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POSTED UNDER Breast Implant Removal REVIEWS

Age 53, Remove Ruptured Silicone Implants. Don't Wait!

ORIGINAL POST

Several months ago my left breast swelled and was...

Friedeien
WORTH IT$3,500
Several months ago my left breast swelled and was slightly uncomfortable. A physician suggested a mammogram and breast US to rule out various problems. Later, an MRI confirmed both implants are ruptured and there is intra- and extra- capsular leakage of the silicone. Needle aspiration of some fluid came back negative for ALCL. I feel fine. So far so good.
My reasons for explant are to clean up the leakage, remove scar tissue, and avoid future surgeries. My first BA was in 1989. I was talked into a size larger than I was happy with. I developed CC and one side "bottomed out". The current set was implanted in 1996. This set lasted me 18 years with very little problem until now. They seem to have ruptured suddenly. Last year's mammogram was normal and I can't account for any trauma.
I spoke to a few surgeons and found one who has done a lot of breast reconstructive surgery. I have learned a lot of what to expect from Realself.com stories and hope to encourage others who want to consider this procedure. I am fortunate that my health insurance will cover most of the costs.
Here goes...

Friedeien's provider

Gil Kryger, MD

Gil Kryger, MD

Board Certified Plastic Surgeon

Friedeien rating for Dr. Kryger:

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Replies (16)

March 20, 2015
Hi there! Welcome! My own search for a PS (5 consults total) did not yield one with 'explant only' experience. I ended up going with one that has experience with breast reconstruction also. He recommended a staged approach and that's what I've decided is best. That said...it's so tempting to go with explant with lift when I see so many that had no issues with complications to blood supply etc. The other 4 PS were on board with explant with lift. Look forward to following your blog...2 months ugh! you have a ways to go :(
March 20, 2015
Yes, it seems most people get the implants replaced. I'm gambling that my results will be acceptable to me, When is your surgery?
March 21, 2015
My date is March 25th, so right around the corner...I actually didn't have to wait long for a surgery date with any of the PS I consulted with. The one I chose had the longest wait time, hoping that's a good sign. My PS suggested that we try and get my explant covered by insurance and surprisingly it was approved 100% of the cost...I'll believe it when I see it...skeptical! Likewise, I'm hoping beyond hope that I can live with my appearance post explant! Keep in touch and let me know when you get your date!
March 26, 2015
I happened to log in today and saw that it was your surgery date! I wish you a speedy recovery in all aspects: physical, emotional, mental...
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May 1, 2015
How do you go about seeing if insurance will cover it?? Does PS call and say medically necessary?? Or do we do it ourselves??
May 10, 2015
Your PS will most likely be the one to get this authorized by your insurance plan. I work in the health care field so I did some research myself too. In the end, you personally don't get to decide what's "medically necessary". Lol, even the doctors and insurance companies don't always agree on that! Read on... In 2002 , I applied for an Anthem Blue Cross PPO health insurance plan for myself, my husband and 2 children. We are self-employed. Since I am younger than my spouse, the broker suggested we get the policy in my name. That's when Anthem told me they would be charging me 20% more on the premiums because I had existing breast implants. Even then, the premium was less than if my husband were the policy holder. It is a catastrophic plan with a high deductible but has served our situation well over the years. When my breasts became symptomatic I had full confidence that Anthem would cover me, because both Anthem and I PLANNED for this eventuality. You could call your insurance plan and ask about specific coverage but it will come down to what your physician deems "medically necessary" and what your specific plan covers. For a good example, Google "Aetna CPB 0142" as a sample of an insurance company's coverage policy for breast implant removal. Here is an excerpt: "Extra-capsular rupture of silicone gel-filled implants, because extra-capsular silicone can induce granulomatous reaction and can occasionally migrate to the axillary lymph nodes, producing a lymphadenopathy, which can mimic cancer. Clinically, extra-capsular ruptures are often associated with a change in size and consistency of the breast. Extra-capsular ruptures can usually be identified on mammography or other imaging studies. Explantation of these implants is clearly indicated. The health consequences of intra-capsular ruptures are uncertain since theoretically the silicone is contained within the fibrous capsule. Furthermore it is known that intact implants routinely “bleed” microscopic silicone particles, which are also contained within the fibrous capsule. Nevertheless, an intra-capsular rupture can evolve to an extra-capsular rupture and the FDA has indicated that ruptured implants, whether intra-capsular or extra-capsular, should be explanted as well." -from Aetna CPB 0142 My procedure fell under the CPT code 19330 for Removal of Breast Implant Material. I qualified because I had an MRI done which clearly showed extra-capsular rupture with possible uptake of silicone material into my lymph nodes.
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May 13, 2015
Mine turned out like yours...but I feel better. I need to update my progress. Boobies popped out a little. I had my surgery January 16th 2015. Our photos are more realistic to this process.
May 14, 2015
Good to know. I'm not seeing any other photos with such a dramatic fold . Here's hoping.
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May 13, 2015
I'm on medicare because of my age and have Kaiser Permanente supplemental health insurance (Northern California). It covered all but $150. Talk to your doctor about it.
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June 16, 2015
Mine are sort of like yours. I had issues similar too. Mine had to be chipped out.
UPDATED FROM Friedeien
2 months pre

No price yet

Friedeien
I don't know what the final cost will be. My health insurance is covering it. I have a high deductible with a maximum out of pocket. I will track the charges though and report it at the end.

