want to remove implants, contemplating what to do after

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ashell
ashell Member Posts: 108

Hi all!

I've been around for a while and I believe I've posted before about wanting to remove my implants. I had a UMX almost 5 years ago, TE placed, and exchange with an implant placed in my non-mx side as well (for symmetry, according to my PS). At the time I was looking forward to having slightly bigger breasts, seemed like a small bonus for going through all this.

Now, all this time later, I'm still not happy. I hate how I feel with the implants. While I am happy with my size, that is about all. I am set on wanting to remove the implants. I have been seriously contemplating a flap such as PAP or TUG, maybe DIEP although I was originally told I am not a candidate for that and would be concerned if I were to get pregnant in the future (I am still pretty young and do want to have children).

Lately, I have been seriously considering not getting recon. I want to feel comfortable in my body, and I had always told myself that I wouldn't be completely comfortable without any recon, but I'm wondering if I could be. It is a nice idea to not have to go through an extensive, irreversible flap procedure. I was quite flat chested before all this, and I'm not sure how much it would really bother me to be completely flat on one side. Of course no one can tell me how I will feel, but I'm wondering how others feel who are going au natural. I'm also wondering about ways to make the mx side look nicer, flat without any concavity or maybe even a minor projection without implants so I could possibly create an illusion of cleavage? May sound weird but that is something I've been concerned about. I'm not much of a cleavage-shower but I like to have the option ;)

If anyone has advice, thoughts, or knowledge about grafting without implants or other ways to improve the aesthetic after "going flat," I would love to hear it :)

Comments

  • Bosombuddy101
    Bosombuddy101 Member Posts: 182
    edited October 2017

    Hi Ashell,

    I recently had a bilateral mastectomy with no reconstruction and my chest is not concave. The best way to describe the look is what a pre-adolescent chest looks like. My surgeon didn't leave any bumps or lumps and the scars are symmetrical and diagonal. I look very slender and lean --- almost athletic. Of course, now I'm more into fitness .The thing I really miss are my nipples. Maybe doctors will figure out a way to regrow nipples? I know they're working on regrowing breast tissue.

  • ashell
    ashell Member Posts: 108
    edited October 2017

    Bosom buddy, sounds nice, are you mostly happy with the results? I feel you on the nipples, I miss having 2 lol. I'm hoping removing these things will help me regain my athleticism, it's discouraging when I can't even do push ups anymore, I used to be much more active.

    BosumBlues, is that where they suction to add volume? I've heard of that but seems like it wouldn't work if there is no breast tissue. Do you have any experience with it?

  • ravzari
    ravzari Member Posts: 277
    edited October 2017

    From the way I understand it, Brava is usually used for a few weeks/months before fat grafting (and generally for people who still have breast tissue; I'm not sure how it'd work without that in place if it'd even do anything) to help stretch the skin to give the grafted fat more room to settle in and allow for a larger volume of fat to potentially be grafted to the area.

  • Lula73
    Lula73 Member Posts: 1,824
    edited October 2017

    SGAP flap may be a good option. Wouldn't interfere with pregnancy later either. Sorry I don't have any info on going flat.

  • ashell
    ashell Member Posts: 108
    edited October 2017

    Thanks for the input all. I'm pretty sure I don't have any breast tissue left so I don't think Brava would work for me, but can you link me to that forum BosumBlues?

    I am interested in fat grafting if it would be possible, I definitely need to talk to a PS. The one who did my implants doesn't work at my hospital anymore so time to find someone else.

    I'm wondering how long the recovery would be for implant removal? I was thinking it can't be nearly as bad as the mastectomy, but I've read on some of these forums that it is like a mini mastectomy. Is it totally naive to think I would be able to do it during my 2 weeks off from work for winter break?

  • ravzari
    ravzari Member Posts: 277
    edited October 2017

    Some of it might depend on if you just have the implant removed, or if you have the implant and its capsule removed; I don't understand the reason surgeons sometimes leave the capsule behind, but some women don't have them removed.

    I'd guess if it's the implant + the capsule removed it'll probably be a little more invasive than just having the implant itself removed.

    If your job is primarily a desk job and you don't have to do a lot of reaching or lifting, 2 weeks should be okay. I took two weeks out of the office for a BMX (no recon) and while I was a bit tired at work for a couple weeks following that, I was okay to actually work.

    If your job is a bit more active, I'd be sure to bring that up with your surgeon and ask their opinion on whether they think two weeks will be enough.


    As for fat grafting, it'd most likely be possible, but likely not in just one round.

    For fat grafting to be really successful, it has to be done in small amounts so the fat has a larger chance of fully developing a blood supply and not being reabsorbed or going necrotic. Even in best case scenarios, they tell you to expect to only keep, at most, 70-80% of the grafted fat (with the rest usually being reabsorbed, but sometimes going necrotic). Necrotic fat can sometimes be painful and/or leave you with hard, lumpy areas as well and the only way to fix it is surgery again to have it excised. It's not a super common side effect if the surgeon doing the fat grafting is experienced with the procedure, but it is something that can happen and something to keep in mind.

    They left some fat behind and moved a little around after my BMX so I wouldn't look concave, but some didn't survive and turned hard and lumpy and left me looking more like I had two deflated, flat AA cup breasts rather than flat; I ended up having a second surgery to have the necrotic fat excised and the rest they'd put lipo'd out as I decided I'd prefer to risk looking concave than looking like I had uneven, deformed breasts.

    Going from flat to something that looked like a relatively normal A or B cup might take 3+ rounds of grafting over the next couple of years so it's worth considering whether having a small breast is worth future multiple surgeries or not. While fat grafting is considered 'minor', it's still a surgery, and you still have to recover from both the liposuction on the donor site as well as recover from the areas that received the graft, and that does often mean some downtime (or out of work time) and several weeks of soreness, bruising and swelling.

