TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!
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candles can i ask a question? how does rippling look like? im curious? maybe google has a pic
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kae you can google rippling and see lots of pictures. Mine is visible on one side, but only when I'm in certain positions. I could leave it but I'd like to at least try to correct it.
If my skin were thicker, it probably wouldn't be as visible. Also, even tho I "only" had DCIS, I'd had many procedures on both sides over the past decade (biopsies and lumpectomies) so I didn't have a lot of cushioning tissue left to try to avoid a mastectomy. So, I'd say my skin is not terribly thin, but certainly not terribly thick either.
I did bruise, but it all went away. I had 4 drains in for 8 (?) days, but probably could've had them removed after just a couple days. The output was never that much and it didn't occur to me to ask to have them out sooner.
Overall, the surgery really couldn't have been easier. If you qualify, I'd recommend it. I also must say I have "twins" that match pretty well. But for the scars, you wouldn't know. The downside is, it is not clear to me how chest wall recurrence is monitored after all this. A recurrence on the chest wall would not be felt by manual exam since it's under the implant. And, nobody seems to think annual MRI is indicated, even though my DCIS extended to close to the chest wall. MRI would be the only method of detection as far as I can tell.
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Hi Carla, I have 494c Mentor Anatomic Silicon Implant. I was at also 600cc with the TE, which wasn't hugely bigger than my R breast. Unfortunately, my PS was using some crazy computer program to estimate what size implant to put in. He initially gave me a 420 Anatomic Implant. It was way, way too small. I knew it was wrong the minute I woke up from surgery. I tried to live with it, but I hated it, so went under the knife again and increased size, and projection, from moderate to high profile. It's better, but still a little smaller than I would like. Because he gave me the too small implants and cut off extra skin, there is no way to get a larger size unless I want to go through another 6 months of tissue expansion to make more skin. I had 5 episodes of fat grafting before I tried the implants. It didn’t work out, for the most part because the PS I had then was not very experienced with the technique, and then I had 2 severe infections. Even with all that, my implant is completely covered and I have no edges or rippling, in part because of my grafted fat.
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please add my surgeon as one that does pre pectoral implants in rochester, NY (western ny, not NYC) Dr. Andrew Smith.
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I am scheduled for revision with fat grafting this Thursday. My bmx followed by pre pectoral direct to implant was in January. I noticed after my shower this pm that I have something that feels like a BB beneath the skin or in the skin of my left breast. This is the side that I had rads on 10 yrs ago.
Has anyone had this issue? Maybe it's fat necrosis though I have not had any FG yet? The skin on his side is very thin and tight. There is no redness or pain- of course it's all numb.
I am so scared of infection and complications.
Any input would be appreciated.
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Alli, I'm sorry I do not have any experience with this. Sending you hugs and don't let yourself get too worked up. Call your dr in the morning.
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Alli, keep us posted! It.could.very well be fat necrosis- but yes, do call your MO for peace of.mind.
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Hey, all. Have been following along on posts. Glad everyone is doing well and finding the information they need. Alli, I'm with 2FUN and littleblueflowers - contact your docs; hopefully they can give you some peace of mind.
I am now just over five weeks post-op from having right TE replaced pre-pecotorally. Had a potential infection scare a couple of weeks ago but multiple cultures have come back negative. I'm on abx from the PS just as a precaution and have been in for one IV Vitamin C. Also taking liposomal vitamin C (which is disgusting, btw - I have liquid drops) just to be on the safe side.
Edit: Not sure what happened, but half my post disappeared. Oh well. Take care, all!
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I read here to keep up with the thread, but I don't post often. I had my exchange surg on .Friday to take out the rt. TE and put in the implant over the muscle. My lt side was done the under the muscle (cancer 9 years ago.) That implant was redone last May with the implant going under the muscle. So one over, one under for me! When I told you guys about this in the winter, I was saying how could he possibly get symmetry with one under and one over. He used 450s. Well, he did it!! the exchange was a breeze. No pain meds needed at home. I still have the drain til Thursday, but I went back to work today (I teach). I'm being super careful. I got a first good look on Sunday when we took off the surg bra(the worst part). The rt side looks awesome. I am so pleased with how well he was able to get symmetry on both sides. All in all, it's been a tough year since I did the proph rt mast last May and then had an inf last summer. I had to start all over again with the TE removal, then reinsertion, then this final exchange.
I am very active at the gym, so I am looking forward to easy workouts with these implants.
Raven has been my biggest cheerleader, and I am thankful for all here who gave me hope!
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misty, SO GLAD to hear your good news! I'm looking forward to my TE removal, but I'll be waiting a few months for that. I have a growth on my thyroid that needs to be biopsies next monday, and a CT scan to rule out any lung problem they saw on last CT scan. Probably should have colonoscopy given my luck.
I'm working hard on eating well, still having a hard time with exercise due to AI.
sending good healing thoughts to all!
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Hi 2FUN, just added on your PS to the list. Hi Alli, sorry you having that scare. My money is on fat necrosis.
