TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!
Comments
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macb04,
I am so grateful for this discussion. I had not been considering prepectoral implant placement until my third consultation last week in St. Louis with Dr. Marissa Tenenbaum. She recommended prepectoral placement with textured implants and fat grafting. She is clearly up to date with the latest research so she is another physician to add to your list.
I have capsular contracture (Baker scale 3) on one side and a migrating implant on the other. I also form significant hypertrophic scars (keloid). I am still processing the recommendations, plus I want/need to lose weight to my normal/previous amount before fat grafting. I will be reading updates to hear how others reconstructions/recoveries are going. She told me that with fat grafting, from 20 to 60 (I think) percent of grafted fat does not "take". Have others found this to be accurate
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SeattleBound, yes, the downside to fat grafting is that much of it is reabsorbed. While there, though, it can do wonders to repair a lot of damage. Good luck with your decision.
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Thanks Seattle Bound. I will add your PS to my list.
Hey Ladies, I have seen women dealing with Capsular Contracture here on this thread.
Have you tried Pentoxifylline and Vitamin E??? It is used to prevent Capsular Contracture, but I have also heard of it being used to treat it too. I take Pentoxifylline and Vitamin E daily and use a topical Compounded Prescription of it daily as well. I use it preventively for Capsular Contracture, and to help keep the rad fibrosis from causing me problems again. I have no symptoms from using it at all, and have been on it about 2 years.
Also found info on treatment of Capsular Contracture using Low Level Laser Therapy to resolve or greatly improve it This laser treatment sounds really marvelous, innovative and effective. Totally what this thread is about, thinking outside of the box.
Here are some articles discussing these very topics.
Reduce skin fibrosis & possibly breast implant contracture after radiation therapy: vitamin E & pentoxifylline
Aug 1, 2011 Brian D. Lawenda, M.D.
Most patients typically develop only minimal skin fibrosis after their radiation therapy, however for those who have a more significant degree of fibrosis I often recommend a combination of vitamin E (400 I.U. twice a day) andpentoxifylline (400 mg, three times each day).Fibrosis can develop months-to-years after radiation therapy to any region of the body, but is most common in theextremities, breasts (read more about implant contracture, below) and head and neck where higher radiation doses are often required on or just below the skin surface.
How does this treatment work?
It is not entirely clear how these molecules work to reduce fibrosis.
Vitamin E may act as a antioxidant, helping to prevent ongoing free radical damage to the radiated tissues.
Pentoxifylline may be involved in blocking the molecular signaling pathway that is responsible for the development of fibrosis as a response to inflammation and injury. Additionally, pentoxifylline increases the flexibility and permeability of red blood cells which enables them to more easily bring oxygen to the tissues and carry carbon dioxide away. It is because of this mechanism that pentoxifylline is used in the management of peripheral artery disease, leg ulcers, strokes, high-altitude sickness, eye and ear disorders, and sickle cell disease and diabetic neuropathy.
Results of treatment:
Significant improvement in pain, tightness, muscle strength, edema and range of motion have all been reported with this treatment.
It seems that the earlier that this treatment is started after the development of fibrosis the quicker the response, however this combination therapy is still effective (approximately 60-70% reduction in fibrosis) even when started many years after radiation therapy.
Have patience:
It is important to recognize that this medication combination can take 6-48 months to achieve the best possible results. In one study, it took a median of 16 months to achieve a 68% reduction in fibrosis for those who started treatment within 6 years of completing radiation therapy and a median of 28 months for those who started treatment greater than 6 years after completing radiation therapy. Relapses were found to occur more commonly among patients who took this treatment for less than 12 months.
Duration of treatment:
- For severe skin fibrosis, I recommend that treatment continue for 3 or more years.
- For mild-to-moderate fibrosis, I recommend that treatment continue for at least 1 year.
