Exchange City
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Had my exchange and reduction/lift yesterday. The exchange side is totally pain-free. Reduction is sore. No real pain tho. Today had my follow-up with plastic surgeon and the 'unveiling'. Boy, was I ever pleasantly surprised! Of course, swollen, but symmetric and lifted. The scars will fade, but I am very happy with result!
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hi all - I had my initial mast direct to implant Jan 2017 and have had issues with the tear shape implant flipping around. Having an implant exchange/fat grafting in January and wondering what you all had as far as recovery. Could you drive/how did you feel/etc after the surgery? Any advice/experiences would be appreciated!! TI
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DCISinAZ, sorry to hear of your complication. I am on my 3rd set of implants since April 2017 for various complications. Although I have smooth round not the tear shape, my 1st set were flipping over backwards, flat side facing front. The exchange each time has been much less painful and restrictive than msx recovery. I was driving in 3 days, even with a drain. Weight restrictions were no more than a gallon of milk..no pushing and pulling, no overhead movements. Of course you need to ask your surgeon for his/her specific instructions according to your case. Now if you have fg at the time of exchange you may not be up to driving as quickly as I was. The donor sites will likely be very sore! Like you worked out way too hard. That can last a couple weeks but gets better each day. Compression garments to the donor sites ONLY are your friend! Feel free to PM me if you like.
Best wishes to you in your upcoming procedure!
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As I prepare for my 2nd exchange on Monday, I have been gathering my important documents and reminders from last surgeries and other items...found this in the pile of items, written a year ago thanksgiving when I was still deep into the throes of the incorrect surgery that took place:
thanksgiving thankfulness:
I am thankful I can email Whippetmom (Breast Implant Sizing thread) and she always finds time to email me back.
I am thankful I am not diseased anymore.
I am thankful I only have to look at my potentially failed reconstruction once a day - when getting out of the shower.
I am thankful my rcn is man made and has nothing to do with the nice beautiful person I am.
I am thankful my physical activity, mind and ability has not been affected by any of this.
I am thankful I am a stronger person from this.
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Healing and Pain Questions
Thanks to everyone for sharing their journeys. My exchange surgery will be January 2, which is in 19 days. Advice?
I am staying small, because right side had radiation in 2003 and has struggled to stretch much. I will have Not Huge silicone implants, and they will be below the pecs (skin too thin for pre-pec). I'm meeting with PS on 12/17 for my pre-surgery consult.
PS has said that he won't prescribe narcotics/pain meds. I needed them for 8-10 days after BMX. I don't want to experience pain! Maybe since there's less internal work this time, pain is much less, recovering after this surgery?
He's going to remove the TE's and detach their tabs that are sewn into me, and "swap" the TE's for implants, which he'll set into the Alloderm "pockets" attached to my pecs. Perhaps a bit more cleaning-up work for shape. I notice that the TE's have created a goodly amount of Side Boob, and perhaps he can pull things into a better Foob shape, so maybe there will be a bit more work than merely the swap. I'll ask him about that on 12/17.
Can anyone share how much pain you had, and for how long? When were you independent, taking care of yourself; within how many days? My husband plans to be with me for 5 days to help, and then go back to work. The BMX was so traumatic, but I'm hopeful that this will be easier.
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HikingLady, I am quite shocked your ps won't prescribe pain meds!! It's SURGERY after all!!! We can't forecast the outcome and what level of pain you will have, and you may be fine with Tylenol but its best to be prepared. For my recent 3rd set of implants, I did have to rely on percocet for a week. Just one side was painful, the side he added alloderm and a drain to which also required deep internal sutures. But I was off pain meds in 3 days the other 2 times. I would sure be pressing him on that when you see him next. Who wants to be in pain?
All that being said, I was never dependent on anyone in caring for myself after any of the exchanges. The msx...yes. I remember 3 days after my 1st exchange going to see Ringling Brothers final performance an hour and half from home. 3 days after 2nd exchange going Christmas shopping at the mall. 3 days after this last exchange I drove my self an hour to my post-op appt. I realize everyone is different but I believe if you read through some of this thread you will see for the most part we recover pretty quickly after exchange. The main thing is to follow your surgeons orders, and don't do too much too soon just because you feel good. There is still lots of healing going on and lifting restrictions. I do have to remind myself sometimes to take it easy. I am 10 days post op today and I had to get on my hands and knees outside and dig a 1' deep hole to rescue my chihuahua/jack russel mix that got himself trapped beneath our deck!! I just took it slow and took breaks.
