Prepectoral vs subpectoral implants

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farmerlucy
farmerlucy Member Posts: 3,985
edited March 2018 in Surgery - Before, During, and After

Just watched a very interesting webinar from Johns Hopkins re: advances in breast reconstruction. This renowned surgeon seems to mainly be doing the prepectorals now. I feel a tad cheated because I went through all the agony of the TE and having my pecs stretched. I thought it was kind of barbaric back then (six years ago).

I guess the only thing I'm glad about now is that a local recurrence should be easier felt.

What are your thoughts on this? What are surgeons in your area recommending?

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  • Peacetoallcuzweneedit
    Peacetoallcuzweneedit Member Posts: 233
    edited March 2018

    Hi farmerlucy -

    I just had my implant exchange in Nov 2017 and getting ready sometime in the next 3-4mos to do nipples....I asked about prepec placement when I was dx in May 2017. My PS said "no"...mine are obviously sub pectoral placed. I told him what I had hoped for, and one of the things was that I could choose to wear a bra or not.....so when he said no - he said " pre pec was not an option." The TEs were a pain in the rear... I mean good riddance to those!!! The implants are much more comfortable, but I still wonder about the prepec placement and hope others chime in here.... I know with my anxiety levels there is some comfort knowing that a recurrence would be really apparent with my current placement. I still freak out at times wondering how my BS and Onc will be able to check my chest wall adequately.

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited March 2018

    Thank you for story. I’m glad you are nearing the finish line. It seems that they use an alloderm sling for prepectoral as well. I wonder if a bra is required for those.

    How are you doing after the ooph?

    I just had my six year checkup. My onc was ordering yearly MRIs for me. We talked it over and decided I could stop those. The only reason I know that MRIs are not standard is from this site. Most women do not have any type of screening except Dr and self exams. That gives me comfort.

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  • NotVeryBrave
    NotVeryBrave Member Posts: 1,287
    edited March 2018

    I specifically chose a PS that would do the pre-pec placement. I was told going into it that I might still need TE's, depending on the condition of my skin. Thankfully, I did not and was able to get the implants immediately.

    Like everything - it seems people are given a wide range of advice and that includes bras. Alloderm is used to secure the implants inside since it's only skin holding them, but there's always the fact of gravity. I don't wear a bra at night but do during the day.

    I actually wish that there was a better plan for assessment than just exams by my BS, MO, and me. Yearly MRI's would be embraced by me! I do worry about a recurrence that is not caught and am currently waiting on US and mammo with possible biopsy for a lump under the nipple.


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  • Legomaster225
    Legomaster225 Member Posts: 672
    edited March 2018

    I have pre pec implants too. I went right to implant - no tissue expander. It was nice just to get it all done in one surgery - BMX and implant. I think they look good and I don't wear a bra all the time. I was told no bra for the first few months actually. I think that was to keep pressure off my breasts though since I had skin/nipple sparing. I am petite though and my implants are small at 225cc. It is very close to my real size so they look quite the same as before surgery. The only thing that Is a little weird is that they seem to start a little closer to my armpit than my natural breasts and my nipples are just slightly to the outside of where they were before surgery. Nobody would know other than me really. My husband said they look about the same to him but they are not on his body so what does he know. Lol. I am happy with the result and if I had to do it over again I would do it the same way. I do think it is important to find a good PS who has experience with pre-pecs if you do this route and I think many PS who are not familiar with this method will go with what they know and even discourage pre-pecs. Just do your research and decide what is best for you.
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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited March 2018

    Very interesting!

    Funny you mention the armpit. I used to be able to see my armpits. With the implant behind the muscle, that area is now quite cavernous, and it is hit or miss re: shaving.

    Direct to implant, prepectoral sounds heavenly. Back in the day I did Dino arms for four weeks at the te insertion and at the exchange. 😩

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited March 2018

    Lego- I see you,too, received a nasty surprise after your bmx. Aarrgh. That doesn't help instill confidence in the screening tools, huh?

    What makes that side 1B, instead of 1A - just curious. Preadjuvent chemo is so fascinating. Congrats on clearing that node.

    Take care.

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