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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 19, 2015 11:47PM - edited Jul 14, 2020 11:44PM 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 Anne Peled, MD - 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. Sandeep Jejurikar - Downers Grove & Batavia, IL , Advocate Good Samaritan Hospital

Dr. William Dougherty - Taos, 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. Oscar Masters - Oklahoma City, OK

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. John Hijjawi - SLC Utah

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. Helen Perakis - Hartford, CT

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

Dr. Kenneth Lee, UF Orlando Health -Orlando, Fl

Dr. David Lickstein, Palm Beach FL

Dr. Joseph Woods - Piedmont Hospital, Atlanta GA

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

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

Dr Amy Colwell - Boston MA

Dr Russell Babbitt - Fall River, MA

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

Dr Therese K White - South Portland, ME

Dr. Michelle Roughton - UNC Chapel Hill, NC

Dr. Tzvi Small - Valley Hospital , Ridgewood NJ

Dr. Glassman - Pomona NY

Dr. Andrew Smith - Rochester, NY

Dr. Andrew Salzberg - NYC

Dr. David Otterburn - NYC

Dr. Constance Chen - NYC

Dr. Sameer Patel - Fox Chase, Philadelphia, PA

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

Dr. Stacy Stephenson - UTMC, Knoxville, TN

Dr Kent Higdon - Vanderbilt Medical Center, Nashville, TN

Dr. Mark Leech, Chattanooga Plastic Surgery, Chattanooga, TN

Dr. Brad Medling, in Murfreesboro (and Franklin), 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 David Habin-Song - Washington DC/ Maryland and Virginia :https://www.medstarhealth.org/doctor/dr-david-habi...

Dr. Joanne Lenert - Washington, DC

Dr Troy Pittman - Georgetown University, Washington, DC

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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Jan 9, 2020 11:21PM willa216 wrote:

VegGal and Macb04:  Thank you!

I appreciate all these details. Yes, it is going to be really challenging to pursue another attempt at a pre-pec implant.  I am just frozen with indecision.

I've been  reading about the laser therapy treatments for CC. I wish I would have tried that before this last CC became so severe.   I didn't have rads.   It sounds like you have done well with the Pentoxfylline and E.  So great to hear you have had luck.  I hope you're feeling good and happy with your  reconstruction.

The vitamin C is interesting to me though at each explant /revision there was no sign of any bacteria at all. I think my body just passionately despises implants.  

Anyway, thanks  so much for your kind and thoughtful response.  It is  much more than I have heard from any PS consult.  

Take care.


IDC; 2cm; 0/4 nodes; ER+ PR+ HER2+; UMX and reconstruction July 2016; Taxol , Carboplatin, Perjeta, Herceptin 12x/weekly August 2016; Herceptin through Aug 2017
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Jan 11, 2020 12:10AM macb04 wrote:

Best of luck Willa. I can't exactly say I am happy with my reconstruction because the last PS screwed up and put an implant in that was about 150cc too small, like a freaking moron. He then cut away the extra skin I spent months slowly, painfully creating with a TE.

I tried to fix it, ( he insisted I pay the surgery fees not covered by insurance, wouldn't admit he screwed up) I just wanted to look better. That was surgery number 17 in four years. I had had enough.

So I look normal in clothes, just can't stand the lopsided look when nude, but whatever.

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Jan 20, 2020 09:27AM JRNJ wrote:

Does over the muscle make it harder to find a recurrence? This is really bothering me because all my drs are saying no more scans. If you have a lump under the implant how would it be found?

Pleomorphic Multifocal, Extra nodal Extension, Lymphovascular Invasion. TEs removed due to infection Dx 8/15/2019, LCIS, Right, 6cm+, Grade 3, ER+/PR+, HER2- Dx 8/15/2019, ILC, Right, 2cm, Grade 3, 2/5 nodes, ER+/PR+, HER2- Surgery 9/24/2019 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 12/2/2019 CMF Radiation Therapy 3/30/2020 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 6/4/2020 Aromasin (exemestane) Hormonal Therapy 8/6/2020 Arimidex (anastrozole) Surgery 8/25/2020 Prophylactic ovary removal
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Jan 20, 2020 10:20AM hapa wrote:

It does make it harder to find recurrences.

