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TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!

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Comments

  • littleblueflowers
    littleblueflowers Member Posts: 391

    Hi ladies, I have another fat grafting question. Does anyone know about how long it takes for the grafted fat to develop blood vessles? In looking online, it looks like it takes up to 6 months??? Wondering, because apparently my PS told my DH that since I tolerated the first round so well, he was thinking about scheduling me for round two in just 4 weeks. Google doesn't seems to address fat grafting to radiated skin very well....

  • macb04
    macb04 Member Posts: 756

    Hi littleblueflowers, I tried to find exact info for you,but couldn't find anything. I think that I had read that decreased activity thefirst 4 to 6 weeks was a good idea, so as not to take away blood supply from the newly transplanted cells. I followed that, not sure that helped much. I only did easy walking first 5 weeks after fat grafting. I had little success, due to rads, to infections, due to a PS who wasn't that skilled. I wish I had a great bit of advice for you. Good luck and I hope someone gives you better advice.

  • littleblueflowers
    littleblueflowers Member Posts: 391

    Thanks, Mac! I'm sorry you didn't meet with much success with yours. Well, I guess I won't worry too much about dislodging it then. If the fat takes, it takes. If it doesn't, well, hopefully the happy little stem cells will do their bit to heal my radiated skin befor they get reabsorbed. This whole process is soooooo weird!

  • StaceySue2U
    StaceySue2U Member Posts: 83

    Thanks Jessie and macb! I never mentioned the numbness before because I was too busy worrying about other stuff LOL. Now that I've mentioned it, it just went away suddenly! Coincidentally, I had started rubbing the backs of my arms, and as much of my back as I can reach, as you mentioned macb. I'm looking forward to re-uniting with my husband soon. We've been apart for most of this ordeal - long story r/t my cancer and his job - and pretty soon he'll be available to rub my back. Woohoo!

    It sounds like you've really been through a lot, macb. I thank God that I didn't have to have radiation!

    Jessie how far have you got on your fills? Did you say you get to get your implants in July?

  • JessieJake
    JessieJake Member Posts: 170

    Too funny StaceySue2U. It's kind of like once you give something your complete attention it gives up! I've seemingly had that happen with pains from the TEs. I put up with it, then I mention it here, and wham, it's gone. Well, good stuff either way! Enjoy your reunion with your husband! Oh my, back rubs. I've been relying on those because I get so stiff sleeping on my back without pretty much no movement at night. Tolerable, but, oh, to sleep on my side or stomach.....

    I'm taking my hubby in to get his meniscus (knee) cleaned up today. Will be odd to be the caregiver this time.

    I had 4 fills so far. I think one more on Wednesday and I'll be done. My skin isn't too accommodating to stretching much. The fills have been smallish and I have that pointy spot they are watching. That is why they moved my exchange up to June 22. My DH thinks they won't want to add anymore Wednesday. I think they will but maybe only 30-40 cc which will get me to 200cc or so.

    Hope you are continuing to feel better!!!

  • StaceySue2U
    StaceySue2U Member Posts: 83

    Jessie are you normally a side sleeper? I'm normally a belly sleeper and there is just no way on earth I can sleep on my back. I wouldn't get any sleep whatsoever. I've found some ways to be comfortable on my side and sometimes in the middle of the night I give into the temptation to roll onto my stomach for a while, using one of those long skinny snake-shaped pillows with one expander on either side to keep the pressure off of them. I've found that if I wear a sports bra to bed and put something soft (like a rolled up pair of fluffy microfiber socks) between my expanders I'm perfectly comfortable.

  • JessieJake
    JessieJake Member Posts: 170

    I'm with you - I was a devoted stomach sleeper but would also sleep on my side a lot. I truly thought I wouldn't be able to do my back so I am surprised I've been doing it for 10 weeks. I think I should check out a pillow like you are saying so I can try different things. I've gotten sort of comfortable on my side sometimes but I'm afraid to truly fall asleep in case I don't realize I'm putting pressure on a spot on that will be painful.

    I have to say I'm shocked I got this far sleeping on my back. I feel like a mummy. Oh, and did I mention that I sleep in a semi-upright position? I use a bunch of pillows so I don't lay flat. Ugh!

