TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!
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for those who has done revisions ( nipple sparing), is it possible to go smaller without compromising the nipples?
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Well, I did have some redundant skin removed. My PS removed it from the inframammary crease area. It did make the nipple go a little lower, but everything made it just fine. I guess it depends on what you're willing to trade.
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thanks VegGal!
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just met with my plastic surgeon in CT and over the muscle is pretty much all she does now! Possibly more and more drs are doing it this way unless the other way is needed.
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Hi SLL101984, glad you have found this thread. Is your PS on my list?
Prepectoral is the wave of the future in reconstruction. It is bad enough we are chopped up and disfigured. We shouldn't have to suffer any further with miserable tightness, animation deformity and loss of strength.
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hi macb04....no she is not! Her name is Helen perakis and she operates in Hartford ct.
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I will be having DIEP on my cancer/radiated breast and my new PS will remove the TE under the other side and put in a pre pec implant. So glad I found him. Dr. Terry Myckatyn in St. Louis.
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OCDAmy, good luck with that plan of action! I REALLY don't want the bother of any more surgery and recovery but have seriously considered taking that same route to fix my bad outcome. I'm looking forward to following along to see how things turn out for you. Best wishes!
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Hi Ladies!
I don't think I've posted on this thread but recognize or have convo'd with some of you. I had chemo, skin sparing BMX with TEs, and rads (in that order) and am scheduling DIEP in lieu of implants. I've had such a hard time with the TEs that I don't think I'll like implants - 9 months out from surgery I still have the scritchy sand paper feeling and can feel the TEs stick to and unstick from my chest.
A couple things to share. I am switching from Zoloft (for mild anxiety) and gabapentin (for TE pain and foot neuropathy) to Cymbalta as it covers both. I've also recently started turmeric supplements. Not sure which is doing the trick but my pain is MUCH better. More good days over all.
Also, I am also in bra hell but remembered I'd bought a “half tee" (halftee.com) several years ago and tried it on and it is wonderful. It's cut longer than a bralette with a nice wide band. They have a tank version that looks interesting. My problem with many bras is the straps are too short (especially pull over styles) - not this. I can wear the short sleeved version I have under flowing tanks and get a head start on summer. Take a look.
Lanne
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Hi SLL101984 and OCDAmy I have added your PS to the list. Thanks for the information.
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Lanne- thanks for posting! It's good to hear the full range of recovery experiences. I am having bmx, snb, and prepectoral recon on the 16th. I am a compliant patient and will do what they tell me to do, but I am an avid trail runner and deep down, all I really want to know is what kind of bra I should wear for running and how quickly I can get back to running. (I assume it will be two months or so at least.)
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Hi all, I haven’t been on for some time. I have had above muscle implants since September of 2016. I’ve been fortunate that I’ve really had no issues. Over this past year and a half even the amount of numbness has decreased more than I thought it would.
I always knew my right side was lower than my left. My ps tried to correct thisbut wasn’t able to during surgery. We decided at my 1 year that all was good enough as she didn’t think a revision would make much difference. I agreed.
Well, I’ve changed my mind. I really think the space between the implants has gotten wider as though they’ve migrated towards my sides. I also feel the unevenness has become greater. My husband thinks it’s because the fat that was infected has been absorbed. Whatever the cause I’m calling on Monday to be seen.
I’ve never been able to properly shave my arm pits since getting the implants or even the TEs. Perhaps if they were slightly closer that would help.
I’m feeling disappointed. I am very curious to see what my previous pictures look like compared to now. That will help confirm if my assumptions may be true.
Has anyone else experienced migration of pre-pec implants or heard of this?
Thanks!
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I’m having my surgery May 21st, my PS dr Amy Colwell in Boston MA also does above. Though she advised me about the possible rippling side affects. Has anyone heard about a newer implant that is “overfilled” which can cut down on this affect? I have implants now over the muscle and I’d like to keep them over to muscle to aid in healing, but I obviously want the best cosmetic outcome.
Ps- happy Mother’s Day to all the mommas out there!
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HI Michi
I had implants under then switched to over the muscle after 1 year. Under was painful almost all of the time, loss of movement and activity that I have not recovered even 1.5 years after original MX with DTI. I have more rippling with the implants on top of muscle, mostly when I lean over - which no one ever sees so it becomes a mute aesthetic point. Mind you, I am topless in front of my husband and any BC patient who ever wants to take a peak but to be clear, there is just no one that sees my rippling unless I show them myself leaning over and topless.
