Still Uncomfortable with Implants
Comments
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Ladies - what do you consider to be "large" implants?
My Original Girls were 38DDD, heavy, fibrocystic, painful, and hung to my waist. The one thing I was looking forward to after BMX was perky New Girls.
Because I was so heavy at the time of my surgery, my PS put in TEs that were 16cm wide. Shortly thereafter, I entered a weight loss program, and would eventually lose 60 pounds. I was expanded to 620ccs, then I delayed any further expansion until I met my weight loss goal.
I consulted with whippetmom (God bless her!) who helped me determine an appropriate size implant for my body shape and size. I'm 5'5" tall and weigh 144 pounds. My rib cage measures 32".
The PS put in Allergan Smooth Saline High Profile implants, filled to 700 ccs. They were 14 cm wide, so at the time of Exchange, he did a lot of pocket work: removed scar tissue, released the pectoral muscles at the top and bottom on both sides, and performed bilateral capsulorraphies, where he stitched completely around each pocket to prevent any migration.
When I woke up from exchange, I never felt that immediate "AHHHH" feeling reported by so many women. I just hurt, and thought that was normal,considering the extra work he did.
When the bandages came off, Lefty was significantly more swollen than Righty. The PS told me it was "excess fluid from all the pocket work" and to be patient, that it would reabsorb into the body over the next few months. (I never had drains at Exchange.)
Well, here I am, four months out. I saw an LE specialist at the hospital last month, and her first words were "Oh my, you are so swollen on the left side!" Well, duh....
She ordered me two Belisse compression bras with two Jovi-Pak inserts. She also gave me several handouts for MLD exercises.
But the reason I had gone in to see her was the pain I started experiencing, especially in Lefty. Whenever I raise my arm, I get a sharp, painful pinching sensation somewhere under the incision line. The incision moves freely over the muscle, so she doesn't think it's adhesions.
However, to me, it feels like an area of the pectoral muscle is rubbing against a nerve, and there is an almost audible "thunk" as it slides over the place in question.
The LE PT said this was most likely due to the pectoral muscle needing to be stretched, and gave me more exercises.
Yet how does this explain the Iron Bra feeling I have 24/7? And the annoying displacement/deformity I feel and see every single time I flex one of my pectoral muscles?
Or the exquisite pain I feel when a low pressure weather system comes in and my New Girls ache for days?
With the exception of the implants being squishy, they feel exactly like the TEs did.
At my last appointment with the PS in November, I tried to tell him the concerns I was having about symmetry. He stared at the implants for the longest time, then said "Actually, I think they look pretty good."
He wasn't trying to be snotty or arrogant, that's just his communication style and I really like him, but sheesh! I could have used a little emotional support at that point.
During the past month, the pain has gotten worse. I never go braless, except at night, and even now, I've started wearing a sports bra again.
Size-wise, I don't think they're too big...depending on the brand and style, I can wear a 34DDD, a 36DD, or a 38C, and I look pretty much the same in all of them.
I see the PS again on the 29th of this month, and I don't think I'm going to be a happy camper.
Asymmetry I can live with. Pain, however, is a different story.
Your thoughts?
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I had recon with implants in March 2012 and another "tweek" Sept 2012. I do not like the implants, they are a constant reminder. I feel them all the time! the effected side had LD flap done, so that side is tougher, does not like to move in a bra, when I wear one. The left side, not too bad but still hate implant. Bras do not fit me properly and if I do not wear one then in some shirts you can see the outline of the football shape scar so it looks like I am uneven. Sigh..... I was not a candidate for the tram flap and the first PS I saw only did one on a cadaver!! So I went shopping for another PS, he mentioned the LD being the best thing in my case. I wish the implants were softer and more bouncy. Some of my friends are jealous because I do not have to wear a bra. "Take them" I tell them "but you have to take it ALL not just the perky boobs".
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Blessings
So interested to see your post. As you will see on my profile, our stories are pretty similar. I have 800cc silicone implants and have for the most part thought they weren't that big as I, too, had large natural breasts-38-40DD. Now I'm not so sure. I have had lots of ongoing problems which are beyond frustrating.
