Breast Revision Disaster- Staph Epidermis- 38 Years Old, 5'7, 112 Lbs, Nursed 2 Babies. Dedicated Yogi. - Utah

After nursing 2 babies my 14 year old 600cc...

After nursing 2 babies my 14 year old 600cc saline, smooth, round, high profile implants desperately needed to be revised. I did my homework & consulted with numerous surgeons. Each surgeon had a completely different treatment plan. 1.Breast Pocket revision, 600cc silicone, Mentor Memory Shape anatomical implants. 2. Full Anchor Lift, Breast Pocket revision, 480cc (maximum allowed) silicone, Mentor smooth round high profile implants. 3. Tacking of Breast Pocket, 600cc silicone, Mentor smooth round moderate plus 4. 650cc silicone, Mentor smooth round high profile implants. After weighing all the options, me & my mister decided to go with Dr.#3. I made arrangements with family & babysitters to care for my children for 1-2 weeks so I could heal. I also made a commitment to my surgeon that I would not go back to yoga for 6 months in order to allow my body to heal fully. I had surgery on 12-29-2014, the surgeon removed 600cc saline implants & replaced with 600cc silicone, Mentor smooth round, moderate profile plus. He also "tacked" my right & left breast pockets. The next day at my follow up appointment I told the doctor something was different about the left breast. It felt hot, firm & more painful then the left. He assured me it was too early to speculate that there was a problem. I questioned his "tacking" procedure he claimed was done to restore upper pole fullness & correct bottoming out. My left breast was much higher than my right. I had upper pole fullness on the left & no improvement on he right. The surgeon said they both looked great to him. My breast fold might not be even, but my nipples were even, so I should be happy with that. I was at a loss for words & left his office feeling hopeless. I'm an optimist by nature so by the next morning I was ready to fully believe that everything would heal & improve with time just as the surgeon said it would. After 2.5 weeks I requested a follow up. My left breast had become hard, extremely painful & swollen. My surgeon planned do exploratory surgery, drain some fluid, stitch me up & assured me everything would be fine. The day of the surgery I told my surgeon I had a very strong feeling the left implant needed to be removed. He assured me again that wouldn't be necessary. As strange as it must sound, when I woke up from surgery with no left implant, I was relieved! At my follow up the surgeon told me when he opened me up he discovered I had a severe infection causing capsular contraction. A week later my test results came back, I tested positive for staph. It would be 4 months before I have a new implant placed. And I would have to buy a new implant. I asked if the "tacking" done on the left breast could be reshaped to match the right side & my surgeon said that wouldn't be possible. I asked for suggestions to 'fake' having a left breast, he told me to put bird seed in a baggy & put it in my bra. I left his office feeling defeated & even more hopeless. The next morning my optimistic side was back in action, I took a visit to a mastectomy boutique, bought myself a new boob & special bra to hold it. And began to feel like I could actually face the 4 month healing time I had in front of me. At my next follow up I asked my surgeon again if he would be able to even up my breast folds after placement of the new implant in 4 months, and again he told me no. It's been 6 weeks since having my infected implant removed. I am trying to stay positive. It's a daily struggle.
I keep coming back to the question, Why would I buy another implant to have it placed higher than my current right implant? And sadly after 6 weeks of healing I personally feel the right implant looks too low, so why would I want to match it?!. The amount of stress & strain I feel I've put on my husband, children, babysitters & extended family is extremely upsetting to me. At this point i feel like I'm ready to remove the right implant, let it heal & start over with a new surgeon. I'm very conflicted. I have a follow up appointment today & I'm dreading it.

Considering Removing right implant to allow for skin retraction

I saw my surgeon today, he walked in the room & said, so how's everything settling in? I knew right away he didn't realize who I was or remember my case. I told him I was unhappy with the result of the right breast & told him I wanted to remove the right implant. He said, OK, we need to decide whether or not to dissect the breast pocket. He said in cases where the patient leaves the implant out for a long time or permanently he typically dissects it. If left intact it can cause fluid retention & bubbling. He said he dissected the left breast pocket because of the staph infection, so it's already gone. He told me to think about it & get back to him. I expected more of an explanation or guidance. I'm guessing he agrees the work he did on the right breast is not ideal or favorable. So why wouldn't I take it out? His nurse told me it's their busy season so it's likely they couldn't fit me in for a month or more. Very discouraging after everything I've been through. Feeling unsure how to proceed.

Seeking out a new surgeon

The last follow up with my surgeon made it clear to me I needed to seek out alternate recommendations to achieve the breasts I desire.

A friend that works as an esthetician highly recommended I meet with the board certified surgeon that works in her medical clinic. This Dr. & his wife own a successful local yoga studio. I practice yoga daily so having surgeon that understand my lifestyle is a bonus. My consultation went well. The doctor was kind, knowledgable & explained the options clearly. His personal recommendation was allowing 3 months of healing time before doing the surgery. Which would be April 16th, 2015. He would contact Mentor & get a comped implant for the left breast, so it would be no charge. He would reshape my breast pockets. Total = $ 5,662.50
He said if he were to choose an implant for my body it would be the Sientra textured round silicone because it is a higher cohesive gel & would ripple less on my thin frame. He wold remove my right Mentor mod plus 600cc implant & do a new set of the Sientra smooth round high profile along with the pocket repair. Total= $6,600
He said the Seri product would be a great choice for me but is very expensive. He felt like he could give me a favorable outcome with the textured implant without using Seri.

