TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!
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Andra- wow! 100 at a shot?? Lucky! How is your hide holding up to the stretching? My PS only does 60 at a time. It makes for some slooooooow going, especially this time of year when its a 7 hr round trip to town. I'm hoping to be done here by the end of January, then rest for a month, and hopefully exchange in the middle of march before my field season starts up again, otherwise I will have to wait until next winter. I"m jealous of your snowboarding! I haven't gotten out yet, but I did a trifecta today- xc ski, snowshoe, and ice skate. its a winter wonderland out there unless you are driving lol.
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littleblueflowers - After the TEs were put in, the surgeon used air in them....but the air somehow goes away after many weeks and I was totally flat/deflated. He said the air escaped through the membrane and is absorbed by my body. So...there was plenty of room for 100ml since they just put back what was air filled for many weeks. I didn't even feel it - doesn't have any stretch! Not sure how much more goes in on Monday or if I might need a third fill. Oddly I think they are smaller now than the fill 5 days ago - as if the fluid escapes too - so weird. They feel great right now though! I can lift weights as much as I want but I'm avoiding push-ups.
My plan is to finish fills this month and do the exchange Feb 24th (after 3 day Missoula trip). I understand about long drives for appts...so much time on the road. It is 4.5 hours each way to where my PS and oncologist are in Santa Fe. My fiancé lives there too though, so I'd be driving back and forth even without the appointments....just not as often (and he'd likely drive to me on the Rez sometimes). I'm so eager to get to the exchange, 6.5 weeks to go!
Your trifecta sounds fantastic! yay winter sports and fun!!
Looking forward to snowshoeing for my 2 weeks of activity restriction after the exchange when I have drains again. happy I'm allowed to do that!
- xo
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Andra, yr gonna get drains again? Barf. I.hope to avoid that! Interesting about the air! Wonder if the fluid is escaping.or if your tissue is just stretching? My radiated side looks a lot bigger because it doeant stretch as.much. Weird but....
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Jen - I think I just expect drains every time I have chest wall surgery (except for that one round of fat grafting). I have a small seroma after TE placement on the non-radiated side. I imagine it will be drained at the next surgery.
That is strange about the tissue stretch and your radiated side looking bigger, I would expect smaller because it is tight. Hmmm. Mine are pretty equal but are a little smaller now than they were a week ago. It will be interesting to get the next fill.
I hope you can stay on schedule and ahead of your field season for the exchange surgery! Waiting another year would be crazy.
- xo
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hi ladies, I love the idea of over pec implants, but my bs today said her experience is they are associated with more infection and implant failure. its hard to find the literature to back this up, and perhaps it was just her experience with our local ps who does those. any articles I can read appreciated - ty!!!
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Wow, up to 23 PS ,and counting, across the US who will do cutting edge Prepectoral Implant Reconstruction!
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I follow this thread, but I don't usually post much. I would like you to include my PS who does pre pec surgery, Dr. Eric Chang in Columbia, Maryland.
I am currently seeing him for a proph right side mast with over the muscle TE. I am almost done my fills and will hope for exchange surgery in early spring. I had under the muscle on my left side in 2008 when I was diagnosed with IDC. He replace my left implant so I could start with two "fresh" dated implants. He kept that one under the muscle. So, I will be curious to see how this looks when my right side is done and has the actual implant over the muscle.Love my PS.
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Annoyingboob, my January friend! I have pre-pectoral TEs thanks to this board. I had to switch my PS because my original one was really a DIEP guy and wouldn't even consider pre-pectorals. Below are some articles which I had previously forwarded to my current PS. The articles all speak of immediate recon but of course you can do it on a delayed basis too! He had only done 3 prior to me but believes it is the wave of the future. He wrapped my TEs in Alloderm above the muscle. Message me if you have any questions! I'm seeing my PS on Tuesday & can ask him any questions you might have....
https://www.sciencedaily.com/releases/2016/03/160302182438.htm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4494482/
http://www.nesps.org/meeting/abstracts/2016/57.cgi
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4727683/
And it looks like they'll be starting clinical trials soon:
https://clinicaltrials.gov/ct2/results?term=Pre-pe...;Search=Search
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thanks pugsmama!! im in my information gathering stage and im mulling over 2 complete extremes in treatment:
1. lumpectomy only with no xrt or tamoxifen for my high grade dcis. this puts me at increased risk for subsequent recurrence on both sides.
or
2. prophylactic bmx which, of course, has little chance of recurrence and actually the same long term survival.
the first option is not recommended by the doctors and places me at increased risk. the second option is considered overly aggressive but gives peace of mind. its a bit of Russian roulette and I have never been a good gambler!! anyway, im meeting with all the experts over the next few weeks, and will eventually make a decision. thank you for the resources!! xx (ps, im a frenchie mama)
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Thanks for the article links, PugsMama! I like reading about the success with prepectoral implants :-)
Misty1, I am interested in hearing about what you think of the differences in your implants and hope all goes smoothly with your exchange. I have a TE in right now and meet with my PS at the end of the month and I assume we will schedule the exchange surgery.
