Still Uncomfortable with Implants

faithroad- I admire your bravery in having your implants removed.  I hope it brings you relief finally.  I agree that the PS out there should be more forthcoming about the downside to recon.  Unfortunately, no one really knows how they're going to feel until it's done.  (Wish there was a way to test drive implants!)  I believe, though, that for a lot of women their implants are just too big.  I can understand that some women may have been endowed prior to BC and just want to look like they did before.  But I wonder how many of them would have chosen that knowing how heavy they were?  I thought it was interesting what you wrote about the prosthetics being as heavy.  Maybe they should send women home with them for a few weeks and then see how they feel about it?  

faithroad- The exact same thing happened to me except I was barely a B before BC.  I told the PS I would like to be a full B because it was hard to find bras to fit.  She made me a 32D!  I had ongoing pain from the day the implants were placed.  My revision completely took the pain away though.  My new PS put in implants that are half the size and then did fat grafting over the top.  They aren't heavy anymore and my pec muscles are not as constricted.  I think they feel (and look) as close to natural breasts as you can get after a MX.  I had originally considered just having them taken out until I learned about this option.  I was nervous about it.  I thought what if I go through all this and it isn't any better and then I have to go through another surgery to take them out.  But it has all turned out.    The nice thing about what you're doing, though, is you don't have to worry about having any implants replaced 10-15 years down the road.  You will be done!

I love the idea of fat grafting and really want to remove these implants.  I went from being cancer free and healthy to a million issues related to autoimmune stuff. I want them out.  Does anyone know if fat grating is happening near Massachusetts?  We are normally on the cutting edge of things.  Find it hard to believe that there is only one doc in Florida.  Although at this point willing to fly down and give it a shot.

I'd like to put my 2 cents in:

For my implants after a DM I chose to go smaller than I am, so now I've a 195cc and a 225 cc implant.  The PS said I was naturally 300ccc before the surgery and that I could get to that with fills. I chose not to and had smaller implants put in to decrease the number of surgeries and thought I would be less uncomfortable carrying implants smaller than my natural self.  I was right. Now, 4 months later, I have totally forgotten my left implant isn't me (except for the lack of feeling) and my right one needs increasing in size to the left as the LD flap has atropied and it's sliding around in there and driving me nuts.

My point is, I do think we women need to think of having smaller implants than we actually were, as they are still foreign objects we are trying to carry around on our chest.

On here, I  mainly see women have revisions and go smaller than larger.  Plus, this new fat grafting seems to be working well.

So, maybe for less pain, less stress on our pec muscles and overlying skin, we all need to think smaller implants.  They will stay perky  and not require such heavy duty bras for support.

It's just an idea................

Truly, on the card I got, via my PS, with the serial numbers of my implants, it gives their sizes in cc's.

250cc's equals a cup and I thought that was way to much for me to have stuck under my muscle and to dangle off my chest wall.

Yes Rennasus, silicone, I would imagine, would weigh more than saline in an equal amount.

All I know is in the blog wear women talk about getting fitted for bras after having implants due to a mastectomy, they all seem to be at least C to DD in cup size.  Me, I was an A cup size with my natural breasts and now with these implants my old bras fit perfectly.

My plastic surgeon said 95% of the women she did reconstruction on wanted their new boobs to be bigger than before.  I asked her why, and she said all most women say is that is what would make them happy.

chiming in here....3.5 months out from my exchange I have noticed over the past few days NOT being aware of my implants. I chalk it up to having the right size for my body and general healing with time. Going in this Thursday for my nip surgery and some revision fat grafting. Overall, I am still happy with my decision which is no small thing for a whackjob like me.  I vacillate all the time depending on my mood. One minute I think I need to be 48 DDD and the next I think they are perfect. Nature of the beast I guess.

It is so essential to have a PS that you trust and who respects you. If I would have insisted on huge bazooms, he would not have done it. Totally respectful of my body and the end result.  We openly discuss things and have from day 1 when my head was still spinning from my DX.

I don't think there is one right way for everyone. There is so much to consider it would be impossible to declare. I wish for all the resolution that works best for THEM. big breasts, little breasts, no breasts...we are all still women and we are ALIVE:)!

