Exchange City
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hi ladies. I am day 6 post exchange and everything is still tightly wrappe. Fron what i can see it looks like there is a lot of bruising on my boobs is that norma? I did have fat grafts. Drains at 35 and 22 for 24 hrs. See PS tomorrow for firs post op. Worried. Just don't want anything to go wrong this late in the game.
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Diane, I think bruising may be more common with FG. I had a lot of bruising and swelling for the BMX, much less with the exchange.
I'm sure your PS will look you over and tell you that it is normal.
It's good to see you on the other side, sweetie. I'm sorry that you're bruised. I hope you heal quickly.
love,
Mominator / Madelyn
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Hello everyone! I just got back from seeing the PS nurse who does my fills. She had told me last appt this would be a mini fill and I thought she said right side only (that side nipple is still a bit inverted, while the left side, the cancer side, is on high beam all the time....they tell me this is good because it shows I still have really good blood circulation left which can be a problem with nipple sparring). Well, my mini fill ended up being 45 cc on each side instead of the usual 50 cc.....not sure what is "mini" about that 5 cc difference. I am now walking around with 360 cc total on each side in 200 cc TEs. But, this should be my last fill. Exchange surgery is scheduled for April 28 so I only have 37 more "sleeps" before these rocks are exchanged for my gummybear anatomical implants. I can hardly believe how excited I am to get this surgery done....not just excited for the outcome, but excited to have it. Sounds crazy even to me, but that's how I feel. I know 360 cc doesn't sound like a lot compared to most, but that is a little more than 30 cc than was removed with my original BMX. I've always been small chested and used to wish I had more to work with....I've changed my mind on that one, at least with the increase in the TEs form. They get in my way and I keep elbowing myself in the chest! Now that is NOT fun and the constant pressure/pain is NOT fun. I just keep telling myself that I'm almost done and keep the pain meds to a minimum. Not sure how well I'll be able to sleep on my side now, but I absolutely can NOT sleep on my back.
I see my PS in 2 weeks for my final appt before surgery just to make sure he doesn't want to add just a little bit more. Apparently by having nipple sparring BMX the exchange is a bit more complex because he is trying to get both nipples pointed in the right direction. Surprisingly the nurse told me today that this upcoming surgery may be much more painful than the BMX.....this is the same nurse who told me before my first surgery that I would only need Motrin after BMX.........boy was that one wrong since I ended up with Norco 10/325 in addition to the Motrin. Not too worried though cause even though my last few fills have caused me to have more constant discomfort and outright pain which requires medication, I still have about 8 Norco left from my original #90 pills I was given a day or two after BMX December 18. Since I'm past the 3 month mark, I think I'm doing pretty well with my pain management.
Gotta get going now, but I just HAD to share my good news about my upcoming exchange surgery with all of you whom I know truly understand why I am so excited. My DH and family don't get it......but then none of them have ever had to live with these torturous TEs like we all have. I truly wouldn't wish TEs on my worst enemy.
Cyber hugs to all.....
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Hi everyone. I have been reading this thread for a few days now. For those of you who have implants post radiation, how are you doing? My PS really wants to do muscle sparing TRAM flap. I have been researching and reading about all things flap surgery including LAT, TRAM and DIEP. My PS does not do DIEP. The problem is I have a very ill special needs son at home for whom I am the primary caregiver. I cannot imagine being able to handle such a complicated surgery and recovery with him needing me. Plus I worry about the effect TRAM will have on my ability to move him and help lift him in the future. I am getting ready to make an appointment with my PS to tell him I want implants with fat grafting to hopefully help prevent capsular contracture. I only had a umx but have discussed a prophylactic mx on the right with TE placed at the time of my reconstruction. Do you know how long typically the TE would need to stay in prior to exchange on a non radiated side?
