TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!
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I am so grateful that everyone has shared their story. This entire journey has been tough trying to determine what pathway of surgery, lumpectomy or mastectomy, and now deciding on placement of TE. I am beginning the journey next week on Nov 1, having a single mastectomy (skin & nipple sparring). I met with my PS today who said I was a good candidate for over the pec implant.
Like Littleblueflowers, I am concerned with recurrence and how accurate mammograms will be in detection. I love my PS, he's young, but very forward thinking. As of now, I have a high grade 3 DCIS in two areas- one being 4.4cm and both close to the chest wall. I am at Scripps, in San Diego.
After reading the board, I am going with over the pec TE. He did say that if there is not enough skin, he will end up going below and that he won't know until he is doing the surgery.
Has anyone with over the pec had a mammogram? Did the tech have a hard time getting films?
Thank you, all, for sharing your journey! It has made a world of difference….
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pickmorewildflowers - I was told by med onc and the interventional radiologist that screening is not done via mammogram after mastectomy and with implants. IF any diagnostic imaging needs to be done, for me at least, it would be Ultrasound or MRI. No more mammos for me again, ever. The majority of screening is done by physical exam.
Sounds like you are going directly to implant at the time of mastectomy. I hope that means they already know you don't need radiation?
Hope all goes well for your surgery on Nov 1st!
- xo
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Thanks for the info, Andraxo!
I am getting an expander, they are not certain that DCIS is not invasive. And after reading many of the post on this discussion and other information I found on line, I am going to ask for the over the pectoral implant and hopefully I will have enough skin to support the procedure. I am a A-cup with no intent of going larger or having anything done to the other breast. Initially I thought I would go a little larger, but I am so over all the appointments etc that I just want this to be done. I keep telling myself 'one day at a time', but I'm getting more anxious as my surgery date draws near. ~hugs!
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Hi Wildflower, perhaps this tidbit may help...
I had less than an a cup prior to all this (which is why I felt insulted to have to deal with all this!! Not logical, I know). I went from dang near flat (size simply doesn't apply) to a 30D (32C)
I was thinking about the fact that your ps is wondering if you'll have enough skin to cover an implant. I had expanders and they stretched my skin enough for 290cc implants. My skin held up, but I was told at each expansion that my skin was very tight. I had small fills - 30cc-50cc and breaks in between.
When I saw my before pics I couldn't believe it. Sometimes I still feel quite small but when I compare, wow, what a difference! I think I now look like I did beforewith a very padded Ill-fitting bra.
Hope that helps!
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Thanks JessieJake, that is a big help! I have been going back and forth. I can't wait for the first part of the process to be over. My PS has been wonderful and not pushing me to make any decision. He keeps reminding me that I have time and can decide as the process moves forward.
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Made it through te surgery! Not too sore, just chillin and napping. Looks like i woke up with about an A cup under all the bandaging. 1 drain, because the PS found a spot he felt might have the chance to fill up? Not sure. Went pretty smoothly and i was out an hour ahead of schedule. Guess we will see how it all looks in 48 hrs!
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Littleblueflowers, I was thinking of you and your surgery today. Glad to hear that you sailed through. Let us know how things go. How's your skin been doing?
I saw my reconstruction surgeon this week. My foobs (under the muscle) are going to need some revision. Now that the expansion has settled in since the last fill in July, but they remain, to use a baseball analogy, hard, high and "outside". My surgeon is suggesting an exchange, and he can put in a softer implant, and move things around a bit so I have something more like normal cleavage. They are pretty far apart, at the moment. Skin is good, though.
I will probably go for the suggested revision, but I'm not in any hurry. Maybe in the spring.
Warmest regards,
avmom
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Hooray Littleblueflowers! Hope it all keeps going well.
I was told to expect to have a drains with TE placement.
- xo
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Avmom! i have been thinking of you! Sorry you dont care for your foobs- they looked great to me and were a big part of why I chose to start recon. Please do keep in touch. It was lovley to meet you this summer and I hope you had a great fall. Good luck with your revision and please do keep in touch!
Best-
Jen
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Andra, I expected 2 drains as well. My surgeon says he tries not to use them, but will if he has to. One thing I did not consider- he said circulation is a concern in radiated tissue, so he tries to use the least possible cautery during surgery. That may be why the drain on that side. Anyway, still a not to sore. Took half a percoset since i have been released, and thats it. Nausea is subsiding. So far so good! Lifting restrictions are no arms above head and no more than 10 lbs.
