SubMammary Inplantation

Hi All -

After four months of activity with my pacemaker, I am noticing irritaion and inconvenience as a female with the standard upper chest inplant.  One, both my swim suit and sports bra grand over the pacemaker.  My regular bras have to be purchased with a strap narrow enough to run along side the pacemaker and then they have to be cushioned to stop irritaion.

Have any of you had a Submammary device placement (SMI)?  How is it working?  Also, were you given this choice when you faced a pacemaker install?



It can only get better :)

by KirstyM - 2019-01-16 08:50:01

I had my PM put in 6-7 months ago (through the standard procedure - not SMI) and would say that the first 4 months suuuuucked in terms of trying to get comfortable. 


I found I couldn’t wear bras with a halter neck strap as the pressure was so uncomfortable over my PM, and if I fell asleep on my left side I’d wake up in the morning with a sore spot where the edge of the pacemaker had been pushing into me all night. 


However, personally I’ve found that as time’s gone on it’s not so bad. My doctor had said that it can take up to 12 months for the tissue to fully form around the PM and that once that’s done patients find it more comfortable, and for me that definitely seems to ring true. 


I’ve not tried a bra with a halter neck again yet, but I think in the next month or so I’ll be in a place where I can wear one without the pressure over the PM bugging me too much. 

Just hang in there - it might not be quite as comfortable as it once was, but it will get a bit better :) 


by Tracey_E - 2019-01-24 11:16:17

My first 4 were submammary, my current one is subpectoral. It's possible to have it repositioned but I would wait at least 6 months, preferably a year, before doing anything about it because that's how long it can take to fully settle in and for scar tissue to build up around it. If it still bothers you at that time, you could consider having it repositioned to a deeper location.

My first choice would be going lower and deeper but on top of the muscle, assuming you have enough padding to do that. Second choice would be between the pectorals. Submammary is overkill, imo. The surgeon who did mine submammary retired and the one I switched to did not like how deep it was which is why he moved it to subpectoral. It was stuck and he had trouble getting it out so he didn't put it back in as deep. It's still out of my way. The deeper it is, the longer the recovery and the harder replacements are. 

Many doctors don't give a choice. If we ask, some still say no, some are willing to work with us to make it look/feel better. EP's are concerned with our hearts, some are also concerned with how it looks and feels but many of them want to do the simplest placement that will heal the fastest with the fewest risks so they still put it under the collarbone, just under the skin. It's the least invasive and the shortest path to the heart.

When I got my first one in 1994, alternative placements were unheard of but I was young and very underweight so my cardiologist brought in a plastic surgeon and they got creative and that's how it ended up under the breast. I liked having it there but it wasn't without some minor complications. Replacements were more complicated/painful and scar tissue built up and was bad enough that when I got #4 the plastic surgeon came back and cleaned it up and rebuilt the pocket. When a lead went bad, they had to put the new one in from a different vein and tunnel it to the box. OTOH, it was out of my way, very comfortable, I was/am able to have mammograms and nurse my babies.

 I don't like my current placement but not because it's subpec, it's because it isn't the whole way under and the edge sticks out. It's still inconspicuous and it's more annoying than painful. I considered having it repositioned but decided it wasn't worth the trouble of another surgery, another healing period, risk of infection from another surgery. 

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