Revision from subpectoral to prepectoral.
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Met with my plastic surgeon today she said that they can't put the pec muscle back to original insertion but can tack it down to the breast wall and move the implant out from under my pec to on top. She would keep the aloderm envelope on bottom to support the implant.
No way to know if this will be better or worse for using my pec muscle. I swim. And want to rotate my arm. Would. Like to. Have basic shoulder. Muscles I have no illusion about doing planks again.. For those who have moved their implant to the top of the pec. Can you share if there was any. Improvement in your range of motion or. Muscle use.
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hi E.g.!
Oh wow that's a great question. I definitely feel my pecs are much better. But I'm surprised every now and then that the odd feeling is back, however I opted not to have physical therapy post op. I think I'd be better athletically if I did.
It's hard for me to gauge swimming since I swam leisurely this summer (probably 6-12 weeks post op).
Rotating arms would be much better if I had PT. My range is back but one side still a bit tender.
I have not done push ups yet. I have not been able to since mastectomy in 2012. But I believe I will someday.
There are a lot of little things that tell me my pecs are better. But probably 70%
Two things I've been meaning to do an update on which don't address your question, but while I'm here ... my arm pits are normal to shave again. The caverns are gone, and I can shave like I used to.
The feeling is less ={. with muscles under skin, there was more feeling. But still I would do this again in a heartbeat.
Good luck with your decision!
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Had my revision from subpectoral to prepectoral this morning. Home after a few hours with 2 JP drains. Feeling pretty good (with meds). I can't believe it happened because my insurance gave me such difficulty over the alloderm. Still worried they will give me a hard time
. Obviously too soon to say how they look but looking forward to not having the muscle distortion and discomfort! Oh and shaving normally 
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Best wishes on a strong recovery.
For those of you who have had this done what did they do with the pec muscle? My surgeon said she would sew. It to the chest wall but that she couldn't go next it back where it used to be.
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this is a good direct question which I have never asked my plastic surgeon. He knew I wanted my pectoral muscle back where they belonged and I do feel much stronger and certainly a lot less inhibited to use my muscles now that I've healed after my revision surgery. I think I didn't want to hear that I had limitations and so I didn't ask the sensible direct questions after my surgery or before, which would have made a hell of a lot more sense.
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Hi Yaniza,
I am from NS as well, I am seeing my PS this week and have been researching the prepectoral procedure. I am really struggling with the subpectoral implants. It has been over 6 years, so I no longer think it will get better. You mentioned fat grafting as well, did you have to pay for that. My PS doesn't seem keen on revision, which made me wonder if you had the surgery done in Nova Scotia. I am really glad to read that your procedure went well and especially that the distortion, the iron bra and weakness are improved! I have all of that too.
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Hi, yes I did pay for the fat grafting but it at least was done at the same time as a pocket adjustment on the right side, which of course was covered. I don't mind private messaging you my phone number to discuss the pros and cons as I see them. Since we're both in Nova Scotia maybe we even know the same surgeons.
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Hi Yaniza, Yes that would be great, I would really appreciate Your feed back on this. It is so difficult to work out what to do.
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Ladies,
Surgery date 11/21, THANKSGIVING 7 days later... will I be able to tolerate a 1.5 hour drive, a 5 hour family Thanksgiving dinner, where I will be lucky to find somewhere to sit and a 1.5 hr drive home ??? Quick backstory, I had BMX 12/14 with TEs, 1st recon 5/15, 2nd 8/15, 3rd 12/15, seems my PS was a perfectionist, who knew at the time, so now 5 years later my teardrop on the left has shifted sideways and a new, renowned PS is going to do a revision to prepectoral rounds. My MO wanted me to do a DEIP flap, but due to the fat grafting for my TE to implant exchange I don't have enough fat on one side. - Thanks!!
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Someone else can speak to this better than I can but I will throw in my two cents and hope the ladies here will also give feedback to. My conundrum.
My pec muscle works but pulls. My shoulders forward and makes it very hard on my arms to rake leaves, swim with full rotation, do planks anything pull downs etc. I wish I had never ever let them cut t my pec muscle and put that implant under.
My ps told me to move the implant to the top of the pec she would separate the alloderm from the pec muscle and use it for the bottom of the implant and then scrape the facsia from between my chest wall and the pec muscle. Then stich my pec muscle down to the chest wall by putting some quilting stitches in. She said she couldn't attach the pec to the original insertion point because it would be under too much tension. Hence my pec muscle would not perform like a real Pec muscle.
She told me the women that she had performed this on had a very difficult recovery comparable to their first mastectomy surgery. So if that is the case I am not sure how long to expect a recovery but my original mastectomy with TE was 5 to 6 weeks. I was on a lor of. Pain meds and the drains took a long time to be removed.
I went back to My lymphedemia PT and we talked about it and I still don't know if this surgery would get me closer to Rowing and swimming pain free.
