TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!
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I am very interested in this surgery. I know Dr. Chen in NYC does this but does anyone know of anyone else who does it in the NY metro area? She's out of network for me.
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I am going to use Dr Tehrani. He is in NYC & L
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Hi McCMom, Raven is right. I had a TE under my Pectoral muscle initially. I had it removed, did Fat Grafting several times. Lost much of the grafted fat secondary to 2 severe infections. I did, however get from a crater to an "A Cup", with my grafted Fat. Wasn't enough to create a breast, so I went on to Prepectoral Implant Reconstruction with a Textured Mentor implant, with a new PS. I am infinitely more comfortable and have 95% of the strength I had before the uni mx. I do think that it was better to do Fat Grafting before putting the TE/implant in, but plenty here on this thread have done the Fat Grafting after the TE/Implant is placed. I have ZERO implant edges visible and a lovely cleavage. What we need is for women here who have had the Implant First/Fat Grafting second, to chime in about if they are happy with their results, can they see implant edges, ect. It is a newer method, going over the Pectoral Muscle and is still being studied for the optimum way to get the best results.
Hi CarlaEM. Well every surgery is a bit nerve racking, but the recovery is much easier after Prepectoral for most of us. Good Luck to you.
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trying to gather data, what kind of restriction/ directions did yo u get after your pre pectoral implant surgery? My dr seems pretty laid back about restrictions, others seem more restrictive. Please share!
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Hi 2FUN. Was told to limit weight lifted to 5 lbs for the first (week to 2 wks?) Can't exactly remember. Also was told no stretches/abduction type maneuvers for the first 2 weeks. That was it. I had the Dermabond Prineo Tape instead of stitches, so I was able to shower right away. No wound care needed, which was super nice too.
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2FUN, my max lifting weight after my TE insertions was 10 lbs. I was barred from doing any lifting over 10 lbs. and housework, etc. for maybe 3-4 weeks until my PS gave me the green light. My limitations were due more to the length of time I had the drains than anything else.
Went back to see the PS today after they punctured me on Monday. He refilled me with a smaller gauge needle to see if I would start leaking again; so far so good a couple of hours after the appointment. I estimate that I lost about 75 ccs of saline, by they pushed in another 95 or so.So now I'm overfilled by about 120 ccs on a 650 cc expander. Assuming there's a slow gradual leak internally, and I'm sure there is, I should be good to go until I go back for my next appointment on 8/14 to schedule the exchange surgery, hopefully in September. I saw the ID doctor yesterday also as a follow-up on the redness. When I told him about the puncture he was incredulous. "They did WHAT???? That's just one more avenue for infection we have to worry about now!" Tell me about it, doc. He had me do follow-up blood work again yesterday because of the length of time I was on the abx and, of course, they had to poke me four times to try to get two tiny vials of blood. And because of the LE I'm limited to my left arm now, too, which is the more difficult arm to try to get blood. There's no way I'll be able to do a Vitamin C infusion before my next surgery. I think I'm just going to have to wait and if - God forbid! - I should run into another infection I'll just bite the bullet and go in for the IV and just have them push it in the right arm.
I've been toying with the idea of finding another PS who does pre-pectoral implants but it would likely mean traveling and at this point I just want to get this over with. I really do love my PS and he has a really great reputation but you wouldn't know it from my experience, that's for sure. It's such a tough decision.
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Dr. Glassman in Pomona NY (works out of Nyack Hospital) is awesome! He teaches others how to do pre-pecs...he only charges the out-of-network co-pay...
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Hey, Raven4mi. Great to hear no leaking so far. I hope rhat continues until you get exchanged. Your veins shot too? I am in the same boat. I am weìght lifting 15 lb ten reps every day. Plan to progress to higher weights, although I am moving slowly. Hopefully that will spur bigger veins on my R arm.
Thanks PugsMama, I will put your PS on the list.
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I wouldn't say "shot" exactly - I've dealt with this my whole life. Evidently I just have really tiny veins and always have. It's such a joy.
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I have those small veins too, and apparently very large veins in my left. You can't get a needle past a valve. I've had them bend a catheter needle trying to push past a valve!
