41 Years Old Breast Augmentation Revision - Virginia Beach, VA

I am 10 days out from my breast augmentation...

I am 10 days out from my breast augmentation revision. My original surgery was May 2012 with a second surgery to release a capsular contracture in my right breast a year later. Since then I have developed another grade 2 capsular contracture and a spot of very thin skin that is bluish in color and I can feel the implant.
My upcoming surgery is by a different doctor (I was satisfied with my first sense of urgency or his seeming lack of desire to perform a revision surgery). My new surgeon diagnosed the CC and said I have an impending extrusion. He said that I had about a year before the implant would poke through my skin. That's enough convincing for me!
I got for my pre-op appointment in 5 days (it's so close to the surgery date because they really worked with me to get me into surgery as soon as possible to accommodate my schedule. So..here I am, about to go at this all over again. This time I will have a full revision- replace implants (current Mentor Spectrum Round Smooth Saline 525cc left, 555 cc right) with gummy bear implants. I'll get those specifics at the pre-op. He will also address the impending extrusion and CC.
Not happy at having another surgery but I am happy to have a doctor who puts me at ease and is very proactive.
I'll keep you posted and pictures to come soon.

The Longer Version

Original surgery was May 2012 where in addition to a neck lift and chin implant I had breast lift and augmentation. Under muscle Mentor Spectrum Round Smooth Saline implants- 525cc left, 555 cc right. In my before and after pictures from my first surgery you can already see the difference between the two. My right side is much lower and you can’t tell by the pictures but the upper pole area was extremely tight. My scars were kind of jagged, which was concerning to me, but my doctor offered several free sessions of pixel treatment as standard care for his patients. (it worked great)
After this surgery I went through the whole emotional roller coaster I see other patients have gone through. The bruising and numbness of my face and the pain from recovery, not to mention drains and bandages really had me questioning why I would do this to myself. Today- even with the complications I would do it all over again because I feel fantastic! But back to the story-
A year from my first surgery I went in for a correction. My doctor released the tissue in my upper pole area and sewed me back up. (there was no charge for the correction surgery). The area felt better immediately and recovery wasn’t that bad either. I few months later at a post op visit I pointed out to him the tightness on the outer portion of my right breast. I also pointed out an area at my breast flap where I could feel the implant (he said that’s not abnormal). He also agreed it felt tighter but suggested that it was probably better to live with a little tightness than to go through surgery again. So I have lived with tightness.
A few months ago I started noticing another problem in my right breast. Wearing under wire bras because painful and I noticed a spot that looked bruised and where the implant was palpable. During a skin treatment session with the nurse aesthetician at my doctor’s office I asked her to take a quick look to see if it looked like anything I should be concerned about. She looked at it and then went to go ask my doctor to take a look. I told him about the underwire issue. When he looked at it he seemed perplexed. He said it was odd and then told me to wait 6 weeks and then come back for another evaluation. He also said he wasn’t exactly sure how he would treat it because making an incision in that area could puncture the implant or just make the situation worse. He also said an option might be to go in and move the position of the implant.
So I went home set on waiting 6 weeks to go back. But the longer I waited, and the more I thought about it, the more worried I really became. The pain wasn’t going away, and sleeping wasn’t comfortable anymore either. I started researching extrusions and saw nothing but horrifying pictures of implants popping out through the skin- yikes! I decided to get a second opinion.
My new doctor listened to me discuss my problems and before he did an examination suggested I might have a “blue window”, which is the precursor to an extrusion.
On to the physical exam- he said my left implant (not my problem side) was sitting on top of my breast tissue and it appeared it had never really settled, that’s why I had so much fullness in my upper pole area. On the right side I did indeed have a blue window with an impending extrusion (rough estimate of about a year before we could see it start to push through my skin). I also have a grade 2 capsular contracture on that side. He was amazing at telling me what my options were and what his approach would be to the revision. We decided to go back in, replace both implants with Allergan Gummy Bear Implants, remove as much scar tissue as possible, and repair the thin skin. I was sick when I heard how much the whole thing was going to cost ($8100), but nothing that is quality is ever cheap.
I was so depressed when I went home. I really just felt sick over the cost (I paid for my first surgery in cash), and was upset that this one was going to have to go on some form of credit. I felt defective. But, as it gets closer to the surgery I am really just excited at the prospect of having something close to two breasts that look the same.
At this point this no longer feels like an elective surgery. It definitely feels more urgent than that. My original consultation was July 30th. On August 3rd I scheduled my surgery (3 hours) for August 18th with my pre-op appointment on the 13th. I was really trying to time my surgery during a time when my son was on vacation and the office was great at helping me do that. (My son is a worrier and I really don’t want him to see me in that post-surgery condition).
And so here I am. Of course since I got my diagnosis I have started to have the paranoid delusions that my implant is going to fall out any day now! Irrational! I also have mixed emotions about my first surgeon. My face is great! And I am so grateful that my first correction was free. I really just feel like he didn’t want to do another surgery on me and maybe wasn’t ready to admit that something he did wasn’t perfect.
Now we wait.