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Yaniza, I have not had this operation, but I have read about it. There was an article in the New York Times in September 2018 (Titled "New Approach to Breast Reconstruction May Reduce Pain and Weakness for Some") last year on the subpectoral to prepectoral operation. May help you gain some more information. The surgeon mentioned in this article (Hani Sbitany) did my breast reconstruction, and he was excellent. Hope this helps!
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Hi ladies, I’ve been following this thread and decided to post my question here (my first post). I was diagnosed earlier this year while pregnant. Went through chemo 3 weeks after labor and had BM in September. I spent most of my time researching about the cancer diagnosis and failed to do the same about the reconstruction. I now have tissue expanders under the pec. My range of motion is fine but I notice animations when I flex and the discomfort (the iron bra feeling) is bothersome. I wish I knew more about the surgery before going into it but I felt like I just wanted it to be over with. Does the discomfort get better after the exchange surgery? I’m done with the fill and the PS will ask me about the exchange during our next appointment. Is it possible to place the implant above the muscle during the exchange surgery even though the TE are under? Thank you all very much!
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RECOVERY - my teardrop under pec implants will be removed and replaced with round over the pec implants this Thursday. What should I expect for recovery restrictions and time? When will I be able to reach dishes above my head, open the sliding door to the deck? Those are the two things I remember as being difficult. So any hints as to what will be tricky would be helpful too,, as I have 4 days to modify things to make recovery easier.
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Hi knmtwins, I am looking to have a direct exchange from under the pec TE to over the pec implant. May I ask if your surgeon suggested to have the TE placed pre pec before placing the actual implant? Is there any risk or advise he provided? Thank you in advance and good luck on Thursday. I wish guy a speedy recovery!
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Would like to hear from ladies who have had the operation to remove subpectoral implants and replaced them with prepectoral implants and are through the healing process. How long did it take you to heal? I don’t understand what the surgeons do about the pectoral muscles that are now too long because they stretched them out with the tissue expanders before placing the subpectoral implants. Are you happy with the new feel? Are you happy with the look. I don’t want a lot of ptosis. I’d rather have them up on my chest
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Trying to bump this up to the top of the thread.
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Hi! I switched from sub pectoral to prepectoral in October. It was a big surgery and I had 2 drains for a couple of weeks. I think I was pretty much healed after 2 months. I had fat grafting and a nipple procedure prior to the surgery. I am really happy. I don't have much rippling and I have my chest strength back. I had horrible chest muscle distortion and weakness with exercise. Let me know if you have any other questions.
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Hi! I switched from sub pectoral to prepectoral in October. It was a big surgery and I had 2 drains for a couple of weeks. I think I was pretty much healed after 2 months. I had fat grafting and a nipple procedure prior to the surgery. I am really happy. I don't have much rippling and I have my chest strength back. I had horrible chest muscle distortion and weakness with exercise. Let me know if you have any other questions.
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Your outcome is amazing!
I am having revision surgery from subpec to prepec due to tightness, animation and just plain uncomfortable. I am 5'1 and 125 lbs, currently with 485cc inspira rounds. I want to move to a smaller implant because I don't like the weight and tightness. My original PS who did the surgery says I need to stick with the same size or go larger due to my stretched skin (I had skinsparing/nipple sparing surgery). If I move down in size, a breast lift with an anchor incision would be needed. What is the major difference moving to pre-pec from an implant sizing perspective? It's hard to know since my highest priority is the pain/tightness issue but I still want a decent outcome - less rippling. Any suggestions are greatly appreciated.
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hi ladies! Cfashiongirl I went up a size. I'm not as athletic as I was when I had my subpec implants so these are size appropriate. I seriously cannot say enough how much I love them. They look and move like real breasts, and truly I rarely feel like they're fake. They're not fake to me. This is truly a case of best thing i ever did.
Downside is that now I don't have much feeling. I had a little after all the surgeries I had for subpec. This final surgery to prepec took more feeling. If you go with the lift, you will lose more feeling. But you won't have those awful squeezing pecs that tense up in the cold or when you roll over in bed or lift anything. Yuck.
Truly every time I shave my armpits I feel normal again ... no more deep caverns that are hard to shave. I have me again.
I had my year check up a few months ago and had no problems. I looked and felt great.
Good luck to everyone. This wasn't a miracle but it's close =
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Crescent5,
I am SO uncomfortable subpec. I have seriously been talking with the PS who use your own tissue but Im too nervous to travel right now due to covid (it would require plane rides, recovery in a hotel etc). So, I am looking at Pre-pec as an interim stage since it's local and a smaller surgery. I simply want the tightness and animation to go away. I also feel like my breasts are wider and moving towards my armpits. It does sound like you are very happy with the surgery decision. I am in so much pain right now I am very anti-implant, but I wonder if that's because under the muscle is so tight and constricting?
