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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 Nov 12, 2018 08:43PM 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 )

WEST COAST

Dr. Hakim Said - UW Medical Center, Seattle, WA

Dr. Jonathan Hutter -Valley Hospital, Renton, WA

Dr. Mark Tseng - Multicare, Auburn, WA

Dr Reid Mueller - OSHU, Portland, OR

Dr. Lisa Cassileth - Beverly Hills, CA

Dr. Leif Rogers - Beverly Hills, CA

Dr Kamakshi Zeidler - Campbell, CA

Dr. Michael Halls--La Jolla, CA

Dr Elizabeth Kim - Los Angeles, CA

Dr. Charlotta Lavia - Los Angeles, CA

Dr. Charles Tseng - UCLA , CA

Dr. Mark Gaon - Newport Beach, CA

Dr. Sara Yegiyants - Santa Barbara, CA

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

Dr. Jyoti Arya - San Diego, CA

Dr Karen Horton--San Francisco, CA

Dr Arash Momeni - Stanford, CA Has done >100 prepecs/Only does Prepectoral now

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. Terry Myckatyn - St. Louis, MO

Dr William Stefani - Renaissance Plastic Surgery, Troy, Michigan

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

Dr Ryan Gobble - UC in Cincinnati, OH

Dr. Neil Kundu - Jewish Hospital, Cincinnati, OH

Dr. Timothy Schaefer - Edina, MN

Dr Tiwari & Dr Kocak - Columbus Ohio. mwbreast.com

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

Dr Philip Sonderman, Greater Milwaukee Plastic Surgeons - Milwaukee, WI

Dr. David Janssen & Dr. William Doubek, Fox Valley PS - Oshkosh and Appleton, WI

EAST COAST

Dr Jessica Erdmann-Sager - Brigham & Women's/Dana Farber, Boston MA

Dr Amy Colwell - Boston MA

Dr. Helen Perakis - Hartford, CT

Dr. Glassman - Pomona NY

Dr. Andrew Smith - Rochester, NY

Dr. Andrew Salzberg - NYC

Dr. David Otterburn - NYC

Dr. Constance Chen - NYC

Dr. Tzvi Small - Valley Hospital , Ridgewood NJ

Dr Russell Babbitt - Fall River, MA

Dr. Joseph Woods - Piedmont Hospital, Atlanta GA

Dr. Mark Deutsch, Perimeter Plastic Surgeons - Atlanta, GA

Dr. Stacy Stephenson - UTMC, Knoxville, TN

Dr. Irfan Galaria - Ashburn, Chantilly & Haymarket, VA

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

Dr Mark Venturi - McLean, VA

Dr. Nahabedian - 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. James Craigie and Dr. Richard Kline Jr. - East Cooper Plastic Surgery, Mount Pleasant, SC

Dr Kent Higdon - Vanderbilt Medical Center, Nashville, TN

Dr Davinder Singh - Annapolis, MD

Dr. Vincent Perrotta - Salisbury, MD

Dr Claire Duggal - Annapolis, MD

Dr. Eric Chang - Columbia, MD

Dr Justin Sacks - Johns Hopkins, Baltimore, MD

Dr. Joanne Lenert - Washington, DC

Dr Troy Pittman - Georgetown University, Washington, DC

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

EAST COAST, CANADA

Dr Mitchell Brown, Toronto Canada

Dr Jason Williams - Hallifax, Nova Scotia

AUSTRALIA


Dr Beverley Fosh - Adelaide, South Australia

Dr Amy Jeeves - Adelaide, South Australia

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

https://www.ncbi.nlm.nih.gov/pubmed/29978367

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.

Having extra Vitamin C, 1,000mg to 3,000mg per day for at least a week before surgery and for at least 2 weeks afterwards. That is what Dr Andrew Weil says. I tend to think it is possible to have even higher amounts of Vitamin C safely. I did that on a number of occasions, what is called "Titrating to bowel tolerance " Basically it means to take a Vitamin C tablet, (chewable type are some of the easiest) once an hour throughout the day. When your body is finally starting to have more Vitamin C than you need, then you will begin to experience loose stools. Then you stop taking Vitamin C, count up how many tablets you have had over the course of the day, and the next day take one or two less tablets of Vitamin C for that day. Repeat that for several days, but as you heal and your health improves you will get to the point of loose stools sooner and sooner (needing less and less pills every day in a gradual taper downward) It is quite safe to do it this way, if you have normal kidney and bowel function. The worst that happens is that you can get diarrhea. It is a great way to tell exactly how much Vitamin C your body needs. Sufficient Vitamin C is crucial to wound healing, helps with making strong collagen. When you hear stories of surgical wounds that dehise it is a high probability that there is a Vitamin C deficiency leading to inadequate collagen production.