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molly - I did not have rads but have skin issues stemming from necrosis after my original surgery that mimic the same things that happen with rads skin. I lost my left expander after several surgeries to try to save it due to this so that I could proceed to chemo without further delay, and afterward had it replaced and filled and exchanged successfully without incident, but we went very slowly. I had a repair surgery a couple of years later and again had skin issues that ultimately resulted in the loss of the left implant, again after several surgeries. I did have two fat grafts, six months apart, to the flat side in prep for a new TE, which I have now - fully filled and waiting to exchange in May. The fat grafting done for those who have had rads is less for capsular contracture and more to help with skin integrity - the issue with radiated skin is that it has more trouble stretching. If you decide to go with expander/implant I would counsel you to do the FG and then proceed very slowly while expanding. How long you would have the TE would be dependent on how large you want to go, or can go, and how well your skin tolerates the stretch. Most PS leave the fully filled in place for a minimum of a month - up to three months, sometimes more. How long your TE stays in on the non-rads side would be more dependent on how long the rads side takes to fill and rest prior to exchange. Just remember that placing an expander on the side that has already had MX will potentially be less painful than the non-rads side that will have MX plus TE. Also, most PS won't initiate expander recon for someone who has had rads for at least six months, often a year or longer.
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Hi Molly,
I had a UMX with radiation. I only wanted to do an exchange because I have kids and couldn't imagine being out of commission for a long time.
I did wait a long time (2 years) before my exchange- most because a) I wanted to let my skin heal b) it was hard to find a good time with my young kids. c)probably was avoiding it! I finally had my exchange a year ago with a lift on my good side. Fortunately, I did not have any complications with the radiated skin. It's not beautiful- and I won't get nipple reconstruction or mess with it anymore because I know it's not normal skin. But it serves the purpose of looking good/ fairly even in clothes with a bra.
It's been great being on the squishy side! I can wear bras and bathing suits again well that I wore pre-BC.
Best of luck to you.
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Felt like I needed to post this and MAYBE someone will benefit from it. I am 6 months post exchange this week! Woohoo for the most part. Debating some minor FG still but my big issue now is shoulder pain and lack of mobility. It has been going on for months and I kept thinking it would "go away" with time. It is my left shoulder. I saw my PS this week and he said get this fixed now. Or else they will have to do it surgically. So I am in PT and the therapist said I should have been here at the 3 month post exchange point. Again, I just kept thinking time would heal. So if anyone is having rang of motion issues still, or pain or anything above the ordinary healing ASK your doctors! I am mad at myself for not listening to my body but it was the holidays and I was happy to have a doctor free spell for awhile. But now I am paying for it. The therapist said I am functioning at about 40% on my left shoulder. I can't use it much without pain. My posture is affected as well. I know physical therapy after our surgeries is a debatable topic and maybe most ladies don't need it but for me, I needed it and just hope I can recover and gain all that mobility and strength back!
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SpecialK, I am sorry you have had so many problems with your skin! You must have the patience of a saint to go through all of that. I already have the TE in place on my mx side. I finished radiation 3 months ago and have to wait at least 3 more months for recon. I have read that some women get FG to help prevent capsular contracture. My TE is not really uncomfortable and my skin doesn't look/feel bad at all. There definitely was shrinkage after rads. I massage it twice per day in hopes of helping break up any potential fibrosis. I need to have an MRI around December and both sides would need to be done by then.
momwriter, thank you so much for sharing. I don't care too much how it looks without clothes on just how it with them on! I will probably opt to go smaller than I was. I was a good size C cup and am okay going down to a B. I don't want to stretch my skin too much. Does your PS have you massage the implants?
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molly - thanks, it has been a long haul recon-wise, but most of these issues didn't happen all at once - it has been stretched (no pun intended, lol!) out over a span of time. It has now been so long since my BMX I almost don't even connect the recon problems to the cancer anymore. I am not sure how much fat grafted to the area can cut down on scarring - which is what CC is. You might discuss taking Singulair, an asthma med, as it is thought to potentially be preventative for CC. Was your TE maximally filled prior to rads? Would the need be to have the right side MX and fill to match the left, and then exchange, prior to Dec and the MRI? When I originally had the left TE put back in 2011, it took about six months to go from zero fill at surgery, some healing time prior to fills, and then to 550ccs - it was put in mid-July and exchanged in Feb of the following year. I did weekly small (25cc fills) so as not to stress the skin, and my PS only needed to wait a month prior to exchange because we had gone so slowly.