    Thanks for the ideas, though. I'll give them a try!

  • JessieJake
    JessieJake Member Posts: 170

    I had my 5th and final fill yesterday. I'm at 200cc in my 300cc TEs - whoop, whoop! Again, very minimal noticeable effects from my above muscle expansion. I can feel them more on the side as they seem to like filling up there (Or I'm just not used to having anything there to bump into). I played catch with my son last night, my pec and arm muscle on my right side were sore (I'm so out of shape in my upper body!) and I think that did keep me up some last night, but feel great today. I'm just so happy to be out there doing that with him. I just wasn't sure when/if I'd be back to doing that with him and for some reason I really like doing that with him.

    My pointy spot on the bottom of the right TE did relax slightly from my last fill. Enough so that the PA said to keep my pre-op appointment with the PS on May 26th but she wouldn't be surprised if she says I can wait longer. I was supposed to wait until September originally. To be honest I don't mind either way except, boy, am I lopsided! Each fill highlights that these things are uneven. Kind of a bummer but in clothes I know it's not noticeable. We do have a Florida trip planned in August so I'm going to be looking at some interesting swimsuit tops to mask that.

    I'm hoping to have a quiet 3 weeks as I wait for that pre-op appointment and I hope you all do to. To be honest, I'm very curious to see what my PS is thinking for implants when I see her. There is this little part of me that is keeping the option open for a possible additional fill at that time based on what she says. I'd be bummed to be smaller than I am now and I've read so much about that possibility here. Can only wait and see......

    I noticed at the office that they began a study comparing over and under the muscle reconstruction. Ugh, I missed the start of that so I can't participate, but I'll be very curious to see their results!

  • raven4mi
    raven4mi Member Posts: 215

    Hi, all. Just wanted to jump in and say thanks for this thread. I had BMX (left prophylactic) on 4/15 with TE over the muscle. Until I found this thread I really had no idea that it was as rare and new as it seems to be. My PS made it sound like he'd been doing this for a couple of years at least. After reading all of the posts I now will be armed with tons more questions regarding the eventual exchange than I was before - my PS has not once mentioned any kind of fat grafting so that wasn't even on my radar!

    Currently my TEs are filled only with air. Has anyone heard of this before? I was suppose to start getting the saline fills last week but, unfortunately, I have to go back in next week on 5/11 to have a nipple excision done due to necrosis after NSM (quite unhappy about that) and the PS is planning to add saline at that time.

  • JessieJake
    JessieJake Member Posts: 170

    hi raven4mi,

    Sorry u r losing your nipple. I was in a similar situation. My right nipple didn't have good blood flow during surgery so they told me there was a chance I'd lose it. They had me use nitro-paste on it (that's a story in and of itself) to promote blood flow. Did you have that? I used it for 10 days, I think. My nipple did survive. It had turned kind of black. Originally they made me think it would stay dark, but that skin simply peeled off later.

    Because of that situation, during surgery I was also only filled with a little air. This was to prevent any added strain on that nipple area.

    They took the air out before they added saline.

    Hope all goes well next week.

  • macb04
    macb04 Member Posts: 756

    Hi raven4mi, so sorry to hear you have lost your nipple. Is there any possibility of getting Hyperbaric Oxygen Therapy to save it? I lost mine initially and hate to hear of someone like you trying hard to keep it and not suceeding. I am going for a 3D tattoo with Vinnie Myers in June down in California. I am taking my 11 year old and her friend down with me. They will wait in another room while I get tattooed, then the next day I am taking them to Disneyland. It will not be perfect, but I have seen the tattoo artists work on Vinnie's team and should have a very close match.

    JessieJake, glad you are feeling comfortable enough to play with your son. I hope you can get that fill you want so you can be bigger like you want, and as even as possible. I am not perfectly symmetrical, but about 85 to 90%of symmetry compared to my real right. I am taking a Rowing Class now on Green Lake. I was worried I wouldn't be able to do it, but it is working out fine for me, and I really really like it.

