TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!
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Ready - i waited until after rads to do fills. I have 650cc TEs that were filled to 500 at BMX. No antibiotics for fills. I did a 100cc fill the first time and had no pain and little tightness. Second fill was 3 wks later at 50cc. That onecontinues to feel tight. Fills were handled by the nursing staff and I chose timing and cc amounts. Fills did make the TEs more comfortable overall but didn't relieve the sandpaper feeling. Only gabapentin helped with that. I could have scheduled the exchange surgery 2-3 weeks after the last fill. Lanne
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I saw my PS yesterday, and he said that if he made any changes to ensure that the implants were more central when I am supine, the cosmetic result when I am sitting or standing would be compromised. So essentially, I need to find out what bothers me more....looking odd when I am lying down (which I think would impact my comfort/self esteem during intimacy) or looking odd when sitting/standing (right now, I look pretty much normal, thank goodness.) Not a good choice.
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ReadyAbout. Fills are fairly numerous, relatively speaking, depending how big you are aiming for and how many CC's per fill. I have never heard of antibiotics before fills. Prophylactic Antibiotics would be entirely too much antibiotic use, that would markedly increase the risks of Resistance. Your PS sounds off on this and a number of other things. Maybe I SHOULD remove him, he kind of sounds a menace to women going through Reconstruction, who have already had a very difficult time of things as it is.
1plus2, using the Clairsonic Care Mia completely resolved the cording I had, I did daily maintenance MLD using the Mia in the shower for months after. Now I only do the full MLD with the Mia every once in a while if my arm feels funny, you know, achey or " different "
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Hey Shadie, I would say to get a second, or even third opinion to see if that is all that can be done. Then you can make your best informed choice. Good Luck. These choices all suck in one way or another, and I think few women are very happy with their results, most of us are just "somewhat" happy with our reconstruction results. I think many of us have seen much, much, much worse in our tiny peeks in the mirror, and we set the bar a bit low in what we are willing live with. . I am no fan of this whole bc industry disaster I am forced to live. Shouldn't be this hard to look normal, but this is what we are left with.
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Shadie, I agree with more opinions. I had the same problem with initial reconstruction. When I was revised to pre-pecs all that was fixed.
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I have an appt with my breast surgeon's PA Friday for a routine exam. I am glad because there is a strange, irregular linear area just beneath the skin over one implant's upper pole that is not only palpable, but it hurts both when being touched and not being touched. The other day it was hurting in rythmic waves like a uterine contraction. Weird. This particular implant may be developing CC as it is much firmer than the other. Maybe it is fat necrosis? Hopefully she will do an ultrasound and rule out anything nasty!!
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Hey Shoregirl, ask about Pentoxifylline 400mg three times per day, and Vitamin E 400IU three times per day. I don't see if you have had rads, but there is research on it for implants. Quite a bit about that as well. Also there is a research study on using Low Level Laser Therapy for treatment of Capsular Contracture. There is more available than just another surgery to replace your implant. Remember to think outside the box. Just because a PS hasn't heard about this, doesn't mean it is not worth a shot. There are a lot of risks with surgery. The Low Level Laser used in this study has been used to treat Lymphedema after BC treatment, for several years, which it is FDA approved to do here and in Australia where this Laser is manufactured. Another name for it is Cold Laser Therapy.
http://www.aestheticchannel.com/cosmetic-surgery/laser-therapy-capsular-contracture
Low-Level Laser Therapy: An Alternative Treatment for Capsular Contraction
Jason D. Johnson, DO, Paul M. Glat, MD, FACS, William L. Scarlett, DO, FACS, , ...First Published March 1, 2015 Research Article
Article information Abstract
Introduction:
Fibrous capsular contracture is the most frequent complication leading to patient dissatisfaction after breast augmentation and breast reconstruction. This multi-factorial phenomenon has been treated both surgically and nonsurgically with mixed results. At the present time, the more severe grades of capsular contracture are treated most successfully by surgical means.
