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

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Comments

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

    Macb, His name is Dr. John Hijjawi, SLC Utah. He has great reviews.

  • macb04
    macb04 Member Posts: 756

    Hello Bird-of-light, thanks for your PS's name. I just added him to the list.

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

    👍

  • Shoregirl
    Shoregirl Member Posts: 338

    Bird-of-light that is great news!! I am glad you have a good rapport with your new surgeon. I tell you, these implants have been a struggle. I personally am not a candidate for diep, but I mentioned to my (previous) surgeon I wished I could have been. He told me to be glad I didn't have one. The reason being if in the future I ever needed a cardiac bypass the internal mammary artery in the chest is no longer available. I didn't pay a whole lot of attention to the comment as I am not a candidate anyway but in a Google search I came up with This Johns Hopkins article FYI if you want to discuss with your ps. I honestly think my previous surgeon was not "all in" with breast reconstruction procedures, more of a cosmetic surgeon. I am so glad I left him.

    I am status quo, my f/u appt is July 9. The botched left side remains flat at the lower/outer quadrant so it will def require surgery. I will need more fg too. For now just enjoying the summer!! Do you have a date or are you still thinking about the options?

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

    Shoregirl,

    Thank you so much for the link! I will definitely talk to him about it. He isn’t available until Sept or Oct, so I actually think I will wait until Nov or Dec because I teach and classes are out the first week of Dec. Enjoy your summer! I’ll keep you posted. Keep us all posted too

  • macb04
    macb04 Member Posts: 756

    I really hope this is it Shoegirl, that you get fabulous results. You certainly deserve it after all the screw ups.

  • Shoregirl
    Shoregirl Member Posts: 338

    You're welcome Bird-of-light, enjoy your summer!! Thank you macb04! I will truly be amazed if he can make the left side look fabulous. They are more level now though as the left side dropped some so that's encouraging. I will keep ya posted!

  • CENOK2017
    CENOK2017 Member Posts: 54

    Hi Jesse,

    My PS wants to do over the muscle TE and implant which I am happy about. However, I’ve noticed the term fat grafting. Is that the same as liposuctioning my tummy and inserting it into my chest? I read an article that scared me that said some docs feel fat transfer can stimulate cell growth and could cause dormant cancer cells to grow. Were you told this at all? Always something

  • macb04
    macb04 Member Posts: 756

    Hi CENOK2017, no never heard of that. If it were a big issue it would have already come up as Fat Grafting is common for the past decade or longer.

  • TWills
    TWills Member Posts: 509

    Ceno, I’ve read about that too, it’s been discussed here as well but it’s been a while and I’m not sure which thread. It’s like everything else, if you read the fine print it most likely doesn’t apply to most situations. I’ve had 3 rounds of fat grafting at a cancer center and was told it was not an issue but who knows.

  • macb04
    macb04 Member Posts: 756

    Everything else has they do to you has risks of causing bc, so I suppose it is possible, but have never heard about it, and God knows, enough women mention stuff like that that I am not going to worry about it.

  • Crescent5
    Crescent5 Member Posts: 64

    Dr Therese K White, South Portland, Maine

    Did my revision from subpec to prepec. Great to work with!

  • macb04
    macb04 Member Posts: 756

    Hi Cresent5, I just added your PS to the list. Thanks for giving me her name.

  • Crescent5
    Crescent5 Member Posts: 64

    Thank you fo starting this thread Macb04!

  • macb04
    macb04 Member Posts: 756

    Glad to share, important to pass this info on. You are so welcome Cresent5.

  • Crescent5
    Crescent5 Member Posts: 64

    hi Mac04. Dr Therese White is in Maine (ME) not Massachusetts (MA). Sorry for any confusion! Thanks again

  • DiveCat
    DiveCat Member Posts: 290

    Hi all,

    Not sure if this is advice or just general spilling of my thoughts as I weigh options.

    I currently have sub-pectoral implants...my initial surgery in 2014 was direct to implant, nipple sparing, smooth rounds, with Alloderm. My revision in 2015 was to Allergan 410s, in order to address rippling on my right side (very thin skin)

    I am in talks with surgeons about replacing the 410s. I am also looking at moving to pre-pectoral. I am in Canada, so need to see if I can find a surgeon locally or within a reasonable driving distance who does it.

