Topic: Going from under the muscle implants to over the muscle....

Forum: Breast Reconstruction — Talk with others facing decisions about whether or not to have breast reconstruction, and if so, what type and when.

Posted on: Feb 12, 2020 12:15PM - edited Feb 12, 2020 12:15PM by Tigger969

Posted on: Feb 12, 2020 12:15PM - edited Feb 12, 2020 12:15PM by Tigger969

Tigger969 wrote:

I'm 4 years out from my bmx and recon surgery. At the time I chose implants since my children were younger and very dependent on me. Within the last year or so I've been dealing with a lot of tightness/discomfort with my implants. Unfortunately, I'm not a candidate for the DIEP flap but was advised that I could remove my existing implants, repair the pectoralis muscle and go over the muscle with cohesive gel implants.

Has anyone here gone from under to over? Would you advise it? What was your recovery time and is it still covered under your medical insurance?


Dx 12/1/2014, DCIS, Right, <1cm, Stage 0, 0/1 nodes, ER-/PR- Surgery 1/12/2015 Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 6/1/2015 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 9/9/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Feb 12, 2020 04:54PM veggal wrote:

I did it a couple of years ago. Recovery was a couple of weeks of being very careful and then slowly returning to normal activity. The new implants look and feel tons better.

Insurance covered it all.

Dx 1/12/2016, DCIS, Left, <1cm, Stage 0, Grade 2, 0/3 nodes, ER+/PR-, HER2- Surgery 3/11/2016 Mastectomy; Mastectomy (Left); Prophylactic mastectomy; Prophylactic mastectomy (Right); Reconstruction (Left): Tissue Expander; Reconstruction (Right): Tissue Expander Surgery 6/9/2016 Reconstruction (Left): Silicone implant; Reconstruction (Right): Silicone implant Surgery 9/7/2017 Reconstruction (Left): Fat grafting, Silicone implant; Reconstruction (Right): Fat grafting, Silicone implant
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Feb 12, 2020 05:30PM Tigger969 wrote:

Thank you for responding.

It seems that a lot of plastic surgeons are no longer going under the muscle. I guess I’m just worried that they will have a fake appearance. I’m really looking for relief from feeling like I’m in an iron clad bra that I cannot adjust. I’d love to also not feel the implants 24/7

Dx 12/1/2014, DCIS, Right, <1cm, Stage 0, 0/1 nodes, ER-/PR- Surgery 1/12/2015 Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 6/1/2015 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 9/9/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Feb 12, 2020 07:09PM - edited Feb 12, 2020 09:14PM by veggal

Minelook less fake than my under muscle ones did, especially when my chest muscles contract.

Dx 1/12/2016, DCIS, Left, <1cm, Stage 0, Grade 2, 0/3 nodes, ER+/PR-, HER2- Surgery 3/11/2016 Mastectomy; Mastectomy (Left); Prophylactic mastectomy; Prophylactic mastectomy (Right); Reconstruction (Left): Tissue Expander; Reconstruction (Right): Tissue Expander Surgery 6/9/2016 Reconstruction (Left): Silicone implant; Reconstruction (Right): Silicone implant Surgery 9/7/2017 Reconstruction (Left): Fat grafting, Silicone implant; Reconstruction (Right): Fat grafting, Silicone implant
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Feb 12, 2020 07:19PM Tigger969 wrote:

That’s it ~ the distortion is insane.

Thank you again ~ I really appreciate your candor and honesty

Dx 12/1/2014, DCIS, Right, <1cm, Stage 0, 0/1 nodes, ER-/PR- Surgery 1/12/2015 Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 6/1/2015 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 9/9/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Feb 12, 2020 09:15PM jrnj wrote:

Tigger, see existing thread

TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!
https://community.breastcancer.org/forum/44/topics/835911
My PS does over. I had tissue expanders in but were removed due to infection. I was researching over vs under but Now because I’m doing radiation changed plan to diep. I have 6 months to gain weight. I’m in central jersey.
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 9/23/2019 Lymph node removal; Mastectomy; Mastectomy (Right); Prophylactic mastectomy; Prophylactic mastectomy (Left); Reconstruction (Left): Tissue Expander; Reconstruction (Right): Tissue Expander Chemotherapy 12/1/2019 CMF Radiation Therapy 3/29/2020 Whole breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 6/3/2020 Aromasin (exemestane) Hormonal Therapy 8/5/2020 Arimidex (anastrozole) Surgery 8/24/2020 Surgery 1/28/2021 Reconstruction (Left): DIEP flap; Reconstruction (Right): DIEP flap Hormonal Therapy 3/9/2021 Femara (letrozole)
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Aug 7, 2021 11:07AM Srcoh wrote:

