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

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  • macb04
    macb04 Member Posts: 756
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    LiveLoveLaugh, they say the cancer industry is a huge cause of bankruptcy. One year I had 13,000 dollars out of pocket, between 3 surgeries and all the other medical bills.

    I itemized it, and I wasn't even able to get money back, because you can't claim it off taxes unless the amount spent is a ruinous high percentage of gross income. Even the government is in on the swindle that impoverishes and bankrupts cancer industry victims.

  • DiveCat
    DiveCat Member Posts: 290
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    @willa216

    I have sub pec but was direct to implant so have Alloderm slings (placed 2014) and it caused no issues. I DID get that temporary “red breast syndrome” under one breast for a little while but that is not uncommon and is just a visual thing. It went away fairly quickly.

    My sister had pre-pec with Alloderm in December. While she has to go back for fat grafting due to significant rippling and perhaps get larger implants (her PS was concerned at time of revision about skin so went smaller), the Alloderm caused her no issues thus far. I know her doctor did talk to her about how some patients do have an issue with it but it was rare in his experience.


    But with two bouts of capsular contracture, you are at definitely at higher risk of more with more implants (especially pre-pec as I understand it but that is from my own research before my surgery years ago, not sure if that is still the case so don’t rely on me there!) and I am not sure how the Alloderm may work for you with that either. The issue is it is still another item foreign to your body, so if your body has a history of reacting to that it may be an issue.

    I am sorry you don’t have many people in your life who are willing to talk about this with. I am so grateful for my husband and my sister to talk about this kind of thing with. I hope you find this community helpful. Hug

  • orchidgal
    orchidgal Member Posts: 43
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    Just want to echo what SimoneRC wrote. I currently have nine year old subpectoral implants that have capsular contracture on one side and have been driving me crazy since day one. I just got back from a consultation with a PS who does prepectoral exchange/reconstruction using TEs and Alloderm. He explained that since the skin is so thin it's best to create a pocket using alloderm so it forms and holds rather than taking a chance that the prepectoral implants migrate after surgery. This greatly lessens the chance of that happening. I hated the TEs too but am willing to go for it if it means freedom of movement, etc., and having my pecs back on my chest wall as nature intended. The fat grafting if desired would happen after exchange surgery.

  • macb04
    macb04 Member Posts: 756
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    I might say that rehabilitation of fragile skin with the improved micro circulation that occurs after fat grafting might not be a bad idea.

    I had all of my fat grafting done prior to changing TE/Implants.

    My PS did say my skin looked better than others he had seen, with similar history, but not fat grafted.

  • macb04
    macb04 Member Posts: 756
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    BUMP

  • LaVue
    LaVue Member Posts: 69
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    Is the issue with rippling cosmetic or is it painful?

  • veggal
    veggal Member Posts: 261
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    Cosmetic...yet emotionally painful.

  • macb04
    macb04 Member Posts: 756
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    Totally understand VegGal. For many of us getting a decent cosmetic result is as elusive as finding the Holy Grail.

    It is something we are entitled to, getting a result we can be comfortable with. I wonder how many of us just give up because we are worn out with endless suffering and painful procedures, and just settle for what we’re left with. I know I have just finally given up and just feel stuck with how it looks.

  • Pkitty
    Pkitty Member Posts: 2
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    So I had BMX with delayed reconstruction due to circulatory issues--which wasn't a shock, cause I was a size D and had undergone reduction surgery 10 years earlier, so I was a higher risk. My PS reconstructed prepectoral with ADM but had to use slightly smaller implants because of concern over circulation--so used 400cc instead of 450cc. I'm fine with the size, but they are quite rippled when I lean forward and slightly streaked/lined rippled when I stand straight. I can also feel a hard lump on the bottom part of the left breast and I can REALLY feel the implant in that area. Anyone have this experience? I wonder if the implants are too small for my skin flap or if I just need to do the fat transfer. Has anyone gone through the fat transfer to help smooth the ripples? if so--did it work??? Any tips on this procedure?

