Breast Reconstruction for an athletic sort

We are about the same age, similar diagnosis and both very active, so I thought I share some info. I have 400 ccs of high profile Natrelle implants. I am 5'5", 122 lbs. Small frame. The implants look and feel great. I run, do bootcamp style exercises (burpees, dumbells, elastic bands, lifting a bosu ball overhead etc)., I do yoga twice a week and spin. The only thing I was advised against are chest exercises that go beyond light dumbbells presses etc. No bench presses, no push ups, no pull ups. I don't want to built/change my pecs and possibly distort the look of the implants. I don't do real chatterangas either. I probably wouldn't sign up for CrossFit but not just because of the chest exercise limitations lol

My look is a C cup but I wear a 32DD bra (used to wear a 34B). That's deceiving, I don't have big breasts but a fuller look. My new breast do not move or very little, but it is not uncomfortable. It helps when running. I also had fat grafting from my thighs (the recovery was hard, I won't lie, but it was highly recommended by the PS). I can wear all of my "old" sports bras. Anything without an underwire. The old bras had to go obviously but no other changes.

I support my breast day (and at night with a stretchy camisole bralette) and wear a good bra when not wearing an exercise bra. I wear only Wacoal and went to a special bra shop. I have had no problems doing the described activities even during the expander phase but initially you can only walk. I think I started with lighter exercise after 6 weeks.

Planks are not a problem, actually side plank where you lift your leg is my favorite! I used to do hanging leg raises (for killer abs) but when I tried just hanging from a bar there was no way I was going to try that. You get a feel for what's ok pretty quickly. Just focus on what you can do. Lots of people, some half our age, can't do push up because they have rotator cuffs issues, tennis arm or other limitations.

I think I started real exercising after 2 months following the BMX. I went to Germany 6 weeks after my first surgery, almost no pain. I had the expanders in for 7 months. Was told, the longer, the better. No chemo, no radiation (best news ever). The breast exchange surgery was way easier than the BMX, the fat grafting was not. It is not just some light lipo. They don't perform traditional lipo but it is still super invasive. It takes months, possibly up to a year, to look not swollen and feel normal. The legs get super tingly because all the nerve are regenerating and recovering. I wore XS Lucy capri yoga pants for at least 2 or 3 months (not a problem these days) and it wasn't super warm yet. The nerve damage and bruising is substantial but walking helps tremendously. The result of the fat grafting on my thighs were no big difference as far as leg appearance. Nobody really focused on that and measured, so hard to tell in inches or whatever. The focus is on the breast and if the fat "takes" and to smoothen the look of the implants. I'm happy with the result, I have some rippling but even in a bikini you cannot see it (textured implants can cause ripples but usually don't "bottom out" I was told). I could have more fat grafting to correct the breast size but I am not.

My fitness level really did not suffer. You have so much muscle memory from all those years of working out, you don't wipe that out in 2 months. The change in fitness routine (to long walks instead of bootcamp or body pump) was actually really good. To be out walking on the beach instead of exercising inside is great mentally. Some of us get caught in a work out grind/routine and being forced to modify and try new stuff was good for me.

Basically it depends on what your PS tells you and how you feel. In the beginning there is only walking because running, spinning increases the blood flow too much and then the impact, of course.

Some women deal with a ton of tightness, some nerve pain on the upper chest and all that takes a while to normalize. Like I said, I flew to Germany from the West Coast 6 weeks after surgery and walked all over the place and even kayaked a bit. The expanders "held" up and didn't cause issues. Expanders are very sturdy I was told. I was in the middle of expansion, looked and felt fine. I left the expanders in for 7 months, then exchange and fat grafting from thighs. After the final implants I was more conservative with approaching exercise such as weight lifting, running and definitely some yoga asanas that require your arm to be stretched out (like triangle etc.) and involve the pec muscles. Once you are cleared for cardio beyond walking, stairmaster, bike, all that is no problem.The implants I have are silicone and they cannot break. A year after the final implants you get a final MRI and they see the implant placement and possible issues. It should be a no stress MRI.

Hi Ladies! I'm excited to hear there are other trail runners going through the same thing. I LOVE to trail run and was very concerned with the ability to resume it after my BMX and reconstruction. My BS and PS calmed my fears!

