BMX with immedicate implants? Will you share your experience?

I had this almost a year ago. It was a four hour surgery with my BS and PS working concurrently. I arrived in the early morning (had the injections for the SN done the afternoon before), had the surgery, and was kept overnight - going home the next afternoon. My incisions were under the breasts and held together with surgical glue. I had one drain on each side for six days.

There was a lot of swelling initially. I think that was the main cause of pain, really - even though the incisions were long. It took a while to see how everything would look in the end. I had an area in fluid on the non-cancer side that the PS tried to aspirate twice. And I did develop an infection 5 weeks later on the cancer side that required hospitalization for 3 days. Personally, I think it was probably related to how aggressively they removed tissue behind that nipple.

I was able to keep my skin and nipples. The implants are in front of my pectoral muscles so no problems with the chest muscles. I do notice a little movement on the one side - probably the Alloderm attached to the muscle there.

Overall - I'm glad I chose this route. I have a number of things that could be tweaked if I wanted to. Some days I do and some days I'm glad to be done!

This is my first post and I have found many of these posts helpful on my journey.

I had a bilateral mastectomy 6 weeks ago with reconstruction at the same time. I also had 6 lymph nodes removed on the left side. The implants were placed on top of the muscle. I really didn’t think my movements would be so limited and I would be so stiff. I have started physical therapy which has helped but it’s a slow journey.

The stitcher line that goes under my arms are hard and swollen which I think limits some of my movement. My ‘new’ breasts are also hard as a rock underneath. Has anyone else experienced this? Is it normal?

I have been blessed in the fact that my lymph nodes came back clear so I don’t need treatment.

Be blessed each one of you who is going through this journey of very sucky Breast cancer.

Hi,

I had a double mx, nipple sparing with direct to implants, with Alloderm, last August. It went well. Done in the morning and out by next afternoon with a drain on each side for 6 days and the incisions were with glue also. Rolled of like the gummy stuff on the back of gift cards that are stuck to paper, It looks natural, perky, though I can see ripples and certain movements with arms make an awful appearance to it because of the muscle, but unless youre planning on flexing with no shirt and bra on outside, I think you'll be ok with it. I have some nipple sensations back and mostly only still feel numb on the upper outer part of my breasts going near the shoulder. I healed uneventfully. Of course if you are feeling your foobs, then you know you have an implant, unless its under the muscle maybe. I had a bikini top on this Feb on vacation and outside of seeing the node incision on each side of the arm,,don't think anyone would ever know. My size is maybe a B cup. i did not have much more before anyway and my PS said my skin was too tight to initially do any bigger. After my last followup he said I could do a revision surgery and swap out for a larger size. At this point, I'm good with it.

Yep, I had this surgery too. Mine was last year May 17th. It was due to a recurrence of cancer from 2014. I had radiation the first time. Last year I had a skin and nipple sparing, direct to implant, over the muscle double mastectomy. Like many others, I also had no issues healing. I have full feeling in both breasts - the radiated one is still a little sore towards my arm and the nipple does not have as much sensation as the non radiated, but it came through the surgery with flying colors. I have no numbness in either breast. I never had issues with movement - beyond being sore directly after the procedure. No one could ever tell in clothes or a bathing suit that I've had a mastectomy. Yes, you can feel the implants in certain places ... but it's really not too different than real breasts - a little different, but not vastly so - they just become your new normal.

Some things are kind of nice about them. Mine are anatomically correct and have a natural slope. But even with the natural slope, they don't sag more than they were designed to. I can go without a bra much easier and not look all saggy and dumpy (If I don't mind my nipples showing through!)

I see very few women who have gone this route after radiation. I did experience more rippling on the radiated side - but nothing that a little fat grafting in November didn't fix! (I'm also a big fan of fat grafting - it makes a big difference) I was not allowed to go smaller or bigger, as radiated tissue will not stretch easily. Luckily I wanted to be exactly the same size. I think this surgery is a great option. More and more surgeons are performing this as the standard least invasive breast reconstruction procedure - and with advances like Alloderm, fat grafting and state of the art implants - they are getting better with it...even for us that have gone through radiation. I had the option of choosing DIEP or another more invasive procedure - but for me... the least invasive thing I could do for my body while retaining my breasts was what I wanted. I didn't want to subject any other part of my body to invasive surgery if I didn't have to. For most of us this is a one and done surgery. When it comes to breast cancer I like that word - done!

