Beware: Athletes who choose reconstruction may regret it

Kiwi... I have never heard of anyone losing their skin due to using the muscle.... My surgery (flap) was based solely on blood supply, and the standard is if it survives the first few days, then it is good to go. Of course, if someone had trauma etc before being fully healed that is a game changer. But using your muscles I would think would only improve blood flow. I would look for more info on that.

Hi, just wanted to say I was explanted today, in the PS office.  Not bad.  Local injection to numb what's pretty much numb, but she wanted to make sure.  Avoided cutting the pec muscle, and then PUUULLLLLLLSSSSSS out the very small ( 300?) Mentor silicone.  What was "newsworthy" was her suprise to find one had ruptured - and there was some of the gel on the outside of the implant, think she called it a "crack" in the implant.  Took it out and rinsed & rinsed the capsule in saline solution.

Pec muscle FEELS BETTER ALREADY.  And it's just been a few hours.  Wearing the same sports bra this PS had me wear after the implant 6 years ago.  So glad I went "with my gut" to have these OUT before there could be too much damage.

Won't know how it looks, and honestly don't care much - just know it FEEEEEEELS so much better, as if a vise has been taken off my chest.

Erica - thanks for good wishes I HONESTLY feel better than I have in 6 years - since the implants were implanted.  First thing I noticed this am, was taking a VERY VERY deep breath and not feeling like there was a strong runner band/vise around my chest.  Really had no awareness of how restricted I felt - even with the slight soreness at the sides - where PS put incision to remove - I feel better than I have literally in years. That's also because I have finished my 5 1/2 years of Arimidex

I just HOPE HOPE HOPE women realize how restricting silicone implants placed UNDER the pec muscle can feel. My PS, who is just SUCH a wonderful woman, human being, was also honest and said the rupture of the silicone Mentor implant is not that unusual.  The GOOD NEWS is that with the newer silicone used now, the stuff just kinda oozes out and stays within the breast "capsule" - unlike in earlier ones where I guess it could migrate around the body.  My discomfort, having had many surgeries in my life, I rarely now use the word "pain" - was not as related to the rupture (tho that foob was harder to the touch than the one which had wandered nearer to my armpit) as much as the way I constantly FELT them when ever I used my pec muscle.

From taking a deep breath, to doing my favorite yoga ( Sun Salutation, Downward facing dog) I felt like a very large rubber band was closing around my chest - with a foreign substance underneath it.

Still, I probably wasn't ready to go from huge DD's to flat when I had my BLM, tho if I had the PS I use now THEN, I may have tried it - always knowing I could "implant" at any time later...still, Live & Learn - I feel blessed to have the PS I do now, and the cosmetics aren't as important to me as the COMFORT.

Also SO grateful to PS for doing it in her office, not having the hassle of hospital, I dorve myself to office and home, no problem.  Stopped for Bart's Peppermint Ice cream on the way home - I deserved it Probably only women in western MA know about Bart's Ice Cream - delicious. Favorite is also their "Three Geeks and a Redhead."  Try it if you're visiting the Berkshires!

Granis

I don't know what your health insurance is - but MOST HAVE to cover it breast cancer related.  Your "discomfort" properly worded by the PS is important.  Before my explantation, the PS noted in her write up that one had "migrated" ( mostly under my arm!) - and of course, after, there was the RUPTURE ( there was a "crack" in the implant and it had oozed into the "capsule" where it was placed under the pec.

My insurance is Medicare, with a BCBS supplement - I also live in MA.  Which has different ( better?) health insurance law coverage than most states - but  is so close, I think you should definitely check with the Insurance at the State level - darn chemobrain, can't remember what the dept is called - someone will chime in with it

Seriously - though still "sensitive" where she cut ( along the old scar line) I notice myself GRINNING every time I take a really deep breath - swinging my arms around and NOT feeling an extra tight huge rubber band pressing down on foreign objects on my chest is worth more than I can express.

Downward Facing Dog has to wait for a few weeks ( per my PS) - Sun Salutation follows!

I CAN understand a PS not wanting to do it in office if She/He didn't put them in.  Mine put them in, and knew the terrible job the previous PS had done putting in the expanders ( which I didn't NEED) and had to "build" a pocket for one implant because of my terrible ( seroma, irritation) reaction to the expanders on that side.  Still, there was more scar tissue than she expected, and of course, hadn't expected to find one ruptured.  She had to do many Saline injections to wash out that side of my chest. Lots of wet towels on that side. Fine, but honestly, she at first wanted to do it in the hospital, and agreed to do it in office, cuz she knew me, and $$$ was an issue for me too.

