Still Uncomfortable with Implants

mom3b- Dr. K took out my implants and replaced them with smaller ones.  The space left behind is what he filled with the fat grafting.  He said in order to get me to no implants at all I would need to go through 2 more procedures.  If I wanted to do that he would have me wait 3 months and then take out these implants, replace them with an even smaller implant and do additional FG.  The third procedure he would take out the implants all together and do more FG and I'd be done and have no implants.  Not sure if I want to go through all that and I think just putting a lot of fat over my implants is going to make everything feel so much better.  But it would be tempting to not have implants since down the road they will need to be replaced which will involve another surgery 10-15 years from now.

Your insurance has to cover revisions.  It is a federal law.  Dr. K was in network for me so everything was covered.  (It'll be the only time in your life that insurance will pay for lipo so that's a benefit.)  Just to warn you, though, doing the fat grafting will probably be much more painful than any breast surgery you've gone through.  Also, just because a PS does FG doesn't mean he does it the same way Dr. K does.   I believe the way Dr. K does it more of the fat is retained afterwards, the stem cells survive and there is less likelihood of the fat forming lumps.  He transfers the fat drop by drop.  It is very painstaking but it helps get a better result.  There are surgeons out there, though, that have been trained by him so you don't necessarily have to go to him but I would ask the PS what their method is.  As far as how I feel about the procedure- the jury is still out on my final results but I've definitely seen a lot of improvement.  They feel and look much more natural especially now that they are warm to the touch.  They felt like "Barbie boobs" before and that is now gone.  I may not have the other two procedures and will still be happier than I was before.

bher- From everything I have read Dr. K's method works really well for those with radiated skin.  It has to do with the stem cells that are transferred with the fat.  I understand what you're saying about the heaviness of the implant.  That is something that bothered me a lot.  Not sure if it's because I now have a smaller implant or the fat being added but they definitely feel a lot lighter.  As far as the new incisions, he said he didn't want to use the old incisions because they had healed so well and were barely visible.  He said he could make a much smaller incision in the armpit and swap out the implants through there.  He said it would heal quicker, be less visible and he also didn't want to disturb all the Alloderm by the old incision.  (He hates Alloderm, by the way, and doesn't think it should ever be used.  He said why use cadaver tissue when your own fat works so much better?  Wish I'd known about him before I had gone through all my surgeries.)   As far as the permanence of the fat it is going to vary from patient to patient.  Most PS's, though, who do FG claim that only about 50% of the fat will be retained.  With Dr. K's method, though, I think it's more like 85-90%.  Some of his patients are 5 years out and haven't lost any of it.  Just realize, though, that if you lose weight afterwards you will lose it there, too, which is why he really wants you to be at your ideal weight before beginning.  

For those of you who just want to improve the look and feel of your implants you can do so with just one procedure with Dr. K.   If you want to get rid of your implants all together you can do that, too, but it will take about three procedures to get there.  If anyone has questions I would encourage you to go to Dr. K's site (miamibreastcenter.com) and click on the link to email him.  He's busy so it might be several days before he gets back to you but he will take the time to answer your questions.  You can even email him your photos and he will give you his opinion on what can be done.

bher- During my consultation with Dr. K he had originally said that he would have me wear the BRAVA for 4 weeks prior to the second procedure during which he would remove the implants.  But when I saw him for my surgery he was talking about replacing these implants with even smaller ones and not taking them out all together until the third procedure.  I was so focused on this surgery that I didn't think to ask him which one was right.  Maybe I could go either way?  Probably a moot point since I don't think I could get to Florida again.  My DH was just DX with Parkinson's and is going out on disability so once I'm feeling better I'm returning to job hunting.  

ronqt1 - Hang in there!  We are here listening to you and we care about you.  Keep us posted.  It is a hard and confusing decision since everyone is so different. And it takes a while to decide what you want to tolerate, what's comfortable for you, and when you have just had enough. 

For me on my road, I'm all for simplifing my life. I want to have them out, and call it a day! 

Kate33- Yes, I like that idea about the docs telling a person about all their options and the pros and cons of each.  That would have helped me immensly!!!!  Or if not the docs, then an intermediate person who could give the needed information and help you with a decision.  Sometimes the docs don't really care.  Or just don't have a clue themsleves, about what things are really like.   I didn't know enough to know what to ask.