First surgery pre and post op pictures

Pre-Op Appointment Tomorrow

Tomorrow is my pre-op appointment where I will get the rest of the surgery plan. I am ready to have all of this taken care of so I can actually sleep comfortably!

Less that 72 hours!

These are my pre-op pics taken today. I had my pre-op appointment on Thursday and I feel like we are on the same page. I am going to try and take care of some stuff around the house today so I won't be laying here next week letting it drive me crazy.


I’m not suggesting misery loves company but it is good to know that I am not the only one who is freaking out the night before surgery! This all seems so much scarier since I am doing it to be better as opposed to the excitement I had for the first surgery. I have been really out of it the last few days.
I just talked to my anesthesiologist and sounds like everything is good to go. I took a Hibiclens shower last night so that smell was in my nose all day. One more Hibiclens shower tonight and then surgery in the morning. I am trying to do everything possible to make sure I heal as well as possible. I hate to think of how I overdid it after my first surgery and wonder how much of that made my current situation even worse.
I am really excited to not have pain in my breast anymore. I can’t imagine having put off this surgery any longer. It already feels like this stupid implant is going to pop through my skin any moment.
So- 12 hours to go. My husband will be off all tomorrow to take care of me. In the meantime I am trying to stock everything in the house that I may need. Protein, sprite, crackers, ice, pillows. I really think the best thing about surgery is the absolute loss of time. Close your eyes and then open them and it’s all done.

At home to recover

I am at home now. My doctor placed Natrelle 410 Anatomically Shaped Gummy Bear implants 640 cc's to replace my saline implants. He removed quite a bit of scar tissue from my right breast and removed the weak portion of skin and stitched it up. He said the implant was already resting on the dermis so it was good that I had everything done so quickly. I would say always go with your intuition, and if you feel like something is wrong go get it checked out.
My surgery was started a little late as dr. was called to the hospital last night for an emergency. No worries though because if I had an emergency I would hope that he would respond for me late at night also. There was also a small hiccup with anesthesia. I take several medications for PTSD (served in Afghanistan for a year) and one of them, Fetzima, listed several interactions with the regularly used as a pain reliever during surgery. After a few tense moments (I definitely did NOT want to reschedule my surgery) it was decided that since my pain was going to be blocked my local anesthesia as well as me being put to sleep that everything would be fine. The only result was that I might have a little more discomfort when I woke up.
I am actually glad I didn't use fentanyl. I didn't have that horrible groggy feeling when I came to. I wouldn't say I am in pain- just discomfort. The nurse recommended that not use ice since I have the local in my breast because there is the worry that I won't feel it if it gets too cold. Right now I am in bed resting with my head propped up. I feel pretty good.
They said I can shower since I have waterproof bandaging. I can't wait to take a look at them!
Thanks for all the love and support Post op pictures coming soon! The right one already feels so much softer.

1 day post

Here they are! I already feel so much better about myself. The pain is a little worse today- I am stiff and feel a lot of pressure everywhere. Percocet doesn't really do wonders for my pain and it seems like the muscle relaxers help the most. For the most part I am doing my best to relax and let someone else take care of me.
Not too much bruising. I have a little on the sides but I am too sore to try and contort my body to get a good picture. I am going to try and shower today. I am feeling really good about my results. I believe my right breast will end up being a little smaller but you can't customize silicone like you can saline. It doesn't matter- I already think they look great! Very happy so far.

I am so glad...

I am so glad that my scale is broken! Holy crap I feel bloated and disgusting. I would hate to see how much I weigh right now.
I am feeling better in every other way though. My pain is way down and I just have some moments of discomfort. The chest muscle around my left boob has moments where it feels really tight but I find that if I adjust the position of my arm it gets better. The area that had to be repaired because of the super weak skin is probably the one area that reminds me that I just had surgery. Of course I still have plenty of swelling.
I took another shower today and have been able to taper my medication. I am scheduled to go back to work on Monday, though I am not sure how I am going to hide my drains underneath my work clothes. I have my post op appointment on Tuesday after work.

Everything (except my boobs) hurt!

