40 Years Old, 2 Kids, Silicone Implant Removal After 9 Years. Toronto, ON

I got my implants in 2005, after being insecure...

I got my implants in 2005, after being insecure about my A cup breasts for as long as I can remember. I was very happy with the results (silicone, under the muscle, 270ml per side), although they turned out slightly larger than I wanted (large C cup, while my goal was a B cup; I never had the intention of being large, just not tiny). Problems started when I had two kids in the last 3 years. I nursed both of them for a year, but it was not easy with recurrent yeast infections in the breast (not the nipple, but inside the breast), that were more stubborn than anything my Dr. had seen before. Not sure whether that had anything to do with the implants, but at least one PS I consulted thinks it's possible. Then I noticed a nodule and changes in the shape of my left breast. The shape changes was the beginning of capsular contracture, which has gotten worse since then. More worrisome to me, an MRI and ultrasound showed that the left implant has ruptured. It's an intracapsular rupture, which means the leak is contained in the scar capsule that your body builds around the implant.

I have spend almost a year doing research on how to best proceed. I didn't want to have implants again as that would inevitably mean more surgery down the road (as implants are not lifetime devices, no matter how much manufacturers want you to believe in their reliability; also the chance of developing capsular contracture again, once you have had it, is significant).

I had already decided to get a simultaneous implant removal and fat transfer to the breast, but had second thoughts, as the idea of using BRAVA (necessary before fat transfer) on breasts with ruptured implants seemed worrisome to me (those worries were confirmed by at least one PS I talked to about fat transfer). Instead I decided to get the implants out first, see what I actually look like and then decide on possible other steps later.

So here I am. I just had my implants removed yesterday by a local Toronto surgeon, Dr. Mitchell Brown. Dr. Brown was highly recommended to me by the surgeon who performed my original implant surgery (Dr. Kenneth Shestak in Pittsburgh). I cannot say anything about the results yet, as I'm still wrapped up in the post-surgery bra and final results will take months. I will try to keep posting updates.

My interactions with Dr. Brown and his staff have been very pleasant and professional. I consulted with a total of 6 surgeons in Toronto, before deciding on Dr. Brown. He seemed one of the most experienced surgeons, in particular when it comes to implant removal and not just placing new implants. I liked that Dr. Brown was willing to answer all my questions in as much detail as I wanted. I also appreciated that he accepted my decision to remove the implants, without replacing them. Most other surgeons were not very comfortable or supportive of that option.

Pre-op photos

Here's a photo taken a few days before surgery. It shows the capsular contracture on my left breast, which also has the ruptured implant. I feel that my right breast recently also started to change shape (moving upwards), wondering whether that's the beginning of capsular contracture on that side as well. Or it might just be due to loss of breast tissue after two pregnancies and nursing each child for a year.

Two days after implant removal

I didn't include many details on the surgery or my recovery in my original post, so here they come.

Surgery was very easy. I found all the staff (nurses, anesthesiologist) in the clinic very nice and genuinely warm and friendly. I was not very nervous before the surgery, but I think if you were the nervous type everybody there is very good at making you feel more relaxed.

I woke up drowsy from the anesthesia, as expected, but was in no pain. Dr. Brown saw me shortly after I woke up and told me that the surgery was easier than expected. The implant on the left side was ruptured, as an earlier MRI and ultrasound had indicated, but the rupture was all contained inside the capsule, but there were no signs of infection in either breast and the capsules in both breasts were thin and soft. On the right breast the implant was intact, and he just removed the implant, leaving the capsule in place. I believe on the left side he washed out the pocket and removed only part of the capsule. This is what we had agreed upon before surgery. I know others might be more adamant about en-bloc removal, in particular with a ruptured implant, but I never had worries of auto-immune or other issues from my implants, and went the route that causes the least trauma during surgery.