My left side is much fuller and swollen out to the side under arm. It has been that way since my mastectomy in April. Worsened during filling. My TEs came out in July. Right side was filled to capacity in April. Left to 650 and then I had 3 fillings of 50cc each added to left to make it 800. I did PT towards the end of TES then resumed beginning of september after strict restrictions were lifted. I NEVER felt the relief everyone talked bout either after getting those damn things out.
I had a lot of extra sutures laterally on both sides when implants Put in because PS moved them inward at my request. I felt like my TEs were way out there to the sides. He said my ribcage limited how close in they could be placed.
PT released me about 6 weeks ago saying lymphedema gone and we had reached the goals I came in with. True I have full range of motion but left side is tighter and I have had extensive issues with my left arm shoulder upper back. Tingling numbness nerve pain all way down to my pinky and ring finger. Have faithfully done exercises and stretches throughout all of this except during my restriction periods.
Started a more extensive exercise program through a woman I met at my gym, who has worked a lot with reconstruction patients with much success. I have lost about 15 pounds and have a long way to go. My breast surgeon was of the opinion that I'm still uncomfortable due to my extra weight and to the size of my implants. I do agree with this but it still doesn't explain the left side bullshit.
Overall tightness does seem better the last couple of months. Fr the most part I can live with how my right side feels. Although I do get the achyness from the cold like you mentioned on both sides. That is just miserable!! And I seem to be cold much of the time. Was also getting pec spasms but not as bad.
I am constantly trying To figure out the bra thing. I used to only wear padded underwire pre cancer and haven't even tried since surgeries. Was wearing genie bra types pretty 24/7 till it seemed they weren't supportive enough. So got 2 different playtex 24 hour things soft B size cup (so weird B cup) but after half day or so I just feel like it makes them hurt worse. But if I go without, I am more aware of the swelling and end up feeling more achy and tight everywhere. Never ending,trial and error with the bras.
Tks for listening. I would love to chat with you more and compare notes. Sure didnt sign up for still feeling like crap this far out. Losing patience. I did start seeing a chiropractor about a month ago who thinks he can help the left side issues. I sure hope so. The fear of never feeling better gets completely overwhelming at times! -
I'm in the process of fat grafting (for very reasons I'm not a candidate for a free flap). The first surgery, the doctor put fat around a smaller implant. It felt better for awhile, then started to bug me again. This last surgery, we weren't sure whether she'd try another round of fat over the implant, or take it out altogether, but in surgery she saw how tightly scarred down the implant was and removed it completely. I do feel better without that thing in me. I can't say I feel totally better, because I still have the mastecomy scar, which is fresh again from this surgery, and that feels tight. Also there's irritation from the radiation (which was several years ago). But it's not as bad as when I had the implant. I also had a very painful nerve under my arm which the doctor has put fat over twice, and I don't notice that like I used to, either.
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hi ladies, had exchange dec 4. still having iron bra sensation. is that normal? seems worse than expanders.
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Shabby, I had that problem and could not take it any more. I took them out 3 weeks ago and feel so much better. I hurt where they put the drains in under my arm but that should go away. Don't let your doctor make you feel like it is just you, mine tried to do that and I let him have it..lol With the implants I looked great but felt horrible, and it seemed to get worse for me. Can you believe I lost 5 pounds after the implant removal .no wonder I hurt so bad. I couldn't take my femera ( anti estrogen drug because the hotflashes and pain were too much to deal with. I am starting back up again..blah
Hope that you feel better
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Sandrav - you have given me so much encouragment! I am scheduled to have my implant removed on Jan. 17. It has been a miserable 2 years, and I decided living without pain is much more important than having something that resembles a breast. I hope I get the same relief that you experienced! I have felt so terrible with body and joint aches, that I took myself off of the Tamoxifen last month to see if that would help. My oncologist doesn't even know that yet! But maybe after I get this implant out, my body will get out of "attack mode", and I may try going back on the Tamoxifen. I pan to try a few fatgraft sessions so I don't have to have my skin and nipple removed. We'll see how that goes!
