Exchange City

Here's a question.  My ps used alloderm at time of mx and te surgery.  Maybe I misunderstood, I remember him telling me that implants used to be put completely under muscle, but now are put partly under and partly not, with alloderm forming a sling to hold implant (in my simplistic medical terms) Yet, I've read here that it should be completely under muscle. 

mom2B,

I did have Alloderm when my TEs were placed. I'm pretty sure they were under the muscle, but I don't know how far.  I remember something about a sling for the Alloderm too.  I think it's supposed to make a better pocket or surface for the implant.  I haven't had any problems...

To all this weeks Luckies, including you mom2B, wishing you quick surgeries and BEAUTIFUL results!

Cindy

Katey,

That alloderm website is interesting.  My PS used alloderm on one side with the TEs, but I don't know if he used it again with the implants.  He doesn't really like to use it, but it seems like a really useful product.  thanks for posting,

Kristen

Andy: I agree, go to the new PS.  Sometimes you just have to move on.

All the surgeries this week:  Good luck for fast procedures and fabulous results!!!

Alloderm/submuscular placement:  The literal "how" of recon confused me for a long time, but I finally figured out some of the variations so I'll share for anyone interested.  As described on the lifecell website in a full submuscular procedure, the TE/implant is placed beneath the pectoralis and the serratus muscles, whereas in the partial submuscular, the upper ~2/3 of the implant is under the pec but the bottom is only supported by skin.  Some critical consequences are that full submuscular may result in TE/implants that are too high (like mine!  I think the problem is that there's a limit to how low the bottom edge (IMF) can be because of where the bottom of the serratus is attached to the ribs), and can be misshapen by muscle contracture; they're fully supported by muscle & skin though.  Partial submuscular gives more flexibility to locating the IMF, but the bottom of the implant is supported only by skin and thereby more likely to bottom out or otherwise move (more problematic for larger implants).

This is where Alloderm comes in.  With it you will almost certainly have a partial submuscular implant (under the pec only).  To make up for this, the PS sews a piece of alloderm (the "alloderm sling") between the lower edge of the pectoralis to the tissue on the ribs, creating extra support.  Now you have both skin and alloderm supporting the implant on the bottom, although not muscle.   Kristen, if your PS used alloderm for the TE he almost certainly left it in place for the implant. 

An interesting twist is that some (all?) PSs using alloderm release part of the edge of the pec from the 6th rib to provide more space, and then sew the alloderm onto that released edge as well so as to re-anchor it on the ribs.  I'm unclear if PSs doing partial submuscular w/o alloderm also release part of the pec or not.

The variations in technique among PSs continue to boggle my mind!!

katey & cs7777 - I think I'm one of the few around here who doesn't have any Alloderm.  My ps uses it only when there is enough skin left to expand the TE some at the bmx/TE placement.  I barely had enough skin left to cover the TE, let alone put any saline in.  So, I have "complete sub-muscular implants."  I will say that my inplants ride pretty high, but not too high for my torso - but they're HP style anyway.  I do not think he released the pec in my case, at least. 

Okay, I did end of asking my dh what he thought last night about my size discrepancy.  He said he did notice some upper pole difference, but that it was minimal.  He said (and I quote), "Come on, Val, Dr. X  has made you into a goddess, your boobs are awesome, now just let him finish the job."  Goddess, huh?  Guess I need to turn in my tiara for something more goddesslike....sweet guy, though.....   I did not call the ps nurse.....at least today.....

Val, don't GODDESSES wear togas?

JustmeAlicia -vpkb143 -vMaggie66 - crusader1 - Bellz - Ronqt1 - Have safe and happy surgeries this week!

Kristen -- you are such a delight!  (LOL at the realization that you were wearing a tight bra)... I was wondering how you would still have that tight bra feeling post-exchange!

