Forced to Make a Choice Due to Biopsy Puncture of my Implant! - Denver, CO

I am a bundle of mixed feelings. On the one hand,...

I am a bundle of mixed feelings. On the one hand, now age 60 and after 11 years of moderate-sized above muscle saline implants, I find them annoying and somewhat of a source of daily discomfort. There was nothing wrong with them, until I found a lump, which they said needed biopsied -- suspected fibroadenoma. But, it turns out that what appeared "solid" as a mass simply was not! I watched as the ultrasound-guided biopsy was performed and saw whatever the lump was appear to shrink once the needle hit it. Fast forward -- now ten days later, with a negative pathology report in hand, I now have a deflating implant. I see the insurance company's recommended plastic surgeon next week to decided what to do. I am thinking I want both implants removed, but I have hardly ANY breast tissue over these implants. I am afraid of the resulting appearance -- just hanging skin? I am forced to make a decision because of another's mistake, and I do not want to make a wrong decision. I can pay more out-of-pocket and get replacements, but I have not felt good for the last few years, and bras are terribly uncomfortable by the end of the day. I am only a 36B, but I am stretched to the max it seems. I do not want to be totally flat again, as I had to alter all my clothes in the past -- yet, I do not want to keep them if continued screening is going to be a huge hassle the rest of my life. Since having my implants, I have not been able to have mammograms -- fought the insurance company -- finally they agreed to MRI screenings after two radiologists insisted that was the only thing that could be done. I have only had two MRI screenings in ten years (last one was 5yrs ago). Instead of an MRI this time, the order was for ultrasound of the lump, followed by ultrasound-guided biopsy -- I wish I had never agreed to allow this biopsy! Watching my breast deflate since that procedure has been devastating. All of this was avoidable -- had the doctor just ordered another MRI instead to see the lump. I am so uncertain of what to do now. I had my implants done via a TUBA method -- through the belly button -- so I never had ANY incisions -- now I will. I am very scared about any/all pending options. My husband is very scared for me also. This is such a shock to both of us, and it makes any decision of what to do now almost impossible. There are many of you that are glad you had them out, and I am leaning that direction, but what about those of you who had little to none for tissue afterward? Is hanging skin enough to make one happy?

Forced to Make a Choice Due to Biopsy Puncture of my Implant!

So today I started making some phone calls to find a surgeon closer to where I live and to research local docs. I am determined to get at least one second opinion before I agree to anything. I am completely ready to have both of them removed, regardless of the "look" afterward -- it just seems right to me to get it done. I have no promise that the insurance/network will take responsibility for the damage or cover any costs -- frankly, I do not care to fight that battle anyway. AND, so far, I am finding it may cost less overall to stay local, so that would be a bonus! Having to drive 120 miles roundtrip and navigating through Denver several times for multiple appointments is not something I look forward to. I will do it ONCE to see the network referral PS on Monday, but then I will meet with a local PS (only 10 minutes away) on Thursday. If I am not mistaken, the local PS might be the same one who did some work on my primary care physician several years ago. If he is, then I know I am in good hands going to him, plus staying closer to home.

Forced to Make a Choice Due to Biopsy Puncture of my Implant!

One of the members on here responded to me with a suggestion to check out information provided by Dr. Susan Kolb. So, I found her website today: http://www.***********.com/
If you scroll down a bit, she has two videos -- one regarding silicone implants, the other regarding saline.
When I got saline implants 11 yrs ago, my doctor told me unless I experienced a traumatic event (car accident, etc.) there was no need to think I would ever need to have them removed. I remember asking about the life-span and questioned the truth about a potential 10-year limit at that time. He assured me there was no reason to think they wouldn't last for the rest of my life if there was no contracture or complication affecting them. I am confident he was sincere in what he knew at that time. He said he was using the very best, highest quality products available for his patients.
Who knows how long mine would have lasted had the one not been punctured during my biopsy. I am now thinking the accident may have been a blessing, and I am fully assured that removal is absolutely the best option for me. I have struggled with being forced to make this decision due to the damage incurred, but today I am feeling grateful that it happened! I do want to be implant free!

