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All TopicsForum: Breast Reconstruction → Topic: TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!

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

Forum: Breast Reconstruction — Is it right for you? Discuss timing and various procedures and techniques.

Posted on: Oct 20, 2015 12:47AM - edited Jun 11, 2017 12:31AM by macb04

macb04 wrote:

I want to put this out there as an option for implant reconstruction. Initially I had uni mx and delayed reconstruction with a TE put under my pectoral muscle. Hated, just hated it. Was painful and crampy for all the muscles of my chest. No strength because my pectoral muscle was cut. So bad I couldn't open a bag of chips. Was slowly inflated, while waiting to do DIEP. Changed my mind and did fat grafting 3 times with an inexperienced PS who took out my TE. Had infections twice and lost a lot of my grafted fat. Got a new , better, forward thinking PS who agreed to putting a new tissue expander OVER my pectoral muscle, with no cutting of my muscle whatsoever. In August 2015 I did implant exchange, to a 420cc Mentor Anatomic Implant. Then had breast lift of right side for symmetry in September 2015, about 4 weeks ago.. Plan nipple reconstruction this December, with areola tattooing in late spring with Vinnie Myers.

Looks pretty good, have a very realistic, custom made prosthetic nipple that I wear every day until I get the reconstruction done. Made by Feeling WholeAgain.com. Really nice guy named Paul created it for me. Used to be called Custom DSE.

Using Embrace Scar therapy system for the next 8 weeks on the vertical lift/breast lift incision. Hope it will minimize my scar. I will update how that goes.

Important point, had 5 weeks rads, had rad fibrosis. Got Hyperbaric Oxygen therapy in conjunction with fat grafting which healed my skin almost back to normal. Despite these setbacks I was still sucessful at Implant reconstruction. Realize is still early days. Plan to keep taking Pentoxifylline and vit E for a long while yet to prevent capsular contracture. Not perfect, but enough to make me feel nearly whole. Plan to go back to my gym and change in the locker room like a normal woman again, instead of hiding and changing in the toilet.

UPDATE : List of Plastic Surgeons doing OVER Pectoral Implant Reconstruction , ( Prepectoral Implant Reconstruction ) [This list will be duplicated in a new thread]


WEST COAST

Dr Bryan McIntosh -Bellevue, WA

Dr. Jonathan Hutter -Valley Hospital, Renton, WA

Dr. Mark Tseng - Multicare, Auburn, WA

Dr Reid Mueller - OSHU, Portland, OR

Dr Kamakshi Zeidler - Campbell, CA

Dr Karen Horton--San Francisco, CA

Dr. Charlotta Lavia - Los Angeles, CA

Dr. Michael Halls--La Jolla, CA

Dr. John G. - San Diego, CA 619-222-3339.

Dr. Jyoti Arya - San Diego, CA

MIDWEST/CENTRAL/MOUNTAIN

Dr. Julie Park - University of Chicago Medicine, Il

Dr. William Dougherty - Santa Fe, NM

Dr. Minh-Doan T. Nguyen, MD, Ph.D -Mayo Clinic, Rochester,MN

Dr Steven R Jacobson - Mayo Clinic, Rochester MN

Dr. Bruce Chau- Berkley, MI

Dr. Marissa Tenenbaum - St Louis, MO

Dr. Richard Hainer - North Oakland Plastic Surgery, Rochester, MI

Dr Michael Bateman - Denver CO

Dr. Hardy -Northwest Plastic Surgery Associates, Missoula MT.

Dr Jeffrey Lind II - Houston, TX

Dr. Danielle LeBlanc - Ft Worth, TX

EAST COAST

Dr. Lawrence Glassman - Nyack Hospital, Rockland County NY

Dr. Andrew Smith - Rochester, NY

Dr. Tzvi Small - Valley Hospital , Ridgewood NJ

Dr. Joseph Woods - Piedmont Hospital, Atlanta GA

Dr. Samir Rao - 3299 Woodburn Rd Ste 490 , Annandale, VA 22003

Dr Mark Venturi - McLean, VA

Dr. Thomas Hahm - Charleston, SC

Dr. Kevin Delaney - Medical University of South Carolina (MUSC), SC

Dr Jason Ulm - Medical University of South Carolina (MUSC), SC .

Dr. Michelle Roughton - UNC Chapel Hill, NC.

Dr Justin Sacks - Johns Hopkins, Baltimore, MD

Dr Kent Higdon - Vanderbilt Medical Center, Nashville, TN

Dr Davinder Singh - Annapolis, MD

Dr. Eric Chang - Columbia, MD

Dr. Joanne Lenert - Washington, DC

Dr Hilton Becker - Hilton Becker Clinic of Plastic Surgery, Boca Raton, Fla

EAST COAST CANADA

Dr Mitchell Brown, Toronto Canada

RESEARCH LINKS ABOUT PREPECTORAL RECONSTRUCTION

https://www.sciencedaily.com/releases/2016/03/160302182438.htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4494482/

http://www.nesps.org/meeting/abstracts/2016/57.cgi

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4727683/

https://www.ncbi.nlm.nih.gov/pubmed/28027223

VITAMIN C HELPS WITH HEALING FROM SURGERY/and can kill bacteria such as Pseudomonas with high dose IV Vitamin C. If you can't get Intravenous Vitamin C, Liposomal Vitamin C can be a big help if you can't afford or find IV Vitamin C.

ALSO, WANT TO BRING UP ESSENTIAL OILS SUCH AS OREGANO/THYME and GOLDENSEAL have Synergistic Effects against bacteria, alone or in combination with antibiotics. I posted this info somewhere else, but copied it to here again.

