Revision Surgery and Questions

ml143333

Hi everyone!

I had a BMX with immediate reconstruction in August of 2014. My PS used alloderm and implanted gummies. I saw him in the fall of 2015 and he agreed with me that revisions need to be done. The alloderm in the unaffected side did not hold, the implant has fallen and migrated more under my arm that it should be. On the affected side, the breast did not fall enough. There is also a chasm between my breasts that you can fit your whole hand in. He said that we need to take everything out, put in larger because they weren't as large as what was originally there and fat graft.

My questions are:

1. Should I go with gummies and alloderm again?

2. If the alloderm failed once, is there something else?

3. Should I go with fat grafting as well or another type of surgery all together?

4. Will insurance cover this as it did the original surgery?

I just want all of this fixed as I hate looking at myself in the mirror. I can handle the scars, but having lopsided boobs along with my weight gain from chemo is just too much.

Thank you.

SpecialK

Your PS may not have used enough alloderm, or used it in enough locations - or the type may not have been ideal for you.  I had a similar issue with the type my original PS used not being strong enough to hold up the weight of my implant(s) due to abnormally thin pectoral muscles.  I had perforation of the allograft (like Swiss cheese) and so had the original material replaced with TIGR mesh - which is synthetic and worked better for me. As far as implant type, I can't offer any info about whether you should use an anatomical again, but my understanding is that they generally offer less projection, so possibly a round might offer more fullness if that is what you are seeking.  Pocket work could bring the implants closer together, fat grafting could offer more softness in the upper pole and extending down into the cleavage.  I would talk to several PS and see if you can get a consensus opinion on the best way forward.  I would advise a post to whippetmom on the implants 101 thread for some advise there.  Fat grafting may, or may not, work - it is not a sure thing as some degree of fat may be reabsorbed, but it was very good aesthetically for me, and I also had additional FG done to help fix a skin healing issue.  Insurance should cover a revision since you have reconstructive issues beyond the aesthetic.  Good luck!

ml143333

SpecialK - thank you so much!