TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!
Comments
-
NotVeryBrave, Reconstruction is covered, but I had thousand plus in out of pocket costs to pay with each surgery, with additional IV Vitamin C a few times for each surgery, along with HBOT before and after the last few surgeries, effectively bankrupting me.I have a very high deductible. I am a especially screwed by the severe rads damage Dr Christine Fang caused at SCCA, so not everyone needs the extras of IV Vitamin C and HBOT to get through Reconstruction sucessfully. I am also forever on Pentoxifylline and Vitamin E daily to keep from having my skin/fascia tighten up due to the rads fibrosis they inflicted on me.
Thanks again Shoregirl for the good wishes. The same to you.
Brightness456, I wanted to know if those PS do Prepectoral and should be added to the list?
0 -
Hi aisling,
It is so great you are reaching out to women who have direct experience to share with you. As you mentioned, this is a thread where women have chosen prepectoral. Hopefully you will get lots of feedback from many different women to help you decide what is right for you.
For me, the decision was a no brainer. I like Pilates, swimming, skiing, hiking and other outdoor activities. I am not a gym rat. My concerns were animation deformity, limited range of motion, weakness, pain and good projection. I am 5'3", 115 pounds, and was a small C Cup.
My breast surgeon and plastic surgeon work together often and are both very experienced. My plastic surgeon does a lot of prepectoral reconstruction. I was a good candidate for prepectoral with nipple sparing due to tumor location, breast size and condition.
Despite very thin skin, I kept both nipples.
I had round, high profile implants with fat grafting done almost a month ago. They look great in clothes, bras and bathing suits. They look pretty darn good when undressed. They are more full up top, like you would look in a push up bra, but without a bra on. The nipples are not exactly in the same place but are pretty darn good. Range of motion and strength are just the same as before. Projection is great. Used high profile rounds which I wanted anyhow, and BS said they are less likely to flip than the shaped implants so that reinforced my decision. No rippling. And no and animation deformity.
Will be having MRI's every couple of years which not only checks on the implants, it will also serve as surveillance as well.
Given that post mastectomy nothing is perfect, for me this was absolutely the right choice. And I know if I change my mind later, they can always be changed out.
Good luck! Hopefully you will confidently decide which option is best for you!
0 -
aisling - I also had to make this decision, but it was made easier by the fact that the PS that I was working with does both types of implant procedures so he had no reason to try to talk me out of or into either one. He just laid out the pros and cons and let me decide. For a prepec implant, I could expect more rippling, and there was a chance the implant would rotate, though if I went with round instead of anatomical it didn't matter if the implant rotates. Also, since there was no cutting of the muscle it would be an easier recovery. He also said only about 10% of his prepec patients were dissatisfied enough with the rippling to bother with fat transfer, and the FDA has recently approved overfilled implants that supposedly result in less rippling. For subpec implant, I could expect to feel the implant and see the muscle whenever I contracted it. Less rippling, but a more difficult recovery. I'm going with prepec round implants for the same reason I'm going with implants in the first place - I want as little of the rest of my body messed with as possible. If I hate the prepec implants I can always get them put under the muscle later, but if I get them put under the muscle, the muscle is cut and while I could still get the implants removed and placed prepec, the muscle will still be damaged. I hope to not have to do fat grafting so I will probably just live with whatever rippling is there. I feel like a prepec implant is the least invasive procedure possible, and that was my choice, and I'm going with round implants so there's no worry of them rotating. It's the laziest recon option there is an frankly I'm pretty lazy.
0 -
Hi Aisling,
Here is my 2cents. I am a PT, very active, use my body all day to treat clients. When they told me what they would do to place a under the pec implant I was apalled! Dr said "you don;t really use your pec muscles anyway"WRONG!. You use them all the time! I am glad PS decided to try pre-pectoral with me. I think I was a bit of a guinea pig, but my surgical side looks EXACTLY like my 55 year old droopy breast, so he did a good job. The only thing is no nipple on that side. (nipple sparring was not possible due to the CA location) That doesn't bother me at all, but everyone is different.