Nutritional Support for Wound Healing - Alternative Medicine Review https://www.ncbi.nlm.nih.gov/pubmed/14653765

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4915787/

Pharmacokinetics of oral vitamin C

Abstract

Purpose. To test whether plasma vitamin C levels, following oral doses in supplemented volunteers, are tightly controlled and subject to a maximum in the region of 220 µm L−1, as suggested by previous researchers for depleted subjects. To determine plasma levels following single, variable‐sized doses of standard and liposomal formulations of vitamin C and compare the effects of the different formulations. To determine whether plasma levels above ∼280 µm L−1, which have selectively killed cancer, bacteria or viruses (in laboratory experiments), can be achieved using oral doses of vitamin C.

Design. This was a single blind study, measuring plasma levels in two subjects, in samples taken half‐hourly or hourly for 6 hours, following ingestion of vitamin C. Data were compared with published results and with data from 10 years of laboratory plasma determinations.

Materials and methods. Standard 1 gram tablets of vitamin C; liposomal vitamin C. Plasma levels were analysed using the method of Butts and Mulvihill.

Results. Preliminary investigations of the effects of liposomal and standard formulation ascorbate showed that blood plasma levels in excess of the previously assumed maximum of 220 µm L−1 are possible. Large oral doses of liposomal ascorbate resulted in plasma levels above 400 µm L−1.

Conclusions. Since a single oral dose can produce plasma levels in excess of 400 µm L−1, pharmacokinetic theory suggests that repeated doses could sustain levels well above the formerly assumed maximum. These results have implications for the use of ascorbate, as a nutrient and as a drug. For example, a short in vitro treatment of human Burkitt's lymphoma cells with ascorbate, at 400 µm L−1, has been shown to result in ∼50% cancer cell death. Using frequent oral doses, an equivalent plasma level could be sustained indefinitely. Thus, oral vitamin C has potential for use as a non‐toxic, sustainable, therapeutic agent. Further research into the experimental and therapeutic aspects of high, frequent, oral doses of ascorbic acid either alone or (for cancer therapy) in combination with synergistic substances, such as alpha‐lipoic acid, copper or vitamin K3, is needed urgently.

Essential Oils and Their Components as Modulators of Antibiotic Activity against Gram-Negative Bacteria ..

http://www.mdpi.com/2305-6320/3/3/19

Essential Oils and Future Antibiotics: New Weapons against Emerging ' Superbugs ' ?

Nicholas A Boire1, Stefan Riedel2 and Nicole M Parrish2*

1The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA

2 Department of Pathology, Division of Microbiology, The Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA

https://www.researchgate.net/publication/253567306_Essential_Oils_and_Future_Antibiotics_New_Weapons_against_Emerging'Superbugs'

PDF]Antimicrobial and synergistic effects of some essential oils to fight ... - The Battle Against Microbial Pathogens: Basic Science, Technological Advances and Educational Programs

www.microbiology5.org › book

by H Padalia - ‎2015 - ‎Cited by 2 - ‎Related articlesEssential oils can be individually effective or they may be combined with antibiotics or plant extracts. Traditional healers often use combinations of plants to treat or cure diseases and found that synergy was most

According to a report published in The Review on Antimicrobial Resistance, the government of the United Kingdom estimates that by the year 2050, more than 10 million deaths and 100 trillion dollars in global health care costs will have resulted from drug-resistant microbes.

https://www.ncbi.nlm.nih.gov/pubmed/27872555

https://www.ncbi.nlm.nih.gov/pubmed/28224112

https://www.ncbi.nlm.nih.gov/pubmed/27895802

https://www.ncbi.nlm.nih.gov/pubmed/26256994

https://www.ncbi.nlm.nih.gov/pubmed/25185110

https://www.ncbi.nlm.nih.gov/pubmed/16085104

https://www.ncbi.nlm.nih.gov/pubmed/12643856

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Mar 9, 2017 03:44PM JessieJake wrote:

I'm trying to remember to who and what I wanted to comment on....

reneeCA - I have pre-pec teardrops. I have had them for basically 7 months. I consider myself done and normal at this point. I do everything with the exception of sleeping or laying on my stomach (although I will do a little bit on my stomach such as yoga). To me they look incredibly natural except for a few minor things that only I or my hubby see (such as the scar and some edges that couldn't be completely hidden under my thin skin).

Hi Shoregirl, Elaborating on what I said above - I think that my results are specific to my body and won't be the result all have, but you mentioned a couple of things that sounded similar to me. I had fat harvesting twice. Once at exchange time and once more 3 months later. You mention not a lot of fat for yourself and that's definitely an issue. I really didn't have enough and what my PS harvested the first time was from my butt. I now have an old lady flat butt - not that it was perky and cute before but it certainly wasn't this flat. The second time she searched around my butt and inner thighs but didn't get enough to make the difference we hoped for. The difference we were aiming for was to fill in the minor rippling I had and to pad the upper edges of the implant better. So, yes, I have rippling despite having the teardrop gummies that minimize this issue. I also have alloderm completely covering my implants which she told me today was to help give me a sling to hold the implant, and an extra layer of padding. If I don't slouch the rippling is not noticeable but if I'm bending over or in some way letting gravity pull down on my chest the rippling is noticeable. We talked today about future options to deal with the rippling and lack of padding (the edges of implant are a little noticeable). She mentioned, of course, fat harvesting but only if I gained weight and fat, or when the time comes for new implants, using a second layer of alloderm to create more padding. I will worry about that later -- hopefully much much later!

