Still Uncomfortable with Implants

Hi ladies, I've been reading this thread & I am so sorry some of you are unhappy & uncomfortable. You would hope with ALL you've been through you could at least not be left uncomfortable & unhappy.

I am 5 weeks out of my exchange and not that happy either. I was hoping to be a bit bigger as I was a D & now have a hard time filling out a C. One side is smaller & has some unevenness. I was told by my PS we have to wait 3-4 months to see. I guess my question is, how much are they going to really change by then? And is it normal that when you flex your pecs that they become so weird looking? I am not a body builder but was a strong women.

Thanks leeinfl. When you had your revision what did they do? Different implants, fat grafting?

Stanzie I am so sorry for all that you have gone through.  I see you live in Georgia.  If you haven't already been there, you may want to consider a consult at Emory. 

I'm appalled that your surgeon won't order PT.  If you have not tried it, why the heck wouldn't they give it a try???  

Kate-your reply to stanzie------brings tears to my eyes.  You always give such good advice. We are blessed that you come here---Namaste sheila

Sas- Thank you for your kind comment.  I really needed that today.  You give good advice, too, and I think that is a great idea that the size has to be listed on the consent form!  What an excellent idea!  Over and over I hear of women who were made bigger than they had asked for.  I know some women are large breasted to begin with, and want to stay close to their natural size, but would they choose that knowing what's involved with their pec muscles?  I was in pain with a 375 and now have discomfort with 225.  I cannot imagine having my pecs stretched over 850 cc's!  That's inhuman and irresponsible of your PS.  

My oncologist is female and she is really great.  It is harder to find female surgeons though.  It kind of seems like a boys club.  But that said....I love my breast surgeon.  He is such a dear man.  My PS, is more the typical surgeon type....all business.  But he is kind and always wants to make sure he addresses all of my concerns.  He may not be able to do much about them, but at least he listens.

sas-schatzi, my surgery was 10/30/09 with t/es and exchange 3/30/10. Hated the t/e, and PS had to remove the implant that was initially put in on mast. side. When I go to PS on 3/6 I am going to mention pec muscles and shifting. Last visit PS said definitely more surgery would be on way because of my complaints. I have no idea what is in store for next surgery. I have completely had it.

 Like everyone here has said, THANK YOU KATE. I am relieved I am not alone. Every day I get up, put the bra on and say when will this nonsense stop.

When I flex my little foob does "magic faces".  Last night on 20/20 there was a segment on revision of implants, but I did not watch it, and I do not know if they were for "mast" gals or just augmentation and the uncomfortabless involved that led to the revision. Pig skin, netting were all involved. Did anyone watch it??

Thank you again Kate.

stanzie and all thanks. 2 and 7 months later , it's not as bad as it was. Seriously.Now I just wish they were different.

My implants were put in last May 26, 2011. I never got the tissue extenders filled, because I had such a terrible infection (cellulitis). It got so bad, that my original surgery was April 7, 2011, and then only a month or so later, had to have the te's taken out, and the implants put in. 

I used to say for the short time I had the te's in, that they felt like two bricks duct taped to my chest. Then with the implants, which are about a B cup, they feel like two oranges duct taped to my chest. I did not find out till last Fall, that the reconstruction involved AlloDerm. Am I the only one here that did not have the doctor explain that to me? I don't know how thrilled I would have been to have implants put in, if I had known ahead of time about the fact that they use AlloDerm. 

My implants are also underneath the muscle, and when I make the muscle move on my chest, it moves the whole 'foob'. My PS said that is normal.

This Tuesday, I go to see my Breast Surgeon for the first time in over 9  months. I hope I remember to recommend to her that she and the Plastic Surgeon should give more detailed information about reconstruction, than they do after a woman is diagnosed with breast cancer. I think we all were so mortified when we first found out about having breast cancer, that maybe we didn't even fathom what would happen down the road after being giving the different choices of what we should do.

Best wishes to you all! Right now, I am still always aware that I have something sitting on my chest, kind of like how odie16 described it, like a rack sitting on my chest. It has now been 9 months since my implant surgery, so maybe it will continue to improve (I hope).

Kouragio- You have good reason to hurt.  I've never heard of a PS putting that much in the TE so quickly.  Think about your pecs that used to lay flat now being pushed out, and wrapped around, 250 cc's.  That is a lot and it's going to cause some pain.  If you're not currently taking pain meds I would ask your PS for a Rx for a muscle relaxant.  Are you planning on doing more fills?  I would take them slower and smaller and use the muscle relaxant for a few days with each one.  Don't judge how it will be based on the TE's.  The implants are much better and most do not have issues afterwards.  Those of us who do are the ones posting here so you won't really hear too many good stories on here.  As far as being Stage IV you may want to post a new thread in the Stage IV section and ask them about recon.  Personally, I say if it helps you then it's worth it.  (((hugs)))

Just recently I heard about a PS who will do the implants over the pecs and then do fat grafting over the top.  I really have to wonder if none of us had ever had our pecs involved in all this would any of us be having issues right now?  If this is a viable option, with less complications, why isn't everyone doing it?  I would think less of us would have that sensation of the implants being stuck to our chest with this choice.  My fear, though, is once the pecs have been altered there is no going back as far as them feeling normal again. 