  • raven4mi
    raven4mi Member Posts: 215

    Thanks, JessieJake and macb04 - I hadn't actually heard of either of those options prior to all of this but have come across them since doing a little more research. I have a message into my PS to see if either are viable options. I'm having more trouble emotionally with losing the nipples than I did for the original mastectomy, crazy as that may sound.

  • macb04
    macb04 Member Posts: 756

    Hi raven4mi, no that is not crazy to mind loosing your nipple. It is a huge part of the identity and sexual responsiveness of our breasts. It is easier to build a breastmound, than to create a realistic protruding nipple. I had surgery to make one and it has gone almost completely flat. I plan toget Restylane injected into the itty bitty nipple that was made, to makeit havemore projection. Not worried at all about having headlights.

  • Newgirls
    Newgirls Member Posts: 37

    mac04-how long was it before your reconned nipples flattened out? I had mine done and am keeping the gauze pads on for longer than the doc suggested as I'm hoping to keep the projection. Could you share your experience? Thank you!

  • macb04
    macb04 Member Posts: 756

    I had the nipple reconstruction in December 2015, I would say that it got flatter after a month, put when Ihad another surgery to put a larger, high profile Anatomic MENTOR implant in, it went even flatter. I am planning to go back to my PS to inject Restylane into it in a month to give it abitmore projection. The Restylane only lasts about a year, but for some women it lasts longer. Then on June 9th I am flying down to see the Vinnie Myers Team in Rancho Santa Fe, California., to have a 3D nipple tattooed. Right now it has a very small amount of projection, I hope those steps will help it all to look real as possible,.

  • macb04
    macb04 Member Posts: 756

    One month till nipple 3D tattooing.

  • Robins_Mess
    Robins_Mess Member Posts: 8

    I'm looking at where all of you are from - doesn't look like any in Colorado Scared I thought I was making good head way when I found a PS who would actually do fat grafting and an implant on my radiated side. Now I see this and I asked her if she would go over the pectoral muscle and she said no. So now I'm going to have to find ANOTHER PS (a fourth) to do it this way! I'm very active - a climber, kayaker and obstacle course runner. The first PS was a total loser. The second only offered the lat flap or DIEP (really, a lat flap with a climber?!) and now this third who will do the fat grafting, but wants the implant under the muscle. Though i think finding a doctor to do the work is the easy part - getting insurance to cover it is a whole different game. Grrr.

  • macb04
    macb04 Member Posts: 756

    Hi Robins_Mess, welcome to my over the Pectoral thread. I feel that leaving the muscle alone, and offering to put the implant over the Pectoral is the best of a bad situation. I am active like you, am currently taking a bi weekly Rowing class. Men would not tolerate the loss of function that occurs with the standard under the pectoral implant reconstruction method. It is ridiculous, really to consider that a viable solution. It was initially tolerated in reconstruction because bc used to occur more in a older, assumedly less active, population of women. I really hope you can find a doctor you can work with that is covered by your insurance. I had begged my PS to do it that way. I didn't at the time know that it was being done as a new procedure anywhere, I was just desperate to have a breast without having my strength and comfort destroyed by under the pectoral. I was his first patient done OVER the pectoral muscle. He actually started to read up on it and found one of the research articles I posted at the start of this thread. If I asked him he might be willing to speak with your doctor. PM me the info if you want to me to try speaking to him. He is a super nice guy. He did over the pectoral for one of the other women on this thread, after me.

  • TealWarrior
    TealWarrior Member Posts: 3

    I had my bi-lat mastectomy with under the muscle direct implants in Jan 2015. I hate them! The muscles flexing over them looks horrid and the muscle cramping sucks. I went to my PS last month to complain and he told me about this new procedure going over the muscle. We're waiting for insurance to approve it. Meanwhile I went to another PS yesterday for a second opinion and he said not to do over the muscle because of scarring. I read through this thread and didn't see much mention of scarring.

    Thoughts?

    Hugs to you all!



  • macb04
    macb04 Member Posts: 756

    Scarring where? All surgery causes scarring , so not really sure what your PS is talking about. I have Seri Silk mesh as a scaffolding to support my implant. My breast is fairly even match to my real right, about 90% of a match. I had a TE under my pectoral like you and I hated it too. This is the way of the future. It may not work for everyone, but is a great idea for most women. My pectoral has returned to nearly normal strength. I am taking a Rowing class now, only bothers my Left arm, think I have a Rotator cuff tear from all the residual tightness from rad fibrosis and trying to perpetually stretch it out.