I am also thin and my mastectomy surgeon was a nincompoop and removed all if the subcutaneous fat on my prophy side so my rippling is due to no fat under the dermis. I think women with more fat have a better cosmetic result with pre-pec.
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hi Renee-
Thanks for the reply, aside from the rippling when you bend (which I have now from saline implants) what do you think of your cosmetic result? I’m also on the thinner side though bigger than I was when I had my implants. My ps advised with thinner women under the muscle was more ideal. I’m certainly worried about pain, was your situation an exception, or a possibles side affect of having implants under the muscle?
I’m so unsure and nervous about the cosmetic outcome, I’m doing prophylactic for ALC and LCIS, so hoping to do nipple sparring and immdiate recon but let’s see. Pictures online see to be all over the map, I’m hoping I can still feel good naked.
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Hi Michi,
I just added your PS to the List., thanks for that.
I can not address Prepectoral Implant Reconstruction in the setting of being thin. I am slightly heavy. I can say that I had a TE under my Pectoral muscle and absolutely hated it. I know it wasn't an implate, which would have been softer, but I was amazingly, extraordinarily uncomfortable every single second, of every single damn day. I had it taken out, had because I was trying to create a breast just with Fat Grafting through several procedures. It didn't work, and I switched PS and then had first a TE and then after several months an implant over my Pectoral Muscle. It was so, so, so much better. No contest how much more comfortable it was. Even the TE Prepectoral wasn't that bad. My strength went back to normal too.
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macb, I have TE over the muscle now. I'm filled to capacity but waiting due to chemo. They don't bother me at all. They are hard but got used to it. I was worried about how I would look in my clothes as I waited for permanent implants and no-one would ever know. It's unbelievable. In fact a coworker was recently diagnosed, didn't know her too well but offered to show her my chest to give her hope. Lol She said if only I could look half that good I would be happy. Now we pass each other in the hall and smile. I'm pretty thin so we will see how the permanent ones go, will fat graft if needed. Michi, I was fortunate to have successful nipple sparing and my results are above my expectations and wish for you the same outcome.
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Hi DebAL, that is great your TE isn't bothering you. The implant you get should work well then. Always glad to hear of good results.
Hey JessieJake, I have heard of the unfortunate shifting of implants. I have seen mention of " uniboob", ""bottoming out" and migration of implants into the axilla, ( no catchy name associated with that). I don't know if that is related to the ADM opening up, or what, but I have heard of it happening. I am sorry to hear you have had these problems. It really sucks.
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thanks Deb and Mac-
I’m so torn about this now, my implants now are over the muscle and I just feel like I want to be the least invasive as possible. Also the new implant I was speaking about is really supposed to cut down on rippling and my PS said that’s all she’s using now.. I think it’s called in inspira? The trade-off is that it is quite a bit firmer, but that’s OK with me.I’m not sure it’s really new, but more advanced than several years back.
I am a runner and am fairly athletic, plus I have young kids at home I tote around quite often, so I’m just worried about putting anything under the muscle and how it’s going to shift every time I move my upper body. I’m heading in next Monday so I guess I’m going to have to have a chat with her before she makes the first cut!
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Michi, I had a pre pectoral implant placed in july 2017. I am a PT and I knew I would lose function permanently with a sub pectoral implant. Thankfully my PS decided to do.pre pectoral. I think I was one of the first he had done, but thankfully it looks pretty good.
I have excellent function, and can lift people in and out of their wheelchairs like usual. I'm 55, so I still need to work for at least 10 years, or longer. For me function is the most important thing.
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2FUN, I'm glad you have excellent function and I agree 100% with how important it is. I have a physically demanding job, enjoy running lifting, yoga (I'm 54) so I was thrilled with the pre pec option. Given that, the sub pec conversation with my PS was just in passing. He told me to watch animation deformity videos but my best friend has sub pec and she performs on demand! It has always bothered her. She is due for an exchange and is considering pre pec. I would be lying if i said cosmetics wasn' t important but in the end i personally would trade a small amount of rippling to regaining function any day. Michi, definitely have another chat with your PS about your concerns and together you will come up with the best plan for what is important to you. Good luck!!
