7 years post op from bi-lateral mastectomy and reconstruction with McGhan 163 saline implants at 530 ccs ea. gained 25 lbs, look pretty flat don't fill bras front to back, too far apart, dip in one, one sits higher, nipples faded and flattened. Originally felt that projection was too little vs the base diameter which seemed too large. What are my options? Is revision covered by insurance? I'm very unhappy but don't want to seem ungrateful. I am 5'3 weigh 190 lbs and have fibromyalgia too.
Unhappy With Look OF Breast Reconstruction- Options? I Also Have Fibromyalgia
Doctor Answers 8
After bilateral mastectomy and reconstruction, a revision is not uncommon to have done. That is a lot of change in short amount of time. Check with our insurance carrier on what is covered in your situation.
Breast reconstruction revision
Certainly some things can be done to improve your result. Things like changing the implants to a different size, adjusting the folds, sometimes fat grafting, etc.. Speak with your surgeon.
You have had many good suggestions.
Your reconstruction can be improved, but need several things done
1: liposuction of the lateral chest. That fat takes away fro the shape of the breast.
2: stabilize and fix the infra mammary line to defibe the breast and shape it. with the support of acellular matrix as well.
3: posssibly change the implant
4: fat grafting in key areas to correct irrigularities and improve in shaping and projection of the breast.
5: once the shape desired is achieved, look at the nipple areola position , should be at the highest projection point of the breast.
6: reconstruct new nipple areola with better projection, may use alloderm for projection
7: re tattoo the niple areola.
Insurance should cover the revision, However there are some insurance companies that limit the number of covered revisions. check with your insurance.
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There is one best solution to your problem
Fat grafting is a good option
There are a lot of options for you. The style of implant can be changed, fat grafting can per performed to fill in some areas of depression and the nipple reconstruction and be redone as well as additional tatooing.
Unhappy with look of breast reconstruction
You need to see your plastic surgeon as there are certainly things that can be done to improve things. The areolar tattoo often fades and can be redone and the inframammary fold on the left could be redefined, for a start. There are limitations with an implant reconstruction and yours don't look too bad. I would advise to you to book a consultation to go through things with your surgeon. Good luck. Jonathan Staiano.
Breast reconstruction has limitations
Aside from the fact that your areolas need to be tattooed again and the left IM crease needs to be retightened, your result is actually perfectly good for a breast reconstruction.
Please remember that breast reconstruction is not a cosmetic breast augmentation which also gets rid of your cancer. Rather, it is an attempt to make a mimic of a breast after the entire breast has been removed. As such the results are totally different.
Also, while it is difficult with fibromyalgia, I am certain that if you could lose some substantial weight (5'3" and 190 lbs is obviously never going to give you a good body image) you will probably like the breasts better as your entire self-esteem rises. Good luck!
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