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Apr 9, 2019 01:11PM
hi ya'll, first I want to say that I just barely skimmed the article that was posted above because of where it was from philly.com!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! The Inquirer post or whatever! NOT REAL NEWS IMHO
I am a surgical nurse and it was not in a medical journal and I work in the operating room and have for the last 21 years. I get all of my info from factual medical journal and RESEARCH articles not just what you can find on the internet. Do not let that stuff scare you. We have to do a research class in Nursing School for a Bachelors of Science in Nursing four yr degree and there are very strong stipulations for research and that article had none of them, no abstract, nothing because it was just an "article" and could site no research! Put no faith in such articles.
I went with over the muscle and I have never been happier. Like some have mentioned previously, I feel that after my reconstruction I look better than before. My risk went down to 1-3% I think with my mastectomy and I did nipple sparing bilateral. Based on my age and health, I am 49 active, healthy, non-smoker, no diabetes or other conditions, my PS recommended the over.
https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm241086/htm My implants are shaped textured. I took the risk as the numbers are below 500 across THE WORLD and the number that have actually died are less than TEN! The cure if you get BIA-ALCL is remove the implants. Simple enough and alright by me. I am young so I wanted the more natural looking implants that the alloderm would "grow" into and my tissue into that.
Also to note, if you read in above article it shows the percentages of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is usually found near the breast implant, contained within the fibrous scar capsule, and not in the breast tissue itself.
I had a mastectomy so a) I don't have 97% of my breast tissue b) I have the alloderm completely OVER the entire implant and c) studies have shown the body doesn't form the capsular contracture around the alloderm because it is NOT a foreign body like the implant is. The Alloderm used to cover my implant is what is routinely used in breast reconstruction. Technically it is called ADM for acellular dermal matrix. It is a biologic mesh-like material derived from animals or donated (cadaveric) human skin. Alloderm is a human product and is the most widely used ADM. It is used in many different types of reconstructive surgery not just breast reconstruction. Before being packaged for use, it undergoes a multi-step process that removes all the cells that can lead to tissue rejection: even though it comes from another person, your body does not reject Alloderm because the immune cells are removed. Alloderm essentially acts as a scaffold and over time your own cells grow into it.
This was a HUGE selling factor for me as I see patients returning back to surgery for removal of capsular contractures around implants that make them rigid and hard and implants are not aesthetically pleasing any longer and the patient wants them fixed. These were mostly augmentation cases where the patient had implants for reasons other than cancer. Knowing that I won't get capsular contractions is a huge plus. I do need to go back and look at the research and see what number of patients that got diagnosed with BIA-ALCL were post breast cancer surgery patients and what number were from augmentation surgeries.
My big concern with under the muscles was also the PAIN. I am a BIG BABY and I hate pain and I have had a lot of surgeries from injuries in the military.
https://opmed.doximity.com/articles/pre-pectoral-breast-reconstruction-a-hot-topic-at-asps <---some of you might find interesting
Very personal decision and ultimately your own. I wish you luck in deciding but go with the decision that YOU are most comfortable with. :)