Visible ripples in implants

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited November 2010

    deekaay- Sounds like your PS and mine are students of the same school of thought.  They both said the same things.  I think I'm finally coming to terms with my new reality, too.  At first I felt way too big but now I'm feeling o.k. with the size.  Definitely wouldn't want to go any bigger, though.  So fat grafting is probably my only option.  My PS also told me insurance wouldn't pay for it as it was purely cosmetic.  Yet, they paid $10,000 for each sheet of Alloderm that was used for purely cosmetic reasons.  Makes no sense.

    The cami's are a good idea.  I think I'll try that!  :)

    sweetie- I've adopted the shoulder back pose, too- kind of like a soldier at attention.  If nothing else, the rippling is improving my posture.

    sunnyhou- I don't believe you should just accept things as they are if you are unhappy.  This is something you'll have to live with for a long time, and it sounds like you are pretty young, so even though it's a hassle I would do whatever it takes for you to feel good about yourself.  Is there anyone who can come in and help you while your DH is at work like family or friends?  Just remember that your family hasn't had to put up with enough the past year from you!  They've had to put up with enough from the cancer!  Big difference.  I think it's hard for any mom to sometimes put our needs ahead of our family but if you end up happier than it will be worth it for everyone.  Good luck with your surgery if you decide to go ahead.

    vanderlady- I never though about the NS connection but it makes a lot of sense.  I think my BS was very experienced in NSM, but I realized after the fact that my PS was not.  Like you, I'm having a lot of pain but not sure what is causing it.  They just ache all the time which my PS said is not normal.  (Really?  You think?)  Her only suggestion was to increase my fibromyalgia meds.  Gee, that helps a lot....  BTW, just curious, did your insurance cover the fat grafting?

  • vanderlady
    vanderlady Member Posts: 154
    edited August 2013

    Kate -- Yes, I believe the insurance covered the fat grafting... I didn't hear otherwise from my hubby.  I found a lot of relief in the pain by using the underwire bras.... thanks to y'all.  Do you get any relief with the different bras?  How about with 2 tabs of Aleve?  My pain goes away with the Aleve, as well as massage, and heat.... I use the muscle Head-On directly to the area.  I reeled in the hose the other day, you know, the type on a handle in a box.... I was hurting for 2 days afterwards.  Again, never had this trouble with the TE because I think it balanced the muscle properly.  Even washing dishes is bothersome because of the motion.  Opening doors too.  At 5 months out, this is frustrating.  What type of pain do you have?  Have you tried Iodine for your fibro? I think MBJ takes it too and we have a thread on here about that. I can't live without it.   

    Another thought about NSM and rippling.  They have to leave some tissue under the nipple and I wonder if that may be the cause of some of the rippling.  Was thinking about that after my posts last night.  If that is the case, not really much we can do about that.  I'm trying to stay positive about the revision, but I'm not going to get excited....realize some things may not be fixable but I hope I just don't do any damage.  That's the worrisome part.  Pam

  • vanderlady
    vanderlady Member Posts: 154
    edited November 2010

    Any others out there with rippling who have an Allograft sling at the bottom?  Wondering if this makes the pec muscle lax if it is not supported by a large enough implant.

    Kate I saw your post on EC and Whippetmom's response.  I think there are multiple factors and each case is individual.  NSM has not been around that long. 

  • sweetie2040
    sweetie2040 Member Posts: 817
    edited November 2010

    Sunnyhou-I'm sorry your going through a rough emotional time right now about your surgery. It is so hard when everyone depends on us and then we need to do something for ourselves. I can't tell you what to do but the fact that you had the surgery scheduled means you weren't happy with something. If you cancel it, it is likely you will still be unhappy. There are so many ups and down with this stuff, but we need to take time to focus on our self and our health and getting well emotionally,physically and mentally. If that means doing one more surgery, then don't feel bad about it. Put yourself first and everyone will be happier because when mama is happy everyone is happy. Wish you the best, keep us posted.

