Breast Reconstruction for Athletic People

CDub

Hi everyone,

I'm pretty new to BCO and after posting to an old forum the moderator suggested I create a new thread on this topic. So here goes!

I am a 52 year old, and had a lumpectomy to remove a small cancer from the left breast. Because I'm high risk, I'm now deciding if and when to undergo a risk-reducing double mastectomy plus reconstruction. I've decided if I do this, prepectoral (above the muscle) implants is the way to go. I don't have enough body fat for flap reconstruction, and I've heard under-the-muscle (subpectoral) causes pain and deformities during exercise.

I swim 2-3 miles per week and cycle 30-80 miles per week, and I fear not being able to do these things for 8 weeks or more will drive me nuts. Has anyone else had a prepectoral reconstruction and gotten back to strenuous exercise? How long did it take? What kind of exercise were you able to do during the recovery period (for example, can you cycle before swim since it doesn't involve your arms as much?) I'd love to hear from other athletic women who underwent prepectoral reconstruction how it went for them.

thank you!

Charlierun

Hi CDub, I was recently diagnosed with the BRCA2 mutation and am scheduled for a breast reduction in a month to prepare for future prophylactic bilateral mastectomy . My PS advised the reduction as my breasts (36D,) are too droopy and large for optimal results of reconstruction. I am 66 years old and very active like you. I have run for 30+ years, hike , cross country ski and snowshoe. I have considered above the muscle saline implants if possible or a diep flap. A big concern is that exercise is extremely important to me and I have read about under the muscle implants and how they negatively impact movement. I would also like to hear about what other people's experiences have been while exercising with prepectoral implants. . I wonder if getting the smallest implant as possible would be better for active people? Some days I question if I should just go flat with an aesthetic closure in order to be able to move freely with less down time. It is helpful to hear what other active women have decided and how they were able to make the decision they did.

SummerAngel

I have subpec implants but I was able to start exercising again after 3 weeks. My arms were pretty week at first but I regained strength surprisingly quickly. I think it helped that I had a good PT for those first few weeks. I'm thinking prepec would be easier, but of course I can't say for sure.

typhoon

Hi CDub - I walk 5-10 miles a day (15 minute mile), do kettlebell workouts daily, and swim a mile or two a day in the summer. In early December I had a skin & nipple sparing bilateral mastectomy, with direct to implant (pre-pec) reconstruction. Recovery for me was pretty easy - I had the full range of movement in my arms right from the start, and I took my first walk the day after surgery. My plastic surgeon used a wound vac system instead of traditional bandages to dress my incisions, and when that came off on the sixth day after surgery, I had no dressings at all to deal with, other than a piece of gauze around each of the surgical drain sites. The first couple of weeks I tired easily, and managing the surgical drains was a bit of a hassle, so not being able to get a good workout wasn't a sacrifice. Once the drains were out, I was back to walking full on with the blessings of my doctors; after six weeks, I got the all clear to start working out with kettlebells again.
We all heal differently, of course, and different doctors have different views on how much exercise you should get and how soon after surgery you should start, but they all want us up and moving around right from the start.

Good luck with your decision!

LaughingGull

I think you are wrong in thinking that you need a pre-pectoral implant to be able to swim or live an athletic lifestyle. Where did you get that from? I am very active, particularly swimming, and also looked into it before my surgery, and my conclusion was that under pec was safer (less chances of complications) and not an obstacle for swimming. I swim masters, and, prior to surgery, I talked to other swimmers who had gotten mastectomies and under pec implants and they didn't report any pain or deformities. My own experience confirms under pec implants allow one to swim as much as one wants. No deformities while swimming but i swim with a bathing suit on 😂

I started swimming exactly a month after surgery. During that month I first walked, then walked faster and then took cycling classes which were a blast and absolutely strenuous.

Of course there are other reasons to prefer pre-pec implants and I don't want to convince you otherwise but rest assured that under pec implants are absolutely compatible with swimming, lifting weights and any strenuous exercise

Best of luck,

Laughing

ShetlandPony

https://community.breastcancer.org/forum/44/topics/878403?page=1

Possibly useful discussion here ^

DiveCat

I have had sub-pectoral implants since 2014 when I went direct to implant (though a a couple different implants since). I am very active - including scuba (hauling heavy tanks and gear on land), lifting weights, kayaking, running, cycling, doing HIIT and similar workouts with planks, burpees, etc and they have never been an issue. No pain. While there may be some muscle animation I can't see it as I wear clothing when I work out.

I also have had fat grafting (second round today) that while done for rippling also will assist there with visual aspects of any deformity. I have not had any desire to switch to pre-pec even going back for surgery for other things. I am thin and my surgeon was aggressive in removing breast tissue and I think I would have been unhappy cosmetically based on having issues even with the muscle coverage.

I work out daily just for me (stopped being competitive a few years back). I was back to taking longer walks day after my surgery and back to other stuff within a month and adding what I could do as I went as lift restrictions eased and so on. I have remained same size I was pre-surgery (30E/32DD). My current ones are about 485g each. Again, has not be an issue and I wanted to remain similar in size.

My sister had pre-pectoral implants put in in late 2019 or so. She lifts heavy weights. But her recovery time was pretty similar to mine due to all the stitching in there as she had more Alloderm than I did. She has had to have fat grafting too and switch to larger, firmer, very high profile implants to reduce rippling (same body type as me but thinner rib cage). She still had lifting restrictions after surgery just like me. Your surgeon will have their own plan for you at discharge, and everyone is different.

While you don't technically use “arms" for cycling you are putting a lot of weight and need your arms and shoulders for control (and things can go badly if you were to crash a bike and pop stitches, etc), plus there can be a lot of vibration up through your arms/chest, so you may find even your can swim before bike (or maybe not!).

ChrisJack1

Gosh laughinggul I'm so happy to hear that! I was so worried and thought maybe I was wrong on getting under the muscle implants. Surgery is scheduled September 16.