  • macb04
    macb04 Member Posts: 756
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    Pkitty, unfortunately I think that the ripples you are experiencing with Prepectoral Implants are very common. Fat grafting over the implants really helps that. Fat grafting improves the health of the skin as well as cushioning the implant so that they don't feel cold, so that you can get somewhat closer to how it would feel for a woman who has implants as breast enhancement.

    Without the Grafted Fat, implants can feel rather cold with just a layer of skin between the implants and the external air.

    I had several Fat Grafting sessions ( I am a special situation as I had severe Radiation Fibrosis damage to my skin and chest)

    Some women can get good Fat Grafting retention and only need one or two Fat Grafting procedures.

    You can loose a certain percentage of the grafted fat to reabsorption. Experience of the PSreally makes a HUGE difference when it comes to Fat Grafting.

    I had a ton of Fat loss due to Reabsorption. Wasted so much time,money and unnecessary suffering. I had a toxic marriage making it impossible to go get a really well skilled PS at that time. Regret listening to my husband.

    Still lopsided somewhat, ok in clothes.

    So this is my real experience, perhaps someone else will chime in

  • LiveLoveLaugh2020
    LiveLoveLaugh2020 Member Posts: 173
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    Pkitty - I have the same issue with rippling when I bend forward. I had fat grafting at the time of exchange and was told it helped to fill in a large indent. I also don't have that cold feeling everyone talks about, so in ways it did help. Downside to prepec is a greater chance of rippling. I am very thin with "thin skin" which also doesn't help. I haven't had a follow up with PS because of Covid but am wondering if I should do another round of FG. I was told at my 4 week post op that I was too thin and needed to gain weight so we shall see. I love the look/feel of my boobs and am otherwise pleased, just that darn rippling! So best of luck to you if you decide to do FG, I'm sure it will help improve things.

  • LaVue
    LaVue Member Posts: 69
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    What's the scarring like with FG

  • kv99
    kv99 Member Posts: 11
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    LaVue, there is a minuscule spot on my hip where the PS went in to do liposuction around my abdomen and I couldn’t even tell you where it went in to each breast. They removed two tiny stitches last week which I think were from fat grafting and looked like they were on the IMF, all hidden under my breasts on same incision line as mastectomy/ implant exchange.

  • LiveLoveLaugh2020
    LiveLoveLaugh2020 Member Posts: 173
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    Very minimal, I have two little scars on my hips.

  • LaVue
    LaVue Member Posts: 69
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    Thank you so for responding to my question. This process is overwhelming

  • emily12
    emily12 Member Posts: 21
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    Hi for the women that have had OTM implants for several years, how much is the sagging? The ADM forms a sling but the flaps are usually very thin and the ADM is also cadaver skin that stretches. How much do your implants sagged over the years? I know normal breasts sag too but I used to have small B cup perky breasts even after 2 kids. Zero ptosis and my concern is that OTM implants would sag more. Thank

  • macb04
    macb04 Member Posts: 756
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    Hi Emily.

    I am actually hoping for some more sag, to match my other, unchopped R breast.

    I had really incompetent care by my PS dr bryan mcintosh, who put in an implant that was initially about 150cc too small to match my R untouched side. I woke up, knew immediately 420 cc implant was way, way, way too small.

    He had cut away too much skin ( that I spent 7 months painfully creating with a TE).

    So three months later I had to pay financially and physically for his error, by going under the knife for another implant exchange to 495cc. That was in March 2016.

    This last implant is still too small, by about 60+ cc ‘s. Because he cut away too much skin, there wasn’t room to fit the right size.

    So I don’t match when naked, and my breasts look lopsided. ( like the breasts of two different women)

    So getting back to your question, four years out, I am hoping for sag of L implant breast so it will look closer to symmetrical.

    By the way, that surgery in March 2016 was the 15th Reconstruction surgery I had had in a four year period of Hell. Numerous errors, botched efforts, horrible infections.

    I don’t even feel safer, the ultimate irony.

  • veggal
    veggal Member Posts: 261
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    I have large prepectoral implants...600+ cc. I notice no sagging 3 years in. I also wear some kind of bra 24/7, just to protect my investment.

  • hapa
    hapa Member Posts: 613
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    I was told they would sag over time but not as much as natural breasts.

