Why I Removed My Implants?
By Kesha Chiapinelli, kesha.milk@yahoo.com
I was able to breastfeed with implants, so why did I remove them?
Melissa Bentley wrote to MOBI about her friend Kesha's experience with hypoplastic breasts, and implants. She struggled with milk supply issues, but still exclusively breastfed into the toddler years. Having the implants did present challenges and Kesha found it very difficult to judge what her breasts were doing, identifying changes with pregnancy and post partum because of the implants. Kesha decided to have the implants removed so she would be better in tune with her body. She was really worried about disturbing her current nursling relationship and did extensive research to find out how it would affect her breasts, her supply her current nursling and any future nurslings.They wanted to share with all you moms who are interested and let let you know it is possible. She and Melissa didn't find much information and it was no easy trick to find a surgeon who removed them (with local anesthetic) while mom was still lactating. They hunted for a doctor that had done a similar removal and Kesha traveled to him.
Here is her story.
My Breasts Looked Different from Other Girls
When I was growing up I knew my breasts looked different from other girls. They weren’t round and perky; they were actually saggy. All of my friends dismissed my concerns and looked at me like I had three heads when I shared my concerns with them. I decided to see a plastic surgeon about it. My hunch about being different was right; I had hypoplasia or “tubular” breasts. One doctor suggested implants above the muscle and the other recommended a breast lift with implants under the muscle. At 21 years old I opted to go with the former recommendation.
The results were aesthetically pleasing but I lost virtually all feeling in my breasts and nipples. To make matters worse, a few weeks after the surgery, the right breast became much firmer than the left. I went back to my surgeon who suggested massage. She took out my before picture and suggested any hardness was a minor inconvenience relative to how I looked before. I studied the photo and reluctantly agreed. I didn’t want, nor could I afford, a revision surgery. She was also right about not needing a lift. |
My Breasts Changed During Pregnancy, My Implants Didn't
 "contrary to popular belief, doctors are not taught much about breastfeeding in medical school and if they attended school before 2006 their textbooks were wrong!"
My initial goal of breastfeeding for a year came and went in a flash. When my son started talking and could tell me in a sleepy voice that he, “needed nursies” my heart melted and I knew continuing was the right thing to do. It obviously fulfilled an important need for him and by that time he was only nursing before naps, in the morning, and at night. Like everyone, my breasts had changed with pregnancy; the skin was more elastic and the nipples were no longer puffy (common in hypoplastic breasts). Of course implants don’t change; the now more elastic skin was kind of hanging off of them which meant my nipples were pointing way south. Annoyingly, the hardness from the scar tissue in the right breast was still there. I started to research removing my implants. My son was three years old and I didn’t see him weaning himself anytime soon. Would this even be possible?
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Breastfeeding With Implants
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Fast-forward about 13 years to my pregnancy with my now three year old son. My breasts grew bigger and the implants, especially the right one, was uncomfortable. My poor back must have been cursing my decision. After my son was born and my milk supply increased I was badly engorged. The right breast was much firmer than the left, because of the capsular contracture, even after pumping and hand expression. It was also the side that produced less milk and was my son’s least favorite. For a moment I contemplated feeding him only from the left breast. Furthermore, because I lost so much feeling with the breast augmentation I really couldn’t feel my son’s mouth or jaw movements as he nursed. Looking back I think he had a very shallow latch in the beginning but I couldn’t feel it. Fortunately, I sought out lots of help and I learned what a deep latch looks like.
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The Quest Begins
I knew from my volunteer work with La Leche League that the lactating breast is often operated on. If a nursing mother has a suspicious lump she will have a breast biopsy. Abscesses require incision and drainage and mom can nurse baby immediately afterwards even on the affected breast. But what plastic surgeon would possibly know this? After all, the gross anatomy of the human breast wasn’t even discovered until 2006! Furthermore, contrary to popular belief, doctors are not taught much about breastfeeding in medical school and if they attended school before 2006 their textbooks were wrong!
I found many online reviews of women who had undergone breast implant removal with no further surgeries like new implants or lifts. To my surprise they all looked better without any implants. The skin was naturally quite wrinkly immediately after the procedure, but they “fluffed up,” as it is called, quite nicely and over a period of a few months they looked like their pre-implant photos. The human body is amazing. It reminded me of how a mom’s tummy shrinks down post-baby after a few months.
