by Jeanette

All through my teenage years, I kept waiting for my breasts to grow. They didn’t. They stayed a 34AA into my twenties, when the rest of my body, including my hips, graduated to a more womanly, rounded figure. I was the classic flat chested pretty girl. This was not a positive thing for my self-esteem, but there seemed no choice. In 1987, I was single, 31 years old, starting out in a new career, and finally earning some real money. I was a professional, and had to dress accordingly; unfortunately, the suits that fit my bottom didn’t fit my top. I love clothes, and not looking the way I wanted started to eat away at me. By 1989, I started considering breast implants. I did my research, had consults with three very well regarded surgeons in my large metropolitan city. All recommended exactly the same surgery and same implant: incision under the breast and insert a Meme implant. This was new type of silicone implant, covered with a polyurethane material that had the texture of felt. The idea was that scar tissue would not adhere as easily to this material, and the risk of capsular contracture would be reduced. All three surgeons said the same thing: These will last you a lifetime. One told me they would be little mounds in the dust in my coffin (obviously, I chose another surgeon!). I had the BA surgery, finding it more painful than I expected, but otherwise uneventful. The breasts were beautiful. Perfectly shaped, perfect size, the scars were not pretty, but well hidden in the crease. They remained soft, with no capsular contracture. I was delighted with my 34C size and spent far too many hours gazing at them in the mirror. Ten years later, I remained happy with my still soft and perky 36C’s (I had gained a few pounds over the years, but was still a size 4-6). I had none of the illnesses that so many other women reported, and counted myself extraordinarily lucky. Unfortunately, in 1998, I had a serious brain disease that required 18 months of steroids (prednisone) at very high doses. (I DO NOT believe this illness was related to the implants.) The side effects from the steroids were awful, including gaining 60 pounds in three months (astonishing to go from a size 4/6 to a 18/20 in three months!). Two or three years later, after the steroid therapy was done and I lost the weight, I found my breasts remained larger, now a 36D. They drooped. The skin underneath was thin and the tissue broken with something called steroid stretch marks – large indentations like canals of empty tissue under your skin. Skin and tissue damange is common with high dose, long term steroid use and permanent. My breasts were no longer perky, and larger than I wanted, but still soft. I accepted it, and went on with my life. AZJAY just prior to her explantation In the summer of 2003, a routine mammogram showed a possible “herniation” in one implant. A follow up MRI confirmed this, but was inconclusive for rupture. That breast had become somewhat tender since I had bumped it quite hard a few months earlier. At this point, I got on the internet and found out that the surgeons now believed that implants do not last a lifetime, and ten years is the recommended limit. I was five years beyond that. I already knew that meme’s had been banned because the polyurethane dissolved into the woman’s body, and there was a concern about it being carcinogenic. I had known for years about the autoimmune problems reported by women with implants, and was concerned. Now I read about the problems with ruptured implants, and began to worry. I consulted a plastic surgeon in Phoenix, who recommended taking them out and replacing with new ones. He made it clear that since there was no proof of a rupture, I could reasonably chose to leave them alone. They might never rupture, might never cause me problems. But the smarter course would be to reimplant. But I realized that this would mean repeating this surgery every ten years, and objected. I was now 47 years old, and couldn’t imagine myself getting a ‘boob job’ in my sixties and seventies. How about if I take them out and not reimplant, I asked? He made it clear that this would be leaving me deformed, even showing me a photo taken of another woman, flat on her back during surgery, after they took her old implants out, but before they put the new ones in. The look of her breasts reminded me of one of those dogs with all the wrinkles – a Shar-pei. It was deformed, and unacceptable to me. I began thinking of reimplanting as a better choice. My husband disagreed, saying he didn’t want me having surgery over and over, but recognized that how I felt about how I looked was very important to me. I kept searching for a surgeon who could give me a better result, but still leaving myself open to reimplanting. I knew that being flat chested again would never make me happy, but I felt strongly that I could accept being an A cup. My breasts remained larger after the weight gain from the steroids, and I wondered if this could be used to form a decent size real breast. Through explanation.com, I found other women and photographs that confirmed that this was possible. It became a matter of finding a surgeon who could had the skills. I called many surgeons in Phoenix, finding only the explant-reimplant drill. The word ‘deformed’ was used repeatedly. I called Dr. Feng’s office in Cleveland, and was comforted by her staff who assured me that I might not need to be reimplanted if I didn’t want to. My husband and I agreed: Travel expenses would be part of the costs of the surgery. My research turned up several PS’s who I felt were skilled at doing this kind of restructuring, and I called them all. I spoke with their assistants and learned that several would not do a lift at the same time as