An increasingly common issue: Breast implant contracture following radiation therapy
As more patients undergo breast reconstruction (with eithertissue transfer/rotational techniques or implant prostheses), it has become more common in oncology and plastic surgery practices to have to address breast cancer treatments in this setting.All patients with breast implants or expanders will eventually develop scar tissue (fibrosis) surrounding the prosthesis as a consequence of the body's normal immune/inflammatory response to a foreign body. This fibrotic response varies in severity among individuals, but it is estimated that up to 25% of women with breast implants undergo revision surgery (at 10 years) due to implant contracture (shrinking and or hardening of tissue surrounding the implant). Following radiation therapy, implant contracture rates are increased due to the effects of radiation fibrosis. (picture on left: This patient developed an implant contracture after radiation therapy to to her right breast and implant. The superior implant displacement and circumferential tightening are common findings.)
Although the rates or lower in women who select breast reconstruction with their own tissues (tissue transfer or rotational techniques), they are also at a higher risk of developing contracture and fibrosis of their reconstructed breast after radiation therapy to these tissues.
Vitamin E and pentoxifylline are being investigated as a prophylactic therapy to reduce the incidence and severity of implant contractures or implant loss after receiving radiation therapy to the chest wall or breast in the setting of breast cancer treatment. The results of these investigations will be important in helping us better direct our management of this condition.
Starting this treatment during radiation therapy is not recommended, as vitamin E may reduce the efficacy of radiation.
Bottom Line:
Vitamin E and pentoxifylline is a useful therapy for patients with radiation-induced fibrosis. It can reduce the signs and symptoms of this condition dramatically in the majority of those who continue taking it for at least 6-12 months (or longer in cases of severe, long-standing fibrosis.)
The use of vitamin E and pentoxifylline following radiation therapy to reduce the risk of breast implant contracture and failure is under investigation.
If you think that you might benefit from a course of vitamin E and pentoxifylline, discuss this with you radiation oncologist.
The dosing is:
- Vitamin E (I recommend you buy "mixed tocopherols", as you want to include more than just the standard "alpha tocopherol" form): 400 I.U. twice a day and
- Pentoxifylline (ask your doctor for a prescription): 400 mg, three times each day
Low-Level Laser Therapy: An Alternative Treatment for Capsular Contraction
Jason D. Johnson, DO, Paul M. Glat, MD, FACS, William L. Scarlett, DO, FACSFirst Published March 1, 2015 research-article
Abstract
Introduction:
Fibrous capsular contracture is the most frequent complication leading to patient dissatisfaction after breast augmentation and breast reconstruction. This multi-factorial phenomenon has been treated both surgically and nonsurgically with mixed results. At the present time, the more severe grades of capsular contracture are treated most successfully by surgical means.
Materials and Methods:
The LTU-904 laser was used on 33 patients with grades III and IV capsular contractures. Patients underwent laser treatments once a week for a period of 6 weeks. They received a 10-minute treatment using the 904-nm laser with a 2-cm square grid pattern with 1 minute of treatment in each area (300 mJ/1 min treatment = 1.5 J/cm2). Patients were administered a posttreatment survey to determine their level of improvement and satisfaction.
Results:
Surgical intervention was avoided in 93.9% of patients with grade III and IV capsular contraction. Of the patients who avoided surgery, the laser improved the stiffness of the breast by 10–95% (average, 43.6%) and an overall improvement in comfort ranging from 10–95% (average, 48.2%).
Conclusions:
Low-level laser therapy is a promising alternative treatment for grades III and IV capsular contracture. In most cases, both the patient and surgeon observed significant tissue softening and improved breast contour after treatment while avoiding surgical intervention.
References
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Just added another article abstract on Prepectoral Reconstruction that came out in January 2017. Progress is going on. Let me know about any other interesting research and I will add it to the links at the top of the thread.
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Hello ladies. I haven't been on these boards for quite some time. Finished my reconstruction last April with my exchange surgery and fat grafting. I'm pretty pleased with the results. Lost some of the fat so I do have some distortion when I lean forward, but I don't care enough to go back under the knife for more lipo. Ugh.
