Tanya's Story: Implant To Explant To Re-implant by Tanya In 1998, at age 49, I was feeling increasingly unhappy with my small, saggy breasts. A few years earlier I had two large benign cysts removed from my right one and that made it even smaller than my left one. I am a small woman: 5'4", 105#'s and very thin. But, I felt good about my shape other than my breasts. Tanya prior to getting Breast Augmentation Side View Pre augmentation My consultation for implants was almost as a lark. A couple of younger gals I knew had gotten them and were really having fun,wearing such cute tops and showing more self-confidence. I decided to at least go in and discuss it. Of course once the seed was planted I too was convinced I would look great and feel better about myself (which honestly I did). I only went for one consultation, and I let the PS make all the decisions: 400cc's, saline, smooth, round, overs. I didn't even think to go for any other consultations (standing with my breasts at eye level with one PS was hard enough). They looked fairly good, they were spaced about 3 fingers apart, which disappointed me, but finally I had breasts to feel good about. After about one month I realized one breast was staying firmer than the other (both were quite firm though). The PS said it was Capsular Contracture (CC). He began painful efforts to "pop" the capsule. He would stand me against the wall and slam the palms of his hands on each side of the breast. I about passed out. I went back about every 2 weeks to get this kind of 'massage'. I also was expected to have my husband do very firm massage at home (which he didn't feel right about and hated trying to do). Also, it wasn't working. I would tighten right back up again within days. Tanya with first set of implants-front Tanya showing rippling from saline implants I lived with firm breasts (one basically hard) for 4 years. By this time I was in my early 50's and had decided I wanted a little lipo suction under my chin. I went to a local PS (in my small town) for a consultation about that. When I told him about having implants with CC he looked at them and told me "You need to get those out, they will only get worse, I can make you look and feel better". Again, I let the PS make all the decisions for me: textured, saline, round, unders. Again, I did not go anywhere for a second opinion/consultation (slow learner huh?). Almost immediately I felt something was wrong. I was in a horrible amount of pain for many days. He had me taped up like a mummy and didn't want me to remove the tape. I was black and blue (deep purple) all over my breasts and areola's. Soon realizing I had hematoma's in both breasts. Tanya after implant replacement. She suffered from severe bruising and pain The pain under each breast made it almost impossible to walk (he had lowered my creases without asking me). When I went back for the first follow-up I sensed the nurses were acting different toward me, quiet and avoiding any eye contact. I thought right then, they know something went "wrong" with my surgery. The PS didn't admit to this yet, and acted like it will just take time to heal. By the next follow-up (around 3-4 weeks) I was still very bruised and sore and noticed one breast was significantly lower than the other (with that areola almost twice as large). I assumed it had dropped first. By this time I had other concerns: there were sucked in looking areas under my breasts and my areolas (dents) and the implants felt and looked lumpy under my skin (due to his aggressive removal of breast tissue with the capsules). Tanya's breast after exchange of implants At this visit he admitted I would need a re-do because these weren't going to workout for me. My skin was adhering to the textured implants so the folds and ripples were obvious. He had placed larger implants in me than we discussed (475cc's) and I looked ridiculous. I also was sure I was developing CC (probably from the excessive trauma to my breasts). He denied this though and claimed it was only due to the implants being firmer. I looked at him in disbelief and asked why he chose "firmer" implants when I wanted softer more natural feeling breasts. He ignored my question, and suggested we try the Becker Expandables (very expensive implants) and of course I would have to pay for those. He also said he would TRY different placement. At that point I basically said: "We aren't trying more surgery until you can get it right. I don't believe you are skilled enough to repair all the damage you've done to me. I don't want you working on me anymore and I want a full refund." He snickered and stated since I felt that way he wouldn't be willing to do more surgery on me either and that he would not give me a refund. As I was leaving his office he came out and said he'd decided to review things and would consider a partial refund. I said, "You let me know". His office manager called a few days later offering $2,000. I declined and said it wasn't enough. I began a stressful search for a PS that could/would repair me (some refused to attempt it). I