I am a function more than fashion kind of person. If you can move and do your life with little or no pain and dysfunction that is more important to me than "looking perfect". I am missing a nipple, but who cares? I wear a printed swim suit and you can't see it. And I can do all the weight lifting, swimming, etc that I want. I mostly forget that I have an implant. I am one year out from my TE exchange surgery.
At some point you have to trust your own instincts, and ask for what you think will be the best thing for you. Hugs!
0 -
I think I have my exchange surgery date! Woohoo! It was touch and go for awhile. One foob got infected and my PS & I were worried it would have to come out. After a few days on IV antibiotics and a few weeks on oral ones, it looks much better. PS said that if he gets in there and there is still a lot of infection in that foob, he will put in a different kind of TE along with an antibiotic "plate" that will stay in there for 3 weeks, then do exchange. If the tissue looks ok, he'll put the implants in that day.
I will also probably do a lift and fat graft at a later date - I haven't had the best luck with post-surgery complications and adding more things to the mix just seems to invite trouble.
I barely noticed my expanders anymore - they really haven't been bad. I'm back to lifting weights and will start playing some tennis soon. I have some axillary cording that has come back (booo) and I'm still sleeping on a wedge pillow, but otherwise I feel pretty normal. And since I couldn't travel or do anything all summer, I decided to try a different craft beer each night, so at least I've been productive, lol.
0 -
I am having bilateral prophylactic MX this fall and BS has said he can do nipple sparing. I meet with PS tomorrow to discuss possibility of pre-pectoral or even immediate pre-pectoral final implants. Question for you ladies - where and what type of MX incision did you have? I like the idea of under the breast (inframammary) for aesthetic reasons, but is that what most BS do? My BS said it's up to the PS.
0 -
I had inframammary.
Good luck
0 -
Me, too.
0 -
Mine was inframammary too. Skin/nipple sparing direct to prepec implant. Honestly, they look pretty much like my real breasts except the nipple is slightly towards the outside. I’m pretty happy with them.0 -
Mine were inframammary and I did skin/nipple sparing. You really can't see the scars unless you're looking for them, unlike my lumpectomy and SNB scars. I was very hesitant to do the nipple sparing because I had vascular issues in both breasts and I was worried that the nipples wouldn't make it due to poor circulation or vasospasms in the tissue. I talked to my cancer navigator at the hospital who was very familiar with my PS and she encouraged me to go for it. I'm glad I did.
0 -
I am worried about my nipples being constantly hard. As it is now I cross my arms in front of them walking through the freezer aisle at the grocery store. My surgery is August 28th. I am eligible for nipple sparing.....but have that concern.
0 -
Hi Druanne,
I had nipple sparing with prepectoral implants and nipples are not constantly hard. They respond to temperature as they always have. Hopefully other ladies will chime in with their experience as well.
0 -
SimoneRC......Oh REALLY???? That is possible? So do you have sensation in them as well? Thank you so much for your reply.
I have been writing questions down and plan on giving my PS a call in the next week or so, I am feeling nervous.0 -
I do not have sensation in my nipples but they do react to temperature just as they did before mastectomy. When I am cold they are hard. When I am not cold they are not. Having them “on” all the time would not be good. At least for me! Definitely ask your PS
0 -
And Druanne,
I totally get being nervous. So far my journey has been problem free with a good outcome. I try to remember that many people who are cruising along with no issues do not post. This site was so helpful to me in getting prepared and educated. I want to contribute to the ladies taking the same journey and represent us lucky ones who are not hitting so many bumps in the road along the way.
Sending positive thoughts your way
0 -
SimoneRC
Thank you! I really appreciate that reminder that there are those that have minimal issues too.
0 -
Druanne, I am same as Simone..skin, nipple sparing with nipples reacting to temperature. Inframammary incisions. Pre-pec and having my exchange and fat grafting next week. No issues up to this point.