I do have a question for everyone who now has prepectoral implants. Do your implants have the same degree of softness throughout? There are 3 areas on my right breast that feel firmer than the rest of the breast. I can't tell if it is the implant, or maybe some fat necrosis.The largest area is between nickel and quarter size, and kind of feels like the TE port did. Almost like a semi-hard disc under the skin. What about capsular contracture?
Has anyone here had fat necrosis, and what did it feel like? I am hoping it is nothing worse. I am seeing my BS on Tuesday but was just curious about other's experiences.
Hoping for the best for all.
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Hi MrsGreenJeans, welcome back. I had fat necrosis. It felt like little very firm pebble to pea sized areas, although I think it has mostly gone away, can't find it anymore. I am on Pentoxifylline and Vitamin E orally and in a Compounded Prescription Cream. I take the pills and use the cream daily for the past couple of years as prevention of Capsular Contracture.
Hopefully someone else will chime in with their experiences.
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so it's 2:30am. I can't sleep. I'm crying a lot since my exchange surgery Friday. My surgery went well, except for the fact that my implants are bigger than we discussed. What the fuck happened in the OR? As soon as the TEs went in I said they were how small I wanted even without fill. My pre-op visit a week prior I expressed that the TEs were too big and he assured me the implants would be smaller, not project as far. To my knowledge they only ordered low projection implants (they come in low, medium, and full projection) of varying heights (low, medium, and full height). Even before getting wheeled in I discussed again with him that I was OK with as big as needed in the in the low projection range based on what footprint was required because he assured me that no matter how big we went in the low projection range it would not project as much as the TEs. I was only expanded to 250cc each side. How the fuck did I end up with medium projection implants that are 310cc?? They do not feel like me. I'm so sad and disappointed. I want them out. Thanks for letting me vent here. - xo
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Andraxo, I'm so sorry you're so unhappy with the results of your exchange. Sending virtual hugs your way. Please let us know what the PS says when next you meet.
It's bad enough to think about all the indignities we likely suffer while we're out like lights on the OR table, but then to get an unpleasant result is just cruel.
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I dropped in at my surgeon's office today and told them I needed to be seen. Met with him. It was as I expected...those were the size implants that fit best in the pockets. When he removed the TEs they are measured for total volume (via water displacement) and it was more than what was filled (filled 250cc, but the whole unit together displaced over 300cc). He was very upset and concerned that I was very upset and wants me to be happy. The choice is mine for what to do - which is keep them or go smaller. Going smaller poses more risk of them flipping/rotating since they will be loose in the pocket for a bit in terms of projection, not height/width though (the footprint can be the same). Likely I will be having surgery again this Friday. Once again, I am anxious to be choosing another surgery when I am otherwise happy, healthy, and fit. Am I crazy? All surgery brings risk. I know they will never look natural, and I can never get back what I lost to cancer, that's for sure. These anatomic pre-pec implants don't look much better than the expanders did, likely because I am lean. Hoping less projection and going down to 250s will help. Thankful I don't really have any pain. Doubt my insurance will cover this despite how great it has been thus far in cancer tx, and I have no idea what this type of surgery costs out of pocket.
Day 3 post-op and on 3 hours of sleep, I hiked 6 miles today up/down Atalaya peak in Santa Fe this morning - the hike up has a 2k elevation gain. It was harder than I remember, but haven't done it in over a year...since before chemo, and right after B mastectomy surgery while I still had drains in.
So thankful to have all of you out there for extra support.
- xo
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andraxo: so sorry you're in such turmoil. Wishing you peace with whatever you decide...
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Hey Andra, it sounds like you are processing a lot right now. It's good that you are taking to chance to just hike, rage, scream, grieve for what you have lost, whatever you need to do. It isn't crazy to want whatever you need to feel good in your skin, or as good as possible. It's your meat suit, you have to live in it! Sadly, I doubt any of us will ever look as we did before. It sucks. You'd think by now they could just 3d print out whatever shape implant we want and graft it on. Anyway, do what you need to do, and dont ever feel bad about venting here! We get it. Also, have you made it to Missoula yet? We just got 6 inches of powder!