If I have ever wished to be able to stay in bed for a week straight I totally take it back! Last night I had to get up and come lay in an upright position on the couch because my back was so sore. Then today my hips feel like they are on fire. I am currently on the couch again, sitting on two giant ice packs trying to reduce some of the discomfort I have in my hips. I am going to have to try and get out of the house tomorrow to move around a little bit.


I have been thinking a lot about my revision and thinking about what would have happened if I hasn't followed my intuition. I have also been thinking about a few issues where I think my original surgeon let me down.
The card that I got from my first surgery said my implants were 475 saline overfilled to 525/555cc's. But when during my revision my new surgeon said my implants were stamped at 425. After doing some research I read that 425's should only be overfilled to 510cc's. Additionally, once I started looking into all of this I could swear I read that Spectrum Round Smooth saline implants should not be re-sterilized and put back in, which is exactly what my first surgeon did when he did my 1st revision where he released my capsular contracture and put the implant back in. Finally-- when I first noticed that my implant was clearly palpable through my skin he told me to come back in 6 weeks. From the day he told me that, to the day I had my 3rd revision with my new surgeon was a total of 8 weeks. When I had this latest revision my new surgeon told me that the implant was already at the dermis layer of my skin. That is anywhere between 2-4 millimeters from poking out of my skin!!
For those that might not know, if you have an extrusion, where your implant comes out through your skin- the main course of action is remove the implants and let your skin heal. Then when the skin is healed you can go back in to have your implants redone. yikes!

Drains are out!

I had my first post op appointment today and my drains are out! What a difference it makes to have them out. I went to my appointment today with them tucked under a shirt and into my pants trying to hide them. I can breath!! Whew. Everything else looks good and it's just time to let my body heal.

The best thing ever for sleeping on my back

I HATE sleeping on my back- but my son has this awesome pillow that I borrowed that has been a lifesaver! Here is a picture and a link to it on Amazon. I'm telling you- life saver. I put an extra pillow at the top and the long "arms" help me stay put at night.

Photo Update

I have learned a few things on this website. First- the lighting in my house is pretty terrible and it makes it very difficult to get a good post op picture! Second- I suck at selfies so maybe it's me and not the lighting. Third, taking selfies with one hand with my i-phone is a pretty hilarious site (but hey...only dropped the phone a few times!) I didn't take any pics with my arms raised because that's still a big no - no for me for another few weeks. I am very pleased with my results.

Nipple sensitivity!

Holy crap my nipples are super sensitive! They weren't like this the first time but I also had a lift. Almost painful sensitive. I keep my super awesome cheapo walmart bra on all the time and if I don't have that on I still make sure to have a tank top on to prevent anything from brushing against them!
I am getting ready to travel to Florida for work next week. It makes me a little sad that I can't go in the ocean or take a dip in the hot tub if I wanted to but I guess that's the price I have to pay for having beautiful boobies!
On another note- my neck HURTS! It has to be from sleeping on my back. Almost all of the pain in my surgery related areas are gone but now I just took a muscle relaxer to get this horrible pain in my neck to go away. I'm going to have to see if I can get my massage therapist to spend a little time on me.
Other than that- everything is great. I worry I pick up stuff that is too heavy (6 pack of water bottles, pushing heavy doors open), but I am sincerely doing my best to try to help my implants heal how they are supposed to. Besides- I'd rather spend money on Vaserlipo than another revision!
Pics soon- I promise!

15 days post

25 days post op picture update

I am healing well I think. Of course I am always paranoid now about picking up something too heavy. I am on a work trip right now and pulling around my luggage made me extremely tired. I had lots of help lifting my luggage into and out of my car.
I have posted new pictures. I am feeling a lot better. Still sleeping on my back though- blah. I have been putting medical paper tape on my incisions because I read some medical research that says it works just as well as silicone sheets.
It's nice to have slope to both of my breasts now. I'm very happy with my results of this revision. Especially considering I could have potentially needed more lift work done. But that is in the future.
Virginia Beach Plastic Surgeon

I am so glad I found Dr. Mancoll- he is absolutely amazing. I went in knowing that I needed to have my breast augmentation (performed by another doctor) revision done sooner rather than later. I knew as soon as I met him that he would be my surgeon. His staff did an amazing job of scheduling me as soon as possible. I appreciated his honesty in letting me know whether or not we could achieve my desired look and also like that he is straightforward. I always felt that he had my best interests at heart with everything thing he did. My revision is amazing- very natural looking results even with my larger implants. The best thing I did was to simply ask him to fix my main problem and however beautiful he could make my breasts in the meantime would be great. He did just that. Amazing experience. I would recommend him to anyone.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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