Just soooooooooo SAD!

So, I searched through some old documents to see if I could find my old before/after photos from years ago -- found them -- and I am just sick to my stomach! My implants improved my appearance so much, and any hopes of being happy once they are gone is rather doubtful now. I will still get them out, but I am truly crushed to the core. I also discovered they are older than I thought -- had them done in 2002, so 13yrs ago instead of 11yrs as I thought. No question -- they need to be removed, but I do not think the tears will stop for a very long time.

Advice I failed to follow!

I remembered today that my PS had told me to always have a PS look at any diagnostic imaging in the future if I ever had problems. He said that "sometimes" radiologists do not always know what they are seeing, so asking a PS for a second opinion is wise. If you find a lump or have any type of test, always get a CD of your images before you leave -- it is free, but you must ask for it. I uploaded this ultrasound image under "Ask a Doctor" but wanted to put it in my update also. My original PS retired, and had I followed his advice, I may not be dealing with deflation and explant without time to prepare or decide on my own in advance. I failed to get a second opinion and show this image to a PS as he advised.

This "lump" appeared to be a fibro adenoma to the radiologist, but when her needle poked it, it instantly shrunk. She was shocked, as was I while watching the needle on the ultrasound screen, then she stated it must have been a cyst. As you know, my implant deflated 5 days after this event, prompting an unexpected explant. Please take it to heart that augmented patients deal with a different outcome at times and trust your instincts. We want to trust in medical experts, but two like opinions is better than only one's "best guess." I hope this helps someone out there!

The mystery lump photo

I have to laugh because the ultrasound picture on here almost looks like a nipple rather than the lump image within the breast. Oh well, I will try to enlarge the section I thought was most vital for anyone else reading what I posted.

Has anyone had discomfort in both breasts following deflation of one?

Geez -- I feel cold all over -- no fever -- but I sure don't feel well. Although the right was the one punctured and slowly deflating, I seem to be more uncomfortable with the left one. Is this normal?

Not sure whether to laugh or cuss like maniac!

You won't believe this! I got a call from the fella I first talked to with the insurance network. He said he found out that they will cover the cost of removal for the one their doctor punctured, but I will have to pay for the other one to be removed, if I "wanted it removed." Are you kidding me? Who wants to be left with only one boob? I think I am heading into a really rough road here that will go beyond the emotional battle of just the deflation alone. I am appalled by all of this -- ridiculous to think someone would choose to have one boob only. None of this was my choice in the first place! I hope I can keep it together once I see the doctor today -- feeling more than mad right now.

My new plan!

I changed directions today -- I am set for March 5th -- with a general surgeon in my own town -- instead of the insurance network's plastic surgeon referral guy. I am not impressed with the network's lack of response this week -- haven't even had a call from them for scheduling and no straight answers to the cost issue -- nothing!!! -- I am fed up!!! So, I met this morning with a female general surgeon -- new to our local surgery group that I DO TRUST! Although I didn't know her, I do know the other surgeons in that group -- they are awesome. She seems great and has done a lot of breast surgeries -- mostly cancer patients. So, it appears a bunch of us will be in this together that week for explant. Prayers all around and hugs! Those hugs will be easier later LOL

Cost Update & Insurance Issue

So, I finally got a response from the referral doc about his statement of there being "no charge" for explant and my request that his remark be clarified. My assumption was correct -- it is a covered/approved procedure, and the patient only pays according to their plan structure, which for me means all of it is out of pocket due to my high-deductible policy. The email response went on to say, however, that they were "working on my concern regarding radiology," and suggested I contact member services and file a formal complaint. So I guess I will!