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Thank for the support everyone! I feel much better after talking with the surgeon and having a good meal. Going to bed early.
Jen - It was hard today to be kind to myself. I worry that people with think I'm crazy for swapping what to me seem like big Bs for big As. With all the shit going on in the US right now, and the world for that matter, I think I shouldn't be concerned about my breast size....as if I'm being vain even though I want breasts that aren't noticed by anyone. You're so right though in that I have to wear these and this body - live in it hopefully for a very long time. I need to be comfortable and feel like me. I'd rather be flat than bigger than I was before cancer.
They make custom implants for pecs and calves for men (to give the illusion of more muscle). Really they can customize anything, but they are more solid, not soft like women's breast implants are. I'd bet it will happen for breasts in the future.
Was in Missoula for President's weekend - so much rain! Should have been snow, but it was too warm. Loved it there regardless - wish I had more days to explore, but we were really there to help and support a friend. I got in one day of boarding at Discovery. Supposed to be getting 12-18 inches in the next 24 hours here, but I can't board or run or lift weights for 2 weeks (really 3 if I get surgery again Friday).
- xo
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Andraxo, don't ever worry about other people thinking you are crazy for going after the size you want. You are the one who has been though this cancer hell. It will be easier to move on past this if you are at least somewhat comfortable with how you new foobs look and feel.
I wish you the best and hope you next surgery goes well.
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Hi Andraxo. I am sorry you got the wrong size. I don't think you are wrong or vain at all. It's essential you feel as close to normal as you can get. Don't give in about getting want you need. If you need smaller, then that's what you should have. It's similar to when I had my my TE exchange to my implant. When I woke up I knew it was wrong, wouldn't match the other side close enough. I tried to live with it, but it just was too off from what I wanted, what would look right. I had flak from my husband about having another surgery, but I couldn't stand how it looked. Made me cry, to have gone through so much, and to still be so messed up looking. The insurance paid again. I really hope your insurance pays for you.
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Hey Andra- How are you doing today?
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macb04, was going over some old posts and realized I had never answered your question about my Vitamin C infusions. At full strength I'm getting 100 grams (and it's very burn-y!) So prior to my next two surgeries I'll get 50 grams around a week before surgery and then 100 grams ASAP after surgery (likely 2-3 days.)
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you are all so awesome!!
Feeling so much better now that I have a plan. Had enough peace of mind (after talking to my surgeon) to get two good nights of sleep in a row, which helped me so much. Insomnia makes me very emotional! Found out this morning that my insurance approved another surgery. I meet with the surgeon again tomorrow morning. Hoping I'll be on the schedule for Friday. My implant volumes are 310cc Left, and 280cc R and they are different heights by more than a cm, though look pretty similar except one side still have a little ripple. Hoping to drop to the 250cc size in both and the same size and footprint (full height, low projection). Going to ask him to start on the non-radiated side since my radiated side is still very beat up from last week's surgery. If he really can't make the pocket/envelope small enough that the implant would be stable and not be high risk to rotate/flip, then I will accept it and embrace my new bigger size. I'm worried about more surgery on the radiated side because the skin is thinner and more fragile. You can see both implants pretty clearly on the top edge as well as the side because of my build. I don't mind that, I'm just so happy they are above my pecs!!
I am thankful for my surgeon. He said all the right things in terms of caring and compassion and that means a lot to me. He also has mad skills, so I am hopeful!
Ultimately, I think I was expanded too much for the size I wanted to be (a nurse did the fills), but it was hard to tell given that I was only filled 250 each side. I know this is not an exact science. Dropping 50-60cc in a larger breast (say going from 500 to 450) isn't too concerning, but when you're dealing with a small breast dropping that amt it's a bigger % of volume. Hope it can be done.
Snowshoed 6 miles today above 10k elevation while my fiance skied. Was tough, but I needed it. So glad I am allowed to walk, hike, and snowshoe since I can't run, lift weights, snowboard, or bike ride. ...for another 2 weeks if I have surgery again.