My BMX was done January 2015 and I had my TE in place for just a little over 3 months. During that time I hiked my butt off! I wanted to keep some level of fitness before I resumed with trail running. I would hike here in the mountains of Western North Carolina for 2- 4 hours at a time making sure to elevate my heart rate and ran a little after a 9 week period but wasn't really comfortable with the TE's. At least I knew I could still run! Then came the exchange surgery on May 1st. The PS made me wait 7-8 weeks after that surgery ( still hiked when cleared to do so) and what a difference the implants make when it comes to running. Once I was cleared to trail run I started out in small increments then got up to a 17 miler and was soooooo happy I could do that. Then on October 23rd I had my revision surgery since I wasn't happy with the implants the previous PS put in. That PS told me to wait 3-4 weeks before I started running and now I'm up to 30 miles a week.

I have some personal pointers I'd like to offer:

1) Listen (and really do) to your doctor when it comes to recovery! Your body needs time to heal after such a major surgery. I waited 2 weeks after my BMX with TE to start hiking again and of course started in small increments. Like mentioned above you don't want to increase the blood flow too much right away so you can heal properly. I did suffer from nerve pain after my TE saline fills but that all went away.

2) Eat good, clean food so your body heals properly. Protein, fruits and vegetables ( organic if you can)

3) Wear a super supportive sports bra. My PS told me he didn't want my implants moving at all while running. I use sports bras that hold them up and against my body.

4) Let's say your doctor tells you that you can resume running after 6 weeks but you still don't feel right just wait another week. I did that a couple of times.

My PS has no restrictions as far me being able to do planks or pushups. He just asked me to wait a good 6 months and to start slowly. I can definitely notice my pec muscles aren't the same. Opening a jar of olives makes them flex and move but I can pick up my Lab who is 52 lbs. (she's an oldie) I even helped my husband move some couches!

Here's my experience, for another perspective. There are no guarantees and unfortunately some women have difficult recoveries and long term side effects, but I feel that in most cases, the fitter you are going into surgery, the quicker you will bounce back, barring complications or other comorbidities. I have been a competitive athlete since I was 9 and still compete in 3 masters level sports, as well as regularly cycling, running, hot yoga, weight lifting, hiking, snowshoeing, soccer, you name it, I am a fitness fanatic. I had NSBMX with direct to implant recon 10 months ago. At that time my body fat was in the 13% range and submuscular placement of implants was my only recon option, as I was not willing to sacrifice muscle for breasts and my body fat was too low to consider above muscle placement. I worked with a bc & lymphedema physiotherapist pre and post surgery to optimize my recovery. My PS did amazing work and I have no ripples and did not require a revisional surgery. I had a single 4 1/2 hour sx. I have anatomical gummies - Allergan 295ccs - which are a B on me and they look awesome. I used to lift 3 days a week and I am now doing so 5-6 days. I have worked up to lifting heavier than I did pre-sx and I am the strongest I have ever been in my life. My athletic peak was in my 20s, and I will never have the speed and reflexes I did then, but I am surprised and thrilled to be stronger and fitter than ever. My body fat is 11.4% now and I probably won't let myself get much lower. I am 5'7 108lbs and all this intensity fuels a bigger appetite, so I am eating about 2500 calories daily. I do everything. Pushups, pullups, bench presses, shoulder presses, deadlifts, squats, hip thrusts etc. At 53 I have a serious booty for the first time ever thanks to adding some serious glute work. I probably do 200-300 pushups weekly. I do multiple sets of 15 pullups with full arm extension (pullups don't work chest if you do them with proper form - they are lat intensive and strengthen the traps, rhomboids, biceps and brachialis muscles). I limit chest to 3-4 exercises weekly with moderately heavy dumbbells/barbell+plates and generally do these on an incline bench to focus on the upper pecs. Working my upper pecs masks any drop off transition in the upper pole, which I would probably have otherwise, as I am boney. I did extensive pec exercises for 6 weeks pre-sx to give my PS more to work with. I think this was a key factor in never experiencing the iron-bra feeling. I felt tightness for 2 days post-sx and then never again.

