Exchange City
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I also have the Sientra's shaped implants, 425cc. I have liked them from day one.
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I have been reading this website since January but just started posting last month. Dx was the day before Thanksgiving last year. 2 weeks later I had port placement and sentinel node BX. Luckily the node was negative. I was also negative for BRCA but, my mom and her 2 sisters had breast cancer. So I elected for a BMX in June with TE. I have been reading the Implants 101 topic and realized I need to be here also. Exchange surgery is tomorrow!! I am expanded to 330cc and will likely get Allergan 20, 450cc - 475. My ribcage is 32". I just want to look like I did before. Anyway, what can I expect for recovery? My PS has only said less pain than MX , no drains and 1 week with surgical vest. What are your experiences with pain? What about restrictions on lifting?
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Hello ladies! This is my first time posting, but I've been a lurker for months. Thank you all for making me feel less terrified!
I had my bilateral nipple sparing mastectomy 8/21/2014, and I was supposed to have immediate reconstruction. I was diagnosed with DCIS, but my BS thought I was a good candidate for the immediate implant instead of tissue expanders. I was NOT prepared for them!!! They hurt soooo much!
I'm over filled to 360cc in each breast, and my exchange surgery is scheduled for November 21st. If you ladies would be so kind, I have a couple questions:
1) will my new silicone implants move at all (as opposed to these bricks I have now)? I'm getting round silicone implants.
2) is the exchange surgery going to be as painful as the mastectomy? I only ask because she'll be using my infammamory fold incision.
3) I have a big roll that looks like they squeezed the skin and stitched it up. It looks like a fat roll that is shaped like a "c" and extends from under my collar bone to the armpit. Will that go away after my implants are inserted?
Any help is appreciated! God bless you ladies for making me feel so much better after I read your posts!!!
(((((HUGS))))!
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Hi Twistiekristie, i have the same thing with the huge roll, and that's only on one breast (i was a UNI mast.). Very uncomfortable. I can't wait to have the final surgery and reduction of other side.
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Thank you for sharing that with me ! I thought something was freakishly wrong because I can't find any photos on google of reconstructions with that roll. Did your plastic surgeon happen to tell you whether or not it would go away?
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Good luck darlin'!!! I'll be praying for you!
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I had the roll after my UMX with the TE and it did flatten out a bit with my fills. After exchange the roll is back I asked about it and the nurse said it would eventually go away and I asked "i thought the fills last time flattened it?" She said that helps but it will eventually go down, I sure hope so!
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Hello all....I am having my Exchange surgery with fat grafting from my tummy Oct. 29th....I tried to write down some tips from previous posts about compression wrap. Anything else I might need?? I have previously at BMX with TE...followed by RADS and Lat Flap on RADS side...How is the pain?? My PS said I would not have drains which was one of the worst parts for me!! How long did you take off from work?? Any tips would be appreciated!!
Thanks!!
Cherri
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yeah, twistiekristie, i see myself in the mirror and think, no pictures i see online are THIS bad. but this too will pass. good luck, xoxo
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Drains: You never really know about drains. I'm 11 days out from surgery #5 and woke up with a drain on one side, even though the surgery was on both sides. I didn't expect to have ANY drains. The PS said the right side was "pretty bloody" but the other side (that has had most of the surgical procedures during the past year) didn't need one. I didn't have a drain at all with surgery #3 or #4 so it was a surprise. This time my PS started all over and the pockets were completely reconstructed with Alloderm added. It was a long 3.5 hr surgery...nearly as long as the placement of my permanent implants right after the BMX. Maybe that had something to do with why I needed a drain. Just guessing. The drain was still pumping out 45cc's a day on post op day 6 so the PS couldn't take it out. Two days later it was like somebody turned the faucet off completely. Nothing. Weird. I usually have drains for 2 - 3 weeks.
