Replacing Implants-- Insights please!

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Dukes_Up
Dukes_Up Member Posts: 149
edited September 2019 in Breast Reconstruction

Hi All,

Hoping for some advice from you lovely warriors!!!

Tomorrow I have an appointment with my new plastic surgeon (my former one did a terrible job with my bilateral mastectomy reconstruction via TEs and exchanged to silicone Allergan nontextured UNDER the muscle implants. This occurred 8 years ago this October. I am having difficulty with my decision to go over the muscle or under the muscle again with new implants. I have had nothing but trouble with my current implants- pain as well as a poor cosmetic result. I should add that I am very physically active (I am a training couch and work out a LOT.) Can you see a great benefit to go over the muscle in this case? My new PS is leaving the choice to me. She told me that I will have rippling if I go over due to low body fat but that she may be able to do some fat grafting. Also, she advised that the recovery process will be more difficult and longer (including drains again) if I choose to go over the muscle.

I would greatly appreciate any insight/help you can provide!!

Many thanks!!!

Alana



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  • VegGal
    VegGal Member Posts: 507
    edited September 2019

    I would get another opinion. I have never heard anyone say that recovery is harder with pre-pectoral implants.

    I switched from sub to pre-pectorals almost two years ago. It has been better in every way.

    Good luck.

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  • Dukes_Up
    Dukes_Up Member Posts: 149
    edited September 2019

    Thank you SO much for your reply! Did you not need drains when switching from sub to pre? You had some fat grafting done also? Was that painful? I honestly can not understand why going from sub to pre would be a more difficult surgery with longer recovery time. I will def get a 2nd opinion if she cannot answer these questions!


    Thanks again!!!!

    Alana


    Bilateral mastectomy on 10/24 /11 with reconstruction. TE's and exchange to silicone sub-pectoral silicone implants. Considered prophylactic but had rapidly changing cells in multiple biopsies.

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  • VegGal
    VegGal Member Posts: 507
    edited September 2019

    I did have drains, but I am a weirdo who doesn’t find drains horrible...just terribly annoying. I also had 2 rounds of fat grafting, which I also found not terrible. Sure it smarted and the bruising was impressive, but it healed quickly.

    Maybe the doc feels that making whole new pockets is more difficult than simply opening the old one and switching the implants. Still, do you want a similar cosmetic result, which is what would happen without some kind of pocket revision?

    Hope this helps.



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  • Dukes_Up
    Dukes_Up Member Posts: 149
    edited September 2019

    Thank You again, Veg Gal! I think I have decided that I want to go above the muscle as long as she is able to do some fat grafting. Is the first round of fat grafting done at the time of exchange surgery or did you have to wait?

    You have been so helpful. I'm not looking forward to going through this again but it would be nice to have implants that look somewhat like breasts! My symmetry is terrible. Even my new plastic surgeon commented that my foobs don't even look like distant cousins 😁

    Have a wonderful day!



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  • exercise_guru
    exercise_guru Member Posts: 716
    edited September 2019

    I would Never put implanta back under the muscle it has ruined planks, swimming an@ shoulder rotation for me.

    I am waiting for my plastic surgeon to get more experience and for them to.improve the aloderm process. My understanding is they form a flat sheet into a cone to form the pocket. That doesn't make for a nice round shape. I am hoping they will improve the process. For me its going flat or putting them on top. I would deal with drains if the PS would reattach my pectoral muscle to.my ribs. Loss of pectoral strength has kicked my butt

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  • Dukes_Up
    Dukes_Up Member Posts: 149
    edited September 2019

    Hi!

    Where are you at now in the process-- currently have them under the muscle? I have occasional shoulder pain and reduced range of motion. I never realized that going above the muscle was a "new" thing. I thought it was always an option.

    Do you work in the exercise industry also?



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  • VegGal
    VegGal Member Posts: 507
    edited September 2019

    Yes, the first round of fat grafting was at thetime of placement. The second round was just perfecting the contours started with the first round.

    To touch on exercise guru’s comment, I did not have my implants wrapped in Alloderm. Instead, I was given an Alloderm sling at the time of mastectomy. It had incorporated well into my existing skin and my second PS just created a pocket between my pecs and skin. My implants are definitely not cone shaped.

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  • exercise_guru
    exercise_guru Member Posts: 716
    edited September 2019

    I am not in the exercise industry I admire the heck out of you to do that with implants under the pec. I have had more problems than most I guess but maybe I expect more from my arms and chest muscles than others.

    VegGal I live in a more remote area. I would really need to travel if I did a DIEP and my insurance would make it challenging. I am traveling to get second opinions.

    Do you have alloderm in the top of your implant? is the entire implant contained entirely in the sling?

    In 2015 there was no one within traveling distance who was putting implants over the pec.

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