TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!
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HI Raven, I would love to use essential oils. What does the cinnamon oil do? Thanks!
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macb0r4. 25 pounds!!! You are a beast! I was trying to demo exercises with a 5 pound ball today and I thought my TE was going to pop off!
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Well not back up to 25 yet, but 15 is on the way to 25. Made me laugh. Just keep pushing yourself, and you too can be a beast. Ha, Ha!
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How are you all doing? The thread has gone quiet.
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Hi, macb. It has been quiet! As for me, it was lovely just to get away from it all in my head for a while over the long Memorial Day week-end.
littleblueflowers, macb has some links in the pinned post at the top of the thread regarding essential oils. Cinnamon, oregano (both of which I'm using, one topically, one orally) have anti-bacterial properties, along with thyme and one other that I can't remember off the top of my head. If you decide to try them find someone knowledgeable to help you with dosing and usage as they are intensely strong. My niece helped me with the doTERRA brand which also came highly recommended by other friends.
Nothing new to report. Don't see any docs until next week again. Boob still red (which is an improvement from purple, so hey, I'll take it.)
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my DS had to do his last hike for his last Eagle scout badge. A 20 mile hike, and his friends had to work, so I walked about 8 miles, and DH biked the rest. That was Saturday, and I'm still tired, but was good to be pushed. Graduation is Sunday, then 3 weeks till the end of school. Then 3 weeks till my exchange. It's all a blurr!
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Hey Raven4mi, sorry the Red Boob Saga, a show that is long past it's run, continues.
Omg 2Fun, heck of a walk. WOW!
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After 6 months of shoulder pain, pectoral pain and lack of functionality, I have decided to go pre-pec with my implants.
I found an LA doctor who has done 5 direct-to-implants on top of the muscle. He hasn't done a swap but he has loads of experience tacking back down pectorals as he is also a microvascular surgeon and likes to hold the space before flap surgeries by using small TE under pec util the patient recovers from MX. So far, he has the most experience of anyone I've met with in LA. I've decided it's him or going to San Francisco with Dr. Karen Horton.
I have a few technical questions to ask if you did a swap from under to over muscle:
1. Did your surgeon remove the alloderm?
2. Was your capsule removed completely or partially?
3. Did you have sutures put in at the side of pre-pec implants to keep them from migrating toward the armpits?
4. Did you have drains?
5. Did you have any fat grafting at time of swap?
I'm not concerned as much with aesthetics as I am with regaining my life. I am over 6 months out and can barely drive a car or pull my pants up. Not fun.
Thanks, Renee
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Hi Renee, I guess I can tell you my story and answer as many questions as possible from my experience. I had a left uni mx, and had a TE placed sub pectorally(under my pec) at the same time. I had that done with the intention to have a DIEP later. I was fully blown up with weekly fills, but was horribly uncomfortable. I had zero strength, couldn’t open a bag of chips. After "treatment " I heard about Fat Grafting with Brava and decided to do that instead. I had Fat Grafting once, and then the PS I had at that time decided the TE had to come out in order to do any future Fat Grafting. He took out the TE, removed as much of the Alloderm as he could. He did not stitch down my Pectoral, just took out the TE and let it just heal naturally after putting it back in the correct position. I then had a few more Fat Grafting procedures with him, got 2 bad infections and poor retention of fat. Some stayed, went from a crater to an A Cup. Just not enough sucess to rebuild a breast successfully with just my fat (the PS didn't really know how to do Fat Grafting very well). I found a new PS and I talked him into putting another TE in, this time OVER my Pectoral muscle. He did, and the later the Anatomic Mentor Implant.
My Pectoral recovered to about 95 % of my former strength and flexibility. Some of my lost flexibility is the result of residual rads fibrosis. I think there is some sutures put in along with a Seri Silk Mesh sling wrapped around my implant. I haven’t had any further Fat Grafting since about 9 months before I had the 2nd TE placed over my Pectoral. I have no animation defect, implant edges can not be seen and I have a normal looking cleavage. It is not a perfect match naked, although in a bra it is really close.
