explant of textured implant & to switch to smooth or go flat

Pete1

I had a masectomy and textured implant of one breast in 2005 (DCIS) and the other in 2006 ( LCIS) Was never happy with them , as the second one appeared much smaller & chest caved in. Found out recently that this was because of scoliosis. I got used to them and have not had any issues (capsular contractor) so felt lucky. Recently I have learned about BR-ALCL which concerned me since a friend told me she had this and her implants were done at MSK where I also had mine. Had an ultrasound and no issues at all. Went to 2 ps for opinion and they both discussed saline smooth implants instead of textured. I had it in my head to just explant so I wouldn't have to worry about health issues ( even went on flat & fabulous website). I was resigned to doing this but recently had second thoughts and not sure I will be able to handle it. I am in my 60's so also concerned about extra surgeries and chances of problems. I would love some feedback and honest opinions from those that understand but do realize in the end, it is entirely up to me. Going to the ps I decided to use in 2 weeks and need to make a decision. HELP !!!!

Moderators

Dear Pete1, we're sorry you have to be here for this reason, but welcome!

Treatment decisions are very personal and sometimes can be tought, but this is a Community where many have faced similar situations and can share their own opinions and experiences. Sometimes it's slow during the weekend but we hope you'll get responses soon. In the meantime you may wat to take a look at other threads such as:

BREAST IMPLANT SIZING 101
Going Flat: Choosing No Reconstruction
Podcast: Choosing to Live Breast Free

Best wishes to you. Please keep us posted on what you finally decide.

The Mods

hapa

Pete - My PS told me that an implant exchange is like a haircut as compared to the original BMX and reconstruction surgery I had. You would be under anesthetic but the surgery probably won't be very long - maybe an hour. Ask your plastic surgeon what the exchange really entails for your case. If I had textured implants and was happy with how they looked I wouldn't worry too much about ALCL because it's really rare and when it happens it is usually treatable, but that's just me. I'd be too worried that I'd hate the new implants and it wouldn't be worth it.

wallycat

No implant is without issues. Also, most implants will require replacement. You mentioned 60, so not sure how well made they are these days...at worst, a revised set in your late 70s.

As others have posted, you are the only one that can know what you're feeling and what you need to feel good (visually). Having said that, I went flat and don't regret a day of it.

Pete1

Made a decision to explant but with fat transfer. Going in Sept. to to fat transfer over my implants first, since my skin is very thin. In December , will remove my implants and am requesting that my capsule is removed as well. Then will have some more fat transfer. Not looking to have breasts but don't want to be concave so this seems to be the best option.

Pete1

Going a little crazy.

Decided to go with removing implants and doing fat grafting. Now read the cons for this from the breast cancer.org site and got a little nervous. The one saying doctors are worried about dormant cancer cell and this can possibly activate cancer was the most concerning. I am in my 60's and can say forget the fat grafting and just explant and use prosthesis but I really don't feel comfortable being concave and do feel comfortable with my plastic surgeon. Some people may say at my age, just go flat and no grafting, but I don't feel like I want to do this. HELP

Is there anyone going through the same thing? Would love some feedback. I know it's my decision ultimately, and I have to be comfortable with my decision, but would love feedback with women that understand. Thanks

Scrafgal

Is there a reason that you are not considering replacing the textured implants with smooth implants? Fat grafting on top would give you a better cosmetic outcome but it is not necessary, if you are worried about activating cancer cells. As you can see from my profile, I had a lot of targeted fat grafting.

I had a smooth implant on my mastectomy side. On my natural side I had a small textured implant for contouring but recently had that exchanged for a smooth, due to the lymphoma risk.

Pete1

Hi,

Decided not to put implants back and don't care if I am very small, just didn't want to be concave. I see all the fat grafting you have done. I'm sure it will be fine, but all this reading can make you nuts with concern. Have to just make the decision and go with it . My ps seems to be very knowledgeable on this procedure & that is a good thing. Where did you do your fat grafting?

Scrafgal

I had it done at MD Anderson. So far, studies don't seem to have confirmed any link between fat grafting and cancer recurrence but you never know. You are correct. You just have to decide what is right for you and go with it. I'm glad that it seems that you are at peace with your decision. Best to you!

Pete1

lol, I am no at peace with my decision and keep changing my feelings about it. May have to have another appt with ps to discuss my concerns before I am settled with a decision. It seems so hard and still contemplating just getting an explant and being flat but unsure of how I will feel about it.

monkeymom

Pete1, I'm in a similar situation. I have textured implants I want removed. I don't want to be flat or concave. Just small breasts made from fat grafting. I'm in the process of consultations now with different plastic surgeons around the country. I too am worried about the link to cancer by stimulating dormant cells but have yet to see any convincing evidence that it happens. All the studies I've seen have found no connection....but I know this website does list is as a "Con" on their fat grafting page. What is your PS telling you about options?

Moderators

Here is our Research News article on Textured Breast Implants:

Allergan Issues Worldwide Recall of Biocell Textured Breast Implants and Tissue Expanders

bluemorpho48

hi

Where is everyone doing their fat transfer? I’m in Ontario, Canada.

hopedreams

HI JUST WONDERING HOW ALL OF U GALS FOUND OUT ABOUT THE TEXTURED IMPLANTS SO EARLY..?? I JUST READ ABOUT IT ON THE INTERNET LAST WEEK & ALSO ON THE TV NEWS.. NOW I AM HEARING MOST PEOPLE KNEW ABOUT IT FOR A LONG TIME.. WELL I CALLED MY PLASTIC SURGEON & INQUIRED..I HAVE THE SMOOTH IMPLANT.. WHEWWW..NOW I CAN BREATH EASIER.. ~HOPE.. GOOD LUCK WITH YOUR DECISIONS..

bluemorpho48

hi are you in Canada?

mybee333

Pete1 - Am wondering what you’ve decided. I’ve got capsular contracture and am looking to explant but don’t want to be concave either. I’ve got a couple of consultations coming up but the whole process is scary to me. Really do not want to go through more surgery but of course need to...fat grafting is no cake walk. I did it before.. In my 60s too.

stillrusty

Pete1, I’m in the same boat as you. Turning 61 in a few days. I’m trying to decide what to do also. I have smooth silicone implants from 2008. The mastectomy side is still itchy after 11 years! I don’t want implants anymore. I thought about diep flap. They would do mastectomy side and then 3 months later do revision on the native breast. So maybe swap that one out for saline. None of the options are very appealing

mybee333

It is a difficult decision but for myself I’ve decided to explant and be flat on the MX side. I’m planning to privately embrace being a survivor, wearing a MX bra and breast form when in public. I had 7 surgeries in 2 years before for lumpectomies, then MX and reconstruction and am not up to the several more that would be needed with additional procedures. I just want to be healthy and comfortable. I also don’t want to put my adult children through caring for me again and again. It’s hard on them to see me suffer. Waiting for surgery to be scheduled before the 1st of the year.