    Vanderlady-thanks for sharing your story. It helps to know I'm not alone. Interesting that your Dr over stretched you and used a larger TE than the actual implant. My Dr did not overstretch me at all. He stopped at 400 and used a 450 implant with a slighter larger dimension than the TE. Still rippling though. I saw your pics and I understand what your saying about the natural look. I think you look really good but I also understand you wanting more upper pole fullness. I feel the same way. When I look down I see the rippling and and more of a slope. I would be ok with that look if I didn't have to deal with the rippling.  Regarding what you asked about NSM. I think it does make a difference in the implant choice to an extent. He told me he has to make sure the implants leaves the nipple in reasonable position. So that would mean not going too big or small. I will say this, I have a friend who had a reg BMX and her Dr does a procedure where he tucks the extra skin and sutures the ribs to the fold of her breast. He also said he uses the extra skin for nipples. He also told her she could expect some rippling. Your wt and ht is so close to mine. I'm only about a inch taller around the same weight. I think Whippetmom is right about filling the pocket. It would seem to make sense that the implant needs to fit that width created by the TE. My TE was only 12.5 so I don't know what the biggest implant he could get in on a revision.  I wonder about the pain you have though. What did your Dr say about that?

    I saw my Dr today to ask about my rippling. He knew right away what I was going to ask and agreed it was more than normal and more than expected. He said the pocket was tight at the time of surgery. He does not do fat grafting for ripples and only uses it for indentations and is not really keen on it. He said they may do more of it in the future but wasn't recommending it for me. He said for me to wait about 2 more months and if I wanted to he could put in a larger implant. He doesn't think the rippling will get any better or worse for that matter. I told him I really liked the shape and size and don't really wanted to go too much larger. He said it will be a little fuller but should take care a good portion of the rippling, hopefully. So for now I'm going to live with it for a while and see how I feel. I am not really happy about going back into surgery and worried about coming out too big because now I'm getting used to and liking the size I am now.

  • hopefulhealing
    hopefulhealing Member Posts: 722
    edited November 2010

    How do I get to the picture forum.  I was suppose to have nipple sparing but lost the projection due to necrosis so have the areolas.  I have one side that has more rippling. I hate the idea of having to stay covered up. But I haven't felt comfortable about any of it since the implant exchange. I feel so sad about this change in my life as I am sure you all do!  This is the part people don't understand. They think when you say reconstruction that you are going to have great bigger breasts or the same. I get so down about this...... and angry.......

    I have 400cc and 450cc. I am going to ask for bigger. What really ticks me off is I had a tummy tuck during the implant. He knows I am think and had bad rippling with the TE why didn't he use some of that during the implant exchange!

  • vanderlady
    vanderlady Member Posts: 154
    edited November 2010

    Sweetie - Do you have your OP report from the BS portion of the MX?  IF not, get it.... find out what size the defect / pocket created it,  My doc dictated it -- it was the same size as the TE that was put in by the PS.... 14 cm.  It sounds like you had a good visit with your PS... seems understanding.  All 4 PS I saw in 2nd consult said to wait 6 months.  Oh, my 475 is 12.5 cm wide not sure what the 450 is.  All that info is on-line from the manufacturer... just google... my are Allergan Natrelle.   You had rippling with your TE?  In the same spots?  Oh about my pain, I liked their response..... if there is a visible pucker or something they can see, then they know what to fix.... with mine there is nothing visible.  He wanted to do an MRI but I told him the pain is not where the CA was, I believe it is muscle related because it is brought on by use and goes away with Aleve, massage, and heat, and is worse with ice. 

    Determined -- I was pretty down about 4 weeks postop.... very, very down.  My family doctor who is into supplements told me to try 5HTP which did wonders.  Never really had anything like that before and was fine all along through the MX phases with infection too, but the exchange was rough emotionally.  I wonder too if part of it is the chemicals from the implants getting absorbed into the body. I'm super sensitive to smells and plastics. I wonder if that will happen again with my revision. I did a lot of epsom salts baths once I was allowed to.  I'd sit and cry in the tub. 

  • deekaay
    deekaay Member Posts: 328
    edited November 2010

    Couple of comments...

    I was expanded to 800ccs and got 650cc implants.  Still ripples.

    I did not have NSM, but have ripples.

