Tag Archives: Implant

Are my breasts uneven?

WARNING: NSFW / graphic content below.

Two months after my most recent surgery I now have the same volume in my tissue expander as I do in my implant. We added 50ccs to the expander, for a total of 450ccs. Even though they are the same, they are uneven. I am at the perfect point to show the difference between the look of expanders versus that of implants.

The tissue expanders are hard, sit high up on the chest wall, and have more projection. Implants are soft, pliable, and more natural. Women who have been through the process and had their exchange surgery often say they are disappointed with size. In a 1-to-1 volume swap, the differences between these two types of devices are to blame.

Here I am as of today: 450cc tissue expander and 450cc implant (Mentor, round, smooth, high profile, silicone). Can you tell which side is which? The one with the lighter areola is the expander. From the front, they don’t look that much different, but from the side or top you can see that the expander is narrower and sticks out further than the implant.

When I was going through the expansion process after my prophylactic mastectomy, I reached my happy point at 400ccs. Having read and heard that women are often disappointed with their size post-exchange, I gave myself a cushion and declared that I wanted 450cc implants. That’s what I ultimately got (took a while to get there, but I’m there) and I’m glad that I decided to do a little extra. I am very happy with the implant size.

My plastic surgeon overfills by 100ccs, so I have two more expansions to do. Then I wait a couple of months for my exchange surgery on September 11. This is going to be a weird summer with high temperatures, skimpy tops, and two different size boobs. Oh well. I already spent six months with a single boob, so how bad could this be, right? 😀

Houston, we have a problem

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WARNING: NSFW / graphic content below.

Before I tell you about what has been happening for the last few days, I just want to say to those that are considering this procedure, preparing for one, or have already started the process: women who undergo a mastectomy, whether prophylactic or not, don’t always experience complications. Actually, I’d say that most do not, based on my involvement in a few online support groups and interaction with women in my local community. Everybody’s experience is different, because of different doctors, hospitals, body condition, other health issues, activities during recovery, nutrition, etc. There are many factors. Each person should consider their scenario and discuss concerns they may have with their surgical team.

Another thing to keep in mind is that usually the people that have problems are the ones that speak up. You know – the squeaky wheel thing. There are so many women out there that have had a completely complication-free experience and have beautiful results! You can’t tell that they’ve gone through this journey unless they tell you! Those women usually don’t linger in the support groups, stop blogging about it, move on, and just leave it all behind them. They are DONE and don’t have to think about it again.

Okay, Houston, we’ve had a problem here

Unfortunately, I’m not one of them. Upon my return from vacation, I started working out again (cardio) and I also began using Kelocote on my hypertrophic scars, as I mentioned in a recent post. Both of these activities began on Sunday. The following Wednesday I saw Dr. M and things looked good. The next day I noticed a bit of redness around the incision on my left breast. By Saturday there was a small area in the center of the scar tissue from my bout with necrosis that had turned blue. I emailed Dr. M and got this response:

Yes, this is a significant problem. Need to see you tomorrow.

By Monday afternoon, I had a hole. By early evening I had chills, sweats, and a fever of 101.7. Panicked, I called the after-hours service to page Dr. M and he called back immediately. The plan was to continue on the antibiotics, take a couple Tylenol, and sit tight unless the temperature spiked past 103, at which point I’d hightail it to the ER. Within two hours the temperature dropped below 100, but I knew what was coming: the implant had to go.

My surgery was at 5pm on Tuesday, October 15. Dr. M cleaned up the incision and removed the implant. I am left with one breast and another drain! I really REALLY don’t like drains, but who does? What’s next? We have to let everything heal for at least three months before we being talking about restarting reconstruction on that side. I’m am so bummed by this humongous setback!

Why did this happen?

A combination of things may have caused this, but it’s hard to say exactly which was the straw. In Dr. M’s experience, implants are usually (but rarely) lost due to complications from three major things: radiation, smoking, and/or trauma. I fall into the third category. The necrosis I experienced in January produced a lot of scar tissue, which has poor circulation. My use of Kelocote on that scar tissue introduced chemicals into the equation. On top of that, I started working out again. My body protested against the combination of old and new trauma. So here I am, uniboobin’ it for at least three more months! Good thing it’ll be during winter and I can camouflage things a bit. I present a foob and a drain:

We’re getting there – third expansion

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WARNING: NSFW / graphic content below.

Fill number three is done. We added 75ccs to each expander, for a total of 300ccs/side (pic below). It is about the same on the pain scale as it was last time – nothing initially, but feeling pressure the next morning. I continue to slather these things with cocoa butter oil with vitamin E to keep the skin soft and prevent stretch marks. So far so good. If you missed the scoop on the first two fills, see: They’re growing and They’re back.

Since I still haven’t decided just how big I want to go, while I was in for the fill I checked in with my plastic surgeon to get his feedback (I trust that he has an eye for these things). Another 150ccs or so will be just right based on my body size and shape. Ultimately, it is up to me how many ccs will be the sweet spot, but I do agree that we’re not there yet. So we are going to continue the fills until I’m happy. What then?

Once the desired size is reached, there are two more 50cc fills done. As you see in my photos, the tissue expanders are kind of boxy and sit high up on the chest wall. The additional expansions are done to overstretch the skin and muscle, so that when the final implant is placed it has a more natural shape. When the expansions are done, we wait four to six weeks before we move on to the next step.

Exchange surgery

When we’re done will all of the fills, including the overfilling step, an exchange surgery is performed. This is an outpatient procedure during which the plastic surgeon exchanges the tissue expanders for saline or silicone implants.

I asked how far out they are booking surgeries for Dr. M and quickly realized that I need to get something on the books STAT. The first available date is September 3rd. That is over four months away!!! My (sarcastic) thanks to Dusky, my rebel left nipple. Had I not experienced necrosis (see Tissue necrosis), we would’ve started the expansion process about two months sooner. What can I do about it? Be grateful that necrosis was as bad as it got.

Current plan: three more 50cc expansions + two 50cc expansions to overfill = 550ccs. Here’s to a Dolly Parton-esque summer! Not sure if this is good or bad. Thoughts? I’ll be celebrating my last expansion with July 4th fireworks. On this day last year, I was struggling to enjoy myself while hanging out with friends at the beach. I didn’t get the call that was supposed to come on July 3rd – the results of my biopsies. I spent July 4th entertaining thoughts of tumors, cysts, breast cancer, chemo, and worse, rather than enjoying fireworks and my friends. It was a really bad day. What a difference a year makes.

Anyway, watch my boobs grow!

100 + 50 +75 +75 = 300ccs