Still Uncomfortable with Implants
Comments
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Mlp, I did have my share of issues, didn't I? :-) It took persistence to find the right docs and therapists and follow through. I am amazed I was able to do all that now that I am pain free and recognize how awful I felt. I had so many kind people help me find my way. It was overwhelming and I couldn't have done it alone. I have only been back twice to the myofascial PT since my deconstruction. I didn't let him touch my chest since it was too soon. Just like your body can get out of balance with the additional weight of the implants, my body felt a little odd once they were removed. The myofascial guy equated it to a pregnant woman adjusting to the body's normal center of gravity after delivery.
If you are diagnosed with LE, I totally agree with dancetrancer about asking your therapist about myofascial treatment. They might want you to wait until swelling is stabilized. I had conversations about myofascial with my LE therapist and LE physiatrist, and they said I could try. My myofascial guy has a gentle but firm touch and is respectful of any area I tell him to avoid. I did let him slowly work on the sides of my ribs and my LE improved. He broke up some of the scar tissue, which can restrict lymphatic flow. It actually eliminated some numbness. Different LE therapists will be okay or not okay with myofascial release. Dr. Massey was on the fence, but said if I had had success prior to surgery that she was okay with it if I waited at least 8 wks before he touched the chest area. I haven't had him do anything in that area yet, but I might, just to make sure there is no new scarring on the side of my ribs. I also agree about proper training for practicing myofascial. My therapist trained extensively under Barnes and was on staff at his Paoli, Pennsylvania center for two years.
Kriserts, that is fascinating about the nerve regrowth. My myofascial PT said my shoulder blades lie much flatter now since the implants are gone. About the torn pectoral muscle, two of the PS's I consulted for deconstruction said they thought the implant was poking through the pectoral muscle. Dr. Massey confirmed after my surgery that it had been poking through and that the muscle was very damaged. She wasn't able to repair and reposition it completely, but everything feels like it's functioning like it did pre-mast. -
mlp- I'm glad they think it is scar tissue and not LE. Not an easy fix but at least fixable! I'm hoping that's what's causing my discomfort, too, since I've had 5 surgeries over the past year and a half. I have an appointment next Tuesday to get things checked out.
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Mlp, oops, I started to draft my post before dinner, so I didn't see your update until now. Yay!
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beacher, I have lidocaine patches and cream. I think that eventually the nerve regrows ... or not. Just have to roll with it.
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Hey beacher. My problem is ROM I had no pain til I started PT. When the PS put in expander my tightness and weird numb feeling went away. My pain is on top of my shoulder where the tendon hooks in. I am getting more ROM but more pain too. I always worry. I have mild LE and I also wonder if PT is causing LE pain Urgh
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I had my heavy implants removed August 12 with smaller ones. Now in gym bra. Just hoping he previous feeling of heavy does not return. Just praying. Maybe I am just not a candidate for implants at all. A little more time will ell.
Thank you for posting ladies
Hugs,
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Hi Ronqt, good for you hope it helps! i really want to do the same, in never wanted them this size! Do you mind telling what you had and changed to? My ps does not want to mess with my mx side but will make my augumented side smaller, i do not know why the hell he put such a big implant in that side anyways??? i have 2 2nd opinions lined up,but will not do anything until i deal with my cording "axillary web syndrome" hope u are feeling better....
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ronqt- Just wanted to let you know I had my implants swapped out in May. I went from 375 to 225 with fat grafting over the top. At first I felt immediate relief from the lighter implants and the fat the pectoral muscles were not being stretched as much. I do find, though, now that I'm 3 months out that the pecs are tightening up again. I'm thinking I may need to do some PT to keep them loose. Hope you don't have the same thing happen but wanted to give you heads up in case it does. Wondering if maybe I'm not such a good candidate for implants, either.
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Are any of us "good" candidates for implants? Considering what we are doing to our bodies when we have implants placed, I don't think so....
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You're right about that, Lee!
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katie33,sorry this has not worked out for you so far. i remember reading back and u were so excited and sure this would be your fix all...i got a feelong none of us will ever have that fix all.i think everyday i get used to knowing i will live with some pain and foobs that are not even close to looking perfect even in clothes. i try to think of the alturnative .........
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I just don't think our pec muscles were meant to have implants shoved under them.
Also, as we are the patient, the PS should keep this in mind and not suggest large implants which will place more stress on those muscles and the skin and tissue which has already had it's blood supply compromised by the mastectomy.
The implants have a weight factor which again, I don't think PS's consider. And, the implant will never really be a part of us like our natural breast tissue.