I’m brand new to this community and was searching for information about exercise equipment for those with reconstructive implants under the pectoral muscle. I feel that the implants really impact my ability to lift, push or do any exercise or movement that may remotely involve my pecks. My PS told me that I was not a candidate for implants over the pectoral muscle but now I’m thinking I didn’t do enough research on my own. I’m 5’7” and weigh 118lbs. My dr told me that my skin is thin and I don’t really have extra fat to spare for reconstructive purposes. I’m a year into my final reconstruction and I feel the edge of the implants every day. Some days I wish I had skipped the reconstruction part. Could I have done this differently? Are there other reconsoptions for a person w/ thin skin and not much spare meat on her bones?

Dx 5/2018, DCIS/IDC, Left, <1cm, Stage IA, ER+/PR+, HER2+ Radiation Therapy 3DCRT: Chest wall
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Aug 7, 2021 02:01PM pi-xi wrote:

Hi Srcoh! Sorry to hear about your situation. I have under the muscle implants and I was definitely able to get back to pre-surgery workouts. Lots of full push-ups (until a shoulder injury this spring) and the like. I don’t do any pull-ups or chin-ups mainly because I don’t have the equipment/ceiling height. I wasn’t pushing any extreme weight, but I regularly used 15 lbs. Perhaps you are at a higher level? However, it did take me three years or so after surgery to feel comfortable cleaning the stove top with my right arm. Things definitely felt yucky at first, but I mostly feel normal now.


Oncotype 12 Dx 4/7/2016, DCIS, Left, 2cm, Stage 0, Grade 1, ER+/PR+ Surgery 7/11/2016 Mastectomy; Mastectomy (Left); Prophylactic mastectomy; Prophylactic mastectomy (Right); Reconstruction (Left): Silicone implant; Reconstruction (Right): Silicone implant Dx 8/3/2016, DCIS/IDC/IDC: Papillary, Left, 1cm, Grade 2, ER+/PR+, HER2- Hormonal Therapy 9/1/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Aug 10, 2021 07:48AM Srcoh wrote:

Thank you so much for your reply. It gives me hope and I can’t tell you what a relief it is to hear that maybe I’m asking too much too soon. I hear you about the cleaning the stove top. It’s sometimes uncomfortable for me to repeatedly pump the big dispenser for hair conditioner and using a big shears to prune bushes. I stopped the pushing and plank-type exercises because they were difficult and uncomfortable but it sounds like with time I can gradually try to add some back in.

Dx 5/2018, DCIS/IDC, Left, <1cm, Stage IA, ER+/PR+, HER2+ Radiation Therapy 3DCRT: Chest wall
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May 6, 2022 11:04PM orchidgal8 wrote:

I had a bmx with sub-pectoral reconstruction in late 2010. Due to problems, the PS insisted on doing another recon three months later, increasing the implant size (350 to 425) to get rid of rippling of thin skin on one side. Have experienced great discomfort ever since: the iron bra experience, tightness, pulling, jumping, burning and itching, etc. Have had capsular contracture on both sides for at least five years. The reconstruction is very round and flat, as someone here called them, Muppet heads. I took the names of five doctors listed on this site who do pre-pectoral reconstructions and visited each one between 2020-2021. No one was a candidate, nor considered me a candidate. I've finally found an excellent surgeon who does reconstruction revisions and sub to pre pectoral surgery. Before BMX I did kettle bell, weight training, strength training, etc. Afterwards, I could no long due pushups, and repeatedly had injuries while working of the cervical spine and pinched nerves, so have been getting exercise from walking and hiking having quit classes and weights, I believe due to the rigidity and tightness in the upper body due to the iron bra, and massive stitching. I'll have the revision survey in early June and for once am excited about going into surgery. After all I’ve been through it’s not a bother dealing with drains and sponge baths once more, hopefully for the last time. The PS says he will put slightly smaller implants in which I imagine will be much more comfortable. I encourage all of you to keep searching and know that it's possible to improve your situation. Thank you veggal, for sharing your story of going prepectoral

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May 7, 2022 07:34AM moderators wrote:

Dear orchidgal8,

Welcome to you and thank you so much for sharing your story. It is so helpful to hear others' experiences and to learn from them. We wish you the best with your upcoming surgery. Please keep us posted on how your recovery goes. We also note here that this thread has not been recently active. You can always reach out to individual members via private message. You can see in members' profiles on this page who has continued to be active in the community. You can also start a new topic.

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