Exchange City
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jxmom. . .a good PS can even up and respace during exchange. My new PS did a great job of giving me near twins during revision EX for CC. The girls have settled in nicely since my March revision. Good luck.
Scottie
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I need your experience...
I went to my PS yesterday, my cancer side implant has some rippling, most noticeable when I move. I only had exchange surgery June 6 of this year, so things may still settle. The cancer side also is a bit flatter and wider than the non-cancer side. Has anyone had success with fat grafting for ripples or helping both sides look a bit more the same?
He said he could go back in and work on the pocket a little bit and maybe add Alloderm, I would like to avoid another surgery if possible.
It is not terrible but would love to hear your experience...
Thank you!
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Exchange surgery question for BMX folks.
Do we go back to limited mobility like after BMX? Or not that bad? I realize it's less surgery but wondering how limited I'll be. I know they'll ask not to raise arms over shoulder height and lifting again -- but hoping I don't have to go back to square one with exercise and all that crapola. I guess the major stuff was already done at BMX.
Will be nice to unload the TE bricks though.
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farmdream- I had fat grafting with my exchange surgery. It did (only 3 weeks out) definitely fill in the pretty large crater above my boob, but my nipple spot is pretty smoothed out. I guess the volume/projection is fairly similar but you can tell there is one flat and one regular side. I am toying with the idea of getting somewhat serious with the nipple prosthesis mentioned in the nipple thread, if nothing more than to keep necklines from going lopsided. I haven't researched it yet but there is a section that tells about how to apply for insurance coverage. Now who would ever thought we'd be thinking of this?'?
https://feelingwholeagain.com/patients
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Bevmomduck - thank you for sharing your experience. I am only a bit more than a month out with my exchange and won't do anything right away but trying to learn what has helped others. Thank you for the link as well.
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I haven't been on the board in awhile- had my exchange surgery yesterday afternoon. I now have Natrelle Inspira SCF's of 695 cc in each breast. PS also reconstructed nipples with skin from my hips. Sleep was relatively elusive last night. Kept waking up every hour or so. I'm looking forward to the day I can return to bed and side sleeping. Surgery went well but I was sad to learn I'd be wearing 2 drains!!!!Ugh. I'm hoping to get them out during first post-op appointment next Friday. Which reminds me I need to get baby wipes or something to clean up since I'm unable to shower until they're out.
Sorry I've been missing out on this conversation!
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Pepper43, I had drains after my exchange, too. At least they didn't stay in as long as after the mastectomy but they're still a nuisance. I used those "body wipes" which are bigger than the baby wipes and seemed to work better. My drain was in for about a week so I was able to shower once the original bandage cam off.
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Question for anyone who has or had TE: Should both sides look the same? I had a nipple sparing BMX about 6 weeks ago. One of mine is nicely rounded (for lack of a better description) and the other sort of looks pointier? That's the affected side where I had my original lumpectomy so the scar is a large c right underneath the nipple. The lump was at 6:00. The scar on the prophylactic side, although the same size, is a little bit lower, so not causing the center to look so pointy. I guess my other question is whether this will likely be the same look once the exchange is made? Or will the PS remove the old scar and make a new incision in the same area? I meet with my PS in about 3 weeks and I will definitely ask, but just wanted to get some insight from all of you, the experts.
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I had to share, I got my call from my surgeon tonight and all my pathology was negative. And margins had no cancer cells!Yay
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2FUN--great news!!
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2FUN- Yay!!! I love good news.
I'm now 4 days out from exchange. I called the PS office today because my drains are driving me nuts and the fluid output is low. I wasn't scheduled to come in until Friday, but the nurse is going to see if she can squeeze me in tomorrow to get drains out. I'm not sure if she'll unwrap me...but I'm hoping. I went out to store today. Wore yoga pants and a long t-shirt to conceal my drains. I'm rocking a Madonna cone style look from Vogue thanks to the top hats on my reconstructed nipples. I can't wait to see what's lurking underneath the gauze.