Any advice would be appreciated. Can you sleep on your stomach?
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cfashiongirl, yes I was very uncomfortable. I had the implant armpit migration thing as well. I also had shooting pains going down my inner arms due to pec damage. That is much better right now but I still have some odd pains now and then. Not as awful as it was. But I really do feel that I have normal breasts again even if I can’t feel too much.
I sleep on my stomach every night!
Once I a while, I can’t go bra less for a few days It feels like there is some pulling. But I’ll wear a bra 24-7 for a few days and I’m good after that. That’s the only time I wear a bra at night. For reference I was 36c when I got sick. 36d with subpec 400ccs high profiles. Now I’m 36dd with 500ccs high profile prepecs
Hang in there it sounds like you’re on a good track
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Hi ladies,
This is a very helpful thread thank you!
Like y'all i am really struggling w tightness and deformity of sub pec implants that have also migrated to my arm pits. My shoulder function / posture is worse and pain into left arm. However too much tissue was taken from my left side and the nerve was cut on that side so it's just painful all around on that side w very thin skin and a lot of scar tissue.
I had a plastic say if i switch to pre pec the muscle will pull up / “window shade" behind the implant ... do y'all have that issue?
Also bc the pec muscle is stretched out now after 4 years that it won't go back into position? I've read a lot of women got most strength back but did they all revise quickly from TEs to pre pec? It looks like several of you revised years later so do you have strength back?
Even if i explant don't you want the muscles sewn back down?
Has anyone NOT used a mesh pre pec? Or would the skin just stick to the implant?
crescent you look very natural... i feel like it will look like circles on my chest.
i'd prefer smaller pre pecs but like others it's trickier now bc of stretched skin.
I'm sorry each of you are suffering too and wishing everyone pain free days w results they can live with.
thanks,
izzy
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CaliRN, Can you talk about your recovery a bit more? I am having this surgery in December and am wondering how much time to take off work. I had a horribly long and painful recovery with my mastectomy so the recovery period is my biggest concern. 2nd of course is will the animation go away? I think probably not entirely...
Thank you!
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exercise_guru I am scheduled for surgery in Dec. to revise my reconstruction because of severe animation deformity. Why was your surgeon unable to reattach your pecs? My surgeon says no as well and I'm unclear as to why not! Thank you.
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I had my Subpec to prepec with alloderm surgery on July 29th. On the one hand, the surgery was a success. The terrible and painful distortion is gone, and I feel stronger. Unfortunately, I got post surgical infection and was admitted to hospital a week after the surgery, for six day. Every night I was made NPO in case they had to do an explant surgery. Thankfully I was improving just enough to avoid that, but I was discharged with a PICC line and put on 6 weeks of daily IV antibiotics. I still have a lot of inflammation (possible red breast syndrome). I am having an ultrasound next week to see if that tells a story. While I am really happy to be free of the distortion and what that brought with it, sadly from an aesthetic point of view, things don't look good and I am told I will need further surgery in the future to fix that. However, I am definitely not up for more surgery any time soon, so I really hope the ultrasound doesn't change that. It has been quite a roller coaster for this kid. I don't regret having the surgery though.
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Megryan57,
the recovery wasn't that bad. I did have drains for 10 days which was challenging. I think I took off 6 weeks but my job requires lifting so I didn't want to risk it. The animation deformity completely goes away and I have regained more strength in my chest muscles. Overall I'm happy I made the switch. Good luck
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HEY ladies.. thanks for all our responses. Sea Foobs if that if your picture you don't look like you have a lot of body fat. My switch to pre pec was disastrous. Have a look back in the comments at my post and pic. I am a massage therapist so the implants had to come out from under my pec! The function is better but the look .. not so much. I am still trying to fix this in canada. Not easy. I am meeting virtually with the surgeon I had wanted from the very beginning but was dissuaded from using because he didn't have rights to operate in the 3 network hospitals I was on the cancer conveyer belt with. This surgeon I'm meeting with today also has a private practice and because of the cost of alldoerm and it being a revision surgery from another surgeon it may cost me up to $16,000! I'm gutted.
Seafoobs .. ask a LOT of questions and although crescent5 had a good result, many of us are not so lucky. It not only depends on the skill of your surgeon but on your skin, amount of body fat, how much tissue and skin they removed etc. My surgeon was the HEAD plastic surgeon for the cancer hospital and look what i got. I spoke with my original surgeon and have signed papers to go smaller.. because for some stupid reason they didnt do the anchor incision and take away excess skin the first time, I Will now have 4 scars on my breasts! I never wanted to be the size i am now. I am athletic and I am not liking it at all. I may have to stick with my surgeon because even if the surgeon today is sure he can fix it with alloderm and fat grafting, I will still be a DD + (AND I DON't have an extra $16,000 kicking around after this diagnosis). I'm so torn with what to do, good luck to all still waiting to have the surgery ! xx0