0 -
aisling -
I read, but haven't chimed in for a while on this thread.
I'm with 2FUN as I'm also a PT. Under the muscle of course LOOKS better as one surgeon said to you, but it's crap for function. They cut the pec muscle and that's just bad. You've read about the horrors of under the muscle in this thread already and maybe other places too. On top of the muscle is awesome for function and I am very athletic (run, hike, mountain bike, snowboard, kayak, weight lift etc) and see my PT patient caseload daily too. I'm more concerned I'll lose an implant to being injured via direct blow with a tree branch in a weird mountain biking crash given the falls I take sometimes. My breast are ugly naked if I'm being honest. I'm barely a B with 250cc implants (same as I was before mastectomies) and every edge is visible and they are a little rippled. The radiated side is also rotated a little so it's thin on the side and thickest along my sternum because the skin on the side doesn't stretch much, but that is the only way it would fit (I have anatomic). In clothes they look great though - symmetrical, even, same size as before!
I also have zero pain. I'm not wasting my time or the risk of another surgery for fat grafting (maybe down the road)...would rather save what little fat I have for harvesting down the line when they know more about using stem cells for other general medical problems. Fat grafting isn't very reliable anyway and many women just absorb it. Sure I wish they looked better naked (just wish the top edge wasn't as prominent), but I would never trade my amazing function for appearance! I wouldn't let a surgeon talk you into something you don't want, nor use a surgeon who isn't happy or comfortable doing what you want. You have many great surgeons in your area to choose from - go with what you want and who really listens to you! Hope all goes well! - xo0 -
I'm inframammary, with reactive nips. I also have a teeny bit of sensation. I certainly wouldn't have them removed to prevent reactions as psychologically the presence of nipples help one feel less traumatized (in my opinion). There are wonderful silicone nipple covers you can use that work well. I also found that my nips have softened over time and even when they are reactive, they're just not as noticeable as before the BMX.
Hope this helps.
0 -
Happy to say when I met with PS today he says I can have nipple sparing and pre-pectoral TEs & implant! Only issue is he and BS prefer incision going around the outer top half of areola and extending out to the side. I can live with that, as that's much better than going under chest muscle. He also indicated he can put more saline fill in implant at time of MX (300cc or maybe more) so I won't have to have as many fills and won't have to have TEs for as long, and between pre-pectoral and having smaller breasts (B cup), the drains can usually come out a little sooner. All good news.
0 -
Druanne- my nipples are actually more compliant now and much less reactive than before reconstruction. They don’t stand at attention very often at all. My PS said that often the nipples go one way or another but it’s impossible to forecast what will happen.
0 -
I don't know whether this has been discussed in this thread (I've read many many pages, but not all) - - - how do you selfcheck for lumps (recurrence) with prepectoral implants? Just the skin and axilla? What checks do you get to look under the implants?as I understand, with under the pecs implants, you could feel any lump, since it would always be over the muscle+implant. with pre-pec implant, the lump may be over or under the implant....
Thanks for clarifying. I'm currently in research for BMX after I finish chemo...
0 -
I just went and had a second opinion with a different PS for my exchange this afternoon. Now that's how a plastic surgeon should behave! What a difference! I was putting up with such a disrespectful jerk! I trust that not only is the new doc very capable but I feel like he listened and got my concerns. I feel like I'll be able to work with him if any fine tuning is necessary. I feel safe. This is the hopeful/ rebuilding part. It should be like this.
0 -
DebAL Thank you for posting!!!
I am feeling hopeful.0 -
JaBoo: There are pros and cons to prepectoral implant placement and unfortunately this is the part of the prepectoral choice that requires imaging. I chose prepectoral because first I was able to physically and for me the pros seemed to out weigh this inconvenience.
0 -
my BS , MO and gyn each do a breast exam and I had mammogram so that someone is looking at me every 3 months
0 -
Thank you ReadyAbout!!
0 -
JaBoo,
Doctors do exams and also will have MRI every two years to check implants. That will also check for anything lurking below the implants.