They put me in a pink bra with hooks for drains that I've been told to keep on 24/7. I wish I had spoken with WhippetMom beforehand to get some insight on what implants would look best- with all the hullabaloo of the past year, reconstruction was last on my mind (they discovered kidney cancer during a post-diagnosis PET scan). Treatment kicked off with 20 weeks of chemo, followed by mastectomy with tissue expander placement, followed by removal of my right kidney, followed by 6 weeks of radiation, followed by prophylactic removal of ovaries (my cancer was ER+ and I befriended a lovely 80 year old during chemo whom had survived breast cancer while she was younger only to get stage IV ovarian cancer later) - after that I was clear for my squishies...and then had really bad GI issues that got my onco to refer me for a colonoscopy/endoscopy. It's been a looooong road to get here.
I don't even know what type of expanders I had placed after my mastectomy. All I know was that my PS was on a fast track to fill them before radiation began and when they were full, it was as if I had two basketballs strapped to my chest. I can't stop touching the sides and tops of my new squishies- they feel so soft. Not quite sure what projection is going to look like. I can tell already they're definitely not as WHOA NELLY Real Housewives level of foobs as the TEs were...and for that I'm glad (but hoping they won't look worlds smaller than Lucy & Ethel did back in all their D cup glory before cancer rode in).
I've been scrolling this thread during my sleepless nights before and after my exchange. My one big worry is I can see by peeking under the bra that there's still a fold of skin underneath my left boob (it was there while TE was in and PS assured me he could fix it). Hmm. I'm guessing I'm headed for at least one revision.
Cheers to great squishies for all!
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Hi ladies, its been a while since I have posted, I see some new gals on the thread. I hope all are doing well!! I am back on to get some thoughts on my latest dilemma. A while back, I had posted about how my smooth round Inspira UHP had flipped over backwards, flat side in front. The next night it flipped back on its own while I was sleeping. My PS told me to wear a bra to bed and no side sleeping for a few weeks. I followed his advice, and all was going well. I saw him a week ago and told him I am starting to get more comfortable with my (pre-pec) implants. We agreed I need some FG to address rippling and fill the upper pole so it is more gradual, and he cleared me for tattoos. A couple days later, I woke up at midnight this past Monday after falling asleep on the couch only to discover the OTHER side flipped over backwards!! I took pictures and emailed my PS on the spot. He replied at 5:30 A.M. asking me to come in later that day. After examining me, he said I have to have surgery to tighten the pocket. I had a 50lb weight loss several years ago (gained while taking Lyrica) and as a result now at my ideal weight (+10 lb) my skin is "loose". SOOO....He told me I could go bigger to fill the pocket. I immediatley shook my head no. I am already a full 36 D. If anything, I want to go smaller, they are heavy! He thinks it would be best to replace the smooth rounds, which are slippery, with Natrelle textured teardrop shaped only slightly smaller than my current implants. He said the texture almost acts like Velcro and my tissue would hold on to it better. Of course he would also tighten the pockets as they have to be super tight so the teardrops don't rotate. We talked about the Lymphoma risk associated with textured implants, and he assured me that only one brand (not Allergan Natrelles) had the incidents. I have tried to fact check that online, but to no avail.
I told him if I had my way, I would not have implants at all, but replace them with my own tissue. While I love the way the implants LOOK, he did a fabulous job, I don't love how they feel comfort wise. I am not a candidate for any abdominal flap as I have already had a tummy tuck. He does not do the only other option for me, the SGAP (love handle area), but referred me to Johns Hopkins as they do it there. Hopkins is 80 miles away, ugh. I called for a consult, they don't take my insurance. I was able to switch my insurance, but after giving it a lot of thought I started wavering to NOT have the consult and just let my PS put in the textured. implants. As I said, they look great! What will a flap look like? But now I am wavering again. I KNOW the SGAP is a very involved procedure, very complex 4-6 hour surgery per breast (they will most likely have 2 doctors, 1 on each side) and a lot of down time, a 3-4 night hospital stay, multiple scars, drains etc and that 160 mile round trip for follow ups. But I am just not comfortable with implants and my PS said if he does the swap, it is also a very major revision. And he told me the SGAP would also give me a bit of a butt lift which I desperately need! My main hesitation with the SGAP is I don't have much tissue in the love handle area either. The results will likely be a lot smaller than I have now, maybe he can lipofill too, I don't know. So I am struggling here. My new insurance that Hopkins accepts will be effective Aug 4. I probably should go get the consult. If I don't, and just go with the implant swap, I will always wonder "what if". Oh also, my PS said even after the swap there is no guarantee they won't flip or rotate, but are not likely to. He assured me he wouldn't be offended in the least if I chose to go with the flap. Sorry this was so long. It has helped though getting it off my chest (ha ha) has made me see I need to fully explore all options. And I was also toying with the idea of another consult anyway for nipple recon as my PS doesn't do them. Surely the doctors at Hopkins do them. So, I am nowhere near done, its a little discouraging
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Oh Shoregirl, that is a dilemma. I'm not sure what I'd do - I've had enough of being cut into this past year. Keep us posted. Are you for sure going to do consult?
