Friday, October 7, 2022

Breast Cancer Fight: Over the Muscle vs Under the Muscle Breast Implant Reconstruction

I'd decided that after mastectomy, I would use an implant for breast reconstruction. Basically after my first talk with Dr Jane, the boy and I saw that there were 3 options ahead for me in terms of breast reconstruction.

Firstly, don't do anything at all... which is the safest option without the added risk from having additional surgeries for breast reconstruction or from any other complications caused by the implants. This is the preferred choice for the boy if he had to choose, and I did consider it.. but then I think I would honestly be very miserable if I saw my body with just one/no boobs at all!!!(πーπ) 

Secondly, I could use muscle or fat transplanted from another place of my body, such as belly, back, thighs or butt, to form a breast shape. Using muscle is a definite no-no, and I "didn't have enough fat" according to the doctor, so this is out.

Thirdly, there was the breast implant which is a round, flexible silicone shell filled with either saline {salt water} or silicone gel. It would need to be replaced after 10-18? years and has some risks involved, but this seems like the best option for me if I want to have my breast reconstructed. 

Breast implants can be placed either over the chest muscle {subgandular} or underneath {submuscular} part or all of the chest muscle. The implant replaces the breast tissue that is removed during mastectomy, restoring the shape and volume of the breast.

Choosing the breast implant for breast reconstruction seemed like an "easy" choice. Now the harder part was deciding if I wanted it over or under the muscle, as both come with risks and one would affect my performance in the gym more, and as you probably already know, to me #gymislife

Advantages for under-the-muscle placement include lower risk of implant rippling or wrinkling as the chest muscle on top of the implant can help prevent the outlines of the implant from being visible through the skin, capsular contracture {tightening of scar tissue around the implant that causes pain and distorts the shape of the breast} may be less likely to occur, and the skin is better protected when it's healing. 

However it would probably take a longer recovery from the surgery and there is a higher risk of dynamic distortion {or animation deformity}, which makes the breast move in unnatural ways when you flex your chest muscle... like when you exercise. 

Also, because you cut and stretch the chest muscle, it will cause strength loss and may prevent me from doing some exercises properly or even at all.. and that really worried me. I mean, I love doing deadlifts, pull-ups, push-ups etc... all of which require a certain amount of use for my chest muscles. I'd hate to completely cut out any exercise for good!

Advantages for over-the-muscle placement include less pain/ tightness/ weakness during and after recovery, and lower risk of animation deformity. However, there is a potential risk of implant rippling and wrinkling showing through the skin if the implant is not covered by enough soft tissue, a slightly higher risk of developing an infection around the implant, and a possible risk that the implant shifts out of the correct position over time, if my skin is thin...  

Actually I might not even have a choice in this as all of my breast tissue would be removed, and the remaining breast skin may not be thick or healthy enough after the tissue has been removed. 

On the second visit to see Dr Jane on Fri 7 Oct, she told me that if my breast skin was healthy and thick enough {unlikely due to the mastectomy and because I already have quite thin skin to begin with}, she could also use a acellular dermal matrix {ADM} to keep the implant in place while the cavity heals if I wanted to do over-the-muscle placement. 

Ahhhh so tough!! There is so much information out there which makes it even more confusing as there are pros and cons for both.

Most athletes or women in fitness that do breast implants prefer over-the-muscle placement as it affects their training less, but then they also go for bigger implants and may not have to suffer a mastectomy too so their situations are different from mine.   

The boy thinks that under-the-muscle would be the better option due to less post-surgery complications {especially infection risk!}, and I spend most of my time outside the gym so better for the implant to look as natural as possible in general. Also since I don't do massively heavy lifting and it isn't going to be very big, the implant should not affect my training that much. 

Mmmm... ok.

Dr Jane 2nd visit cost: S$108.07

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Before mastectomy and breast reconstruction surgeries

After mastectomy and breast reconstruction surgeries

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