pectoral muscle functioning

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sportstrainer
sportstrainer Member Posts: 2
edited June 2014 in Working on Your Fitness

I will be having a prophylactic mastectomy in a couple weeks.  I have started doing triathlons, and I own a girls sports performance business.  Much of my work is spotting and lifting rather heavy weights and demonstrate olympic lift movements. I lift, bike, swim  and run.

 I discussed with my PS that I would prefer to retain as much muscle functioning as possible.  She thought that there would be some permanent compromise of the muscle. We had a discussion about implants placed on top of pectoralis vs. under.  She stated that they can be placed on top of muscle but there might be visible puckering/rippling during certain movement. 

The GS didn't think there would be any problems going under the muscle and stated that it would look much better.

Question 1.  Has anyone chosen implants on top of the muscle?  Do you have problems with rippling?

Question 2.  Do any athletes out there feel that there has been significant strength changes with chest muscles due to implants under and stretching pectorals?

Also reading info on this site indicates that if the implants are over the muscle it may be harder to continue screening  Of course health needs to come first if this is the case.

Part of the surgery is removing some lymp nodes. this is the first that I am hearing about lingering problems with lymph nodes and activity as well.

Any input would be appreciated. 

Thank you

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  • digger
    digger Member Posts: 590
    edited May 2009

    I'm about 9 weeks out from my exchange after a left unilateral mastectomy in Nov 08.  This is an interesting question, and I'll be curious to hear the feedback from others.  I would suspect that some of the recovery of the pec muscle is individual, i.e. some people recover better than others.  For me, my left arm is now permanently shorter than my right arm, and it is noticeably weaker as well.  My left implant is under the pec muscle (and, by the way, I do have rather noticeable ripples, and it's a gummy bear implant which isn't supposed to ripple).  I feel it every day, although I imagine that will get better.  For symmetry, I also got a lift and small silicone implant on my right "good" side (also under the pec muscle) and have had no problems with it.

    I was told not to do any more kinds of exercise that "bulk up" the pec muscle, i.e. push ups, etc.  I also find many yoga positions (I used to love vinyasa yoga) extremely uncomfortable, bordering on painful.  Running is fine, biking I'm having trouble with because I unfortunately developed frozen shoulder from the surgery and it's hard to bend down to grab the handlebars of the bike.  Oh, and swimming is out  of the question right now, again because of the frozen shoulder.

    By the way, I have also heard that implants over the pec muscle might look better, but my PS didn't do them that way, and I didn't want there to be any problems finding any possible cancer in the future, so agreed.

    I am now in physical therapy for the frozen shoulder, so hopefully that will resolve itself at some point and I can get back to most of my activity pre-mastectomy.  I'm sad about my temporary (hopefully it's temporary!) loss of physical function, but I know I didn't have a choice. 

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  • trigeek
    trigeek Member Posts: 916
    edited May 2009

    Guess I should chip in.

    I had a bilateral mastectomy with immed recon with expanders on August 2007, then had the implant exchange ( under muscle) on feb 08.

    Yes initially it was kind of uncomfortable but right now I am lifting the same amount of weights and just completed a half ironman. I was diligently stretching the arm tho doing the bridge pose sometimes at yoga.

    I also was told that the pec muscle will eventually thin and weaken but have not felt anything to that kind, and do not have any problem now with vinyasa yoga.

    Don't forget they practically cut the pec open to push the implant in.. so it is only natural that it will take some time for it to heal.. they also had to add some tissue to my pec muscle cause it was too small to go over the implant so I have a patched pec hehe.. but no loss of strength about 14 months out of exchange.

    Hope this was helpful pm me if you need any other info !

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  • sportstrainer
    sportstrainer Member Posts: 2
    edited May 2009

    Thank you for your info!  I think your right, women may experience a wide range of differences. I plan to take a copy of replies to my next PS appointment to discuss the range of things that may happen. I have the benefit of being able to take time to research these things, I realize that most women are trying to make these decisions under little time and the weight of a diagnosis.

    My respect and appreciation to all willing to share their experiences.

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  • Cheri2
    Cheri2 Member Posts: 285
    edited May 2009

    I had a double mastectomy March 17 with lymph node removal (5 in one / 3 in other) and have TE that are still being filled.  I have gotten up to 5 miles with walking and tried to lift with 3 pound weights today and it just hurt way too much!!! 