I'm 5 days out from exchange. Drains got pulled today (yay!!!!) but reveal on fipples will have to wait until this coming Monday. I put pics up on pics site. I'm loving the softness of the implants. I have Inspira's in as well- mine are SCF. I hope they don't flip!
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The Natrelle 410's (teardrops) are exactly the implants that are having the problem. It is prevalent in textured implants that use Biocell technology. I have 410's...for a few more weeks.
That being said, my new PS got me up to speed on the whole ALCL mess. She just went to a seminar about it and every case had these two findings: 1. A colonization around the implant of a specific bacteria that is found in drain pipes and other common surfaces. The bacteria is easily killed with betadine, by the way. 2. People with ALCL and implants all have a specific gene mutation. I'm sorry I don't remember the specifics, but she said it is a rare occurance.
My PS, who had stopped placing textured implants, now has begun again as she flushes the pocket with betadine before placing any implant. It is her opinion that even if someone has the mutation, her meticulous care negates the risk.
Good luck with your decision, Shoregirl.
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Shoregirl - It sounds like a second opinion at Hopkins will help you make the best decision for you. Just curious: you seem to really like the size & look of your existing implants. If you decide to stick with implants, why not keep the ones you've got & just have the pockets revised & tightened? It would be a fairly easy surgery (I think) & you wouldn't have the concerns re the textured implants & slightly smaller size. Just another option to consider.
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shoregirl, I have Narelle 410 2 1/2 years out. I love them. I haven't heard the Lymphoma deal?? Mine are Under muscle and I don't have any rotation although I know that is a possibility. But, if you follow post op instructions to the T you will have great results. I was bound for a week then wore a sports bra 24/7 for at least 6 weeks. No side sleeping for a while.
Get your PS opinion and go from there. Best wishes, Robin
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shoregirl I agree with getting a second opinion! Coming from someone who isn't happy with the implants (size/shape) I wouldn't have them removed to run the risk of getting something with less projection...especially because it seems that is the biggest argument of the ladies. I think Mrs Bs advice of possibly keeping your implants and just tightening the pocket. Go to Hopkins and ask the big dog the questions cover all of your bases.
Hugs to you Michelle
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Pepper45, hooray for drains out!!! Yes, squishies feel so much better and they will feel even softer after a couple months as your swelling subsides. The more I think about it, I am now certain I will go through with 2nd opinion at JHU. But I feel like you, enough surgery already! But I don't want to just live with it so I wilI just keep trekking on. I don't specifically think they flipped bc they are Inspiras (I have the SCX 470cc), but bc my pocket is too big. It would probably be ok if my doc just went back in and tightened down my pocket and kept these implants. But honestly, I just don't like the feel of them. When I do certain things like shut a window in my house, or put the liftgate in my SUV down, it hurts, like a pulling, squeezing pain. And laying down is not super comfortable. I wake in the night to change position and there is a tightness and heaviness that aches. I am what is known as "hyper aware" of my implants, probably due to thinness of my skin. I asked if FG would help cushion them, he said yes but not likely to the extent I would like. The FG is more for aesthetic reasons than comfort.
CarlaEM, my PS said he is on some board of a 7 surgeon panel reviewing the ALCL. But I thought he said Mentor was the brand associated with all the cases, maybe I am wrong. I should have taken notes. But what bothers me is, before I got ANY implants, still in TE phase he was going to use textured anatomicals. About a month after my BMX, he told me about the ALCL risk and told me they were moving away from the anatomicals and would instead use the smooth round Inspiras. I was happy he was on top of things. I guess now he is ok with the anatomical bc he found out the brand they use in his practice is not the brand with the problem. But its a little unsettling nontheless. I would even hesitate with the Betadine rinse knowing there is a risk. So you are having yours swapped in a few weeks, is that correct? If so, good luck with your exchange! Won't it be so nice to be done done???
