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Category Archives: implants

My Legal Settlement – An Update

I finally found a way to login on the complaints board (see the first part of this posting below) and post a response to the accusation that, it appears, was most likely made by him or a member of the surgeon’s staff. I also sent an email to his office through his website letting him know that I knew about that comment.

In addition, I let him know that, because that comment was so obviously written by someone in his office, I considered that a breach of contract. On the down side, our lawyer has said that just because someone on his side broke the contract, that doesn’t mean that *I* can. So I’m just going to keep linking back to that initial post I made before the contract was signed whenever I need to reference the surgeon.

[Editor's Note: This post has been edited and certain links removed on the advice of my lawyer. Please visit here for details]

 

My Legal Settlement

Earlier today I received the following email from a regular reader here at the blog. For personal reasons, the reader has asked that they be kept anonymous.

Maria,

In your blog, you said you signed papers with your doctor not to name them.  Did you have a settlement?  Did you have the option not to settle, instead spread their name all over? Or did an attorney advice you about libel or defamation?

If you can comment without naming the doctor, much appreciated.

I have written before about how I tried to deal with the legal ramifications of what happened to me. I also wrote about the settlement that currently binds me from mentioning the name of the surgeon. HOWEVER, before I agreed to the settlement that prohibits me and my “agents” from mentioning the surgeon’s name, I wrote a few posts. Those are listed below in my response to the reader’s questions.

Dear Reader;

I am, unfortunately, also bound from talking about the terms of the settlement as well. I DID have the option not to settle. At that point I was deeply clinically depressed and traumatized. I didn’t want that person to have anything to do with my medical care any more. I would start shaking every time I had an appointment. I just wanted it to be over with so I went with the first available way out.

People keep telling me that I’m brave. This is one of those instances where I was not. I DID put up a synopsis of what happened on the Complaints Board [Editor's Note: This post has been edited on advice from my lawyer.Please visit the link for details]

I never spoke to a lawyer about defamation, but I was a journalist so I know that once I signed those papers, I am legally bound, along with my “agents”, not to reveal his name. HOWEVER, those two links were written up before the contract went into effect.

Here is where things get interesting. I just happened to notice that a person I am presuming is the doctor in question or one of the 2-3 staff members familiar with the case (aka one of his “agents”), made a brief response to my initial post on the Complaints Board. I am presuming this because of the use of the phrase “ridiculous herbal remedy’ in the response. That is FAR too personal to have been written by someone just reading entries on the complaints board.

And so, dear reader, I am going to war. For some reason I am having technical difficulties logging on and making a response to that accusation. Once I do, you all may want to stop by for a look because I can guarantee that things are going to get very, VERY interesting.

This surgeon does not know with whom he is messing. He’s about to find out.

 

Nerve Damage With Breast Augmentation

With any type of surgery you can expect to lose some sensation. Sometimes it’s just temporary. Sometimes the nerves are just so damaged that there’s no way you’ll regain all the feeling you had before. Breast surgery is one of those situations where you will never be the same.

Even if you have a transumbilical breast augmentation (TUBA) there will be some nerve damage. Nerves get torn, cut or separated causing a loss of sensation. There can be wide swaths of numb areas. It depends on what type of surgery you have as to how much nerve damage and loss of sensitivity there is.

There are three major types of incisions used in a breast augmentation:

Periareolar – This incision is the most concealed, but is associated with a higher likelihood of inability to successfully breast feed, as compared to the other incision sites. The incision is placed at the bottom half of the areolae. Consider that there will most likely be severe reduction in nipple sensation with this type of implant insertion.

Inframammary – This incision is less concealed than the periareolar and associated with less difficulty than the periareolar incision site when breast-feeding. This incision is placed in the underside crease of the breast. The reduction in nipple sensation probably won’t be as severe with this type of implant insertion. Consider that a big bag of water is being shoved up under the muscle or skin. There WILL be some reduction in breast sensation.

Axillary – This incision is less concealed than the periareolar and associated with less difficulty than the periareolar incision site when breast feeding. This incision is placed in the armpit. The loss of nipple sensation won’t be as severe as with the periareolear, but again, you’re having a big water bag shoved under the skin or muscle. There will be loss of sensation.