At the end of the day, I would whole-heartedly recommend above the muscle. All of it was EZ, surgery, and recovery. Someone mentioned post-op pain being minimized. FOR SURE! After exchange the only pain I had was briefly at the incision site. One dose of pain meds and I was fine. No muscle spasms or anything else.

I am small chested and have small implants. I do wear a non-compression sports bra when active. They bounce around some but not badly and with no issues.

I don't mind the rippling I have, or the slight unevenness (naturally one side a little lower and PS couldn't adjust this perfectly), or the edges that kind of show through my thin skin. I truly feel like this chest is "really" mine. It's just part of me. I love the look of the teardrops. I'm about the same age as you (Shoregirl) and the sloping nature of this style seems to fit our age (I do get the impression there is a "right" person/body shape for teardrops based on what I've read here).

I have a couple of underwire bras I wear that push up slightly on my implants. This hides any rippling and edges and gives me a really nice (albeit small) cleavage.

So, although I shared my "issues" I've had enough time to realize I'm very lucky and that my look is really quite good considering my own personal situation. Now I'm just hopeful things continue as they are with no problems and let me get on with life!

Go pre-pec! :)

Mom of teens, preventative mastectomy
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Mar 9, 2017 08:02PM Hopeful07 wrote:

I have a question for all you prepec ladies. Anyone suffered from significant rippling? I have and am being recommended to go partially above muscle (I guess the top part but not sure how that works) and am being told I'm too slim for fat grafting (but may do that as well if he can find fat - I told him he sure can, lol). Just a little hesitant since I realized the benefits of going prepec now.


Did most of you just deal with rippling by fat grafting?

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Mar 9, 2017 09:28PM candles1 wrote:

I'm about ten days out, and one side has rippling. Unfortunately, it's at the top so it could be seen if I were wearing something cut low and wide enough. That said, I couldn't be happier with my surgery and with these implants. Other than the rippling, they look marvelous, and truly awesome under clothing. The PS went above the muscle AND direct-to-implant; no TE. So, for me it was truly one-step, no pain, easy recovery (I went home after surgery and took a long walk). I did not take a single pain pill at home. All restrictions have been lifted. I can sleep, move, etc. however I want. I only need to wear a bra if I want to. This is literally ten days after BMX/reconstruction surgery.

PS thinks I should consider fat grafting for the ripple, and I may do it. IDK. Right now, I'm just enjoying getting back to my life. I'll think about the fat grafting if I find that the rippling starts to make me self conscious about what to wear. Otherwise, I've read that fat grafting doesn't always work, and results in more down time/recovery due to the donor site. At some point, I just want to get off this BC roller coaster, and "good enough" sounds really good to me right now.

Dx 11/8/2016, DCIS, 1cm, Stage 0, Grade 3, 0/3 nodes, ER+/PR+
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Mar 9, 2017 10:25PM - edited Mar 9, 2017 10:43PM by Sitti

candles1, It sounds like you had done what my PS is recommending, using Acellular dermal matrix (?) to hold in the implants. No tissue expanders, which had me wondering if I would be able to achieve enough fulness after I read other forums. Good to hear the recovery went/is going so well and how happy you are with the process and results. Thanks for the update.

Dx 12/5/2016, DCIS, Right, 4cm, Stage 0, Grade 3, ER- Surgery 1/12/2017 Lumpectomy Surgery 3/21/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Mar 10, 2017 09:11PM Andraxo wrote:

Jen - when is your exchange? I was told no running, weight lifting, or snowboarding for 2 weeks. I have been walking and hiking daily - some at over 10k elevation and steep climbs. I did run on day 12 post op from the original exchange, because it was the morning of the revision exchange. That exchange was even easier but technically the restrictions start over for another 2 weeks. I keep using my arms too much though. Lifted a 40# dog the day after revision surgery (yesterday) and loaded a 30# suitcase into my vehicle today. Also flew to NY today. :)

I think right I have a 310 implant L (radiated side) and 250 R but they look pretty even but the R is swollen from repeat surgery Wednesday though. Not sure if I will be changing out the left for smaller sometime down the road.

I have a little rippling but not enough that I'd do anything about it. Might consider fat grafting for the top edges but that doesn't bother me either.

Love the way these pre pec implants feel - No bother to my muscles.

-x

Andra :) Dx at age 45. Super active in outdoor adventures in the southwest/4 corners area. Dx 7/2015, IDC, Left, <1cm, Stage IIA, 3/5 nodes, ER+/PR+, HER2- Surgery 9/4/2015 Mastectomy: Left; Prophylactic mastectomy: Right Chemotherapy 10/5/2015 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 2/29/2016
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Mar 10, 2017 10:37PM Shoregirl wrote:

Macb04, I am wanting the Vit C (IV), my stepdad is a holistic doc and he vehemently wants me to have it. I hesitate though because I have stage 2 chronic kidney disease (just DOWNGRADED from stage 3, woo hoo!!!!). Anyway, I read somewhere online that people with kidney impairment should not have IV Vit C as their kidneys could SHUT DOWN. I mentioned this to my stepdad, and he said not to believe everything I read online. He got my bloodtest results, some test you have to have to be sure you don't have a bad reaction to the C. Mine was ok, but I am worried about the kidney issue. He said he would use less than he normally uses on cancer patients. I wonder about the powdered supplement C. I take it (4000 iu every couple days), if that is enough to ward off infection?