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Good to hear from you and thanks for the good wishes, Shoregirl. Yes, I am going from 410's to Inspira SCX in a few weeks. Maybe we should just switch our implants! Ha!
I am also going from sub to prepectoral implants and will have fat grafting. I am nervous about it and sooooo hope that I will indeed be DONE done!
If you do some searches on "ALCL and Biocell" you can find info. I was so shocked when I looked up 410's and saw they use Biocell technology. My left capsule will be completely removed during the revision and the right one mostly removed. I'm hoping it's enough. I know the risk of ALCL is miniscule but I also have another disease that only 300 others in the US have so I am aware that lightning can strike twice. Sigh. I should probably buy lottery tickets!
Keep us posted on your progress!
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Like Robin, I have Allergan 410's. I'm 6 years out and have always been very pleased. My doc was the head of PS at a major hospital and had done a bunch of reconstructions with these. I do understand there is now a risk with textured implants, but I too followed the PS instructions exactly and have never had any problems. Used to be that they thought implants would have to be exchanged in 10 years. Now I understand they can stay in considerably longer.
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Shoregirl, did you ever have any physical therapy for the tightness and uncomfortable feeling you're getting? My nurse practitioner gaveme a prescription for PT and it really helped loosen up my chest area.
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Thanks MrsB, ImKopy, Robin, MinusTwo & Leslie for your input! I AM considering just some major pocket work and keep my implants along with fat grafting, but will get that 2nd opinion as well.
Leslie, I have not had PT. My ps gave me a script for it, but I didn't feel I needed it as I have great range of motion. I will ask for another script and give that a shot as well.
Robin, I remember you have the 410s and are very happy with them. I was disappointed when my ps informed me they wouldn't be using them before I got my exchange. Honestly, he emphasized the lymphoma risk is VERY small, I think he said 1 in 50,000 and it is very treatable if caught early. I am not ruling out that option either. That is why it is best for me to have the 2nd opinion consult. There are so many options to consider.
Carla, I asked my ps if being sub pec would be more comfortable and he was emphatic that pre pec is much more comfortable and way less pain in recovery. I hope you get your fat grafting during the swap. I wish he had done my fg during the swap, not sure why he didn't. With pre pec, only our skin and maybe some alloderm covers the implant. FG seems like a no brainer for pre pec.
MinusTwo, I am so glad you are happy with your 410s even 6 years out, that is FANTASTIC!! My ps did tell me the old thought that implants are only good for 10 yrs is false. They can last much longer with good care, maybe a lifetime! He told me to do a vigorous squeeze from the bottom forcing the implant up 5 times each side every day for life and that would greatly reduce the chance of capsular contracture. I don't know if you can do that with the shaped implants.
Pepper, thank you for the info on the picture thread. I hope you are recovering nicely and get wonderful results!
I really dislike having to make all these heavy decisions again, but it helps a lot hearing from you ladies, I really appreciate each and every one of your comments and suggestions!!
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Shoregirl, If you don't mind sharing, what size implants do you have/anticipate getting? I am currently sporting 595 cc but the PS is planning to go into the 600's with the new ones. I am quite tall, so I can handle it, but I worry about my 54 year old thin skin.
I will be having grafting done during the revision. She estimates 100 cc's per side.
As far as restrictions go, I will be in a Tegaderm bra plus a surgical bra for a week. The Teg will come off then, although I can shower on Day 2. I will have drains and a crotchless compression garment on over the donor sites. I am to restrict a lot of activities until the drains come out but then a fairly rapid return to activities is anticipated.
C
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Shoregirl, NO PUSHING on anatomicals! That is where they are very different. The rough texture adheres to your skin and muscle to prevent rotation. That is why I think under muscle is very important for them. That makes a very nice pocket for them to live in. They are more static than smooth ones too.
Can't wait to hear about the second opinion results. Have a great weekend.
Robin
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Shoregirl, I'm glad you are getting a 2nd opinion so you'll be fully informed on all the options to consider. The ladies here provide great info. & are so supportive & helpfu as well. Wishing you all the best & I know you'll make the right decision for you!
