Help, Implants over or under the muscle?

JRNJ

I know there is a thread on switching from under to over, but I didn't see anything with input from both sides pros and cons. My PS put TEs over the muscle without discussing the options with me. Due to infection, they were removed. So I have had time to research. I had a consultation with a new BS and she said definitely under the muscle and I should consult with her PS. I also have a friend without BC that has under the muscle saline and says that is the way to go. I am planning on saline. I'm reading over the muscle has more chance of capsular contraction and if I have any tissue left from bmx, it might be harder to find a reoccurance, which really scares me if this is true. Especially since my new BS said my old one may have left some tissue. But I have thick skin and I read over the muscle looks more natural. I don't want weird muscle pains and the muscle smooshing the implant and a large space between. I don't exercise. I'm also getting radiation, so may be a factor. Plan is to put TE back in before radiation. So tired of making so many decisions! Input please!

JRNJ

bump

mnsotamom74

I just had over the muscle delayed reconstruction. I was terrified of the ( breast cancer hiding behind the implant) my surgeon said that’s a myth. Also, he said because I’m having implants I will automatically get a yearly mri because they have to check the implants and make sure they are holding up and not leaking, etc. he said they will be looking for anything concerning at that time as well.

I’m so glad I went this route, I have had zero pain!!

OCDAmy

I think pre pec (over the muscle) is getting to be standard now. My PS says he rarely does under the muscle.Why do you want saline? The new silicone implants feel much more natural and when they are over the muscle they are more comfortable.

Brilee76

I have over the muscle, silicone implants. I was told that the implants under the muscle cause a longer healing time and when you flex your pecs your boob moves in an unnatural way.

SummerAngel

I have under the muscle silicone. I'm happy with them and they look great, but if I had the choice I would have gone with over the muscle. There was a lot of pain with under, especially because I had "very well-developed pecs" according to my PS. (I've always worked out.) Now I've given up doing push-ups because of the distortion and permanent movement towards the outside it caused when I was doing them. It's also still odd the way my breasts move up and down when using my arms for anything strenuous.

JRNJ

thanks girls!!! I wasn’t getting any responses. My dr does over. Going for another consultation this morning with a dr that likes under. Im stuck on saline just don’t want to risk leakage. I’m looking long term results. I can suffer in the beginning if better in long run. I don’t exercise but I do a lot of house projects. I don’t think they do mris for saline. The “botched” drs on tv appear to do under. Still confused.

SimoneRC

JRNJ,

Hi! Lots to think about, right! The Botched doctors on TV are cosmetic plastic surgeons doing cosmetic Breast Revision Surgeries. They are not doing Breast Reconstruction Surgeries. Two totally different ballgames. Those ladies have breast tissue. Women who have had mastectomies have no breast tissue. Apples and oranges.

Sounds good you are gathering information and getting different options. The new silicone implants are a gel material and if the rupture they do not leak as before. There are pro’s and cons for over muscle (prepectoral), under muscle, silicone and saline.

Keep us posted and keep asking questions to make the best decision for you!

farmerlucy

I have under the muscle and the initial phase was excruciating for me. My sil had her breast tissue removed and 2x over the muscle implants with major capsular contracture. This last time she had under and is not having the same issue w capsular contracture.

JRNJ

Thank you all for the input! So I have a crazy update. Went for a consultation today with a new PS. I'm going to start a new thread because it involves DIEP and a bad mastectomy so I want to pull those people in.

MinusTwo

JRNJ - I have under the muscle and silicone and I'm very happy with them.

Please note: the newer silicone implants are cohesive gel. Think gummy bears. Saline can leak, but cohesive gel silicone can't leak. I suppose a lump could break off, but you're more likely to get a leak with saline than the new silicone.

JRNJ

Thanks MinusTwo. Were you fully expanded before radiation? Has the radiation had an impact on the implants?

MinusTwo

JRNJ - I actually had the implants themselves in place. Radiation was part of the treatment for a BC recurrence. Surgeon was able to do ALND (lymph node dissection) w/o touching the implants or the capsule. Amazing work. Radiation did make that side higher & tighter, but otherwise did not hurt the implant in any way. Original exchange to implants in 2011 and now 4 years out from the radiation after the chemo & 2nd surgery. I just had an MRI and confirmed that everything is OK.

JRNJ

Minustwo, thanks for the info! Going back to PS#1 tomorrow for more information on options.