Beware: Athletes who choose reconstruction may regret it

Argynnis - I had just what you're looking for - a skin sparing BMX with t/e placement, then a DIEP 9 months later.  I was originally scheduled for an immediate DIEP, but came up with a positive node at the last minute.  With the possibility of rads on the table, the PS preferred to wait to do the DIEP till after active treatment.  So I had the skin sparing BMX with t/e placement to hold the skin during active treatment. 

If your surgeon says he cannot do a skin sparing without immediate DIEP, then you need to find another surgeon.  It is absolutely possible to do a staged DIEP - skin sparing with t/e "placeholders" then DIEP after active treatment.  Here's info from Hopkins website on the procedure:  http://www.hopkinsmedicine.org/avon_foundation_breast_center/treatments_services/reconstructive_breast_surgery/deep_inferior_epigastric_artery_perforator_diep_flap.html

My TEs were partially filled - I believe they were placed with 275ccs.  I had a BMX so there was no issue with matching.  I liked that I never awoke "flat" and under clothes no one would have ever known I had a BMX.  Since I wanted to recon smaller, I only had two fills before my surgery.  The skin-sparing is nice - I have no scar lines above the breasts and can wear lower cut bathing suits and tops if I want. 

The TEs felt strange at first, like I had turtle shells inside my chest.  And I had a very tight feeling for several weeks. But once they healed, I was able to do yoga, weight training, etc. with no issues.   They certainly didn't feel natural - they were hard as rocks!  But they really didn't bother me.  After they were removed for my DIEP, I really haven't noticed any muscle issues. 

Gran.... I think you should consult with Dr. Karen Horton in San Francisco....



http://www.drkarenhorton.com/breast/reconstruction-san-francisco-ca/implants/#placement



Deborah

Gran,

Thanks for the info! I had my mastectomy about 2 weeks ago and they placed a TE and removed 26 lymph nodes (only 2 were postive). I will not get radiation and so far I have not developed lymphedema but we will see.

When I woke up from surgery I immediately knew that getting a TE was a very bad idea and after a week of struggle I had it removed - what a relieve - my pec is still sore. I will get a flap recon after chemo anyways so I just stay flat for now - it feels so much better.

bdylanfan.... Why two months to recover from implant removal? are you thinking of going flat or doing something else?

Gran,

Thanks for your reply.

I just assumed it would be that much. That's how long I misssed work when having nipple reconstruction.  It's hard for me to get any real answers from my PS. He's skilled at evading my ?'s. I haven't ditched him because he really did a nice job of sewing me up.

The implants are so heavy (800cc) they are making my back problems worse. 2 bulging & 2 herniated discs in neck (car accident in 1992) & one mid- back (2010). I'd rather have some other type of reconstruction, but I would go flat just to be out of this pain and discomfort.

What did your Doctors say about recovery time if you have implants out?

Thanks again for your help. I wish I'd have seen your posts before deciding on implants. I really underestimated how much pec muscles are needed just in everyday activities. I really feel very limited.

Hi Gran,

I'm sorry I didn't see your reply! There was no notification. I'm also sorry you are having so much trouble you'll have your implants removed. It's another surgery to recover from! I still have "iron bra" discomfort, and am getting relief from learning how to use therapy balls to loosen fascia. It really helps. I still have an iron bra but it's less noticable. I have also changed my exercise routine to kettle bell training and find that it actually loosens up the scarred tissue that is too tight around the arms. No more push ups though. I have had some very expensive trigger point injections which work terrifically, yet I had to have some basal cell removed and the surgery, which was on my collarbone, triggered the muscles to freak out again and tighten up. The sessions for injections are $ 400 a pop, so I cannot afford that anymore. The therpay ball work is good plus the kettle bell is good. I had my nipples done a month ago and the muscles and all freaked again so I had a couple of deep tissue sessions of body work and continue once a week in the ball classes. I'll start the back to kettle bell soon as I was released to exercise again today. the nipples came out beautifully! I cannot have the implants taken out because it's too complicated with all the mesh and Alloderm sewn in and now my tissue has grown inot it. It's too expensive and I cannot handle, in all candor, having a sunken chest. It would make me stop working, and I'm self employed and need to make some income. I wish you all the best and am aware that many women have had theirs removed and been very happy to wear prothesis or to just be natural. Thanks so much for your openness and support. It's something you don't even want to mention to women starting out on this path because the results vary from woman to woman. My breast surgeon was the same as the one who did Angelina Jolie's surgery, and Dr.Funk didn't do well for me. She took more on one side than the other and then tried to blame it on my anatomy saying my rib was sticking out! I never went back to see her after that, Because of the thinner tissue on one side I had to have my first set of implants replaced with larger ones for which I was not expanded. There was too much loose skin on that thin side! The cost and time off work and trauma was too much for me and I avoided nipple surgery, although I wanted to be completed. Psychically I was diminished and couldn't handle going uder the knife again. After the second implant I woke up in recovery not properly medicated and it was a nightmare. I felt like my chest had been chopped up with a machete! I also have more reconstruction work on the "thin" side and that has caused a great deal of problems, all because the BS screwed up. It makes me mad to hear how she is supposed to be so wonderful, but each surgery id differnt and maybe it depends on if you are a celebrity or not how well they take care of you! Anyway, water under the bridge, onward and upward! I'm looking in to tattoos and want to find someone who has had thiers done by Vinnie so I can see them in person. That's my criteria before I hav them to see the artists' work in person. Take care!