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.


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.

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

The only contraindications I know of regarding herbs/supplements after surgery is the increased risk of bleeding that can occur in the early PostOp period, usually the first 3 to 7 days. Blood clots are a very small risk in the PostOp period (for nonorthopedic procedures), but one that is not much affected by use of herbs/supplements, except a few that interfere with the effectiveness of Warfarin/Coumadin anticlotting medications, like CoQ10, Goldenseal, or St John's Wort. .

Certain herbs are known to increase the risk of blood thinning,

Herbal Medicines

  • Garlic: inhibits platelet aggregation (organosulfur), discontinue for seven days
  • Ginkgo: inhibits platelet activating factor (terpenoids, flavonoids), discontinue for thirty six hours
  • Ginseng: inhibits platelet aggregation and lowers blood glucose(ginsensosides [mimic steroids]). Check PT/PTT/glucose, d/c for 24 hours (preferably seven days)
  • Saw Palmetto: associated with excessive intraoperative bleeding(mechanism unknown, likely multiple), in the absence of pharmacokinetic data, no recommendations re: preoperative continuation can be made

Herbal medicines that increase the risk of bleeding:

  • Black Cohosh: Claims to be useful for menopausal symptoms. Contains small amounts of anti-inflammatory compounds, including salicylic acid. Theoretically could have intrinsic/additive antiplatelet activity.
  • Chamomile: Claims to reduce inflammation and fever, to be a mild sedative, relieve stomach cramps. Increases risk of bleeding because it contains phytocoumarins, which have additive effects with warfarin.
  • Feverfew: Claims to prevent migraines. Increases the risk of bleeding because it individually inhibits platelet aggregation, has additive effects with other antiplatelet drugs. Also additive effects with warfarin.
  • Fish Oil: Claims to prevent/treat atherosclerotic CV disease (800-1500mg/day). Also used to decrease triglycerides (>4g/day). Dose dependent bleeding risk increases with dose >3g/day.
  • Garlic, Ginger, Ginko, Ginseng: Increases bleeding risk by interacting with antiplatelet drugs to inhibit platelet aggregation and inhibit fibrinolysis. Also augments warfarin
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Nov 18, 2018 01:57PM Shoregirl wrote:

Lanee I don't know the price for Vinnie and crew when travelling, but from his website I got the following info: For appointments in Maryland we charge $800 for a Bilateral procedure and $600 for a Unilateral procedure. A $400 deposit is required at the time the appointment is made.. Touch up visits are not normally needed but will require a $50 minimum setup/equipment fee. Remaining fees will be decided upon consultation.

Link to Vinnie Myers FAQ

Faith, Hope & Love, the greatest of these is Love 1st Cor 13:13 Dx 12/2/2016, DCIS, Right, 6cm+, Stage 0, Grade 3, 0/2 nodes, ER-/PR-, HER2- (IHC) Surgery 1/26/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 4/24/2017 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 11/28/2017 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/3/2018 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Nov 18, 2018 06:51PM macb04 wrote:

I am not sure if I spent a $1,000. I spent somewhere between 800 and 1000 for one side when I travelled down to San Diego area to meet up with Vinnie Myers. I found that info in an old email.

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Nov 23, 2018 05:24PM rachelcarter35 wrote:

My right expander had moved laterally towards my armpit so when I had my exchange my PS had to do quite of work on that pocket. There was already alloderm present from the exchange. I'm 12 weeks out and by the end of the day with wearing a bra 24/7 I end up feeling a pulling on the side near the armpit. I wouldn't say it hurts but its uncomfortable. Has anyone had this? and is there a solution? It almost feels like there's a stitch attached to my muscle or something. I'm stretching and messaging. I've got through most of this with relatively little pain and want to be totally pain free in the end. I chose prepectoral for this very reason (my mother has had chronic pain for 30 years) and now this one little irritant is bugging me.