I asked my PS about physio after thee DMX with reconstruction and she agreed it was a good idea 6 weeks post op. It really helped me get back 100% of my flexibility and much of my strength, even though the cancer side had a lat flap too. Fixed my poor posture too.
As to the feeling of having an 'iron' bra on, I thinks it's because the skin and tissue is pulled so tight. I'm lucky the feeling is gone for me now.
Even though my implants are small, I have been rubbing an enriched body cream on my breasts and below and to the sides soon as the sutures healed and I do think that has helped keep the skin supple and the massage helps to relax the pec muscles.
My physio said it was a fine line to strengthen the pec muscles to help support the implants and add strength to my arms but not to go too far as to encourage the muscles to misplace the implants. I'm so glad I went.
After all we have been through with BC and having mastectomies, I do think we have a right to look good with a bra on and be pain free.
Is that too much to ask for?
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Lee, I couldn't agree more!
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Katee33--
thanks for keeping us updated on the effect of smaller implants.
Seems they might not work for me.
Considering--recommendation of Dr. Christina Ahn in New York---she only does complete
fatgrafting without implants.
Will let you know.
Eileen
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Hindsight is always 20/20 - in our case (I'm including all my fellow revision via fat grafting friends), knowing how implants impact our daily activities, we would love to turn back time and not have TEs or implants at all. However, since we can't do that, I believe we were lucky enough to get the next best thing. I am so thrilled for all the women who find out about this procedure in time to have a complete reconstruction with fat grafting. That is why we tell our story and spread the word - so others can benefit from our experience. Despite the implants, the revision and fat grafting has been a tremendous improvement and made a huge difference. I was so miserable before that I just can't begin to explain what a difference this has made. Do I wish I had a magic wand to make the implants and the alloderm go away and my pec muscles to return to their original state? OF COURSE! But I'm grateful for what I have and what was possible thanks to fat grafting.
If you have time, YouTube has several new videos from Dr. Khouri where he does an excellent job of explaining the entire process, including the difference between internal TEs and the external Brava. He makes it very easy to understand.
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Hi leeinfl--I am so confused. I have a question regarding implants with fatgrafting.
My present implant is 410. --It would be easier if I change to a 250 with fatgrafting--it would require less proceedures.
If I go for full fatgrafting--Dr. Ahn believes that 4 proceedures would be required.
You imply that you are presently comfortable with your implants and fatgrafting. If possible, could you let me know before after sizes for implants. Are you still uncomfortable.
Thanks so much for the advice, Eileen
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Hi Eileen,
My first implants were 550. They looked like grapefruits shoved under my skin. I had no cleavage except a boney, concaved space and my left implant rolled to the side. Not pretty. Thankfully, I never had pain (like Kate and so many others), but it wasn't comfortable.
Dr. Khouri exchanged the implants for 300 cc and added another 300 cc of fat. He did 2 more touch up procedures where he worked on my folds. He added more fat but not nearly as much as in the initial exchange.
I am comfortable and feel good. The reason I wish I never had implants or TEs at all, is because I work out and do strength training (I'm a personal trainer). The pec muscles don't feel or act "normal" - but I didn't know about fat grafting in time to avoid all that. Other than that, I feel great
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Lee- Do you know if Dr. K removes the implants all together if he can do anything to restore the pecs afterwards? If so, it would be very tempting to move forward. I just had an appointment with a local PS (since it's too hard to get to Miami right now) to see if they could figure out where my discomfort is coming from on the left side. She feels I've formed scar tissue that is pulling on the implant. She can feel it run from about the nipple area to my arm pit. She wrote a Rx for US and PT and also a LE evaluation. Oh boy, the fun just keeps coming.
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Kate - I don't know, but since his plan for you was to remove them anyway, I'd send him an email to ask. I've always wondered if the muscle is able to return back to "normal" (ok - semi-normal would be nice!). Your case really drives home the point: implants are a foreign object! While some ladies may do well with them, I really believe that most of us don't. Maybe this is fate telling you to move forward with the ultimate goal of having the implants removed. Hugs - sorry your roller coaster ride isn't over.
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Awwh, man, Kate. Dang I hope you get some relief soon. Definitely consider myofascial release, too, if the doc says it is ok. It's really effective on scar tissue. BTW, not all PT's are truly trained in MFR. They may say they do it, but often they are doing some form of massage that feels good - but it doesn't get the same results. Sorry if I sound like a broken record, but I had a chronic nerve problem in my leg/back for 10 years...MFR was the main thing that got me better (along with yoga/stretching and consistent aerobic exercise). I'd say I'm about 90% healed (it will never be 100%, but I'm real happy with where I am now compared to the pain and discomfort I had been in for all those years).