JessieJake, my doctor now has switched me to smooth round silicones instead of the teardrop. I laughed about the flat butt, mine has been flat all my life so I can relate!! If they can get any fat off me, I am hoping it is my backfat from around the bra line. For some reason that is where I hold fat.. Or the upper arms. I may get one slight more fill, I just got 50cc yesterday, and have a consult w/ps Monday to see what he thinks. I am filling my presurgery bras nicely so I am nearly done.

Andraxo, you amaze me with all your activities. You rock!!! I need to get my butt in gear!!! But I don't like cold weather so haven't been out much. And now the weatherman is saying we are getting a Noreaster Monday, snow to be measured in FEET. Ugggh....come on Spring!!!

Kindness is Medicine, for the giver and the receiver Dx 12/2/2016, DCIS, Right, 5cm, Stage 0, Grade 3, 0/2 nodes, ER-/PR-, HER2- Surgery 1/26/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Mar 10, 2017 11:50PM - edited Mar 10, 2017 11:57PM by Leslie13

Hi, I'm new to this thread, but I've been lurking and letting your feedback guide my own decision to go on top of my right breast. Initially I had a nipple sparing straight-to-implant, and I mean "straight" because I initially had 475 cc of gummy bear anatomical 410 placed after my MX. I suffer from chronic pain: I had early back surgery and multiple hip replacements, so 3-6 months of expansion pain was too much. Most of my tightness lasted 3 weeks, then it was OK.

My left breast retained most of it's feeling; the right didn't. I had most of the cancer in the right and there was about a 2 cm circle of flap they had to cut out of the breast flap during the first surgery b/c it didn't get a blood supply and my Dr. feared infection & necrosis. My second revision was only on the right as there was a lot of scar tissue from the incisions and drain holes and I'd developed capsular contraction.

This revision failed because I was heavily cane dependent while waiting for a hip replacement. It was sub-muscular, and the rt. Implant rotated into my armpit within 2 months of surgery. After my last hip replacement last May, I've waited and healed. And read this thread about options. I didn't realize I could go above the muscle, but after surgery #2 I had enough alloderm to have padding over the implant.

I spoke with my PS, and we planned to go above the muscle for the third ( and hopfully last) breast surgery. Yesterday, I exchanged my gummy bears for 575 cc rounds. Honestly, except for the incisions and the area they removed the implant tail in my armpit, the implant on top is already better. They look better too. The left is still submuscular, as I didn't want to risk losing sensation, but has a new round too. I like kayaking and other outdoor activities and losing use of my right arm was not an option.

As a takeaway, I wanted to let people know there is an expedited expansion, but you need smaller breasts and qualify in general for a nipple sparing implant. The other is to encourage women having trouble to share that going above the muscle can work, but your PS will need to pad the implant with lots of alloderm. I don't know if fat grafting can work so you can use it with the first surgery.

Reading this thread encouraged me to make changes and assuaged my fears of another surgery with complications. It's been easy peezy.

Dx 4/17/2015, ILC, Both breasts, 3cm, Stage IIIA, Grade 2, 4/22 nodes, ER+/PR+, HER2- Surgery 9/30/2015 Lymph node removal: Right; Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy Femara (letrozole)
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Mar 12, 2017 12:29AM PickMoreWildflowers wrote:

Hi Littleblueflowers, I'm 2-weeks post the exchange and feeling great!

Pre surgery: I drank a gal of water everyday 2-weeks prior & added the EmergenC twice a day in addition to eating about 8 oranges a day. I did a lot of prep prior- pilates reformer, walking, hiking, lifting, massage & stem posterior shoulder, and ROM exercises. Everything was still at a moderate range of intensity.

Post surgery: I have 470cc with an anatomical implant and opted not to do the fat grafting. I exercise daily but do not do any exercises that engage the chest muscles. I continued the water & oranges but have started to ingest less Vit C. I only needed pain meds for a day

You will feel like a new person once the TEs removed. Wishing you a healthy & speedy recovery! :)

Dx 8/8/2016, IDC, Right, 2cm, Stage IA, Grade 3, 0/3 nodes, ER+/PR- Surgery 10/31/2016 Mastectomy: Right
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Mar 12, 2017 10:27AM raven4mi wrote:

For those who don't have access to IV Vit C and are asking about oral Vitamin C prep, if you google "pre op oral vitamin C" you'll find lots of good suggestions on doses to take and why. Here's just one: https://www.ncbi.nlm.nih.gov/pubmed/20689415

My surgery to replace my right TE post-infection is coming up this week and here are words I never thought would ever come out of my mouth: I'm so darned excited for this surgery! I've done everything within my means to ensure a successful pre-pec result and I'm REALLY looking forward to having two foobs again. At this point I don't even care what they look like - my expectations for aesthetics have gone down so darned much since I started this downward spiral nearly a year ago that it's ridiculous. I know that plastic surgeons often use the analogy of "twins" or "sisters" but at this point I'd gladly settle for two girls who get mistaken for each other from behind now and again! LOL!

The ID prescribed Bactroban (nasal abx cream) for 7 days prior to surgery plus an antiseptic skin cleanser to use the day before and morning of the procedure. Surgery is Friday and then I go in for 100 gram vit C infusion on Monday post-op (already had a 50 gram IV this past Thursday in preparation.) Looking forward to now moving on an upward spiral - will hopefully have final implants by end of May so I can enjoy this year's golf season.