explant. This eliminated several from the list. Dr. Feng was one of my first choices, but a long trip from Phoenix, and considerably more expensive than many other surgeons. And, since my implants appeared to be intact, I was not overly concerned with her extensive and impressive skills with removing stray bits of silicone. Dr. Jae Chun was one of the surgeons on my list. I called his office, got information from his very nice assistant, and was astonished to receive a phone call from HIM less than two hours later. He spent at least 20 minutes speaking with me, concerned mostly that I would be unhappy with the aesthetic results of not reimplating. At the end of the conversation, he asked me to send my MRI’s to him and photo’s of my breasts as they are now. He wrote down my cup size, height and weight. He to look at all of this information and try to give me an idea of what he could do if I didn’t reimplant. Essentially, he was trying to save me the extra trip for an initial consult. The final decision of which procedure to have would be mine. Less than two days after he received the photos and MRI, he called me again. He believed that with a lift he might get a small B, maybe a big A size. He told me about the rather extensive scarring that I would have from the lift procedure. He asked that I think about it, and if I wanted to go ahead and schedule, I could call his office in a few days. I was amazed, even shocked, at the time he spent on the phone with me. His concern about my ultimate satisfaction with the results was evident. His office called with the costs, and they were far more reasonable than those quoted by Dr. Feng, who at that point was the only other surgeon I was considering. I scheduled the surgery, was told to plan on being in Newport Beach, CA for two days prior to surgery and seven days after surgery. I found a hotel room with refrigerator, microwave, stove and reasonable costs. I finally met Dr. Chun in person two days prior to surgery, and was even more comfortable than I ever imagined. He really was a nice guy, and truly concerned about my acceptance of the end result of explanting, but he never discouraged me. Every time I asked, “If I leave this alone, eventually these silicone implant are going to rupture, correct?” He assured me that it would. That settled it for me. I was particularly impressed with his attention to my unrelated but significant medical history. The other PS’s had rather ignored it, but Dr. Chun was insistent on getting the details so that he could avoid any possible problems later. My husband especially found this most reassuring. At the surgical facility two days later, Dr. Chun marked me up prior to surgery. I was amused and touched by his repeated apologies about his cold hands and his attempts to warm them on his pant’s leg. I was surprised and fascinated at the precision he used in the markings – tape measures, rulers, different colored pens. He took about 15-20 minutes with this, which somehow made me feel more confident about the final result. The surgery was easier than I expected, far less pain, far less traumatic. The surgical facility was wonderful, and I was back in the hotel room, eating take out Chinese in less than 6 hours. The drains were in, and itched. Two days later, in his office, he took off the ace bandages, warning me that this would be the worst they would ever look. I wish that I had the vocabulary to express my delight with the results. The standard lollipop lift scars were there, but thin. My breasts were there, not large anymore, but certainly no flat. They looked surprisingly normal. The drains were removed 5 days after surgery in his office. My breasts were now yellow and bruised, but still a beautiful shape. I returned to Dr. Chun’s office two days later and was allowed to go home. Since I lived so far away (6 hour drive), he offered to do his “post op scar maitenance” via phone and email. I had not realized that he continues his care following surgery for an entire year! He asked that I send him photos 4 weeks after the surgery, and he would decide what to use on the scars to make them as invisible as possible. Apparently, he utilizes different types of creams, oils, gels, etc. depending on the particular situation. I am, frankly, very impressed with his dedication to perfection. Now, 2.5 weeks after surgery, they are changing every day. I am surprised about this. Now the scars are getting red, as he warned me, and my breasts are settling a bit, as they should be. These photos are immediately following surgery. Note, her drains are still inserted. This is only one week post explantation. 4 wks - taken from below breast 4 wks progress photo 8 wks progress photo Another 8 wks progress photo Azjay on 6/14/04 Azjay on 6/14/04 Azjay on 6/14/04 Azjay after 22 weeks of healing There is no pain, only a little discomfort if I reach too far. My nipples operate as they should, with no change in feeling. My breasts are not as soft as they were, but the natural tissue has been compressed and there are still sutures under some of the incisions (some of these internal sutures will take 2-3 months to dissolve). They are a 36B, but might shrink a bit before this is over, or if I lose a bit of weight. They look, well, lovely. If I had these when I was 30, I would never have implanted at 31. (Jeanette plans on sending updated photos as she progresses. Her photo diary is a very good example of the changes which take place over time.) EMAIL AZJAY through the Delphi Forum. Dr. Chun is "AZJAY's" Surgeon. DR. JAE CHUN, Plastic Surgeon, 1101 Bayside Drive, Suite 100 Corona Del Mar, CA 92625 (949) 644-5000 Has extensive experience with complicated explant; has an excellent bedside manner; he is also contracted with Medicare