I had 1 drain with the 2nd TE, and none with the Implant swap, although I did have a seroma, and in retrospect wonder if I should have had a drain, although I might then have had more risks of an infection. So maybe the drain wouldn't have been great either. I had a scare, but got high dose Intravenous Vitamin C a couple of times and the extra fluid buildup stopped after being drained off once.
Others here can chime in with their experiences. Good luck and keep up posted on how you are doing. I will say that I recovered from the surgery quickly and was up walking around the next day.
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reneeCA, I have a really long story that ends in I have had a pre-pec TE on the left for over a year, and I currently have a replacement pre-pec TE on the right, trying to get to exchange surgery eventually. I have alloderm on both sides with both TEs. I have no side sutures. I had drains for a looooong time subsequent to every surgery. I had extensive fat grafting done on the right side to try to repair damage from an infection but my PS will not do any at the time of exchange. He said that may come later for aesthetics but I've had so many surgeries by now I doubt I'll ever do it.
I went to see PS again today. He thought the breast looked a little better this time. He did a 50 cc fill of saline. Since we're in wait-and-see mode for this redness we figured we'd try a little fill just to see what happens. I have 8 days left on my current course of abx and I go back to see the ID on Wednesday.
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Hi Raven, glad that things seem to be slowly, but surely looking up.
Renee, hopefully some others will chime in too and let you know about their experiences.
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Thx, macb and raven
Macb, that is interesting about Seri Mesh. Do you know why they used that instead of ADM? I got red breast syndrome from Alloderm so I want it out of my body but have heard it's a good idea to wrap the implant first. I had not heard of Seri Mesh.
I, too, am going to get the Mentor Anatomical as the Allergan Natrelles are the ones linked to lymphoma. I am even considering the smooth round but not sure they will look as good.
Anyone have round over the top and like them?
raven, did you have your pecs sew back down?
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I will be having smooth round pre pectoral implant. My PS feels like that will give me a better match to what my native lifted breast will look like. He is a very detailed person, so I am trusting. My TE side looks pretty good now, and if this is what I had to liv e with I would be happy.
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Renee, I don't know why Seri versus Alloderm, which I had initially. I never asked, although I was not happy with the idea of cadaver tissue, which is Alloderm, so I was happy to have Seri Silk instead. I had heard of Red Breast syndrom with Alloderm. A few months ago, a woman PM'd me and wrote about having problems with Seri, so I would say that means anything can be fine, or allergenic, depending on the person. I do think that, strangely enough, all the incisions on my left side that had rads damage, healed with less scaring, compared to my non rad skin ( breast lift and a terrible, nearly useless port) I think that means that there is some degree of immune decrease in that area after rads, and that may explain why I did not have more hypertrophic scars. It's all speculation at this point, but I am good at my job because I notice patterns, so I also notice patterns for myself, good and bad, as well.
That's good 2Fun that you are all set to go ahead. Do you have a date yet? Will you be getting Fat Grafting?
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reneeCA, I never had sub-pectoral implants. I only had pre-pectoral from the beginning.
I went to see the ID today. He said he knows that on a previous visit he had said that I had a better than average chance that I'd have an unsuccessful outcome but now, since I'm not "clinically" sick - no fever, feel great, not hot to the touch - that he's willing to keep going with the "wait and see" approach. I told him that the PS did a 50 cc fill on Monday. He said that he wouldn't want to see me go to final implant with it looking like this, but as things are right now he's hoping I'll eventually respond to the abx. (I didn't bother to tell him that I didn't really care what he thought about final implants - if I'm not sick when we're ready to do it I'm going to go for it.) He prescribed 4 more weeks of abx and since I have about one week left on the last script that means I'm covered for five more weeks. If the PS does a 50 cc fill every week during that time that will take me all the way to where I need to be. I'll just keep saying my novenas that this redness will go away and I'll be able to get to a successful final exchange on this go around!
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Has anyone had a TE over the pectoral where the eventual implant would end up ~D/DD? If so, how did it turn out? Any issues with drooping, rippling, etc? Currently am ~34DD and am wondering if over the muscle is an option for me.
