Still Uncomfortable with Implants
Comments
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Fatgrafting on April 18-definitely solved the problem. Went from a 410 implant to 213.
What a difference. Fatgrafting was the right decision for me. Minimal recovery. Eileen
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Eileen- So glad you are feeling better and everything went well! Amazing how much better it feels with a smaller implant, huh? Hope the rest of your recovery goes smoothly! (((gentle hugs)))
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Yes Kate--certainly learned much from this forum. Smaller implant has made a world of a difference. Will be totally removing my implant with additional fatgrafting in the fall. Eileen
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Eileen- Your PS was Dr. Ahn, correct? Just curious- does she do anything to restore the pec muscles or isn't that necessary? I never heard of Khouri repairing them or removing scar tissue or anything like that. I was wondering what the other FG PS's are doing if anything. Is this something that has ever come up? I would so love to do what you are doing and get rid of these dang implants.
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She did mention muscle repair and loosening up of scar tissue(cannot be totally removed, but can be cut for band relief)
She added fat under the armpit area--and my lymphedema is now gone.
She always stated that I will not have total relief until the implants are gone. But, what a difference.
Eileen
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I would not be surprised if Dr Khouri injects fat into the pecs when he swaps out the implants and adds fat.
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I know that Dr. Ahn is planning muscle repair with me, for sure.
My pec was cut to place the implant, and she implied that she didn't like that technique, that the better way to place an implant was lift the pec and insert the implant under with no cutting.
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Wow, where on earth is this Dr. AHn? Also thanks for both links on the previous page. Will look forward to reading both once I have time.
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Kaisers- I've never even heard of that technique! It makes sense, though. Why cut someone's muscles if you don't have to? Sounds like Dr Ahn looks at the whole picture and tries to eliminate some problems down the road. And comes up with ways to fix existing ones. Good luck with everything.
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This morning I've been researching removing implants and lymphedema. I found this information on the FDA site that says one of the risks of implants is lymphedema. I have never seen this before. LE is pretty serious and chronic (says one who was just dx with it). Shouldn't we be advised that this is a possible risk even if it's a small one? Now I'm wondering if removing my implants would improve or eliminate my LE. Time to do more research.
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Kristerts, that makes so much intuitive sense to me. It's bad enough to disrupt the function of a muscle by placing a foreign object under it...but to cut a perfectly good muscle...just makes me cringe. (I'm a PT, so I have a fondness for babying our muscles, tendons, and ligaments! Rehabbing them is no small task.)
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That's pretty fascinating Kate about the LE and implants! I wonder....
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reducing the size of my implant-especially the width, and having fatgrafting in the armpit areas--seems to have eliminated my lymphedema. Perhaps it is aiding my lymphatic drainage. Definitely another plus for fatgrafting. Eileen
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As I now recall- the lymphedema started after my last implant exchange--5 years ago.
Did not have lymphedema prior to that. Eileen
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Just found this breast implant site that says "upper extremity lymphedema is a common complication following breast augmentation"! Common! Funny how this was never discussed when deciding on implants. And that's with augmentation. I would recommend that anyone having discomfort with their implants also have an evaluation for LE. I read that truncal LE is on the rise because more and more women are having SNB. During SNB they remove the first nodes which may not necessarily be in your armpit but could be truncal. You should confirm with your BS exactly where your nodes were removed.
http://www.justbreastimplants.com/forum/breast-augmentation-complications/110599-lymphedema.html
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Kate33... Perhaps you should consider contacting Dr Marga Massey. She is an expert and very cutting edge with regards to LE... She has symposiums all over the country to discuss it. Its called The Doctor is In.
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Saw my PS yesterday. It's been 5 1/2 months since exchange. He said he did not know why my foobs hurt especially later in the day. He said surgically everything looks good and his job is done. When we went to take the "after" photos, he said "wow, your right shoulder is really splinted, meaning it was curved forward. He asked me to put this arm behind my back and there is no way I can do that. So now he thinks the foob pain and swelling, mainly on the right side is coming from the shoulder and adhesions. He said fascia issues are common and I need someone who can really get in there and break the adheshions and get my shoulder moving again. He has a fascia therapist in this office, but of course she does not take insurance and charges $350 for a 90 minute session. Maybe that is reasonable. She works with a lot of NBA players. I did make an appointment for next week, because she comes highly recommended when I read her bio. Does anyone know, what other kinds of therapists would do this type of work? What does a therapist do when you have lymphadema? Does she actually work/massage the chest, shoulders, or neck? Feels like I am entering a new phase. My physical therapist who I saw in January doesn't do this type of work. Any recommendations or similar experiences?
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Lindsey, my shoulder is pulled forward by the implant. Did he consider that? I'm not big, either. (Don't know the size but equivalent of 34B).
Stanzie, it's Dr. Christina Ahn in New York.
Kate, I read that link. I think my lymphedema started after the implant, too .... maybe any breast surgery, even augmentation, can destroy the nodes or create scarring. And maybe during the fat grafting, like where Dr. Ahn releases the scarring, the lymph can move again. I know that sometimes it works that way in DIEPs. Here's hoping.