Dx 3/20/2018, IDC, Right, 3cm, Stage IIIA, 3/18 nodes, ER+/PR+, HER2+ (FISH) Targeted Therapy 3/28/2018 Herceptin (trastuzumab) Targeted Therapy 3/28/2018 Perjeta (pertuzumab) Chemotherapy 3/28/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 8/22/2018 Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Radiation Therapy 10/22/2018 Whole-breast: Lymph nodes, Chest wall Hormonal Therapy 12/21/2018 Arimidex (anastrozole), Zoladex (goserelin) Targeted Therapy Nerlynx
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Jan 20, 2020 10:51AM SimoneRC wrote:

The protocol where I am being treated, an NCI hospital, is MRI every 2 - 3 years to check the integrity of the implant, which should also show if anything is brewing under the implants. My tumor was closer to the skin than the chest wall and margins were good.

ATM Gene Mutation, Deletion. IDC w/Lobular Features and Focal Mucinous Features. Pre Pectoral Reconstruction. Hysterectomy
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Jan 20, 2020 11:26AM JRNJ wrote:

Mine was by the armpit. I’m planning saline and I don’t think they do mris for that. I’m actually considering silicone just to get the mris but probably will go with saline. The system is twisted.

Pleomorphic Multifocal, Extra nodal Extension, Lymphovascular Invasion. TEs removed due to infection Dx 8/15/2019, LCIS, Right, 6cm+, Grade 3, ER+/PR+, HER2- Dx 8/15/2019, ILC, Right, 2cm, Grade 3, 2/5 nodes, ER+/PR+, HER2- Surgery 9/24/2019 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 12/2/2019 CMF Radiation Therapy 3/30/2020 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 6/4/2020 Aromasin (exemestane) Hormonal Therapy 8/6/2020 Arimidex (anastrozole) Surgery 8/25/2020 Prophylactic ovary removal
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Jan 20, 2020 01:37PM LiveLoveLaugh2020 wrote:

I had bil pre pec implant exchange with fat grafting a week and a half ago. I do have rippling on one side which I never had with those dreaded expanders. Any pre pec with rippling? My implants look good/natural besides the rippling. My PS said he was only able to get very little fat as I'm very thin. I'm guessing that's why along with my thin skin? I don't see him for another 2 weeks.

DCIS Dx @ 34 - Bil NSM 09/2019 - Bil implant exchange with FG 01/2020.
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Jan 20, 2020 02:05PM OCDAmy wrote:

JRNJ, my PS said MRI every three years to check on the implant and that wouldfind any cancer.

Dx 2/2017, IDC, Left, 4cm, Stage IIB, Grade 2, 2/13 nodes, ER+/PR+, HER2- Surgery 11/15/2018 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting, Silicone implant Surgery Lymph node removal; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy Arimidex (anastrozole) Surgery Reconstruction (left): DIEP flap Radiation Therapy Whole-breast
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Jan 20, 2020 02:06PM OCDAmy wrote:

Live, I had rippling and had to have some fat grafting. I also needed a second surgery to move the implant up higher and that really did the trick.

Dx 2/2017, IDC, Left, 4cm, Stage IIB, Grade 2, 2/13 nodes, ER+/PR+, HER2- Surgery 11/15/2018 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting, Silicone implant Surgery Lymph node removal; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy Arimidex (anastrozole) Surgery Reconstruction (left): DIEP flap Radiation Therapy Whole-breast
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Jan 20, 2020 02:12PM LiveLoveLaugh2020 wrote:

I too get nervous about that, wish we could have yearly screening.

OCD..thanks for your response. I'm hoping I just need one more FG but I'll see what PS says. Did you have rippling when you had the expanders? Also did they recommend 24/7 compression bra? I was given one with those instructions.

DCIS Dx @ 34 - Bil NSM 09/2019 - Bil implant exchange with FG 01/2020.
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Jan 20, 2020 03:04PM OCDAmy wrote:

Live, I was put in a surgical bra after surgery and had to wear it 24-7. My PS had me in a bra 24-7 for quite some time. I did not have rippling in TE but mine was under the muscle. I’m surprised at the number of women in here who have no rippling with a pre pec implant.

Dx 2/2017, IDC, Left, 4cm, Stage IIB, Grade 2, 2/13 nodes, ER+/PR+, HER2- Surgery 11/15/2018 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting, Silicone implant Surgery Lymph node removal; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy Arimidex (anastrozole) Surgery Reconstruction (left): DIEP flap Radiation Therapy Whole-breast
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Jan 20, 2020 03:16PM JRNJ wrote:

ocdamy. Thanks. I don’t think they do mris for saline. I have a consult tomorrow. I’ll ask. Love the name, I’m extremely ocd.