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I’m headed to hospital now for DMX and recon. PS said he plans to do pre pec but won’t know for sure til the BS is through. He felt confident it would work, though. My main interest in pre pec is getting back to exercising and regaining full use of arms relatively quickly. I’ve interviewed 2-3 women who had sub pec and wow- that is a grueling recovery.
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I had a prophylactic pre-pec BMX with TEs in mid-January. No pain, just a little discomfort. All restrictions--including lifting restrictions--were gone at the 2 week mark. From the get-go, was allowed to use my arms for all daily activities. I didn't try to lift them straight up until the doc said ok, but all regular stuff was pain free. Had my exchange almost 4 weeks ago, and again, no pain, no restrictions on the use of my arms, and the lifting restrictions were lifted at two weeks. There is a little rippling, but nothing I can't live with. It was definitely the way to go for me!
Caveat: while the PS knew my preferences, he said he could not make the determination until I was actually on the table, and he was able to observe the skin quality, blood flow, etc. If I had not passed muster, then he would have needed to do sub-pec.
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Shadow, that's awesome! Exactly, blood flow and skin quality are determined at the time of surgery. I feel like I can deal with a little rippling to have full function if that is the trade off. Do you expect to need any fat grafting? Glad to hear you are doing well!
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Michi wow, May 25th coming up quick! If you are athletic and also having young kids I would hope you can get pre-pec. My PS told me he would determine if I could get pre-pec once I was in the OR, but felt I would be a candidate. He acted like it is a great priviledge to get pre-pec. Not only for the much easier, quicker and relatively pain-free recovery, but also the end result being no deformity with activity and long term "iron bra" pain. I did originally have the Inspiras pre-pec, put in April 2017. Unfortunately even having "overfilled" cohesive gel I still experienced rippling which worsened when leaning over. I really believe it has to do with the fact that there is just skin over the implants in pre-pec. In mastectomy, the goal is to get all the breast tissue out and unfortunately the fat goes with it. I am by no means skinny, 5'7" 150 lb. I personally didn't like the firmness of the Inspiras and since I needed a revision last November I chose to have the Inspiras removed and went with the Sientra smooth rounds for a softer feel. I had fat grafting also and now only have a tiny bit of rippling only I notice.The fat made a HUGE difference not only in ripples but also added warmth and softness making the implants so much more comfortable. I did not have nipple sparing but have a very nice cosmetic result I am completely happy with. I hope you find the best solution that works for you! Best wishes!!
ReadyAbout, I hope you are doing well following your surgery! Prayers going up for you
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Well ReadyAbout, hope you have smooth sailing with your procedure, and are able to get a great result. I do hope you get a Prepectoral Implant Reconstruction too.
I am a little confused Michi, is it just the rippling that you are having another surgery to fix?
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@DebAl--thanks. I will see what I look like at the 3+ month mark, since I have been told it may take a while for the implants to settle in. But if it remains as it is now, I don't think I would go for fat grafting. Also, I have not experienced winter yet with the implants, so I don't know if I would feel cold with them....if I feel cold all the time, then that would actually be a bigger incentive for me to do fat grafting than the slight cosmetic imperfections.
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Shadie, i never thought about the cold! Good point. I know my expanders spasmed and weren't as comfortable a few months back. I'm with you, it would have to be a big incentive to go back for fat grafting. 2 more months with these expanders before my exchange, can't wait!
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Thanks for the info Shoregirl, actually the 21st! Even sooner, (YIKES). I actually just realized my normal implants are sub-pec. Shows how much I remember from my 20's! I never had an issue with recovery then, but perhaps it's just much different for BMX with sub pec. My PS does it both ways and left the option to me. She said she generally sees a better cosmetic outcome sub pec, exactly for the reason of rippling. I am more torn than even and will have to talk to her Monday pre-surgery. Looks like I'll need TE in place anyways sadly, so I'll likely have some time to choose the implant, but am happy to hear your feedback on the insipras. She did mention they are much firmer and that bothers some people. I guess I'll need to feel them out in her office first.
Mac, I have some rippling from my original saline implants from my breast aug I had at 22. (When BC was the last thing on my mind!) So since my skin is very thin and already prone to rippling she is really thinking sub pec is the better way to go. I have LCIS/ALH and am doing a prophay. BMX Monday. Now deciding on sub or pre pec and having a hard time making the decision. Guess we will see how things look in the OR.
Thanks for all the advice ladies!
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Pre-pec is great if you can have it, IMO. My recovery has been relatively pain-free since being discharged from the hospital.
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