Direct to implant complications

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mellee
mellee Member Posts: 434
edited January 2017 in Breast Reconstruction

Looking for other women's experiences with direct to implant reconstruction and not finding a lot. Anyone had to replace an implant?

I had a nipple-sparing BMX/direct to implant surgery (incisions in the inframammary fold) in November. I got an unbelievably great, natural-looking result with no visible scars. I even had the nurse at my radiation consult stare at them and then remark on how fantastic they are—which is pretty funny because my barely A-cup pre-cancer boobs were nothing to write home about!

But unfortunately, it now looks like I will probably temporarily lose the right implant. I'm trying not to freak out about it, but it's pretty upsetting to be facing more surgery.

I'm so bummed because everything was going great, but then almost 5 weeks out of surgery, I had a small pencil-eraser size hole open up in the incision under my right breast. This was my cancer side, so my BS was very aggressive in removing tissue and the skin is very thin. I had slight but steady drainage through the incision since the surgery (even when the drains were still in), and apparently this eventually put too much pressure on the fragile tissue and opened the incision.

My PS sutured it up and put me on heavy-duty prophylactic antibiotics in an attempt to save the implant, but 10 days later it opened up again. There's no sign of infection, but apparently the blood supply to the tissue flap is too compromised so there's virtually no chance the incision will stay closed long enough to heal.

So I'm heading to the PS tomorrow. Hoping for a miracle, but pretty sure she's going to have to take the implant out. I'm not worried about the removal procedure (it should be virtually painless). But super nervous about the next step.

Apparently, I'll have to wait about 6 weeks to let the blood supply to the tissue regrow without pressure from an implant. Then I'll go in for the implant replacement surgery.

Anyone had this? What should I expect?

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Comments

  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited January 2017

    Don't have any experience with reconstruction, but hope someone else can chime in. Bump!

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited January 2017

    melee - talk to your PS about doing a fat graft to the skin while your implant is out to help vascularize the skin and add some integrity to the thin area. I did this during a time after the loss of an implant and it made all the difference in my ability to keep an implant later. This is very similar to what some PS are doing for those who have had radiation - it helps with the success of stretching the skin, my thin areas behaved as if I had rads even though I did not. PM me if you would like more details.

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  • mellee
    mellee Member Posts: 434
    edited January 2017

    My implant is safe... for now. The incision has miraculously started to heal and did not reopen and expose the implant like my PS was expecting. She was very pleasantly surprised and more than a little shocked. She excised some tissue from the edges that looked like it was turning necrotic, then reclosed with skin that she hopes has a better blood supply. She thinks I have maybe a 30-50% chance of saving the implant.

    I'm supplementing on her advice with a daily multivitamin, 250 mg of zinc sulfate, 500 mg of vitamin C twice daily, lots of dietary protein, and a nutritional drink called Juven that promotes tissue repair.

    Fingers crossed!

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  • AbbyG
    AbbyG Member Posts: 23
    edited January 2017

    I'll keep them crossed for you!! Good luck!!

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