Anyone here who used to have breast implants (purely cosmetic)?

Ammie

I’ve had implants for the past 15 years, and wondering now how that will impact my upcoming mastectomy and reconstruction.

Has anyone had any experience in this? If you used to have implants, what kind of reconstruction route did you get? Did you get implants again, or did you go with flap reconstruction?

If you went the implant route, did you have to get tissue expanders? Or was your PS able to re-use the existing pockets from your old implants?

Hoping to hear some stories so I may know what to expect... thanks

3boysmom39

Hi Ammie!

I had breast augmentation 3 years prior to breast cancer diagnosis. My breast surgeon left my implants in and performed bilateral mastectomy, so had “breast mounds”(as she put it) after mastectomy surgery. Had radiation on left/cancer side and the following year had my saline implants swapped out for new silicone implants. So, no tissue expanders needed, left implants in place. Unfortunately now have pain, contracture and ruptured implant (on cancer side) and am looking into flap reconstruction or possibly going flat... neither an exciting option in my opinion! Good luck with whatever you decide!

Karen

Ammie

Hi Karen,

Thank you so much for sharing your story. I am so sorry to hear that you're having some trouble with your reconstruction, especially with the side that had been radiated. I have heard that radiation does seem to have a negative impact on “unders". It sounds like your surgeon re-used your existing submuscular pockets?

My surgeon told me he wants to switch me to prepectoral implant placement after my mastectomy, despite me having already had my muscles stretched and ready for submuscular placement. It seems that this is a recent trend because many patients have similar issues that you mention - with pain or distortion.

He mentioned that this new technique also works well for patients who've undergone radiation. Have you considered trying this route?

- Ammie

OnlyGirlof5

Hi Ammie,

I had silicone implants 12 years before my mastectomy last February. I had my left breast and implant removed. Leaving the implant in was never discussed, as the capsule was also sent to pathology. I had a tissue expander placed at the time of my mastectomy. I did not want surgery on the right side, as long as my implant was intact. So I had another mammogram and ultrasound to check for any sign of rupture. There was no reason to undergo surgery on my right side. I just had my reconstruction on Tuesday of this week, where the tissue expander was swapped out for a silicone implant. From what I can tell, it looks like my plastic surgeon did a hell of an amazing job matching size and shape even with my age 51 natural sag.

Ammie

Hi OnlyGirlOf5,

Thank you so much for sharing your experience!! That is so encouraging to hear how well your single side reconstruction turned out... this is what I’m really hoping for as well.

I’ve had 2 surgeons giving me very conflicting recommendations — one wants to remove my existing implant and capsule on my cancerous side, and switch me to over-the-muscle; another wants to keep the existing capsule and re-use it for a new under-the-muscle implant.

Did your surgeon put your new implant under or over your pec muscle? Your surgeon wanted you keep a tissue expander in place for almost a year? Thank you for your help!!!

OnlyGirlof5

Hi Ammie,

The previous implant was under, so was this one.

No, he had no plans to wait almost a year. COVID shut down ALL "not life saving" surgeries in Michigan from mid March late May. So all of the cancelled surgeries had to be rescheduled, followed by those that had not yet been scheduled. They had hoped for mid summer, but the first date they could finally get me in was end of October.

Then, again because of COVID, I was not being seen in-person by the surgeon. I insisted on being seen in late September to "regroup." It was then they surgeon dealt the bad news that my expansion wasn't enough to match the other side. I would either have to lose volume by him swapping out the implant on the right side and a lift, be lopsided, or restart fills and delay surgery. I went home and cried for 2 days. Then I got mad. Then I ordered a Peloton LOL.

Having to restart fills after my skin and muscle had rested for 4 months was brutal. I detested that expander. It was hard as a rock and everywhere. Up near my collarbone and over into my side and armpit.My Peloton was also delayed 3 times, so I still haven't used it. My surgery was Tuesday and it finally arrived on Wednesday. I am looking forward to getting back on track. I have gained at least 10 pounds.

Borgel

i had implants after dbl mastectomy (bout 20 yrs ago) NEED to remove the implants and am trying to find a certified dr. in NJ area.

can anyone help with suggestions?

Ammie

Hi OnlyGirlOf5,

I’m sorry I’d missed your message till now!