This is kind of off the subject but this whole lack of information infuriates me so much.  All I can think about is the women who may not have access to the internet and are at the mercy of their doctors and what information they decide to dole out.  My first BS never even told me that NSM was an option for me.  Luckily, I did my homework before my MX.  When I asked her about it she tried to talk me out of it and then I found out she wasn't even trained in the procedure.  The most infuriating part of it all?  I ended up having to drive 2 hours to find a BS that did the NS.  (They don't exactly put out ads in the yellow pages.)  I just recently found out that her partner in the same practice was performing NS but she never even told me or offered me a consult with her.

binga- Good luck with your appointment tomorrow.  If you end up going to Dr. K I'd be happy to help you through the process as others have helped me.   

Lee,

Just curious....have you posted any pictures on the picture website?

Sandy

I am trying to follow the post here. I have a question what is the Brava?

Is it related to helping  the patient to decide what size is appropriate?

I know that Kate 33 is having fat grafting but I am interested in what the BRAVA is

Thanks

Laura

I wasn't able to go to my appt today because I have a bad case of bronchitis.  I was hoping to make my appt even though I am sick but I am running a fever and feel so bad I can't even get out of bed. So I rescheduled and the earliest I can get in is July 1st.  I also sent an email to Dr. Khouri's office so I could go ahead and get an appt on the books with them since I figured they would also be booked. Cindy called me and I am scheduled for an appt on July 12th.  She said I would need to have an MRI done first and scheduled me for that on the morning of July 12.  She explained that I would do the BRAVA and if they put new smaller implants my insurance (United Healthcare) would not cover them.  I guess I need to call my insurance and see what they say.

Becky 

Feel better!!! Bronchitis is such a pain......

Binga- I am going to send you a PM because I think you're already suffering from "cindy-itis".  His PA is, unfortunately, pretty incompetent.  I just had my procedure and I also have United Healthcare so it should be covered.  I will write to you!

lauralu- Your puppy is so cute!  What's his name?  I have two Yorki-poos who are sisters from the same litter.  Just love Yorkies!

Kate- you have a york-poo! How cute are they!!!!

I just LOVE YORKIES!!!! They have such personalities.

How are you? I am thinking of you always. Just love reading about your progress.

Kate- I think the shoulder needs rest and healing. All the manipulation after all the surgeries we've had, it takes a toll on other parts surrounding the area.  My left shoulder still aches from exchange. It's been 3 mo.

Hang in there, it will all be worth it!

I everyone, well I went to PS yesterday b/c of not being happy with implants. I told him I am tight, it is heavy, it hurts, it is pressing against me, makes me nauseous. He suggested a pain management dr. before we take them out. He said he could understand it being too heavy. So I agreed to a pain management dr., then I will have one augmented smaller and have a smaller implant put in. I really think it is just too heavy. I am quite happy with this. However, I am now having knee surg next week, and he won't consider touching me until I am healed witht that, I have a tentative appointment with pain mgt 7-11. I have waited this long, can wait one more month.  Today I had to volunteer/work and I paid attention to how I was feeling. Again, just too heavy for one person to deal with. I hope this nightmare will be over soon. This was a great thread for me to get on to. Thank you.

It is so true about how heavy these things feel.  I have a 600 cc implant on my reconstructed side and it is killing my shoulder.  

Ronna--I have also been sent to a pain management doc (also a psychotherapist, but the way.)  It goes without saying that I hope you have success with that.  I was put on increasing doses of neurontin, which seemed to help at first, but then, not so much.  For me, this pain has a life of its own.

I will be looking to revise my surgery soon.  Right now, I'm having a rough time, regretting that I didn't chose a different surgery.  I've mentioned earlier on this thread that I had an oppportunity to have reconstruction with a 'becker' implant that's in clinical trials.  It's an expandable implant that goes right in the space where the breast tissue was, not under the muscle.  It would have saved me the second surgery to place the permanent implant (it has a removable port--once it's the required volume, the port comes out, and you are done.)  Maybe it would have caused less nerve and other damage, since they don't make a 'pocket' under the chest muscle.

 I just ran into a woman yesterday, whom I know--she has had hers redone three times because of capsular contracture.  I think that because she is very thin, they haven't suggested flap surgery.  So coincidentally, she mentioned that she was thinking about another revision, and she'd heard about Dr. Khouri--I want to share your info with her.

As always, thanks for listening.  Best, Joan