  • Sitti
    Sitti Member Posts: 89
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    Sorry to interrupt this question but, VegGal, have you heard from others that they wear(or were told they should wear) some type of bra 24/7? I also am 3 years out, ( I was suppose to be over the muscle and was expanded for that but during surgery ended up having to go under muscle) and am still wearing some type of bra 24/7. Its my choice b/c I'm afraid of migration but would love to not wear one when sleeping. I'm just not sure if it's necessary or not. Anyone know? I've been looking for a thread regarding this topic but haven't found a thing.

    Thanks!

  • veggal
    veggal Member Posts: 261
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    I think there are good number of us who wear support 24/7. My PS knows I do, but didn’t say I need to do it.


  • LiveLoveLaugh2020
    LiveLoveLaugh2020 Member Posts: 173
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    I'm in that boat. I wear something 24/7. I've finally started wearing a good sports bra I found along with my post-op surgical bra I still wear 8 months out. Do what makes you feel comfortable.

  • hapa
    hapa Member Posts: 613
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    I often sleep without one but my implants are pretty small.

  • minustwo
    minustwo Member Posts: 13,116
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    From what I can see, every PS feels differently. Mine said I would never have to wear a bra with sub-pec implants. But low & behold - truncal & breast LE so I wear a compression bra 24/7. Even so, 9 years down the road there's definitely sagging.

  • macb04
    macb04 Member Posts: 756
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    I don’t wear a bra in bed, only when I am up. I am actually hoping for a small amount of sag.

    My left side implant is too small because the PS screwed up and didn’t match my Right, lifted breast. He put in an implant about 150cc too small. Chopped off too much skin ( that I spent months painfully creating with a TE), so that when I had him replace the ridiculously small implant, he was only able to go 100cc bigger, still 50cc too small to match my Right breast.

    I know I could have another surgery or two, to fix his mistakes with some other PS, but I am weary and broke. I had 15 reconstruction surgeries all together, and am still not really pleased with my symmetry.

    Not the fault of the Prepectoral method, but just an idiot, incompetent PS.

  • macb04
    macb04 Member Posts: 756
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    Have seen lots of interest in the Prepectoral method of reconstruction, so thought I would see about pushing this thread, with a lot of good info, to the forefront again.

  • orchidgal8
    orchidgal8 Member Posts: 3
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    Update: Want to share that over the last few years I've had consultations with some of the above listed doctors who perform pre pcetoral reconstruction with implants: Kim, Tseng, Lavia, Momeni, and one doctor at whom Dr. Kim referred me to as she didn't want to take my case. Plus a PS in Long Beach a friend referred me to. None of them would or could do the surgery, although a few said they would but I didn't like their plan. One actually said she could do the whole thing in two hours, and wasn't sure if "they" would allow her ADM or mesh. Another said he would suspend the pre pectoral implants from the upper chest, like from the clavicle region. Didn't feel good about these ideas. So, I've finally found a doctor who will do the surgery, one I trust and like a lot, Dr. Mark Labowe, and am going to have surgery early next month. He said that fat grafting will be required afterwards. Medicare and my supplemental will pay hopefully for all or most of this. Fingers crossed.

  • katg
    katg Member Posts: 209
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    Dr. L Carrey in Los Angeles does this way.

  • jen2957
    jen2957 Member Posts: 75
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    Dr. Brian Thornton in Louisville, KY does prepectoral as well. He is very proactive about staying up to date on the latest research and working with his patients to determine what works best for them as individuals. He did my non-cancer side for symmetry and the result is very natural looking. I have my TE exchange for implant on Monday, August 1, so I will report back with how that goes!

  • carolehalston
    carolehalston Member Posts: 7,876
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    I just found this thread and have read many pages. I had bilateral mastectomies and immediate reconstruction with silicon implants under the pec muscle almost 15 years ago. Now the right textured implant is ruptured. I was all set for replacing the implants in the same pockets but my ps (the same ps from 15 years ago) is insistent about a top of the muscle placement. I wish that choice had been available with the original reconstruction.

    My implants have migrated a little toward the underarms.

    I worry that the exchange of implants with a new placement might involve more recovery time. Also, I am old enough now that many women my age would go for explant. I just think it would better to finish out my life with boobs.