Ugh, I’m sorry that your exchange surgery was drawn out till a year. If it’s any consolation, the stories I’ve heard in which the surgeons took the longer, conservative staged approach, like yours, have been the ones with the highest satisfaction and positive outcomes. Now you finally are done with surgery (I hope!) and now you have your Peloton so you can get back into great shape well in time for summer!

I finally decided on a PS, and she will be doing under the muscle, like my previous placement. Do you notice any unusual animation or anomalies with your reconstruction, that was not there with the previous implant?? Thank you so much!!

OnlyGirlof5

Hi Ammie,

There is still swelling, so I feel like the foob i farther into my armpit area than I'd like. I did not have the right side done, nor go with the mini lift he wanted to do. I am over scars and pain. Plus the natural sag is minimal. I am 51, so I wouldn't expect to have perky boobs at this age, even with the former implants.

The foob feels just like the other side. The shape is excellent from a head on view. Except for a nipple missing, it is shaped just like the right side. I did lose some projection. My surgeon told me that is normal. It's weird, but it has a slightly flat appearance when I look down or turn to the side. In a bra, you can't tell, but there is a slight area in the bra that doesn't fill. My surgeon assured me that it is normal. He wants to reassess at week 6 to consider some fat grafting.

Ammie

Hi OnlyGirlOf5,

I think as your swelling goes down, and you’re able to use that side more, you’ll have a better idea of the final outcome. I’m planning to have a very similar surgery to yours (I would only be getting the single mastectomy, followed by TE, and then silicone implant under the muscle... the other breast will be left alone with its current implant still in place.)

My PS said to expect the use of fat grafting to help with the appearance when all is said and done. She did mention that if I develop any bothersome animation deformity, that there are non-surgical ways to help alleviate that (such as Botox and nerve adjustments that will control the muscle deformities without impeding normal muscle use).

I’m really glad to hear that looks-wise and feel-wise, your experience is nearly identical to the regular breast augmentation.

P.s. our ages are not far off either, I’m 48. :-)

Hoping for a continued smooth recovery for you!!

JulieUnder50

Hi Ammie,

Your situation sounds similar to mine -implants and DCIS, Stage 0, Grade 2, left side, 1cm, 48 yo, awaiting surgery in few days. I was going for lumpectomy + radiation and so fearful of contracture. My PS said no fat grafting from ab unless DMX and he doesn't do it for UMX. He will do reconstruction and lifting on cancer side and in addition, reduce breast side on right, nonaffected side to match predicted left side breast reduction from radiation. I didn't like idea of surgery on nonaffected side. After reading yours and OnlyGirlOf5, I will talk to my PS about tissue expander. What is TE that you mentioned? Did you get your surgery yet?

Thank you and well wishes!

Ammie

Hi @JulieUnder50,

I'm sorry to hear that you're going through this as well. I think if your DCIS is confined to a small area of your breast, and especially if you have enough natural breast tissue as a buffer against risk to your implant, you may indeed be a good candidate for lumpectomy. My radiation oncologist mentioned that in cases where the patient has already had breast implants for several years, there is also less negative impact to the existing capsule, and therefore less to worry about capsular contracture than for newly implanted (or future-implanted) patients. But if you go with lumpectomy / radiation and don't want surgery on your healthy breast, I think you would likely need some fat grafting to smooth out and fill in any uneven or lumpy areas after that on the cancer side.

If your DCIS covers a very large area of your breast and you also have barely any natural tissue left, therefore increasing risk of damage to the implant during surgery, then your surgeon may recommend the mastectomy route instead. That's what happened in my case, I'm not a good candidate for lumpectomy because of the size of my DCIS.

I haven't had mastectomy yet... I'm first having a nipple-devascularization + lumpectomy + sentinel node biopsy next Friday to determine whether my nipple can be saved. Then mastectomy (hopefully nipple-sparing) plus TE (tissue expander) placement will be happening 3 weeks after that.

I think in your case, whether you do lumpectomy or single mastectomy, if your PS is not willing to do fat grafting, you should get a second opinion with 1 or 2 more PS's. It's worth the time and research to find a PS who is willing to work with what you want, since you'll be the one living with the results!