How do I deal with this? very upset

[midori1999]

I'm sorry, this may get long, but I'll try and keep it short.

I have PIP breast implants. (the ones in the media) I have had an MRI scan which shows silicone in my lymph nodes, so basically outside of the implant where it should not be, although the MRI shows no definite rupture. It's still possible there is a rupture though. Because the silicone in these implants should not be in them, no one knows how it will react outside the implants or whether it will migrate to other parts of the body and what damage it may cause once there, if any.

I have made the decision to keep breast feeding based on the fact that there are known and proven benefits to my DD and that any risk to her is minute as silicone cannot get into breast milk and any risk would really be based on something being in my implants that wasn't in the ones tested by the MHRA and there's no reason to think there would be.

Ideally, to minimise any potential risk to my health, I would like the implants removed before they leak any more. However, I am having problems finding a surgeon to operate whilst I am lactating and suspect I may not be able to.

So, I need to decide whether I potentially risk my own health by keeping the implants in, although there is no known or proven risk, or whether I stop breastfeeding much earlier than I hoped to and get the implants removed.

I am sure there will be plenty of people who think I am being dramatic (and I have met with many so far) but I am heartbroken. I managed to breastfeed this time despite not managing to BF my first three children and wanted to keep BF until DD weaned herself. It's very unlikely I will have more children either. DD is 9 months and no one understands why I do not just stop feeding her (except DH and very close family members), including health professionals.

I think my only option is going to be to stop when DD is a year old, but I really think I am going to struggle to come to terms with this and am not sure where to go from here.

Very, very unMN hugs. I understand exactly where your coming from having not BF DD1, but managing to BF DD2.

I think all you can do is research as much as you can the risk of the silicon leaking and make as informed a choice as you can.

I BF for a long time so can not help with weaning a toddler. However, I do know it becomes very hard to discreetly feed a child over about 14 months, they are just too tall.
From a year onwards DCs become much more able to do things for themselves and I think it might make a much more natural progression to give up BF between a year nag 18 months as the child natural learns to feed themselves and carry a cup about.

At one year old your child may still fell like a baby, by the time they are walking and causing trouble, you may find moving on a whole lot easier.

i have no idea, but i can see why you dont want to stop, my bet would be to ask on the analytical armadillo on fb, or the leaky boob, la leche etc, anywhere you can get some more info on the problems etc.

Thankyou very much for the replies.

I have spoken to a surgeon who may be able to help. He will not operate whilst I am lactating, but as only one side is/seems to be leaking then if I dry that side up he will remove that implant and the affected lymph nodes and then I can have the other removed and have any reconstructive surgery once I have finished BF. It will leave me extremely lopsided, but I can cope with that I think.

I feel so relieved I won't have to stop BF or risk my health.

that sounds like a goo compromise and you can easily feed from just one breast, lopsided is a pita but you can get some good bra fillers for appearances sake so you dont look uneven when clothed etc, or not if it doesnt bother you :)

glad you have found someone who can help, can i ask you will get the other removed when you do stop bfeeding as tho its not leaking now it may do?

Yes, I will definitely be getting the other implant removed once I stop BF. I will discuss with the surgeon whether he feels it sensible to be scanned again in another 6 months or so to check the remaining implant is still intact/not leaking too, although I have had lots of symptoms and recurrent mastitis in the affected breast, so it was fairly obvious there was a problem.

that should be gooD not goo?! what is a goo compromise!

i think getting re scanned in a few months if you can is a good idea, unless you are confident you would spot a problem, and it sounds like feeding from the one breast will be fine and hopefully you will have no further issues like mastitis etc :)

Probably a bit late on here, but I have had implants for 14 years & last year I had a scare, which, appeared to be caused by my implants diffusing silicone. I had a biopsy which was free of silicone. I also had an MRI that showed no rupture.

I don't have PIP implants, but because of their age I'm having them replaced tomorrow.