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Blessings,
I have waited to respond to your post of January 2, not certain whether I should or not. I don’t want to sound like a Debbie Downer, but so much of that post could have been written by me: not getting the Ahhhh feeling after exchange, persistent swelling, disappointing asymmetry that we did not expect and what your wrote that really took me by surprise, the “thunk” that you say is almost audible. I have that exact same thing in the area I have had such severe pain since the exchange surgery. If I move the implant on that side, I can feel and almost hear it jump over something. Thump, thump, thump as I displace it upward. Very odd, indeed. The other side is nothing like that and moves smoothly in the pocket. After almost a year, a pain management physician was finally able to block the feeling of pain on that side, but the “thunk” feeling is still there when I move that implant. As you said, living with asymmetry is one thing but we cannot live with constant pain. Gosh, that sounds so much like me the past year. I am sorry to read that is true for you, too.
And alas, the lack of support by the plastic surgeons when trying to discuss where the results disappointed us is devastating. Yes, a little emotional support would have been appreciated so much.
I am sorry your pain has gotten worse. I know exactly the path you are walking now and I think you know from my prior posts here and on the picture forum what I bad time I have had with that and so many of the same issues you describe. Please make certain you do not do what I did and just hope time will take care of things. It will not. Do not let your surgeon ignore or postpone taking care of things. That can only allow the physical pain to get worse which in turn makes the emotional pain more hurtful. Despair might be the best word for it all, taken as a whole.
I will be thinking of you on the 29th when you have your next appointment. I am glad for you that you are able to see your original surgeon again. He knows what has been going onwith you and is probably the best one to help you if he is able (and willing). Please don’t let yourself be ignored and dismissed.
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Oh, Monday'sChild - you are definitely NOT a Debbie Downer; in fact, you were a HUGE inspiration in motivating me to call a local LE massage therapist today.
My Kaiser PS said all that extra swelling on the left side was just fluid from the pocket work he did at exchange, and that it would go away on its own. It didn't.
My Kaiser LE/PT therapist told me the swelling was from LE, and ordered me two compression bras. She also said the pinching/tearing pain in my left breast - which is getting worse - is from the pectoral muscle that needs to be stretched. I have full range of motion, I keep stretching that muscle, and nothing happens.
She gave me some handouts and sent me home to do all the manual lymph drainage and pectoral muscle stretching...but never laid a hand on me herself.
Somehow, something's not getting done. Somehow, no one is understanding me. And that's NOT o.k.
So today I made a call to a local therapist who comes with rave reviews. After listening to me for just a few minutes, she told me it sounded like I needed myofascial release. I said I think you are absolutely right.
I'll see the Kaiser LE person on Wednesday to be fitted for the Belisse bras (I don't have to pay for them; they're a covered benefit, so I might as well try them...), then on Thursday, thanks to a cancellation, I can see the new therapist.
She wants to see the actual surgical report from my Exchange so she knows exactly what's going on inside me.
She also said to plan on being on the massage table for at least an hour as we worked on different areas.
I am hopeful.
SO, Monday's Child, thank you for sharing your stories with me. It is making me get off my butt and go out there and find some answers.
xoxoxoxo
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Blessings,
I am glad you have someone listening to you and giving serious consideration to a solution. My biggest problem had been severe pain in an area on the chest wall, behind the implants, and that is what another physician finally improved for me. I also had LE therapy which included complete PT work and 1.5 hours of hands-on each time I went. I also have massage but mostly for drainage. She did work on scar tissues some and that helped with a burning area along the IMF scar a little but it still flares half the time. It is just not much compared to the other, almost unbearable, pain I had before. It sounds like your sternum pain may be the equivalent level as that. I hope you find a solution and the myofacial work sounds like a good one.
For me, I am going to consult to see if surgical scar revision can help that burning area. My breast surgeon told me to talk to my pain management physician about having it injected with ethyl alcohol. No kidding. He said that is a permanent fix to disable the nerve. The other side needed the nerve disabled all the way around, from the sternum to spine. I guess this is a more isolated area.
For the iron bra feeling and tightness, get a foam half-roll. You may be able to buy it through the PT facility. You have to do it almost every day, but you lay on it and let your arms fall to the side and hang for a minute. Then bring them up slowly and back down for another minute. Do five times. As your new physical therapist about it first, of course, and if agreed it would help you, also get a correct demonstration of form. This has really helped me.
