Exchange City
Comments
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Yeah...I think I need a tummy tuck and it seems awfully vain of me. I probably won't ever do it but on this road of trying to get myself back to feeling well body, mind and soul....my flabby belly is a bothersome part.
I am going to ask my PS surgeon about it but unless it's an easy, inexpensive fix...I wouldn't put myself through another surgery and long recovery.
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I've been wanting a tummy tuck for years, even scheduled it once about 7 years ago. I just couldn't see spending the money for it, though! I don't exactly want to deal with another big surgery, either.
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Summerangel,
My sister had a tt and it was horribly painful! You might want to go to the tram flap board. They would be able to tell you about the tummy part.
Robin
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I haven't been here in a while, but checked in tonight and just wanted to jump in and mention that I had a tummy tuck with my exchange. I had triplets (plus one) and my belly was wrecked. I was considering getting a tummy tuck at the end of this year anyway, so we just moved it up. For me, it was a far easier recovery than the BMX and TE surgery. My PS said it's a much easier recovery than TRAM or DIEP, too. It is really the only thing about BC that I consider good. I had my totally separated abdominal muscles repaired along with the tummy tuck, and now I have support through my core and can workout more effectively. I honestly wish I would have gotten a tummy tuck a long time ago. Anyway, I'm happy to share some pictures privately if anyone wants to message me.
I had some fat grafting and scar revision done today on my breasts. This should be the last surgery. . . .
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Halee- I have to assume that there was a separate cost to your tummy tuck?
I am a slim person but skin on my stomach is like elephant ankles. There just seems nothing I can do to get rid of it. My exchange is scheduled for 3 weeks and I never mentioned to my PS. I kind of wish I had. But I do think I will mention it next time and see what he says. My reconstruction on my healthy breast may take two surgeries anyway. Maybe I can get a tuck then and rock a bikini in the summer. LOL
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Halee, now I'm tempted again to go ahead! Ha! Suzanne, my skin is just like yours - it's skin that's wrinkly but without underlying fat. Surgeons who take a look say, "Yes, there's some laxity there..."
When I had originally scheduled a tummy tuck, the PS told me that my abdominal muscles were fine and wouldn't need any work, the surgery would just involve the loose skin. That was reassuring. I still can't get past the expense, though. It's about 10k in my area and I'm a single parent with one child in college. I feel ridiculous even considering it!0 -
Often plastic surgeons will not combine a cosmetic procedure with a breast cancer reconstruction surgery because it offers your insurance company an opportunity to deny the entire claim. If you are using the OR, anesthesiologist, etc., for a BC related surgery the insurance company can't suss out which part of the charge is their obligation to pay, and which they will not cover due to a cosmetic procedure. Unless you are using the tummy tuck for the breast revision most won't combine, and this is not only to be sure they are paid their professional fee, it is so you don't get stuck with a larger bill than you bargained for.
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$10,000! I can't consider that either. I have two kids to put through college and it just seems awfully vain of this 50 year old woman. If I won lotto then I would consider.
Ok- well I will just keep doing my stomach crunches and keeping my weight down. No more bikinis for me!
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Suzanne, I took 2 weeks after my exchange. That being said, my docs said I only needed to take two days off after my BMX. I took 9. I wish I had taken more. 2 weeks was okay for my exchange though. Best of luck!!! As everyone says, each of us are different!! xox
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Yes, there was an added cost to it. I had a hernia, so insurance covered the hernia and the muscle repair. I paid for the lipo and skin removal. The total was $5750 ($4000 went to the PS and the rest was anesthesia and hospital fees).
I am fairly slim but with a huge belly. It sat on my legs when I sat down and would trap my panties under it (so yuck). I was a size 10 before the tummy tuck to fit my waist, and I couldn't wear most pants because if it fit my waist it was too baggy through my rear. Within a month of the tummy tuck, I was in size 4 pants because my tummy size matched the rest of me. The difference for me was shocking. And because of the muscle repair, I have a lot more core strength and can workout more, can run again for the first time since I had children, and am generally stronger. It was very worth it for me, but I know it's not for everyone. . . .
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katykids - 2 days off after BMX???? WTH? I had drains for 3 weeks! I had mine in the summer so I was off anyway but I would not have gone back to work with drains!
Thanks for all the info ladies. Thanks halee for the tummy tuck info. It sounds like it was well worth it for you.
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Hi All!
2 days Postop from exchange. I would say for me it's been less painful than MX but I had extensive pocket work done and liposuction in 3 places. My surgery actually took 4 hours. The pain is mostly in the drain/pocket area and the Lipo area which is really bruised. The incision over right breast is numb. Getting the tight compression garments on and off for showering and going to the bathroom is painful too. That being said, I have to stay up on pain meds q 4 hours. I am not working now but I would think at least 2 weeks off. I wanted to say also I am really pleased with result and it looks pretty even on both sides. The implant feels so much better compared to TE. Excited for everyone of you ladies to feel difference!