This time the drain came out on it's own. I felt something on my lower leg and looked down to see the tubing hanging down. Didn't feel a thing and the sutures were still in place. Also weird. Recovery: I always get a fresh set of implants whenever the PS has to open the pocket. (Decreases infection risk.) So far my score is 1 set of Allergan Style 20 800cc rounds, 1 TE, and 3 sets of Allergan 410's FF 740 gr gummy bears so I have more than the average persons recovery experience. I've never had a simple exchange without pocket work so I can't give personal experience about how your recovery might be. What I CAN say is that every single one of my recoveries has been different. #3 kicked my butt and it took a full 4 weeks to turn the corner. #4 took only 2 weeks. This time, even though I've had so much more work done and have Alloderm for the first time (which is supposed to extend recovery time) I felt fine at 10 days post op, never took prescription drugs & am off Tylenol already too. You just never know.
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Chiming in with a quick note on my exchange, which was on Wednesday, Sept 24 (BMX with tissue expanders on May 12, no radiation). The exchange surgery took about 5 hours because my surgeon had to remove some additional skin due to positive margin after BMX before the PS did her thing. Expanders were replaced with Allergan 410 655s, plus fat grafting in the upper pole for fullness, and no drains (yay!).
Recovery was surprisingly easy. I had minimal pain, mostly from the lipo/fat grafting, and probably could have worked the next day if not for post-anesthesia brain fog. I worked from home on Friday afternoon and was back in the office on Monday for a 10+ hour workday (and drove my 30+ minute commute each way).
A few thoughts on my results and some questions:
- My PS recommended wearing high waisted Spanx for a while to get the best results possible from the lipo. I did this for two weeks, and wear a compression wrap on my midsection at night. I haven't really been able to tell much of a difference from the lipo, other than maybe a bit of contouring in my midsection.
- I cried when I took the hospital bra/bandages off my breasts for the first time two days after my surgery. They looked terrible (bruised, puffy, and with yet another scar), felt almost as hard as the tissue expanders, and did not move at all. It wasn't what I was expecting to see.
- Three weeks out from the exchange, I am much happier with the results. My breasts seem to be settling and look very close to the shape/size they were before (36C), just perkier and much (MUCH) more firm. I'm still concerned about the lack of movement and the firmness of the gummies; they just sort of stick straight out, and don't even push together with a bra. Is this typical?
- I am worried that I won't be able to find bras that fit right even after everything settles into place. The Spanx bra-llelujah wireless is a pretty good fit, but I don't quite fill out the cups like I would have before. For those with 410s, have you found a bra with a cup that fits the shape/projection of the 410s?
Good luck to those of you doing exchanges soon. May you have a successful surgery, an easy recovery, and a beautiful end result.
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Lawyergirl - on others recommendations the Bali Comfort Revolution Bra is working for me style #3488 or 3484 depending if you want padding or not. I am a UNI and was having difficulty with the scar under my lifted breast so was searching for something comfortable there. So far so good, a little more substance than a Genie and they run in sizes of S,M,L,XL,XXL instead of cup sizes. Might be worth a try. I have a 410 and no puckering at the end of the cup. I tried on my old bras and they did that though so out they went.
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I am to meet with my PS today to talk about the permanent implants. I know my PS really pushes the "gummy bear" implants. However, I keep seeing some others on here post that they are extra firm feeling.
What are some other implants that others have had they are happy with that are not extra firm? I'm not sure that I would be happy with an implant that is so firm, I think I would be happier with something that feels much more natural.
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For me the exchange(s) have been much much easier than bmx. Shorter surgeries, youre home the same day. I was back at work in less than 2 weeks. No drains. That being said, its still surgery and you cant over do during your recovery, so you still need to be cautious. I also had the exchanges in imf area. My ps is a no bra guy so I dont wear one and love it. I was wrapped for 3 days til my first post surgery visit to him, then was able to shower. In general, we seem to find ex surgeries much easier, less painful, and quicker recovery. But we are all different, so take that will a grain of salt.
