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I had a breast augmentation revision 4 weeks ago...

I had a breast augmentation revision 4 weeks ago in London after 17 years of implants from the age of 23. I don't know what my bra size was before the implants, I didn't need a bra, but you can see in my pictures from the first pre-op surgery. My current surgeon says I was an A cup. I had 270cc Hydrogel subglandular, I was never happy with them but I could cover them up and make them look natural enough in clothes. I buried the whole shameful affair and told nobody, not even my partner of 17 years after that. I had the revision as the implants were dangerously old and the rippling had become very visible, also I'm doing IVF treatment and thought that if I am going to conceive, that I should sort this situation out fast. Sadly I didn't do my homework. I did what I did at the age of 23, I was hasty and scared and just put my body in the hands of the most expensive surgeon I could find. I was very wary of how he seemed reluctant to make me smaller but we had many conversations and he seemed to understand, we also had my existing implants as a realistic measure of how small I could feasibly go. Anyway, 245cc anatomical 'teardrop' Mentor memorygel 'gummi bears' submuscular later, and I really hate them. They are bigger and higher and the scars are wider, all typical of this implant apparently, but not something he warned me about. He told me on two occasions that the scar would be the same size, when it seems normal for a cohesive gel shaped implant to require a wider incision, but he wouldn't give me that possibility. In our follow-up yesterday when I asked, he said he 'didn't know' if the new incision was bigger, he 'didn't think so'. So I am afraid that I can't trust him. He knows I want to explant and will do it as part of my package, but very reluctantly. He wants me to wait for them to settle; again, these textured implants do their best to grip to the tissue and they don't drop much. But all of my research and questions are dismissed by him as 'trash on the internet', he 'has done thousands of these implants' etc. I got upset in his office, not so much out of my own situation anymore, but for his dogged insistence that his implants for me were 'textbook' and right for me. I felt drowned out by his own sense of being right.

My sensation was always reduced after the first implants, which bothered me a lot and got in the way of intimacy. But I had some at least. My surgeon knew I was afraid of losing more and now I am completely numb from the top of the implant at armpit height, to underneath. I have a tiny bit of sensation in one nipple. My main distress about this revision is the possibility that I could perhaps have breastfed a baby with what I had before the revision. My surgeon told me it was unlikely, so I had the revision thinking I had nothing to lose, but I wonder now if I could have managed. It's all a bit late and I'm ruminating and obsessing.
But what I want now is to explant and to get these massive balloons out. I may still be numb but the offenders will be out of my body and this cycle of implanting will be finished.
I am looking for someone to do this, but wary of cost to myself financially and emotionally. I had time off work for the revision and the discomfort of going submuscular meant more time off than planned. I've been very emotional and distracted and I can't tell a lot of people why. I'm doing a cycle of IVF treatment right now, and the embryos will be frozen. My partner and friends don't want me to explant, as they think I'm in the wrong state of mind, that I should accept what I have now and focus on my fertility treatment. My partner is already hesitant about me even having an embryo transfer as he thinks I'm not up to it emotionally. So I made a terrible mistake by having this revision when I did, how I did; I didn't consult with any of my friends or my partner, I just went and did it as I was so afraid and ashamed. It's only since the revision that I have opened up and told any friends at all; they're amazed to know I had implants all this time.
There are a few good doctors in the UK that explant, but they all implant as well, so I'm not going to get a Dr Melmed or Dr Feng. I have spoken to Dr Melmed on the phone and by email. He asked me about symptoms, and I said I have severe persistent sciatica and recurrent yeast infections, but I didn't associate them with the implants. He believes they are. But given my situation, he does not want me to fly to Dallas to be explanted by him. The other surgeons here will consult with me gradually over the next month, but I can't be sure about their attention to removing all the capsules. My new implants will not have formed a capsule at least, but I am worried about the old capsules, and how much my surgeon really did remove, as I don't feel I can believe much of what he says. He tells me that he left the capsule closest to the skin as I have no breast tissue, that he cleaned the pocket out with water and hydrogen peroxide. The old implants were not ruptured, but with a thin bleeding shell, so there must have been silicone in the pocket. He has closed the pocket, and I don't know how disruptive it will be to my remaining sensation to have the pocket re-opened to check. The only surgeon who might do that is Dr Feng in Ohio. I will speak to her secretary soon, but I don't think I can afford her or the trip as well as IVF.
My surgeon will remove them for free but tells me that I will just have empty pockets, loose skin. That I have NO breast tissue at all, that implants can rub away the old breast tissue. I will be an AA cup instead of my previous A cup. In short, he is giving it all the scare stories. Dr Melmed said I would be the same as pre-implants, and that breast implants can encourage breast growth if anything?! My surgeon says it will be quick and easy to do, a day-case, 20 mins to do!? I wonder about drains, as these usually stay in for a few days; he used them for the revision BA. I am worried he is rushing it and that I shouldn't use him, but I am tempted by the locality and that I won't have to borrow money or travel far and wide. I wouldn't have a lift with any of the other surgeons anyway, so as long as my POS removes them, will I be okay and my results will be much of a muchness? I won't have a capsule to worry about. I made a mistake the first time, I don't want to make it again. I will ask Dr Melmed, but I don't want to go through this and feel no peace of mind, eventually travelling for further surgery to be sure. I am pretty sure I won't get the sympathetic aftercare that a dedicated explant surgeon would give, but as long as they are safely removed, then the rest is up to my body? I hope to do this in one month, I would really appreciate any advice or support, I feel so out on a limb. Thank you.