Dx 2008, DCIS, Right, 1cm, Stage 0, Grade 1, ER-/PR- Dx 1/2016, DCIS, Right, 2cm, Stage 0, Grade 3, ER-/PR- Surgery 4/15/2016 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery Lumpectomy: Right Radiation Therapy
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Mar 12, 2017 06:15PM littleblueflowers wrote:

Flowers, thanks for sharing your pre surgery routine. Im really in the count down now. In addition to upping the intensity of my workouts, ive had a massage Nd plan to get another 2 days pre op. I quit all my supplements, including Turmeric and omega 3 s, and am slugging sour cherry juice and ginger root in smoothies. Emergen c is a good call, dunno why i havent been taking it. And way to bump the water! Im always a big water drinker, but now is the time to get serious. Gah. I hate surgery. Think my surgeon will give me a local and let me watch? Thanks!

If it stops the nightmares, it probably won't kill me Surgery 3/8/2015 Mastectomy: Left, Right Dx 3/9/2015, IDC, Left, 1cm, Stage IB, Grade 3, 2/16 nodes, ER-/PR-, HER2- Radiation Therapy Lymph nodes Chemotherapy AC + T (Taxol)
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Mar 14, 2017 05:35PM PickMoreWildflowers wrote:

Littleblueflowers- you will do great and feel like a new woman! I just got in from long walk and a bunch of lunges; (I'm in San Diego). I'm already cleared for ROM exercises, back to work, and cleared to fly. If you can stomach it, I chugged 32oz 10 minutes prior to cutoff of no more liquids which is supposed to make the tissue easier to work with. Keep us posted~hugs

Dx 8/8/2016, IDC, Right, 2cm, Stage IA, Grade 3, 0/3 nodes, ER+/PR- Surgery 10/31/2016 Mastectomy: Right
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Mar 18, 2017 12:44AM littleblueflowers wrote:

exchange DONE! and actually not feeling too bad. Even under the bandages, they are so soft! Not at all like the turtle shells. Havent needed any pain meds yet, hopefully wont need any. I woke up in bandages and a surgical sports bra. Very curious to see whats under there!

If it stops the nightmares, it probably won't kill me Surgery 3/8/2015 Mastectomy: Left, Right Dx 3/9/2015, IDC, Left, 1cm, Stage IB, Grade 3, 2/16 nodes, ER-/PR-, HER2- Radiation Therapy Lymph nodes Chemotherapy AC + T (Taxol)
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Mar 18, 2017 01:07AM SeattleBound wrote:

Hello, Has anyone heard of prepectoral placement without the use of some kind of sling or pocket?

Also, those of you who have had prepectoral, I would so appreciate a private message if you are willing to share your PS's name. I am traveling a long distance for a consult on Monday. The surgeon says more than 300 prepectoral have been done but ADMs are not normally used by this individual. I did not find out about this until after making the appt and travel arrangements. I have never heard or read anything about prepectoral surgery without ADMs or other material. Now realizing the 300+ may have been augmentations! My TE to implant surgery (under the muscle) did not involve anything to provide implant position stability and the side without capsular contracture migrated Aahhhhhh! Feeling very worried.

Dx 11/2015, DCIS, Left, 2cm, Stage 0, 0/2 nodes, ER+/PR+ Surgery 1/6/2016 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/17/2016 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Mar 18, 2017 11:55PM - edited Mar 19, 2017 12:05AM by macb04

Hi littleblueflowers, I think that Lipospheric Vitamin C is a good substitute compared to standard formulations of Asorbate/Ascorbic Acid/Vitamin C tablets. It uses the encapsulation of Vitamin C by Liposomes (fat molecules) to increase absorption levels of Vitamin C, which is limited by bowel tolerance. I have been able to have 10 to 15 grams of Lipospheric Vitamin C by mouth, without diarrhea, whereas I get loose stools with around 7grams of the standard formulations of Vitamin C (Ascorbic acid/Asorbate). I space the oral dosing out over the course of the day, that way, I hope to keep my blood levels of Vitamin C elevated as high as possible throughout the day. I actually take a combination of Standard Vitamin C tablets and Lipospheric Vitamin C, because then I feel that I am covering all my bases.

Hope this helps you figure out some good ways to get the best benefits of Vitamin C if you can't afford Intravenous Vitamin C.

ALSO, WANT TO BRING UP ESSENTIAL OILS SUCH AS OREGANO/THYME and GOLDENSEAL have Synergistic Effects against bacteria, alone or in combination with antibiotics. I posted this info somewhere else, but copied it to here again.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4915787/


Pharmacokinetics of oral vitamin C

Abstract

Purpose. To test whether plasma vitamin C levels, following oral doses in supplemented volunteers, are tightly controlled and subject to a maximum in the region of 220 µm L−1, as suggested by previous researchers for depleted subjects. To determine plasma levels following single, variable‐sized doses of standard and liposomal formulations of vitamin C and compare the effects of the different formulations. To determine whether plasma levels above ∼280 µm L−1, which have selectively killed cancer, bacteria or viruses (in laboratory experiments), can be achieved using oral doses of vitamin C.

Design. This was a single blind study, measuring plasma levels in two subjects, in samples taken half‐hourly or hourly for 6 hours, following ingestion of vitamin C. Data were compared with published results and with data from 10 years of laboratory plasma determinations.

Materials and methods. Standard 1 gram tablets of vitamin C; liposomal vitamin C. Plasma levels were analysed using the method of Butts and Mulvihill.

Results. Preliminary investigations of the effects of liposomal and standard formulation ascorbate showed that blood plasma levels in excess of the previously assumed maximum of 220 µm L−1 are possible. Large oral doses of liposomal ascorbate resulted in plasma levels above 400 µm L−1.