- xo
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Andraxo: I just want to say that I totally get where you're coming from. There isn't anything wrong with wanting to be comfortable and happy with your reconstruction outcome. We only get one precious body in which to live on this earth.
I don't post here often but am thinking of you all today because a couple weeks ago I had revision for capsular contracture on a single MX. I have an above the muscle silicone implant. I'm not sure how I'm feeling about it the revision. It's still very big compared to my real breast. I just spend 6 months with capsular contracture that made my implant feel HUGE so I'm disappointed. Maybe it's swelling, as surgeon says, but it doesn't feel like it. Anyway, Andraxo, this is why I'm responding. I feel strongly that we can and should do the best we can to feel like ourselves again after BC. Kind of like when flight attendants tell you that in an emergency it's important to take care of yourself first before you help your child. If we're in a good spot we're better with others. Yes, there are many, many terrible things going on in the world. There are also many good things. I tell myself it's okay for me to want to find my own tiny spot of peace - however that looks. This reconstruction process sometimes seems more daunting than chemo (although maybe I've forgotten just how bad that was). I may have said this before but I don't think surgeons make it clear upfront that lots of people do lots of surgeries to get to their final endpoint.
Anyway, I'm wondering about sizing with over the pec implants. I have a really small implant - low profile 140 cc - and as I said it seems like it belongs on someone else. It's obviously small but it appears so large. I'm wondering if it's the position that makes it appear that way. I'm a small-framed person and maybe the over the pec position isn't great? If this doesn't work out I may see somebody about a traditional under the muscle implant. I know it's too early to be really frustrated . Thank you for letting me vent here and not feel guilty about it.
Anyway, Andraxo, good luck with your surgery. So nice to hear your surgeon is accommodating and willing to move so quickly. Here's to the bigg(ish) A cups. I want that too!
Mrs Green Jeans: my capsular contracture was very pronounced around the entire implant - so the whole implant was really hard and more projected. Not sure what to think about it being in just certain areas of the breast. There are varying grades of contracture so maybe that's possible. Best wishes to you.
Happy rest of the week, everyone. Love.
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Andraxo: so glad to hear things are working out for you!
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Andraxo,
Good luck with your revision getting the breast pocket to fit does seem to be the challenge. I am small framed and the first implant was 350cc and was very high and large, second time around 225cc was placed and the size was perfect, but the incision area did not fill out but the surgeon just switched out the implants. Reconstruction is not the simple matter so often there are so many details we are not made aware of and so many details we just don't know to ask. I know what you mean by the differential in % of volume and I hope your surgeon can make it work for you.
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Thanks Willa216! And...I find this is the best place to vent. People here understand, that's for sure. Don't feel guilty about venting!
Thanks Kmahalick and PugsMama
My surgery will be Wednesday next week. It was supposed to be yesterday but the implants did not arrive in time. If he keeps the same footprint, and sizes down from medium to low projection, I'll lose approx 1 cm in projection (it's not much), which is enough that I think I'd be happy. Wish he could size down the footprint too, but I don't see how I could drop that much and have the implant be stable. Likely I'll still be a little bigger than I was pre-mastectomy, but acceptable. Remembering that even deciding on reconstruction was an extremely hard decision. Felt weird to CHOOSE surgery because of worry about complications when I felt so great. I must say though that is it nice to heave breasts again, even if they aren't natural.... and not the right size yet. Super happy I have pre-pec implants - they are comfortable when I use my arms.
My house was broken into a couple of days ago. It is 4.5 hours from where I get my cancer care and surgery, so I wasn't there when it happened or to deal with it. Thankfully my coworkers/neighbors met with security and the police, took videos and pics for me, cleaned up the broken glass etc, and secured a few valuables that weren't stolen. My coworkers/neighbors are awesome! Driving there tomorrow to assess the damage, then driving back for surgery again. Funny that I'm not as bothered by it now as I would have been before cancer....cancer has certainly made many things so much less significant.
Hiked another 6 miles in the snow, above 10k elevation today. Such a beautiful day!!