No matter what type of insertion you have for breast augmentation, there WILL be some nerve damage. Whether it is temporary or permanent is an individual experience.

 

Woman Jailed For Fake Breast Fraud

A SoCal woman plead guilty to charges of burglary, grand theft and identity theft. She committed these crimes in order to obtain a $12,000 line of credit for liposuction and breast implants in September of 2008.

The 30 year old woman received 180 days in jail and three years probation. She was also ordered to pay restitution but the amount wasn’t made clear according to the article.

What does this say about our society when women are committing grand theft level crimes in order to obtain plastic surgery?  Was this a greed issue? Was it driven by extremely low self esteem issues? Is the media driving women to the point that they feel they have to commit crimes in order to have that perfect body?

What do you think?

 

Questions About Plastic Surgery

One of my readers had some questions. So to help her and and anyone else who might want these questions answered, here we go!

Question #1) I want to know what you found that scared the hell out of you. – What scared the hell out of me is that even saline implants aren’t safe. MANY women have had symptoms similar to fibromyalgia with these implants. Some doctors think that the silicone shell is a contributing factor to these symptoms.

Here is one website that talks, in anecdotal terms, about possible complications from saline implants. \”Could Breast Implants Make You Sick?\”

Question 2) I want to hear about breast implants and failure rates:. Currently there are two types of breast implants on the market that are commonly used. One is the silicone implant. It is a textures or untextured silicone outer shell that holds silicone gel. The gel is what gives it the supposed breast-like feel. Though I have heard that while silicone implants have a better appearance, groping them is still like groping a bag full of something. They are reportedly harder than breast tissue. Though no studies have found any links to illness and the gel, there are thousands of women who blame that gel for their illnesses.

The other type of implant is the saline implant. This is the type I have personal experience with. The shell, again, this is a silicone shell, is textures and the implants are filled with sterile saline solution. These feel like having a water balloon shoved into your chest. If you poke them, you can HEAR the saline solution sloshing around.

As for failure rates, approximately 70% of all women who have a breast augmentation will have to have some form of revision surgery. This is not a one-time surgery for most women. Here is a list of possible complications: Breast Augmentation Complications
Question 3) How Can I Tell If A Plastic Surgeon Is Good? There are a few rules. First, make sure he or she is a Board Certified Plastic Surgeon. Sadly, ANY surgeon can perform plastic surgery without ever having taken a course in that specialty.

Second, interview them. There are 11 important questions to ask them. This article talks about them 11_questions.htm

Ask for multiple references. Talk to the references about the doctor. Ask about his or her bedside manner, the pre- and post- surgical experience and how accessible the surgeon was after surgery.

Ask to look at photos of the surgeon’s work. You may not like their technique.

Plastic surgery is an art form. Your surgeon should be as much an artist as a medical practitioner.

My most important piece of advice is this: Think long and hard about this before you do it. Why do you want this surgery? Once you do it, you will NEVER be the same. Sometimes that’s good. Sometimes it isn’t. Even if it goes well, there may be permanent nerve damage. You may have numb spots. Your nipples may lose sensation. And there will always be scars.

Think long and hard before you make your decision.

 

Boobjob Versus Breast Augmentation

Dr. Grant Stevens speaks out on the subject:

An excellent breast augmentation can look natural, feel real and have a natural shape. Plastic surgeon Dr. Grant Stevens, Los Angeles, makes a distinction between successful breast surgery and the obvious “boob job” where it’s easy to tell a woman has had surgery

“Part of an excellent breast augmentations the fact that the breasts look as if they could actually occur in nature,” he explains. “There should be a question in the viewer’s mind as to whether or not these are real or are surgically created.”

A good breast augmentation has a natural fullness and gentle sloping off the chest wall. There should be natural cleavage, without webbing between the breasts and a certain amount of perkiness. Dr. Stevens lists five basic considerations that make for a desirable breast augmentation:

*which incision to use

*what type of implant to use

*placement of the implant

*texture of the implant

*size of the implant

Before having surgery, you should go over photographic examples of the breasts you want with your surgeon so that you both have a clear, visual understanding of the desired result. “My job is to make the breasts look like the photographs,” says Dr. Stevens.