Will think more of how to help you get insurance covereage - having brain flops at the moment.  I'm also blaming it on the RAIN RAIN RAIN...

Gardenmama, how lovely that you have had good results.  

Sadly, good results are not guaranteed and your experience does not negate the need for women who are considering reconstruction to carefully consider it, especially if they are interested in athletic pursuits.  

I would like to read the study your surgeon mentioned, because I haven't heard of it.  Do you know the title or can you post a link?

The only study I know of that considers breast cancer and weight lifting is the a study that indicated women who have lypmphedema can lift safely lift weights (if they do so under supervision and wear compression).   

Gran! - I remember you from the pic forum!  You were such an inspiration to me.  I am so sorry to hear about the issues you are having now.  I could write a book here and I'll to be brief but in short THANK YOU for starting this thread.  It is extremely relevant and important.

I was 39 when diagnosed.  I had always been fit and thin. I wasn't the extreme sports woman that you are but I was 3x a week 6 a.m. Body Pumper at Gold's Gym, a hiker and speed walker.  When dx I voiced my concerns (specifically about weight lifting) about reconstruction with my PS and he told me that while it would take me a bit longer to get back to where I was, I would eventually get there.

I haven't found that to be remotely true for me at all.  It is three years ago this week that I had my TE's exchanged for silicone implants.  Like you, they are distorted when I do anything pec related (vacuum, scrub toilets, mop floors, clean out litter boxes, etc.,). I was one of the 'rare' ones who developed bi-lateral LE from a BMX with sentinel nodes removed on each side.  I can't do a plank, a regular bench press, a dip, a push-up ... none of it.  I can't do anything that puts pressure on my hands in yoga (because my LE is primarily in my hands) ... so that means no down-dog or any of the related poses.  It makes me sad.  It makes me angry.  I've been told again and again, "You're a rare case."  Well ... maybe but it is still me.  It has greatly altered my life.

I've worked with a LiveStrong Trainer affiliated with a local university and while my weight lifting regime is very different (NatsFan posted the link regarding weight lifting and LE) I can do a little ... but no where near what I was doing before.  I've found different ways to work my core other than planks ... so I'm in a better place emotionally than I was 2 years ago ... but had I known then what I know now ... I would have never gone the TE/implant route.  The DIEP wasn't an option for me because I didn't have enough body fat.  I felt pushed into getting reconstruction.  My BS actually called me, personally, one evening and told me all the reasons why a young woman should get reconstruction.  It was ultimately my choice ... but I don't feel like the outcomes were fully explained to me ... what really it would mean to cut my pecs ... to remove sentinel nodes (where often it's more than one) ...and the possibility of LE was definitely downplayed.  I specifically asked about LE (because my mother developed it after her BC surgery) and the BS said, "No, with just the sentinel nodes removed you won't get it."  

Ugh.  Woulda.  Shoulda.  Coulda.  

I hope and pray for you ... that removing the implants helps you get some of what you had before back.

You were and continue to be such an inspiration.  

Let us know when you can what you find out about the nerve test.

Much love to you ... and healing.  

arygnnis,

I waited to respond to you because I knew that I would see the PS today and I wanted to ask him some questions before answering your questions.  Primarily because I actually knew very little.

I have shaped expanders that are filled to 200ccs. He considers the port to be about another 25ccs.  

We will be exchanging them for medium or high profile shaped mentor silicone implants with a width of 11 (cm? for the radius?).  He will order two different sizes and make the determination during surgery. Implants can rotate but it is only a problem with a shaped implant.  To prevent that they need to be especially snug so we wants a really tight fit, possibly 245ccs.

In the book "Living Through Breast Cancer" the author states that implants are best for women who have relatively narrow rib cages and who desire small breasts. (The PS confirmed, in his opinion, there is a correlation with issues and size starting after 300ccs). I would say that I used to be a full c cup and these are about 1/3 less than what my breasts used to be. 

I told him if he would let me leave the expanders in I would walk away today.  He was surprised at this.  He often assures me that the implants are much more comfortable. I don't find the expanders uncomfortable except when there is contact from a certain angle. I have to adjust my angle when I hold my kids and when I hug people.

Hope this is helpful. I wish you the best. I will likely be having the implants done in August and I can let you know the outcome if you wish.