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Kate33 and Leeinfl
Thanks so much for your input,
Kate33--good luck-let us know
Eileen
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Kate33....I am going to a le pt that also does know how to take care of aws "axillary web syndrome" I do not have le but have discomfort,tightness,sometimes pain in my armpit into my implant and towards my arm at this piont not sure where it is kida that whole area,my ortho agreed after doing mri's of shoulder areahe said i definatly had something going on in that area and to pursue it but of couse it really was not his field. So i see her friday it is not covered by my insurance at this piont but if it works i will pursue getting reimbursed. it will take more than i visit she says anywhere from 2-6 . i will let you know how it goes.I also sent an e-mail out to Dr. K in Miami if i have to i WILL fly across the country to fix this..So sad pt really have NO idea what they are doing..just SLAP THAT IMPLANT IN THERE AND SEND YOU ON YOUR WAY......
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I would encourage everyone thinking about implants to go to the LBBC website and read the information concerning implants and problems. When I visited a PS and discussed implants, he said no problem with the rads to the breast area. Stats show that 60% or more have to have more surgeries because of problems. Remember that the PS is also a salesperson, and is selling a product.
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dancetrancer- Thanks for the info. I'll check into that when I schedule the PT. So much to learn about all this PT stuff now!
beacher- The pain you describe sounds exactly what I am feeling- armpit to implant. Am really hoping it is not LE but just scar tissue. It can be so confusing trying to figure out what it truly is- LE, post mastectomy pain syndrome, auxillary web syndrome, cording or just the pecs themselves. All these possible issues they never warn us could happen.
Just found this article-
Complications Common With Post-Mastectomy Breast Implants
Related Health News
By Amanda Gardner
HealthDay ReporterMONDAY, Dec. 19 (HealthDay News) -- Almost one third of women who have reconstructive breast implant surgery after a mastectomy will face short-term complications, a new study finds.
One in five women will require additional surgery, although complete failure (loss of the implant) is rare, Danish researchers report in the December issue of Archives of Surgery.
"This doesn't surprise me at all. Everyone thinks that this is a simple surgery. It's really not," said Dr. Jay Brooks, chairman of hematology/oncology at the Ochsner Clinic Foundation in Baton Rouge, La.
Breast cancer is the most common cancer among women in most parts of the developed world.
According to an accompanying editorial, about 15 percent of mastectomies done in the United States today are followed by breast reconstruction -- a 147 percent increase from 1992.
Breast reconstruction can be done with an implant, with tissue taken from another part of the woman's body, or a combination of the two. Implantation is the most frequent, the study authors said. It is also the simplest procedure and requires the least amount of time.
Many more women today can choose between a mastectomy, which involves removal of the entire breast, and lumpectomy, in which only a portion of the breast is removed. Unlike a mastectomy, however, a lumpectomy usually needs to be followed by radiation treatment. Mastectomy may also provide women with more peace of mind.
"Survival rates for lumpectomy may even be better than for mastectomy," Brooks said. "The problem is breast irradiation. A lot of women have the concept in their mind that if it's in their breast and we remove it, everything's OK."
The current study looked at information collected by the Danish Registry for Plastic Surgery of the Breast. In all, 574 women who underwent post-mastectomy reconstruction with breast implants were tracked. The women were aged 21 to 78 years.
This study was funded by the International Epidemiology Institute, which received unrestricted funding from the Dow Corning Corp., a maker of breast implants.
Almost one third (31 percent) of the women who underwent breast implantation developed at least one adverse event, the researchers found. Almost half (49 percent) of these events occurred within three months of the initial surgery, and 67 percent occurred within six months. Sixteen percent developed two complications, and 8 percent had at least three. The most common problems were infection, blood clotting, seroma (build-up of fluid in the tissue) and skin perforation.
Twenty-one percent of the original women needed additional surgery, most frequently because of capsular contracture (when scar tissue tightens and hardens), asymmetry or displacement of the implant. That number, the editorial noted, is "alarmingly high and arguably unacceptable."
Among 302 women who underwent subsequent implantation, 36 percent experienced at least one adverse event, and 21 percent had more surgery.
Patients need to be given detailed information on the risks and benefits of procedures involving breast implants, the authors stated.