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MC: I am printing this out and taking it with me when I see the new therapist on Thursday! Thanks!!!
When is your next appointment? Keeping you in my prayers for answers and relief....
xoxo
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Hi Ladies, I was just catching up on a few of the boards I used to read when I felt EXACTLY as you describe. Mondays, I debated posting the entire time I was reading, but after seeing your post I thought I would chime in (I wish someone had for me sooner). I had a double mast with TE in January of 2010, rads and then implants. I expected the ahhhhh that never came. It was OK, but for me the iron bra was 24/7 and drove me NUTS. As time went on my radiated side grew higher and tighter and developed LE--I still believe because of the implants, but I guess we will never know. My PS was sympathetic and willing to help/listen, but he was the one who said you need to do a flap. Not a lat flap, but a tissue flap (i.e. a diep or a TUG), that will put your muscle back where it should be and get rid of the implants entirely. I listened to him and, after 6 months of debate, took the huge leap of faith to have the damn things removed and get a TUG/PAP (you can see my previous posts on the subject if you are interested). I can't tell you the difference it makes. I didn't realize how truly miserable I was until they were gone and replaced by something that feels normal and right. Flap surgeries are big and not easy but, in the words of my awesome PS, the high initial investment should have a lifetime, big, payout. He was so right. Recon is a personal/individual choice. There is no best option, but this is the one that really worked for me. I hope you all find a peaceful, pain free, existence soon!
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Wow, this is wonderful! I have thought about doing this as well but the thought of additional surgery scares me to death!! I'm so afraid the pain could get worse if that is possible!! You must feel like the nightmare is over! So happy for you!
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Ditto to amac's experience. A very personal choice that fortunately was the answer to my implant misery too.
I had a bilateral SGAP to replace both implants with my own warm, soft jiggly buttock tissue. Im not very big because Im very thin, but after the amount of pain i went through with implants it's okay for sure. I could have had bigger breasts by having tissue transplanted from my butt and belly, but i didnt want the big scar on my belly in front. For ladies with more weight, getting a tummy tuck is a perk, but not in my case.
It is so nice to have pec muscles returned to their natural position. My microsurgeon had to do a lot of repair to pec muscles and chest wall fixing torn muscles, removing scar tissue, and removing chunks of Alloderm that had bunched up and adhered to chest wall. He did a little fat grafting to fix a spot in axilla. The next surgery will involve shaping fine tuning breasts and also s lot of fat grafting where ever the heck he can find fat.
I wish you all the best in your decisions and pray for relief of pain and discomfort for you. -
mpl, the surgery was big (14 hours) and the discomfort very real for about 2 to 4 weeks. BUT it got better pretty fast for me. It will be a year this April, and it already seems like a thing of the distant past. I can't imagine one of these surgeries making it worse (with great micro surgeons that is), but I guess you never know. It certainly solved things for me. I get my nip tatts on Feb. 5th. Can't wait. I certainly hope it's over. We all deserve that!
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What is LE?
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I am seeing my PS tomorrow to discuss options. I really hate the implants so I hope we can do something.
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Mlp,
If you decide to research this option, the surgery can be done in 8 hours if you go with top microsurgeons devoted 100% to breast cancer patients and who do their surgery with a partner microsurgeon, not solo and not with residents. Mine has done thousands. I am also very thin.
Recovery is longer, but worth it.
This is just my personal experience, so please get several opinions and ask the surgeon how many free flaps like DIEP and SGAP they have performed. Also ask how they communicate with you afterward. I had a free lengthy phone consult and I can email with him and update with pictures. He answers emails promptly and answers each and every one of my list of numbered questions in my email.
Dr. Kline and Dr Craigie, The Center for Natural Breast Reconstruction, also accepts ALL insurance, and does not balance bill. I could not find a high level of expertise and compassion locally, so I did have to travel to beautiful coastal city of Charleston, SC. Please PM me if you would like. -
Having my 410cc implants replaced with total fat grafting. Went from a 410 to 213 to 120cc implant. Presently a mild discomfort. Having my implant totally removed next month. Hoping for total pain relief at that time. So far quite pleased with my results--both regarding cosmetics and comfort. Quite happy with my decision, as healing time is minimal. Eileen
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LE = lymphadema
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FYI the 14 hours on my flap was due to complication and because of the type of flap I used (TUG/PAP), which are more challenging. Apparently my anatomy is a bit unique on the right side. 8 hours was the plan. I guess things don't always go according to plan huh. My microsurgeons are very experienced, trained by the best, and totally AWESOME on communication, etc. I couldn't ask for more, and I would do it again in a heartbeat. Feel free to PM me if you want more info.