I also watched an explanation surgery and it seemed easy enough. The patient was under general anesthesia. The surgeon went through the previous incision and literally pulled the implant out. An audible pop was heard. The implant looked fine but he didn’t stop there. What was he doing digging around in there? Worry sank in as I watched. He was removing the capsule of scar tissue that remained behind. This was a “capsulectomy”; all implants have a capsule around them which is the body’s natural response to a foreign object. As an aside, I discovered through my research there is a type of lymphoma that is unique to breast implant capsules! Back to more research I thought. There appeared to be two schools of thought among plastic surgeons. First, some doctors insisted the capsules be removed to prevent a seroma from forming in the capsule where the implant was previously. If there is a dead space, the body will try to fill it with fluid and that could mean return trips to the doctor to drain the seroma, leaving drains in place for a time, and possible infection and subsequent treatment with antibiotics. Not my idea of a good time. The second approach was to leave the capsules in place and let the body absorb the scar tissue. Some surgeons choose to take just a portion of the capsule. It was clear that capsulectomy was more invasive than simply removing the implant.
It would mean possibly disturbing glandular tissue, which we now know is delicately intertwined with fatty tissue making it impossible to separate out. I needed that glandular tissue for my next baby. Heck I needed it for my toddler! In addition, many doctors said that it was impossible for them to decide what to do with the capsule until they were in there and could see how thick and hardened the capsule was. It seemed that for a woman with soft pliable capsules, the capsules could probably stay. But where did that leave me? My right breast was pretty hard; I felt like I had to dig a hole in the sand to lay out at the beach.
I found many online reviews of women who had undergone breast implant removal with no further surgeries like new implants or lifts. To my surprise they all looked better without any implants. The skin was naturally quite wrinkly immediately after the procedure, but they “fluffed up,” as it is called, quite nicely and over a period of a few months they looked like their pre-implant photos. The human body is amazing. It reminded me of how a mom’s tummy shrinks down post-baby after a few months.
I also watched an explanation surgery and it seemed easy enough. The patient was under general anesthesia. The surgeon went through the previous incision and literally pulled the implant out. An audible pop was heard. The implant looked fine but he didn’t stop there. What was he doing digging around in there? Worry sank in as I watched. He was removing the capsule of scar tissue that remained behind. This was a “capsulectomy”; all implants have a capsule around them which is the body’s natural response to a foreign object. As an aside, I discovered through my research there is a type of lymphoma that is unique to breast implant capsules! Back to more research I thought. There appeared to be two schools of thought among plastic surgeons. First, some doctors insisted the capsules be removed to prevent a seroma from forming in the capsule where the implant was previously. If there is a dead space, the body will try to fill it with fluid and that could mean return trips to the doctor to drain the seroma, leaving drains in place for a time, and possible infection and subsequent treatment with antibiotics. Not my idea of a good time. The second approach was to leave the capsules in place and let the body absorb the scar tissue. Some surgeons choose to take just a portion of the capsule. It was clear that capsulectomy was more invasive than simply removing the implant.
It would mean possibly disturbing glandular tissue, which we now know is delicately intertwined with fatty tissue making it impossible to separate out. I needed that glandular tissue for my next baby. Heck I needed it for my toddler! In addition, many doctors said that it was impossible for them to decide what to do with the capsule until they were in there and could see how thick and hardened the capsule was. It seemed that for a woman with soft pliable capsules, the capsules could probably stay. But where did that leave me? My right breast was pretty hard; I felt like I had to dig a hole in the sand to lay out at the beach.
Who Can Help Me?
I called a few doctor’s offices. When the patient coordinator at one office asked me, “have you been dry for at least six months?” I knew I was in trouble. Women can produce milk for years after weaning so her question was not logical. A couple other offices were just as ignorant on the subject so I contacted an IBCLC and fellow LLL Leader and asked her to post my situation on a few closed Facebook groups to see if anyone knew of a surgeon.
To my surprise, someone responded almost immediately that she knew a mom who had her implants removed while nursing her one year old! I frantically sent a friend request and scrawled out a quick message begging for the doctor’s name. Thoughts were racing through my mind: I hope the doctor isn’t in Timbuktu, I hope he or she is still among the living, please tell me her daughter continued to breastfeed post surgery. Fortunately, Dr. Dascombe was alive and well in Savannah, Georgia. The patient had an excellent outcome and her child continued to nurse afterwards!