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Has anyone here (with their TEs placed over the pectorals) had problems with sagging? I am 2 months post op and my right side has dropped about 1/2 inch lower than my left. My PS said he can fix that when he replaced with the implants but I am concerned about future sagging.
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mine looked a bit saggy to start with, but was still higher than my native side. I have 54 year old breast sag, and he only needed to lift the native side a bit to match. They are now both equally saggy. LOL. If PS was trying to match implant side with native side he did a great job
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Mine don't sag at all, but I kind of wish they did (to match my age). They are beautiful, but almost too perky for my age IMO. A little sag would've been much nicer
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candles, did you have both reconstructed?
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Raven - the puncture, I'm so sorry that happened. Glad to read it's hasn't been leaking anymore and hope you can get to your exchange on time or sooner.
Question - I had a NS BMX. I had 400 cc TE's placed after BMX. I've been filled to 340 cc's (I think) but can go no further due to skin integrity. The nips are not symmetrical. At all. After BMX I had a seroma at the bottom of right breast and I don't know if it has anything to do with this but it seems like the skin stretched on the top half of my breast but not the bottom. Did anyone that's been through exchange have a similar circumstance? How was the final result? I'm trying to adjust my expectations.
2Fun - congratulations on being cancer free!
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2Fun, yes, I had both reconstructed at the same time.
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candles, that makes sense. I only had one done. Don't know how you all managed that did BMX. Not for the faint of heart!
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Sitti, I'm sorry things aren't looking symmetrical for you. As for lowering expectations - mine have gone completely out the door at this point. My right side is so high and the left (non cancer, prophylactic MX side) is about three inches lower than the right on the horizontal plane - I look effing ridiculous. At this point I just want to get through this with my sanity intact. At the very beginning when the PS told me he would make me look "beautiful" I laughed at him and told him I would NEVER be happy with any results, but I had no idea just how UNHAPPY I would be.
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Hi Raven4mi, sorry it looks awry. Mine do too. It looks like the breasts of too different, although similar women. I look at myself in dim light, and then not too bad. If my real right gets too much more saggy, I would have to have a lift again. The worry is I have poor veins and can't get IV Vitamin C and antibiotics don't seem to work anymore.
I do feel a bit jealous sometimes who at least get a great looking result, to have gone through such an awful mess of surgery, after surgery and still not completely be happy with it. SIGH..............
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hang in there ladies! This is the part about BC that people (on the outside) miss. They just thing you have a MX then get foobs. I suspect it's a low number of people who get a good result with few difficulties. My son's coach told me her story after I got my DX, and she had many surgeries and still wasn't happy.
I'm focusing on being cancer free, being the best steward of my body as I can.that all I can do. ((((HUGS)))))
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Thanks, everyone. I'm just so discouraged at ever looking like anything but completely mutilated at this point. I'll get through it. Always do. Nothing to do but move forward.
2FUN, you're so right about people not grasping what a nightmare reconstruction can be but, honestly, I think that I'm in a pretty small minority. It "seems" like the largest percentage of people who go through this have pretty satisfactory results. We're just "lucky" I guess.
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I have run into a lot of people, much younger than I that opt to go flat. That wasn't an option for me, as I did not feel the need for prophylaxis and I needed something to keep a bra stable for my native side, LOL!
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I wouldn't have been able to stand being flat or lopsided. When I look down at myself now, I see a relatively normal silhouette. I felt such overwhelming anxiety and grief when I looked mutilated and badly lopsided. Sometimes I felt like I was suffocating. I never looked down when I was naked, closed one eye in the shower and blocked the mirrors, so I didn't accidentally catch my reflection. I was and still am, basically horrified by what had been done to me. I wish I could have had someone guide me through all the bad surgery pitfalls, it shouldn't be this chaotic and hard to get decent care. People hear about Angelina Jolie and think we are all that lucky, to be put together better than before, perky, symmetric and scar free. What a load of sh*t this whole stinking mess is.