Val -- aw what a sweetie your DH is.... tell him that as a goddess you now expect some very special treatment (and see how that flies   

Kimberly -- aw that is so great that you are ready to date!  (Did I read that right?)  You go girl

Andy -- I'm with everyone else: it's a no-brainer -- keep the new PS, dump the old.  So glad you found one who could hear you!

Good luck all of you ladies on the exchange list (and nips) this week!

Lilah

Thank you Kristen! 

Now for the tight bra stuff! I loved those Olga bras I bought but found that in the center of my cleavage the wires came up too high and were leaving dents in my girls... so I went up a band size and different style & brand that the wires are only half as tall and do not poke me. The problem? Felina does not make this bra any longer.

My issues on the bigger size - I have to hook the bra as tight as I can BUT if I lose more weight it will be even looser and too big, on the smaller band size I hook it on the loosest hook and have room to tighten it as I lose weight but the wires bite me.

The clerks are not much help in fitting me to bras, they just want to sell me what they have, not what I need. For now, I am wearing pretty lace bras but I am on a mission to find this style in a smaller size and a current brand so when I have to go down a band size I will have a style that fits. I am focusing on the wire and how far it comes up in the front.

I am ready to return 4 bras to Kohls... wish they had something I could wear comfortably! I will keep buying, trying, and returning... 

Lilah, I sat and cried because they don't seem to make wire free bras in my size or they don't stock them in my size... OR if they do they were old lady anti-rape bras! I want something to make me feel good about myself. I was looking for a 38DD - not easy to find without wires and then the tips of the cups were floppy because of no nipples... so I settled for 38D but the band is not going to fit if I lose more weight... My TEs were so perky and stiff there was no need to wear a bra, but with the soft squishy gels, I want to support the 800cc so they are in the right place. It is exhausting to shop...

OH YES - you read that right! I am ready to date. I went out Saturday Night to watch Karaoke at a bar and two guys tried to give me their number! WTF? what happened to them asking for my number? (things have changed in the last 25 years!) as if I am desperate enough to call some drunk guy who doesn't even ask for my number!

Thanks Lilah - I don't have a Bloomingdales in Richmond that I know of - I will have to google the closest one.

Nordstroms, Dillards, JC Penny, Sears, Kohls, Stein Mart, Marshalls, TJ Maxx, you name it, I have tried it... and the mastectomy shops...

It's the lack of nipples - there is a floppy space in the cups so they wrinkle. Mail order seems good, but I have been trying them on and must be too picky... I love these Felina bras they are perfect - but out of production now... I bought every one in my size at 2 different stores! I still want to lose another 50 lbs and that will definitely put me in a smaller band...

You know what I just realized??? DUH... I have not been back to VS since I can now wear under-wire! They might have something to fit now! NOTHING WIRE-LESS in my size.

hi Ladies

good luck to all the lucky surgery girls this week:)

10 more days for me and Cindy but who's counting???  

Kimberly, you are picking up where I left off with the bra shoppinig and returning.  I'm sorry you're having difficulties finding the perfect bra.  Fingers crossed that VS has something for you!

Lilah, I actually do feel tight across my chest a lot of the time, perhaps because I was underexpanded.  It's different than with the TEs, but the pec muscles are still having to stretch, and it's not that comfortable for me.  Of course, when you throw in a tight underwire, things deteriorate.  Some of the Warners no-underwire bras are very comfortable, but my PS recommended wearing underwires...

Musiclovermom~

I'm a "unilat" so I have had to make adjustments in my bras when needed which is most of the time.  I always make sure my bras have the stiff formed cups not the type that is so soft that they collapse at the tip.  My augmented healthy side fits perfectly of course but my MX side there is a void at the tip.  To correct this I place a formed bra cup insert inside my MX side.  The insert is from a "Bandeau bra" I got from Fashion Forms lingerie line.   The regular inserts for swim wear & such are too soft & do not do a thing but these inserts are stiff & works perfectly to contour the projection of the bra cups. 

NAE