Over the muscle implant reconstruction

Philagirl,

I had my surgery Jan 20th. I am overall satisfied with the results. I had BC 10 yrs ago and had lumpectomy followed by radiation. The BMX was to treat a recurrence.

The radiation can complicate things. In my case, the implant placed was smaller than I had wanted-385cc. But because the radiated side would only stretch just so much, it sort of dictated how large I could go. I did have skin and nipple sparing BMX. I lost about 80% of the radiated nipple due to poor healing but the other side looks good. I would absolutely do it again. The size is smaller than my native breasts but honestly don't look much different in clothes since I have no droop anymore. I have absolutely no sensation in the breast area but do feel like keeping my native nipples (most of them anyway) and areolas has helped them retain some sense of them feeling more like me. I really like the shape and projection of my implants and I have nice cleavage. They are Natelle Inspira smooth round high profile cohesive gel.

In your case, I think this may be a great option to explore. You have time to select a great surgeon and gain as much information as you can about your options. I think the pain was definitely less than what others have described with the below muscle TE. If you are a candidate for pre pec direct to implant, it would be a one and done big surgery. There may always be the possibility of some revisions or fat grafting down the road. I do have my journey posted on the reconstruction picture forum and would be happy to share if you don't have access to that yet.

Good luck with you decision making. You have definitely come to the right place for information and support

Why do you say if someone want to be the same size or smaller?

Hi Philagirl, I've had by prepecs for 8 months now. I am very satisfied, and as odd as it may sound, I feel like they are really part of me. They aren't perfect, but knowing that women who have their natural breasts are not perfect does make me feel more natural.

Of course I can't truly compare my experience to the sub muscular implants, but I can vouch for what I believe was a fairly straightforward recovery and return to activity. The biggest part was allowing everything to heal after sugary which meant restricted activity. However, that was only mentally challenging. Physically I felt well very quickly.

I have alloderm completely covering my implants and they are the teardrop shaped ones with the textured surface. Prior to getting the implants I had TEs to expand the skin as I needed to add room. I had 2 rounds of fat grafting to pad the edges of the implants as they are visible through my skin due to thinness of skin from stretching and no natural padding left.

At the end of the day, my fat grafting was partially successful as I didn't have a lot of fat to harvest. So, it was up to me to be satisfied with my result and I am. If I slouch or feel my implants I can tell I have rippling. However, I've chosen to wear a bra (in part because I was instructed to for a while after surgery while alloderm healed, etc...) and I can create a nice looking cleavage with an underwire and no one would suspect implants (I think!) or see any type of rippling. Given my body shape, I really like the look of the teardrop. It seems very natural looking with the upper slope. I do know that really depends on the person - round seems to be the correct choice for many ladies on here.

I simply can not imagine any other option. I knew nothing when I went in to discuss reconstruction. I didn't even know there were options outside of implants! My PS said implants were my only choice, really, and she presented both above and below the muscle as equal options. Again, I had no idea it was something "new". After discussing a lot, I chose above because I was worried about muscle spasms and she showed me a video of a woman who's implants would contract when she used her pec muscles.

I have "tiny" implants - 290cc but for me they are appropriately sized. I wear a 30D or 30DD in bras (that would be like maybe a 32B if had a larger rib cage).

Negatives? I mentioned - I have rippling and to some degree the edges of the implants are slightly visible. These problems may by unique to me as fat grafting only did so much. I guess that might be a negative, too, depending on how you look at it. Fat grafting may be extra surgeries and healing time. I also have noticeable changes where the fat was taken - my butt is much flatter and I'm pretty sure I have a little bit of ripple or lumpiness on my inner thighs from the last try (I'm hoping I'm the only one to notice that!). Also, I have the type of implant linked to the implant-related cancer that was recently in the news. For that, I will be staying in touch with my PS office over the coming years, but understand this risk is still incredibly low. I can't think of others negatives.

However, as I mentioned, I am happy overall. I think it took a handful of months to arrive at this place which is also important to keep in mind.

Good luck to you!

Dear Mischomaker,

Welcome and thank you for joining the community and sharing your story here. We hope that you will stay connected and active on the boards. Let us know if there is anything we can help you with in the way of navigating your way around. The Mods

fisher - Yes, it's a full mastectomy. It's usually only advised if your skin can be saved - so the tumor can't involve the skin. The incision is made and the breast tissue is removed and then the implant (or tissue expander if needed) is placed. Alloderm is used to help to hold it in place.

If you know that you are going to need radiation, it's probably better to go with the TE first and do the exchange for implant later. I'm not aware of Alloderm helping with "thin skin" - perhaps fat grafting? That is often used to soften the appearance and feel.

Not all PS's do the pre-pec surgery. You may want to ask your BS for recommendations.