Ref having a GA when breast feeding, I would ask some questions over it affecting her teeth as I am convinced my dds enamel has been affected.

Although i'm very pro bf, i would be inclined to stop bf your dd. I think the silicone within the PIP implants is a complete unknown....I wouldn't risk it. 9 mths is a great achievement.

midori, what is the process for waiting until one side has dried up?
is it simply a case of stopping feeding for a certain amount of time and then having the OP?
because I know people who can still squeeze milk out after several years of not breastfeeding!

anyway, I am wondering, if it was only a short time, you may be able to relactate from the operated breast? and then do the other side? thus not having to stop at all?

I'd say that if there were any harm done its too late now and anyway you'll never know that x or y was caused by it. Given that you've already done 9 months and dd will be weaning then how about reducing feeding after she's a year until you stop completely, say by the time she's 15 months. By that point the benefits to her of bfing probably (and this is very subjective) don't outweighs the risks, before that they probably do.

If you aren't comfortable with that plan though, I guess you need to put a timetable together in your own head. You'll probably feel better once you have a plan and have made a decision about how you are going to deal with the situation.

It's a very difficult situation to be in, please remember that it is totally not of your making.

Thankyou.

I have recently seen a surgeon with a view to having the one implant removed. He feels there must be a rupture due to the amount of silicone in my lymph nodes/how enlarged they are and says that fluid around the implants, as I have, can distort the MRI images and make a rupture hard to detect. I do trust him, he is an NHS breast specialist/breast reconstruction specialist.

However, he will not agree to to remove one implant only, although I feel this is partially down to being unsympathetic about BF and also not really understanding how it works. I did 'agree' to stopping BF at a year and then having the surgery 3 months later to remove both implants, but I am not sure at all. I am going to seek another opinion I think.

thisisyesterday i have always been able to squeeze a drop or two of milk out when not BF also, but the surgeon I have seen says he will operate 3 months after I stop BF. The way I understand it is that if I stop feeding from one side the milk will dry up on that side only, but I am going to speak to the lactation consultant a bit more about this. I have mostly stopped feeding from that side anyway now.

Willowisp good luck with your op. These are my second lot of implants, I had the first replaced after ten years. I've done a lot of research and am happy that continuing to BF DD is not doing her any harm, particularly as she is nearly ten months now.

Thanks - I'm feeling very nervous, just want it done. I think you may have gone bigger (?) I'm going a bit smaller !

I really feel for you - I bf my 2 dd's for a long time & appreciate the emotion involved.

I hear what you are saying ref the surgeons too, I guess they don't want to give you definitive advice incase there is any comeback. I found them the same when asking for advice about to replace, it's a tough decision

Best of luck with it all.

Btw I found this thread by searching for implants & found some info about the PIP's from a nurse, might be worth looking at it ?

yes you are right that if you stop feeeding on one side that side will dry up, and the other side will continue to produce milk.

what is the reason for being unable to do it while you're lactating?

i still think you could potentially let the bad side dry up, have the op, and once recovered re-lactate from that side. then let the other side dry up and do the same...
if you are really keen to continue to breastfeed that is!

just need to find someone who will do one at a time i guess, good luck with it all, it's not a decision i'd like to have to make either

Thankyou.

The reasons I have been given that surgery is not possible whilst lactating are increased risk of bleeding, increased risk of infection and the risk of milk ducts being damaged and milk leaking out into the breast causing problems such as infection. I am already at increased risk of bleeding due to the damage done to my breast by the implant and also as I will need heparin around the time of surgery due to a clotting disorder I have.

I am extremely keen to continue to BF, but for some reason that makes a lot of people, even HCP's, think you are some sort of lunatic. I obviously need to see some more surgeons, which is costly. I think currently my best options are either to get the left implant removed for now (I couldn't realy care less about looking wonky if it enables me to keep breastfeeding) or to keep both the implants in but have regular scans to asses what is going on with the silicone that is leaking.

