TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!

Macb, His name is Dr. John Hijjawi, SLC Utah. He has great reviews.

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Shoregirl,

Thank you so much for the link! I will definitely talk to him about it. He isn’t available until Sept or Oct, so I actually think I will wait until Nov or Dec because I teach and classes are out the first week of Dec. Enjoy your summer! I’ll keep you posted. Keep us all posted too

You're welcome Bird-of-light, enjoy your summer!! Thank you macb04! I will truly be amazed if he can make the left side look fabulous. They are more level now though as the left side dropped some so that's encouraging. I will keep ya posted!

Hi all,

Not sure if this is advice or just general spilling of my thoughts as I weigh options.

I currently have sub-pectoral implants...my initial surgery in 2014 was direct to implant, nipple sparing, smooth rounds, with Alloderm. My revision in 2015 was to Allergan 410s, in order to address rippling on my right side (very thin skin)

I am in talks with surgeons about replacing the 410s. I am also looking at moving to pre-pectoral. I am in Canada, so need to see if I can find a surgeon locally or within a reasonable driving distance who does it.

My results are not bad, if both were like my left side I would be thrilled, but I am quite active (daily workouts, other physical activities) and have always had more animation deformity and "twitches" on the right side which makes that side look a bit off. I have also never been convinced on that side my implant settled in quite right, a lot of fullness higher up and a much tighter and shallower profile at bottom (remember, these are anatomicals!). It not only feels "tight" but always has looked "tighter" - like it was being squeezed "up" instead of down. And yes, I can flex my breasts but not something i would miss, ha.

I definitely am not comfortable being 'uncovered" because of that side. They look good under clothes though, and honestly, if it were not for wanting to take out the 410s I just could not be motivated to have more surgery. But I was diagnosed hypothyroid a couple years ago and have none of the usual risk factors for it, and in light of suspicions BIA-ALCL is consequence of an inflammatory reaction of some sort...eh. And, there have been some other things I have noticed in last few months that have me worried enough ("full sensation" in armpit that feels like swelling, tightness across base of one breast, increased spasms in the right side, etc).

So, I need to talk more to my surgeons obviously, but I am considering this option. My main concerns though is how my pectorals will "heal" after being stretched out for the last 5+ years, as well as rippling, which I am already worried about when moving away from my 410s because of past experience. I am fine doing more ADM, I had no issues with it before, but I am a little worried about fat grafting. I was not a good candidate before and while I may have a little extra now (been diligent about not saying no to chocolate!) it is still not a lot and I worry a lot about recovery. I have very good pain tolerance, and am even fine with doing drains again (likely will be required anyway as they are going to have to do a capsulectomy whey they remove the 410s) but very low tolerance for not being active and taking things "slow"!

I think a small reduction on the right side would solve some of the rippling issues I had before (I do have looser skin on that side and some "excess tissue", that breast was always larger than the left pre-surgery). I know that may mean additional scarring but I scar pretty well and am okay with a few more scars versus the misshapen look/excess skin I have now on the right side. I actually don't even care about keeping the nipple on that side. I can't feel my nipples anyway - if losing that nipple might otherwise mean other advantages I'd be prepared to say goodbye to it (so different from a few years ago when I wanted so badly to save them and was worried they were going necrotic during recovery!).

Thank you so much for your response macb04, I am really relieved that you have normal strength and function.

I have been fortunate in both my surgical recoveries were quite smooth sailing, but it was a few years ago now so who knows how predictive that is! I do know I was back to driving after my revision following the weekend (surgery on Thursday, back to work on the Monday). After the original I went back to work at a month (but was working from home earlier than that, as I was going stir crazy). Both times was back to long daily walks within a handful of days - couldn't work out, but rationalized I could walk!

I will discuss with the surgeons here. If neither of them are familiar with pre-pectoral reconstruction I will probably get a referral back to my original surgeon in Calgary or another one up there as well. I would just rather do it closer to home this time if I can.

Reading your experience again reminds me that it is always so difficult to settle on a surgeon, even the great ones will have unhappy results, but it is definitely worse when they don't even try to get good ones. I'd rather a cautious surgeon with less experience in some ways than an apathetic one with extensive experience!

Lexica - I had to massage my right scar after my revision surgery to get it to release and go back to a normal shaped boob. I would put two fingers next to each other facing opposite directions on the scar line and then rub them back and forth in opposite directions to stretch and break up the tissue. I also did that around the edges and basically anywhere rubbing the tissue hurt, until it didn't hurt anymore, to break up scar tissue. It seems to have helped. Also, maybe take some vitamin E and you can also try bio oil or silicone strips to soften the tissue.

As for your surgeon, listing him is no different from any other surgeon, who any of us can realistically only see if they are in our networks. So I would give up his name, because tons of people are on Tricare.