Also, I know there's antedotal stories about DIEPs reducing lymphedema. If FG helps, too, that would be fantastic.
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Sorry, one more thing. Lindsey, I developed a frozen shoulder after my initial surgery. (There were complications with expander in, expander out due to infection, etc.) Couldn't put my arm behind my back. Frozen shoulders are fairly common in women even without surgeries. The arm issue could be separate from the foob issue. Of course I'm not a doctor. I'm just throwing that out there to think about ....
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Betsy- I was researching LE and recon today and found Dr. Massey's website! That's so funny that you recommended her. Thanks!
Lindsey- I'm sorry you're having these issues. I know how hard it is when you think you're all done with this crap! If it's definitely adhesions a LE therapist wouldn't be able to help. They do a very gentle touch to get the lymphatic fluid moving again. There is LE of the breast which can cause swelling but don't think that would cause shoulder issues. And, hate to say it, but there could always be two different issues going on. Like kriserts said, frozen shoulder is very common and our posture can get really messed up from MX/recon. You might see if just regular PT could help with that. As far as the swelling you might want to have an LE evaluation just to rule it out. They'll spend part of the time going over preventative measures so it won't be a waste of time either way.
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in addition- I definitely am no longer being pulled forward from my implant and scar tissues.
tremendous difference in my posture. Hope for more improvements with healing--and again with removal of the implant and additional fatgrafting.
two weeks out--my biggest issue--was never pain--fairly minimal--still waiting to get my energy back. my stamina is down. eileen
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Lindsey - if you can find a PT who does myofascial release that is in your insurance network, you will be very thankful to not pay that kind of ridiculous money for a 90 minute session. $350 is crazy, IMO.
And yes, there are PT's that are excellent at shoulder orthopedic rehab and manual therapy (joint mobilization - which NO massage therapist is licensed to even try) and myofascial release. You have to hunt to find the good ones, but they are out there.
And then there are PT's/OT's who do LE work and are excellent at that.
Sometimes you are lucky to find one that does all of it, but most specialize in certain areas.
And yes, there are excellent massage therapists who do myofascial release. I went to one myself b/c I couldn't find a PT who was well trained in it (I'm a PT trained in both MFR and orthopedics. I'm really picky about who I will see.). So they absolutely have a role to play. BUT, if you can get insurance coverage for this, why not try that route? AND, as I said, if you have capsular adhesions in your shoulder or altered joint biomechanics, massage therapists are not trained to evaluate and treat that or prescribe effective exercises to restore normal alignment and function.
Whomever you work with (even if it is several practitioners), make sure you know what is safe or not safe for them to do regarding not flaring any potential LE.
Do an internet search for PT's in your area and look for those qualifications. Call and ask to speak to the specific PT before you make an appt. Ask them what their treatment style is. Ask them how much they do manual therapy during a typical session. Ask them if they keep you as their patient, or if you get tossed off to another therapist or PTA. Ask them if they've ever worked with a patient with an implant before. Ask them if they know what precautions to take to not flare potential LE.
OK, I'll get off my soapbox for now! I'm biased, so take my opinion for what it's worth. LOL
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Kate I think Dr. Massey has offices in Chicago
Think you should make a visit. -
Kate... Dr Massey works in Chicago, New Orleans, Charleston and Utah... She has office visits in Chicago but does not perform any surgeries there.
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Hope- Probably a good thing she doesn't do surgeries in Chicago or I'd be crashing on your couch for my recuperation. lol!
Sadly, no surgeries any time in the near future with me not working and DH on disability. Maybe if I win the lottery I can spend it on new foobs! Or no foobs at all and fat grafting. Oh well, a girl can dream.....
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Oh I am so thankful I found this site! My implant has been killing me, and there is a weird sharp corner or something--a bubble that has appeared near the cleavage recently. I need to go see my PS--but I was seriously thinking about getting it taken out and I felt like I was going crazy. It really helps to know that others have had the same experience, and that there are options. I have wondered if just getting a smaller size would help, my reduction on the other side made them pretty equal in size but they are at least three inches off in placement. My implant starts with a big bulge on top, and no gentle sloping like my real side, and I never did get a nipple placed, so it is truly a barbie foob! Do they do the fat implant to just fill in where they take out the silicone? My shoulder has been frozen and pulls forward--really--is this the best they have to offer us?
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I have newly been diagnosed with either a new cancer or a recurrance. Not sure yet. I was first diagnosed with cancer in 2003. Had spread to lymph nodes. Did lumpectomy, chemo and radiation. My oncologist says I will probably have to have a mastectomy. Not sure what to do. I have just started researching. I was thinking of an implant but after reading your posts I think I will decide not to do that. I am feeling a bit freaked out at the moment. I have not yet had an appointment with a surgeon. Just trying to gather information. I think I would like to have immediate reconstruction. Does anyone know of a good PS in the Los Angeles area? What would you recommend doing if you had it all to do over again?Thanks for your help.
