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

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Comments

  • raven4mi
    raven4mi Member Posts: 215

    Kimmy_nl, I also get those same spasms in the same location, but they're not as frequent as yours. I know how painful they can be. Similar to macb04, mine only happen when I move in a certain way and if I straighten up and sort of arch my back to stretch things out a little that seems to counter-act them a little more quickly.

  • macb04
    macb04 Member Posts: 756

    bump

  • raven4mi
    raven4mi Member Posts: 215

    Bump, indeed! Hi, macb04! It's been so quiet on here lately. Hope everyone is doing well!

  • simonerc
    simonerc Member Posts: 149

    OK, I'll jump in.

    I had BMX with pre pectoral tissue expanders and Alloderm. Did my exchange three months later. I am 5'3", thin, fit and active with thin skin. I had Mentor Memory Gel Smooth High Profile Xtra 535 with fat grafting. I had no physical limitations. Full strength and range of motion. I did not have any significant rippling. They did not make me feel cold at all this winter and I went skiing often when it was super cold.

    However, one side was slipping out of the pocket. Moving down and to my side. And they stuck out too far on the sides. And they looked a bit too fake when nude.

    One week ago I had them swapped, had pocket work done on the slipping side, hysterectomy and BSO. So no fat grafting yet this time.

    I had Mentor Memory Gel Smooth Moderate Plus Profile Xtra 440. They look so much better!

    Upon reflection of the whole process, I wish I would have had the opportunity to put on a bra at the PS office when flat and try different sizers to help decide on shape and size of implant. It was difficult for me to see and communicate effectively with the tissue expanders expanded. The expanders are not shaped like breasts so it was hard for me to translate “size" vs the expanders. They asked if I was happy with the size I was at last fill and felt like yes, maybe, probably but in something that resembles a breast. It was tough for me since the expanders were so unlike my old breasts and the look I was going for. So, my bit of advice for anyone going through the process would be to ask your PS if you can narrow down size and shape before fills, obviously reconfirming before exchange.

    Good luck to everybody who is on the journey

  • Shoregirl
    Shoregirl Member Posts: 338

    SimoneRc, that was great information! I agree wholeheartedly with you. My ps told me to let him know during fills when I was the size I wanted to be. But as you said, it just isn't the same with TEs and before I knew it we ended up filling to capacity (actually over cap). The initial implants were ultra high profile Inspiras. They looked great, filled my pre msx bras near perfectly which I was amazed at. What didn't register with me was how darn firm and hard they would be, as well as very heavy in a pre-pec installation with thin skin. I wished I had the discussion with the 1st ps about going smaller than my original boobs, would have saved me so much time and trouble!! My implants started flipping over backwards in their pockets when I lay down. In order to correct this, my ps wanted me to go bigger. Of course that would have been the easier route. My implants were also ice cold like un unheated waterbed mattress. After reading a lot on this site, I heard fg could warm them up. I told him I didn't think I could handle implants after all. This ps doesn't do extensive fg, only around the edges of implant and he wouldn't do nip recon either so I moved on.

    Long story short, I downsized a few times, from ultra high profile to moderate and down 90 cc to 340 with extensive pocket work and a bit of fg. They are still Allergan but the Soft Touch line and feel much better (less stiff) than the Inspiras. Mine don't have any side boob and don't look nearly as good as the initial set though. In fact (PS3 of 4!) botched 1 side so bad I have to have it corrected later this summer. But they are much more comfortable and I feel I will be able to live with them

    So I feel communication with the ps before implants is key. I just let him put in what he thought was best. For me, I was so scared and just wanted the nasty cells taken out of me right away. I didn't realize with DCIS I had time to do more research and vet more PS. Now I am healed from my lates revision done April 11 and waiting patiently for the next round to fix the botched side and do more fg. Hopefully after that I can schedule nipples and tats. This October will be 3 yrs since my mammo that discovered the DCIS. So hard to believe I am still not done and I didn't even have chemo or rads.

  • simonerc
    simonerc Member Posts: 149

    It sounds like it has been quite the journey Shoregirl! Hopefully the finish line is near!