Replies (6)

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April 4, 2015
I'm looking forward to your story. I'm 53 and have had two sets of implants. The first was in 1990, the second (to correct the capsular contraction) in 1999. I'm seeing the original surgeon in two days. I'm so done.
May 1, 2015
How did your visit to the surgeon go? Mine had semi-retired to another state so I had to search for new person.
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April 23, 2015

Ugh, I know how that high deductible thing goes. When you get a chance, we'd love an update. :)

May 1, 2015
Surgery in one week! I've almost hit my maximum out of pocket expenses of $3500. $750 was for a colonoscopy, the rest was "breast related" for mammogram, ultrasound, MRI, needle aspiration, down payment to surgery center and physician. I'm pleased. It could be so much worse. I'll still post a listing after all is said and done to give an idea what it might have cost to pay cash.
May 20, 2015
I'm finding that none of the private office of PS that I have consulted don't accept insurance to cover my explant because I got them originally for cosmetic purpose and not for health reason, I'm not sure if I'm looking at the wrong PS or it varies by states insurance policies any thoughts?
September 1, 2016
What health plan do you have? Will they cover the cost if their is a rupture and distortion?
UPDATED FROM Friedeien
2 days post

Surgery completed May7th, 2015

Friedeien
My surgery was done by Drs. Zol and Gil Kryger in Thousand Oaks, CA. Their mission was to remove my ruptured silicone implant material and not re-insert any new implants. They said it was a difficult explant surgery. I did not get more details since I was out of it. I will get the whole story when I go back for my first follow up appointment. Coming out of anesthesia, my pain level was high. They got that under control quickly but then a Percocet pill later brought on MAJOR NAUSEA. A Phenergan injection and Zofran helped a little bit. My aftercare nurse Lana was awesome and really everyone was kind, helpful, and professional. On the drive home (about 1 hour 45 minutes) we went through rain, hail, and a dust storm. (I was mostly in a fog. Pun intended.) My nausea finally subsided by the next morning and today I’ve only taken one 800 mg Ibuprofen for the pain. I’m sore but not really in pain. Using my icepacks sometimes.
I have drains but no wrapping of any kind. I am comfortable, sleeping fine and have already been outside a bit to walk around. I will post some photos. I'm not very good at it and was very nauseated when I took the first ones post-op. The breasts look awful right now but I was ready for that after reading other postings. It feels great to be "lighter and flatter" and I just have to wait and see what happens as time goes by.

Replies (10)

May 10, 2015
did you had the "en block" procedure??? Did your doctor told you why are your breast folded?
May 10, 2015
No, my silicone implants were not intact. They were ruptured and had leaked outside the capsules. I will ask my surgeons about the folded appearance of my breasts at my first follow-up appt. I have some guesses. "Under-the muscle" implantations are not necessarily completely covered by muscle. It's more like a hat on your head. Your head is under the hat but it's not covering your entire head. Your nose, face and chin poke out below. When you take your head out of the hat, it collapses. I think that accounts for the "top" fold. The bottom "fold" might be the drainage tube coiled upside where the breast pocket was, or swollen breast tissue. Stay tuned for details and I apologize for the goofy analogy.
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May 10, 2015
Congratulations on your explantation. I'm very interested in your case because I'm also 53 and have had implants for a long time. Can I ask if your implants were under or over the muscle? Saline? I am sending my best wishes for a speedy and full recovery.
May 10, 2015
Thank you! My implants were silicone under the muscle. My ruptures were a mess.
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May 10, 2015
Many blessings to! Thank God the surgery is behind you and now you are on to the rest and healing time. I wish all the best, Friedeien:) and Hugsxx
May 10, 2015
Thank you! I'm feeling very good about it, despite appearances at the moment.
May 11, 2015
Just realized I could "burn" my old bras. If I wanted to. :D
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May 11, 2015
That's actually a great analogy! Mine are also silicone under the muscle and will come out on May 20th. I'm scared of the fold result but am preparing myself for it just in case. I don't know if they are ruptured. They've been in for 27 years. Ugh. As to the drains, in what way are you pinning your blouses? What do you use to pin the bulbs together? Large safety pins?? Also, what is the "washcloth idea"? thank you!!!