Annoyingboob, good luck as you gather info and decide on a course of action! It's so difficult to figure out which one is best for yourself. I looked into a lumpectomy with no radiation too. Ended up going the mastectomy and reconstruction route.
I also want to put out my doctor's name.......Julie Park from the University of Chicago Medicine. I was her first pre pectoral implant......yikes! I was the guinea pig but things are going okay so far :-)
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Ladies, You are a breath of fresh air! Thanks for sharing doctor names andresearch articles!
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13 days post-surgery & had PS appt. He removed all 4 of my drains!! Whoo hoo! He's thrilled with my progress. Had some air injected, they're now up to 400& he said I might be almost done with the filling! Have a cruise planned for the end of May & he said I'll definitely have my implants by then! We're both sold on pre-pectorals!! So far so good!,
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Yay PugsMama! Drains out and doing well!!
I had another fill on Monday...added 150cc each (yes EACH!!). That seemed crazy, but I didn't even feel the first 100. So after two fills I'm up to 250cc in each and they already seem WAY too big. The computer imaging I had before mastectomy estimate my breast volume as around 250cc, but these seem so much bigger. My old bras don't fit.
I don't have another appt until mid Feb, a week before the exchange surgery. Likely they will add a little more (I think to get me to 300 since we're shooting for 285 implants). Can't wait to be done with these scary balloons. Ran 5 miles this morning before work and my pecs hurt underneath them. It is also painful (pecs again) to lift weights overhead or do pushups so I'm not doing those right now. Good news though is that they don't think I will need drains for the exchange.
Snowboarded over the weekend before the fill. Hooray for fresh powder!
- xo
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Andraxo, it gives me hope that you won't need drains for the exchange! I didn't feel anything either when he injected the air. Still no exercising for me, doesn't want moving the arms around too much - I guess that helps the acellular dermal matrix adhere to everything it's supposed to.
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I posted this in the other forum but want to mention it again here too. For those getting implants over your pecs....
Make sure your doctors have a plan in place to monitor you for local recurrence. After BMX, mammography is not done "because breast tissue has been removed. Local recurrence still occurs in approximately 2% of cases. For me, I could feel the recurrence because it was between my pec and my skin. If there was an implant there on top of the tumor, I likely would not have felt it. Understand I am NOT discouraging you from getting this type of implant. Not at all; I think it's exciting and applaud all of you for being willing to try something new which may benefit women for years to come! But when new things like this come into practice, there are no standards for monitoring for recurrence in place because no precedent has been set. As trailblazers, you need to advocate for yourselves to have MRIs or whatever your docs deem suitable, to monitor for local recurrence. Self exams and clinical breast exams will NOT pick up a tumor under an implant until it's grown quite a bit. So just make note to bring it up with your docs and be sure to advocate for yourself. You're worth it.
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Hi KBeee, thanks for your post. It's a very good point. I was concerned about the same issue and we've already decided MRIs will be part of my screening protocol going forward. MRI is the only screening I'm comfortable with since my tumor couldn't be felt and it didn't show up on recent mammos or ultrasounds. If I didn't have a screening MRI, I still wouldn't know about it!
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That's perfect! Glad your docs are so on top of it (and that you are too). I see you're from Warwick. I'm originally from Vernon, NJ!!!!! I live in Iowa now, but my family is in NJ. Warwick is beautiful!
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KBeee: Wow, small world! I love it here...I see you haven't had treatment in a couple of years. Hope you're doing well & thanks for looking out for us newbies!!
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I am; thanks... hoping for no more recurrences! I hope you recover quickly from your surgery and move forward with zero complications!
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Hi all,
Just updated the listing, now up to 26 Plastic Surgeons across the US and Canada. I will also periodically add Research Links to make it easier for women to do fact finding when they are making Reconstruction decisions.
Good Luck to us all.
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Woohoo! That's quite a list Macb04! Thanks for keeping it so current!
Thanks Kbee - My MO has been planning for annual MRI to monitor the areas that cannot be palpated.
OK - I'm so tired of these TEs already. While they only have 250cc in each, they feel gigantic to me. I'm very conscious of them and I don't want any more volume added. I don't know how women who naturally have large breasts deal with them! I am aware of every step when I run. My jacket layers felt tight across my chest when snowboarding this past weekend. Thankfully they aren't painful, just a little uncomfortable sometimes.
Counting down 4 weeks and 4 days until the exchange surgery. The week prior I meet with my PS one last time to review sizing...I'm asking for even smaller than we planned because the smallest we though would work based on the footprint for my ribcage is a larger volume than I am now...and I just don't want that. If I size down the footprint by a cm I can go with 250cc implants per the chart. Fingers crossed we can do that!