    I really want to find out if insurance really covers fat grafting.  I had presumed yes, but then when I went to PS last week he said he just "throws in" the fat grafting when he's doing another procedure like nips/areola grafting.  He doesn't get paid for the fat grafting since it's considered a cosmetic procedure.  I was bummed to find this out since I think I need another round of fat grafts, but I don't have another surgery to tie it to.

    Anyone else know for sure that their insurance paid for fat grafts?

  • sweetie2040
    sweetie2040 Member Posts: 817
    edited November 2010

    Vanderlady- I didn't think of getting the op note. Good idea. I do think the pockets are pretty close the implant size. They actually feel tight if I pull my shoulders back. They don't move around or anything or appear lose. It just seems like extra space at the top where all the ripples are. I did start to see rippling with my TE and basically the same spots. I remember thinking the implants should fill up that void and take care of it, wrong!  I have some muscle pain and soreness to. I think it's pretty common from what I hear from other women.

    Deekay-I guess size doesn't matter with ripples. I hear fat grafting is covered but I haven't had it so don't know for sure. Maybe it is the way your Dr. bills it.

  • hopefulhealing
    hopefulhealing Member Posts: 722
    edited November 2010

    vanderlady thanks for the encouragement. I have never had depression and have snapped back from some difficult things in my life but this has thrown me for loop. I am hoping when I start walking again it will help.  I just hate feeling so sad and unlike my old self. 

     I wonder if there are any docs in the Chicago area doing fat grafting?

  • sweetie2040
    sweetie2040 Member Posts: 817
    edited November 2010

    Determined-I must have missed your last post. I felt very much the same as you after the exchange. It is a hard time trying to adjust to all this and then not being happy with your results.  I had a NSM but I lost one of nipples and you know I have the rippling too. I relate to everything you said. I have ups and downs too. Days when I get so frustrated with everything and then days when I'm thinking I might be starting to feel like me again. The winter is the worst though because it's so cold and dark and all I want to do is sleep! I think walking is great. I walk an hour a day, every day. I have been doing  it for six years straight. I did it pretty much through all my treatment and surgery. There are times I don't feel like doing it but I make myself and I do think it helps. Give yourself time, the old you is still in there and she'll back full strengh!

  • hopefulhealing
    hopefulhealing Member Posts: 722
    edited November 2010

    sweetie 2040 thanks, I also was suppose to be NSM but lost both I do have the areolas though. You are right I need to get out and walk again. Before my surgery I was walking about 2 miles evrery day.  Can't you just wait for the time when this disease does not consume you!  Thank you so much for your kind words. It is nice to know that I have this place to come to. Where you can talk to women who really get it.

  • Anonymous
    Anonymous Member Posts: 1,376
    edited November 2010

    Determined- The feelings you are describing are very normal.  For me the feelings of sadness post exchange was the biggest surprise throughout this whole thing.  I felt like I sailed through the MX and the whole TE process.  But a few weeks after exchange I got very down.  I think that's the time we can finally take a breath and deal with the emotional stuff finally.  It's tough accepting this new reality of ourselves but it does get better.  I had my exchange the end of June and I can actually have entire days where I don't think about it at all.  (Except when I'm naked and see these damn ripples, of course!)  Anyway, just wanted to tell you there will come a time when you'll feel like your old self again- or at least the new version of your old self and you'll like her just as much if not more.

  • hopefulhealing
    hopefulhealing Member Posts: 722
    edited November 2010

    You women are fabulous!!!  I think with all the complications for so long that I concentrated on all of that and grieving for the loss of how it was suppose to go if that makes sense and just getting through worring about the infections and dehiscence of the wound.

    I feel a lot of pressure at times. I am in the sixth week post op exchange so I am hoping that it is still healing inside and that will lessen as well.

    Thank you Thank you Thank you!

  • sweetie2040
    sweetie2040 Member Posts: 817
    edited November 2010

    Determined-awww, your sweet for saying that. I know complications are hard. I had some too with my TE and had to have another surgery to replace it.  I relate very much to what your saying about "grieving for the loss of how it was supposed to go" I think we all have such high expectations through all of this and really we don't know how things are going to turn out. When they don't turn out like we hoped we have to deal with the let down again and finally the acceptance. The main thing is getting healthy again and I think it's a process. We have to deal with our emotional and physical well being too. We don't know how are emotions are affecting us sometimes and other times we worry about our physical well being. I'm also about six weeks out too and think it is still early. Healing from surgery takes a long time. Every day we are one day closer. Hang in there, your doing great and we are all in this together!