I went home about an hour later after waking up from surgery, and was able to have dinner and play with my kids (18 months and 3 years old). I'm 2-days post-op now, and can't say that I'm in any major discomfort. I pretty much go about my days as usual, except no shower&baths until after the post-op appointment in 3 days and no heavy lifting, although I do pick up and carry my 18-months old daughter, just don't tell my doc :-) The incision on my left breast feels a bit sore, but other than that no discomfort.

I took a peek from the top under the bandages and post-surgical bra. As expected two deflated looking boobs. After two pregnancies and nursing, and 9 years of implants I can't blame them :-)
So far I feel very positive about my decision, but I realize that there might be a bit of an emotional roller coaster ahead of me. Luckily, it's the beginning of winter. Swimsuit season will be more challenging. My inlaws live in a beach town in Greece and we spend much of our summers there. It will be hard to explain the sudden shrinking of my boobs...

12 days post-op, overall happy

The positives:
- Recovery was very easy, I really had no major discomfort except for tenderness around the incisions.
- Although my implants were not huge (270cc), I do feel lighter on my chest. I'm surprised. I didn't expect that. I also feel that it's easier to keep good posture (stand straight with shoulders back, rather than slouched). Some of it is maybe psychological, since previously I didn't want to make my boobs look even bigger than they were, but I think having less weight on my chest and less pressure on the chest muscles helps.
- I was expecting to be more bothered by going back to flat. I'm surprised so far it hasn't hit me too hard psychologically, given how insecure I was about my breasts for so long. I credit all of you ladies on real self who have shared your stories for that. It really helped a lot looking at others experiences and knowing what to expect. Thank you!

The negatives:
- One side effect that I hated about the implants is still there: when I flex my pectoral muscles my breasts get distorted. That was expected with the implants in place, since mine were under the muscle. However, my PS had told me that it would be resolved after implants are removed. Not so!
Have to ask in my next follow-up appointment.
- My breasts are flat & jello-ish, (although there definitely has been some improvement over the last 12 days). They are somewhat similar to my before-BA breasts, except that I have even less volume in the upper pole and they are much less firm. It will be tough to even fill an A cup. I'm currently wearing a VS sports bra (compression is recommended by my PS for post-op) and add one of those add-a-cupsize pads into the pocket it has. With that in place, I'm ok with my silhouette when dressed. Wearing a sports bra without padding makes me look as flat as an ironing board. Maybe I could even get used to that, but nobody knows about my surgery and I prefer not to draw attention to it.
- I don't want to lie: this has been emotional at times, in particular the days after surgery. What surprises me is that I'm not so much bothered about what my breasts look like right now, but I get emotional because looking at my body now reminds me of myself ten years ago and how insecure I was back then.

Distortion of breast when pectoral muscles are flexed

Just wanted to add a photo to explain what I meant in my previous post. When I flex my chest muscles, my tiny breasts get distorted much the same way they did when I still had the implants. I was hoping to get rid of this side effect of under the muscle implants with the surgery :-(

Flattering pictures

I should also note, that the pictures look flattering, compared to what I see in real life. It's maybe the lighting and also that I have my arms raised (to hold the camera).
Toronto Plastic Surgeon

I consulted with a total of 6 surgeons in Toronto, before deciding on Dr. Brown. He seemed one of the most experienced surgeons, in particular when it comes to implant removal and not just placing new implants. He also came highly recommended by my previous surgeon (Dr. Kenneth Shestak in Pittsburgh, PA, who I was very happy with, however, I have since then moved to Toronto and didn't want to travel for surgery). My interactions with Dr. Brown and his staff have been pleasant and professional. I liked that Dr. Brown was willing to answer all my questions in as much detail as I wanted. I also appreciated that he accepted my decision to remove the implants, without replacing them. Most other surgeons were not very comfortable or supportive of that option.

4 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
4 out of 5 stars Staff professionalism & courtesy
4 out of 5 stars Payment process
3 out of 5 stars Wait times
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