Next I met with a surgeon recommended by numerous of my yoga friends. The doctor was kind & thoughtful. However he was conflicted on how to get me to my desired results. He first suggested taking the right implant out, allowing the tissue to relax & heal evening the playing field. Then he felt that may not be required. His personal recommendation was to wait 6-8 weeks to put a new implant in on the left. Which would be Feb. 27-Mar. 13. He said Sientra implants were not necessarily the answer to my problems that all implant brands are very similar. He typically uses Mentor. He would reshape my breast pockets. Place a new Mentor smooth round mod plus silicone implant on the left. And Use Seri scaffold to create an internal bra to lift and support my implants. Total = $8,300.

I reached out to Dr. Revis in Florida. He responded to my email in 2 days which was very impressive. I explained the recommendations I had received from the other 2 surgeons. He told me I was an excellent candidate for a revision. He stated, "From your photos obviously you have a fairly low implant on the right, with a lot of rippling, but if you also notice you have some synmastia. I assume you do not want your cleavage to be kissing so we should deal with that as well. Here is what I think of your recommendations: Sientra implants- I actually would intentionally avoid this brand. They are the thickest, most textured, and regardless of what you have been told during your consultations they DO NOT ripple less. I have had to take a lot of them out because of this misconception. Seri scaffold: I am not sure why they are recommending this. if it is for the rippling up top then Strattice is a thicker product & much better at the job. If it is for support along the crease, I don't really need it because my Internal Bra alone will properly lift & support your implants. My plan is: 1. I always use a nipple incision, 2. The Internal Bra: my strong permanent internal suturing technique which corrects your bottoming out & synmastia on the right & prevents it on the left. 3. Implant Exchange for new Mentor High profile saline implants in the size of your choice-although counterintuitive, I have learned and seen through hundred & hundreds of revisions that when silicone ripples, especially up top in the cleavage area, the only solution is overfilled saline, with the 20% or so overfilling rounding out the saline shell & reducing or eliminating rippling.
4. Optional Strattice- it is expensive at $3000 per sheet, and thus $6000 to do both sides but if you want to do everything possible to reduce the risk of upper pole rippling then by all means the single best product would be to place a sheet of Strattice in each upper pole. Total before Strattice= $10,000 Total including Strattice= $16,000
Dr. Revis's 1st available surgery date was in June.

Another friend of mine works in medical office doing botox, fillers etc. She had heard from her patients frequently the best surgeon in town was a woman. I made an appointment and was able to get in the next day because they had a cancellation. What a different experience. Meeting with a female is awesome because they really understand what you are going through. She was very kind, sympathetic & thoughtful during my appointment. She had me try on different implants which was a first for me. Her personal recommendation was waiting 3 months before doing surgery. She would take out the right implant. Reconstruct my breast pockets. Request 2 new comped implants from Mentor because she felt my 600cc implants were too large for my body. Use 400cc High profile smooth round silicone implants. She does not use Seri on thin skinned patients because there is a risk of seeing it through the skin. I would heal for 3 months & follow up with her to see if I needed a lift, if so, she would perform the lollipop lift. Surgery 1-Breast implant exchange, capsulectomy, silicone implants, bra. Total= $10,330 If she was able to get comped implants it would be Total= $8,330 Surgery 2- Breast lift. Total= $4,500-$7,600. For a grand total of= $17,930.

The final surgeon I saw on Friday has 29 years experience. My consultation went well. He was kind & made me feel at ease. He asked me numerous questions about my goals & how I felt about how my right breast looks. He had me stand in front of a mirror & explain my concerns. He agreed that my right breast had bottomed out. He felt I was on the borderline of needing a lift. Once he placed a new implant he would have to assess if I needed the lift. He said his staff could contact Mentor & check on getting a comped implant but when he checked with his assistant she said that wouldn’t be possible because it was her understanding Mentor only replaces implants that have ruptured. She said she would call Mentor on Monday & double check. I asked him, if Mentor won’t comp my implant what implant would you hand pick for me? His personal recommendation for me was Sientra textured round high profile silicone in 505cc’s or 565cc’s. I told him I had concerns about using textured given my thin skin & obvious rippling now. He said there have been a lot of case study reports that claim textured causes problems but he has yet to experience any of those problems in his practice. He would also use the Alloderm as an internal bra to support the implants. I asked him why not the Seri? He told me he didn’t feel like it lived up to all the hype, and that the Alloderm is a better product. Once reconstructed my breast pocket he would try to use just internal stitching to create an internal bra. If the internal stitching was not adequate he would add the Alloderm. At that point he would decide if I needed a lift. If so, he would make an incision under the nipple to the breast fold & pull everything together. Total before Alloderm = $ 10,441 Total including Alloderm = $ 13,341
As I was finishing up with his assistant I asked her to email me some photos of patients that have undergone the same treatment plan Dr. Thomas is recommending for me with a positive outcome. She emailed me later saying, "I don't have anyway of telling what implants the patients have on the website-I didn't use their names. I will see who I have post-op photos with Sientra implants on, but you wouldn't be able to tell the difference between any of the different brand implants if they are the same size. I will also see who we put Alloderm in, again you can't see it." I wrote her back, "I completely understand what you are saying. Before my husband is willing to write a check for $13,400-$16,300, in addition to the $6,000 he already paid, he is requiring I show him 5 breast reconstruction cases where the Dr. used the recommended treatment he is proposing on me, on other patients with a successful outcome. I understand this is a time consuming request however my case is more complex than most. My husband is frustrated & doesn't know who to trust. I have received numerous recommendations from numerous surgeons. Not one of them have had the same approach or treatment plan. I personally feel confident in Dr. Thomas, but need that extra proof to give my husband the chance to feel confident in the Dr. so I can move forward with the surgery." I didn't get a response back yet. We'll see what happens Monday.