  • Anonymous
    Anonymous Member Posts: 1,376
    edited November 2010

    OK, Ladies, this probably isn't the right thread for this but I'm going to have a little rant now.  We all know women who could have had NSM but didn't so now are not happy with their recon because they lost their nips.  Then there's women (like me) who didn't know that they could make breasts with fat transfers rather than implants.  And now I find out that some BS's are doing something called sensory nerve preservation during MX which allows you to retain feeling in your breast.  WTH?  Why can't there be one place where ALL our options are listed like a menu in a Chinese restaurant (yes, I'll have the NSM with a side of sensory nerve preservation)?  Makes me ticked that they just cut right through that sweet little sensory nerve (jettisoning yet another erogenous zone) when there is a way to avoid it!  Why isn't every surgeon being taught this if it exists?  Or ways to prevent rippling?  They should at least make it easy to find the surgeon who does the procedure you want.  Though we shouldn't have to choose!  (If you go to this surgeon they can save your nipples but that's about it.  If you go to this one they can save your nerve but they don't know how to do fat grafting.  Etc, etc, etc.)  The whole thing makes me crazy.

    ......ok, I'm done with my rant now..... 

  • Claire82
    Claire82 Member Posts: 684
    edited November 2010

    I agree. I even asked for a NSM and was told it wasn't done there. But I found out from this website that one of my PS's partners does them... grr

  • sweetie2040
    sweetie2040 Member Posts: 817
    edited August 2013

    Hey Kate- rant on cuz you are sooooo right! That really ticks me off too. I have who is considered top Docs in my area and I was only offered lumpectomy w/rads or MX. In a twist of events after hearing about NSM on here I called the cancer center of the hospital and asked if any Dr's in the area did NSM. Of course, it was one of the Dr's in the same practice I was already going to! Thanks, for telling me! Luckily with persistence on my part I was able to get the NSM by having to  push my way in to see the Dr who did them. Now your telling me I could have saved my sensation too, or reconstructed my breasts with my own fat?!! Sounds like we have to be medical research analysts to even find out what is "available" to us out there. It is frustrating and in retrospect it would have been nice to have "EVERY" option available to choose from. I can only hope in the future that women will be told about these options without having to learn it after the fact.

  • PB22
    PB22 Member Posts: 315
    edited November 2010
    Thats been my rant since my surgery as well.  Wasn't aware of the sensory nerve sparing procedure. Going to have to inquire about that.  There is a web site call breast reconstruction.org which is informative on the options.  I have been thinking about this for awhile and would like to see a law instituted like in NYS.  This past Aug, the breast reconstruction options law was signed by the outgoing Gov. Paterson.  It goes something like any woman having a lumpectomy, mast.,lymph node removal must sign off that she received in writing all her options and she must have the right to go to another facility that offers the options and must be told of these optionss despite insurance.  This is to assist those woman who are either underpriviledged who say went to a community hospital that doesn't offer much in terms of reconstruction  or saw a general surgeon who only offered mast. and not reconstruction.  Most of us get our information on internet but there are those who don't have access to internet.  I was thinking of visiting my district congress woman to get the same thing into law here in Fl.  I was involved in three local tv station news interviews which included my PS and breast surgeon.  All gave an hour of their time being interviewed and one station even went into the OR during a mast.  I gave my story.  When it aired it was so fluffy, no mention of NSM but referred to it as "cutting edge procedure" and didn't say what the beauty of the procedure was,  no other valuable information.  They pulled a line here and there. What they pulled from my breast surgeon was him saying "my job is to remove the cancer". It was stupid. I was so mad.  The other interview made it sound like an augmentation. I was disappointed for weeks because I thought I was getting the word out.
  • sweetie2040
    sweetie2040 Member Posts: 817
    edited November 2010