There are four choices regarding where to make the incision for a breast implant: underneath the arm, around the nipple, or in the inframammary fold (where the breast meets the chest wall). The fourth is the umbilical incision, but is not as preferred as the others. There are advantages to each incision.

“l allow the patient to direct me as to which incision she wishes to have,” says Dr. Stevens. “We know that each incision has a certain amount of scarring, but our goal is to have the scar so minimal it’s inconspicuous.”

Sometimes there are ethnic factors(in terms of skin type and color) that might encourage one incision over another. Dr. Stevens refuses to recommend any incision per se but notes that: “Of all the breast augmentations I have performed on nurses, physicians or even my own employees, none have ever asked me to do either the inframammary fold or armpit approach. I find it highly significant that women who have been surrounded by the plastic surgery industry and have seen the most results, have never asked for an incision other than beneath the areola.”

The type of implant used has certain limitations in terms of availability. Currently, there is a moratorium on silicone implants; the silicone gel implant has been limited to women who fit into specific inclusion criteria. “lf there were no moratorium I would be putting in far more silicone gel implants than saline implants,” says Dr. Stevens. “The silicone gel implants, in general, feel more like a breast and look more like a breast. However, we can certainly adjust the saline implants and in most cases are able to give the woman a natural-looking breast.”

The next question is where to put the implant. It can be placed either on top of or behind the muscle. “l place implants behind the muscle so the implants are partially covered,” says Dr. Stevens. “The muscle allows a nice smooth take-off from the chest wall. lf put directly on top of the muscle they can look like a half-grapefruit or rounded balloon the chest.”

The fourth criterion in an excellent breast augmentation is the choice of specific implant. Should it be smooth, textured, low profile, high profile or anatomic? It’s important that each implant is individualized to achieve the size and shape the patient desires. According to Dr. Stevens, that individualization should dictate the decision.

“It’s my feeling that if the surgeon is wedded to only one type of implant then all the breast augmentations will look the same. This is not cookie-cutter surgery. Cookie-cutter breast augmentations are, in my opinion, ‘boob jobs’.”

Finally, although there is a size range from which to choose, the breast implant must be appropriately sized for the individual.

“When a breast augmentation is extremely large compared to the woman’s body, in my mind, it falls into the category of a ‘boob job’ because any one can certainly spot it,” notes Dr. Stevens. “If you take a little woman and you give her size double-D breasts, most people would agree that this is inappropriate. For a larger woman however, that size may be reasonable.Mostlf my patients want to be In the C to D range but certainly some women want to be a large D and some women only desire to be B-cup size.”

“Boob jobs” are often hard, round balls on a woman’s chest. Beautiful breast augmentations have a natural shape and size. Allowing natural movement, the implanted breasts slope gently off the chest and feel soft to the touch

 

Breast Necrosis Photos

Below you will find photos of what breast necrosis looks like. These are EXTREMELY graphic photos. This post is for MATURE VIEWERS ONLY!!

I am putting these photos up, not for shock value or to evoke pity. I am posting these images of breast necrosis so that when another woman has this happen to her, she will be able to look at the photos and evaluate for herself if she just has really bad bruising or if her tissue is necrotic.

I have said SO many times before that when I was going though this I did not have ANY pictorial references. I didn’t know what to look for. Now YOU, dear reader, do. If you are unfortunate enough to be reading this, searching for answers, please contact me at boobcast (at) gmail.com if you have ANY questions at all.

During the period you see below, I felt so very alone because I couldn’t find anything to compare myself to. I was also sheltering my husband and my family from what was going on. So I WAS alone. YOU don’t have to be.

The first photo (below) is approximately a week after surgery. Most of what you see is bruising. However the black spots are necrotic tissue.

The next photo you will see is closer shot. In this second photo you can see the difference between the bruising and the necrotic tissue. Here you can see the difference in the texture of the skin where it has really started to die.

