TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!
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After reading comments, I am thankful that my PS is experienced and I can depend on him.
Dr. Kevin Delaney is a Plastic Surgeon at the Medical University of South Carolina. My oncology surgeon was Dr. Mark Lockett, also MUSC. They have both been extremely knowledgeable and I have complete confidence in them both. I did not choose either of them. They were chosen for me. I call it fate.
I chose a bilateral mastectomy over the recommendation of lumptectomy by Dr. Lockett. I have/had extremely dense breast tissue with widespread diffuse microcalcifications. I had my first biopsy in 2000 and many mammogram callbacks and needle aspirations since then. I chose a bilateral mastectomy in 2000 if any mammogram/biopsy came back positive. You can only take this stuff happening for so long before you decide enough is enough.
I am 5 weeks out from skin sparing, nipple sparing bilateral mastectomy with immediate reconstruction using silicone implants over the pec muscles. Wow, that was a long sentence. I am not at the exercise stage, aside from the exercises they gave me when leaving the hospital. My implants are wrapped in alloderm and stitched to my chest wall. I get burning pain between the implants and the chest wall. I just read on another topic page about pressing on the scar. I did, burning pain stopped for a few minutes. I am taking gabapentin, a muscle relaxant, ibuprofin and tylenol (staggered dosage). I am still sleeping on a 12" wedge.
Regarding fat grafting to improve appearance, my doctor is ready and willing to do this. Me, not so much. We will see. I am 61 years old and can live with a little rippling.
I was in the grocery store this afternoon and it was freezing cold. My nipples did the wierdest thing. They felt like they responded to the cold (not I did not touch them in the grocery store lololol), but the nerve feeling in my nipples was strong.
I cannot imagine having a PS or OS that I don't have faith in. I've met a lot of doctors over the years who I had absolutely no faith in and those were awful experiences.
My question is: does the pain - nerve and otherwise - slowly go away? I have a partial knee replacement and I know that it slowly got better until one day, I didn't think about it all. Is this the way the mastectomy recovery works? When reading others say that this is brutal surgery, I have to agree. But I am happy with my decision.
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Yes - my experience has been that the nerve pain does gradually get better. I've also regained quite a bit of sensation. At first it was only around the edges but it's moved further in toward the middle of the breasts now.
I still use the massage setting in my shower on my breasts. I think it helped with nerve "retraining" and sensation. I do still get funny feelings of pulling or pressure and the occasional odd zing. Overall - so so much better.
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@wallacemathteacher - I remember a PS who did over the muscle had a similar technique of suturing the alloderm pocket directly to the muscle to keep things from dropping later. He explained that pain resulting from the stitching, if present, resolves when the sutures are fully absorbed by the 6 week mark. Hopefully that's the burning feeling you feel, and that it gets better and better long before that point, but at least you can put that date in your head as worst case
A nurse or doctor could hopefully confirm this for you. 0 -
I had my double mastectomy in April of this year. I did not have nipple sparing as I had been a size H and wanted to be a C so they had to remove a large part of my skin. Also there was some questionable cells right under one nipple. I felt like the pain fell off in a steady way for about 5 weeks and then if it were a graph fell off much more steeply. Yes zings here and there but mostly pain free by 6 weeks. I so agree that trusting your doctors is so important. I had to push back for second opinions and changing PS mid stream (between mastectomies and exchange) and it was well worth it. This is brutal enough without the stress of a rude disrespectful doctor....or worst incompetent. This choice of prepectoral implants has been great. I full range of motion, no pain and I like the way my new foobs look.. Tattoo cherry on the top on October 19 then done God willing.
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Hi wallacemathteach, pain improves over time for most of us. You are right, it is crucial to have PSs that you have faith in.
Did you want me to add your PS to the Prepectoral PS List?
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bump
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Just wondering if anyone else has had an issue with sutures showing through their skin where alloderm has been anchored. I have undisolved knots causing several small bumps about halfway between my nipples and the top of my breasts toward the center. The situation seems to be improving but it's taking an awfully long time. My surgery was on the 21st of August. It was a revision from dual-plane subpectoral to prepectoral.