0 -
Right, the MRI will be a way to check without increasing the lifetime radiation dose, which is the case with Mammograms and CAT scans. All radiation exposure is cumulative and well know increase risks of to cancer.
Can radiation from mammograms cause cancer?
Radiation from CT scans, X-rays, and even mammograms can increase the risk of breast cancer
Published: February 06, 2015 02:45 PM
Common imaging tests, including even mammograms, expose you to radiation.
What do you think is more likely to cause breast cancer: chemicals such as BPA, phthalates, and pesticides or imaging tests such as X-rays and CT scans? The surprising answer: the imaging tests, particularly CT scans but also X-rays and even the mammograms used to detect breast cancer.
The Institute of Medicine, the nonprofit health arm of the National Academy of Sciences, reviewed possible causes of breast cancer in 2012 and found that no product or chemical could be conclusively linked to the malignancy. Not so for radiation-based imaging tests. The report, "Breast Cancer and the Environment: A Life Course Approach," concluded that about 2,800 breast-cancer cases a year among U.S. women stem from medical radiation.
"While these represent a small proportion of all breast cancers, they're important because they can potentially be reduced," said Rebecca Smith-Bindman, M.D., director of the Radiology Outcomes Research Laboratory at the University of California at San Francisco, in an analysis of the findings.
The IOM concluded that one of the most important steps women can take to reduce their breast-cancer risk is to avoid unnecessary imaging tests. (Find out when to question CT scans and X-rays.)
Learn more about the dangers of CT scans and X-rays and check our advice on screening tests for breast cancer and other malignancies.
But that advice becomes tricky when it comes to mammograms. After all, mammograms are proven to reduce your risk of dying of breast cancer, by helping to detect the malignancy early, when it's more easily treated. So how do you balance that against the slight breast cancer risk posed by mammograms? Here's our advice.
Should you still get mammograms?
Yes—but not more often than necessary. Mammograms don't expose you to much more radiation than a traditional chest X-ray, and the risk posed by a single scan is extremely small. Still, any needless exposure poses needless risk. And some doctors recommend that women get screened every year, or start at a young age. We think that's usually not necessary. The U.S. Preventive Services Task Force, whose advice helps set government policy on screening tests, says women ages 50 to 74 should get screened every two years. Those in their 40s or 75 and older should talk with a doctor to see whether the benefits outweigh the potential harm.
Can ultrasound or MRI of the breast be used instead?
Neither of those tests emit radiation, but they are usually paired with regular mammograms, not offered as an alternative. So they can't really help you avoid radiation from mammography. And while adding them to regular mammography may improve cancer detection, the combination tests are more likely to trigger false alarms. Moreover, there's no convincing evidence that adding the tests to mammography saves more lives. The tests may make most sense for women with "extremely dense" breasts—that is, who have relatively little fat in their breast tissue—since they face a greater breast cancer risk, in part because mammography is less accurate in them.
3D mammography, or tomosynthesis, creates detailed images of the breast.
What about 3D mammography?
You may be hearing more about this form of mammography, which goes by the technical name tomosynthesis. It exposes you to about as much radiation as a regular mammogram, but allows radiologists to view the breast in detailed slices instead of a single, flat image. With more views of the breast, the radiologist can zoom in on areas-in-question and better determine whether more testing is needed.
Piggybacking tomosynthesis and mammography can increase cancer detection rates while cutting the number of invasive follow-up tests in those with questionable mammograms. But it's not yet proved to save additional lives.
But because the test is done in combination with a standard mammogram, until recently it meant getting a double dose of radiation. That's now changed. The Food and Drug Administration recently approved a tomosynthesis scanner that creates both 2D (standard mammography) and 3D images at the same time, eliminating the increase in radiation exposure. So if your doctor suggests a 3D mammogram, make sure it's with the newest version of the technology.
—David Schipper
0 -
I kinda lost it yesterday. I am thinking & worrying about too many things and need to try and relax. Just needed to say that. 0