I was thinking back to when I first noticed the lump and went to the doctor (she is retired now). At that time, she thought it should be cut out with a tiny incision if it became problematic or changed, suggesting a wait and watch approach initially. The first ultrasound of the lump did not indicate any leakage or other compromise of the implant's integrity. Since the biopsy puncture and subsequent deflation, two surgeons (general and PS in my local health system, not insurance network) have suggested that the needle biopsy was a completely wrong approach, that the radiologist likely missed the lump entirely during the procedure, and that puncturing the implant in the process was a huge risk given my breast anatomy. Both stated the recommendation should have been for an excisional biopsy. So, the main issue I will address in the complaint is the radiologist's recommendation for needle biopsy in the first place, and make known her expressed concerns during the procedure itself. She verbally stated to me and later wrote in her report that she felt a post-biopsy light-compression mammogram to check marker placement (normal protocol) was not advisable given my breast anatomy. She even expressed that she expected the marker she placed in there may come out in the oozing of the incision sight during the healing process because the breast tissue above the implant was so thin. Thus, her recommendation for an ultrasound-guided needle biopsy (without further consult with a second medical professional concerning my particular breast anatomy and its inherent risks for this procedural approach) was inappropriate, irresponsible, and negligent. Maybe straight forward truth stated in medical lingo will get their attention!

It is time to find some uplifting (pun intended) humor to get us through this!

I am not exactly sure who sees what when I post a reply here and there, or how to best share on this website, so I am reposting this into my review section -- originally wrote it in a reply section this morning -- WHY? Because I either have a sick sense of humor, or you have the same type of humor I do and need a laugh for your own sake, or I am just hoping to find some coping mechanism to keep things uplifting until "E"-day! True story! Still laughing throughout the day about it! Here it is:
As I was waking up, I saw a picture of my flat boob, a rope tied around the nipple, then the rope strung out and attached to a pole on a boat. I was yelling, "I'm sailing. I'm sailing!" Later as I was drinking my coffee to really get awake, I had another thought about the boob sail. Maybe I could star in a re-make of the movie, "What About Bob" where he yells, "I'm sailing," and the new movie could be called, "What About Boob?"
Oh -- by the way -- sending you all love this Valentine's Day!!!!!!!! xoxoxoxoxo

Every day seems to bring up a different consideration!

So, today I got a call from the general surgeon's nurse stating that the surgeon felt I should have the implants removed by the plastic surgeon, as his expertise of this holds a stronger focus than hers. Although she has removed several, she knows he would do an awesome job as well. Her decision was based primarily on the lesser anesthesia approach (sedation/local) which she would not be able to do. She would only be able to go with full anesthesia, which would also double my costs in the end for obtaining the same results. Once explanted, and fully recovered, she will then perform an excisional biopsy of the lump in her office.

Scheduled for Monday, the 23rd, at 3:00 p.m.

According to my insurance company, explant is ALWAYS considered as "cosmetic" versus a "medical necessity" -- whether the network PS does it (the guy we didn't like) OR the local PS does it (the guy my general surgeon prefers). I got set up for Monday, but I was also told that I will be expected to pay in full up front AND to sign a paper agreeing to pay him even more money if he is ever pulled into anything legal down the road that involves my insurance company and his precious time. F&%&%&% them all! Fine, whatever -- good grief! Just take the dang things out of my body! Can't any of these people just focus on caring about my health? Cost wise, the PS is just over half of what I would pay to do it through my lousy insurance network or through the better, local contracted system. Plus, his approach is way less invasive! Even the surgeon didn't see a need to be invasive in my case. Too bad she cannot do the sedation/local approach through the hospital here. What a bunch of crap! Oh well . . . If anything further becomes medical beyond this explant, I NOW KNOW better than to EVER trust my network's doctors or its imaging personnel!!! I will stick within our local healthcare system and with the general surgeon after I am explanted. How anyone can say that removal of an implant that was damaged during a medical procedure is a "covered procedure," but considered strictly "cosmetic" in nature and of "no medical significance," is beyond me!

Boobless Wonder!!!