Materials and Methods:
The LTU-904 laser was used on 33 patients with grades III and IV capsular contractures. Patients underwent laser treatments once a week for a period of 6 weeks. They received a 10-minute treatment using the 904-nm laser with a 2-cm square grid pattern with 1 minute of treatment in each area (300 mJ/1 min treatment = 1.5 J/cm2). Patients were administered a posttreatment survey to determine their level of improvement and satisfaction.
Results:
Surgical intervention was avoided in 93.9% of patients with grade III and IV capsular contraction. Of the patients who avoided surgery, the laser improved the stiffness of the breast by 10–95% (average, 43.6%) and an overall improvement in comfort ranging from 10–95% (average, 48.2%).
Conclusions:
Low-level laser therapy is a promising alternative treatment for grades III and IV capsular contracture. In most cases, both the patient and surgeon observed significant tissue softening and improved breast contour after treatment while avoiding surgical intervention.
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Thank you for the info macb04. Unfortunately I don't think I could take the Pentoxifylline as I have stage 3 renal impairment due to prolonged NSAID use for a herniated cervical disc and subsequent fusion surgery back in the 1990s. Now I have to be super careful with meds and even supplements since my kidneys don't filter like they should. I will be having a revision to downsize my implants hopefully in the not too distant future anyway though, it was planned before I even suspected CC. I just got my appt with the new PS at Hopkins today. I see her July 5 for initial consult.
The laser treatment is really interesting!! Very good info to have on hand for all of us implant gals. I am bookmarking in my breast folder!!
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I went in for first fill today and I guess I was subconsciously nervous because my armpits started sweating like crazy - like sweat ROLLING down my sides in torrents. Yikes! Fill went great and this time the PS spent time with me and answered questions and asked me how the nerve pain is. I am seeing a pain dr tomorrow. The pain has improved but I want to be prepared in case it happens again in subsequent surgeries. Still don't know why he likes the magical antibiotic before and after each fill: one the day before, one the morning of, and one right after the fill. Anyway, he put in 180 ccs and I feel fine so far. We both think one more fill and then possibly the exchange surgery in early September and if I need it, fat grafting during Christmas break when I'm off work. All in all, I left his office in much better spirits than I have felt in a long time - it felt like tangible progress towards resuming a normal life, and for that, I am very grateful.
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ReadyAbout, I don't know if this would be helpful for your nerve pain but you may want to research it. My mom just got over a 6 week bout of insanely painful shingles. She described it as nerve pain. Her husband, (my stepfather) is a holistic MD. He put her on Gabapentin, ibuprofen and Acylcovir which didn't do much of anything. She really suffered, especially at night while trying to sleep. Just the fabric of the sheets or nightgown hurt her skin. So dad started researching and found a study on Tagamet for shingles pain. This was about 4 weeks into her ordeal. She got on the regimen and was tremendously relieved. The dosing is different than you would take for heartburn. I will get a link to the study for you.
Tagamet for Shingles The article is from Life Extension. They have wonderful vitamin and nutritional supplements my dad sells in his office so of course he trusts them. He even buys their organic coffee which tastes amazing. He says coffee is one of the most polluted crops there is and we should all be drinking organic coffee. Anyway, I hope you feel better!!
I had my 6 month breast exam Friday. The suspicious linear mass I felt under the skin was checked by ultrasound. It was just a fold in the implant thank God!! The rythmic pain has gone, I suppose it was nerves regenerating. I used to get that feeling in my breasts before the MX when I had too much caffeine. Like a hot needle every few minutes. I have one more 6 month follow up and then I "graduate" to yearly exams instead of every 6 mos as I will be 2 years out.
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Shoregirl - Thank you for the info- I will read the study on Tagamet. I met with a pain specialist and she listed several medications along with potential side effects, then we agreed on Cymbalta. It's an antidepressant also used to treat nerve pain in diabetics. She also prescribed Voltaren, an ibuprofen gel that I apply topically. Anyway, the first day on Cymbalta was rough: nausea, jitters, insomnia. I think it will get better, but in the meantime, I'm definitely going to read up on Tagamet as an option. Thanks again!