I've just had my *real* implants put in 2/17/11. They look great, but they feel awful. My TEs weren't any better though. I'm too thin for any of the flaps (except lat flaps & I don't want to screw more muscles up). I'm too chicken to go without foobs though. In a way I'm glad to see others voicing their issues with their implants. I'm sad that we have to go through this.

Justagirl - Sorry I wasn't more specific. Here's the run-down of what I've had done.

7/7/09 DX
7/31/09 FAC chemo began while 22 weeks pregnant
11/26/09 Healthy baby girl delivered (came on her own - no induction or c-section necessary)
12/09 Taxane chemo began
2/19/10 Bilateral NS mastectomy with immediate reconstruction/expander placement (flap surgery was not really an option as I didn't have enough body fat & the lat surgery was going to need implants anyway)
8/31/10 Bilateral ooph with severe bleeding (4 units of blood transfused); exchange surgery delayed
10/2/10 Emergency hyst due to abscess at ooph insertion site(s)
2/17/11 Bilateral exchange to 700-800 cc silicone implants with capsulorophy; surgeon said that the dermal matrix product used 2/19/10 was not in place & pectoral muscle retracted; surgeon created a new 'sling' by attaching my skin/fascia (I think) to my ribs a full rib higher than she actually wanted to create a solid IMF.

Ever since my exchange surgery I've been having tremendous pain in my chest, neck, shoulders, & collar-bones. My theory is that my retracted pectoral muscle is bunching up when I use my arms, but since it cannot function properly (its detached from its origin on my ribs & 2cm of my sternum according to 2/19/10 surgical report) it is putting stress on my collar-bones & other muscles. The implants themselves don't bother me too much. Its the muscle damage that came from putting them in place. There's also the problem of the implants simply being held in/up by my skin -- no muscle. According to this PS I have very stretchy (more so than average) skin. My IMF is still in place, but the implants are actually rolling over the IMF. Her current 'solution' is for me to wear a super (uncomfortably so) tight bra with a wide underbust band and use the shoulder straps to help hold the implants up in place to avoid more stretching of the skin. The bras I've found (I've been to 3 post-mastectomy bra stores & been professionally measured) help to a degree, but there's always at least one problem -- the band rolls up, the shoulder straps cause pain in my neck/head, the cups stretch, etc. Its been a long 5 (almost) months since my exchange. Its been an even longer 17 months (almost) since my initial breast surgery.

Prior to my dx (& pregnancy) I was large busted. I'm actually wearing the same size (but different styles) bras now as I was after my first baby (I have a 3 year old son too -- he was 18 months or so when I was dx). When people look at me they assure me I'm not leading with my foobs -- IOW my foobs look in proportion to my frame. I'm an hour-glass -- pre-dx I was a 38 bust, 29 band, 27 waist, & 38 hips -- my measurements now are 38 bust, 29 band, 29 waist, & 40 hips. Technically, the implant size is appropriate to get me where I was before. However, the lack of muscular/tissue support of the implants is causing MANY more problems than my normal D/DD cup breasts did. I actually want(ed) to go down to a comfortable C, but all the PS heard was that I was a D/DD prior to surgery.

It has been a LONG & HARD journey. When I began I had an 18 month old son and was pregnant. Now I have a 3 year old son & a 19 month old daughter. I also work full-time about 35 miles from my home. My preferred oncologist/surgeons are over 900 miles away in Houston, TX. I've been passed from dr to dr due to lack of funds/capability to travel that distance very often.

My current PS gave me the only option of having another surgery. During that surgery she'll do another capsulorophy (reshaping/sizing the capsule), try to create another sling (connected to my ribs only -- not to the muscle at all; maybe with a dermal matrix product this time), and use implants that around about 1/2 the size of my current ones. I don't mind going smaller -- actually that's what I wanted in the first place. However, she says nothing can be done for my muscles & that the surgery may or may not actually help any of the issues. She says that even with the smaller (lighter) implants, they're liable to stretch my skin out again. She has not referred me to PT or anything other than a pain management doctor.

She's primarily a cosmetic PS, so I'm going (120 miles) to U of L's chief PS (he was the one my TX PS referred me to initially) Friday for a 2nd opinion. He does both cosmetic & reconstruction. He has more reconstruction experience than my local/current PS. I'm hoping he'll be able to offer me a better solution. If he concurrs with my local PS I may just go ahead & let her do the surgery. However, my initial PS is now at Johns Hopkins, so I may try to travel to him for a definitive answer. There may not be an answer, but I'm hoping...