Conclusions. Since a single oral dose can produce plasma levels in excess of 400 µm L−1, pharmacokinetic theory suggests that repeated doses could sustain levels well above the formerly assumed maximum. These results have implications for the use of ascorbate, as a nutrient and as a drug. For example, a short in vitro treatment of human Burkitt's lymphoma cells with ascorbate, at 400 µm L−1, has been shown to result in ∼50% cancer cell death. Using frequent oral doses, an equivalent plasma level could be sustained indefinitely. Thus, oral vitamin C has potential for use as a non‐toxic, sustainable, therapeutic agent. Further research into the experimental and therapeutic aspects of high, frequent, oral doses of ascorbic acid either alone or (for cancer therapy) in combination with synergistic substances, such as alpha‐lipoic acid, copper or vitamin K3, is needed urgently.

Essential Oils and Their Components as Modulators of Antibiotic Activity against Gram-Negative Bacteria ..

http://www.mdpi.com/2305-6320/3/3/19

Essential Oils and Future Antibiotics: New Weapons against Emerging ' Superbugs ' ?

Nicholas A Boire1, Stefan Riedel2 and Nicole M Parrish2*

1The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA

2 Department of Pathology, Division of Microbiology, The Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA

https://www.researchgate.net/publication/253567306_Essential_Oils_and_Future_Antibiotics_New_Weapons_against_Emerging'Superbugs'

PDF]Antimicrobial and synergistic effects of some essential oils to fight ... - The Battle Against Microbial Pathogens: Basic Science, Technological Advances and Educational Programs

www.microbiology5.org › book

by H Padalia - ‎2015 - ‎Cited by 2 - ‎Related articlesEssential oils can be individually effective or they may be combined with antibiotics or plant extracts. Traditional healers often use combinations of plants to treat or cure diseases and found that synergy was most

According to a report published in The Review on Antimicrobial Resistance, the government of the United Kingdom estimates that by the year 2050, more than 10 million deaths and 100 trillion dollars in global health care costs will have resulted from drug-resistant microbes.

https://www.ncbi.nlm.nih.gov/pubmed/27872555

https://www.ncbi.nlm.nih.gov/pubmed/28224112

https://www.ncbi.nlm.nih.gov/pubmed/27895802

https://www.ncbi.nlm.nih.gov/pubmed/26256994

https://www.ncbi.nlm.nih.gov/pubmed/25185110

https://www.ncbi.nlm.nih.gov/pubmed/16085104

https://www.ncbi.nlm.nih.gov/pubmed/12643856

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Mar 19, 2017 12:54PM avmom wrote:

Jen,

Glad to hear your exchange is done and you are doing well. I saw my PS last week. Was supposed to schedule exchange, but am deferring until at least the fall, as my DH needs some surgery this spring/summer, and he will need some support. I'd rather not be wrestling with any potential post surgery problems while he is recovering. He needs cataract surgery, but the ophthalmic surgeon who did his evaluation has indicated that he needs laser iridotomy first. So, that will happen within the next month or so, and cataract surgery on his right eye after that. I know cataract surgery isn't necessarily a big deal, but complications are always a possibility, and DH doesn't seem to snap back from medical stuff so quickly. He also needs a hip replacement, but the eyes are his priority right now. He has had to change prescription lenses three times in the past 18 months, and is just barely legal to drive, though his close up vision is still pretty good.

I don't post much, but do read from time to time. So glad things are going well for you. I remember our camp out last summer fondly.

Donna

Surgery 12/23/2014 Lumpectomy: Right Dx 1/7/2015, IDC, Right, 4cm, Stage IIA, Grade 3, 0/11 nodes, ER-/PR-, HER2- Dx 1/7/2015, DCIS, Right, 6cm+, Stage 0, Grade 2, 0/11 nodes, ER-/PR-, HER2- Surgery 1/12/2015 Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right Surgery 10/19/2015 Prophylactic mastectomy: Left Dx 10/27/2015, LCIS/DCIS, Left, 6cm+, Stage 0, Grade 2, ER+/PR+ Surgery 5/25/2016 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right Chemotherapy AC + T (Taxol)
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Mar 19, 2017 01:26PM breastcanceryogi wrote:

Hi! I'm new to BC and this forum and just finished reading through the 18(!) pages in this thread. I had my nipple-sparing BMX 13 days ago with TEs placed over the muscle. They were filled with 120ccs of air in the OR and I am scheduled to have my first saline fill tomorrow. They've deflated a little since surgery, but they're still about the same size as I was pre-mastectomy. Maybe a little bigger due to the projection and the fact that they don't compress. Thanks everyone for providing such interesting and helpful information regarding this process.

Dx 12/27/2016, DCIS, Right, 3cm, Stage 0, Grade 2, 0/1 nodes, ER+/PR+, HER2- Dx 12/27/2016, IDC, Right, <1cm, Stage IA, Grade 1, 0/1 nodes, ER+/PR+, HER2- Surgery 3/5/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 3/19/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Mar 20, 2017 06:36PM Love2Hike wrote:

Littleblueflowers, glad your exchange surgery went well. Mine is scheduled for May 8. I'm a little nervous about the recovery. Do you have to keep your arm still for a couple of weeks?

Has anyone had a drain placed after their exchange? My PS said she hopes to not need to but it's a possibility.

breastcanceryogi, hope your fill went well. I found them to go pretty smoothly and finished up a couple of weeks ago.