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So glad you mentioning the circulation issue Jen. I'm going to ask my surgeon about it and cautery before they wheel me in. I also just noticed that I likely have a small seroma on my radiated side (kind of hidden in between 2 ribs - if I palpate just right I can isolate a small ball of fluid). Hopefully that will be addressed with this surgery and having a drain will help.
I was told no lifting weights and no running for at least 2 weeks or until drains out (whichever is later). Hoping to hike daily.
I had a few moments over the weekend of wavering on having surgery, but I'm back on track mentally today.
Hope you're still feeling well post-op!
- xo
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Hey Andra! Just wanted to give you an update- no real pain from surgery 4 days out. Pretty itchy though and even at 60 ccs in each TE, it feels like bricks on my chest. I tend to walk around holding them even though I am swathed in a compression bandage. My surgeon said to maintain compression and movement rewtriction until my post op on the 3rd. Im being as compliant as possible! The first day my drain produced 35 ml of fluid. Since then, its been less than an ml every 24 hrs. I would like to get it removed sooner then Thursday, but its a long drive! My biggest complaint, other than the movement resteiction, is joint pain from either the Keflex or the anesthesia. Its been pretty bad. Other than that....eh. Is what it is
When do you go in? 0 -
Yay Jen! - happy to hear no real pain at 4 days post. Wow - 60ccs seems like a lot. I don't think I'm getting filled with anything when he places the expanders...but if anything it would be air (my surgeon uses air, not saline). I hear that saline fills feel heavy, especially after being flat for so long. Another friend said hers felt like kettle bells on her chest right before the exchange...and she was delayed for months to exchange because of an ankle fracture.
My surgery is next week Wednesday Nov 9th. This Wednesday I go in to meet with anesthesia for a pre-op exam/clearance. They said it is required because I had chemo, yet I talked them out of it when I had fat grafting surgery.
Hmmmm Joint pain. Sounds atypical for a post-anesthesia or antibiotic side effect. All over? Hope it resolves quickly!
- xo
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Huh. I didnt do any pre op meeting with an anesthesiologist until i was deep into the versed lol. Well, ill be thinking of you! Air sounds like a marvelous option. I wast expecting to wake up with anything in the tissue expanders but there ya go. A pair of itti bitti a cups. You know i thought the body pain was weird too so i asked the pharmasicist and he said its pretty common side effect. Im back on the turmeric ginger sour cherry wagon and have take 2 ibuprophen which kicked it to the curb. It will be interesting to see how your experience goes! I tried to get my ps to pull my drain today but he said its a good idea to keep it the full week even if it stops producing.
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Hi littleblueflowers , glad to hear your surgery went well, glad you got thejoint pain thing figured out.
Hi Andraxo , haven't seen an update, but hope you are doing well.
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Hi, JessieJake , glad that it went well for you. Heard you say that you have a few things you wish were different. Is it something that will bug you,or do you think you will get used to it? I mention that because I wasn't happy with the way the moderate profile implant looked, hated to have another surgery, but changing to the high profile has made it much easier to feel normal in matching my other side . Not a perfect match, but looking close enough to live with.
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Hi Macb04,
Yes, overall everything is great. Back to normal, feeling comfortable, etc...
I see my PS on 11/21 and I'm curious to get her input on what happened. I'm assuming my fat reabsorbed as the top edges of the implant are noticeable (not horrible but looked way better in the beginning). Although, I am wondering if possibly it was also in part swelling that has since gone away. I have a little side rippling when I slouch. I wear a bra all the time and that keeps them in good shape.
I got the low height extra full projection. I love the projection but I'm am wondering about the low height. I feel with the fat grafting it looked natural and full enough on top but that is gone (not sure how much was swelling, too). The tops of my bra cups are a little empty and I blame it on the low height. There is a part of me that is thinking of talking about that issue and asking if the moderate height might be the answer if fat grafting isn't working. My husband says they look great and no more surgery, but......
I am on the books for fat grafting on 12/15. I know this is crazy, but I'm concerned she'll push back on fat grafting. I lost weight over the last year or so and she doesn't think I have much of a selection. It does seem silly to pursue that only to have it not work again in the end. My butt is kind of like a pancake since they took fat from there originally. Not that it was all perky to start but....
Thx for understanding and sharing what you chose to feel better. I feel that I'm getting more of the message to just be satisfied. It may be that a good discussion with my PS on 11/21 will give me a new perspective.
We'll see!
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Howdy ladies- well Im on week 2 of expanders and still on keflex and ace wrapping. PS says my radiated side needs another week to heal befor starting expansion. Arrrrgh!!!!!! And still on movement restriction. Not gonna lie its driving me nuts. I have one spot that is a little red and maybe has fluid behind it...ps said he didnt think it was infection, but im pretty concerned.