I just found this thread and wish there had been something like it when I was making my choices. I'm not sure if I would have made a different one - bmx with silicone implants - but after going through all the pros/cons of lat flap and DIEP and deciding to skip those, no one bothered to tell me there would be restrictions and issues with implants. I am only now getting back into fencing, and I don't think that will be a major impediment, but it certainly has driven me nuts with the discomfort and concern about trying to lift/carry and get back to my pre-surgery habits (bad enough lymphedema concerns shift everything to my left shoulder and arm).

Thanks for sharing your stories. I hope other women can benefit from it.

This is an incredible post and so helpful to me at this point of my decision process. I had tram flap reconstruction following my first mastectomy, and now am trying to decide what to do after my pending second mastectomy. I am concerned that my range of motion, strength, shoulder stability, etc will be adversely impacted by reconstruction with expanders under the pectoral muscle. It is so helpful to hear of the issues other faced, so that when I meet with the PS in a few weeks, i will have more questions to ask. My concern is based on my experience with the tram flap reconstruction impacts on my ability to use my belly in a range of activities. I am trying go into this new venture with as much information as possible. I want to be able to continue backpacking, yoga, chopping and stacking wood, walking my Pyrenees (110 lbs of love), etc. Thanks to all of you who are sharing.

Jwoo - congratultions on giving yourself PERMISSION to trust yourself, and do what is BEST FOR YOU. One thing for sure, you'll be able to get back to physical activity MUCH faster without any recon now.  Happy Healing.

You have TIME TIME TIME.  In case you haven't yet found it, the Triple Negative Foundation http://www.tnbcfoundation.org/ is an excellent dedicated source for 3N bc.

unowhoandwhy: just read your June 11 post.  Recently found this thread and thought it might be interesting.  I'm so glad you passed that Policy Academy test you were so worried about earlier this year....YAY for you!!!  I had my exchange to implants 2.5 weeks ago and am doing great.  I expect to always experience a bit of the iron bra sensation.  I do, after all, have two large foreign objects on my chest, right?  And I know my pecs are always going to feel different than they did before, and look somewhat distorted when flexing, we just can't get away from that now.  I'm not the hardcore athelete that it sounds like many of these women are and expect to get back to my normal workout within a few weeks with no problem.  Good luck to you in your law enforcement career!

Working out is a big part of my life and has been for years. I work out b/t 5-6 days a week. From crossfit, weight lifting, all forms cardio, biking, hiking...etc Before getting my implants I expressed that to my PS (and several times throughout the process). I don't look strong, I'm thin, but I can out lift a lot of men my age. He said my only restrictions would be weighted isolated pec exercises. My last surgery (7/2013) was suppose to be my implant exchange, he was going to use strattice. Instead, I was told on the day of surgery, my contralateral healthy breast bottomed out (aug/lift 5/2013) and he performed a capsulorraphy, using permanent stitching to the ribcage. He did an implant exchange on the left but didn't use the strattice. I didn't get the time to come up with a lot of questions. I'm dealing with a lot of emotions because I feel it was a pretty huge change to drop on me the day of surgery, I wasn't fully informed of what it all meant, I still trying to figure out what it all means. When I went back to ask my questions, I stated we can all google why a breast would bottom out and asked if it was over dissected, he said I didn't really bottom out, it was just minimally lower. I don't know if the last surgery was necessary or not, I wasn't given the option at the time. And now I just learned that my mastectomy side has bottomed out and will need a revision, alloderm most likely will be used.

I'm very concerned with all these revisions what that means to my lifestyle. All I've done since July is focus on my legs, ab work, and walking, I'm afraid to do much more. My healthy breast at time aches, along inferior border, today for some reason its aggravated more than usually, the ache referring to my back. (sleeping on my side?) Anybody out there that can share their experience who have had a capsulorraphy and/or had alloderm/strattice used and if you felt limited in activities in any way? Or if you can offer any kind of input on the subject I would greatly appreciate it. I'm waiting as long as I need to before I go into another surgery. I'm also getting a second opinion.

Delialahbear- thank you for sharing your experience and so sorry about your falls! It is so interesting to hear how different doctors tell their patients different things. My doctor used permanent sutures, he told me never to wear underwire bra ever again, all he wanted me to wear after any of my surgeries was a cami type bra that wasn't too tight.

If you don't mind me asking- what size implants did the doctor want to go and what size did you end up? Did you have a DMX or UMX? Did he ever mention permanent sutures and why he chose the ones he did? Did he put you on any restrictions?

Sounds like you've been through a lot, two jobs, multiple surgeries for shoulder and foobs- happy to hear that you are finally looking and feeling good!! I'm going to a PS appointment tomorrow, you gave me a few extra questions I need to ask. Thank you!!!