- xo
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Hi raven4mi. That is a high dose of Vitamin C, that should help keep you safe. FINGERS CROSSED! I never had higher than 65 grams of IV Vitamin C. I wish more women knew about how effective High dose Intravenous Vitamin C is in preventing/treating infections . I talk about it on the boards, but people don't respond or acknowledge what I have said about it, or the numerous Research articles I put up. Considering how many women suffer awful infections despite full use of antibiotics, seems like they would be willing to try something different to help keep them safe. I had a large number of surgeries, and was on IV Vancomycin during most of those surgeries. I never had a infection when I got IV Vitamin C the day after surgery, but got 2 severe infections, even with the antibiotics, on the 2 occasions when I couldn't afford to get the Intravenous Vitamin C. Isn't that sad? My insurance will pay for useless (for me) antibiotics, but wouldn't pay for something as basic as IV Vitamin C. For one of the infections I had 300cc of pus taken off my chest. (Yes, thats about a 1 1/2 Cups of pus) Caused me all sorts of problems due to adhesions. I wish there was a way to get a fund together to make things like IV Vitamin affordable to every women going through this, who wants it. No one should have adhesions and extra surgeries because they are too poor to afford good care.
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Amen, macb04! I will NEVER have surgery again without both pre- and post-op vitamin C infusions. I too wish other women would look into it, and I wish more "mainstream" medical personnel would acknowledge it. When I mentioned it to my PS he just kind of shrugged and gave me a "whatever makes you feel better" kind of response, like this was some kind of really wacky, avant-garde treatment I was trying or something. Ridiculous. I don't even tell anyone on my medical team about it anymore (PS, MO, OB-Gyn or ID.) It's unfortunate that it's so difficult to even find anyplace to do it. It was just a stroke of luck that I found a holistic medical facility not too far from me that had a cancellation so I could get in for the initial consultation just to get the Vitamin C. Now, however, I just have to call and pick the day/time I want and they get me right in now that I'm an established patient. As for cost, it's worth every penny not to have to be so consumed with worry about another infection and I didn't even bother trying to submit the costs to insurance. I don't get why insurance is willing to pay for the 3 days I ended up in the hospital (being treated with the WRONG antibiotic, I might add) and not something preventive. It makes zero sense. My center provides a discount if you buy the infusions in "packs" of four or more, so at least there's that.
So, luck led me to a PS who happens to be one of the forward-thinking docs doing pre-pec implants, which lead me to this thread, which lead me to you and your info on Vitamin C. That's been one of the bright spots in this whole shit storm, I've gotta say. So, hope you don't get tired of hearing it, but thank you, thank you, thank you!
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raven4mi, I am so glad I could help you. It makes the stinking mess a little more bearable to know some good for someone else came out of all my troubles. It is so true, they act as if we are crazy to bring up Intravenous Vitamin C as a way to prevent infections. I frankly don't get it. It is a well known fact that Antibiotic Resistance is increasing at an alarming rate over the entire world. I never used to see MRSA when I first started working in healthcare. Now I see people with it several times per month. I know people want to have faith in the medical establishment, but where infections and Antibiotic resistance is concerned, that is completely foolhardy.
The definition of insanity is doing the same thing over and over again, but expecting different results.
High dose Vitamin C kills infectious bacteria, even Pseudomonas, that scourge of Implant Reconstruction, and it is known in research to kill Cancer, what could possibly be not to like?
Vitamin C vs Pseudomonas Aeruginosa
Bactericidal Action of Ascorbic Acid on Pseudomonas Aeruginosa: Alteration of Cell Surface as a Possible Mechanism (Vita C as Catalyst)
Abstract
Neutralised ascorbic acid is found to exert a strong bactericidal action on Pseudomonas aeruginosa suspended in isotonic phosphate buffer at pH 7.1. Both the bactericidal and bacteriostatic action of ascorbic acid are antagonised by magnesium ions. In the absence of complex formation between magnesium and ascorbic acid it is concluded that ascorbic acid acts by competing with the magnesium binding sites in the cell wall, cell membrane or ribosomes. Using the chequer-board titration method the synergistic action of ascorbic acid and erythromycin is determined; such a potentiation of erythromycin is also adversely affected by magnesium ions. P. aeruginosa cells, washed and suspended in isotonic phosphate buffer containing ascorbic acid, became increasingly susceptible to the action of polymyxin, erythromycin, chloramphenicol, neomycin and tetracycline. It is suggested that ascorbic acid alters the cell surface to render it increasingly permeable to these antibiotics.