Tina- your up next !! What day? Will you get fat grafting? I noticed my pooch disappeared from fat they sucked out.
PNY- how are you doing? Is Lipo area less painful? Are you wearing compression garment 24/7? I feel like I got ran over by a truck. I think we both had similar experiences.
Will have my drains until they are bone dry my PS said due to my fluid/Seroma problems in past.
Mominator- is your infection cleared up? I started taking Keflex postop right away. 4 x a day. Did you start antibiotics as part of post op or only after you got infection? That is my biggest fear. To go this far and have infection. I can handle pain.
Katydid- I think your doctor way underestimated recovery time. I can't imagine anything less than 2 weeks. I was tired after shower and slept 3 hours today.
Goodnight All. Xoxo
Patty
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Hi Patty,
Only 3 more sleeps for me. My surgery is Monday the 22nd. I'm excited to feel the difference too. No fat grafting for me so hopefully I will have a pretty easy recovery. I'm taking 2 weeks off work just to make sure I give myself enough time.
I hope your pain gets better.
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Tina, I took 2 weeks and it was plenty. I had some pocket work on one side to even them out. I didn't have drains or fat grafting. I have Allergan 410 gummies 475cc. I live them! Almost a year now.
Robin
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I know this sounds stupid but what exactly is "pocket work". I have no idea if I am having it. I do know that I am getting a silicon implant on mastectomy side. Other side he is doing a lift and then hopefully putting in a saline implant to even me out. But he isn't sure he can do both same surgery. Something about the blood supply to the nipple being cut off and he won't know till he gets in there. So is that "pocket work"?
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Suzanne- I had more pocket work done because my tissue expander and Alloderm had moved under my arm and stretched out the skin. My PS inserted my new Allergan 410 Implant and also had to replace Alloderm and get that whole area tightened up and resutured. I had 2 drains placed also and fat from my stomach injected to the upper pole area. I know that there is more to pocket work than this explanation, but I can't remember much that was said after surgery. I will learn more at first postop.
Please chime in with additional comments on pocket work for any of you that understand it better.
Patty
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pocket work is the surgical techniques a doc uses to keep the implant in place under the muscle. Stitches I assume or just their magic!
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When the TE's are placed, the PS creates a "pocket" within the pectoralis muscle to hold the TE and eventually the implant. Most of time, during the exchange from TE's to implants, the PS simply opens the breast mound, opens the pocket, removes the TE, inserts the permanent implant, sutures the pocket, and sutures the skin in the breast mound. However, sometimes the pocket itself requires adjustment. Maybe the pocket stretched into the armpit (too lateral--implants in your armpit) or is too close to the sternum (too medial) in which case, "pocket work" is performed which may involve more cutting to open up the pocket in a certain direction or suturing to close/change the shape of the pocket. This "pocket work" is obviously more invasive surgery than a "simple" exchange and therefore, recovery MAY be longer and more painful. The medical term for "pocket work" is lateral capsulorrhaphy.
I had my initial exchange without pocket work and a revision to a different set of implants with pocket work. For me, the revision including a lateral capsulorrhaphy on each breast was only slightly more painful and the recovery was slightly longer BUT definitely worth it.
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Thank you LoriWNY for that explanation! And for everyone else sharing their experience. It is all very helpful. I guess my PS won't know what kind of pocket work I will need until he gets in there. This whole surgery is going to be a "wait and see" how it all goes. He said he will have to make decisions during the procedure and we won't know if I will need another one after this or if he can get it all done in one shot.
Looking forward to this being behind me! Getting closer to the BC finish line
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Thank you LoriWNY-
That was a great explanation. Right on the money. My TE and Alloderm migrated under my armpit and I had extensive pocket work. It still feels better now after exchange than with TE. It feels firm and in place. It hurts like $!&@"
Patty
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PMR53, yep we sound pretty much the same. Now 3 1/2 weeks out I am doing much better. I went back to work last Monday but only stayed in the office half a day. Then went home rested for about an hour and finished up my day from my computer at home. I still have pain under the implants but not all the time. After I reach to get something or crunch as I sit at the computer or try to lie on my side for too long. I am wearing SPANX when at work and the compression band PS gave me at the surgery when I am at home. Not sure i even need it anymore but figure it can't hurt. I must say the lip area feels fine at this point:)
Suzanne50 - pocket work is just the work the PS does to have the implant sit properly. In my case my TEs were so far apart you could fit a truck up the middle of my chest. PS had to get the implants to sit closer together which required alot of internal stitching. But i have to say, they look pretty good. I would have even liked it a drop closer but PS said they would not have looked as good on the outer side.
