Immediate reconstruction, deciding implant type

Hi - I had left mastectomy with immediate reconstruction but, because I was to have radiotherapy, I was advised to have polyeurethane implant to withstand the radiotherapy better.  Over the muscle.  I didn't bother to have nipple reconstruction however I can have nipple tattoo'd on if I wish (I haven't yet and probably won't).  Yes there has been some rippling and a bit of a ridge as I lost weight so have had fat taken from stomach (great!) and injected into the areas needed around the implant and one area where the skin was very thin.  I need to have one more (hopefully) session of fat injections (some was stored as you often need two or even three sessions).  All is fine really, just feels a bit tight and hard but got used to it.  I wish I had gone for the double mastectomy as now I am feeling lumps on the "good" one but apparently it's fat necrosis because of the surgery to make it smaller to match up with the implant one!  Don't know if that's helped at all but it's what happened to me!

Hi Kitz, thank you a lot for sharing your experience, I found it very useful. Was your rippling very bad and noticeable? Would bra help to hide it?

Is your implant round or anatomical?

Thank you so much again, sorry for many questions!

Hi , 

my mx was in April 2018, had a pear shaped implant under part of the muscle. In a padded bra it looks fine, though is a tiny bit higher than the ‘good’ side. My surgeon advocated waiting to see if I needed radiotherapy before deciding between a temp and a permanent implant. In the event my nodes were totally clear so she went for the permanent. Because of the scar (almost horizontally across breast, due to previous surgeries) and some adhesion with the mesh sling, there’s some puckering but I’m ok with that as it’s not visible unless I remove bra. I’ve not had any need for nipple, either tattoo or reconstruction. 

Hope you manage to decide on what is best for you, that’s what it’s all about, really, feeling comfortable with your own decision and your body. Do have a look as soon post-op as you’re able. 

Hugs xxx

Hi Katya - no it wasn't too bad really.  Not noticeable to anyone else only to me and I could feel it around the edge but it didn't stop me wearing a bikini on holiday!  Yes definitely a bra hides it and it won't be seen through clothes.  I'm not sure which shape my implant is - I think anatomical.  I wasn't given any choice.

If you do get rippling you will be offered the fat injections like I had but only if you want them.  

Don't worry about asking questions - this is what this site is for and has been so helpful to me!

Hi Kitz,

Thank you for your reply and support.

Were you at a higher risk that you had to have your nipple removed?

I was given a choice - to keep or remove them (the nipples). I'm not sure what to do now. I wonder is the nipple something that is a potential risk for cancer to come back, especially I have cancer in both breasts. Or maybe it doesn't matter.

Hi Moomy,

Was really good to know about your experience, thank you for that. I am totally lost in all this and what I should do.

What was the reason your nipple had to be removed? As I don't know whether I should keep mines or not, in case of a higher risk for cancer to come back. I was told there would be another operation to remove them if cancer cells are found during the 1st operation. 

Do you feel comfortable with the implant under the muscle?

Hugs to you as well and thank you again xxx

Hi again,

I had previous surgeries, one was to free the nipple from tightening scar tissue, and in those days cysts were surgically removed; I’d had a couple! So my surgeon decided an incision to join up previous scars which removed the nipple anyway. it didn’t bother me. 

Having the implant under some of the muscle layers means that it moves slightly oddly when I flex that muscle, but also means it feels a normal temperature to the touch. Pluses and minuses I guess. Again, as I wear padded bras, my shape while clothed doesn’t bother me at all.

Hugs xxx

Hi Katya,

No - I wasn't at any higher risk to have nipple removed but I just said I really wasn't bothered about keeping it.  The surgeon said that made his life easier!  I can have it tattoo'd but again, I am not really concerned about how it looks to be honest.  The shape is fine in clothes.  I also felt I just wanted to get rid of as much as possible really.  Wish I had had the other breast removed at the same time.  I don't know if the nipple is a potential risk but would be worth asking?