    You also do have to have enough fat at donor sites, usually hips, abdomen, and/or thighs, so if you're slim it may not be possible unless you gain 20 or so pounds (basing that off recommendations I've seen other patients on RealSelf.com say their doctors told them to gain before either a breast or butt fat transfer procedure) to provide the surgeon with enough fat to harvest for the graft site.

  • Bosombuddy101
    Bosombuddy101 Member Posts: 182
    edited October 2017

    Ashell,

    I do miss my breasts but given a choice between cancer and keeping my breasts, the girls had to go! They were not very large to begin with ( a small B cup) and you know, most models are very flat and fashion favors the flat chested woman.

  • Lula73
    Lula73 Member Posts: 1,824
    edited October 2017

    if looking at fat grafting, that's where the BRAVA device comes in. It's not about breast tissue but about helping the grafted fat survive and thrive to create the new breast.

    Links on BRAVA & fat grafting:

    http://www.breastcancer.org/treatment/surgery/reco...

    https://www.miamibreastcenter.com/


    Link on the SGAP procedure from previous post:

    https://www.breastcenter.com/breast-reconstruction...



  • ashell
    ashell Member Posts: 108
    edited October 2017

    Thanks for the replies :)

    So many options! The more I think about it, the more I lean toward just going flat. My remaining breast is pretty small, I don't think I would mind the asymmetry. And it seems like from some pictures I've seen that there is an illusion of cleavage with a lot of the non reconstructed breasts. I can picture myself being "fabulously flat" and would love to just feel like myself again without a bunch more surgeries.

    One thing that I keep going back to is wondering how my planned tattoo would look on a completely flat surface. I've wanted a tattoo over the area for a while, floral, most likely daffodils, but I've been waiting until done with surgery because I've known for a while that I don't want these implants. But for some reason I feel like it would look better on a bit of a curve.. don't know why lol.

  • ashell
    ashell Member Posts: 108
    edited October 2017

    saw my doctor today. She seemed against my idea of going flat, said I'm "so young and beautiful" as if being flat on one side would change that. She referred me to plastic surgery, we will see how it goes over there. I sense that I'll get a lot of resistance.

  • ravzari
    ravzari Member Posts: 277
    edited October 2017

    Honestly, as hard as it might sound, push back.

    I was lucky enough to have a PS and general surgeon that were both on board with what I want, but I've seen SO many stories here from women who had a PS that tried to push them into reconstruction that they didn't truly want and it always ended in extended unhappiness for them until they eventually went flat.

    If you can't get your surgeon to listen to what YOU want vs.what they think you should want (and too many can't fathom the idea of a woman wanting to be flat), take it as a sign to start shopping around for a surgeon that will listen if you're able to do so, or get ready to double down hard on the surgeon you might be stuck with for insurance reasons to get what you want.

    While I'd agree that most women, in a non-cancer or non-cancer risk scenario may not want to truly be flat, a lot of women in the situation in the context of breast cancer or high risk for breast cancer just want it to be done with and don't necessarily always want to go through multiple surgeries to get a result that ends with them having breasts, and that's really hard for some surgeons to understand.


    It may help if you point out to your PS that you know that it's not a 'forever' thing and that, if you decide later (even years later) you want breasts again that there are options (flap procedures, TE to implant, or possible fat grafting) that you'll keep in mind if you ever change your mind, it can help them to believe that you've "thought it through". And don't let them lie, you can change your mind about being flat ANY TIME and choose to have those options done. :)

  • Jennie93
    Jennie93 Member Posts: 1,018
    edited October 2017

    I suppose you have already read this thread, but just in case:

    https://community.breastcancer.org/forum/82/topics/823502?page=1



  • Herculesmulligan
    Herculesmulligan Member Posts: 175
    edited October 2017

    ashell: I once was in the uncomfortable position of having to convince a neurologist that my husband who was recovering from a terrible brain infection was backsliding in his mental status. He said I needed to be sure because " if you consult a neurosurgeon you're going to get neurosurgery ".

    My point here is that when you go to the plastic surgeon he or she will most likely recommend some form of reconstruction. Not because they're bad doctors or insensitive but because that's what they do. So have a good sense of what you want when you go in. I also dislike the way my implants feel. I think one day I might want them out but right now I frankly think I'm too vain for that. I admire your confidence.

  • ashell
    ashell Member Posts: 108
    edited October 2017

    Thanks everyone :) I plan to stay firm in my decision. Thanks for sharing the thread, yes I have read the whole thing haha.

    Part of my confidence comes from the fact that I don't really feel like my reconstructed breast is a breast. I've already accepted that I only have one breast, and seeing how nice some of the prosthetics look in clothes has really reassured me. This foob isn't fooling anyone outside of clothes anyway ;) I desperately want to feel like myself again and get my strength back. I'm excited about my future without implants.

  • Momine
    Momine Member Posts: 7,859
    edited October 2017

    Ashell, I got the "young and beautiful" (although I am neither) crap from my doc too. As you say, the recon boobs only convince when clothed anyway. As such, it seems a prosthetic does the same job, without having to have foreign objects wedged under your pecs. The only situation that doesn't work for me is the idea of getting nekkid with a man, but if I had reconstructed boobs with scars across them etc. I would feel equally uncomfortable in that situation, possible even more uncomfortable. In all other contexts, foobs or just going flat work just fine, without the discomfort of implants.

  • Gracejoy
    Gracejoy Member Posts: 48
    edited October 2017

    Very well said Momine and Ashell about saying no to reconstruction and your reasons. That's how I feel about it. I did no reconstruction and very happy about my decision as I seek my comfort and my well being firstbefore how I look. Besides a good prosthetic does a great job.

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