had several consultations with almost as many suggested solutions (realizing how rare it is to get two identical evaluations). Most suggested another exchange and wanted to lower the other crease instead of raising the lowest one (which on my small frame, lowering mine at all should never have been done anyway). Many wanted to go larger (to help smooth out the lumpiness) and use regular silicone implants for a softer feel. All said I would still have one larger areola, a lot of rippling, some lumpiness and probably some adherence issues. Not the results I wanted to hear. Unfortunately none said what I really wanted to hear: "I can fix you up as good as new" or "My god what did he do to you, you should sue him". They were all very careful how they worded their comments and acted a bit like "Oh well $#!+ happens". Then I found Dr. Barry Fernando in Phoenix. He is a calm, straightforward, very professional man who concentrated on my situation for a long time and then looked me in the eye and said "My first suggestion is:we remove these, let everything heal down and then decide IF you should even consider re-implanting". He knew I went into shock, but he stayed firm. He said he too could do an exchange but it won't eliminate existing problems and he was sure my pectoral muscles had rolled up and most likely couldn't be completely repaired. He also said I probably didn't have much breast tissue left, but he would be very careful to not remove any more with the explantation. He also said things like: "you probably won't like the way they look, they could fill out some over time, I won't do a lift because you need to see how you end up",etc. But, I was still numb from his suggestion of complete removal and can remember leaving his office thinking "No way, I don't want two or more surgeries, or to probably end up deformed, etc." Then I got on the implantinfo.com forum to share my experience with the gals I had come to bond with about implant problems. I think it was Tracey who read my post about his suggestion and told me about explantation.com and that I really should research and understand it all. I started visiting here regularly and asked a lot of questions and learned why I needed to consider that option. I went back to him for a second consultation (this time with an open mind and educated questions). I had to wait over 6 months from my nightmare exchange before he would consider any more surgery though. That gave me time to research, accept and prepare for what it all meant. My explantation was in January 2003, he was very careful, removed only the implants and scar tissue (en bloc) and elected to not do any reconstructive surgery at that time. I am sure he realized a lift would only accomplish leaving me look like a boy (with possibly some adhered areas also). There wasn't enough remaining breast tissue to even work with (due to the carelessness of my X-PS and compression of any remaining tissue from implants). Once in there he also realized how badly my pectoral muscles had retracted (window shaded) and they could not be completely unrolled. That was caused from having had overs with the first BA and then when I had the exchange my X-PS went to unders and didn't tack the pectoral muscles down after releasing them and they were no longer attached to my ribs or any breast tissue so they "rolled up". The doctor repaired them the best he could. He had warned me I could have some concave appearance but I still was not mentally ready for the results. As you can see in my explant photo, I look like someone took a straw and sucked all my breast tissue out of me. It's not pretty, but worse I ended up with scar tissue that was tight and painful. Tanya ended up deformed from the damage to her tissue I tried various exercises that helped a little and went to a Physical Therapist that used ultrasonic massage. While these things loosened it so it felt better, it still looked sucked down. I was probably going to have to have that surgically released eventually. I ended up very deformed (no fault of Dr. Fernando's) and had to decide what options were available to me. I don't have enough body fat to consider fat transfer and I knew regular implants would not look or feel good in me. Dr. Fernando is on the Mentor Cohesive Gel study but would not guarantee that I would be a good candidate until I had healed down a few months. Soon after the study started (when I was a few months post-explant) I called his office and spoke with his wife (who is also an MD and assists him in surgery). I asked her to discuss my situation with him. They had me come in for an evaluation and he decided I probably would do fine with them. He has been very happy with the results he's had so far with other women. On June 25th 2003 I was re-implanted with the new Cohesive gel mplants: 280cc's, anatomical, textured. I went smaller than I was even on my original BA. Placement is under what little bit of pectoral muscle he could salvage. So far they look a bit high and square and feel firm (all normal so soon after placement). I will do updates