    Final thought for other ladies out there. I would make sure your PS is a reconstructive PS, not primarily cosmetic, AND that your PS had lots of experience with pre pectoral reconstruction if this is the path you want to take!

  • Druanne
    Druanne Member Posts: 74

    Hey everyone!

    I just had a revision surgery! My right one also seemed to slip out of the pocket! It felt really loose! So now he has added more alloderm and secured it to my chest wall. OUCH.....I am not happy with how it looks at the moment. :( It has only been 7 days so there is still healing left I know. I see my PS in about an hour. The nipple is about an inch lower on the right side now without a bra. :( I don't really like it. You can see it through stuff and it makes me feel self conscious. In a bra it can look ok, but I am a dancer and we wear "cholis" and I don't need a bra with that but they are thin and because my nipples are kind of erect all the time now and it is very noticeable. I do love that it feels secure now. Why do I feel like I am being picky and should just be happy? My fiance says things like.....but you're alive that's what counts and I love you no matter what!!! I am so grateful for that but he doesn't understand. :(

  • macb04
    macb04 Member Posts: 756

    Hi RavenNerdy.

    Hi Simone, I hope you find the new implants a closer fit to your hopes.

    Hey Shoregirl, what can I say? We have been through the ringer, and like Druanne, we just want to look normalish.

    I don't think you are being picky at all Druanne. We deserve to feel comfortable in our own skin. Symmetry is not too much to ask for. I certainly don't have it. The last PS, Bryan McIntosh screwed up the sizing, really made a huge, spastic error. That's why I took his name off the list. He had that plastic surgeon ego thing. Didn't take into account that I have to live with his mess. I am frankly too worn out to attempt to fix it.

  • simonerc
    simonerc Member Posts: 149

    Hi Druanne!

    Oh, the nipples. Yes. I get it. I am thinking of getting covers for mine. Mine are symmetrical, but not where one would typically imagine they should be. I wear a thick bra. I completely understand feeling uncomfortable when they are asymmetric or in the wrong place!

    And macb04!

    So very sorry that this journey has been so tough and without a good outcome for you! Sounds like your PS earned his way off the list. That stinks and I am sorry. I hope that in the future you can get to a better place🤗.


  • Druanne
    Druanne Member Posts: 74

    Hi again guys!

    Yeah, I don't know what it is but why am I worried about making my PS feel bad or that I am being picky?? My appt went well. I did mention the things I am concerned about after first saying what I was very happy and satisfied with! LOL....what is UP WITH THAT??!?!?! Why do I do that?? I don't want to hurt his feelings by telling him I am not happy. ANYWAY....I started tearing up and he said that he wants it all to heal and see me in 2 months. If I am not happy with where my nipple sits at that time he said we will address it. He is a very kind man. I don't want to have to wear covers but you did just give me that idea SimoneRC! I can use that in the mean time! My fiance again this morning says things like....you should be very grateful with what you have.....you have your skin and your nipples.....etc etc.....I KNOW and I AM!!! It is so difficult for someone to understand if they have not gone through it. I do love his sweetness and appreciate his effort to make me feel better. <3

    macb04......It is never good when egos get in the way :( I am sorry you had to go through that.

    Other ladies.....I wish I had had more say about my size! He asked me and I said a D would be great.....I was a DD....I was supposed to have TEs so I thought I'd have time after but ended up waking up with my implants and they are HUGE! The biggest you can get! 790CC!! I am 5'2"...I guess he filled my own skin so I suppose.....but I was really looking forward to being a bit smaller.....but again.....that "Just be grateful and thankful and happy" feeling rears up. So now I am still a DD. I really AM grateful though. <3 Sigh........

  • PRides
    PRides Member Posts: 9

    Hi Everyone,

    I just had my exchange surgery with fat grafting yesterday. I need to wear compression bras for 4 months. Can anyone recommend a soft compression bra that zips/snaps in front? The one I'm currently wearing, from the hospital, is really scratchy and uncomfortable. Thx

  • macb04
    macb04 Member Posts: 756

    Druanne, a lot of us women were raised to be "pleasant", and worry about making the other person uncomfortable. Never mind, that THEY ( plastic surgeons and the bc industry) should be working hard and thinking about our more than reasonable wishes of symmetry and comfort in our own skin. Did your PS say he thought that your nipple symmetry would improve over the next couple of months? Or what is supposed to change? That you are just being given time to become resigned to being assymetric?