Dx 3/8/2010, DCIS, Left, Stage 0, Grade 3, 0/1 nodes Surgery 6/3/2010 Lymph node removal: Sentinel; Mastectomy: Left; Reconstruction (left): DIEP flap Dx 9/2016, DCIS, Right, Stage 0, Grade 3, 0/1 nodes Surgery 12/5/2016 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Tissue expander placement
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Mar 20, 2017 06:42PM raven4mi wrote:

Love2Hike, I'm weeks away from even discussing an exchange but, ever the optimist, asked my PS if there would be drains when it happens and he said yes. But, of course, every PS is different it seems, so I would encourage you to ask specifically.

Dx 2008, DCIS, Right, 1cm, Stage 0, Grade 1, ER-/PR- Dx 1/2016, DCIS, Right, 2cm, Stage 0, Grade 3, ER-/PR- Surgery 4/15/2016 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery Lumpectomy: Right Radiation Therapy
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Mar 20, 2017 09:32PM breastcanceryogi wrote:

Thanks Love2Hike! First fill was a breeze. 120cc of air out, 150cc saline in. I got a kick out of the "deflated beach ball" look when my PS took everything out. Two weeks till the next one!

Dx 12/27/2016, DCIS, Right, 3cm, Stage 0, Grade 2, 0/1 nodes, ER+/PR+, HER2- Dx 12/27/2016, IDC, Right, <1cm, Stage IA, Grade 1, 0/1 nodes, ER+/PR+, HER2- Surgery 3/5/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 3/19/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Mar 20, 2017 10:34PM Sitti wrote:

I haven't read all the pages of this thread, just some here and there. It seems most everyone has TES placed first. I'd like to hear from anyone who has gone with NSMX w/immediate pre-pectoral straight to implant. Were you pleased with the process? Can you tell me how the recovery was/is? Thanks!

Dx 12/5/2016, DCIS, Right, 4cm, Stage 0, Grade 3, ER- Surgery 1/12/2017 Lumpectomy Surgery 3/21/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Mar 21, 2017 02:02AM macb04 wrote:

Hi breastcanceryogi, Welcome. Do you want to give me your PS's name to add to the list?

Hi Love2Hike, I think that most PS's want you to minimize arm movement, but realize that you will still need to move around to keep from stiffening up. I would say, having a drain varies by PS, and even by the surgery. My PS had me have a drain for the TE surgery, but not for the implant exchange.

Remember to get enough Vitamin C for good tissue healing. When you have surgery, Vitamin C levels drop in all tissues. You can't overdose on Vitamin C because it is water soluble. When your "tank is overflowing "with a little bit too much Vitamin C, the worst that can possibly happen is some loose stools. At that point, stop taking Vitamin C for that day. The next day, take Vitamin C, but at a slightly lower amount than what caused the loose stools. Space the Vitamin C out over the course of the day. That is my description of titrating to your individual bowel tolerance, a very safe way to make sure you are getting adequate Vitamin C for all of your post surgery tissue healing needs.

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Mar 21, 2017 11:16AM breastcanceryogi wrote:

macb04 - My PS is Dr. Jyoti Arya in San Diego. I have nothing but lovely things to say about her so far. Thanks for the tip about Vitamin C! I have been taking about 1000mg/day pre and post op, but I didn't consider the effects it might have.

Dx 12/27/2016, DCIS, Right, 3cm, Stage 0, Grade 2, 0/1 nodes, ER+/PR+, HER2- Dx 12/27/2016, IDC, Right, <1cm, Stage IA, Grade 1, 0/1 nodes, ER+/PR+, HER2- Surgery 3/5/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 3/19/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Mar 21, 2017 12:56PM Andraxo wrote:

Jen - so happy your exchange went well! Yay!

Love2hike - I did not have drains for exchanges.

Macb04 - Thanks so much for posting all the info on oral vit C and essential oils! Going to start Vit C orally in 2 weeks in prep for my next surgery.

I was cleared to run last Thursday - 8 days after the R side re-exchange (for smaller) so I ran 7 miles the next day. Yay! I'm very aware of the left implant (310cc)running because it is too big for me even though it looks close to the R. The R now feels better at 250cc. I wasn't cleared to snowboard yet though - he's worried I'll hit a tree or crash flat onto my chest and blow out the incisions. yeah...that's always a possibility. Hopefully I can hit the closing weekend of the season for snowboarding which is April1-2. I also started back at lifting weight and doing plyometrics with weights. No pain with any muscles around the implants. I just tried 5 push-ups in my office to see how it feels (haven't done them in months). No pain, but just an awareness of the L implant....and that I'm so out of condition for doing push-ups! Ugh! Want to build that back up to 40 by August.

Re-exchange for L is sched for April 21st, follow up with surgeon on the 10th to confirm/order implant etc. Surgeon wants to give the radiated side more time to heal from the original exchange. I've noticed that the L/radiated side skin gets cool quickly with this implant in. I know that is partly due to the thinness of the skin (compared to non-radiated side) and decreased micro-circulation in radiated tissue, but also due to the simple fact that there is non-vascular material (implant) in my chest. I'm hoping going to a flatter implant may help that a bit. The R side with the flatter implant is always nice and warm. In the end, they'll still be a little bigger than I wanted, but totally OK if I don't notice them both while running.

Getting married in 3 months. :) Can't believe I'm having surgery again 8 weeks before....which is cutting it close, but I'm determined to be done with implants/exchanges before then and don't want to wait until July. Not sure if I will ever fat graft for the edges or ripples. I don't have a lot of fat and maybe I should save it for harvesting for stem cell injections to joints as I age!