I was walking hallway laps and doing lunges the night of my surgery. I rested the second day and walked every day after and did some hiking without carrying a pack. Even though I was more active than most people, I was still less active than normal to facilitate healing and my drains were removed day 4. My PS did not want me to lift my arms or carry more than 5 lbs for 3 weeks. At 3 weeks I returned to the gym for lower body work, but did not run or do any high impact activities, as she didn't want me to wear a sports bra until 4 weeks. At 4 weeks, all my restrictions were lifted and I could do anything except lie on my stomach (12 weeks) or water ski for the whole summer. I could not do a single pushup when I first tried and started on my knees. Today I am back to cranking off one arm pushups, but they were the hardest to accomplish and took over 6 months to regain the ability to do with proper form. I had to push through yuck feelings and discomfort to get where I am today. Someone mentioned hanging leg raises above and everyone has to decide what they want to do and are comfortable doing. I had Alloderm slings and with the pec dissection, you do feel the stretch when you first hang and I was leery about how it felt, so didn't do these until 4 months. I don't feel it anymore and do leg to bar toe touches. I still don't like the feeling of pec distortion contracting my implants, but ignore it now. Yoga poses with spinal twists do it, opening jars, grating parmesan cheese, lots of everyday movements and activities as well as certain exercises. As for the concern that working pecs will ruin results, not only did my PT encourage me to include chest work, I can attest to the fact that despite multiple contractions and weird unattractive distortions of my implants if I look down my top, they return to normal after the contraction ends and there has been no permanent alteration in appearance or structure at all.

Lunderwood, if you go the autologous route, you will have a longer recovery and probably a couple of recontouring surgeries with FG, but will have natural-feeling breasts that don't get cold in the winter and best of all, not need future sx for leaks and replacements. There aren't a lot of women on here who have had PAP recon, but consider starting a thread for feedback. I don't think you have to be concerned about gait changes, but sitting is a big issue for a few weeks, which could be a consideration, if you work and have a desk job. I don't know about walking up stairs or running uphill, since there would be some stretching at the back of the legs. Best wishes on your sx, a quick recovery and getting back running asap.

Quick question: for those who have had exchange surgery (from expanders to implants), how long did you wait until you could resume workouts? My doctor said stick to walking for a month. We are having rather unseasonable weather around here and I would like to bike and maybe resume running.

Lunderwood, I see you're considering a Pap flap and that you won't have your surgery until June. There seem to be so few people who have done this type of surgery posting, so please lmk here or PM me to lmk what you've decided and how it goes. I had radiation and a failed TE on that side. Best of luck to you. Thank you. Honeybadger

Commenting to follow this post!

I am having delayed reconstruction this summer (and prophylactic mx/reconstruction of my other breast at the same time) and I want to do implants as well as going smaller than my breasts were before. As a 38C - D before, my breasts often felt too big or awkward on my frame & activity level (dance & yoga don't always pair well with big boobs ), but not big enough that it really seemed worth doing a reduction. I'm thinking that smaller implants will be the way to go, but would love to hear how that's been for others.

Curious if you ever discussed over the muscle? I'm still in the TE stage with exchange possibly on 6/22 depending on what PS thinks of a pointy spot my TE created on my right side. They thought this might compromise my skin so surgery was changed to June but would have been September originally. I won't be surprised is she thinks we can wait because my skin is just fine where that pressure point is.

Anyway, I wanted to share that I went above the muscle because I am and will be very small chested. I have a completely benign condition called costochondritis that I thought would make below the muscle unbearable and I think I was right on that call. I don't have high expectations for a perfect chest, just something to make me look feminine. So even if the implant won't be perfectly hidden I'm ok with that. I will be doing some fat grafting, I guess, but there is concern about whether I have enough fat for that. I just wanted to share that I have slowly gotten back to my workout routine which does include some workout using my pec muscles. This is slow going but only because I can tell I pull on the few stitches used to hold the TE to my chest wall. This isn't a real concern just a new feeling that tells me how far I can go. If I had to live with my TEs forever I'm confident my body would adapt and I'd be able to increase my workouts to whatever limit. This reassures me that my petite implants should work to allow me to resume my old activities.

Anyway, since my expectations are low and I was quite concerned about handling the muscle stretching, just having some small lumps sitting on top my chest seemed a simple choice. Not to far off from the uber padded bras I used to wear all the time. Something to think about....

Regarding an implant under the skin rather than under the muscle- my plastic surgeon thinks its the best option for me even though I was radiated. He is doi g fat grafting first to heal and strengthen my skin on that side.