  • simonerc
    simonerc Member Posts: 149

    Oh Druanne,

    Please do not be so hard on yourself. You have every right, and reason, to feel disappointment, anger, sadness, frustration....

    A couple of thoughts. My incisions are IMF. When I think about it, the only way to go smaller is to cut the skin on the bottom and pull it down to sew it back together. That will move the nipples as they are attached to the piece of skin. If you keep your nipples, they will move. There is no other way unless they cut and pull in more areas. Just my uneducated guess. So going significantly smaller and keeping your nipples probably cannot happen. My PS did mention that if I wanted to go a lot smaller, it could not be done with this method.

    My dad was a doctor. My husband is a doctor. I grew up around doctors. Many of my friends are doctors. My dad always reminded me that it is called the practice of medicine for a reason. Bodies are not like cars. You cannot just change parts, do procedures, without consequence of some type. You must balance risk and reward. Our bodies are imperfect.

    Doctors are regular people. They have lives and families. Sick kids. Leaky roofs. Issues just like everyone else. Some are better at what they do than others. Just like in the general population, some are pompous jerks, some are exceedingly kind and compassionate. All types!

    Overall in my experience, most reputable doctors want and try to do their best for their patients. Yes, they are often pressed for time. Some are not great communicators. I look at every appointment as my chance to grab the full attention of my doctor. And being my own best advocate. That includes being nice and engaging, organized with my questions, being open minded to their answers. Not because of societal pressures, but because that is how I treat other human beings.

    Our perfectly imperfect bodies may not always be able to do exactly what we want them to do. If my doctor is not actively helping me to manage my expectations I actively engage them to do so.

    All that being said.... having cancer sucks. Having reconstruction sucks. Living with all everything that goes along with it sucks. Men often want to “fix" things. I often want to smack my hubby upside his head when he comes out with gems as your fiancé does. I try to not be tooooo annoyed and chalk it up to the wiring of his brain:-)

    Sending gentle hugs and warm thoughts your way.

  • simonerc
    simonerc Member Posts: 149

    Hi PRides,

    Goodbye expanders! That was such a great feeling for me! I hope you are feeling good without them as well!

    I first ordered front zip Jockey from Amazon.

    Later I ordered Fila front zips from Kohl’s. They had more support and compression.

    Good luck and smooth healing!

  • hapa
    hapa Member Posts: 613

    Hi Druanne,

    I'm sorry you're unhappy with your reconstruction. I too am not satisfied. My implants are too narrow, project too much, and have poor symmetry. My husband keeps telling me they look fine and I shouldn't mess with them, but idgaf because I'm the one who has to carry them around and see them every time I look in the mirror. I am getting a revision next week (!) to move to wider, low profile implants. I will continue to have revisions until I can achieve some semblance of symmetry. If this revision doesn't get me reasonably close to my desired result I will go to a different PS. I think if you're still not happy and want more revisions, you should consider a different PS.

    Regarding going smaller, they will likely have to cut some skin if you want smaller implants. If you are only going a bit smaller maybe not, and how much they have to cut will depend on how much smaller you want to go. I had one PS tell me that she could remove skin by basically pinching it at my scar line, and she thought she could still get symmetrical nipple placement. This was at MDA in Houston; I can PM you her name if you'd like. But what Simone said about the nipples is true, and if you've had previous radiation then nipple reconstruction is probably a no-go. I am in this same boat.

    I am wondering why you are saying OUCH regarding the alloderm? Does it hurt where it has been stitched to your chest wall?

    I have heard that folks with alloderm have discomfort where it is stitched to their chest wall. For those with Alloderm, does the discomfort go away? Or is it permenant?