I called his patient coordinator. As soon as she answered I felt relieved. Something about her voice calmed me. I cleared my throat and explained my situation followed by, “and I am nursing…”. She replied, “okay” and continued without skipping a beat. A smile spread across my face. She gets it! And that means the doctor does too!
At the pre-op appointment I showed the doctor my before picture from 15 years ago. He examined me. I asked about the right side being hard and whether the capsule would need to be removed. He said he was going to go in and take them out, leave the capsule, and everything would be fine. His confidence totally put me at ease. I opted to be awake for the implant removal because I am not a fan of general anesthesia. The implant removal only took about ten minutes. The doctor deflated the implants before removing them, which required a smaller incision than the original. Popping them out like in the video I watched was not an option; he said that would have been painful for me. I was really pleased with the decision to only have local anesthetic and be awake. I was totally alert and feeling fine on the way back to our hotel.
I had been prepping my son for this day for weeks. I explained to him that mommy’s “nursies” would be smaller and that I would be wearing a big “Band-Aid” for a while so he would have to be gentle. The evening of the surgery we laid down to nurse. I slowly unwrapped my “Band-Aid” which was actually a wrap for the abdomen (like a postpartum belly wrap). Nervously, I watched him as he latched on. He stopped for a second to tell me they were “broken” and asked, “why they like this…what happened?” as he pointed to where my cleavage would have been. I reminded him that I had to fix my “nursies”. Unfazed, he continued to nurse and he is still nursing to this day. Success!
To my surprise, someone responded almost immediately that she knew a mom who had her implants removed while nursing her one year old! I frantically sent a friend request and scrawled out a quick message begging for the doctor’s name. Thoughts were racing through my mind: I hope the doctor isn’t in Timbuktu, I hope he or she is still among the living, please tell me her daughter continued to breastfeed post surgery. Fortunately, Dr. Dascombe was alive and well in Savannah, Georgia. The patient had an excellent outcome and her child continued to nurse afterwards!
I called his patient coordinator. As soon as she answered I felt relieved. Something about her voice calmed me. I cleared my throat and explained my situation followed by, “and I am nursing…”. She replied, “okay” and continued without skipping a beat. A smile spread across my face. She gets it! And that means the doctor does too!
At the pre-op appointment I showed the doctor my before picture from 15 years ago. He examined me. I asked about the right side being hard and whether the capsule would need to be removed. He said he was going to go in and take them out, leave the capsule, and everything would be fine. His confidence totally put me at ease. I opted to be awake for the implant removal because I am not a fan of general anesthesia. The implant removal only took about ten minutes. The doctor deflated the implants before removing them, which required a smaller incision than the original. Popping them out like in the video I watched was not an option; he said that would have been painful for me. I was really pleased with the decision to only have local anesthetic and be awake. I was totally alert and feeling fine on the way back to our hotel.
I had been prepping my son for this day for weeks. I explained to him that mommy’s “nursies” would be smaller and that I would be wearing a big “Band-Aid” for a while so he would have to be gentle. The evening of the surgery we laid down to nurse. I slowly unwrapped my “Band-Aid” which was actually a wrap for the abdomen (like a postpartum belly wrap). Nervously, I watched him as he latched on. He stopped for a second to tell me they were “broken” and asked, “why they like this…what happened?” as he pointed to where my cleavage would have been. I reminded him that I had to fix my “nursies”. Unfazed, he continued to nurse and he is still nursing to this day. Success!
Success! I am Elated!
I have to say I am elated with my natural breasts. They actually look better now and I got more feeling back than I ever expected which means in the future I can actually feel if something is wrong with my child’s latch. The puffy areolas are gone thanks to the nipple and breast changes of pregnancy. I am also more symmetrical. I can actually go braless if I have a formfitting tank top on. My implants were so hard they kept my nipples a bit distended so it always looked like I was chilled but it was the implants pushing them out. After surgery the skin was very stretched out and wrinkly but that has improved almost daily along with increased sensation! My husband told me I looked younger, slimmer, and that my breasts felt so much better! What woman doesn’t want to hear that from her husband. A friend at church exclaimed, “you lost a LOT of weight!” If she only knew!