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Thanks MrsB, I am so grateful for you ladies!! Such a blessing. I would feel so alone without you!!! I am anxious to get the consult. I called John's Hopkins today to give the new insurance ID# they need to schedule my appointment. Unfortunately they still can't schedule till August 4. I have to call back on the 4th to make the appointment.The receptionist said I could get in within a week though, so I just need to tough it out. It's getting hard, more uncomfortable. When I lay down the implant sticks out like a flying saucer up on it's edge straight out the front of my chest. Really pulling on the incision. I tried to grab it and flip it back but not working. I will just try to stabilize it with a tighter bra to sleep.
Robin, good to know on the no pushing! I wonder be if being under the muscle reduces CC chances...
Carla, my implants are 470cc, which gives me the same full 36-38D I was pre mx. I am 5'71/2" and 145lb for the record. The implants are the ultra high projection so they are a bit narrower, no "side boob". The PS had planned to fill me to 525 but had to stop bc of my 53 yr old thin skin. It was getting all shiny. I can't imagine how big I would have been had they put 500s in, maybe a double D. How tall are you? I will say that I would have some reservations about a bigger implant with pre pec if you have a slim-ish build. The 470s are heavy, pull on my skin. When I lay on my side they fall together and it's not comfortable. If I end up keeping implants I will probably have him go smaller, in the upper 300- low 400 range and he will have to do a ton of pocket work. Have you held the various sizes in your hand? Even the 300cc feels heavy in my hand. I meant to ask you what you meant by "removing the capsule?"
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Shoregirl, thanks so much for all of the info. I really appreciate it. I'm sorry you are having such a time with your implants! It must be so uncomfortable physically and emotionally.
Yes, I am thin. I weigh 135-140 most of the time. My BMI is 19.2. I worry about the skin for sure. Shoregirl, do you know if you have any Alloderm or Strattice or other "support materials" in your skin envelopes? I have a thick ridge of Alloderm along the IMF and up the sides and Strattice covering the tops of my current implants. It supposedly is an internal bra. If you have neither of those, that could really be the problem for you as our thin skin can't do it all by itself.
As far as "removing the capsule" goes, my PS will remove the entire scar capsule around the left implant because of capsular contracture. She will remove most of the right one as tissue supposedly adheres better to fresh tissue rather than scar.
Have you seen any prepec photos? I saw three different ones in my PS's office, allof which were revisions from sub pec. They were beautiful, and one was from a patient very much like me--410's to SCX.
Keep me posted!
C
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Shoregirl:: wish I had words of wisdom, I'm having my exchange next week. Looking forward to hearing how your JH consult goes...giving love & support!
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Carla, you are most welcome, anything I can do to help!! Thank you for your support. Yes, I do have Alloderm, I did not see pictures of pre pec, but my PS told me beforehand that is what he wanted to do if he could, which he wouldn't know for sure until the mastectomies were done. He said much easier recovery, less pain, less capsular contraction and no distortion with muscle flexion. And Alloderm was standard with pre pec. Again, my results are beautiful. That is one reason I am so discouraged. If I go with a flap, I have seen pictures of that and they look like patchwork, with the football shaped graft. I wonder if the ps can just graft the tissue and fat, but leave my breast skin intact. And I wonder if a much smaller implant would be less annoying to me. I have no problem going to a B cup. I actually had a breast reduction from a Double D to a B back in 1993. I LOVED IT!! No more gapping button shirts, I could wear any top I wanted. But I had dieted down to an unrealistic weight for me to maintain, 128. The doctor back then never told me that weight gain would cause the boobs to grow back!! That 2nd opinion consult can't get here soon enough! I will keep you posted, you too!!
PUGS!! Wow, next week...the countdown begins! Thank you for your support as well! Stay positive, don't let my setback worry you. Even though its discouraging, after all we have been through we can certainly get through revisions if needed. I think I would have been better equipped to handle my necessary revision emotionally had I gone into my reconstruction not with the thought that I was nearly done, but with the thought that some more tweaking will be likely. You will do great!! One thing is for sure, these implants are way better than TEs!!
I am wishing you ladies with your upcoming exchanges Pugs, Carla, Anniealso...much love and positive thoughts. And those in recovery that I know of, Farmdream, Mominator, Bevmom, Pepper; hugs and best wishes for smooth sailing and speedy recoveries!!
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so I am 2 and a half weeks post pre pec exchange, and I'm getting some good sharp pain from my pec major and minor tendon. When I had my TE I had no pain or discomfort at all. I have had no pain at all up to this point. Anyone willing to share experiences?
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