  • Druanne
    Druanne Member Posts: 74

    macb04

    My breasts were great when they were first done. BIG, but nipples were level. There was a lump in my right armpit and a crease in the front that he said he would go in and "release". Ever since that time the right side started to sag and get lower and feel loose. I knew immediately something wasn't right but everyone told me to wait and see. I did and it kept feeling worse. I called it my "googily boob" lol because it jiggled when I walked and just felt loose and was lower than the left. It drove me insane! So I went in to have it secured. He said he had to make a whole new pocket for it. He also sewed it up higher than the other one and tells me it will drop. The nipple is one inch lower and is really noticeable. I asked him if he could just reattach what he released at the top the first time and he said it doesn't work like that and there would be a scar. He wants to let it settle into the pocket and see where the nipple rests in 2 months. We shall see. I may just learn to live with it. I am tired of all of this....and I've only had 3 surgeries!!!!!!

  • Druanne
    Druanne Member Posts: 74

    Hapa,

    Hi!

    Exactly!!! I know my man means well but we see ourselves all the time and carry them around every day! My left radiated breast is PERFECT.....I wish he could make my right un-radiated breast look just like it! :) I am intrigued by what you heard from that PS about pinching skin to help reduce size. Hmmm. I am bummed because they looked great at first. I had to go in to have a lump in my armpit removed and he released an area on top because it was making a crease. It started going slowly south after that!

    I think the pain is from the stitches to the chest wall. It also feels a little itchy. For me though it does go away! It did the first time. :) These are just so heavy that it seems to take a while to heal! I have been wearing two bras to help relieve the pain of gravity.

    <3

  • Druanne
    Druanne Member Posts: 74

    SimoneRC

    Yay! Congrats!!!!!

    <3

  • Druanne
    Druanne Member Posts: 74

    SimoneRC

    Thank you so much for your reply. I try to keep that very attitude about everything. My PS is very caring and wants me to be happy. :) I am going to just relax for the next two months, let my body heal and see where we go from there!

    I had to laugh at "Men often want to "fix" things. I often want to smack my hubby upside his head when he comes out with gems as your fiancé does. I try to not be tooooo annoyed and chalk it up to the wiring of his brain:-)"


  • simonerc
    simonerc Member Posts: 149

    Hi Hapa!

    My Alloderm was placed when I had my BMX and tissue expanders. Everything was uncomfortable so I do not know what part was Alloderm. However, upon exchange surgery and subsequent revision I have no feeling from the Alloderm at all. Would not even know it is there!

    Druanne,

    I downsized last week from 535 to 440. He cut skin. I believe that is why my nipples moved a bit more south and out.

    It sounds like a great idea to relax and heal for the two months. Then reload and start learning and planning for any next steps. Your job right now is to heal! This is quite the process!!!



  • PRides
    PRides Member Posts: 9

    Thanks SimoneRC. I ordered the zip front jockey, arriving today.

  • simonerc
    simonerc Member Posts: 149

    PRides,

    I hope they are comfy and you are feeling ok!!

  • meeko1452
    meeko1452 Member Posts: 10

    This is an old, old thread but I thought I would share my surgery. I had a single MX (left) with direct to implant (saline) over the muscle reconstruction 4 days ago by Dr. Oscar Masters in Oklahoma City.

    The scar is a little jarring still (I know it will fade over time), but so far I am amazed at how good the implant matches my healthy breast (I opted for no surgery on the healthy breast...I'd rather have some asymmetry than mess with a surgery on my healthy breast).

    My cancer breast was a full cup and a half larger than my healthy breast, which my plastic surgeon said was actually a plus with DTI and the DTI breast usually ends up being smaller after implant because of the amount of skin he has to work with.

    Nipple sparing was not an option for me because my cancer was very near the nipple.


    I understand that my implants will last 10 years and then have to be switched out, so I am wondering if that means I cannot do a nipple tattoo since the surgeon will likely cut through the the tatoo at exchange. It is something I will bring up at my postop visit.