I guess I'm asking if anyone has had issues with undissolved sutures after 7 weeks?
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Hi Yaniza, yes some of my sutures took over 9 weeks to dissolve in the IMF. Keep an eye on them for redness in case a suture granuloma occurs. Sometimes a dissolvable suture will partially poke out of the skin. I had this and the ps just snipped it in his office. Depending on the material used and the specific application, dissolvable sutures can take a few days to several months to dissolve.
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Thank you Shoregirl. That's very reassuring. I don't notice any redness but I will definitely watch for it. Sometimes there is some itching and a bit of an achy feeling in the area but it doesn't last too long. There is, I'm guessing, some fluid around these knots because when I run my finger over the area it feels a little like bubble wrap. Anyway I'm happy to wait... had enough procedures in the last few years.
Cheers, and thanks again.
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Yaniza, I have many bumps and several that are visible along the alloderm line. The IMF incision healed fine, but after two years the granulomas along the alloderm line have gone nowhere and are more apparent with more fat loss. It makes me a little sad.
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Pi-Xi,
Having permanent bumps in these areas will make me sad too! I had better call my plastic surgeon on Monday.
When did you realize that there were granulomas?
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I'm four weeks out from exchange and just the last three days am having pain at the outside of my right breast near my armpit. It also feels tight in my armpit similar to the way it felt after my mastectomies in April. I attributed it to lymph node removal back then and just healing from it. It pulls again when I reach upwards. The doctor had quite a bit of revision work to do there because my expander on that side had shifted under my armpit laterally. I joined a gym and started work after 5 months on Monday. At the gym I've only been doing leg cardio work - no weights upper body work yet. Is the bouncing around too much? I'm wearing a bra 24/7 per PS. I felt so good afterwards and now by the end of the day am quite uncomfortable.
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I’m only 4 days out but this question is for those a few months out from exchange. How long did it take for your implants to settle and not be as noticeable? For the most part I don’t feel them but if I move or stretch certain ways they feel funky
please tell me they settle in0 -
Yaniza, I internet self-diagnosed suture granulomas a couple weeks after surgery.0
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PiXi, I looked up granulomas and they can be removed. Are yours inaccessible? My sutures are very near the surface.
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Hi ladies! I had my TE surgery this week, delayed recon with prepec. It is by far the most pain I have been in. I am taking prescription pain killers for the first time ever! I never even filled the script after my skin sparing MX, just Tylenol or Advil got me through.
My PS said the pocket was very small and tight (thanks rads) and he cut as little as possible to maintain good blood supply to the area. He also used a wound vac for bandaging, which was never mentioned to me but seems like a great idea to increase blood flow to radiated skin.
There was a lot of pressure pain for the first two days like someone was pressing really hard on the pressure point near my armpit. Pain was radiating down my arm and around to my back. It is improving and I’ve been cutting way back on the meds and filling in with Tylenol.
Right now it’s all hard edges and square shaped, kinda gross looking like it wants to tear through the skin. My drain is slowing down, should come out on Tuesday. Not sure when they’ll want to start fills.
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Yaniza, they are fairly close to the surface, but I'm surgery-averse. In getting those removed (many across both breasts) I'd probably get an infection and lose the implants. I do fantasize about those lumps being gone though!
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Cpeachymom,
I'm sorry you are experiencing so much pain. Did you have tissue expanders placed prior to your exchange? I just had my bilateral mastectomy on 9/26, and I have tissue expanders that were slightly filled that day and will be filled 50 cc's per side until they are the desired size. I will then start radiation treatment sometime in November.
I have been really curious about how radiation will affect my final result with the pre-pec implants. If you don't mind me asking, do you have symmetry on both sides? What size did you choose? Thank you for any feedback. Hope the pain subsides quickly!