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my kid takes cymbalta. She"firgot" to take it for a few moths. Her depression is worse, as well as her chronic pain. She doesn't want to re start b/c of the nausea she gets. She said it usually lasts a week or so.
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Hi Ready - sorry you are experiencing nausea with the Cymbalta, I didn't have that problem but I'd been on Zoloft for a month first so maybe that's why. Does the ibuprofen cream help? If so I might ask to give it a try . I think I'm having good luck with Cymbalta and Tumeric, but towards late afternoon I might pop one Gab to feel completely comfortable.
I wanted to report back on the CBD gummies. The one I have is strawberry flavored (but not good!) and each one has no THC AND 15.14 mg of CBD. The first day I tried it I did feel a bit better. Took it twice a day for 3 days. It didn't seem to improve and I feel ambivalent about taking it again. If I do I would switch to drops (taken under the tongue) and increase the dose a bit. I notice you can buy CBD items in the market now (at least in Oregon). I have surgery in July so will wait to try again after. I've read that you start at 25 mg and increase until you find your sweet spot. Also read that there wasn't a problem taking it with Letrozole but there could be with Tamoxifen (I don't remember the specifics)
Lanne
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Ready...I would look carefully into Cymbalta. It is notoriously difficult to wean off of it.
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Shoregirl - thanks for the heads up. I just Googled it and gee whiz, you'd think doctors might *mention* this to patients before putting them on it! Sigh. I will see pain specialist again in a few weeks and ask about this. I am worried about having nerve pain again after the exchange surgery - my nerve pain is better but still not gone, so I am nervous about revisiting the experience.
About how many days of "down time" are needed for the exchange surgery? My doctor said I could probably do it on a Wednesday and be back at work on Monday. Does that sound feasible? I'm a middle school teacher so there's no "taking it easy" when I'm at work.
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Ready- a friend of mine had her boobs done (augmentation not reconstruction so a little different) in December on a Friday and went back to work on a Monday. We work in a bank so very low physical demand. She was sore but otherwise felt good. She did have arm movement and lifting restrictions but I was surprised she felt well enough that fast. My dr said to plan on taking a week off so that’s what im going to do.
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Ready, I personally think if your nerve pain is better, the exchange shouldn't set you back. You have to remember the MX was where all the trauma occurred. The exchange, while it is invasive, typically doesn't involve lots of cutting or scraping etc. I have had 2 exchanges and neither one was anywhere REMOTELY like the mx recovery. As for pain, I did have some with my 1st exchange (though not as bad as MX). For the 2nd exchange, my ps gave me a drug called Exparel in the OR at the surgical sites. It is a long acting (72) hour numbing med. It made a huge difference! I was out Christmas shopping 3 days after my 2nd exchange and I had fg too. If interested, you should have your ps check with the hospital to be sure it is available there. I had to travel 20 miles further to a different hospital as the one closer to me does not have Exparel.
I think Wed surgery w/return to work Monday is do-able. But you do have to "take it easy" in the sense of no lifting, pushing, pulling. For me, I regained my energy more quickly with exchange. Less time under anesthesia, less trauma etc. I did Google supplements to help prepare and recover from surgery and ate LOTS of pineapple. Milk Thistle is excellent to help rid the body of anesthesia and get back to feeling like yourself again. Have you Googled any natural pain relievers...Turmeric and other herbs, flax oil and essential oils etc. I know Magnesium and Vit B12 and B6 are supposed to help as well as fish oil. What about PT? My stepdad is an MD. He gets insulted and tells me "don't confuse my medical degree with "Dr Google" but it doesn't stop me!!! Just be sure to do diligent research on any supplement you think of taking. Some can't be used by people with kidney or liver issues and some shouldn't be used just prior to surgery. I hope this helps!