  • lala1
    lala1 Member Posts: 974

    meeko--I've had quite a few conversations lately with my docs about implant replacement since I'm at almost 7 years. My PS told me from the beginning that most implants could potentially last "forever" if one wanted to keep them and they didn't develop any leaks/tears in them. He said the warranty on them was for 10 years so lots of women like to swap them out just so they have warrantied implants. He said he recommends going at least 15 years. My BS on the other hand says as long as they don't tear, keep them! He says warranty or not, they are strong and will last a long time. He does an MRI on me every other year just to thoroughly check for lumps and to also check the integrity of my implants. He's very against swapping them out at 10 years just because a warranty runs out since it is a very real surgery. And I do have to keep in mind that my PS makes money if I swap them out so he's probably not the best one to ask. I find that it's more likely that I swap them because my native side will eventually sag so much that it won't match my implant side. When that happens, I'll probably get another lift on the native side and swap out the implants while I'm there. Also, I've got a Vinny tattoo on my mx side. He said no problem if I get the implants swapped out down the road. He'd just touch them up, easy peasy.

  • meeko1452
    meeko1452 Member Posts: 10

    lala1, that was the most helpful reply ever! Thanks so much for the great information!

  • shimmergal
    shimmergal Member Posts: 2

    I had direct to implant BMX with OTM implants and I am also considering a downsize soon, due to a lot of pec pain. I am a little over a year out from BMX and I think the weight of the implants is causing the pec pain. I'm also just not happy with the size, I am finding it difficult to be active/athletic with the size I wound up being. the "footprint" of my original breasts was the deciding factor I guess, so the implants that fit the footprint were about 550cc and on my frame they are just a wee bit much.

    I've read a few times that the capsule is removed when there is contracture. Will the capsule be removed if I'm swapping to smaller implants? And will my skin shrink down on its own to the new smaller size? (I won't get to see my doc to ask about this for a couple of months, so any insight is appreciated)

    meeko -- my surgeon told me to hold off on tattoos until she was done with this swap. usually she only needs about 5mm of incision to swap, but I might need additional pocket revision, so that is another factor to consider.

  • macb04
    macb04 Member Posts: 756

    Hi meeko1452, I put your PS's name in the list.. Welcome to the Prepectoral Thread.

    I think that what I have heard is about implants aging out is the old expression: IF IT AIN'T BROKE, DON'T FIX IT.

    I know several women, who had even the old style Silicone implants that have lasted, without problems, for decades. Then there are women who have had problems with implants in just a couple of years.

    There seems to be no concrete logic to how things work out, so just play it by ear. I am keeping my implant forever. It isn't a result I wanted, because the PS B M of Bellvue, WA screwed up, and put in way too small an implant, and cut away too much skin, so the new larger implant he put in 2 months later is too still too small. End result after 17 surgeries is still lopsided. My veins are shot, so I don't dare try for more surgeries.

  • TWills
    TWills Member Posts: 509

    Hello, does anyone have any knowledge of adding an implant to a previous DIEP reconstruction? I’ve only found one member that has had that done recently but hers was added sub pectoral and my PS is planning to do pre pectoral on min. Any info would be great, thanks!

  • Bird-of-light
    Bird-of-light Member Posts: 143

    Hello Friends,

    Yesterday, I saw the PS regarding DIEP as an option. PS is an experienced micro vascular surgeon who specializes in breast reconstruction. He said I am a candidate for either DIEP or moving the implants over the muscle. When discussing over the muscle, he said that under the muscle is an outdated practice that he called “garbage.” I was a little shocked as my implants are only 2 years old. I am choosing DIEP in hopes of no longer feeling like I am wearing a tight bra stuffed with tennis balls 😆. He said he wouldn’t promise to get me the size I am now, 470 cc, but could guarantee 3/4 of what I have now. He also said that I could end up the same size if the fat takes well. I will need 3 surgeries. The second two will include lipo on the legs, which is a bonus to me. I feel good about his plan and it was very easy to communicate with him, unlike my previous PS. He showed me pictures, and they looked great. 🤞🤞🤞

    Shoregirl, I hope all is well with you Hugs!

    Bird

  • macb04
    macb04 Member Posts: 756

    Thst sounds great Bird-of-light, very encouraging and possibly of big help to TWills.

    Is the PS you mentioned on the list above since he does Prepectoral Implant Reconstruction also?

    How lovely, a PS with an easy to communicate manner. Pretty funny that he called subpectoral implant reconstruction "garbage".