Direct Implants - After Prophylactic Mastectomy

Hi TMP,

I had just one of my breasts done with direct to implant using alloderm. I am pleased with the result and in terms of recovery, I felt it took about 1 month and a half to get back to work. Again, I had only 1 of my breasts done so it's hard for to say what it would be like having both done. Of course surgery takes a lot out of you, but in a couple of weeks I was able to walk around and try to keep myself busy.

I had DIEP on my BC side 5 years ago and had decided at the time to keep my right healthy breast. After a few years of mammograms, ultra-sounds, MRI's I just couldn't handle the stress anymore and I was a candidate for direct to implant.

Good luck TMP and I hope you have success and a speedy recovery.

I had a BMX with direct to implant reconstruction about a year ago. I was a DD and told I could only be a full C with this type of reconstruction. Avoiding the TEs and a second surgery was more important to me than being bigger. Its taken awhile to adjust to being smaller but Im getting there....Good luck

Hi,

I'm having direct to implant (had previous saline implants from augmentation) sometime in the next couple weeks. He will be using alloderm. I am dreading the "no showers" for the 3-4 weeks that he anticipates the drains being in. Hoping he is a worst case scenario guy and that really means 2-3 weeks but either way - I am hung up on that. He also explained the fa grafting - and said many need that on the upper part of the breast to smooth the transition - has that been your case(s)? thanks so much.

I have been told that because my skin is so loose on my 60-year-old saggy breasts that I am not a candidate for direct to implant. Thoughts? Doctor suggestions? Info?

I had bi lateral direct to implants back in 2012. I am so glad that I did. I did have a little tweaking down but compared to what my co worker went through I am happy I did it this way. One major surgery, that's it. My co worker had a single mastectomy and several months after that surgery she had to go back in and have another surgery for the final implants..

Hi all. I had a BMX with direct to implant reconstruction about a year ago. Im 63 and had saggy DD beasts. My PS told me the biggest I could be was a full C with this type of reconstruction. I agreed that the trade off would be one surgery, no fills and no TEs. Im not going to lie. It took me a while to get used to my smaller breasts but overall Im happy. The recovery was about 6 weeks but I also have autoimmune disease which complicates things. IMO its very important to find a PS that has done a lot of this type of reconstruction and is there for comfortable with it. Sometimes I feel PS are like car salesman and want you to have the type of reconstruction they are most comfortable with so do your research. Mine was brilliant. She is at a major NYC facility if anyone is interested please PM me. Good luck to all. I hope this helps....

Hi

I am new here as well. Insurance finally approved my surgery and I plan to have the surgery all at one time- breast removal and implants. I am debating on the nipple sparing. I want to keep them but am wondering exactly how much of a risk I run keeping them as the tissue can form cancer later. I was told that there was no option to keep me at the same size, which is fine with me as I would like smaller ones.

Natty - There are several vendors of temporary nipples and temporary nipple tattoos online.Some are at the exotic sites.

I found mine thru a link on breastfree.org. The day they arrived by USPS my DH said, "Dear, your nipples just came in the mail!"

NattyB, I wish it only took 3 days for my insurance to approve anything. It's taken 1 to 2 weeks to get anything approved! That's military insurance for you. My DH gave 20+ years in the Air Force and they give him crumbs. What a trade off!

I had a BMX with direct implants and alloderm two years ago in August. I only took two weeks off of work and was back. My recovery was really easy and good once the darn drains were removed. Those things are irritating in so many ways. Just make sure to follow the exercise instructions and do them even if you don't want to. I was lifting my arms over my head before I went back to work.

Unfortunately the alloderm failed on my unaffected side and the implant shifted so I go back in on Monday to have everything removed, new implants and something other than alloderm and a little bit of fat grafting!

I wish you all the best!

I had a direct to implant on 4.28, was cup size B before surgery and looks like I am a size B afterwards , but fuller with more projection and not tear drop anymore. PS was able to spare both my nipples and skin. He used alloderm. ISpent one night in the hospital and was able to get in and out of bed by myself with some pain. Today is exactly one week after my surgery and I have full range of motion with my arms and even took my dog for a 45 minute walk. I started driving yesterday again. I still take my pain medication throughout the day, alternating tylenol and advil, have not taken any narcotics. I do take a valium at bedtime, that is supposed to help with the muscle tightness. Overall I feel pretty good considering the major surgery I just had last week. I'm glad not to have to go through the TEs and another surgery. And oh, I only had to keep my drains in for 6 days, had one on each side.

Willow iris: Good luck on your surgery! It will be a big relief when it is all over. And don't forget to do these exercises they tell you to do after your drains are removed. I feel much more stiff when I realize that I haven't done them for a while.

Hi to all!

I just wanted to post an update. I am 2 months post exchange (exchange TE with teardrop implant after a mastectomy on left cancer side and direct to implant prophylactic nipple sparing mastectomy on the right). The bruising which had formed on the right has been absorbed. The scab that had formed around the nipple incisions, fell off the skin only a week ago. The right breast still looks a bit bigger than the left and it also looks more like a breast because the skin and nipple were spared. I can now sleep on my sides without feeling any discomfort, exactly the way I used to before reconstruction. I can move my hands and lift household weights and do my chores just as before (but I am still not overdoing it). I like the fact that the teardrop implants are firm and I have never felt them move around. The right breast feels harder when squeezed, whereas the left breast feels softer, probably because of the thinner skin and the lack of fat on the left. I even did the flashlight experiment. The left breast was bright and red, when lit, with small veins going through the skin, whereas the right breast could barely be lit by the flashlight and large veins were going through there.

As a conclusion, I suggest to everyone who is given the option, to have a skin & nipple sparing mastectomy. I love my right breast, it feels and looks as though I had a cosmetic surgery to it and not a mastectomy. My left breast which had to go through a modified radical mastectomy and then TE placement, is just OK. Maybe if I had fat grafting (which I did not) it would be better and it would look more like a natural breast.