This next photo is blurry and I’ll ask your forgiveness for that. You can see where a hole has opened up in the dead tissue.

There is a process called debriding where dead tissue is cut away. It doesn’t hurt because the tissue has died and has no nerves. It’s just rather horrifying knowing that part of your body has died and is being cut away. They don’t put you to sleep or anything. They just cut it off with surgical scissors. The completely black area used to be my nipple. That is was totally necrotic tissue looks like.

The yellow tissue is, as you may have already suspected, breast fat.

A photo of my other necrotic nipple and areolae:

Finally, a VERY graphic closeup of one of my breasts after the debriding:

 

Boobjob Verus Breast Augmentation

Dr. Grant Stevens speaks out on the subject:

n excellent breast augmentation can look natural, feel real and have a natural shape. Plastic surgeon Dr. Grant Stevens, Los Angeles, makes a distinction between successful breast surgery and the obvious “boob job” where it’s easy to tell a woman has had surgery

“Part of an excellent breast augmentations the fact that the breasts look as if they could actually occur in nature,” he explains. “There should be a question in the viewer’s mind as to whether or not these are real or are surgically created.”

A good breast augmentation has a natural fullness and gentle sloping off the chest wall. There should be natural cleavage, without webbing between the breasts and a certain amount of perkiness. Dr. Stevens lists five basic considerations that make for a desirable breast augmentation:

  • which incision to use
  • what type of implant to use
  • placement of the implant
  • texture of the implant
  • size of the implant

Before having surgery, you should go over photographic examples of the breasts you want with your surgeon so that you both have a clear, visual understanding of the desired result. “My job is to make the breasts look like the photographs,” says Dr. Stevens.

There are four choices regarding where to make the incision for a breast implant: underneath the arm, around the nipple, or in the inframammary fold (where the breast meets the chest wall). The fourth is the umbilical incision, but is not as preferred as the others. There are advantages to each incision.

“l allow the patient to direct me as to which incision she wishes to have,” says Dr. Stevens. “We know that each incision has a certain amount of scarring, but our goal is to have the scar so minimal it’s inconspicuous.”

Sometimes there are ethnic factors(in terms of skin type and color) that might encourage one incision over another. Dr. Stevens refuses to recommend any incision per se but notes that: “Of all the breast augmentations I have performed on nurses, physicians or even my own employees, none have ever asked me to do either the inframammary fold or armpit approach. I find it highly significant that women who have been surrounded by the plastic surgery industry and have seen the most results, have never asked for an incision other than beneath the areola.”

The type of implant used has certain limitations in terms of availability. Currently, there is a moratorium on silicone implants; the silicone gel implant has been limited to women who fit into specific inclusion criteria. “lf there were no moratorium I would be putting in far more silicone gel implants than saline implants,” says Dr. Stevens. “The silicone gel implants, in general, feel more like a breast and look more like a breast. However, we can certainly adjust the saline implants and in most cases are able to give the woman a natural-looking breast.”

The next question is where to put the implant. It can be placed either on top of or behind the muscle. “l place implants behind the muscle so the implants are partially covered,” says Dr. Stevens. “The muscle allows a nice smooth take-off from the chest wall. lf put directly on top of the muscle they can look like a half-grapefruit or rounded balloon the chest.”

The fourth criterion in an excellent breast augmentation is the choice of specific implant. Should it be smooth, textured, low profile, high profile or anatomic? It’s important that each implant is individualized to achieve the size and shape the patient desires. According to Dr. Stevens, that individualization should dictate the decision.

“It’s my feeling that if the surgeon is wedded to only one type of implant then all the breast augmentations will look the same. This is not cookie-cutter surgery. Cookie-cutter breast augmentations are, in my opinion, ‘boob jobs’.”

Finally, although there is a size range from which to choose, the breast implant must be appropriately sized for the individual.

“When a breast augmentation is extremely large compared to the woman’s body, in my mind, it falls into the category of a ‘boob job’ because any one can certainly spot it,” notes Dr. Stevens. “If you take a little woman and you give her size double-D breasts, most people would agree that this is inappropriate. For a larger woman however, that size may be reasonable.Mostlf my patients want to be In the C to D range but certainly some women want to be a large D and some women only desire to be B-cup size.”