I do get a fair amount of pain, but I can cope with that if I need to, it's just inconvenient.

I also feel that as I have had heparin for several prolonged periods the benefits from BF reagrding osteporosis are particularly valuble to me.

oh no i thought you had found a surgeon who would operate on the affected breast provided you stopped feeding with that breast, and now they wont :(

if you are not feeding from the breast that they are operating on the surely the milk ducts and leaking etc is not an issue?

have been in contact with any bfeeding organisations or the leaky boob or analytical armadillo on fb? only they may know someone who can offer advice or put you in touch with a surgeon who is understanding?

Thanks. I think the problem is that most breast surgeons just don't know very much about breastfeeding at all. Most seem suprised to hear the recommendation is to BF for two years!

Yes, I agree that if I stop BF on the affected side that the milk ducts leaking etc isn't an issue, but so far I have been met with the opinion that BF isn't that important and I may as well just stop. Or pretty much that anyway.

I have emailed via the Analytical Armadillo blog page and have also previously been in touch with a lactation consultant at my local hospital, although she is very hard to get hold of. The latter was recommended by LL as someone who knows a lot about BF and implants and she certainly seems to so far.

I appreciate the support, thankyou.

i would get in touch with the lactation consultant again, and ask if she could perhaps write a letter for you stating the importance to you and your child of continued breastfeeding, and suggesting that if possible it would be beneficial if you could have just the leaky implant removed.

I can understand that they would rather do one op than 2, for cost reasons, but if the result of them refusing is you not having either removed then that's not good either, so worth going through it all with the consultant again and just re-iterating that continuing to feed is really very important to you and you really are quite determined to do it this way?

Thanks again.

I don't think cost would be an issue as i will be paying for the surgery as not using my original surgeon, so if anything, they stand to benefit by me having two surgeries. Obviously it's safer to have it done in one go and only have one general anaesthetic, but this type of surgery is usually considered starightforward and low risk anyway, although it's more complicated with the leaking implant/breast damage.

I have spent the morning trying to find another surgeon to see and have found one with a lot of information regarding PIPs and breastfeeding on his website. He has the correct qualifications and is an experienced surgeon. I've spoken to his PA and she says that he and his son did a lot of research regarding PIPs and breastfeeding when it all hit the media and he will be sympathetic to my breastfeeding. Hopefully he is also fairly knowledgable about it, but it's at least reasurring he felt it important to look into it. I've booked a consultation but am going with an open mind with regard to my options and will see what he says. i think it's useful to have a different opinion regardless.

Thanks again.

Are you looking at Bupa surgeons ? As I didn't pay for the consultations, apparently the decent surgeons aren't charging as they don't want to put people off.

What a dilemma...I feel for you.

Thanks again. How did your surgery go? Hope you aren't feeling too bad!

I am looking at individual surgeons via BAAPS/BAPRAS rather than any companies or hospitals. Obviously if any of them happened to be with BUPA that'd be great, but I am mor einterested in the surgeon's CV than anything else. The surgeon I have already seen was charging for consults, but is offering a reduced price (I imagine it's around half or a bit less) for ladies with PIPs, and less so if they are ruptured.

We're not made of money, but if I can get the right surgeon who will enable me to continue to BF then the cost will have to become irrelevant.

I feel great actually ! Freezing after the op, but watching tv, eaten, wee'd, feeling slightly euphoric (insane !).

I've gone from 250 to 175, am pleased. Also the implants were completely intact, no leaking so bit confused how silicone showed up on the scan. Mind you, when they bioposied my lymph node, there was no silicone there, just silicone wrapped round it. Writing that, I'm even more confused....

I think the better surgeons operate at BUPA hospitals ? It was about £4000, I had a cheeky bit of lipo too, so not sure of exact cost. I also paid on my credit card, so could you apply for an interest free one for the op ?