause the fat to be reabsorped. Just one PS's opinion but he's done a ton of fat grafting.

PinkHeart

Kate~

More questions 

Did the PS take from the inside or outside of your thighs?  Thanks for the tip on taking it from multiple donor sites.  I'm really thin, too, so he's got to work hard to find it.

I'm 5'6".  During radiation last year I was down to 113 lbs with the dietician chasing me with sacks full of Ensure samples.  Got up to 118 for this past surgery.  Am trying to gain weight (I don't think it will help much for fat grafting but worth a try) and am now at 121.  My Stage II of SGAP, fat grafting, and lymph node transfer surgery is December 14.  My microsurgeon encourages high protein diet and multivitamin and excercise to prepare for surgeries.   

Did you wear a compression garment (or bike shorts) after surgery for the donor site areas?  I am flying home 3 days later -- ouch -- will bring a throw-away pillow they give at the hospital to sit on.  They might be tweaking my butt (donor site of SGAP), too . . .

PinkHeart

Csquared~

Your sis is so lucky to have you a sister for your support and knowledge of LE!

Too bad she doesn't live in Charleston.  There will be a BS assisting my PS and another PS during my lymph node transfer.  He obviously understands the LE issues from ALND quite well and involved in treatment options -- surgery or not. 

Crescent5

Ginger: None of the PSs I've met with have talked about scans, and I really didn't bother to ask more than one. I may or may not do them, and if I do, it won't be for a while. Interesting that I was told that the warranty would not be voided if I didn't do scans.

Kate: Thank you so much for the tip on massage with FG! That could have been a disaster. Will double check with PS next month to make sure I can massage scars.

PinkHeart: My PS used fat from hips, possibly sides of waist (my guess is based on the bruising) and lower butt. She told me beforehand that they don't like to use stomach fat the first time in case it's needed later (I assume in case the implants fail or something).

I was not told to wear compression. Another tip for your flight and drive home depending on your donor sites,  but have a sweatshirt or something to lay across your lap wear the lower seat belt squeezes. The point of entry for my donor sites were near the hip bones, and holy moses that hurt in a car!

Good luck!

kriserts

tlew, my insurance is covering it. When Dr. Ahn's office says she doesn't take insurance, I'm not quite sure what they mean. They told me that, too. I think it means they need to petition the company to pay for her. At first my company denied it, then they had me write a letter and jump through some hoops, and then they gave their permission. So, delve further with her office. She is back from her vacation now.

 The only thing I'll say is 1. I loved the liposuction on the first surgery and 2. now that I'm facing starting with the brava, I'm not sure how committed I am to this idea. It's a long process and I feel I have other things to do with my life. I'll give it a go for the weeks before the next surgery and see how it goes.

kriserts

Pinkheart, I wore a compression girdle after the lipo. It was required, I'm surprised Crescent5 wasn't told to wear it. I'm a big cyclist, and I kind of fought the idea that I'd be off the bike for 5 weeks, but I was, and then when I started again, I really felt the heaviness in my legs. I'd come home and put the girdle back on. It really makes you feel better, and it's not hard to wear, after you get used to it. Get two so you can swap them.

PinkHeart

kriserts~

I have "shaper" bike shorts.  They are about halfway to my knees.  Do you think they would be suitable? 

How long are the girdles -- to the knees?  What was the suggested time period for wearing the girdle?

Thanks again!

Anonymous

PinkHeart- My PS took the fat from the inside of the thighs.  As far as compression I, too, am surprised that Crescent wasn't told to wear it.  I thought even those that were getting liposuction were advised to wear compression.  From what I was told it is to ensure the areas that received the liposuction heal smoothly or you can end up with lumps and bumps.  Despite that, I would still recommend them.  Like kriserts said, you actually feel better with it on.  Just make sure whatever you buy covers up all the areas that get the lipo so if they do your thighs get the ones that go just above the knee.  If they do your stomach get the ones that go up to just below the breast.  I found one that went from just below breast all the way down to thigh.  It was made by Spanx and I bought it at Kohls.  Just make sure you get them nice and snug- probably a little tighter than say bike shorts.  I found the tighter they were the less the bruising hurt when you moved.  Also, different note but start walking as soon as you're able.  It will help with circulation and speed up the healing.  I also took Arnica which helped the bruises go away quicker.