Dx 2/21/2018, DCIS/IDC, Both breasts, 2cm, Stage IIA, Grade 3, 0/5 nodes, ER+/PR+, HER2- (FISH) Surgery 4/24/2018 Mastectomy: Left, Right; Reconstruction (left): Nipple reconstruction, Nipple tattoo, Silicone implant, Tissue expander placement; Reconstruction (right): Nipple reconstruction, Nipple tattoo, Silicone implant, Tissue expander placement Chemotherapy 6/14/2018 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Chemotherapy Targeted Therapy Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Nov 24, 2018 11:15PM macb04 wrote:

I still occasionally get pulling pains in the muscles of my chest that are affected near the reconstruction. For instance if I flex forwards sometimes the muscles of my upper abdomen go into an incredibly painful muscle spasm, that won't abate until I stand up and stretch backwards. I am 3 years since the last reconstruction surgery.

So, I don't know if things like that go away completely if given enough time. It seems to be very individual is all I can say about it.

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Nov 27, 2018 09:49PM NCGirl1 wrote:

RachelCarter

Thanks for your feedback on getting your tattoo's, makes me more confident about doing it. My Plastic surgeon encourages his patients to do nipple/tattoos as a final step/closure to your reconstruction. My surgery to replace my TE's is Dec 14th, Soooo Ready! How long did you have to wait to get you nipples tattoos ? Thanks!

Dx 7/3/2018, DCIS/IDC, Right, 4cm, Stage IA, Grade 2, 0/7 nodes, ER+/PR+, HER2- (FISH) Surgery 8/13/2018 Mastectomy; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 9/18/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Nov 28, 2018 12:32AM - edited Nov 28, 2018 12:33AM by rachelcarter35

This Post was deleted by rachelcarter35.
Dx 2/21/2018, DCIS/IDC, Both breasts, 2cm, Stage IIA, Grade 3, 0/5 nodes, ER+/PR+, HER2- (FISH) Surgery 4/24/2018 Mastectomy: Left, Right; Reconstruction (left): Nipple reconstruction, Nipple tattoo, Silicone implant, Tissue expander placement; Reconstruction (right): Nipple reconstruction, Nipple tattoo, Silicone implant, Tissue expander placement Chemotherapy 6/14/2018 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Chemotherapy Targeted Therapy Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Nov 28, 2018 12:32AM rachelcarter35 wrote:

About 8 weeks after implant exchange.

Dx 2/21/2018, DCIS/IDC, Both breasts, 2cm, Stage IIA, Grade 3, 0/5 nodes, ER+/PR+, HER2- (FISH) Surgery 4/24/2018 Mastectomy: Left, Right; Reconstruction (left): Nipple reconstruction, Nipple tattoo, Silicone implant, Tissue expander placement; Reconstruction (right): Nipple reconstruction, Nipple tattoo, Silicone implant, Tissue expander placement Chemotherapy 6/14/2018 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Chemotherapy Targeted Therapy Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Nov 29, 2018 01:01AM macb04 wrote:

I was on the waiting list for Vinnie Myers for about 5 months, give or take.

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Dec 1, 2018 01:56PM raven4mi wrote:

macb04, I get that crazy abdomen muscle cramping thing too! I thought it was just because I could stand to lose a few pounds, but now that you mention it I never had it before I started this reconstruction nightmare! Huh. Interesting.

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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Dec 1, 2018 03:08PM OCDAmy wrote:

two weeks ago I had my sub pec TE replaced with a pre pec silicone implant. I had a nipple sparing MX on that breast and the nipple was really far down. I switched to a new PS and he did the pre pec implant and attempted to get the nipple in the right placealthough I'm still not sure it's exactly right. It feels and looks great so far. Skin was stretched quite a bit and was red and shiny but getting better now. How long before you started sleeping on your side and went braless?

Dx 2/2017, IDC, Left, 4cm, Stage IIB, Grade 2, 2/13 nodes, ER+/PR+, HER2- Hormonal Therapy Arimidex (anastrozole) Surgery Reconstruction (left): DIEP flap Radiation Therapy Whole-breast Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery Lymph node removal; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Dec 1, 2018 07:48PM joy2 wrote:

Hello OCDAmy I am happy for you that you are satisfied with your reconstruction. I slept on my side after 3 day of my last surgery which was 3 weeks ago.I had bilateral mastectomy nipple spring direct implant on April and 3 weeks ago i suppose to do the lifting as my nipple was left down as it was due to large breast that i had, and now my PS did just a little lifting because he said that he can't do it in one shot because is afraid that nipple could not make it to live. he said that I need multiple revisions. I am sick of so many surgeries as i have done 4 till now, not just lifting but i had skin necroses after mastectomy and i had to be in surgery 3 times in a month. I think i am going to see another PS to get an second opinion. I have sub pec implant but i m thinking to change .

