Necrosis never went away after removal and reduction - what can be done to treat this?

Question

About 4 years ago I had my implants removed as they were above the muscle and had started to pull my breasts down. The weight of my breasts had caused immense back and shoulder pain and I made the decision to have them removed in conjunction with a reduction and a lift. I went through a lengthy recovery as the wounds below the breast would not heal. I went through debridement multiple times daily, which was incredibly painful. finally healed after several months and left really gnarly scars. My breasts were really firm immediately following the procedure and once the wounds had healed it became concerning to me that the hard nodules were not going away on their own like the surgeon advised they would. I just assumed that I Needed to just wait it out until they dissolved. Fast forward to present time. They have not dissolved . My most recent mammogram, which admittedly I delayed by 2 years out of fear of what they would tell me about thieae nodules, revealed that I have a massive calcified fat necrosis in each breast. One the size of an orange, one the size of a lemon. Clearly removal would distort any semblance of having a normal and symmetrical shape. I already have significant distortion on one side as the nipe has been inverted by the pull of the larger mass. I am concerned about future mammograms and false readings or masked issues. I am so traumatized by my experience up to this point, I don’t even know what to do. What can be done and can insurance help?

Daniel Barrett, MD · Answer

Dear Helpful837510,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

If you have large calcified masses of both breasts then most likely they will need to come out. If it decreases volume then you may need implant reconstruction or autogenous reconstruction. Insurance companies are notorious for not wanting to pay. They may say that since you had implants that the complications are self-inflicted and will not provide coverage. You will need to pay out of pocket for this. I would need to see photographs of your breasts to help determine what kind of reconstruction may need to be done.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Mats Hagstrom, MD (license on probation) · Answer

I think you’re going to have a hard time and getting insurance to cover your procedures, but it’s not impossible if you have a plastic surgeon who is willing to work with you and accept insurance reimbursement, which tends to not be very good.
It all depends on how it’s documented and what diagnosis codes are used for what procedure.
 The bigger problem is there is really no good operation for you from what you describe if you had a new paragraph, it would be helpful to see pictures.
When a breast implant is placed above the pectoralis muscle, the blood supply to the breast tissue can be changed significantly.
We usually don’t do a breast lift, reduction, etc., in conjunction what’s putting The implant above the muscle.
Reviewing your outcome after the fact, probably isn’t helpful. In paragraph most likely you’re going to have to live with the outcome and if you want assessments, you’re going to need to have in person consultations.
I recommend you consult with plastic surgeons in your community who do a lot of breast cancer reconstruction.
 At least those surgeons are used to working with insurance reimbursement and are willing to accept those rates. 
Best,
Mats Hagstrom MD

Necrosis never went away after removal and reduction - what can be done to treat this?

Answers (3)

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