I will say to you Raven4mi, 2FUN, and all the rest here, that we deserved to come much nearer to normal than we have gotten. I think at the moment, for me, the improvement in my mental outlook didn't start till I could at least feel even a little symmetry, and get my 3D Vinnie Myers Nipple.
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I'm not saying we should be happy with a bad result. I hope you didn't take it that way. I agree it should be easier for us common people to get a high level of care and good outcome, what ever that means to each individual.
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Oh no, 2FUN, I didn't think you meant that at all. It's alright.
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good!
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macb04, we are so on the same page it's eerie. My PS hates when I use the word "mutilated", but basically that's what it is in my eyes, so he's just going to have to cowboy up.
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I posted this in PMPS forum as well so forgive me if you've seen it already.
BMX with TE two years ago in March and I hated the expanders. Took all sorts of muscle relaxants and even wore a Butrans patch for months, but those only took the edge off. Everyone told me the implants would be better, but they're not at all. Yes, I had radiation (and chemo before that), but the iron bra feeling is completely uniform across both breasts...one poster said it was as if someone had wrapped duct table around her as tight as possible and that's a pretty good description. I liken it to someone squeezing my breasts super hard every minute of every day. I used to wear inexpensive bras without underwires, but as the pain continues I can't even wear those and typically go braless or wear a tank top under shirts.
My PS had no ideas and sent me to a physical rehab doc who prescribed PT (my 4th therapist in 1.5 years), a topical lidocaine/gabapentin ointment, two rounds of botox injections, a nerve block, four weeks of acupuncture, and finally Lyrica. Nothing has worked except the Lyrica, but at 300 mg per day it makes me foggy, off balance and just loopy overall. If I took more, I'd be a mess, and I wound up discontinuing it. My head is more clear, but my chest hurts worse.
I've found a surgeon who thinks a pre-pectoral reconstruction would alleviate much of the pain, but as you all know it's a fairly new procedure and he's only done about 30 pre-pec revisions. I've spoken to one of his patients who says he's changed her life, but she didn't have radiation and doesn't have my other surgical risk factors. I have a family member in medicine who thinks surgery should be the last option given my risk factors for a third surgery, especially in a radiated breast that may not heal well, but no doctor has suggested any other sort of new procedure or a medication that won't make me a zombie.
I think the surgery makes sense, but I really need input from those of you who had radiation before the pre-pec revision. Thanks!
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Hi klgnyc, Please read all that I posted when I started this thread. That is my story, had rads, hated it with the TE Subpectoral. Was miserably TIGHT, TIGHT, TIGHT!!! I had rad fibrosis on top of that. My skin just like boot leather. I took out the TE, had fat grafting, 2 bad infections. Lost most of the fat because of the infections. Decided to try another TE/implant with a new PS. I told him it could only be done for me Prepectoral (over my Pectoral Muscle). I was his first Prepectoral Implant Reconstruction patient. He read up on it and it has worked out quite well. My only complaint is that the size is a little too small, he used a screwy computer program and a photo to estimate a match for my other side which is about 50 to 70cc too small by my estimate. In a bra it looks almost perfect, great cleavage, no implant edges, no animation defect and no crazy, painful tightness. I got rid of the radiation fibrosis by several measures, Fat Grafting, HBOT (Hyperbaric Oxygen Therapy), and Pentoxifylline and Vitamin E daily in an oral and Topical Prescription form. Healing the rad fibrosis meant that I was sucessful in getting through an TE gradually filled over 6 months, with a change to a 495cc Mentor Textured Anatomical Silicone Implant. It was crucial to improve the blood flow, by the methods I mentioned, in order for my skin to heal.
Hey Raven, maybe we are twins from another life? We do have a remarkably similar take on this entire God Awful mess we are living through. Like me, you don't drink the "KoolAid". I don't feel grateful for any of this sh*t, not in the least. I am like a dormant volcano, with boiling, lavalike rage, sometimes miles below the surface, and at other times simmering just beneath the surface. Why should we make nice? You are right, all the PS's should cowboy up.
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macb, I'm totally stealing your "dormant volcano" analogy. SO spot on!
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