Brooks himself is not a proponent of reconstructive surgery after a mastectomy, at least not at the same time as the mastectomy.
"We do not know the extent of the cancer, and having a reconstruction can cause problems for the oncologist treating the person for their cancer," he said. "Many of these things become infected, they break. They have all sorts of problems and I'm left with postponing treatment which will determine whether they will live or die, basically for a cosmetic implant."
And the longer a woman goes without reconstructive surgery, the less likely she is to want one, Brooks said.
This is what Brooks tells his patients: "Before you make a decision about your body, talk to other women. Most women will let you see what it looks like and you'll be able to make a decision, because it's your body. [The implant is] not making you live longer. It's purely cosmetic."
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The "foreign object" thing brings up the possibility of capsular contracture. I had general scar tissue outside the capsule area just due to the disruption of the entire breast/chest area. Myofascial release worked great on this. However, capsular contracture, which I also had, is related to the implant and the scar tissue that forms directly around it. While both can cause a feeling of restriction and tightness, for me, the CC continued to progress in spite of the therapy. It became more painful. When my implants were removed, the surgeon discovered the capsules on both sides were very thick and tough. They don't know the cause of CC, but FDA articles note that if you've had CC, you are more likely to get again with another set. Switching the type of implant can sometimes prevent, but the risk is still quite high.
As far as the muscle returning to a more normal state after complete removal of implants, I would say that mine feel much more like they used to. My PS tacked the pec back to the chest wall as it should be. The side that had the pec damaged from expansion/implant couldn't be completely repositioned, but it was still tacked back to the chest wall and feels like it is functioning normally. I can flex my pecs like before. Since the past four months since my surgery, I have noticed the muscle is continuing to retract and look more normal. I think what makes it appear less normal is the concave areas due to expansion and implants.
I'm not a candidate (by choice and because of lymphedema) for any further surgery or procedures, but I am quite curious to see if/how fat grafting changes the standard for reconstruction. Lee, do you know whether fat grafting can fill in the concave areas for women who deconstruct?
Kate, I'm so glad to hear that a LE eval was included in your tests. Women can have a difficult time even getting a doctor to recognize that as a potential problem. I hope for you and beacher it is not the source of your discomfort. -
Hi ladies - I am sure I missed some posts that describe the pain you are having from the implants......I have been suffering from pain in my MX side for months now and I had 2 MRIs and they were clear and I alos think my PS doesn't take me seriously....I have pain that goes from the implant side to the shoulder blade and collar bone, it is more painful when I yawn and pull those muscles.....Does anyone have similar pain? would it eventually go away?
Any answer would be much appreciated.
Patricia
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Tina337 - I'm glad to hear that your pec muscles are close to what they were. That's great news and it's encouraging. As far as your question about fat grafting - it would seem that fat grafting would be such a natural option even if you didn't go for full reconstruction. It wouldn't hurt to send Dr. Khouri an email (with photos, if possible) and ask him. I know you don't want any further procedures, but I'm sure he could fill in and smoothe those concave areas and have you come out with a "social" (small) breast. Just a thought.....
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Patricia- One of the hardest parts of all this is figuring out the source of the pain. There can be lots of things going on- post mastectomy pain syndrome, lymphedema, tight pectoral muscles, capsular contraction, etc. It seems the list goes on and on. I just saw a PS yesterday who said my pain from the side of the implant to the armpit was probably scar tissue that has formed and recommended PT. I know a lot of times our pec muscles get really tight, too. You might want to look into some kind of PT, too. It definitely couldn't hurt. It's good the MRI's didn't show anything and I'm sure if you were developing CC your PS would have detected it. My guess would be the scar tissue or tight muscles. If your insurance requires a referral I'd call the PS's office and see if they can write one out for you. Sorry! If it helps I can sympathize with what you're feeling! (((hugs)))
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Kate thank you for replying. My PS PC and Onco. All think it is muscular, my PS initially mentioned PT before I did the MRIs but I haven't heard from him since, it was my Oncologist's NP that called me with the results but I see my PS in September and I will see what he has to say, he doesn't think it is lymphedema.....Hugs back to you
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hello I finally just posted some photo's on the picture forum. Could anyone take a look and tell me am i crazy or are these foobs way off? the r side has dropped and fluffed very comfy but way too big for me im 5'2 small framed...and the l side is tight and sometimes painful,lots of tightness and bumpy under l armpit think cording too will know tomorrow when i go to le pt for aws. Im thinking that this 500cc foob in my l mx side is too big and causing some of this problem,Please anyone tell me wht you think
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