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To the ladies who are about to go through their exchange: My two cents - I am 4 weeks out from my exchange and have Allergan 410 - 420CC High projection. The physical recovery seems easier for all of us. You go home the same day, less drains (if any), shorter surgery, less pain. However, I feel like the thing I didn't expect was how it'd feel emotionally! I expected to be so much better (in the head) than after my bmx. But that was NOT the case. I think there's something really difficult about knowing, ok this is permanent now. At least for me. The expanders - I knew they were temporary, so that helped me deal with the reality of this whole ordeal. But this time around I've had a much harder time with the emotional fall out. I've done a lot of crying, and mourning my old boobs and old life. BUT it does get better. I've really turned a corner, so I don't want you ladies to get worried. We are all different, but all in all I think the exchange is def an easier surgery. Just be really kind to yourself and seek out the support you need for the psychological component. Oh and yes…my gummy bears are super firm and also don't 'push up' or move in any way. My PS said this will change and get much better in the coming months. Also I'm going to do a revision in January when I get nipple reconstruction. She's gonna do fat grafting to help with the ripples.
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thanks for the words of encouragement gindugirl. two more weeks countdown for me............
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This is my humble two cent experience: I had my exchange last Monday, and oh boy, what a difference. I almost cried when I felt how soft they were and more close to normal. I had bmx in March and it was a terrible journey. I had so much pain that I had to see a pain specialist and then the left side became encapsulated. In addition, I went through chemo and radiation during summer, so that enhanced the encapsulation. The TEs were hard as rocks, my friends even noticed it when hugging me, and the feeling of having an extremely tight leather strap around my chest never left. In terms of the surgery, mine was relatively easy, no drains, and I could feel the softness the second day. Other than lifting and bracing, there were no limitations, other than a light bra for one week to keep the pads in place. My ps only uses Mentor Memory Gels. He will not use gummy bears because he says they are too hard, plus they can rotate while inside the breast. Hope this helps.
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Gindugirl
thanks so much for the report. Exchange was yesterday and I ended up with Allergan 20 - 425cc. I expected larger implants so I am a bit nervous. Like you, I looked at the TE as temporary. They felt like juice boxes in my chest. But the implants should last for a while. I have the surgical vest 24/7 for 2 days and then I can take it off for shower only. The vest is to be worn at all other times until the post-op visit next week. I haven't taken a peak under the vest.
lawyergirl, Thanks for saying how you felt when you first got the bandage off. So, I won't freak out if they look funky right now. No drains but, he did some pocket work medially which is where most of my pain is. But this is so much easier than the BMX.
Has anyone else been on antibiotics after exchange? I was surprised to have a prescription for Keflex.
Thanls ladies for sharingDiane
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dianems, I had my pre-op today and was told I would only get antibiotics in my IV as I won't be having drains.
I have a question for you ladies. Am I the only one who wants to go a little bigger than I was before?? My plastic surgeon from the get go has made me feel like I was stealing or something. I've told him about 20 times I just want to be in proportion with my large frame. I'm not asking for huge ones, just want to look better than before. I'm working with whippetmom right now and it's looking like I might have to reschedule my surgery. I gave her the implant info he gave me today and she said TOO SMALL.( A little advice, don't be a dope like me and wait until the last minute to contact her!) Anyway, if my skin can take it, what is wrong with wanting to go a little bigger?
Karmenn
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Had my last visit today before the exchange in December.
Dianems, I was told I would be on antibiotics after surgery, just like with the mastectomy. I asked what kind I will have and he rattled off some names but I can't recall which I'm getting, guess I'll leave that to him. I did talk to the nurse later and she said he does not use the gummy bears because they had several complaints of them being hard of of them moving, so just like life in general, different strokes for different folks. I will have to have some pocket work and plans to liposuction under the arm area and use that to match up to the natural side, I am a uni. Not sure I want to agree to a lift but we have it on the schedule, so I have until December to make up my mind.
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gindugirl - Totally agree on the emotional aspect. For me, personally, BMX was a much easier part of the journey then the exchange has been.
clmtootie - I was pleasently surprised after exchange how soft my 410's felt to me. So many say that they are super firm, so I was prepared for that. I guess it all depends on if your native breasts were soft/firm. They do not move around much though. Several friends have felt them (I know that is a weird visual lol), and cant believe how natural they feel.