Thank you for posting! I have a spacer (Right mastectomy and spacer, april 24, 2013) that has become infected, and needs to come out. It needs to come out before unexpected radiation treatments, too.

Like you I'm finding physical activity awkward, though I thought that it would get better over time.

My current primary exercise is yoga. And while it's helped regain movement in the right arm, there are so many things that are awkward to do, my posture is out of balance and it takes a lot of muscular effort just to stand straight with shoulders squared.

I've also been considering foregoing reconstruction after it's removed (tomorrow!), and you've just given me a few more reasons to follow that plan.

Thanks again!

I am so sorry that so many of you haven't been able to return to full pre-surgery activities! I had BMX December 2012 and while I did have some issues with one of the TEs coming loose, I was back to full range of motion in less than three weeks. I did a lot of gentle stretching, as recommended by my PS and was walking 3.5 miles daily in two weeks. I firmly believe that this helped speed my recovery.



I had Sientra 550 cc silicone implants "installed" April 30 and exactly one month later I passed the entrance exam for the Police Academy. Bench pressed 120 pounds, did 15 modified pushups, and exceeded standards for situps and 1.5 mile run. Three days before that I did a 5k obstacle course race & only had to skip the monkey bars, because I didn't want to risk injury.



Do my implants sometimes feel odd when I work out? Yes



Is there pain sometimes? Yes, but less & less as time goes on & I get stronger.



So, I don't want to take away from the pain some of you are suffering, but I just wanted to present the fact that not all athletes regret recon.

Had I known then.... would NEVER have had expanders.  Had VERY large breasts, know now could have had immediate implant at BLM.  But surgeon went the expander route as it gets the hospital more money.  Many visits to PS, huge seroma in one "breast" had to be drained 4 months after putting in. Never had saline added cuz the damn expanders were bigger than I wanted to be. Surgeon & PS did NOT LISTEN ( yes, they were both women!)  I refused to have drain put in 4 months later, think both surgeon & PS were horrible- and give thanks, and thanks, and thanks, I learned about a PS operating out of another local hospital, went to her - had exactly the size 300cc she said she'd use. Just didn't think then, still reeling from chemotherapy, beginning Arimidex, and the horrible experience with the other surgeon & PS, to go flat. This NEW PS was and still is an angel.  She SHOWED me the 275cc, and the 300cc - and honestly, I can't be sure which one she used..but she said she wanted the option to decide when she was in surgery.  I HAPPILY agreed.  She did EXACTLY what I wanted - put in 2 small "poached eggs." 

What I DID NOT KNOW, and I guess no one could have told me, how HORRIBLE I would find the feeling, sensation of having these foreign objects under my pec muscle.  Sometimes, mostly when doing yoga ( repeat I am NOT an athlete, unless ya count my wonderful wooden rocking chair!) it feels like a vise around my chest.  Am sure I am more hunched than ever too, just do NOT like the FEELING of these things.  PS, as I said, is an ANGEL.  She will remove the "offending poached eggs" in her office, said it is a very simple procedure.  That she'd "prefer" me to be an outpatient in the hospital, but would and has done removal in her office.  In my case, because the expanders were SUCH a problem, it took her a lot of "clearing out" of my chest in initial implant 6 years ago.

But I am determined this will be EASY, and happy to have it done in her office. Should be in a few weeks.