Visible ripples in implants

leeinfl, I thought my insurance paid for fat grafts since I got fat grafting when I had my nip/areola surgery.  It was only when I later asked my PS about further need for fat grafts that he said insurance doesn't pay for it, he just adds it gratis if he's doing another surgery for which he's getting paid.

So my mission is to find out: 

a) has anyone seen insurance reimbursement for fat grafts on their statement?

b) has any one had fat grafts ALONE as a surgery that was covered by insurance?

YES on either of the above questions would confirm that insurance does pay.  I am putting off just calling my insurance company since I don't want to hear them say NO. 

leeinfl- So glad you are much happier with your results now.  I know how hard it is so psyche yourself up for another surgery (I also had 4 in 1 year) so I admire you for putting yourself through that to get what you want.  It's great that Dr. K was able to fix things for you.

Determined- I agree with you- the loss of sensation is the greatest loss.  If I could have the feeling back I wouldn't even care about the damn ripples.  (OK, maybe I'd care a little.....) Hope your post op appointment goes better with your PS than it did with mine.  When I told her about the ripples she said, Oh yeah, sometimes that happens.  Nothing we can do about that."  WTH?  (When I got upset she said she should show me some photos of other women who have been horribly disfigured by their MX and then I would feel so much better about mine.)  (Wonder how those women would feel about being described as horribly disfigured.)  Needless to say, if I decide to do something about these ripples it will be with a new PS.  

joanne2- Sorry about your bike accident.  (That's why I try to avoid exercise whenever possible- it is SO dangerous!  LOL!)  I've read a lot about those tear drop shaped implants.  I think they would look better but I heard they are much firmer so they don't feel as natural.  Why can't they make something that doesn't ripple and feels natural?  (I feel like Goldilocks- I just want the implant that feels just right!)  

deekaay- Good question about the insurance.  I've been wondering that myself.  My PS told me they don't because it's a cosmetic issue.  How is it any different that them paying for a revision which they do?  I don't get it.  I'll be very curious to see what the responses are.

So I sent an email off to a doctor who supposedly does the sensory nerve preservation thing.  I asked if this is something they can reattach after you've already had your implants put in.  I'll let you all know what she says! 

Kate -- Sorry about your doc' response .... similar to what my original PS said..... no wait, better yet, he offered to removed the implants and leave them out for a year.  I thought, what a jerk.

PB -- What a great idea.  Yes, I sometimes worry about the women who get radiation without knowing all the complications that it can cause down the road...... ya know.... the clinicians don't really go into all that.  I had to ask for my NSM, the BS wasn't too forthcoming, however, it was the PS who pushed it through for me.... well, I do have that to thank him for even though I've now left his services. 

vanderlady- So glad you found a new PS that you're happier with.  Sorry, but the last one sounded like an ass.  Take your implants out for a year?  WTH?  And how exactly will that help with the rippling?  Really hope the new guy can give you the results you want and deserve.  Good luck!

leeinfl- Thanks for sharing the procedure code.  It will definitely make it easier for finding out if it's covered by our insurance companies or not. 

fat graft/ insurance..  establish good comunication with your PS or better yet the insurance coding person of the facility.  Everything they do results in a ICD code... Keep all bills and EOB's from your insurance.  First make sure they pre-auth everything!  Ask if something doesn't get covered if they will eat the charge, (my place does that).  Also, if you get a non covered charge... call your facility be it hospital or clinic... In my case the clinic was fine but the hospital coded a few things with incorrect which was followed by me getting a $3,000.00 hospital charge.  I had to be persistant to get the hospital billing department to give me the codes they used, (extra effort for the billing gal... ho hum...), anyway it was completely stupid... reconstruction of my thigh???   I called my PS office, found out the codes they used, and told the hospital folks to use the same codes and resubmit.. it then was covered.  (spoon feeding yields the quickest results and less stress!)  good wishes everyone!  

joanne2-Wow 5 revisions? Why so many? Was it all because of the ripples or did you have other issues?  I too have many ripples and my skin is very thin. My Dr could have done the tear drop gummies for me and I chose the rounds because they seemed to be more of what I wanted. After my exchange I asked if tear drops would have helped with the ripple issue and he said no. He said I would have still had ripples even with them. Maybe slightly less but still some. I think in my case and maybe yours it has a lot more to do with our skin being thin.

Kate33-I can't even believe how insensitive your Dr. was to your concerns. So not right.

Vanderlady-that is so great you had a good appointment and have confidence in your new PS. I know everything is going to turn out great. I'm still contemplating a revision too. My only issue is I'm happy with my size and I'm afraid of being too large. If he can fix my ripples with only 50cc's I may do it. I talk to him again in Jan. It's hard to think about surgery again especially since my scars are starting to heal so nicely and I'm starting to feel somewhat normal. However, the ripples are not getting any better and if I decide to do a revision I'd rather do it sooner than later.

Deekaay, I think my revisions were all coded as mastoplasty...  I'm going for a PS visit next week or so... I'll ask the code and info... it's up to your insurance if it is covered... I have blue x, blue shield... But it is a law, that they have to cover the recon and have an obligation to make them try and match... 