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Hi everyone. I’m so glad I found this thread. I need some input. I had saline implants under muscle prior to BC. I had a lumpectomy, followed by rads which I finished in November 2017. My radiated implant is becoming more painful and is definitely rising so I need a revision. My concern is that the muscle in the radiated side is still tightening (based on feeling as there is no way to know for sure). Now I’m wondering if I should switch to over the muscle gummies with a probable lifton the unaffected side. Can anyone offer me insight?
Also, I’m in Maryland and would love info on the best PS to use nearby, although I’d be willing to travel for the right PS. I doubt insurance will pay since I had implants already' but it would be nice.
Thank you!
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Hi Brightness456,
Sorry I cannot speak to your first question of switching. My prepectoral reconstruction with silicone was done by Dr. Justin Sacks at Johns Hopkins. My experience and outcome was great!
Good luck
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Hi Brightness, sorry to hear of your troubles! Where in MD are you? I agree with Simone, the team at Hopkins is top notch. I wanted to throw out there that one of the ps there, Dr Kristen Parker Broderick also has an office and surgery priviledges at Howard County Gen Hosp in Columbia. I had a great aesthetic outcome with Davinder Singh at AAMC in Annapolis. I would think since your pre bc implant has been impacted by the radiation insurance would cover it, and maybe the unaffected breast as well as you are entitled to symmetry.
Best wishes!!
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Hi Brightness 456,
Yes, they are all right, in should be paid for under the law, as we are allowed to have repeated surgeries to achieve symmetry.
I have listed 4 PSs in MD,
Dr Davinder Singh - Annapolis, MD
Dr Claire Duggal - Annapolis, MD
Dr. Eric Chang - Columbia, MD,
Dr Justin Sacks - Baltimore, MD.
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Hey Shoregirl,
Does PS Parker Broderick do Prepectoral Implant Reconstruction ?
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Thank you ladies. I’ll try to make some calls and do some googling later this week. I also need to read all the pages on this thread. I didn’t have time this morning and wanted to get my question out there. I love the helpfulness if this board
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Hi ladies, just wondered will I be " beach ready".. LOL..what I mean by that is just presentable in a bathing suit... 7 weeks after exchange and fat grafting surgery? Of course , I won't get in the water if there is any question at all regarding healing. My surgery date got changed and is closer to a vacation than I planned. Thank you for any advice!
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8 days out from prepectoral exchange, incision and lifting restrictions aside, on a purely aesthetic level I am totally beach and cute bathing suit ready. I am so excited to see where I am 6 weeks from now when I can work out again. Going stir crazy with post surgery light duty! I hope you will be ready and looking great 7 weeks post exchange
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Simone, glad you are doing well!! I'm hoping to be pretty much healed by then. My bikini days are over but PS mentioned taking some from thighs ..possibly...if needed. Light duty at work is fine with me lol. Just looking forward to this vacation. Hair will have only 4 months of growth but but I will be ready to go!! Thank you and I wish you speedy healing!
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Back at you Deb!!
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Hi DebAL, you should be back to regular activities by 7 weeks PostOp. So plan to get a nice bathing suit and enjoy yourself.
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Definitely ask your doctor. For me, do not lift arms over head for 2 weeks. Do not lift, push or pull more than 10 pounds for 4 weeks. No heavy exercise for 4 weeks. No baths, swimming or submerging for 4 weeks. If your restrictions are similar you should be ready to have a well deserved vacation at 7 weeks! And again YMMV, but this procedure was virtually pain free for me. I hope it will be for you as well, Deb!
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I had a preventative bilateral mastectomy, direct to implant, prepectoral, 1 week ago today. I am LOVING the size and shape. They were able to go a little bigger than my natural size. But (I think due to the extra stretch) now my nipples are suffering. The tip of one has begun to turn black. I'm taking liposomal vit c and drinking protein shakes. They just prescribed me nitro paste. Both breast surgeon and PS aren't fans of HBOT. I'm just really worried it's a goner. Anyone with experience?
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