    My results are not bad, if both were like my left side I would be thrilled, but I am quite active (daily workouts, other physical activities) and have always had more animation deformity and "twitches" on the right side which makes that side look a bit off. I have also never been convinced on that side my implant settled in quite right, a lot of fullness higher up and a much tighter and shallower profile at bottom (remember, these are anatomicals!). It not only feels "tight" but always has looked "tighter" - like it was being squeezed "up" instead of down. And yes, I can flex my breasts but not something i would miss, ha.

    I definitely am not comfortable being 'uncovered" because of that side. They look good under clothes though, and honestly, if it were not for wanting to take out the 410s I just could not be motivated to have more surgery. But I was diagnosed hypothyroid a couple years ago and have none of the usual risk factors for it, and in light of suspicions BIA-ALCL is consequence of an inflammatory reaction of some sort...eh. And, there have been some other things I have noticed in last few months that have me worried enough ("full sensation" in armpit that feels like swelling, tightness across base of one breast, increased spasms in the right side, etc).

    So, I need to talk more to my surgeons obviously, but I am considering this option. My main concerns though is how my pectorals will "heal" after being stretched out for the last 5+ years, as well as rippling, which I am already worried about when moving away from my 410s because of past experience. I am fine doing more ADM, I had no issues with it before, but I am a little worried about fat grafting. I was not a good candidate before and while I may have a little extra now (been diligent about not saying no to chocolate!) it is still not a lot and I worry a lot about recovery. I have very good pain tolerance, and am even fine with doing drains again (likely will be required anyway as they are going to have to do a capsulectomy whey they remove the 410s) but very low tolerance for not being active and taking things "slow"!

    I think a small reduction on the right side would solve some of the rippling issues I had before (I do have looser skin on that side and some "excess tissue", that breast was always larger than the left pre-surgery). I know that may mean additional scarring but I scar pretty well and am okay with a few more scars versus the misshapen look/excess skin I have now on the right side. I actually don't even care about keeping the nipple on that side. I can't feel my nipples anyway - if losing that nipple might otherwise mean other advantages I'd be prepared to say goodbye to it (so different from a few years ago when I wanted so badly to save them and was worried they were going necrotic during recovery!).

  • macb04
    macb04 Member Posts: 756

    Hi DiveCat, welcome. Definitely a complex story, but similar to ones I have heard before. I had a TE subpectoral and hated it for a year, and then wound up taking it out while doing Fat Grafting. I did several Fat Grafting procedures which didn't help enough because my PS screwed up, and because of radiation fibrosis damage. The surgeon took out the TE, didn't even stitch my Pectoral down, just put it back in the right location. Long story short, switched to new PS and did Prepectoral TE, then Prepectoral Implant exchange. Now looking at my story, you can see I did things in multiple surgeries. The new PS also screwed up by putting in the Anatomical Silicone Implant too small in size. He also cut away too much skin, so he couldn't put the correct size in to match my other natural breast. So unfortunately I am somewhat lopsided. Hate that, can't stand looking at myself nude. In clothes, with certain bras, I look ok.

    Now to your question. My Pectoral wasn't stretched out as long as yours, only about a year, to your 5 years. I do want to let you know that I have completely normal strength and function of that pectoral muscle. I have zero animation deformity. Other women on this thread and other threads, have also recovered normal pectoral strength and function when switching from subpectoral to Prepectoral Implant Reconstruction. Compared to the inital mx, recovery from Prepectoral Implant Reconstruction surgery was considerably easier for me and most women I have heard from. I think I was back up to driving in about 10 days, and lifting groceries, and other moderate weight items in 2 to 3 wks. My recollection is a little hazy on the exact details but that is close.

    Hope this helps, and perhaps someone else will chime in with their experiences.

  • DiveCat
    DiveCat Member Posts: 290

    Thank you so much for your response macb04, I am really relieved that you have normal strength and function.

    I have been fortunate in both my surgical recoveries were quite smooth sailing, but it was a few years ago now so who knows how predictive that is! I do know I was back to driving after my revision following the weekend (surgery on Thursday, back to work on the Monday). After the original I went back to work at a month (but was working from home earlier than that, as I was going stir crazy). Both times was back to long daily walks within a handful of days - couldn't work out, but rationalized I could walk!

    I will discuss with the surgeons here. If neither of them are familiar with pre-pectoral reconstruction I will probably get a referral back to my original surgeon in Calgary or another one up there as well. I would just rather do it closer to home this time if I can.

    Reading your experience again reminds me that it is always so difficult to settle on a surgeon, even the great ones will have unhappy results, but it is definitely worse when they don't even try to get good ones. I'd rather a cautious surgeon with less experience in some ways than an apathetic one with extensive experience!