I am not sure what to do. So many different opinions. A lot of money. No guarantees.

Feeling Hopeful

After never hearing back from the female surgeon, who charged me $100 for a consultation, and never obtaining any photos from the last surgeon I saw, to view his reconstruction results, I immediatley crossed them off my list. Feeling discouraged & confused I decided to make a few calls to cancer reconstruction surgeons. All of the surgeons I contacted only see patients who have had cancer. And they all referred me to the same Dr.!!! And can you believe, it was the Dr. my friend who is an esthetician works with! The 1st surgeon I saw after this whole mess started. I called his office & set up a 2nd consultation. We met on a Saturday, and my husband was able to be there too, which was so awesome because he works 20 hour days right now & has no extra time for anything. The consultation went very well. He went over all the same information he had covered with me during the 1st time we met. He answered all my husbands questions & really took his time with us. After discussing everything for nearly an hour the Dr. came up with a new treatment plan. Remove my right implant (Mentor mod+ silicone 600cc), replace with EITHER 1. Natrelle 410 XF (textured shaped) silicone implants OR 2. Sientra Shaped Classic Base silicone implants. No breast lift, filling up the tissue with a comparable sized implant to what I have now (600cc). Then he will create an internal bra with Strattice. This will ensure the implants do not shift & also create (some much needed) volume to soften the look & cover the lower part of the implant to hide rippling. Total = $8,500
After the appointment my husband & I talked out in the parking lot for a few minutes, and decided this was the surgeon I should go with. I'm excited, nervous & relieved. Surgery is scheduled for April 27, 2015.

Anyone out there with Natrelle 410 XF implants????

I would love to see some before & afters of Natrelle 410 XF implants. Evidently this particular model of implant is relatively new. I have been unsuccessful in finding any before & after photos of women that have this implant style. Help! I really want to have a visual of this implant prior to my surgery.

New Surgeon. New Hope. New Beginning.

My surgery was 2 weeks ago today. I used the Hibiclense all 4 days prior to my surgery. My surgeon recommended 2. I wasn't taking any chances this time. My first surgeon didn't ever have his patients use Hibiclense. The day of surgery I was allowed to take a Valium with a tiny bit of water to calm my nerves. What a completely different experience. I tend to get very nervous, although I should be a pro by now, I still get wound up. I arrived at 7am. My surgeon met with me, my husband & his assistant to 'Map' my chest by making markings with a pen. I had only ever seen this done on TV. Once he had answered all my questions, and walked me through his surgical plan, my husband & I felt confident & said our good-byes. I was introduced to my anesthesiologist. He was very kind and compassionate as I explained how I ended up with exposure keratitis after my 12-29-14 initial revision surgery. He assured me I would be in good hands. My surgeon had 3 different styles & sized implants available to choose from. During the surgery he used sizers to determine which style/size to go with. NONE of the other surgeons I met with in Utah use this method. He also uses the Keller Funnel method which allows implantation of silicone gel breast implants via a no-touch technique. My surgeon selected Allergan Natrelle 410 FF 595cc's. He used Strattice to create an internal bra. And also placed a drain on both sides which I would have for 7-10 days. After my surgery I woke up feeling pretty comfortable & alert. I was impressed with the simplicity of the drains. The drain my former surgeon placed after my surgery on 1-16-15 was hanging out of the end of the breast crease incision. Which is extremely painful & constantly tugging on that delicate incision tissue. My drains this time were exiting out of my rib cage below the breast, neatly tacked to my body with tape to prevent the painful tugging I expirenced before. I was able to get home, into bed, have lots of water, some crackers & start my medications. My follow up was 2 days later. My surgeon explained how he found sutures left behind from my from my former surgeon. They were NOT a suture typically used or left behind in a patient with a known infection. My left breast was scarred down & proved to be achallenging task. However my surgeon felt confident I would have a "very pretty result" after all heals. My drains were removed 9 days later during a very simple in office procedure. I was able to discontinue my heavy pain mess that day. My surgeon explained it may take up to 3 months for the left implant to relax. So now we wai & heal.
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