Okay -- two hours, and I am home. Took 1/2 valium, had shots to numb, implants drained, then he made his cuts, then slowly worked to get the implants to release -- high area above the implants hurt a bit during that tugging out part, but manageable. He only found minor, normal thin layers of calcification on the implants, and he saw nothing that would require drains. Stitched up and wrapped and that was it. I go back Thursday to make sure no fluid does collect inside -- if so, simple needle poke to drain fluid pocket. I was overcharge, but maybe with it so simple, it was worth the extra.

Before I left, I got a call from the Kaiser nurse manager for northern Colorado telling me that a board investigation and review of the biopsy that did this damage was happening this Thursday. She said there may be compensation to help off-set everything this is costing out of pocket since I have a deductible plan -- no promises, but at least they are following up on this rotten ordeal.

I imagine I may have some bruises in those areas where the implant was so stuck inside, but who knows. I am hoping for no fluid pockets and super fast recovery. Excision of the lump is next, so the sooner I get healed the better. Love to you all for your caring support and prayers! Thank you from the bottom of my heart!

Requesting feedback!

Since I did not get any post-op care instructions, I am wondering if anyone out there that had explant done in-office with plain scalpel cut incisions (not a cauterizing tool for cuts) and none- visible stitches under the breast could share their first few weeks of healing experience? I have no drains, and no real pain, except for the incision area itself, but it looks fine (no redness or bruising or major swelling). I wanted to use some ice last night, but wasn't sure if that was okay? I'd like to know what anyone else was advised? I am not entirely stupid, but I am thinking some do's or dont's were in order. I am trying not to lift things, etc. I return late tomorrow afternoon to check for fluid pockets, but since I met with so much defensiveness at that office when I questioned their excessive costs, I hate to even call before then to ask them anything! And, I had no call from them to check on me yesterday as I had hoped, so I could ask about these things. I did try calling around 4:00 pm, but the office was already closed. I think I am perfectly fine, but my confidence in these people is shot! Right before he did this, he made a comment about that legal paper I was required to sign. I told him I was not pursuing anything legal at all -- that Kaiser was engaged in some inter-departmental investigation and review according to the northern Colorado nurse manager -- initiated by HER, not me! When he stepped out of the room, the nurse whispered to me that it was a "cover our butt" deal. Geeeez -- what about caring for the patient? He didn't talk much during the procedure. I asked how long I would need to wait afterward before the general surgeon could do the excisional biopsy of that lump. He said tomorrow if they wanted. That response was a shocker -- seemed bazaar to suggest such a short time to have that done! I didn't ask or say anything else after that, and the only thing he said afterwards as far as care was that I could shower the next day and to have my husband help re-wrap with the giant ACE bandage (keep on 24/7) snuggly around. The shower felt awesome! Boobies are okay for being just skin. At least the nipples aren't completely southward! But, this ACE bandage is itchy as all get out! I put folded gauze over the stitched area (tucked up under the drooping skin) which helps some. I will ask plenty of questions tomorrow when I go back, but any feedback from someone that had this same procedure would at least give me a comparable way to judge my progress during the initial healing. Anyone?

Post-op morning of day 4!

So, I slept all night with the regular and the push up pad inserts in the sports bra pockets, which I think made a HUGE difference in the results this morning already. I decided to take pictures. I think they look bigger in the pictures than in real life, but hopefully these will help someone out there. I call them my new BEAGLE EARS -- ahahahaha. The bending over view is YUCK -- but I thought it was helpful to try all positions for you to help with expectations -- especially if you do not have much actual breast tissue like me. I am hoping to find a AAA cup in a juniors push up bra at some point!