  • raven4mi
    raven4mi Member Posts: 215

    I agree with macb04 - what kind of scarring are they talking about? I have scars from the incisions under the breast, but I think that's pretty standard. I will have some additional scarring due to losing the right nipple to necrosis, but that's it. I haven't heard of any scarring specific to over-the-chest implants.

  • TealWarrior
    TealWarrior Member Posts: 3

    Yeah, I have no idea where he was talking about there being more scarring, the Alloderm wouldn't cause scarring, right? He just freaked me out yesterday, I wasn't expecting him to say he wouldn't recommend the over the muscle version. I think I'll mentally feel so much better not having my boobs flex that even if there was more scarring i'd be happier.

  • macb04
    macb04 Member Posts: 756

    TealWarrior, sounds like he might have been talking about the possibility of increased Capsular contracture from over the pectoral implants. It is not a definite risk, but it had been known to occur slightly more with over the pectoral Breast Augmentation. I don't think there has been any study of Capsular contracture comparing over the pectoral to under the pectoral implant reconstruction because it is kind of new in reconstruction techniques. He probably just doesn't know how to do it so he is scaring you off of it. He has no study data to make that assumption with.

    On another note, ladies, I want to compile a listing of Doctors who are willing and able to do over the Pectoral Implant reconstruction. I think we will be doing our sisters a great service to make it easier to find these PS who are doing this advanced technique.

  • mshel
    mshel Member Posts: 9

    Hi Ladies.... I haven't updated in a while.  My surgery was April 5; nipple sparring mastectomy with TE over muscle.  I had 80cc put in during surgery and then two fills of 100cc.  I'm currently waiting for an exchange date.  I only had one little problem.  I had a stitch surface in my cleavage area and the doctor had to pull it up, cut the knot and pull it out.  I currently have a small lump with more stitch.  I'm on antibiotics for two weeks. 

  • truffles1968
    truffles1968 Member Posts: 6

    I had a NSBM on 12/5/15 with the implants over the muscle. My PS is Dr Justin Sacks at Johns Hopkins and he suggested the over the muscle TEs since I have 4 young children and I wanted to recover as quickly as possible.

    I was a 36DD before surgery and am going down to a C at my exchange next week. They told me they don't usually do NSMs on larger than C cups but were willing to try. I will need fat grafting to balance out one side. I haven't had any real issues with the expanders other than some back pain and and am so glad they aren't under the muscle.



  • macb04
    macb04 Member Posts: 756

    Hi Truffles1968, glad you could get your PS to be forward thinking enough to go straight to Over the Pectoral Muscle right from the start. Wish I had done that to start, didn't know it was an option at that time. A lot of women still don't know this is an option, so I am hoping we can all spread the word. We all deserve the most comfortable, effective, beautiful reconstruction we can get.

  • raven4mi
    raven4mi Member Posts: 215

    macb04, I think putting together a list of physicians that others can access is an excellent idea. I'm in the Detroit area and my PS is Dr. Bruce Chau. I had a NSBMX (left side prophylactic) with TEs over the muscle. I've since lost some of the nipple on the right side and I also developed a seroma on the right after drain removal so I now have another drain on that side, but there have been no complications directly related to the over-the-muscle placement.

  • macb04
    macb04 Member Posts: 756

    Thanks raven4mi for sharing your doctor's name. I think I will start a new thread listing these PS's. I want everyone to see it is being done all over the country, and at some major cancer treatment centers too.

    Thanks to you all for your willingness to share your info with others.

  • raven4mi
    raven4mi Member Posts: 215

    Thanks, macb04. Let me know when you start that thread; I'd like to follow that one. I'll keep an eye out for it in the meantime.

  • macb04
    macb04 Member Posts: 756

    Hi raven4mi, I started that new Listing of PS's thread last night. I would like to keep both going. The new one as just a listing if doc's, and this one where we talk about the nitty gritty of reconstruction this way.