I had a radical double mastectomy in 1974. I've had 11 surgeries on left side due to adhesions, rupture, scarring. I'm 68. I have small saline implant now that is surrounded by adhesions, scarring. It is almost under my arm. My pain is unbearable. I want the implant removed. Isn't it necessary for the surgeon to remove every adhesion and all the scar tissue? Surgeon told me he only wants to slip the implant out. I don't have a picture. I hope my question is clear.
Implant Surrounded By Adhesions And Scarring, And Want It Removed Safely. What's The Best Way?
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Doctor Answers 4
Old Breast Reconstruction Implant Surrounded By Adhesions And Scarring, And Want It Removed Safely. What's The Best Way?
I have to agree with your surgeon. Although one would think that going in and cleaning things out surgically by " remove every adhesion and all the scar tissue" would improve matters, it has been shown NOT to be the case. Every surgery heals by generating scar tissue and 11 operations must have caused a lot of scar tissue. The pain you may be having MAY be related to the weight of the implant but is more likely caused by neuroma (a cut nerve end which forms a very sensitive round swelling on its end) which may NOT be desensitized by removing the implant. Attempting to remove the scar tissue may be associated with serious complications and most surgeons would avoid it if at all possible. I would remove the implant only and see how it changes the symptoms before taking any further action.
I usualy recommend removal of as much of the capsule as possible and safe, especially if there is pain..
Breast reconstruction issues
Usually it ia best to remove all scar tissue if you arehaving these kind of problems, although it may not be possible. You may be a candidate for autologous tissue reconstruction as well.
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Fat May Be the Solution to your Problems
We have seen in reconstruction cases where fat grafting is used for volume replacement that pain from chronic scarring (radiation) improves dramatically. This is anecdotal information, but may suggest that fat transplantation has some regenerative effect on pathologic tissue. In your case, an option is to remove the implant and have several sessions of fat grafting. This would probably remodle and help soften up our scar tissue instead of excising it. Excising scar creates more scar- a sometimes visious cycle.
Dr Del Vecchio
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