Breast reconstruction is not going as planned AT ALL.

I'm a C. I've had a few residents (I'm at a teaching hospital) assume I was still in the expansion process. I wanted a nipple sparing immediate implant, and was told I'd have to be the same size or smaller to be successful. It has been, but I must admit that I want to be a little larger once in awhile.

Hi lori. I know exactly how you feel. I was a DD before surgery and now Im a C cup. I knew I would be smaller but opted for it anyway because that was the only way I could have one stage reconstruction. Im so grateful that I don't have to get fills and a second surgery, but getting used to my new boobs has been difficult. I feel like it completely changed my figure. I went from being curvy to being pear shaped. My clothes don't look good anymore either. Its been 7 months since the BMX and as time goes on I am adjusting to the new me. Just one more thing bc steals from us. Sorry to be so negative but want to validate your feelings. Good luck and keep us posted...

I received your pic and sent one to you. Your expanders look exactly like mine did at the very beginning. I can go back and see what I was filled to if you want. I'm thinking I ended up with 400cc implants

I had a great deal of skin necrosis, particularly on the left side after skin and nip sparing BMX in 2010.  My skin ripped open through the necrotic area and my TE was extruding, so I had an emergency surgery about 7 weeks after the BMX.  I had difficulty healing and had two more skin excision surgeries before the left TE was completely removed so that I could proceed to chemo.  This area was about two inches long, for reference, and exceedingly thin - compounded by an abnormally thin pectoral muscle.  I finally healed (with the TE out) and it was replaced, without fill, about two months after chemo was done, while I was still on Herceptin.  No problems at all, and filled at 25cc weekly all the way to 550ccs and exchanged without incident to a 600cc implant. I would recommend being focused on healing your skin first, then on expanding later.  You can PM me if you have any specific questions, or if I can help in any way. 

I am certainly hopeful that you do heal now that your surgeon has debrided the area and excised back to healthy skin.  I will warn you however, this does not always work, particularly if your skin is reacting to the TE as a foreign body.  I had 3 skin excisions back to healthy bleeding skin prior to having my first expander removed.  Once the skin had healed over the seven months the expander was out I had no further issues with replacement of the expander and expansion and exchange to a silicone implant.  Even though I exchanged and had my implants in place for two years, during a surgery in March 2014 to replace my allograft material (mine was perforating - a very unusual development) the same thin area of skin tore open in two locations.  I had three surgeries over the course of the following three months, each time cutting back to bleeding skin, but the skin would not stay closed - also remaining quiet trying to heal - and it just didn't happen.  I ended up losing the left implant and it was out until last month, I had a new TE placed in December and am now going through the expansion process again, after an additional two surgeries to graft fat in hopes of encouraging the skin to thicken and bulk up underneath (I do also recommend trying this!) with the hope of exchanging sometime this year.  I would advise you to try to eat a lot of protein - like 100g daily, and possibly supplement with bromelaine and zinc to help you heal.  Good luck - I'm pulling for you!

Also wanted to add that these types of complications, and/or loss of a TE, does not signal the end of the road for implant reconstruction.  Not minimizing the difficulty or how upsetting it can be for some, but there are many that have gone on to successful reconstruction after some challenges!

Lori hoop, I'm so sorry you are going through this. There are women on the board who have been through a lot. (Hi, Specialk! ) Some women have had to have the TE removed. Some more than once (look below) Some have had to pack open wounds for weeks. Not trying to scare you, most of these women did have successful implants after their problems. There is a TE Trouble board with lots of women with stories. Feel free to pop in there for support.

Doctors don't always take the time to explain that implants for reconstruction are not the same work as for augmentation. For one thing, augmentation is done over breast tissue so the projection is much greater. That is impossible for reconstruction because, of course, we have NO breast tissue. Sad but true. Our implants are under the chest muscle to help support their weight. A natural breast is basically held up by every cell in the breast interconnecting. Our implants are held up by the muscle it's placed behind and skin. Sometimes there's an added matrix sling like Alloderm to support and hold it up. But physics has limits.

I feel the pain of not being the self you always knew. However, even though it's not the same, you are still you. Bloodied, battleworn, and befuddled as you are, you're still in there. It takes a while till our vision of ourself matches what we see. But it does happen.

Hugs and much love.

I'm so sorry you are having so much difficulty with recon. I did DIEP. After my first revision surgery to lift and shape I looked down and the mounds looked so small. I cried for days. My PS reassured me that they would loosen and fall into place, and they did. I'm a little smaller than I wanted to be, but nicely shaped and lifted, unlike the originals. I've gotten used to them.

Take it one day at a time. Let your body heal. Things  may turn out better than you expect. If not, there are likely other options. For now try to relax and heal. Good luck to you.

Lorihoop and debiann, Thanks for the responses. I realize there are many people worse off than me, so I feel bad complaining. Lori, glad you are looking forward to the final results. Since I had delayed reconstruction, I spent all last summer with one breast. I got a prosthesis and it looked great and was very comfortable. I really considered not having reconstruction. The biggest reason to do so was being comfortable in locker rooms since I swim and work out alot. Also, if I didn't get reconstruction, I'd always wonder "what if".

To answer your question, yes, the implant on my non-mx side is under the muscle. What I also don't understand is that the TE was very high and misshapen, and the ps said that didn't matter-the implant would be in the right place and right shape. Well, it isn't, at least not yet. I can't see how the implant is going to shape the muscle right if the TE couldn't. The ps mentioned that if the mx side doesn't drop like the other, he could do a lift to the non-mx side. I hate to have him monkey with the side I like however. Hopefully there will be some improvements by June when I see him. I guess I just have to be patient. At least I have been released from all restrictions and I am free to run, swim, exercise and HOLD MY GRANDDAUGHTER, which I couldn't do for 5 months. So for now I'm enjoying life.