© 1978 S. Karger AG, Basel
http://www.karger.com/Article/PDF/237777
http://www.ncbi.nlm.nih.gov/pubmed/207492Synergic interaction between ascorbic acid and antibiotics against Pseudomonas aeruginosa
Luciana CursinoI, II; Edmar Chartone-SouzaI; Andréa Maria Amaral
NascimentoI, *
IDepartamento de Biologia Geral; Universidade Federal de Minas Gerais;
Avenida Antônio Carlos, 6627; 31270-901; Belo Horizonte - MG - Brazil
IIDepartamento de Genética ESALQ/USP; Av. Pádua Dias, 11; 1340-097;
Piracicaba - SP - BrazilAbstract
Studies were carried out on in vitro combination of ascorbic acid (AA)
with six antibiotics against 12 multi-resistant Pseudomonas aeruginosa
isolates. Synergic activity was detected with AA chloramphenicol,
kanamycin, streptomycin and tetracycline. Indifference was observed to
any antibiotics and antagonism only for chloramphenicol. Results
indicated that multiresistant P. aeruginosa was affected by combination
of AA and antibiotics. Future research on ascorbic acid-antimicrobial
interactions may find new methods to control strains of multiresistant
P. aeruginosa.
Key words: Ascorbic acid, antibiotic, synergy, Pseudomonas aeruginosa
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-0 -
Dang - wish I had remembered to ask about Vit C this round. I'm on Abx again for another 2 weeks. Bleh.
Surgery was this morning. The swelling had gone down significantly in the past few days from the previous TE>implant exchange so they didn't look as big and I almost debated cancelling to avoid the risk of yet another surgery. They also didn't feel as big since I went for a 5 mile run before surgery (more of a shuffle since it was 2 days earlier than allowed). Oddly the right looked significantly bigger and more bulbous, especially in clothes, despite being only 285cc, while the left (radiated side) is 310cc but a different shape (taller). The right definitely projected more, but part of that has to do with the skin and subcutaneous tissue being much thicker since it didn't get radiation. Anyway...I had a detailed discussion with surgeon during pre-op and we both agreed that if changing the right to a taller but less projection implant matched the left better, then he wouldn't touch the left. We were both concerned about more trauma to the radiated skin - it is thinner and more fragile compared to non-radiated tissue and always will be. I was very clear that while I'd prefer even smaller breasts/implants across the board, I didn't want to risk losing my skin and ultimately the breast and/or nipple.
Soooo... that is what happened. My pre-pec implants are now 250cc right with 3.4cm projection and still 310cc left with 4.4 cm projection and both have the same footprint (height/width), but they look much more even since the right has better/thicker skin. The right will likely appear to have a tiny bit less projection than the left in the end when all the swelling is down etc, but that's how my breasts were pre-mastectomy. The right also has some ripples. And while I'm only about 4 hours post-op, it doesn't even feel like I had surgery today aside from the 5 (yes FIVE) failed attempts at getting my IV going (it ultimately ended up in my foot!).
I think I can be happy with these implants - I will embrace them.
Likely still need some fat grafting later though.Just want to say thanks to all of you for your support! This is my safe space to share and voice concerns and talk things out. You are what makes all of this *stuff* easier.
- xo
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Andraxo: Great news! So happy for you!!