    I hope I get back to running soon but just not sure with the TE it will happen- they feel so heavy and hurt so much- perhaps this won't be the case when I am finished with the injections and my body has a break for a bit!!!

    As for swimming, I tried last weekend for the first time and wow did I pay for it that night.  Had to take a valium (which I hate to do)  Just did one lap of breast stroke and several with the kickboard (no problem with that) and then swam frog style with my 9 year old for about 30 minutes- that is what killed me I think!

    I am still hitting the wall at 7 but I don't care- I have taken off from work until the middle of June so I do wake up in the middle of the night and watch the DVR and play on this site! :) 

     My biggest fear is lymphodema and the effect of lifting weights and running will have on my arms as both arms are affected!!!  Any idea's for not getting lymphodema? 

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  • Binney4
    Binney4 Member Posts: 8,609
    edited May 2009

    There's good information out there about reducing your lymphedema risk, and even specifically about post-bc exercise, but it can be hard to find. I'd like to suggest that you get a referral from any doctor on your team to a well-trained lymphedema therapist. S/he will do an evaluation, offer personalized risk reduction tips, take baseline measurements of your arms for future reference, and fit you for a compression sleeve and glove or gauntlet (fingerless glove) to use when exercising, traveling, or for any strenuous or unaccustomed activity. S/he can also teach you a gentle directional massage you can use prophylactically.

    Here are some information sites:

    The National Lymphedema Network has Position Papers on risk reduction, exercise, and air travel. They're here:

    www.lymphnet.org

    The StepUp-SpeakOut site (which is specifically about post-bc lymphedema) has a page on reducing your risk here:

    http://www.stepup-speakout.org/riskreduction_for_lymphedema.htm

    You'll also find pages at StepUp-SpeakOut.org specifically about exercise and about how to find a well-qualified lymphedema therapist.

    We also have an active Lymphedema discussion forum here at bc.org, and you'd be welcome to ask any questions you may have there, where the "Sisters of Swell" are happy to share their (unfortunate!Tongue out) wealth of experiences.

    Be well!
    Binney

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  • Jorf
    Jorf Member Posts: 498
    edited June 2009

    I had mine under the muscle only on the left. I was in the PT office within a week and went frequently. She did lots of manual work on the chest muscles and guided me in strength. I was back up to 50 pushups pretty quick. Part of my problem was that with my first surgery (lumpectomy and ax dissection 6 months previously they nicked part of the rotator cuff - can't remember which muscle - but, again, I was in PT pretty quick after that. It's 3 years later now. I do notice a slight difference in strength between L and R but, honestly, being right handed I have no idea if this was exactly the same difference before. Overall I'm much stronger because I've continued to focus on my upper body strength. Other than an increase in exercise it hasn't affected my Tae Kwon Do or horseback riding. Hope that perspective helps a little.

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  • Lemur
    Lemur Member Posts: 2
    edited September 2009

    I'm BRCA2 positive and am considering a prophylactic mastectomy to reduce my risk of ever getting breast cancer. I'm glad some one is discussing the impact of rconstruction procedure has on return to full athletic activity. I'm a dancer and do some acrobatics as well. I've been considering autologous reconstruction using the DIEP flap method which usues abdominal tissue but is fully muscle sparing. The big down side there seems like the extra days in hospital and prolonged recovery period. I don't know how the inscision that goes through the abdominal muscle impacts stregth, flexibilty etc on one side though. I've been trying to find out more about implants and how they impact the functioning of the pectoral muscle afterwards and this was the first instance I've seen of anyone bringing it up. The booklet I have from my the surgeon I've been referred to only lists a 2-4 week recovery period but what they consider 'recovered' is impossible to guage. I look forward to following this discussion and hopefully getting a better persepective on what my best options are.

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  • Cheri2
    Cheri2 Member Posts: 285
    edited November 2009

    Hi Lemur,

       I am getting from your note that you are using this surgery as a precaution and have not been diagnosed.  I had a DCIS and took both because although I am not BRCA positive 2 women in my family have been diagnosed.  I have implants under pecs.  There is a procedure for implants OVER pecs.  My plastic surgeon offered it to me as an option.  My breast surgeon said no way because it covered about an inch of interior wall that she can't check but in your case, if you aren't diagnosed that might be a good option.  When they take your breast tissue out, you are numb forever.  Please consider that.  Also if you have not been diagnosed you might opt to not have your lymph nodes out.  That would cut the risk of lymphodema.  Good Luck to you!

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