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I have a over the pec. TE and I am a natural.40C. My TE is about the same size as my natural size, and I can't imagine having something bigger. It's just your skin holding up the effects of gravity on the implant. There is no connective tissue like on the natural side. That is my perception, have you asked your PS?
My exchange is in July..
Sorry I can't be of more help.
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Hi LoveK9s, I am a 36 C Cup, and even after a lift on my other side that is where I have stayed. I have a 495cc Mentor Textured Anatomical Silicone Implant. I would ideally have a slightly larger implant. The TE I had in before the implant was up to 600cc and not a crazy bit bigger than my real right breast. I figure the PS put in too small of an implant initally, he first put in a 420cc and it was way, way, way too small. I woke up from surgery knowing it was all wrong, and I would have to do it again. So then he put in a larger implant, but not as large as I would have liked because he cut away the extra skin with the first smaller (wrong) implants, and then he couldn't fit a 550cc which would have beena better match. To match better I would have to have another 6 months with a TE to create more skin for a larger implsnt, or I would have to lift my R breast, again. I don't want any more surgeries, maybe forever. I look very close to normal in a bra, still screwed up looking naked, not hideous like before, but more lopsided than I ever thought I would be after all my hardship and suffering.
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LoveK9s, I'm not sure this will help as I'm still only in the TE phase, but I have a very large TE = 650 cc (can't find the paperwork that says brand/shape at the moment - can find it if you want to know) and it's filled to 750 cc. I'm not yet scheduled for the final implant and have had a fully expanded TE on the left for over a year (long story - don't ask) and even the TE looks good. I'm sure the final implant will look even better.
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raven, glad to read that things are improving for you, even if it's slowly, glad it seems to be turning around.
littleblueflowers, how are you doing? Hoping you are healing and remain infection free.
Your both in my thoughts!
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Glad you're holding steady Raven! There is definitely hope for good resolution!
- xo
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Thanks,everyone, for your kind words of support. I've got one more glimmer of hope.....
I had an interesting appointment with my MO today. He feels that the redness and inflammation may be an issue with lymph drainage. Upon physical examination he thought he felt a very, very slight increase in swelling in my right arm which, he said, may be imperceptible to me but that he thinks quite possibly could be what's causing this redness. He did NOT think it was an infection situation. He has given me a referral to a PT that specializes in lymphedema to see if they can give me some exercises that will help to combat the drainage issue and clear this up. How fortunate that I just happened to have a 6 month follow-up with him this week! Edited to add: I only had one lymph node removed and according to the MO that gives me only a 5-9% chance of having lymphedema. So, OF COURSE, I may have it! Oi.
On the other hand, he was very adverse to any kind of future screening MRI simply because a) my tumor was T1A, meaning it was very small and so has a very low possibility of recurrance and b) it wasn't indicated in the "guidelines". However, because I am concerned due to the pre-pectoral implants he promised he would look into it on my behalf. I don't plan on holding my breath that it will be approved but at least he's keeping an open mind about it.
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Thanks so much 2FUN, macb04 and raven4mi for the replies. I have an appointment with my PS in a couple of days to discuss a possible over pec option but am trying to find out as much as I can b/c my mastectomy and start of recon is 4 days after that meeting. Trying to weigh the pros/cons (will over pec have an issue regarding detecting any cancer that might come back in the minimal breast tissue they may not get during the MX, would a C or D cup cause too much pain under the muscle, etc.). Did you all have the same situation as 2FUN ... that is only the skin is holding the implant in place? I would think if it isn't in some type of sling tacked in somehow that it would float around/drop down. Did any of you need to have fat grafting (or something else) done to prevent rippling since the muscle wouldn't be able to help? Any questions you can suggest for me to ask my PS regarding over the pec? Thanks again.