  • avmom
    avmom Member Posts: 45

    Hi DiveCat,

    I’m in Alberta, too, and while I have sub pec TEs right now, my surgeon in Red Deer indicated to me that I could do revision to pre pec if I wanted to. I asked my Oncologist about going to pre pec this month, and we are going to talk about it again in the fall. My concern is mostly about recurrence on the chest wall, because with sub pec implants you chest wall is on the “outside”, while pre pec implants put the chest wall under the implant. I’m pretty high risk, so we are going to consider whether MRI will do for surveillance. Where would be close to home for you for surgery? Feel free to PM me if you would like.

    Avmo

  • macb04
    macb04 Member Posts: 756

    Hey avmom. Welcome. Could you give me the name of the PS near you in Alberta, that can do Prepectoral Implant Reconstruction for me to add to the list?

    Canadian PS's are rather sparse on the list, and I am sure there are more that do Prepectoral Implant Reconstruction than are listed.

  • happyperidot
    happyperidot Member Posts: 19

    A new name for the list:

    Dr. Nassif Soueid (pronounced "swayed") - Baltimore, MD

  • macb04
    macb04 Member Posts: 756

    Hello happyperidot, just update the list with your PS's contact. Thanks for giving me the name.

  • macb04
    macb04 Member Posts: 756

    This is great! Over 75 PS's on the List, who do are doing Prepectoral Implant Reconstruction in the United States.

    I am sure there are more out there. Keep the names coming, especially for Canada and Australia.

  • macb04
    macb04 Member Posts: 756

    bump

  • lexica
    lexica Member Posts: 138

    I just had prepectoral reconstruction at a MTF (military treatment facility near DC) on July 15. I am hesitant to share the PS's name because his care is technically 'closed' to anyone who is not under TRICARE insurance, but PM if you would like his name.

    I had a skin sparing mastectomy in 2017, so he just used the spare skin and created a pocket for the implant. No mesh or anything. I'm still a bit skeptical, but they seem to have turned out well! Unfortunately, my mastectomy scars are wide - horizontal across the middle of my breast, so the shape is a little wonky. Wondering if anyone has dealt with this and if it's possible to get around this issue of shape with the previous scars?

  • hapa
    hapa Member Posts: 613

    Lexica - I had to massage my right scar after my revision surgery to get it to release and go back to a normal shaped boob. I would put two fingers next to each other facing opposite directions on the scar line and then rub them back and forth in opposite directions to stretch and break up the tissue. I also did that around the edges and basically anywhere rubbing the tissue hurt, until it didn't hurt anymore, to break up scar tissue. It seems to have helped. Also, maybe take some vitamin E and you can also try bio oil or silicone strips to soften the tissue.

    As for your surgeon, listing him is no different from any other surgeon, who any of us can realistically only see if they are in our networks. So I would give up his name, because tons of people are on Tricare.

  • macb04
    macb04 Member Posts: 756

    😯😯😯😯😯 SCARS !!!

    Minimize them where possible....

    Here's some helpful info on Embrace Scar Therapy. Things your doctor may not mention. Wish I knew at the start.

    I found the best thing was using Embrace Scar Therapy over the new, just healed incision from my R breast lift. I kid you not, it has helped the incision heal so well there is almost zero scar visible, or able even to be felt. The PS 6 months later was absolutely astonished how wonderfully it healed.

    When I first used it, it was only prescription, but now it is available OTC in places like Walgreens and Amazon. It is kind of like a Steristrip built-in to a very thin silicon gel sheet. Takes all tension off the healing scar so that it can remodel into it's optimum thin, flat shape without any hyperpigmentation.


    Hope this helps. I wish I had known about this for some of the earlier scars which I am trying to improve after the fact.

    https://www.embracescartherapy.com/shop-now/embrace?gclid=CjwKCAjw1f_pBRAEEiwApp0JKNgMLvwg5roFFrdRaKeHCq9j872dxKTMh56IFlvjHILhsoDnWcg-zxoCL0sQAvD_BwE

    image

    image

  • macb04
    macb04 Member Posts: 756

    Has anyone else tried Embrace, or anything else that did a good, or great job in minimizing scars?

  • hapa
    hapa Member Posts: 613

    mac - I have not used embrace but I am intrigued. I'm using scar away on my port scar. Nothing will stick to my right mx scar because I have to slather moisturizer on it all the time since I had radiation on that side.

    You mentioned a lift on one breast, what did that entail? Was it a lift after mx or did you only have a umx and this was on the "good" side?