Raven4mi, cool that your recovery is going so well. I bet your IV Vitamin C is a big help for preventing infections. Out of all the surgeries I had, I only got infections when I did not get the Intravenous High Dose Vitamin C.
Hey Misty, I know of a women in England who one over and one under like you. Your PS sounds like a miracle worker to achieve such great symmetry. CONGRATS!
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Congrats Misty! Hope this is truly your final and you can relax and get back to your routine with more ease. I have to say, I only think about my guys (not sure why I refer to them as guys instead of gals) when I'm doing some extreme yoga move and am impressed at how easy it all is.
2Fun, hope things get better quickly for you. Everyone seems to be so different and getting back to normal is so varied. Sometimes I know I felt a little defeated reading about some who bounced back so much more quickly, but sooner or later we all catch up!
Good luck Alli! Hope you get good news on your BB spot. Probably unrelated, but I have a ridge of scar tissue on my right implant. It's actually noticeable (if you know to look) and one spot is even a little poked out. Hate it, really, but PS says it's ok. She said it's probably the alloderm she used. Hope yours is as equally benign.
kae_md and Carla, just commenting on the rippling. I have it, gosh, all around unfortunately. If I have good posture or wear a push up bra it's minimized greatly. I noticed yesterday that when I use my pec muscles I can see some rippling - similar to what I'm guessing sub-pec women might experience with animation, but I'm sure much less. It just is what it is. My PS categorized my rippling as, "moderate". The ripples look like dimples when they are visible and mine are around the edge of the implants. My PS recommended that in the future when I need a revision that a second layer of alloderm might be a helpful solution to add more of a layer between skin and implant. Until then I'm accepting the rippling.
I can wear a bikini top or other low-ish top and it looks fine with a bra or if I'm not slouching.
Carla, did you notice that I said I had changes where my fat was harvested? The biggest change for me was the flattening of my butt. I can also tell it is harder to sit for long periods as in general I lost padding there. Wish it as least looked pretty but that ship has sailed. I think I recall that in my first surgery she might have used about 200cc like you mentioned. She didn't get that much the second time. Think it varies so much with the individual and where we carry our fat reserves.
Good luck everyone!
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Thanks JessieJake and MacB! Your experiences give me much food for thought. I am absolutely on board for trading in the 410's, but not so much for going prepectoral and doing the fat grafting, aside from filling in a small divot in the left upper pole that resulted from too vigorous scraping during the BMX. I definitely will need to have a long talk with my PS during the next appt.
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Alli - I had my exchange in October and felt 2 BB-sized lumps right under the skin a couple of days later. Turned out one was fat necrosis (I did not have fat grafting done during the exchange) and the other was a surgical clip. Get an ultrasound for sure, but hope my experience helps to ease the anxiety
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Hi grandma3X. Do you have Prepectoral Implants? If so, do you want me to add your PS to my list?
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macb04 - I don't have the prepectoral implants - my PS was worried that they have not been in use long enough to know what might happen down the road, and I worry about recurrence, so we went with under the muscle implants. I just wanted to reply to Alli's comment about the lump, since I went through a similar experience.
Wishing you all the best.
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Well..... By the time I saw my PS which was actually in preop holding, I could hardly find the "BB". So obviously she was not worried about it. Im not sure how quickly fat necrosis comes and goes but hopefully thats what it was/is. Fingers crossed.
I underwent FG on Thursday. She injected fat all around the implant on the rads side and both upper poles. So far so good. The pain at the donor site- my abdomen is manageable. I am sore but am so happy that it is nowhere near the pain of BMX and I can use my arms just fine and no drains!
The biggest problem for me is the compression wrap and the coastal NC heat. I have ordered a compression garment and hoping it will be more comfortable and cooler.
I am so hoping the majority of the fat survives. It already feels more cushiony between my thin skin and pre pec implant. The PS also used an instrument called a pickle fork to break up some of the scar tissue from my previous lumpectomy scar and rads. It feels less tight already.
Hope all you lovely ladies have a great week!
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Alli, glad things are looking up for you!
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question....can I cause damage to my pre pectoral TE, or when I get my implant?
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2Fun-thanks so much. Good luck on your upcoming tests. Hoping you get good news!
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thanks, all of us here know the importance of good news!
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That's good news, Alli!
I had FG 6 weeks ago and will see the PS tomorrow to discuss a second procedure. I've already decided to wait until fall for the same reason you mentioned - can't imagine wearing compression garments in the summer!0 -
Hi Alli. Glad to hear your FG went well. Hopefully most of it will stick around. I will cross my fingers for you. I didn't love the compression, but I graduated to a lighter weight Spanx type garment and the it was doable, although thrre isn’t much of an issue with heat in the Pacific Northwest.
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I'm just making the jump to BMX next week and the PS will be doing pre-pec implants (or TE's if he thinks it will be better for healing). He's been doing them (pre-pec) pretty much exclusively for about 3 years. He says there's less drainage so the drains don't have to stay in as long - which reduces the risk of infection.