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LoveK9s, my TEs and eventual implants are wrapped in Alloderm which acts kind of like a sling. As I said, my left TE has a 650 cc capacity and is filled to 750 cc, so the breast weighs about 25 oz. or 1.5 lbs and I don't have any problem with shifting, drooping, etc. FG is absolutely an option for aesthetics. My PS likens it to "spackling" a wall to make it smooth.
Having said all that, you're absolute #1 most important question is how much experience your PS has doing pre-pectoral reconstruction.
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Hi LoveK9's, ditto what Raven4mi said. Excellent metaphor about Fat Grafting being like Spackling a wall to cover up imperfections. My implant is wrapped in Seri Silk Mesh. I would say 95% or more of Prepectoral Reconstruction involves some kind of Acellular Dermal Matrix stuff like Alloderm/Strattice or Seri Silk. It is anchored by sutures to the pectoral muscle. What I like about Prepectoral Reconstruction is that a TE has a much easier, less uncomfortable time stretching out skin, versus trying to stretch skin and your poor pectoral with subpectoral reconstruction. Having had a TE used both ways, I absolutely hated having the TE stuffed painfully under my pectoral.
Oh, Raven4mi, good luck with the Lymphedema treatment. I am sure it is much more common than they tell us, and contributes to many serious complications. I really wish I had never let them touch my lymph nodes.
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Lovek9s, I also have TE's placed for pre-pec implants. And I also have Alloderm acting as a sling to hold the TE's in place and eventually will hold the implants. These TE's haven't budged.
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Hi lovelies- just checking in. Hope everyone is doing well! Raven, im so glad you may have an answer finally! 2Fun, i have implants wrapped in alloderm and sewn in place. They arent budging! Well, i still have stitches. My PS removes a few every week or so, but he is being soooo cautious now. I am on doxycycline only at this point, and suffering from massive photosensitivity. Better than iv crap though, so i dont hate it. I will be on it at least until im completely healed up. Fingers crossed this works! My PS has gone from cautiously optimistic to wildly self congradulatory that he swapped out my left implant rather than trying to save it. Guess now i will really be paying this off the rest of my life. Oh well. Anyway, they look ok and are comfortable. Guess thats a win! Take care!
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littleblue, I'm so glad everything is going well for you. It is also helpful to hear that there are many ways to accomplish the same goal!
My date is july12! I am trying to figure out what my functional limitations will be. I need a cm wide strip of skin removed along my suture line due to close margins for the DCIS. Too bad b/c my scars look so good. After that they will swap out the expander and do the lift on the left.
I am hoping to.get to an important party 3 days post surgery. Did I mention my thyroid is also coming out,? hopefully it will be benign. I think the summer will be another blurr. But I will be back (mentally) to get DS off to college halfway across the country.I meet with the endocrinologist today. Too many things to deal with! Better me than someone else!
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littleblue, glad to hear things are going well! What is it with these PSs? When I was at my last appointment I was lamenting that I just don't understand what kind of lesson I'm supposed to be learning from all this crap I've been going through and he said that he thinks maybe HE was getting too proud and full of himself so God wanted him to be humbled. Yeah, dude. That's why God is making ME go through all this bullshit. Way to make it all about you.
2FUN, oh my! HAD you mentioned the thyroid thing? I don't recall reading that. You've so much to deal with - PLUS moving DS to college! Wow, you're right, your summer will be a blur. But some of it will be a joyful blur, I hope! I know it's far away yet but of course I'm already sending out great good luck vibes.
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littleblue, it's wonderful that the swap seems to be ok. Staying out of the sun temporarily is a small price to pay for foobs that "look ok and are comfortable". I still have my under the pec expanders - I could have done an exchange this spring but decided I wanted to be able to swim this summer without having incisions to worry about, and general anaesthesia just wipes me out. My PS will do the exchange whenever, so I will just wait and see. The expanders are still not super comfortable, even a year later. If it doesn't improve after exchange, I would consider just going flat, buthe says we could switch to pre pec implants.
I was a bit taken aback at your comment that you will be paying this off for the rest of your life? Did you have to pay out of pocket for reconstruction? That sounds crazy to me.
Wishing you all the best for the summer.
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