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Greetings everyone!
I'm day 6 s/p TE placement over pecs. I have little frankenboobies! They look pretty scary...ripples, mis-shapen and I swear one is upside down but hoping it looks different when drains are out (they distort everything). They are super small but I'd bet one fill will do it for me size-wise and that should happen late Dec, early Jan.
It's been rough. Day 1 post-op was the worst ...worse pain than any I had mastectomy and ax node dissection....and of course I would not take any narcotic pain meds. I think I sobbed most of Thursday questioning why I did this to myself. I was also upset about the election and that didn't help. Pretty stupid to have surgery the day after election day in a presidential voting year. Quite a bit better now that I'm allowed ibuprofen! Yay! I've been walking 3.5-7 miles every day except day 1 post-op I only walked 2 miles. Last night I supermoon hiked in Canyon De Chelly for 2 miles. Spectacular! Probably used my arms too much yesterday driving 5 hours and then unloading my vehicle. Nothing heavy, but it was repetitive. Have restrictions until 2 weeks post-op.
My biggest problem right now is 3 segments of my Thoracic spine muscles on the Right side are in a ball of spasm
It is constant pain no matter what position I'm in - walking, standing, sitting, lying down. As a PT I tried everything I could on my own to relieve it to no avail. Thankfully I'm at work (yeah, crazy...but only going to work 7 hours, not 10) and a coworker dry needled the area. She could visually see and feel the exact area and muscles. Needling only helped only a little though. I don't know what triggered them to do this...never had anything like this before. I cannot get comfortable.- xo
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Hey Andra! Oi. That sounds rough. Wow. Bummer about thd pain! Glad you are able to keep active. Ok. Questions...how come you have to wait so long for fills? Any idea why you were in such pain??? And...did your PS make you stay compression wrapped for 3 weeks to avoid seromas? Asking because...my ps is ready to start fills at 3 weeks, depending on healing, and im planning to go much larger. Also...i havent had any surgical pain. Im concerened that my ps forgot to sew things down or something! And...he strictly wont let me use my arms (t rex arms) or get my heart rate up for a month. Just wondering about the differences in experience with different doctors! Also, super jealous you are allowed to excercise and your hike sounds wonderfully magical. I miss the 4 corners area! Ive been walking very slowly 4 to 5 miles a day. Ugh. Sux. Well, wishing you the best!!!!!
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Hey Jen!
I was told 5 weeks to start fills, but I will be in Israel and Jordan then so we have to wait until I get back (and work the holidays) which would be at 7-8 weeks post. Likely I will need just one fill, but maybe two. I'm not sure how many weeks he waits after the final fill - I assume another 5 weeks. I'm shooting for exchange surgery late February after the holiday weekend because I wanted to go to Montana visit friends in Missoula and snowboard that weekend.
I've been using my arms way too much I'm sure. Not supposed to be. He said no running and no weight lifting for 2 weeks. I think I carried 20# yesterday with both arms at my sides. Trying to stay below 90 shoulder elevation, but I know sometimes I go to 110 or 120. No restrictions on heart rate, only restricted for impact/running. I'm at the end of an 8 hour work day and did a ton of computer work. Tomorrow I will ride the stationary bike at work for an hour, maybe try the elliptical (no impact) if I can balance without using my arms. of course it depends on this stupid rib/back pain.
Yes, compression. Not sure how many weeks but I'm sure they will tell me Thursday when I get the drains out. I'd bet it is at least 3 weeks. My surgeon is at a conference though, so I'm really seeing the nurse Thursday and she will pull the drains.
I just had one of my PT staff manipulate my T spine and a rib. Didn't help much. Thought the rib for sure was "out". It feels like it. Burning right where a rib attaches to Tspine. Even typing right now is burning my Tspine/rib in one spot. Maybe it will get better when the drains are out. Certain arm movements cause pain and I know it is the drains.
Glad you are able to get out and walk, though not as brisk as you'd like. Just a little longer and you'll be rocking it like you want to!
I think you need a road trip down here in 2017!!! Come visit
xo
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Hey Andra- thanks for answering my questions. Wow, everyones experiences are so different! Im trying to be compliant. I really want this to work, but yeah. I probably use my arms too much too. Just walking my dog and being me. How does your radiated side look? Is it a little redder and firmer than yiur non radiated side? Mine is. Not much, but noticable. Daaaaaaaang. Im hoping to be off movement restrictions by december so i can go to north carolina as part of a fire rehab team. This recon is for the birds lol. Hahaha well Im in Missoula right now! Where do you snowboard? I live in Helena. Thinking of heading down to Cortez CO here shortly to visit friends. Hope your back pain resolves soon. Im dreading not being able to go to the chiro if mine goes out, as it inevitably will.