Incisions DAY 3

I lifted up my beagle ear boobie skin to take these pictures of the incision sites for you all. I went for my post op exam yesterday. I met a gal before I left for my appointment, who had a horrible experience with this same PS, long story, but after four surgeries with him, she finally went to someone else in Denver. It took six months of scar tissue work before she could even have her breast repaired due to extreme deformities after his work on her, but she now has silicone replacements and is finally "fixed." She dealt with his "attempts" to fix things correctly for over a year. Of course, hearing her story made me very scared to go back yesterday! But, it helped to know it wasn't just me that encountered a bad experience with this PS and his staff! She knows several others who have not had good experiences with him either. He offered minimal to me for feedback or care yesterday -- just said I could switch ACE wrap for sports bra, and he would see me in 6 weeks, and left the room. The nurse was a bit more engaged and suggested the push up insert to get the breast skin off of the incision areas and continued ice for the discomfort. I did ask him about activity limitations before he walked out, and he said, "None, do whatever you want." I will follow-up from now on through the general surgeon -- get the lump dealt with -- and maybe she can oversee the rest of this healing process. I do not intend to go back to see him ever again!

Day 5 Swelling is gone -- Boobs are gone!!

Yesterday's swelling must have caused those pictures to appear so good to all of you. Today, all has changed. Now, the upper pole is completely flat, and the tiny BLOBs of what I imagine will ultimately be remaining boobs is hanging as low as my bottom rib bones. Those of you that think your results are disappointing should use my day 5 pictures as a way to cheer yourselves up!

Incision Question?

I am wondering if any of you that had incisions underneath could help me understand what the healing process involves -- what to expect? This is new to me because my BA was thru the belly button, so I never dealt with incisions at the breasts. The right one seems to have more of a hard lumpy feel than the left one. The bras are still very uncomfortable over the incisions, especially if I try to wear them without a lift pad to keep the breast tissue off of the stitched area. The tenderness and itchiness continues. I did use some Gold Bond on the sites last night which helped. But, what happens with these dissolvable stitches? I assume the thick hardness of the stitched skin eventually softens, but is it normal to feel like a hard lump for a time? How long does it take to become less hard feeling? Do these type of stitches work their way out or just dissolve inside? There is no swelling, redness, or anything indicating infection. Sharing your experience would help me if you have dealt with this healing process underneath the breasts. By the way, the warmed coconut oil massage of the breasts does make a huge difference in the skin retraction -- amazing so far. I am not using it on the incisions yet but wondering at what point I could? Thanks.

Fluff fairy must have flown on by! 2-week post-op pics

I still have excess skin on the sides (see bra picture), mostly remaining under the arm to the back area, which I HOPE will retract in time. Overall, I imagine this is about as good as things will get. As you can see with the sports bra, my ribs stick out almost as far as my blobs -- just like prior to BA -- and the reason I got the BA in the first place. Flat upper poles stay flat from what docs on this website state. However, I find it MUCH nicer to sleep now since I no longer have to adjust my water balloon bags into comfortable positions! Once the incision soreness is gone, I will be happy with my flapper tits! It is so nice to be explanted and moving beyond this phase of my life.

Insurance Update! And the MOOSE & BEAR await!

Well, I heard from the Kaiser resolutions department today. They said the same as the nurse manager in northern Colorado -- they cannot do anything about the cost of the explant. However, they ARE going to waive the costs of the biopsy and the consult in Denver with their PS -- whom I wouldn't let touch me with a 10' pole! They fully acknowledge the damage done to me and plan to do more internally to see to it this does not happen to another patient. So, that means a total of $1,217.17 off the bills now staring me in the face. I am grateful for at least some concession. I knew there was absolutely NO way they could view that biopsy video and say it was NOT the radiologist's fault for the damage to my implant. I do not think insurance companies make concessions back to patients very often, nor this fast, unless it is undeniably obvious that it was their fault. Also, without listing our home yet, we have buyers for it already -- AND -- the mountain home we had under contract last fall (bailed when uninsurable) came back on the market. NOW it is insurable through a different company, so we are going to buy it and move. I do not think the moose and bears up where we will be living will care two hoots that I do not have boobies! Unless that means I am depriving them of dessert? hahahaha! YIKES -- A lot of changes in my life in this last month -- major changes! So, L.L. Bean here I come -- no need for fancy bras when clothed in mountain gear!

3-week post-op today!