Good luck Tina
Katykids, I can't believe a BS could say all you need is 2 days for a BMX. WOW, the drains are in for 7-10. Glad you did not listen:)
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Hello to everyone. So ready to have my exchange surgery tomorrow. One more sleep night for us Tina1969! I'm having exchange surgery, fat grafting, and right nipple reconstruction.
Thanks to all for sharing info and personal experiences. It has really helped me to get through this journey
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Hugs and prayers for all having surgery this week
my date is inching closer (march 16)0 -
Best wishes for tomorrow fipjoemom and Tina.
Scottie
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Thank you Ladies! Just one more sleep. I can't believe it's here.
Good luck fipjoemom.....I'll see you on the other side.
Night night everyone.
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Tina and FlipJoe- we are in your pocket tomorrow!! Hugs and prayers for good successful surgeries!! I think you will be amazed even right out of surgery how nice your implant will feel!! It will be a breeze!!
Hugs!
Patty
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Good morning and happy surgery day to Tina and fipjoemom!! Wishing you both smooth surgeries and swift recoveries.
LOL, as Patty said, we are in your pocket! I'm keeping you in my thoughts and prayers today. See you on the other side.
Love,
Mominator
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Patty/PMR: My PS gave me some antibiotics before surgery, and had me taking Keflex post surgery right away 4 x a day. The infection started on day 8, about 5 hours after the drains came out. We don't know if there's a connection or not. The infection was way inside the breast, under the implant, towards the sternum. PS moved me over to Levoflaxin and Clindamycin since the infection started while I was still on the Keflex. The fever broke after two doses of antibiotics, and infection cleared up soon after.
Suzanne50: no, the pocket work is more under the muscle where the implant will be placed, and the nipple is layers above that. Did you have large breasts before the mastectomy and breast lift? I did, and both BS and PS were worried about the blood supply to the nipple/areola complex. I had a nipple-sparing BMX, and the blood supply was in question at surgery, but was saved. I had a small area of necrosis at the tops of both areolas, but all is fine now.
Newgirls and Lori: I love both the magical and the medical descriptions of the pocket work. It is a bit of both, isn't it? My TEs had migrated laterally, especially the left TE was into my armpit. Pocket work helps the implant to sit properly, which is different for all of us. My PS also removed a lot of fat tissue from the bottom of both my breasts. I don't know how much, but he said about 50 gm more from the right than the left.
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Thinking of Tina and fipjoemom today. I can guarantee that you will not miss those expanders.
I am doing good. I have had no problems with healing and these implants are very comfortable. I don't even notice them actually. They just feel like they are part of me. I still wish they were bigger but to go through another surgery just for that, I just don't think I am up for it. First world problems is what I tell myself. I am just looking forward to getting back to life and living again
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Hi ladies. Just a quick update. Had my second exchange on Feb 11---Inspiras, pocket work on both sides and ADM. About 4 hours after getting home I developed almost uncontrollable chills, teeth chattering. I was so alarmed that I called my PS, who said the reaction is not uncommon after anesthesia and suggested I take a valium to try and quiet the muscles. That worked like a charm but I was running a fever all that night---at one point as high as 104. Over the next few days I continued to have fever as well as redness. Called PS and he changed my antibiotic and said he'd see me the next day. Saw PS in his office and he sent me for an ultrasound-guided aspiration of fluid to determine what if anything was brewing. He felt strongly that infections don't come on so quickly postop but because of my history of infection (lost first right implant to infection), he wanted to try and get something to culture. Next day went to hospital and radiologist was able to get some fluid. Meantime had changed antibiotic from Keflex to Bactrim. PS also told me to stop wearing a bra since he was concerned it could be irritating my inflamed skin (he was right). By Thursday (one week after surgery), the redness was gone and fever was only sporadic. Saw doc again on Friday and he was amazed that the redness had disappeared so quickly. Meantime, culture came back negative. I cannot tell you what a relief it's been to know that i am not infected and that I can keep these implants. We are all still unsure what caused the fever and redness, which is irritating to both me and PS. Sometimes there are no obvious answers in medicine.
Things are looking good overall. The inspiras so far are great and absolutely no rippling. He went smaller than with previous Mentors. I'm at 615 ultra high profile-- but it sounds bigger than it looks. You can actually see on the outside where he did a lot of the pocket work on the sides -- which I needed badly. PS said that will soften and it won't be visible after the implants drop and fluff. I am not thrilled with the perpendicular scarring but I'll deal with that at some later point if they don't resolve. With all the procedures I've had (5 in last months), my scars are rough.
Finally, a word on pain. This was by far the most painful procedure I've had other than the original BMX. I've needed pain meds almost every day. Sides of breasts, ribs and under breasts are most painful areas and PS said he expected this. I am going back to work next Monday and I"m so glad I took the time (Feb 11-29). For most of you, there won't be so much discomfort.
Good luck to all and here's hoping your exchanges are uneventful!!
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