Nailing down a date for explant with implant PS

So I must be a sucker for punishment, but I'm probably returning to my nightmare surgeon for the explant. A number of reasons; financial, logistical, all things that aren't enduring so I should probably throw everything I have at it for the best long term result. But I found out yesterday at an IVF scan that I will need a laparoscopy in order to go ahead successfully with embryo transfer later in the summer. That will be with my gynaecologist in London, and as I need two weeks off work for that, I am imagining I can do the explant before or after by a few days. It will be horrendous, I did this before with the revision, thinking I could manage to do that I between IVF cycles, with no thought for it going wrong and having this emotional impact on me. I've pretty much checked out, my partner has too. My PS just wants to make a consultation for a months time, presumably so I maybe change my mind. I am terrified of taking them out, but having them in is like a weird limbo. I think I would be less afraid if I had some sensation in them. I am afraid to be left with numb deflated pockets, but the big numb balloons are such a reminder. I asked Dr Melmed and he doesn't seem to think 20 mins is too outrageous for the explant. Maybe I'm writing myself off here!

Pre-revision pictures after 17 years of 270cc hydrogel subgladular (over muscle)

Finally got some pictures of the old implants from my revision PS, but not sure how useful they are to understanding my explant outcome. They were lower and more sloped than these new so-called teardrop numbers, but also rippling badly. New PS reviser brought 'me in' to be less lateral, but I'm just bursting out of my ribs now. I want to be explanted before I stretch the skin under my arms any further. Also hoping to regain some newly-lost sensation, which comes all the way up to the top of the implant, and all the way into my sternum. I saw a spider crawling across my breasts in the mirror the other day, but could feel nothing, horrible!

Provider Review

Andrew Fleming

Recommended by my kindly gynaecologist, who could see I was in distress! Dr Fleming is older than my plastic surgeon and has explanted only PIPs implants, but is kind and fair and listens. Everything my PS was not. He could only remove them, no capsulectomy unless they were calcified. He excised my old scar and used less of the revision incision to remove. He has given me the care and attention I need, and answered all of my questions openly, is concerned to follow up everything in writing and even insisted on speaking to my GP to make sure I wasn't making the decision to explant from a depressed state of mind. As a surgeon who implants, he would make a good choice, the care is such you would expect from a family member.