Pleomorphic Multifocal, Extra nodal Extension, Lymphovascular Invasion. TEs removed due to infection Dx 8/15/2019, LCIS, Right, 6cm+, Grade 3, ER+/PR+, HER2- Dx 8/15/2019, ILC, Right, 2cm, Grade 3, 2/5 nodes, ER+/PR+, HER2- Surgery 9/24/2019 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 12/2/2019 CMF Radiation Therapy 3/30/2020 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 6/4/2020 Aromasin (exemestane) Hormonal Therapy 8/6/2020 Arimidex (anastrozole) Surgery 8/25/2020 Prophylactic ovary removal
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Jan 20, 2020 03:36PM - edited Jan 20, 2020 03:36PM by LiveLoveLaugh2020

It's great for those who don't. Guess I was caught off guard because of the fact that I had no rippling with the expanders.

DCIS Dx @ 34 - Bil NSM 09/2019 - Bil implant exchange with FG 01/2020.
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Jan 20, 2020 11:39PM macb04 wrote:

I had 5 sessions of Fat Grafting before getting the TE Prepectoral and then the implant. I lost most of the fat twice due to massive infections ( a cups worth of pus drained off my chest each infection) . I had all of those infections when I couldn't afford to get IV Vitamin C the day after the surgery, and because of the hugely, destructive radiation damage the bc industry gave me interfered with healing.

I have no animation deformity or rippling. Some of my grafted fat survived

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Jan 21, 2020 06:32AM LiveLoveLaugh2020 wrote:

Wow, sorry you had to go through all of that! But glad you're happy with your results now.

DCIS Dx @ 34 - Bil NSM 09/2019 - Bil implant exchange with FG 01/2020.
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Jan 21, 2020 09:13AM - edited Jan 21, 2020 09:15AM by macb04

Wouldn't say happy with my result. Lopsided because the PS screwed up Big Time and put in an implant about 150cc too small to match the other size. So I redid it, 3 months later, at my expense. He also chopped off the extra skin I spent 6 months creating with the TE, so he couldn't fit the matching size of implant. He put in a bigger implant that is still about 75cc too small to match and look symmetrical.

So long story short, 15 Reconstruction surgeries later, I am still Lopsided. I am ok in clothes, but look somewhat f*cked up nude and never look at myself in the mirror. I would have to have to have another one or two surgeries to fix that, and I am, frankly weary to the bone of the whole stupid, stinking mess. I will never trust another doctor so long as I live.

No happy endings here.

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Jan 21, 2020 09:37AM LiveLoveLaugh2020 wrote:

Oh man...I'm so sorry. That's terrible, you deserve to be happy after everything you've been through.

DCIS Dx @ 34 - Bil NSM 09/2019 - Bil implant exchange with FG 01/2020.
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Jan 21, 2020 10:12AM SimoneRC wrote:

LiveLoveLaugh2020,

Hi again! I have had fat grafting two times. Once at my first exchange. A second time 3 months after my second exchange. I am thin with zero fat up top, very thin skin and thin mastectomy flaps (which is good from a trying not to have a local recurrence point of view😃). I have a little bit of rippling on the top of my right implant and a little on the side. Guess what... I will take it! Way better than having cancer. They amputated my breasts. It’s not just a “boob job”. They look way better than I expected and I feel lucky not to have animation deformation and to have full use of my arms and shoulders. I know some people’s outcomes are worse so I count my blessings! My PS did say that down the road the rippling could become more pronounced and I could do more fat grafting. I have almost no fat so it would be pizza time for a bit beforehand if it comes down to it.

After reading this back, adding - not trying to make you or anyone feel bad. My experience luckily has been pretty good. I am personally ok with it being not perfect given the circumstances!

Take care and keep us posted!


ATM Gene Mutation, Deletion. IDC w/Lobular Features and Focal Mucinous Features. Pre Pectoral Reconstruction. Hysterectomy
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Jan 21, 2020 10:35AM LiveLoveLaugh2020 wrote:

Hi Simone. I tried pizza time it didn't work, guess I'll have to try harder for the next round. I am by no means looking for perfection and I count my blessings as well believe me. Our original boobs weren't perfect and nothing is. I am happy with my results so far and was just wondering if other skinnies are going through the same thing. This is all new to me.

DCIS Dx @ 34 - Bil NSM 09/2019 - Bil implant exchange with FG 01/2020.
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Jan 21, 2020 12:14PM - edited Jan 21, 2020 12:16PM by macb04

I appreciate the kind sentiments LiveLoveLaugh. I manage ok, just don't feel like I can say I am happy with the lopsided result after so much expense and suffering. We all certainly deserve competence, which I most certainly did not get.