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LKscolo, You should ask your doctor and PT about myofacial release. I went to OT about 6 weeks after my BMX but then continued with a PT for myofaical release the whole time I had my TE's. I am now 8 weeks since my exchange and I go to the PS tomorrow for my second post op. I have very nice range of motion (and am back to swimming laps) BUT I am hopefully going back for some more sessions of the myofacial release therapy. If you do go for myofacial release make sure it is with someone who specifically works with mastectomy patients. I found it to be so beneficial.
good luck I hope you find something that helps you
Phyllis
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lkscolo. . .I postponed PT until after EX because insurance only pays for 25 visits per year. I am 8 Mos post EX and have been in PT since last August. I'm a work in progress and still do not have full ROM. I am slowly getting there and am dealing with continued nerve pain. It too is slowly getting better.
Scottie
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lkscolo - I had an apt with the Gyn just prior to exchange - happened to be a new nurse practitioner that I had not seen before. Turns out she had a BMX and implants, and she insisted that I see a PT for ROM work after exchange. I had already been seen for LE between my BMX and exchange, so that is who I went back to, and it was an excellent decision - I highly recommend it.
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I had a double masectomy Oct 20 followed by 4 rounds of chemo (no radiation). I am scheduled for my exchange on 4/27. I guess I am excited but not really sure what to expect. I look at myself and feel like my body has been taken over by aliens (no hair, no eye lashes, rock hard boobs with giant scars). I guess I don't think this is going to make me feel 'normal' again but I hope it is a step. My expanders have been tolerable. I never forget they are there (i.e., can constantly feel heaviness and mild discomfort). But I guess I feel like this is normal and maybe hoping it will go away after the exchange....but I don't know. Fingers crossed. Taking 3 days off work with a long weekend. I work from home and have a desk job so I am hoping that is enough. I was told it would be easier than the double masectomy but certainly would like to hear others experiences. Thanks! Virtual hugs!
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Hi SpecialK, Yes my TE was filled to the max prior to radiation. I had 120 on the table, then 180, and another 120. If I do the other side I would hope I would tolerate quick fills like before but with no pressure of having radiation scheduled I could take my time. Exchange would need to happen prior to having an MRI in December. Due to my genetic mutation I am on twice per year monitoring of mammogram and then MRI. This would cut me back to once per year MRI.
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proctor 1725, I am just one step ahead of you. I had my BMX in September followed by 4 rounds of TC no rads. I had my EX just 8 weeks ago. I took three weeks off, although i was feeling pretty good after 2 so I did work form home. The pain very much depends on how extensive the pocket work is. I had pretty extensive so the pain did linger in certain spots but I can honestly say I don't feel any pain. I do still have slight tightness right near my underarms when when my pectoral muscles contract. (i.e. trying to open a jar, washing down a counter, folding laundry etc)
Good luck with your exchange. Phyllis
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One week post exchange. PS unwrapped me today and said it is looking very good. Removed drains. Have to go back to see him next week and then 4 weeks. Everything feels comfortable.
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I saw my PS today - 2 weeks post surgery. He removed the surgical tape and said everything look good. My mastectomy side seems to be a big higher. He said that it may settle down lower - I had a lot of scar tissue due to radiation. If it doesn't he said he can go back in and correct. Ugh. I don't want to do that. But I think I just have to wait and see. He told me we were looking for "sisters not twins". I get that. I just want to look normal in clothes. My other side got a lift and a small saline implant to give me same shape. I have to massage both sides 1x a day and that may help things "settle".
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LKscolo: I went to PT after my exchange. I had lot quite a bit of ROM, but they got me back in shape in about 4 weeks. Maybe my ROM would have come back on it's own but this did force me to work on it. And the deep tissue massage they gave felt wonderful. I'm now back to my pre-surgery swimming (3.5 months post exchange)
Proctor: I took 3 weeks off after exchange, but part of it was because it was leading up to the Christmas holidays. I have a ton of sick leave built up at work. I think I'd have wanted to be off at least a week, however, and I have a desk job.
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thanks for the response. Glad you are doing better!
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I had my exchange surgery yesterday. I have 700 cc inpmants. I was a B before but wanted to be a bit bigger. She said this eould give me a full c. Woke up from surgery in quite a bit of pain. I think what hurts the worst is my entire stomach and sides from the fat grafting... I didn't have drains this time, but I do have to wear compression around my foobs and belly for 2 weeks. Just been keeping the pain meds on top of the pain and sleeping alot. I hope to be able to at least return to work from home either tomorrow or next week. Here's to healing up nicely and no intentions!
