April 30, 2013

I am scheduled to have my last surgery on Monday, May 6th…6 more days!!  I will have my chemo port removed and also my tissue expanders removed and replaced with the implants.

For those interested, I have decided to go with the Allergan Natrelle 410 highly Cohesive Anatomically Shaped (Tear drop) Silicone Implant. The exact implant is the Full height, Full projection, 595cc implant.  Dr. Little did numerous measurements of my body in order to decide on the best size for my body type.

The following are some of the pros of selecting this particular implant:

1.  This type of implant feels soft and supple and they maintain their anatomical shape better than other implants.  The edges blend into the surrounding tissue better than “round” implants and they look more natural.

2.  Because of their shape, and the cohesive material used, they do not fold or ripple and do not shift from one area to another which typically occurs with round saline implants.

3.  Since there are no fold lines as with the round saline implants, it is less likely that the implants may rupture.  This happens more frequently with round saline implants since the folds tend to weaken over time.

4.  If the implant does become damaged or ruptures, it will maintain it’s shape and will not leak.

5.  There is less likelihood of capsular contracture.  This is defined as “a painful and potentially disfiguring condition that occurs when scar tissue tightens around breast implants”.  It is oftentimes the result of the body ‘s immune system trying to protect itself.  I have developed this condition with the tissue expanders that I currently have and it is not pleasant.  I am considered a grade 3 at this time.

According to http://breastcancer.about.com/od/breastcancersurgery/a/Capsular-Contracture-And-Breast-Implants.htm the grades of capsular contracture are:

  • Grade I – the breast is soft and appears normal, and the capsule is flexible.
  • Grade II – the breast looks normal, but is somewhat hard to the touch.
  • Grade III – the breast is hard, has some distortion caused by contracture, or the breast becomes a rounded shape, or the implant is generally tilted upwards.
  • Grade IV – similar to grade III but with greater hardening of the capsule.

When I have surgery on Monday, Dr. Little will also be removing scar tissue that has formed around my tissue expanders in order to make the implants sit more naturally.  I hope that the scar tissue does not form as badly this time.

Some cons to this type of implant:

1.  This implant is highly cohesive and feels firmer than other implants. This firmness is needed in order for the implant to hold it’s shape.

2.  The incision needed to place this implant is larger than the ones needed for the softer silicone or saline implants.  because the implant keeps it’s shape, it cannot be placed through a small incision.  The normal incision size for this implant is 5.5cm.  Since I have already undergone a bilateral mastectomy, I already have large incision scars and the surgeon will re-open the existing scars.

3.  These implants are some of the most expensive on the market right now.  Since I am having reconstruction due to cancer our insurance covers the cost of the surgery.

My next task will be to finally decide one way or the other on if I am going to continue with the reconstruction and have new nipples made.  This will be another surgery after I heal from this one.  I will leave this for another day.

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