Biologybrain-  I would agree with justagirl that PT would definitely help.  I read that our pec muscles, which are essentially "relocated" to support our implants, are constantly trying to revert to their original position.  It was recommended that patients who have had this done have lifelong PT!  (Something no one tells us about beforehand.)  800 cc implants would be extremely heavy, too.  Between the two no wonder you've been in so much discomfort.  I just had a revision and had my implants swapped out for smaller ones and then had fat grafting done over the top so stayed the same size.  Everything feels so much better now because the implants are lighter and the pecs aren't being stretched as much.  Also, do you have a Nordstrom's in your area?  They are wonderful for doing bra fittings on MX patients.  If you go make sure you call ahead to make an appointment with one of their specially trained fitters.  I went there and they were amazing.  They found several different bras that fit like a dream and were more comfortable than anything I had worn before MX.  (You might want to wait, though, if you're considering a revision any time soon but keep them in mind for afterwards.)

faithroad- I didn't realize your deconstruction was coming up so quickly.  So glad everything went fine and you're feeling so much better!!!  

Kate - thank you!  I was able to have it done earlier than I first anticipated so I jumped at the opportunity!!!  They were really dirving me nuts, lol!  I'll get the drains out Monday I hope and back to work next Wednesday as long I don't do any lifting, etc.

Annette - Hello there and thank you!!!  Nice to see you friend.  I love your avitar pic.  You are so sweet!!  I know it sounds crazy but I feel so much better with the implants out. I don't know what it looks like under the bandages yet, but I know i'll be ok with it because I just feel so much better.  Happy!!

amen to that justagirl.

justagirl and annette - thank you for your kind and encouraging words!

Tina - I am so thrilled to hear how well you are doing.  Not only because it encourages me, but because I'm so happy for YOU!!!!  I'll be going flat for about a month as I heal, and I'm ready to just go with the flow!  I don't think people really have a negative feeling about it, I think they may just take a second look because it is out of the norm.  I think if we did a poll, we would find most people to be very understanding and sympathetic. 

joansf- I've had mostly pros from my revision with a few cons thrown in.  The pros are the rippling is completely gone even when I bend over.  Everything feels much softer and looks so much more natural now.  My PS was able to fill in my cleavage area where it was very concave with the fat grafting.  Another bonus is the skin is now warm where before I could always feel the cold implants underneath.  The pain is so much better but I still feel as though the pec muscles are too tight so maybe I'd benefit from some PT.  And my new incisions have really been bothering me as they heal.  Overall, though, I am so glad I did it.  My updated pics are on the picture forum if you're on there.  Same screen name as here.

Dear Kate and Faithroad--

Thanks for responding to my questions.  I'm glad you're both happy with your decisions.

Your photos look great Kate--keep me posted on the pt.  I hope your incisions get more comfortable--they should with time.  But we keep putting time in with this, when we want to move on.

Faith--you are my hero!  I couldn't do it yet myself.  Maybe someday.  I'm glad you feel so much more comfortable.  All the best as you continue to heal

I had my appt with the ps last fri.  He is very reluctant to do a revision.  I've had it in my head to have the implants placed in front of the muscle.  I know this is done, and it was an option for me, but I chose to go the conventional expander route.

He says I would have a much less satisfactory cosmetic result--more rippling, etc.  He is sending me back to his PT of choice.  I have very mixed feelings.  It is a big pt practice with lots of mx patients, and it feels like an assembly line to me.  I found someone who works one-on-one for the whole hour--no aides, no lounging with a heating pad and an ice pack.

But the other gal has more credibility with my doctor--they have a well-established relationship, and he wants her to evaluate me, to see if there is some treatable explanation for the pain.  

I also think he's concerned that the pain might not be alleviated with more surgery.  It's a very scary thought that this may be as good as it gets.  

I have a lot of things I can do to lessen the discomfort, but I feel outright despair to think that this is going to be my life.  And on the other hand, I had a HER 2+ tumor--I'm very fortunate that it was caught early--1/2 cm, and that herceptin was available for treatment.   I could have been 'a goner'.  What is the price?

Anyway...have a great day.  Thanks for listening/reading.  Good health.  xo