as I progress. Dr. Fernando did an excellent job of making a silk purse out of a sow's ear. There aren't any ripples or lumps and they already feel better than I expected. Tanya shortly after re-implanting to fix her severe deformity. They still need to drop and relax, but they are not nearly as large as her other augmentations. I would never attempt to encourage or discourage others regarding re-implanting, but for me it was the right decision. I did not have any known symptoms of silicone reaction and I was so deformed and flat that I couldn't even anchor pads in my bras to feel comfortable. I weighed my options carefully and had to do what I felt was best for me. I don't regret getting explanted and healing down. Healing down meant I could go with smaller implants without requiring a lift, too. It allowed my areola's to return to their natural size and be equal again, it allowed my creases to raise back up to their natural place(without having to be stitched up and hope that would hold), and I found out that in my case I can never "go home again" to my pre-BA status. Someday maybe something safer and better than silicone will come along and I will elect to have more surgery, but for me, for now, I can move on feeling normal again for the first time in a long time. As for my legal issues with my X-PS, I did talk to an attorney who was willing to take my case, however he warned me it would be lengthy and difficult. It's very hard to find an expert witness PS and also it is hard to prove he "breeched a standard of care". I felt because of so many problems I had a good case,but decided to give him one more chance to settle this out of court. I had discussed my situation with the State Board of Medical Examiners also and was advised to try to resolve it myself first. I called him (almost a year after his surgery on me) and to make a long story short he agreed to almost a full refund if I was willing to sign a release form (which kept my family or myself from ever attempting to recover more money from him). I decided to save myself a lot of stress and agreed to those terms. I took the money and ran. The other very positive thing from all this has been finding this forum and having the support, love and understanding from the gals here. It got me through one of the most difficult times of my life. I have also made a few special friends that I expect will be a part of the rest of my life. This has shown me how much of a sisterhood women can and do have. If you have any other questions, please e-mail me. UPDATE: Tanya writes: I am a little disappointed with the overall shape of my breasts. At the sides where the muscle ends, there are obvious dents. That is partly due to having no breast tissue on the underside of my breasts to right under the skin sits the implant and partly due to the way my top muscle rolled up and now won't lay flat (as it could not be completely unrolled). Since the implant is cohesive and holds its form well, I have very little rippling though. The PS said there is no good solution to this problem and would possibly see improvement if I ever gained some weight (which isn't likely). So, I do have to be careful what tops I wear as it is noticeable under knits, etc. Tanya's update photos   I just had my two year follow-up and otherwise seem to be fine. I asked if Mentor would at some point recommend removal. He said "Not unless you have a problem". So, at my age (56), there is a chance I might actually never have another breast surgery of any kind in my life. That sounds so great after what I've been through. One thing I must add: We see beautiful breasts all day long on TV and on gals walking down the street. It seems so "easy" to just buy breasts... It is "easy" to find some PS willing to give you big boobs, it is even possible you will turn out great and look wonderful (for awhile). Then at some point things most likely will change and you will see or feel somesagging, hardness, etc. or it will be 10+ years and you are warned by a doctor to replace them. You will think "Okay, I'll just go buy new (maybe even bigger) breasts". That is when things usually go very wrong. So, to any gals considering a re-do, realize that your original breast tissue has been damaged from the cutting, pressure of the implants on it, etc. So, many times when they put in new implants (and often they suggest larger to give them an easier time with nipple location, placement, etc.), you probably won't feel or look as good as you did orig. You have a greater chance of problems like Capsular Contracture. There are of course exceptions and we all hope to be one, it is just a gamble even with a very good doctor. They can only do so much with what each of us have and if any of us had a decent amount of breast tissue we wouldn't be dealing with this in the first place. But, if you are considering being reimplanted, please resist the temptation to go larger. Talk to your PS about your results with same size or a little smaller implant. It will reduce the trauma on your tissue. Good luck to each of you. Tanya