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Hello everyone,
I had a double mastectomy 9/10/2012 with expanders, I didn't do any fills and had my swap surgery 10/16/2012. He put in 300cc silicone implants, I weigh 130 and I am 5'6. I am still in a lot of discomfort and pain, I get a burning raw feeling in the upper corners where I have a little denting.
I also did physical therapy and have great range of motion but still very tight. My implants are heavy and move around. I look good and they are soft but I am not happy with the pain. I live in a major city and was told my doc was one of the best. I saw him today and he said he thinks it is post- mastectomy pain syndrome from the mastectomy and not the implants and wants me to wait till summer and see how I feel.
Does anyone have any suggestions? I don't mind a small chest, I rather prefer it but I don't want to be concave. He also said I don't have enough tissue for any flap.
Any help or ideas would be greatly appreciated.
Thank you Deb -
Deb,
Definitely get another opinion, especially with his comment of you don't have enough tissue! Your PS isn't familiar with or have the skills to do a free flap, such as DIEP or SGAP. I am very thin (5'6", 118), and after going through implant hell, I ended up with having a bilateral SGAP, with a very down-to-earth, highly talented microsurgeon.
The top microsurgeons CAN do flaps for thin patients, either an SGAP (from buttocks/hip), or DIEP from tummy. They can do stacked flaps as well to add more volume if you want to be bigger. Make sure you ask them their numbers of how many surgeries they have performed.
I had post-mastectomy pain AND pain from implants and radiation. My first PS tried to tell me I needed to "wait and see" until 1 year to 18 months. No way was I going to spend that long in pain when I knew it was the implants were literally tearing me up inside. As things turned out, my implant tore its way out through breast skin anyway, ended up in ER, then surgery to have it removed. Had no other option at that point to have a free flap because of all the damage.
Do you live in a major city, or have family or friends in a major city where you could go for surgery if you can't find one locally?
Take care and take time to research.
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Thanks for replying. I live in Chicago. What have you heared about the brava/ fat grafting option. I think I would like that.
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The option I have chosen is fat grafting with brava-multiple surgeries-going quite well. Good luck in your decision. Eileen
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Eileen,
Do you know if patients with radiation damage can do the Brava procedure?
Glad that is going well for you. It will be interesting to see in five years what recon options are widely available and discussed with mastectomy patients.
Is your surgeon participating in the Brava/fat grafting study? -
Yes-my PS is doing fatgrafting with brava on radiation patients with great success. I am sure--techniques will be improving. Very satisfied to date. If my finished product is not perfect--will be looking for more solutions in a few years. But --to date--my improvements are tremendous--most of my discomfort is gone. Hoping to be pain-free when my implant is totally removed next month. That is my experience. Eileen
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Pinkheart, I've had radiation and I'm doing the fat grafting (same doc as Eileen). It's challenging because the radiation can scar down the skin. But I think I'm seeing improvements with using the Brava. (Some of the photos on the Brava discussion board look great.) I would have done a flap if I could have, but was not a candidate. This was my only option, and I'm happy so far.
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Deborah, just wanted to second the "get a second opinion" advice. In addition to the options listed above, a TUG or PAP is also an option for a flap (inner thighs). I know several women who are VERY thin that were able to get a flap with this option. You may not be a DD in the end, but who cares. To me it is all about perspective--I'll take small, real and pain free any day over the synthetic one or, worse yet, the ones that tried to kill me.
Also, again in my opinion, Docs (even very good and kind ones) push what they know and steer you away from what they don't. There are many talented docs around who could help you with these options. You know your body. Do what you have to do to get it right. Good luck
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Thank you all for the advice, I really don't care how big I am, I actually perfer to be a small b or smaller, I just don't want to be indented and I am really tired of the tightness and pain. I am looking for a second opinion now.
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