“Boob jobs” are often hard, round balls on a woman’s chest. Beautiful breast augmentations have a natural shape and size. Allowing natural movement, the implanted breasts slope gently off the chest and feel soft to the touch.

 

Talking Is Harder Than Writing

I’ve been writing BoobCast for so long, one would think that losing my breasts to necrosis would have gotten somewhat easier to talk about. I would have liked to believe that writing about it makes it easier to deal with at all.

It hasn’t.

Yesterday I hung out with someone I haven’t seen in about a year and a half. After we talked about the initial reason she contacted me again, she asked me what had been going on with me since last we saw each other. So I told her. Not in vivid detail mind you but enough so that I was kind of choking up.

What surprised me even more is how much anger I still have towards the man I feel is responsible for all of this. I’m still legally constrained from mentioning his name or the name of his practice. That doesn’t keep me from hoping that some day someone will break his hands with a sledgehammer so he can’t put some other poor woman through this.

Almost 2 and a half years and I’m still angry beyond belief. I think what made me the most angry has always been his manner. There was The Valium Incident, generally replying “I don’t know” when asked what was going on and insulting my practice as an herbalist by calling it voodoo even though, as part of prep for the surgery I was given herbal supplements to take. Add to that, telling me to stop screaming as he sewed cadaver skin onto my rotting breasts to try to act as some kind of bandage. The screaming happened because he was sewing it on to a spot that hadn’t been numbed. Of course I left out those details. I can write about them but, as I type, I’m choking back tears.

When does this get easier??

It HAS to one of these days or I’m never going to be able to talk about this on stage. I still have hopes of turning BoobCast into a Vagina Monologues style stage show.

Do any of you know how to get speaking gigs?

For new readers, please read my earliest post in the Archives.

 

Fallout – The Implant Difference

If you are one of my regular readers, you know that I had implants with the initial breast augmentation and lift surgery. If not, implants are used to replace the breast volume that has been lost either over time or due to breastfeeding and pregnancy. They can also be used in the case of benign fibroid removal to help fill out the breast blGflA

My surgery was purely cosmetic. My breasts had degraded as far as they could go. According to the RN at one consultation, “they weren’t going to get any worse”. By degraded I mean that the areolaes covered the entire end of my breasts, my nipples pointed at the ground and my breasts had very little volume. They looked like a couple of pizza slices hanging from my chest wall.

It is not physically possible to put breasts back where they were when you were 18. Skin stretches far too much for that. What they CAN do is add volume. That’s where the implants come in. But there are big differences once the implants are in. Remember, these are foreign objects placed in your body. So they are not going to act like your own natural breasts.

Here’s what I’m talking about when I say “Headlight breasts”. They look like they were pasted on her.

Whether they are saline or silicone, they are not going to feel or act like your own natural tissue. For instance, with a natural breast in a 30+ year old woman, when we lay down, we end up with our breasts migrating towards our armpits. This is commonly referred to as fallout.

It’s just what breasts do after a certain age.

With implants, those puppies aren’t going anywhere. You lay on your back and they stay where they were put. They may move a little but not like real tissue.

This is one reason I advocate for tissue-based reconstruction whether it be TRAM flap or Lat Flap reconstruction for women who have lost their breasts.

The other reason is the feel of the breast. I can only speak from the point of a woman who has had saline implants. You can FEEL the implant through the skin. From my perspective it feels like you’re squeezing a warm, overfilled water bottle.When I poked at them, I could HEAR the saline sloshing sometimes.

My husband says, “They were very hard kind of like groping a hard, squishy melon. Well, something not as hard as melon but not as soft as breast tissue.”. He enjoys my reconstructed breasts much more. The reason he likes the tissue reconstruction better is that “they’re natural. They’re all you”.

The down side to tissue reconstruction is that, on a deep feel, you can feel the edges of the flap. You really have to search for it, but it’s still there. For my husband, there IS no down side now that the flap has softened.

 
 
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