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Hope- I’m afraid I’m not much help as I just got my tissue expanders. I’m just starting this whole reconstruction phase. I had skin sparing mx, but I was small to begin with and rads tightened that whole area up and made it firm and rubbery. I opted to do delayed reconstruction because I couldn’t get a ps soon enough and I wasn’t willing to wait to get my tumor removed to accommodate his schedule.
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Cpeachymom,
Thank you for your reply. It makes perfect sense. I am just over 2 weeks out from getting my TEs too, and I am very tender, especially around the outside edges of them, likely where they were stitched to the muscle. Did they fill your TEs right away?
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Cpeachymom, have you heard about fat grafing for radiated breasts? I don't have experience with rads but I have read comments by some that fat grafting the radiated pockets in prep for implants really improved the skin's integrity. I believe the member SpecialK had some posts on the subject.
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hope- there was no room for any fills. I only hope things loosen up a bit so that I’m not completely miserable with each fill! It’s definitely pushing on a nerve because it keeps shooting pain down to my elbow. Today is better. How Have fills been for you?
Shoregirl- I had heard about that and did ask my PS about it. He didn’t seem to think it would be necessary or worth it, as it would all likely get reabsorbed. I know it has worked for others though.
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Peach & Hope, praying you both get to feeling better! TEs were a pain, especially in the 1st weeks. I found that the fills actually made them feel better as it smooths out the wrinkles as the shell is expanded. Nerve pain for me resolved in a couple months. Hang in there!
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same. The fills helped to pull in the sharp edges
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Cpeachymom, gabapentin is a drug that can be used specifically for nerve pain. it made a huge difference for me. You may want to ask your surgeon for a prescription. It is not a narcotic. It can be used in conjunction with narcotics. Hope you feel better!
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Yanzia, I have subpec implants with nipples spared. My breastslook very fake but quite beautiful. My scars are under each breast and I've had them for two years. When I flex they look terrible. Also, my cleavage is off because there is more fat on the left breast. The right breast showsdistortion more. My chest muscles are weak and tight so they pull my shoulders forward. I am considering going prepec but I'm afraid. Why did you go prepec and are you glad you did? If so, why?
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I'm 4 weeks out from my exchange and am worried I'm bottoming out on my right side. My right side is a little lower than the left and I can feel pulling in my right armpit and along my collar bone. I did some research online and this seems to be the only con in choosing pre prectoral implant. I've been wearing a supportive bra 25/7 since surgery and am supposed to for another 2 months. I hope it will heal in place and won't be a worry for ever. My scars under my breasts is about 1 inch above the crease and I'm worrying they are both bottoming out. I started exercising this last week. 4 days of cardio leg work and one day of light free weights 3-5 lbs. I decided the weights were too soon oops. I hope I didn't screw things up. I have an appointment for tattoos on Friday so I can talk to my PS about this then.
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Cpeachymom, that is so typical of a PS to say "it's not worth it." But if you want it, then push for it. I had fairly extensive fat grafting done to repair some post-infection damage and yes, while most of it was re-absorbed, while it was there those yummy fat cells did their job and led me to try again for TE placement. I'm a strong believer in advocating for yourself and not letting the PS dictate anything for you.
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Hi Bird-of-Light, check out the thread, "Revision from Subpectoral to Prepectoral". I haven't updated my progress lately but I explain my reasons for choosing to go through with the revision. I'll give it a bump for you and update my progress tomorrow.
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Thank you for all your suggestions and well wishes. I told my husband that the thing I was dreading most was the drain, but that hasn't even been on my radar. I did get it out today, but it was stuck! She had too pull for a good minute or two to get it out. Let me tell you- ouch!! She stopped twice to ask if I was doing ok. She said that it's sooo tight in there, I was thinking there was a stitch or something she forgot to snip. I was expecting just a quick weird pulling because that's what I remembered from mx. I even brought my toddler with me to the appt! Yeesh. She did say it will be small slow fills, which I expected. Didn't expect the thing that hurts the most to be my arm, hoping that resolves. I will keep the gabapentin in mind. Hope I don't end up with some freak nerve damage from this. She couldn't say for sure I wouldn't when I asked... sigh.
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