My TEs are starting to lose air & of course my PS will not do any fills until I'm done with chemo! I may be back to post-surgery teenage puberty foobs by then! Lol. In the middle of May, he's going to swap the air for saline since I'm going on a cruise on May 21 (the light at the end of my chemo tunnel) & I'll live with that until I'm ready for the exchange
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PugsMama - my TEs lost air too. I didn't starts fills until 2 months after placement and they were pretty much fully deflated by then. I liked them when they had a little air though - they were As, like I wanted to be. Deflated they were a little too small, even for me! I'm now Bs. I hope your chemo is going well. Chemo sucks, but hoping your side effects are mild and you keep your energy up.
- xo
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Thanks Andraxo: I lose my energy for the most part until day 9, other than that I'm doing OK with the SEs...halfway done today! Maybe I'll bounce back more quickly this round since I won't have the stress this timeof not knowing what to expect...xo
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Hi ladies, just checking in as I count down the days to exchange. Pugsmama, glad that you are powering through chemo. Andra, glad you are happier with your foobs now! Please do keep posting about your recovery- i will be following you next week and interested in what to expect! How soon after exchange can you start running again? What about less impact excercise like hiking or stairmaster or xc skiing? How about lifting and core work? Oh, so many questions! Ladies who do IV vit c- do you think oral vit c would help at all, for those us who cant afford the IV stuff? What othet supplements do yoh take pre and post surgery? Oh so many questions! Xoxoxo
Jen
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I'm trying to remember to who and what I wanted to comment on....
reneeCA - I have pre-pec teardrops. I have had them for basically 7 months. I consider myself done and normal at this point. I do everything with the exception of sleeping or laying on my stomach (although I will do a little bit on my stomach such as yoga). To me they look incredibly natural except for a few minor things that only I or my hubby see (such as the scar and some edges that couldn't be completely hidden under my thin skin).
Hi Shoregirl, Elaborating on what I said above - I think that my results are specific to my body and won't be the result all have, but you mentioned a couple of things that sounded similar to me. I had fat harvesting twice. Once at exchange time and once more 3 months later. You mention not a lot of fat for yourself and that's definitely an issue. I really didn't have enough and what my PS harvested the first time was from my butt. I now have an old lady flat butt - not that it was perky and cute before but it certainly wasn't this flat. The second time she searched around my butt and inner thighs but didn't get enough to make the difference we hoped for. The difference we were aiming for was to fill in the minor rippling I had and to pad the upper edges of the implant better. So, yes, I have rippling despite having the teardrop gummies that minimize this issue. I also have alloderm completely covering my implants which she told me today was to help give me a sling to hold the implant, and an extra layer of padding. If I don't slouch the rippling is not noticeable but if I'm bending over or in some way letting gravity pull down on my chest the rippling is noticeable. We talked today about future options to deal with the rippling and lack of padding (the edges of implant are a little noticeable). She mentioned, of course, fat harvesting but only if I gained weight and fat, or when the time comes for new implants, using a second layer of alloderm to create more padding. I will worry about that later -- hopefully much much later!
At the end of the day, I would whole-heartedly recommend above the muscle. All of it was EZ, surgery, and recovery. Someone mentioned post-op pain being minimized. FOR SURE! After exchange the only pain I had was briefly at the incision site. One dose of pain meds and I was fine. No muscle spasms or anything else.
I am small chested and have small implants. I do wear a non-compression sports bra when active. They bounce around some but not badly and with no issues.
I don't mind the rippling I have, or the slight unevenness (naturally one side a little lower and PS couldn't adjust this perfectly), or the edges that kind of show through my thin skin. I truly feel like this chest is "really" mine. It's just part of me. I love the look of the teardrops. I'm about the same age as you (Shoregirl) and the sloping nature of this style seems to fit our age (I do get the impression there is a "right" person/body shape for teardrops based on what I've read here).
I have a couple of underwire bras I wear that push up slightly on my implants. This hides any rippling and edges and gives me a really nice (albeit small) cleavage.
So, although I shared my "issues" I've had enough time to realize I'm very lucky and that my look is really quite good considering my own personal situation. Now I'm just hopeful things continue as they are with no problems and let me get on with life!
Go pre-pec!
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