I know many ladies have not had to have drains for exchange. I did, because sometimes (especially with 410's) pocket work has to be done, to get things very precise (this is a good thing). I had 2 drains for about a week. Easy peasy compared to 4, for what seemed like ages after BMX.
Keep your heads up, we got this!
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Oh my gosh...so many things to reply to I hardly know where to start. I have gummies and have also had rounds so I can offer personal experience of the difference in firmness...there is virtually none! They are slightly firmer, but even my husband, who claims to be a expert on this (
) says he can't really tell a lot of a difference between my Allergan 410 gummy bears and the Allergan Style 20 silicone rounds I started out with. (He says I feel like I did when I was 21.) There is, however, a BIG difference in how ANY kind of implant feels compared to your natural breasts.Let's get real here.If you are an average 40-50-60 year old, your breasts have changed a lot since you were 21. They are much squishier and softer than they used to be. They can be pushed up and manipulated quite a bit. Your implants AT FIRST are not going to feel like that... maybe even if you get saline rounds that don't fill out the available skin after your mastectomy and your pec muscles are looser than most. Swelling after surgery can take a couple of months to go away and contributes to the feeling that your chest is still "hard." Your pec muscles can be incredibly tight after surgery. Remember, the implants are UNDER them. Your own breasts were over the muscle. The pec muscles have to relax in order for the implants to move down into the pocket created to for them (Drop) and for gravity to move more of the silicone down to the bottom of the implant so it assumes a more natural shape. (Fluff) This takes several months. Form-stabile shaped implants do not fluff but they do move down and smooth out over the first few months. And yes, they do move and make great cleavage.
So if you are making a judgment about how hard your breasts are or how weird they look after days or weeks, you are making a mistake. Of course they aren't as squishy (and perfectly "perky") as you thought they'd be! They are still a work in progress. Check back in about 3 months.
I had a BMX with direct to permanent 800cc Allergan Style 20 round silicone implants in August of last year. In December I changed to 740 cc Allergan Style FF gummy bears - NOT because I didn't like what I had. (I had an infection that destroyed muscles and soft tissue on one side. Gummies fit my altered and repaired anatomy better.) Since then I've had more surgeries to continue repairs to my body and always get a new set of sterile 410's at the end in order to reduce infection risks. So I can tell you what a new silicone round looks and feels like compared to a 3 month old one, and what a new gummy bear looks and feels like compared to a 3 month old one AND a 6 month old one. I'm 12 days out from surgery #5 and once again, have a new set. (It's deja poo all over again...new day, same ole shit.) I'll have these for 3 or 4 months until surgery #6. THAT'S why I'm a self-proclaimed expert in the care and feeding of new implants.
Every doctor prefers one "tool" over another and am implant is one of his tools. Could be a style or a certain manufacturers product appeals to him. He has his own reasons. I don't think it's fair to tell a patient that gummies are too hard and move around. The REAL fact is that gummies are not as easy to place unless the plastic surgeon is experienced with them. With rounds, they can just create a pocket and not be too concerned if it's bigger than the implant. It's round...if it rotates, it's still round! With pre-formed implants, the pocket needs to be EXACTLY done to keep them in place. The statistics show that when an experienced PS puts in 410's, they fit and don't migrate or rotate.
If your PS doesn't have much experience with Direct to Implants, don't do it...get TE's instead and go the traditional route for the next three to six months (or more) and then exchange to implants. If your PS hasn't done very many gummy bears, find another PS or stick with rounds.
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From the permanent header on BCO thread Breast Implant Sizing 101:
EMOTIONAL ISSUES AFTER THE EXCHANGE:
Many of us and I mean MANY of us go through a period of sadness and depression after the exchange. It is an emotional journey we have been on since diagnosis and we suddenly seem to start experiencing all of the emotions we have placed on hold throughout the mastectomy and TE expansion process. So just rest in knowing that we have been there and we know what you are going through right now. Try to avoid obsessing over the appearance of your new breasts. Feel free to ask any questions or voice your concerns, but it is quite normal as this point in your journey.