kriserts

No, bike shorts aren't at all like the compression garment they give you after lipo. Two different animals completely. (I raced bikes for years, I spend half my like in bike shorts, so believe me, I know.) The compression is more like a real girdle, and it hooks up the side of each leg. It's not lycra, it's a heavy elastic fabric. Yes, to the knees, and high-waisted, as Kate says. My PS ordered it and we tried it on the day before surgery in her office to make sure it was the correct size, and then I brought it to surgery, woke up in it (she put it on in the OR) and wore it for six weeks. It's crotchless. Sounds terrible, but seriously, it wasn't. Sort of got to like it, I looked really slim. And it made me feel much better. If you do any research on standard lipo, everyone wears compression. It helps tighten the skin and protect against fluid pooling.

jessicav

Hi ladies-

Been off the boards for abit. My dad passed away. I'm back and am so grateful to be able to come here and read your posts.

I had my 500cc saline implants removed after 7 years because the pain became excrutiating. My chest is concalve and there is still pain from alot of scar tissue o nerves trapped? Feels like the scar fascia is cemented to my bones. Like an internal cast. It just feels like there is not enough skin to cover my bones. Or sometimes its like I have 2 jumper cables clamped on my chest at all times. Or another day its like I was bite by rotweillers all across my chest. Then, another day its as if my chest is literally on fire. And I never know which it will be on any given day. Not exagerating. I am never pain-free. And this is an improvement! 

Do you really think fat grafting can help with pain? I am 100lbs now (used to be 120) because very hard to sleep/eat in pain.  Mayofascial release helps abit. Can I even do fat grafting with this weight. Not sure if a PS can do FG on a de-constructed chest. What about what Suzanne Somers did?

Again, I have learned so much from you and it has been a great gift in my life to be able to come here. You can never really imagine this experience unless you have LIVED it. You are warriors..not survivors.  I hate pink. Imagine warriors going into battle in pink. 

Anonymous

jessica- I'm glad to see you post again but sorry that things haven't improved very much for you.  Also sorry to hear about your Dad passing.  Just too many kinds of pain to deal with all at once.  I know how long you've been struggling with this and the difficult decisions you've already made in trying to be pain free.  I would think as far as the fat grafting that a) you would need to put on some weight somehow and b) that you would almost surely need to do the BRAVA.  Probably your best bet would be to consult with a PS who does fat grafting both ways- with BRAVA and without.  But, yes, they can do FG on a deconstructed chest.  (((hugs)))

EileenKaye1

Jessica--Fatgrafting--has not totally eliminated-but has helped much with discomfort.  Presently using Brava--and will be totally removing my implant.  So far--pleased with my results.  Eileen

ronqt1

Hi everyone, been reading the posts from all gals suffering.  I am still in surgical garments, tomorrow I go to PS with my bra. I am not technical in language like most of you are, but either I am on too many meds but I feel pretty good. He did the fat grafting around the foob and in appearance it looks better.  I guess when the surgical garments come and and stitches are gone I can give more of an intelligent answer. When PS came to see me before I was released from hospital I asked him how much scar tissue did you take out. His answer was yes. Yes???? These guys are always on the run. Tomorrow morning I will need to go for kennolog(sic) shots in scar areas, (that was part of the deal). He also used steroid shots while cleaning my scar tissue out).  I am still having problems raising my right (foob) arm all the way but I will work with it. He did use fat from belly for fat grafting. I do like the way my foob and that area look now. He also lifted my other side and corrected the nipples on both sides.

All I can say is I had had enough. If any of you need more work, be adament, tough, nor more games. Make them listen. This is not easy ride we are on. My own little system of refusing to go into the examining room seemed to have worked. If this should hapen again, I will do the same thing.

Surg was last Wed and I am still restricted from driving, exercising and of course lifting. Yet, I can walk without a problem.

Love to all, again sorry for not using technical language.

 Love to all,

June-Rose

Hi,  I had a double mastectomy for triple negative Stage 3 breast cancer in February.  The expanders have given trouble ever since and I even had to go into hospital for a week for IV antibiotics in July when I developed cellulitis.  All better now, but the bottom edge of the expanders digs in badly, and I can't wait to exchange them for the implants.  I'm supposed to be having 375 ml implants, but am scared they will be too heavy, so have asked if they will order the smaller one 335 mls and I can decide on the day of operation.  The date is 23rd October, and I'm getting a bit nervous, but am looking forward to it all being over and done with.  Fingers crossed I don't have continuing pain!