    PB22-I think it's great that you want to be an advocate for other women as well. I know it can be frustrating. It always is when your passionate about something and you don't  see change or get the support to really get the correct information out there. In my state our Governor put into affect that it is required that when you get a mammogram that they must tell you if you have clinicly dense breasts. By telling you this it gives you the option to pursue an ultrasound along with your mamo. I know this is so important because I had dense breasts and my mamo's didn't show anything. If I hadn't got the ultrasound (which my Dr already ordered because we found a lump)  and went just by the mamo I would have walked away thinking I was fine. So you see we need a little help to know what we need and what is available to us. We have to push for this and get the word out. Like you said not everyone has access to the internet or can spend the time researching. It would be wonderful to go the Dr and see there in writing every option there is in your case so there is no mistake about what you can choose from.

  • Annabella58
    Annabella58 Member Posts: 2,466
    edited November 2010

    Hi gals:

    Maybe I'm wrong in this, but I just kept on using my arm...I am left handed and somewhat ambidextrous, but after the lat flap, I just began to use as normal.

    I saw my BS the other day and asked him why I had no loss of strength in that arm on that side (left)

    He tells me that all of my other muscles have learned to compensate for the loss of the lattisimus muscle.  So I guess it worked out, anyway.

    But no pec exercises or push ups...he says that is what causes the "iron bra" .  And yup, my boob flexes too.  DH says "hey, new party trick!"...hm, I think I won't be showing anyone but him that trick!

    I would not go thru the recovery again either....when I get the prophy late next summer, I will just get the old regular mastectomy, except the core technique one that spares the nipple if I can.

    xox

  • deekaay
    deekaay Member Posts: 328
    edited November 2010

    Rant on, Kate.  Geez, we have to dig and sort out so much info, it is hugely annoying that it has to  be so difficult while we are dealing with bc, surgeries, tx, etc.  Thank goodness we have each other to learn from.

    Nerve sparing?  Are you kidding? I haven't heard ANYTHING about that, not a whiff .  

     I have read the thread on the experimental work with using a women's own fat to creat the breast.  The so. FL MD is pioneering that, but is it viable and approved at this point?  Still, if it is in the foreseeable future, I think the docs shoudl have to inform us it that it may be a choice soon. Maybe we'd opt to wait. If options are still heavily in the reseach phase, I can give them a pass for not providing every piece of info that could be.

    The medical field is way to much about their work, their procedures, their specialities, their outcomes.  It should be about us.

  • deekaay
    deekaay Member Posts: 328
    edited November 2010

    P.S. I'll take a Szechuan nip, General Tzao areolae, and 1,000 cc's of egg drop gel! 

  • Anonymous
    Anonymous Member Posts: 1,376
    edited November 2010

    PB22- I can feel your frustration, girl!  I remember when you were going through that interview trying your hardest to direct it in the right way.  I'm sorry it fell on deaf ears.  What a disservice those tv stations did to women in your area.  I guess we just have to keep trying, though, and hope we save a few nips in the process.

    sweetie- I hadn't heard about the dense breast thing but wonder why, if all these things are so beneficial to so many women, why each state doesn't adopt it?  Why does everything throughout this whole process feel like pulling teeth?

    anniealso- Sounds like your DH has a great attitude about the whole thing! :)

    deekaay- Dr. Khouri in Florida has been approved to do the reconstruction using your own fat.  He does it in conjunction with the Brava bra system.  From what I've read he can also take out your implants and replace them using the fat.  It sounds like he's able to create a B cup the first treatment and if you want to go bigger it makes more fat grating.  I read that insurance covers it, too, but haven't confirmed that, yet.  I agree with you, it should be about us!

    I have to apologize as I've kind of taken this thread off topic but I think all of these issues come down to how best to make a woman feel whole and normal after MX.  If the technology is available to make us feel sensation, look normal with minimum disfigurement why isn't it offered to everyone? 

