47 Year Old Presenting with Saline Implant Fold

Well, really tomorrow will be 7 weeks. Blood blister on left breast has healed, all tapes removed and all scabs gone. Released back to normal activities but was told to keep it light and work up to weight training when at the gym (not that I did a lot of that - mostly do cardio when I'm working out). Things are looking good. For scar treatment alternating between Mederma and vitamin E oil. Massages to breasts three times daily. I can feel some scar tissue under each breast and massage seems to help reduce the feel of it. All good!

At the end of January a lump literally popped up one morning on my left breast. I had saline implants over the muscle done about 8 years prior. Had absolutely no issues and really liked my implant results. I went over the muscle and saline because 1) I wanted a more fuller look at the top part of my breast and 2) chose saline because I wanted to know right away if something was wrong (ie rupture). The lump was "Squishy" so I pretty much knew it had something to do with the implants. I called my PS and made an appointment to have it checked out. That night I went home and when I was getting ready for bed, taking off my bra, the lump disappeared! It wasn't there the following day so I called and cancelled the appointment I had made with the PS. One week later, lump pops back up. Same place and stays. Make another appointment (and keep it) with PS. His diagnosis is a fold in the implant due to capsulary contracture. My options are to wait and see what happens. Keep in mind that it is a possibility that the implant can wear away at the flesh and literally come through the skin! Yikes! His replacement option was: replace saline for saline, go UNDER the muscle, use smaller implant, use Strattice, do a lift and areola reduction. I wasn't thrilled about the lift as even though I had a little sagging it wasn't ANYTHING like I had when I had my first and only lift done in 1999 (post childbirth and breast feeding). I decided to go get a second opinion. I chose Dr. Bernadette Wang Ashraf because a very good friend of mine was her patient. My friend had a double mastectomy with reconstructive surgery that included implants. Dr. Wang Ashraf did an examination and (without me telling her what my previous PS had suggested for revision) recommended replacing the saline implants for silicone gel implants and, if I wanted, areola reduction. When I asked why not under the muscle she felt that making another pocket under the muscle may have a negative effect on the implant staying put ( that is how I understood it). Although a lift was certainly an option she didn't feel it was "necessary". She addressed my concerns about gel implants and when I left I felt at ease and decided to go ahead and plan the surgery with her. I am two weeks post surgery and doing great. My surgery was on a Monday afternoon and I was back to work that Thursday! Please note that I work a desk job. One week after surgery I went in for a post op where tapes were removed and replaced. The only "down" side to this visit was that I had a blood blister/bruise on one breast covering a part of my areola. At this point I should also state that my incision was periareolar (around the areola) as this was the incision site for both previous surgeries I had had - lift in 1999 and implants about 8 years ago)When asked why, I was told that this happens and is due to in part, the strain of swelling causing pressure along the suture line. The nurse told me it would get better, keep it bandaged and the bandage replaced daily. Tomorrow will be one week since that visit and I can see the area is healing just as she said. If things keep going as they are then I know I will be very satisfied with my results and decision. Even though I am still swollen a bit I cannot feel the implant (which I could with the saline - must admit it never really bothered me). I have the fullness still at the top of my breast and I think the areola reduction I chose to have gave a little bit of a lift, not that it would bother me if it hadn't. Dr. Wang Ashraf and her staff (and the staff at Northside Hospital where the operation was done) have been great. I certainly feel I made the right choice.