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If I didn't have a clotting disorder I would have chosen a DIEP flap. I'm about to start fat grafting to replace my implant, and it's a more time-consuming but less invasive solution to reconstruction (vs. flaps). I would not choose an implant again, especially on top of radiation.
But then again, this thread is all from women who don't like their implants, so also check the threads from woman who do like them.
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Jannelle, sorry you are going thru this a second time. There are lots of recon options and yes many of them are done at the time of your mast. I had a mast on and a prophy mast to my non cancer side after chemo with immediate recon--tissue expanders placed, swapped for implants about 4 months after rads. Implants work well for some people, but as you can see on this topic, there are a lot of us who had trouble, particularly if the implant is under radiated tissue. My trouble was not as extreme as some, but I really hated the feel of the implant under the muscle, and it did cause me a lot of related issues. I just had a flap procedure done and am really happy with the results so far. Just do your research, because there's more options out there than you think. But beware, I've found that most docs push the one that they are familiar with as the "best" solution. I'm not in your area to recommend docs (I'm midwest), but I believe you will find several options there. Good luck, you will do great.
Now I can't remember who all talked about shoulder trouble, LE and implants, but I find the subject very interesting. For whatever it's worth, after almost two years with my 475cc implants, I just had a flap procedure, and ALL of that pain is gone. Prior to the flap, I slowly developed LE trouble, mostly truncal. I had a lot of shoulder pain, pain in my collar bone, sternum and rib cage. I was referred for PT with a LE therapist, who REALLY helped with LE massage and general manipulation of my shoulder and ribs. We discovered that the implant was actually pushing so hard against my ribs that several were displaced, causing a LOT of pain. My shoulder was also being pulled forward. You could see the ribs flaring in front of a mirror. Pretty freaky. I'm 16 days out from my flap surgery (a TUG) and ALL of these problems are gone. I feel GREAT. Also, my LE seems to be gone. My arm is it's normal size, no swelling at all. I wondered prior to the flap surgery whether the implant could be causing the LE. It just made sense. It was irritating everything else. Why not adding to the LE problem. It's too soon to know, but it looks promising so far. Very interesting.
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Paula- Not sure why you would be able to feel a sharp corner but the problem with implants is they were designed for augmentation- to be hidden under breast tissue. Having them right under our skin we can feel them. Not sure what kind of implants you have but you should probably get checked to make sure the implant hasn't rotated. If you decide to have them removed and do fat grafting it will probably take at least 3 procedures to fill the space left behind by the implant. Typically what they do is replace the implant with a smaller one and do fat grafting over the top. That alone can do wonders and some women stop right there. If you proceed they usually can remove the implant with the second procedure and add more fat. The third procedure they "tweak" and add fat where needed. So it's a lengthy process and unless you can schedule it all in one calendar year (you have to time it just right) it can be expensive.
Jannelle- I'm so sorry about your new dx. It just seems so unfair and I know it must be overwhelming trying to figure out the options for reconstruction. Like someone else said, keep in mind that we post here because we're all having issues with our implants. Not everyone does but I do think it happens more than our surgeons let on. Like amac said, be careful when having consults because it's like going to a car dealership. A Honda dealership is not going to tell you great things about Toyotas. And a PS who specializes in implants only is not going to tell you great things about DIEP, fat grafting or all the other choices. If I personally had it to do all over again I would have done pure fat grafting. It can take multiple procedures but I had to have a revision with my implants already. With fat grafting there are no additional surgeries elsewhere on your body and no foreign objects (that may need to be replaced 15 years down the road so another surgery). One of our members just had surgery with Dr. Joel Aronowitz in Los Angeles. He does either pure fat grafting or fat grafting over implant. Having fat grafting over implant decreases your chance of having capsular contracture which is common after radiation. What I like about Dr. Aronowitz is I heard if you do implant + FG he will place the implant over the pec muscle eliminating a lot of the problems most of us are having. (When the implant is placed under they actually cut your pecs and then stretch them out to accomodate the implant. You can imagine how this could cause ongoing discomfort afterwards.) Here's a link to Dr. A-
The member who had surgery with him was beacher4209. You could try sending her a PM if you need more information.
I personally had a consult with Dr. Lawrence Koplin in Beverly Hills. I loved him and his staff. His specialty is fat grafting over implant because he feels pure fat grafting is too many procedures for most women. He also finds in Beverly Hills that most of his patients do not even have enough fat to do that many rounds of fat grafting.
If you need more names let me know!
amac- You are the third person in the past week I've seen post that once their implants were removed their LE resolved. I was just dx with LE so this is motivating me even more to get rid of these implants. I'm wondering if anyone is doing any research on this? I think it makes sense that if our pecs are being kind of "relocated" that this may impede lymphatic flow. Our bodies are designed to work a certain way and I can see how the pressure of the implants under the pecs might be putting pressure on lymph nodes.
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