I do want to take doctors off the list if they make giant mistakes like mine. I took his name off for sure.

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Jan 21, 2020 12:18PM macb04 wrote:

I am glad you are doing relatively well SimoneRC. You deserve to be content with a result you can live with.

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Jan 21, 2020 02:01PM LiveLoveLaugh2020 wrote:

You're welcome. It's just horrible because after everything we've been through we deserve to be happy/content.

DCIS Dx @ 34 - Bil NSM 09/2019 - Bil implant exchange with FG 01/2020.
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Jan 21, 2020 02:14PM SimoneRC wrote:

LiveLoveLaugh2020,

You are soooo not alone!!!

Your sister in light rippleness


ATM Gene Mutation, Deletion. IDC w/Lobular Features and Focal Mucinous Features. Pre Pectoral Reconstruction. Hysterectomy
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Jan 21, 2020 02:20PM LiveLoveLaugh2020 wrote:

I meant for Macb that's terrible and no one should have to go through that many procedures. You are one tough lady! And thank you Simone! You are not alone either :)

DCIS Dx @ 34 - Bil NSM 09/2019 - Bil implant exchange with FG 01/2020.
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Jan 21, 2020 02:49PM SimoneRC wrote:

Thanks macb04 and so sorry your journey has been rough!

ATM Gene Mutation, Deletion. IDC w/Lobular Features and Focal Mucinous Features. Pre Pectoral Reconstruction. Hysterectomy
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Jan 22, 2020 12:31AM macb04 wrote:

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Jan 22, 2020 04:51PM Andraxo wrote:

I also am very lean/athletic build and had ripples with my pre-pecs. I could also see/feel the edges and even get my fingers under the edges except for the bottom edges and the laterally on radiated side. Not a candidate for fat grafting for the amount needed and I wasn't willing to gain weight for it. Besides, I'd rather save any fat for harvesting stem cells for joint injections later when that science is better! :) I explanted 10 weeks ago though and am flat now. He was going to swap out the now FDA banned implants for smooth rounds but they looked awful in the OR so he went with plan B that we discussed before surgery, which was flat. I found implants to be a hassle/annoying (both how they felt and looked) didn't realize how much I really didn't like them until all these weeks past having them removed. Much happier! I hope all of you get the results you want or at least can live contently with, and are happy! 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, Grade 2, 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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Jan 24, 2020 07:09PM Magari wrote:

Macb - I too am really sorry to hear all the difficulties you've had with your reconstruction.

But I don't understand why you had to redo "...it, 3 months later, at my expense."

My surgeon told me that in the US we are entitled to as many surgeries as we need, and that all should be covered by insurance.

Diagnosed at 54; Bilateral mastectomy with DTI reconstruction 10/16/17; Revision surgery to switch implants 7/19/19; Cold capped during chemo - TCHP 11/26/17 Dx 9/1/2017, DCIS/IDC, Both breasts, <1cm, Stage IB, Grade 3, 1/3 nodes, ER+/PR+, HER2+ Hormonal Therapy 6/3/2018 Arimidex (anastrozole) Hormonal Therapy 8/16/2019 Aromasin (exemestane) Hormonal Therapy 9/16/2019 Femara (letrozole) Hormonal Therapy 1/14/2020 Arimidex (anastrozole)
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Jan 25, 2020 11:54PM macb04 wrote:

I had the first, screwed up exchange from TE to wrong implant in December. Then had the 2nd exchange to a bigger, but still wrong, still too small TE in March, 3 months later. I had to spend about $3,000 per surgery out of pocket because my husbands insurance had a fairly high deductible.

So that was $6,000 out of pocket ( in a 3 month span of time) to still have an embarrassing, lopsided result. The law is fairly useless that way. High deductible insurance means women like me are screwed over and impoverished every day just trying to look halfway normal. I think it's a travesty of justice, and I am still really pissed at dr bryan mcintosh over my result. At the very least, since he screwed up royally, he should have done his part for free. Too late to sue.

That's why I took his name off the list. I don't want to send women to any doctor who makes terrible mistakes and won't own up to it.

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Jan 26, 2020 10:59AM LiveLoveLaugh2020 wrote:

Mac that's terrible. I totally get what you're saying as I have a high deductible plan as well. I think sadly majority of people do unless your one of the lucky few to still have great insurance/low deductible plan.

DCIS Dx @ 34 - Bil NSM 09/2019 - Bil implant exchange with FG 01/2020.

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