I haven't posted here in a while but thought an update might be helpful. It has been almost 11 months since I had my implants removed and reconstruction undone. The thick capsules were removed and my muscles were repositioned. One of my pectoral muscles was severely damaged and repaired as much as possible. I am still 99% pain free and feel great. My body is MINE again, no longer held hostage by implants and pain. The LE is still an issue but easier to cope with now.




There are so many variables when it comes to determining the cause of pain after recon with implants. For me, it was important to have myself thoroughly examined by various types of doctors, additional PS's, PT, LE and other therapists to rule out possible causes.




When I started experiencing pain six months after the exchange surgery and the implant became deformed, my BS commented that it might be poking through the muscle. PS said this was not occurring, and he wouldn't even confirm capsular contracture until I went and got a second opinion a few months later. After two years of PT, myofascial release, and lymphedema therapy, I got an opinion from three PS's on deconstructing. Two at the time of consult commented that implant could be poking through muscle. Couldn't believe original PS said this wasn't the case and I had lived in pain for two years and paid for therapy that could never have corrected the problem.




In all the time I complained of pain, my PS never suggested an MRI, but after reading the FDA implant documents for doctors, I learned that they are required to do so when patients with implants present with serious pain. Wish I had known that at the time! I only discovered when I was visiting FDA site to get forms to report serious adverse event to MedWatch. Implant failure is considered an adverse event, but implant failure with a torn muscle is considered a serious adverse event, and I wanted to make sure this was documented.



Flash forward to today - I do not wear prosthetics, and while my chest does have some concavity, I just don't care about it anymore. I have found new clothes that make me look/feel great. I am still working on getting back into shape, but the LE is somewhat of a hindrance. I need to take it slowly to prevent flares.




I feel fortunate that the removal of my implants and muscle repair was the solution to my problem, as I had been warned this might not be the case. I feel terrible for those who have deconstructed only to still have the same or worse pain. It just isn't right, and with my original PS always repeating the typical line that I was unusual and that there was no problem with the muscle, I can't help but wonder if he was either oblivious/ignorant about the muscle or intentially blowing me off. The PS I got the second op to confirm capsular contracture never said there was a problem with the muscle, just that he would replace the implant. So, was he an idiot, too, or did he just want to perform surgery? I don't know, but the whole thing is pretty effed up when you have to be so diligent and ask many people for help and opinions before you can get an accurate picture.

ElanaMarie I too had only one fill and could not complete rest of fills. I also have AlloDerm and he makes me think I am the only patient who has ever complained. He did remove the heavy implant and placed a lighter one in.  You story sounds just like mine, my te's were bricks and my foob is just like an orange  or a piece of meet duct taped on. 6 weeks ago, he recommended surgery to once again lift the foob. It really is all over the place.  I will know more on March 6. He told me to go back to upper body exercises and wear a very sturdy bra. I swear I have about 20 different bras. This site is very helpful but again I know I am not alone. Lifting the weights caused other problems for me, I hurt my back in the meantime.

I must admit I asked very little questions before any of the procedures. Too scared.

Kate, My BS was the one who brought up the issue of Alloderm and how there has been problems related to the use of it. He didn't specifically say pain but thought maybe my body was rejecting it?? I did develop an infection for which I was hospitalized during the TE phase. My PS totally disagreed that Alloderm would have anything to do with what was going on. He also said (my PS) that it is impossible to remove it! I know I was never told that this was going to be used prior to my BMX. Seems like there is many things that weren't discussed with any of us. I really get angry with myself when I think of how little research I did prior to my surgery but as I mentioned before, when I got that diagnosis, I put so much trust in my doctors. They were God and could do no wrong.

I just read this about fat grafting improving pain from post mastectomy pain syndrome which I thought was interesting-

http://www.ncbi.nlm.nih.gov/pubmed/21788826 

I just ran across this article I thought you all might find very interesting.  It was just published this month. 

Risk Factors for Adverse Outcome following Skin-Sparing Mastectomy and Immediate Prosthetic Reconstruction 

Background: Attempts to identify risk factors for adverse outcome following skin-sparing mastectomy and immediate prosthetic reconstruction have yielded inconsistent results, and no clear patient selection criteria have emerged. The authors identified patient- and procedure-related characteristics that predict unfavorable postoperative outcomes. Knowledge of these risk factors will facilitate preoperative patient screening to reduce the rate of implant loss and other postoperative complications.

Methods: The authors retrospectively evaluated the postoperative outcomes of implant loss and major and minor complications in 102 patients (155 breasts) undergoing the combined operation from January of 2005 to December of 2010. Univariate logistic regression analysis was performed to determine the influence of six patient-related and three procedure-related characteristics on implant loss and postoperative complications.

Results: The use of acellular dermis was associated with a greater than three-fold increased risk of postoperative complications. Radiotherapy exposure was found to have a significant association with implant loss. None of the patient-related characteristics studied behaved as risk factors for postoperative complications, and none of the procedure-related characteristics acted as risk factors for implant loss.

Conclusions: A cautious and conservative approach to using acelluar dermal matrix in this setting is warranted until its effect on postoperative outcomes is more clearly defined. The authors' data support findings from other studies of the deleterious effect of breast radiotherapy on postoperative outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, IV.