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Dec 2, 2018 12:07AM macb04 wrote:

Hi raven4mi, strange thing, I never had those weird and extremely painful abdominal spasms before all the mutilation. I am careful not to bend in certain ways for fear of triggering it.

Hi OCDAmy, glad to hear your surgery worked out well. It is so much more comfortable, isn't it? , to have Prepectoral versus Subpectoral. I had a subpectoral TE and was just miserable. Prepectoral is the way of the future for most women who want implants.

Hello joy2, it is something to think about, changing from subpectoral to Prepectoral. Several of the women here, myself included have done that change with good sucess. Let us know how things go.

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Dec 2, 2018 10:22PM joy2 wrote:

Hello macb04! I have decided that I will do the change on my next surgery. I did regret that I did not do it on the one that I just did it. The reason was because i wanted to se myself firs completed esthetically, which still it did not happen. That's why now i want to see another PS to get an second opinion since my Ps said that i still can't do the lifting completely again. Thank you and I will let you know!

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Dec 2, 2018 10:44PM - edited Dec 2, 2018 10:44PM by macb04

joy2 , I guess if we all achieved comfort and good aesthetics the first time around, we wouldn't be suffering through more risky procedures, when we have suffered enough.

Have a look at the list of PS's above to see if any of them are near to you.

Hey All. I was thinking of coming up with a rating system, is that worth adding next to each PS name?

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Dec 2, 2018 11:41PM borogirl wrote:

Please add my PS to those doctors who do pre-pectoral: Dr. Brad Medling, Murfreesboro Medical Clinic, 1272 Garrison Drive, Murfreesboro, TN 37129, (615) 867-8080. I have been very happy so far (3 weeks out tomorrow from MX and TEs put in). I'm eager and anxious to see how everything proceeds, but Dr. Medling spent an hour at my first appointment explaining the procedure. I am one of those who researches as much as I can and shows up at dr. appt. with a whole list of questions, and he has always been very happy to answer any questions and explain anything I don't understand. All the medical clinic staff I've talked to said he is a perfectionist, which is what you want in your plastic surgeon!

Surgery 3/13/2018 Lumpectomy: Left Surgery 11/12/2018 Lumpectomy: Left; Mastectomy: Left, Right; Prophylactic mastectomy: Left, Right; Reconstruction (left): Silicone implant, Tissue expander placement; Reconstruction (right): Silicone implant, Tissue expander placement
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Dec 3, 2018 03:48PM joy2 wrote:

Hello macb041 I understand ,that it is a process, i had the fourth surgery till now and looking for more. I have problem closing the wound and getting infections and right now i have the vac therapy foe a week to help me close the wound, And this, thanks to the other doctor that was there when i went to the hospital, because my PS said for surgery, he said to put this one and not going to surgery.I don't know what to tell, if my ps like surgeries or it is all what he knows.

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Dec 5, 2018 02:30AM macb04 wrote:

joy2, sorry to hear you are having trouble healing your incision. You definitely need more Vitamin C. Vitamin C is very important to wound healing. Without enough Vitamin C wounds are much weaker, and more likely to open up.

If you have normal Kidney and Bowel function you CAN NOT OVERDOSE on Vitamin C. My doctor had me take 1,000mg of Vitamin C every 2 hours, while I was awake, after surgery. He told me to stop when I started to get loose bowels or diarrhea. Then the next day, he said to take just a little bit less than caused me to have diarrhea. He had me do that every day for a couple of weeks to improve wound healing. Every day, as I healed, I took less, and less Vitamin C, as I got to the diarrhea/ grumbling stomach moment sooner and sooner.

Makes a Huge difference how strong the incision heals.

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Dec 5, 2018 11:30AM Shoregirl wrote:

macb04, thanks for posting that about the Vit C. I just had my revision yesterday and having a good deal more pain this time. I think it is coming from the farthest end of the drain, but its a constant burning no pain meds have helped. I will up my C intake. My multi has 500mg of C, and I have Just C with Bioflavonoids 1000mg I will take a few times per day. I do have kidney issues, (GFR is 52) so I don't think I will take it every 2 hours. Hopefully he pulls my drain at follow up on Friday and that will bring relief!!