Hope everyone is doing well! Hooray for pre-pec reconstruction!!
- xo
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Hey ladies of the pre PEC world! Ugh. Pain fish. It's like a school of fish that pool behind my left te and then dart off to random places on my left side. Just hit 300 ccs which is the stated volume of these tes. I'm gonna try for 400. 2 more fills. 2 more.
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I need my implants out as the pectoral rolled up right after surgery and window shaded all the way to the top of the implant and into my armpit. Then got cording. Then got a ligament out of whack. All on the prophylactic side. Left implang hurts at top of implant , too, as it is too high profiel for my torso. Very painful.
Any leads on Los ANgeles PS with over the pec muscle experience would be great.
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The pain fish behind your eye sounds awful Jen. I hope they go away soon! Hooray for being down to your last 2 fills. Hope you can still have surgery before your field season starts. you do not want to have TEs for that long. Another friend said hers felt like kettle bells when they were at the end of fills and she had to delay the exchange for 6 months due to an ankle fracture.
Ugh reneeCA - so sorry you've had many complications. I had cording after bilateral mastectomy surgery, but only on the cancer side because of the axillary node dissection (any trauma in the axilla often triggers it, and lean people are also more likely to get cording). I'm a PT, but it was the only thing I couldn't treat myself. Hope your pain subsides and you can get them out and maybe start over....with pre-pecs. A few people on this thread did.
- xo
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Thx Andraxo, I am exploring all options: smaller, lower profile implants, pre-pecs, fat grafting, etc. I'm going to UCLA tomorrow. I'm hoping someone there will do pre-pecs.
As a PT have you ever heard of someone getting cording from an aggressive massage? I think what I had was more of a myofacial release than PT/ MLD and it was at 5 weeks post-op. I swear it caused so many of my problems. I kept asking PT to be gentle and to use lotion but she said this was what I needed to break up my scar tissue and it was "always hardest the first time".
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reneeCA - I have not heard of (or seen in any medical/therapy literature) anyone getting axially web/cording syndrome from myofacial release, or from anything other than direct surgery/trauma to the area....especially if a hematoma developed in the area. It's more common for lean people to get cording, and heavier people to get lymphedema after axillary node dissection regardless of how many nodes were removed. Mine started around 3 weeks post-op and then traveled out to my wrist, and down my torso to my groin over many months. It was pretty awful but I still exercised hard anyway. I saw a PT specialist for it (4.5 hours away) and then I actually took advanced classes myself a couple of months after I finished radiation so I could increase what services I offer the patients I treat here (work in the middle of the Navajo Indian reservation). My PT was very aggressive when treating my scar tissue and adhesions once the cording cleared, but I know it needed to be done to free up my skin and soft tissue for all the sports/athletics I participate in....and also reconstruction once I had decided on it. The one visit I saw a different therapist (who supposedly sees the same caseload/type of patients), and she was so gentle I felt like it wasted my time...could have done that myself with one hand.
I hope they have good options for you tomorrow at UCLA!
- xo
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Saw the PS on Tues. Am pumped up as large as I'm going to be. Didn't even feel it! Exchange surgery will depend on if I have to have chemo, seeing MO this coming Wed. Good news is PS said no drains when the exchange surgery is done. Whoo hoo! Also my laziness prescription is expired. Can finally start walking, and I get to wear a comfy stretchy bra to bed instead of the surgical bra! I showed him his name on the list,he loved it!
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Hi PugsMama, you crack me up. I am glad your PS is happy to be on my list. I started this thread so that the Prepectoral method would be put out into the mainstream of reconstruction discussions. He is right, it is going to be the wave of the future for implant reconstruction.
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I met with UCLA PS Tseng who does pre-pec but he thinks my skin is to thin. Ugh. Anyone heard this before and went ahead and did it anyway? I'm not as concerned with visual ripples as I am with activity and pain reduction.
Thx Andraxo. My MLD therapist and her colleague both think aggressive massage too soon after surgery in axilla is contraindicated adn might have caused my cording. I also have 4 drain incisions in my armpits which added to the perfect storm.
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PugMama, glad to hear you are doing well.
reneeCA, my PS said that if my skin had been too thin, she would have done fat grafting and then done the pre pec placement. Maybe that is an option for you?
I saw my PS surgeon last week and she said I had some fluid built up and drained that off. And she added some saline to my TE. I have air TE's but she said she could put in saline to try to reduce some dimpling in one lower area and also to try to expand out some to match my other side better. I also found out that I may be flying in a few weeks and contacted my PS about my mostly air filled TEs. She said to have the air removed and have saline put in before I fly. Have you all flown with TEs and how did it go? Thanks!
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