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Hi All,
I'm 2-weeks out from my surgery, single right side skin & nipple sparing mastectomy. Today I had my drain removed and feel like a new woman. My PS still does not want me doing any kind of activity or lifting that involves my arm. I am a beach volleyball player and dying to get back out, hopefully this spring. I feel great, minimal pain, tightness and some burning. I'm doing a lot of walking and I'm not lifting anything heavy. Last night I decided it was a good idea to dye my greys using a box dye and one hand, failure! LOL! I look like I'm wearing a patch quilt on my head. I can't wait to get this TE removed. All of the posts have helped through this journey, much gratitude!
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Cracking up Pickmorewildflowers about the patch quilt hair dye job!
I needed a good laugh today! If you do it again, maybe it will fill in the patches. Hope you are able to get back to volleyball sooner than you think!Jen - my radiated side is definitely more firm and the skin is still discolored (looks like a red/brown tan). It was about 6.5 months from radiation to TE placement. Wondering if my skin will always be discolored on that side. Also wondering how much my skin should move over the expanders. Feels like the skin around my nipples is glued to the TEs. They are so warped, but the drains could be causing some of it.
I used to mostly snowboard in Telluride when I had my house in Dolores an hour away, and some at Wolf Creek. Last year I did a few days at Santa Fe and Taos but not as much as I wanted during chemo because of muscle and edema problems in January from a medical reaction. Not sure what this season will bring but I did get a discount card for Santa Fe since I go back and forth there so much. Supposed to be a low snow year
I've never been to Montana, but excited to go. Lenny would love to live in Missoula again if the job market was better. He says the ongoing joke is that the ski lift operators have PhDs! Feels like there is a knife in one spot in my back. If I move a certain way, the knife is twisted. Can't find a truly pain free position. Just typing at my stand up desk at work is ramping it up. I should just go home and take sick leave. but here I am one week post-op working with drains in. This morning I took a shower even though I'm not supposed to until drains out (tomorrow). I just let the hot water beat on my back for a looooong time. It helped a little so I might do it again later.
- xo
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Well I had a masters when I worked at Snowbowl, so hes not far wrong lol. Jobs are tough here. Funny, I wonder if we know some of the same people in Dolores. When I livednin Cortez I used to hang out at the brew pub there all the time! Hopefully we have a good snow year although that would make getting over the pass for dr visits a pain in the butt. Hopefully you get some good days down there too! Stupid expanders. My. neck is all jacked from not excercising and sleeping on my back. Hope your back pain resolves soon. Heading in for my first fill tomorrow, fingers crossed. Sooooo ready to ditch the ace wrap.
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Yes! First fill accomplished! P$ says I have a good substrate so should have good results lol. Fingers crossed! Didnt hurt a bit!
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Hi littleblueflowers , great that you got through the first fill. How many more are you going through ? What size are you going for?
Wow Andraxo , that really sucks that you have such persistent pain. Well you are still pretty early in the post op period . I hope it gets better for you soon. I saw your question about the darker/discolored skin. I had that treated with a single laser treatment at my dermatologist. I didn't like how weirdly hyperpigmented it was . The treatment hugely improved how it looked . Much closer in pigment to my untouched side now.
JessieJake, I am sorry to hear that your top edge is visible on your implant. Can you explain more what you mean by low height, high projection ? Don't let anyone push you. You have a right to stay as you are, or decide to change it. It is your choice. It is a hard call. I had a lot of fat get reabsorbed, that's why I did so many fat grafting procedures (5). I also lost most of it twice with terrible infections. Just enough survives to cover the implant edges. That all happened because rads damage wreaked my skin. I wish I had never did rads.
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MacB- Im not sure! Its been so long since ive had breasts that even 120 ccs seems quite sufficient. I will get at least 1 more fill though. Do you have any advice on how to increase circulation to the radiated skin over the tissue expander? No issues yet but id like to be prepared.
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Littleblueflowers I had radiation fibrosis , with my skin being thick and woody , kind of stiff. So to help that I got Hyperbaric Oxygen Therapy and I am also on Pentoxifylline and Vitamin E . The combination of that with fat grafting has brought my skin back to nearly normal in suppleness/flexibility . Pentoxifylline changes the shape of your RBC's so that they can fit better in the tortuous microvascular blood vessels to help increase perfusion of radiated skin. There is some research on that.
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WOW! ! ! Have 20 foward thinking PS's doing OVER Pectoral Implants nationwide on the list. Keep them coming!
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