Faith, Hope & Love, the greatest of these is Love 1st Cor 13:13 Dx 12/2/2016, DCIS, Right, 6cm+, Stage 0, Grade 3, 0/2 nodes, ER-/PR-, HER2- (IHC) Surgery 1/26/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 4/24/2017 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 11/28/2017 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/3/2018 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Dec 5, 2018 07:46PM joy2 wrote:

macb04 Thank you for replaying about the vitamin C. I have not any problem with my kidney. I will get that vitamin C to help me in my wound healing. I actually booked an appointment with another doctor to seek a second opinion what my doctor did with my surgeries. Last time i was 4 months under antibiotics to close my wound because it got infected. He said that one area is very week to get healed thats why it get infected. the second time now after the other surgery the same spot got infected, so I hope the vitamin C helps to get better.

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Dec 6, 2018 01:44AM macb04 wrote:

Hi Shoregirl, that sucks to have constant pain. I really hope that getting the drain out will help alleviate that. The doc explained that by kidney issues, he meant not to take large amounts of Vitamin C if you have a history of Kidney stones. Sounds like your kidney function is less than ideal, but Vitamin C should still be safe if no history of Kidney stones.

Hi joy2, sounds like a good plan to increase Vitamin C. Also, Hyperbaric Oxygen Therapy (HBOT)can be a huge help to increase the blood circulation and oxygenation of vulnerable tissues as they heal. HBOT has been proven to sucessfully speed up wound healing. I got HBOT through a Wound Care Center at a local hospital. HBOT was a huge help for incisions to heal better/faster. I was able to self refer through my insurance.

Good luck to you both, wishing you sucessful, safe healing.

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Dec 6, 2018 08:05AM Bird-of-light wrote:

Shoregirl, did you have chemo? I had a topical numbing cream for my port that I also used around my drains that helped with pain. Especially, when the surgeon pulled them out. I honestly think my surgeon enjoyed ripping my drains out. She had no empathy for the pain it caused. After the first drain was removed, I slathered the numbing cream all over before the visit to remove the other drains. It helped.

Dx 4/13/2016, IDC, Left, <1cm, Grade 2, 0/3 nodes, ER+/PR+, HER2+ (IHC) Surgery 6/8/2016 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 7/14/2016 Taxol (paclitaxel) Targeted Therapy 7/14/2016 Herceptin (trastuzumab)
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Dec 6, 2018 11:55AM Shoregirl wrote:

macb04, thanks for the well wishes! I have never had kidney stones. Knock on wood!!! But I am throwing the Vit C at it, as well as CoQ10, NAC, Acetyl L-Carnitine with Alpha Lipoic Acid, Bromelain and Vit A. Fingers crossed the drain comes out tomorrow, although that is only 3 days post-op.

Bird, I didn't have chemo. My dcis was non-invasive and triple neg so no chemo or hormonal therapy. I do have the numbing cream Emla though. They gave it to me for the day of msx when they inject contrast dye into the nipple. I am so glad you brought that up, I will try to put some around the drain. That surgeon of yours sounds like a real jerk!!

Joy2, I hope the wound vac helps you. I had that at msx and healed nicely. Macb's recommendation for hyperbaric oxygen therapy is something you should look into if you continue to have problems healing. I have seen a lot of posts by women who were greatly helped by HBOT. Best wishes for complete healing!!!

I have a lot of redness and heat on the left boob. That is where the alloderm was added. I don't feel like I have a fever though. I know we are supposed to "step away from the mirror" but I am amazed at the difference in projection these moderate profiles make. The old implants were 5.1cm proj, the new ones are 4.2cm so not even a whole cm less but they sure look a lot flatter! It will be interesting to see how they settle. I was really happy to hear when my ps was marking me for surgery he said he really loves sculpting with fat. Said I can likely have my fg done 6 weeks from now.


Faith, Hope & Love, the greatest of these is Love 1st Cor 13:13 Dx 12/2/2016, DCIS, Right, 6cm+, Stage 0, Grade 3, 0/2 nodes, ER-/PR-, HER2- (IHC) Surgery 1/26/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 4/24/2017 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 11/28/2017 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/3/2018 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Dec 8, 2018 01:57AM - edited Dec 8, 2018 01:58AM by macb04

Good Luck with healing well and quickly ladies..

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Dec 9, 2018 02:22PM joy2 wrote:

Hello Shoregirl and macb04! Thank you for your recommendation. I will mention it to my doctor when i go to see him again. The vac therapy did a good job to me. I kept it for a week and saw good progress. Now my PS gave me collagen stripes to put in the wound to the wound to help me heal. I will see how this goes.Thank you all!

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