LisaK12 that is awesome you had full range of motion in your arms! Did it decrease as the next couple of days passed and the after effects of surgery caught up to you? I’m not looking forward to T. rex arms but maybe I won’t be stuck in that position!

lisak- that’s where mine will be too, crossing my fingers I’ll be able to function somewhat right after surgery then!

Hello! I had prophylactic BMX on April 25 with immediate implant reconstruction skin nipple sparing which lasted 6 hours. Overall it went good. I was 34DDD in size and i went smaller so my PS did not remove all my skin because he wanted to make sure that my nipple survive. i had another surgery to remove my skin necroses after 10 days of my BMX surgery. I had full arm function and still do. My PS told me not to raise my arms over my breast hight but i was able to use my arms perfectly. I have under the muscle implants. I still am swollen and have skin necroses area, so he is still keeping me every week follow up just to see if my skin is going to dry so he don't have to do another surgery. My last surgery to fix my shape and place the nipple into upper position with fat grafting too was planned to be on September, but now with my necroses skin i don't know what is going to happen. I hope i don't have to another extra surgery as he used general anesthesia last time too. I am not suppose to stay under the sun, he told me not exercise yet, i am able to go out for coffee or at the mall, i am walking , but still i don't feel that I am back to normal life yet.I wish everybody the best of luck!

bennybear-depending on the type and scope of the rads from 8 years ago, you may be a poor candidate for implants. I had full mantle rads 30 years ago and found myself in the boat you’re in. I had heard of natural tissue recon years ago and did additional research on it once I was diagnosed. I went with BMX with immediate DIEP flap recon. Went in with breasts and came back out with breasts. One quick revision 9months later (had a lift, reduction, scar revision and fat grafting) and you’d never guess I had a bmx or recon. Natural looking and feeling breasts. I’d do it again in a heartbeat. Here’s a link to one of the top centers in the world for this type of recon for your reference. If you have questions, feel free to ask!

www.breastcenter.com

bennybear- does your local PS do DIEP? where are you located? PSs that do DIEP often work with surgical oncologists and coordinate their schedules all the time. You should be able to do immediate DIEP. Doing it in separate surgeries puts you with either TEs (if doing skin sparing mx) which can damage the chest wall muscle creating unwanted animation (that cant really be corrected) later or with what they call skin paddles where they use skin from your abdomen to create a breast which means additional scars. If you can do it in 1 shot, that's definitely the way to go. If you hop on the 2018 DIEP thread I've posted some of the questions that are good to consider and to ask your surgical team as well as where some of those answers need to fall. That list should be in the last couple pages of posts. Also read through the other posts of ladies who are in recovery now. Yes DIEP is a bigger surgery than just implants, however, they do not cut any muscle in DIE which makes a huge difference during recovery. Feel free to PM me if you like with any questions you may not want to post publicly. I'd also be happy to talk with you live over the phone (sometimes talking vs typing is better) - just let me know via PM and I'll send you my number.

I had DIEP and do not have big red scars on my chest or at the harvest site. They have all faded nicely. (I had stage 1 last Feb and stage 2 in Nov.)You can still see the harvest site scar but it’s quite faint and is so low that it can’t be seen if I’m wearing panties (even a skimpy thong) or bikini bottoms.

Tibet-those islands are also called paddles. If you’re able to do nipple sparing mx those islands aren’t used. In skin sparing you’d have a small circular island where the nipple used to be and if you do nipple recon or tats you won’t see it. The bigger islands are where someone did not have a skin sparing or nipple sparing mx. That is where they created the new breast. There can be differences in color if the skin and obviously scars that are more noticeable. The really good PSs are able to make the transition as seamless as possible. Part of it also has to do with how your body heals. If at all possible, skin or nipple sparing mx is the way to go. If you have your recon done at time of mx it’s even better results as no TEs are used.