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Nebraska, oh honey, don't go back to work even from home that soon. Give yourself time and rest. Remember, "just because you can doesn't mean you should ". If you don't have drains the amount of movement can make fluid build up. Please take it easy. 😉
Robin
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Nebraska, I wholeheartedly agree with Robin. I took 2 weeks off after both my exchange and after my fat graft. I am a nurse that works long shifts and on my feet constantly. It's worth taking the time to heal properly to avoid complications down the road. I also feel that I also needed the mental and emotional break to rest and recharge. Congrats on getting rid of those tissue expanders. Mine were totally impossible to sleep with...horrible. 8 months of torture, but that's behind me. Take care.
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I had my pre-op appointment with PS on Monday and I'm scheduled to remove the rocks for squishy implants on Apr 7th. I'm right behind you Nebraska and right before you Proctor
I plan on taking about 11 days off work including the weekends. Hope that will be enough. I said I felt a little like I was buying a set of tires when she told me I would be getting 550cc smooth high profile gel implants
I was a DD before and she said this would make me a full C. She didn't overfill my expanders because I was having a lot of pain with fills. I'm just nervous that the implants won't fill out all my skin because I still have saggy skin at the bottom right now with my TE's. Totally ready to get this over with. She seemed to think the recovery would be fairly easy without a lot of pain. As I have read through this thread it seems a lot have had significant pain with exchange surgery. My PS said I wouldn't need drains either.
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what about showering after the exchange. How many days were recommended before doing it and then just put the compression stuff back on after?
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When you should shower should have been included in your post-op instructions - every doc is different. I was instructed to put the compression garment for the donor area back on immediately after the shower. My solution was some pretty long showers, lol! How long and how often to wear compression also varies by doctor - I have had fat grafting several times, with two different PS. The first one had me wear compression 24/7 (except for showering) for 8 weeks, with no gym - only walking. The second PS had compression 24/7 for two weeks, then whatever I wanted. While I hated wearing it for 8 weeks I will do it again, even though it is longer than PS#2 instructs, when I have surgery in May. She will need to harvest a significant amount of fat and I want a good result at the donor site. I have never been instructed to compress at the graft site, quite the opposite, as you don't want to inhibit the angiogenesis. I have not worn any type of compression bra or ace bandage in any surgery I have had - BMX, exchange, or FG.
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Nebraska--Every doctor gives different instructions so ask yours for his! My PS told me to keep the incisions dry for 1 week when I was scheduled for a post-op appointment. I was not tightly wrapped after the exchange--just had lightly taped gauze over the incisions and I did NOT have drains or fat grafting. This is what I did: I have a handheld shower head in my shower. I wrapped myself in Press & Seal like it was tube top and got into the shower but removed the handheld shower head from the mount. I wet my body with water trying as best as possible to avoid my chest; turning the water off to lather up so as to avoid getting water where it did not belong, and then rinsed off. The gauze remained completely dry but my advice would be to replace it with dry gauze should it get wet. I washed my hair separately in the kitchen sink to keep water away from my chest. It was a process but it felt so good to get a shower every day! Just the shower process was exhausting and enough reason to take the first week off from work!
Good luck and let us know how it goes for you!
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the post op sheet says two days.. I just am always curious as to what other doctors have to say as well. I don't go into my follow up until the 2 week mark. Until then I leave the garments on 24/7 for two weeks. I think everything would be a other more tolerable if it wasn't for the fat grafting. Never imagined it being so painful! And I can't decide whether to go buy a pair of compression spanx or something to switch into.
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Nebraska. . .I could shower after two days from both BMx (even with drain) and EX. My PS used internal stitches and surgical glue. Every PS is different. I had some lipo on each side of foobs with EX, but no fat grafting and no compression required.
Scottie
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Can I ask all you post exchange gals - is your breast really "squishy" ...mine is not. I expected it to be more soft and it still feels hard to me. My PS has me massaging the bottom of it daily. And it isn't as hard as my TE but I just expected it to me more soft and more real life feeling...if that makes sense.
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Suzanne, mine is more squishy than the TE, but I too thought it would be more so. I am only 4 months out from exchange, so wonder if it takes time to relax and soften?
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