  • Anonymous
    Anonymous Member Posts: 1,376
    edited November 2010

    Just found an article back in April 2003 (!!!) where surgeons were preserving the sensory nerve way back then.  I'll try to post the link but if it doesn't work just google "Use of sensory nerve provides feeling in reconstructed breast".

    http://www.debakeydepartmentofsurgery.org/home/content.cfm?menu_id=44&pageview=news&article=133 

  • leeinfl
    leeinfl Member Posts: 317
    edited November 2010

    So frustrating - never was offered the option of NSM, never knew micro fat grafting was out there and now preserving sensory nerve!?  I don't let myself get down about "could have's/would have's" but it's a shame that we can't have all our options laid out to make the decisions that are right for us and that we have to live with.

    deekaay: Dr. K took out my implants, replaced them with smaller ones and did fat grafting.  I'm almost 7 weeks post-op and am very happy with the results.  Insurance paid for this but obviously you want to check before hand.  Although I could definitely live with what I have, Dr. K will do some more fat grafting and improve the fold under both breasts in mid-Dec.  There is NO comparing what I have now to how my implants looked before.

  • whitedove
    whitedove Member Posts: 292
    edited November 2010

    Lee - Ditto! Let's just hope that our experiences help to raise awareness about options and in that light, raise the standards of what women with BC demand and are offered. It is like so many doctors are only seeing their view of the elephant.  I truly hope our dissatisfaction raises awareness as well as gets the attention of PS and BS alike to what we really need in terms of the greater picture.

  • leeinfl
    leeinfl Member Posts: 317
    edited November 2010

    At my follow up appt at the end of the year with my BS, I intend to ask him if he's aware of these other options.  If he is, I will ask him why he didn't offer them to me.  If he isn't, I will ask that he look into them so he can better serve his patients.

    If he gets PO'd - oh well....how PO'd are we when we learn AFTER THE FACT that there were other options?

  • whitedove
    whitedove Member Posts: 292
    edited November 2010

    Lee, Yes. It's supply and demand.  I think we are on the brink of a knowledge shift where folks who are not up to speed with best practices are going to be outpaced/out-chosen and thus out-dated in comparison to their peers with more modern skills.  You can see that in how attitudes are changing about how women used to accept disfiguring surgeries as the standard with MX.  I am really hopeful things will change as we make some noise!

  • hopefulhealing
    hopefulhealing Member Posts: 722
    edited November 2010

    I am so frustrated by the whole thing!  I am frustrated from other women as well who have not experienced a mastectomy that say it isn't that big of a deal, or a breast doesn't make a woman, or all the other idiotic insensitive things they say. I know they can't truly understand but a little empathy and realistic thought on their part would be nice.  Sorry venting.

    I never understood when I was pre mastectomy the comment they didn't have reconstruction or this or that because they didn't want another surgery. After four surgeries now I understand!

    I see the PS Monday for post op check will be just over six weeks. Want the ripples fixed on left but not sure how to best accomplish this. I know he does not do fat grafting.

    The worst part of all of it as far as I am concerned is the lack of sensation. It changes the dynamics entirely. 

  • leeinfl
    leeinfl Member Posts: 317
    edited November 2010

    Yep, know exactly what you mean!  I've heard comments like "what? another surgery? is this your last one?"  It's to the point that I haven't told most people that I have another one in mid-December.  I shouldn't have to justify myself in wanting to have somewhat decent looking breasts.  The scars are there.  Even if they fade, they will always be a constant reminder.  Like you said, the sensation is gone.  Your muscles never feel the same.  The nipples are fake, don't move and stand at attention.  At least stand by us and support us while we try to get the best possible outcome.  I'm sorry to vent right with you, but I refuse to make apologies or try to justify something that I feel I deserve.  A lot of times I really have to bite my tongue - my brain is yelling "Right!  I'm ENJOYING getting cut open AGAIN and risking infection, complications, new scars, and the fear of what I'll see when I wake up! Surgeries are my new hobby - what, are you totally STUPID?!!"

    I've had three surgeries and December will be my fourth.  I also understand that many women refuse to go through more surgery.  It's hard.  I see it as a real life version of Chutes & Ladders.  You recover from surgery, start getting your flexibility and strength back, life has some semblance of normalcy, and then you have another surgery that knocks you right back to square one and you start it all again.  and again....and again! 

    Good luck with your appointment.  Hang in there!

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