- xo

Andra :) Dx at age 45. Super active in outdoor adventures in the southwest/4 corners area. Dx 7/2015, IDC, Left, <1cm, Stage IIA, 3/5 nodes, ER+/PR+, HER2- Surgery 9/4/2015 Mastectomy: Left; Prophylactic mastectomy: Right Chemotherapy 10/5/2015 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 2/29/2016
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Mar 21, 2017 01:53PM littleblueflowers wrote:

Hello ladies, just checking in with a report from post-exchange land. No pain, no drains, which is good. I haven't even needed ibuprophen, except to deal with the post-anesthesia body pain. Trying to take it easy per my surgeon's instructions at least until my follow up on friday. At first glance, the new boobs look a little flat, but I'm hoping they will fluff out once I am not in this surgical compression bra anymore. Can anyone chime in on that? As far as movement restrictions, no lifting more than 10 lbs, etc, which means it takes a long time to haul a load of fire wood up on the porch LOL. Trying to lay around as much as possible and not get my heart rate up,but my tolerance for that is rapidly decreasing. Glad everyone is carrying on!


If it stops the nightmares, it probably won't kill me Surgery 3/8/2015 Mastectomy: Left, Right Dx 3/9/2015, IDC, Left, 1cm, Stage IB, Grade 3, 2/16 nodes, ER-/PR-, HER2- Radiation Therapy Lymph nodes Chemotherapy AC + T (Taxol)
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Mar 22, 2017 08:31AM Love2Hike wrote:

Hi ladies~ I'm due to have an exchange in May and have been reading the latest reports about textured implants and the increase in that rare lymphoma, and of course now I'm concerned about the whole thing. I just wondered what your thoughts were on the matter and how you are nevertheless moving forward with your plans.

Dx 3/8/2010, DCIS, Left, Stage 0, Grade 3, 0/1 nodes Surgery 6/3/2010 Lymph node removal: Sentinel; Mastectomy: Left; Reconstruction (left): DIEP flap Dx 9/2016, DCIS, Right, Stage 0, Grade 3, 0/1 nodes Surgery 12/5/2016 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Tissue expander placement
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Mar 22, 2017 09:13AM raven4mi wrote:

Love2Hike, I just had an NYT article pop up on my FB feed about that very same thing. I know my PS is planning to use the gummy bear implants at exchange which are textured. Oh, goody. Just one more thing to stress about. Will bring this up at my next appointment. How "rare" is rare?? Ugh.

Dx 2008, DCIS, Right, 1cm, Stage 0, Grade 1, ER-/PR- Dx 1/2016, DCIS, Right, 2cm, Stage 0, Grade 3, ER-/PR- Surgery 4/15/2016 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery Lumpectomy: Right Radiation Therapy
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Mar 22, 2017 09:20AM - edited Mar 24, 2017 02:21PM by Sitti

Geez, on my way to surgery now where my PS is going to do direct implant after my bmx and I don't what he is using....talk about stressing.

Raven4mi that's my thought, how rare is rare?

Dx 12/5/2016, DCIS, Right, 4cm, Stage 0, Grade 3, ER- Surgery 1/12/2017 Lumpectomy Surgery 3/21/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Mar 22, 2017 10:57AM littleblueflowers wrote:

Hi Ladies, My PS talked to me at length about the possible connection between textured implants and secondary cancer. He said by rare, they mean less than 1% of women. He said this particular type of cancer is found when they go in to replace the implant for some other reason, and is very slow growing. Its a risk, as all things are, however, monitoring via MRI will help catch it. My question, with all these reports coming out now, is did the women who developed cancer have Alloderm or some other cellular matrix wrapping the textured implant, as many of us pre-pec ladies will? I know in my case, my actual implant is not touching my body, as it is completely wrapped in Alloderm. It would be interesting to see if that mitigates whatever cancer factor may be present in just using unwrapped implants. My personal feeling is that we are more likely to die of metastic breast cancer.

If it stops the nightmares, it probably won't kill me Surgery 3/8/2015 Mastectomy: Left, Right Dx 3/9/2015, IDC, Left, 1cm, Stage IB, Grade 3, 2/16 nodes, ER-/PR-, HER2- Radiation Therapy Lymph nodes Chemotherapy AC + T (Taxol)
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Mar 22, 2017 11:57AM Sitti wrote:

littleblueflowers thank you for that information. That's helpful to hear.

Dx 12/5/2016, DCIS, Right, 4cm, Stage 0, Grade 3, ER- Surgery 1/12/2017 Lumpectomy Surgery 3/21/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Mar 22, 2017 12:50PM raven4mi wrote:

Thank you for bringing up the MRI monitoring again, too, littleblueflowers. That reminds me I need to write that down to discuss with PS also. When I mentioned on-going monitoring via MRI at my last appointment with MO he completely shrugged it off and said "No need. You're cured." So short-sighted. I'm just curious to discuss with PS to see how many cases he's run into of recurrence since he's been doing pre-pectoral for a while now, so that I can go back to my MO armed with that information and insist on the MRIs. Of course, can always fire the MO and find another. I am the customer here, after all.

Dx 2008, DCIS, Right, 1cm, Stage 0, Grade 1, ER-/PR- Dx 1/2016, DCIS, Right, 2cm, Stage 0, Grade 3, ER-/PR- Surgery 4/15/2016 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery Lumpectomy: Right Radiation Therapy

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