Wow -- time has gone fast! The retraction of the side skin is starting to become more noticeable now. I think they are filling in where they should be in front better than before, too. I highly recommend the massage! The thick hard incision area is improving, but I am anxious for that to heal completely. I concentrate more of the massage on the incision areas versus the full boobies. I believe it is making a huge difference, along with wearing the lift pads in the sport bra. I lift the extra boobie skin into a higher place -- upward and inward -- once the bra is on, and I think that has done much to encourage the "fluff" response. My PS who did the BA had a preference for setting them more toward the outer side -- he said it was a more natural look. BUT, with the implants, I had a tough time shaving because of how he set them. I could barely shave under my right arm without cutting myself. With them gone now, it is way easier to shave; however, I think that having them set as they were is a huge contributor to the excess skin still remaining on the outer sides. Plus, you can see how much extra skin remains on the right side versus the left side in the latest photos. What is most wonderful, though, is sleeping without wearing anything and in any position I want! YIPPY for that!

Not much Fluff 'n' Stuff

Before I pack up my camera, I thought I should share one last set of photos. I am almost 6 weeks post-op now. I have been aggressively massaging the scar incision area to see if I can get the hardness/lump to soften and dissipate more. As far as the pathetic beagle ear boobies, they are more skin than tissue for sure! If I lay on my side and cup both of them, I have only a handful -- two boobs make one! I do not care, though, as I am so beyond caring now! I will wear my sport bra with the lift pad and be as content as a hibernating bear.

Speaking of bears, I am hoping they stay away while we are moving into our mountain home. I found out I cannot put up a fence to protect our crazy dogs until June, so between coyotes, eagles, owls, moose, elk, deer, cougar, and bears, I will have a full time job keeping these two brats alive! They once chased a big elk all the way up a mountain, so this will be tricky.

No -- they are not related -- the one on the left is a white/parti-colored purebred schnauzer, and the other is a schnauzer, yorkie, poodle mix I rescued from a puppy mill.

My love to you all. I will not be on here nearly as much while packing and moving. Sending you all abounding boob-less bliss and blessings!

Mammogram!!!!!!!

You would not believe how mad I was yesterday after getting a mammogram! That jerk of a PS I had never did flush and clean out the pocket/capsule area as he said he would at my consult appointment prior to surgery. The images of the right breast particularly is full of calcium chunks!!!! The tech thought I had silicone remnants or something, but I told her no way -- they were saline -- so, when she let me look at the images, I knew what she was concerned about. I hope this remaining trash he left in me does not mean harm down the road????????? As far as the mammogram itself -- it was quite easy to smash my skinny puppies between the plates to take views! This is the first mammogram I have been able to have for over 15 years!

Moving!

I just wanted to let you all know that my mammogram came back normal, even with the chunky stuff left inside apparently. The move is on, and today I will be disconnected from the Internet for a week or so. I have tried to pop on as I can to check up on everyone -- not easy because I have been so busy prepping and packing. Regardless, I just wanted to say thank you again to all, and I will get back when I can. BIG HUGS and LOTS OF LOVE!
Fort Collins Plastic Surgeon

Do yourself a favor and get several consults elsewhere. Be diligent, take your time if you can, and find the best pre-op and post-op care, and the best overall support for yourself as a woman as you enter into this experience in your life. Trust your instincts. Be alert to how you are treated by the entire staff, how your questions are answered, how your expressed concerns are handled, how well-educated the overall staff are, and how your cost quote compares to other local surgeons for equal services. Ask around -- A LOT! Word-of-mouth often represents the real truth of others' experiences and of a surgeon's truest reputation and that of his staff. Diplomas and other certificates hanging on a wall represent passing grades on exams -- and, any 5-star ratings or excellent online reviews from years ago may mean very little for what you are seeking currently! Look elsewhere for a professional, high-quality, and compassionate experience through this journey of your life. He did not perform all that he said he would on me during the surgery, yet charged more than other surgeons charge for an in-office local/sedation explant procedure. You deserve better than what I experienced with this doctor and his staff.

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