 Sweetie2040..Yes thin skin and one had RAD... the revisions... one uniboob fix, twice because the pockets sort of didn't hold despite the alloderm, ripples, and one more attempt to decrease the ripples and higher the position... PS said most heal with pockets that get scar tissue to form white and give a place to sew to... I heal like reynolds wrap!  Clear and thin..  I stuck with him because I think I have a hard case, and it's just the way I am... I'm now hoping I get some nips that don't look too stupid and I can start putting this behind me...

sweetie- Good to know that the teardrops probably wouldn't fix the rippling.  I was wondering about that.  I'm like you, in that my scars are fading so nicely, so the thought of another surgery seems so depressing.  I know I need to do something, though.  The rippling seems to be getting worse, my implants ache all the time, they feel like they're getting further apart (even though I wear a bra 24/7) and they just don't feel right.  Last night my DH and I went to see a friend of ours perform (sing and guitar) at a local bar.  Every time I applauded my boobs hurt.  This is so not normal!  I really hope there comes a day when I'm not thinking about mine 24/7 either!!!

joanne2- My PS thought the pain might be related to my fibromyalgia somehow.  She said sometimes getting implants can aggravate fibro but they're not sure why.  I did have SNB on both sides but the pain feels more like I'm wearing an iron bra or something.  I am wondering if my PS did not make the pocket big enough for the implant or did not stretch the pec muscle enough.  (She did not overexpand me.)  My BS just wrote me a prescription for physical therapy but I haven't started yet.  (BTW, I also have a teen that likes shiny things!  LOL!)

deekaay- It is frustrating to know what is and isn't normal.  I do wonder if I'm just hyper-sensitive to every little thing and maybe it will fade in my mind.  I did bring up the pain issues at my last appointment.  My PS just wrote it off to my fibro and the BS's PA just wrote me a script for PT which I still need to start.  (Did I mention I am the Queen of Procrastination?)  As far as your incision still hurting- that doesn't seem normal either.  I wonder if any of the scar creams would help with that.  Maybe it's just not healing as quickly as it should for some reason.  I definitely can relate to the iron bra feeling, though.  I have to wear a bra 24/7 or I'm terribly uncomfortable.  So strange all these issues we didn't expect after exchange!

http://community.breastcancer.org/forum/44/topic/747737?page=2#idx_31

Hello there! Just following the thread and wanted to know if you had seen this other BCO thread called, "Has Anyone Had Micro Fat Grafting?"

...continuing to learn about the ripple issue. thanks for your posts.

Deekaay-I don't have an iron bra feeling, but a very numb feeling. My husband hugged me to day and it felt weird, like something strange was inbetween us. Because it feels so tight I wonder if a larger implant would help with rippling at all. I don' t want to end up feeling tighter. I think some of the tightess could be the muscles around the area too. My PT told me I was all locked up in that area and it can cause all kind of pain and tightness. Have you tried PT at all?

Sweetie, I have the same weird feeling like you describe--like a foreign feeling on my whole chest.  This is in addition to the iron bra.  I don't notice it 24/7, but still very often.

Yeah, I too have the feeling that a larger implant OR a tighter "tuck" on the bottom of exisiting implants would get rid of ripples.  I feel this because when I pull the skin tight at the bottoms of my breasts, everything tightens up and ripples disappear.

However, my PS says that larger implants would not resolve ripples for me since all implants ripple.  Plus after having these 650's for 4 mos. now, I definitely don't want bigger.  I'm really tall at 5'10" so they don't look big, but I don't want more heaviness, more chest, etc.  I was a B before so even going to a C (although officially Nordstrom's say D) seems big to me.

The dilemma is exactly what Determined describes.  Hard to decide when we are happy with size, but not ripples.

Well, tomorrow, we can concentrate on our tummies and enjoy Thanksgiving with family and friends.  Wishing everyone a lovely day, deekaay.

Determined-I feel for you. It is a tough decision to know what to do. In some ways it is good to be done with all this and just try to accept things. In other ways you think why shouldn't I have the best result possible. I agree with your husband, take your time and really think about it. I always say think about what is most important to you and it will come to you. If it does make you feel better you could get a second opinion just to feel confident about what your Dr is telling you. I took Neronton too for a while when I came out of my first surgery and it helped.Keep us posted, we're in this together.

Deekay-we are in the same place too. I understand not wanting to go bigger. I feel big enough. I think C but Nordstroms tells me D. Doesn't seem that big to me but big enough.I wonder how much bigger we would have to go to get sufficient resolution of most of the ripples. I bent over in the mirror today and the ripples are at the top and bottom. Just everywhere. It's weird though because the implants feel tight enough and they don't move around. Makes me think my skin must be really thin. I read something about using additional alloderm in cases where the skin is really thin. I'm going to ask at my next visit. Oh well for now like you said lets all just eat and be happy, enjoy our family and be thankful for having made it this far. I'm still very grateful ripples and all!

Kate33-well if a larger implant is going to make things look worse than that's no good!! I was wondering that myself.  My PS did place alloderm at the time of TE too but I don't know how much they use. If more of that won't help than there goes that option. It looks like there really aren't any feasible options than for us is there? 

Hope everyone had a happy Thanksgiving. Now it's time to focus our attention on shopping!!