Advice/opinions following implant reconstruction please.

Hi everyone. I’d like to get a feel for whether my thoughts are reasonable and my expectations realistic. I’m perhaps not always the most objective. Sorry, I know it’ll be long  

Diag Jun ‘20, with IDC, 2 tumours in right breast, different quadrants, largest attached to the nipple so immediately told mastectomy was my only option. Had SLNB first and also Covid obviously and I wasn’t suitable for DIEP so I opted for immediate recon with implant which takes longer to organise (at my hospital), meaning quite a wait for the mastectomy, and I’d totally got my head around the surgery side of things by time it came around in Sept.

My plastic surgeon opted for implant only, no support measure e.g., mesh, and following surgery it very quickly became clear the implant was not where it should be, having slipped far too low, and it was very uncomfortable, in fact quite painful a lot of the time and very heavy, couldn’t wear even a post surgery bra. I’ve seen my surgeon a few times in the last year as I had a persistent seroma and he fully agreed I needed a revision where he would add a mesh support, and after delays and a previous cancellation I had this last week.

Just to be clear, an anywhere near perfect cosmetic result didn’t feel a priority for me, I’m 52 and happily married, I care about my appearance but personally never had any issues with losing my nipple, or accepting scarring, I had a different incision point this time so another big scar, or the lumpy texture, none of that, but I did hope for symmetry if possible.

He did spend a while marking me up and I’m not a surgeon obviously so appreciate it might be challenging to achieve good symmetry but I’m now just so unhappy with the result. The operation has done its job and the implant (which was replaced) is the right volume and clearly well supported, but it’s now sitting so, what seems ridiculously, high up on my chest, it’s like completely the other extreme. I’m still recovering but the bit of swelling I had has gone, it looks so weirdly out of place and the outline and top third is now very visible above the line of any T shirts and tops I’m wearing. It sits a good 2” higher than the left side and so again I think there will be issues with bras so I think it’s a comfort and practical issue as well as cosmetic.

I’m due a follow up with my surgeon in a few weeks. I had a good rapport with him but now don’t know what to think or say.

Am I unrealistic here? I had really hoped to put the surgical element of this behind me with this op and I am by nature a pragmatic and level headed person, but I don’t think I can accept it as it is. I can’t imagine the NHS would support doing it again, or, I feel a bit rude saying this, even if so maybe my surgeon doesn’t quite have the experience or skill to to achieved a better result. I’m an average C cup and have no sagging on the other (good) side. I’m just surprised and very disappointed he couldn’t get a better ‘match’. 

We’re not wealthy and it wouldn’t be ideal but I could fund a private operation if necessary and my husband would completely support this if that’s what I wanted. I think I will have a private ‘second opinion’ consultation anyway to try to understand what’s realistic, I feel back to square one, but wondering if I’m being unreasonable and I need a reality check here  

I would really appreciate some understanding of other peoples experiences and outcomes from implant reconstruction.


Louise x

Hi @DestinyIsAll  - I can so understand your disappointment and how frustrating for you. Did he ever say why he wasn’t using “mesh” for your first op?

Have you yet had your post-op review appointment with him, this 2nd op only having been a week ago? May it be that it takes a while to settle or “drape” (polite word for developing a “droop”) and just early days yet?

Ordinarily, Covid aside, you’d be entitled to a second opinion with another NHS surgeon. But I don’t know how possible that would be, given the current Covid circs and priorities. Or how quickly to be seen. If it isn’t just a question of it “settling” and gradually lowering itself with time, it would be a shame to have to go down the private route, rather than a second NHS surgeons opinion if it were possible to.

If you haven’t done already, do you have you a Breast Care Nurse you could have a chat with about it? Air your views and concerns to/with about it, diplomatically and independently from your surgeon, to see what she thinks and says about it? Plus may be able to advise what to do, and/or recommend a different surgeon to you for a second opinion if necessary.

Hope you can get somewhere with it soon. Lots of love, Delly xx