Thanks for creating this topic and for all of the great comments!
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good luck not very brave. You are brave, and don't forget that!
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Notverybrave I am definitely glad I went the pre pec route. Hopefully you can go direct to implant. Sounds like you have an experienced surgeon. Keep us posted
Macb04. How long until you can tell if the fat will stay? I really wasn't given many restrictions but am afraid that maybe I have been doing a little too much activity because I feel good. Hope that doesn't affect fat graft retention. Any thoughts or advice to maximize fat retention?
Thanks
Alli
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Hi Alli, Hope you don't mind if I comment on my fat grafting experience. I think it was slightly different than what I expected based on reading here and possibly also hearing from my PS. The first time a decent amount was harvested and transferred, but since it was at the time of exchange I don't know how much of the fullness I saw was swelling vs. the transferred fat. Oh, did I love the look at first though! Over time, I think a month, as that is when I had my follow up with the PS, I could tell that the fullness disappeared, and slowly but surely, the ripples began to appear and I could appreciate the edges of the implants to some degree as being visible. I never had hard areas of fat that didn't take which I heard from others. I actually thought initially the fat just didn't take as that fullness so obviously went down, but when I followed up with my PS she was quite adamant that indeed a lot did stay or else the implant edges would be REALLY visible through my skin. I had that first procedure on 9/7. Almost exactly 3 months later I had a 2nd round of fat grafting and the rippling had continued to get more visible over those 2 months leading up to the second procedure. She didn't really get much to mask those spots that time. Same result, I never had hard spots or obvious areas where the fat didn't take; I just didn't have much. I asked her about these fat cells replicating at my last appointment. I think I've learned fat cells really don't replicate like other cells, but they can plump up and shrink down. So, if I gain weight she said those cells should plump up and I'd get more fullness. Yeah, if I could control where and which fat cells would do the plumping I'd give it my best shot.
Now I'm almost 5 months out from the last try at fat grafting and I feel I've stabilized and haven't noticed any changes in quite some time.
Also, the second time I was oh so careful to not wear anything that pressed on the areas where I thought there was fat grafted. I think after a few months my PS's assistant said not to worry about that anymore. They never told me to do that but it seemed like a good idea. So, I wore looser comfort bras or bras that were low cut to leave the top and inner edges open (figured that was the area I wanted to look the best).
After my fat grafting only procedure my restrictions were only to protect the areas where fat was harvested. That was annoying! Lots of walking encouraged but keep the heart rate low so as not get crazy blood flow through the area as I recall. Nothing due to where the fat was transferred expect the little bandages they used to cover the puncture spots for a few days. I walked - a lot! As you are saying, I felt basically normal except for the discomfort I had in the harvested area. My restrictions were for 4 weeks which I think they increased to 5 at my 4 week follow up (I think they always planned to say 5, but they say 4 initially just to make you feel better). I cheated that last time and didn't follow the restrictions for week 5. I can't say it made a difference either way.
Did you ever mention where they harvested your fat from?
Hope that's helpful info and you are still doing well!
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Oh, Alli, I just read your post about the fat grafting. LOL, I can relate to your heat comment. That last week that I skipped following the restrictions I was in Florida! Ok, it was not the middle of summer, but warm enough to wear shorts most days. I had my harvesting from my inner thighs and so I was wearing compression type things that went to my knees! While I didn't follow the part of keeping my heart rate down I did wear the compression for a long time - longer than the 5 weeks; although I did slowly wean off of it.
Part of my vacation was shopping for stupid compression that went to my knees - harder to find than you might think. Most goes to middle thigh or you have to get full length. Plus, you can't get these things without the stomach compression so my whole bottom half was compressed! I had difficulty finding things that were tight enough on my thighs so I doubled up to create better compression for a while, too. Good thing I tend to run cold. It seemed like quite an ordeal at the time
Hope you are cool and comfy by now.
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NotVeryBrave, I hate to burst your bubble, but having pre-pec implants does not necessarily preclude a lot of drainage. I had drains 7 weeks with my initial BMX and after TE reinsertion in March had them 4 weeks, and they only came out because I basically lied to my PS about the output – I couldn't stand them one more minute. It seems I am the exception rather than the rule, though, so don't want to scare you or anything – but just wanted to let you know so that you're prepared if that happens to you. You may be lucky and have a PS who isn't such a hard-ass about the drains like mine. Fingers crossed for you and good luck next week.
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A while back on the thread there were questions about followup and the fact that the chest wall is not up against the skin and its behind the implant so could a recurrence be missed...
My BS was not concerned. She explained that she took the fascia off the muscle and that's a really good barrier or demarcation. Ie. there's no breast tissue left there. Unlike at the skin side where it's very hard to tell what's breast tissue and what's fat or skin, so it's hard to know how thin to go. Not sure if I'm doing a good job explaining... So even though I only had a 1mm margin at the chest wall it's unlikely there would be a chest wall recurrence. Even with the implant on top.
Fingers crossed of course. I hope I can get insurance to do a MRI at least periodically.
😀
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