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Sandra - wow, you're awesome! Thanks for such a thorough and expert account of this process! You are such a trooper and so gracious through this process. I wish I read more of what you're saying before going down the exchange road. I waited to long to reach out for support, I think that's why I've become such an emotional wreck now. But you're right, my implants look better than they did last week even. They seem to be softening more and more every week. I've done a lot of chest stretching - you know just breathing and pushing my chest out to stretch the pecs. This feels good and seems to relax the muscles, which do seem to soften the implants a bit.
I forget who talked about feeling small right after exchange, but I felt exactly like that! As soon as I took off my surgery garment I cried for an hour b/c my "boobs" were so squished and so much smaller than the TE's. But I will say, that I'm not feeling like that as much anymore. They have filled out a little more, or maybe I'm more used to it, but the size feels better. My only big issue is still with the rippling on my upper pole. It's still pretty bad. I have four months to see how it all settles and then I'm gonna try that fat grafting. I need to go to that thread and check out the consensus on that .
Oh and about antibiotics….I had drains so I did a full course of Keflex. I don't think you have to do antibiotics if there are no drains. As soon as i finished the course I seriously pumped up the pro-biotics to get my gut back in working order. Oh and a LOT of Vitamin C. It works wonders for healing from surgery!
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Karmenn, no you are not the only one that has wanted to be larger. It may only seem that way. There are plenty of others that have gone up in size. I went larger for two reasons. The implant manufacturers don't make implants in my original size (100cc 😉) and yes, I didn't want to be a AA anymore. My PS didn't have any qualms about making me larger. At first I felt I was a bit larger than I wanted but coming from a AA...
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Olaf, if you don't mind me asking, what size are you now? Did you go up quite a bit? I wonder if maybe it's a skin issue with me but he always says my skin looks good. I have a bad feeling the TEs he put in are too small. I'm asking today and letting whippetmom know. I'm just really frustrated and sad. Was really looking forward to my exchange surgery and now I don't know what's going on. Had to cancel my surgery on a voice mail so I'm sure I'll be hearing from them today!
Part of me just wants to say never mind, just pop the small ones in and be done but I think I'd be mad at myself for not holding out for what I want. I know in the big picture it's not what's really important but dangit I was looking forward to filling out T shirt!
Sorry for the long rant.
Karmenn
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Karmenn,
My TEs were an Allergan high profile with a fill of 450cc. I was not overfilled nor under. My implants are Sientra round base shaped of 425cc. I don't think I look smaller than my TEs. One reason he decided on 425 is that I had a very pronounced bone that stuck out (funny because I never really noticed it until he showed me my before pictures) in the middle of chest just below my collar bones. Now you don't see it. I did ask Whippetmom for advise on sizing. Sientra was one of them but 370cc. I believe that would have been ideal but I think he had made up his mind. He said he was bringing in both. So maybe everyone voted on the 425.
I feel your pain as you want it to be the right decision. Go with your gut and guidance from Whippetmom.
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I had my exchange last month. I am surprised that I still feel tender. Is anyone else still tender- under the implant... It is not a horrible pain and I recognize the nerve healing pains. Is this my new normal or will it feel better? I had a lot of pocket work done. I am curious how those of you feel - almost 6 weeks out of exchange. The weather is gorgeous today!!! Fall makes me happy!
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must must must be patient for several months after exchange, to see how they drop, fluff, and change into a more permanent size and shape. Do not be freaked out before then about how they are coming along!
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Goldie, weird pains come and go even months after surgery. Yes, it's perfectly normal in my opinion. My SNB was over a year ago
and I had no incisions anywhere near my right axillary area (under arm.) Sometimes I'll get little zaps of pain there. Why? Who knows. This experience is one of peculiar sensations.0
