Sunday, October 6, 2013

What you are NOT told about implant reconstruction.

Since my reconstruction, I have always been uncomfortable. All of the time it feels like I’m wrapped up in duct tape...I have persistent tightness in my chest that I have since discovered, many women describe after breast reconstruction.
My "foobs" look fine in clothes, but they are never going to feel like they did pre-mastectomy; where they are not pulling or not tight. I've been living with this for 3 years; I thought this was going to be my new "normal".
Even with the best plastic surgeon, breast reconstruction carries the risks of infection, bleeding, scarring and persistent pain in the back and shoulder. Implants can rupture or leak, and may need to be replaced.  There's also a syndrome called upper quarter dysfunction — its symptoms include pain, restricted immobility and impaired sensation and strength — has been reported in those who have undergone breast reconstruction...I'm beginning to wonder if this is my problem; the majority of my problems have always been on the left side; breast, shoulder and back.

Whether they are silicone or saline, implants do not last a lifetime. As many as half need to be replaced or removed within 10 years...or sooner in my case.  I have cohesive gel "gummy bear" implants.  They got their catchy nickname because when cut in half, the implant is stable and retains its shape, much like the chewy, gummy bear candies.  Many surgeons believe they look and feel more like natural breasts. They insist that "gummy bears" are also safer than other types of implants because they have a lower rupture rate.  This may be, but after one year of my first implants, I had revision surgery to change the shape and profile of my implants...problem NOT solved.

Reconstruction is not augmentation.  With breast augmentation, implants are placed on top of the chest muscle, under your natural breast tissue.  After a mastectomy, you have no breast tissue. I'll explain how it reconstruction was started at the same time as my mastectomy.  The first step was to place a so-called tissue expander under my chest muscle, which normally presses against the ribs (the expanders SUCKED and were horribly painful, especially after a fill!)  My surgeon injected saline into these balloon-like pouches at regular intervals several weeks apart to create space for my implants.  Here is one of my originals posts describing one of my fills. 
In November 2009 my expanders were removed and replaced with implants. (Unlike breast tissue, which sits on top of the chest muscle, the implant is situated under the muscle, which holds it in place.)
With every move you make with your arms, chest, back; your chest muscles move and rub.  This can cause scar tissue and pain.
And this is where I find myself, dealing with pain and discomfort on a daily basis.  I do not know at this moment what my options are. 
There are autologous tissue transfer options where muscle, skin or fat from the abdomen are used as substitutes for implants. Some surgeons believe this creates a more natural-feeling and natural-looking breast (better than these hard-as-Barbie pancakes in my chest I'm sure!).  Because of previous abdominal surgeries, I do not even know if I am a candidate for a DIEP or SIEA procedure.  There is also the option of a TRAM flap, but I do not want to loose abdominal muscle. There is also the option of trying implants for the third time! I really don't want to go there again. My final option is to become a "no-boober" and opt to have my implants removed and have no further reconstruction. This is the option I hate the most.  I feel unfeminine enough (after being reconstructed) and the thoughts of having the chest of a 12-year-old boy makes me shudder. Yes, I know there are prosthesis, etc. but it's just not the same.  It's a personal thing and is hard to put into words.  Unless you've been there, you won't get it.
I'm hopeful I get my consultation with Dr. Ross quickly so I can speak to him and discuss my options; dealing with the unknown is not my strong point!  and the daily pain is getting to be a bit much!!!


Lisa Roy said...

I feel ypu shari. Mine are approaching 5years now, but I still have one step saline expanders.

They've been ok, they look fine in clothes, but are very firm and are in slightly different places. One is higher and gets alot more puckering (which can be seen as the tissue is too thin).

I have reduced strength, but am trying to get stronger, but I know that some time in the not too distant future I'm going to be facing another surgery.

I don't think I have enough extra for a flap operation & originally didn't go there because of the extra scarring.

I think the only positive that spurs me on (when having an implant hating day) is that they're not going to kill me lile my own probably would have!

I hope you can get a resolution that makes you happier x


Shari said...

Thank you Lisa! Much love! <3

Anonymous said...

Thank you for sharing this. I am now more knowledgeable about the process and hopefully be able to offer my patients some support.

Three years ago you made a very brave decision and I am sorry to hear that it didn't end with results more positive.

Wishing you all the best and support in this new journey to quality in your life.