Best wishes!!
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That no narcotic plan really stinks! I'm not sure I'd let a doc touch me if I was told that! What would 20 tabs of Norco mean in the big scheme of things even if you were an addict? Nope...not a fan of that plan!
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Shoregirl Thanks for all this insight and for sharing your experience. I have a friend who's an MD, and she said the same thing: ASK FOR PAIN MEDS. I think drs are so restricted about opioids now that they fear prescribing them. I have zero worries that I'll get addicted, for a million reasons, so I'm going to really advocate for a few days of pain meds, just in case. I'll peruse the stories on this thread. Glad to know that the exchange is a simpler surgery; that's what my PS has also said.
I wish you good healing, and I hope that this one is your final Re-Do on the implants!
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VegGal I agree! It's kind of sadistic to NOT give me narcotics. I have needed them for previous surgeries in my life, and each time happily tapered down after the first few days of extreme pain. Side effects are not fun, and I am always glad to not need those meds any more as I heal. I'll work on my self-advocacy language for the pre-surgery consult....
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Hi Hiking Lady.... I am nearing my first anniversary of my exchange which I had on 20th December.... and was I terrified! But it was a piece of cake next to the bmx. I remember waking up after the surgery and going "Hey that uncomfortable feeling of my Turtles has gone!"
I did take painkillers.... I chose Arcoxia (Eterocoxib 120mg) which is stronger than paracetamol It is in the COXIB class and I chose that rather thanand in a different class something like voltarol/diclofenac as the effect on the platelet function and hence on bruising and bleeding should be less .... I say I chose... hey I am a medic and felt totally entitled to render my post op as painfree and comfortable as possible!
I was independent very quickly post-op. I was home by 5pm. By the next day I was independently self-caring. (Apart from carrying of course), but still managed the cooking, shopping (local shop does deliveries) etc.
On the 23rd I walked to the village and took my DD aged 10 to the hairdresser, as well as did errands and walked home.... (Yes - walked as not driving) In the evening I went out to a Christmas concert by her school choir followed by drinks. And 24th... well the Christmas shopping wasn't ready. And Christmas Day was another long day.
So yes it's ok. I did have one localised spot of nagging pain in my chest wall that would come on after I had been sitting in the same position for a stretch of time. That persisted for a number of months, but eventually it went.
Good luck and take heart!
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Thanks for this positive message. It's very nice to look forward to an easier recovery this time, than after the BMX.
What country do you live in? I don't think that we have Arcoxia approved in the US.
Ha ha YES, the TE's do feel like turtles! Any new Foob will be an improvement for comfort!
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When I had my first exchange, I woke up in really bad pain on one side, as well as with an arm that wouldn't move below the elbow as they'd positioned me badly. My PS (now ex-PS) came around to write me my post op script, and I let him know that Norco works well for me. He was indignant, said all I needed was Tramadol, which makes me sick, and finally said Tylenol 3 would be sufficient. A couple of hours later, and still in pain, the ANESTHESIOLOGIST had had enough and went over the PS's head and got me the script for Norco before I headed home (a 2 hour drive). The PS wasn't happy as I left with not one, but two scripts for narcotics as they had been filled at the hospital pharmacy. Ha!
On my second exchange, the new and improved PS gave me scripts for Norco, Valium and ibuprofen 3 weeks before the surgery, so I would be prepared. Again at the fat grafting consult, she provided me with new scripts. I really appreciated that and yes, the side-effects of the meds are such that I never have a problem getting off of them. Who enjoys struggling on the toilet? No one!
Good luck!
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Yep, my ps have always provided my pain scripts along with antibiotics at my pre-op appt. And HikingLady, I just wanted to address what you said about the msx being so traumatic and your husband planning on being home with you for 5 days. Yes, the msx was traumatic. I think that is why everyone is so nervous going into the exchange. I know I personally was even MORE nervous for the exchange than for the msx!! The body remembers that trauma and I think those memories just take over even though we have been told exchange is easier. But rest assured, it really and truly is so much easier!! You get to go home the same day! My arthroscopic outpatient knee surgery hurt way worse than the exchange lol! You will be fine and probably amazed at how good you feel! It is so sweet of your husband to take that time off to help you. Enjoy some pampering and his company!!
Thanks for the well wishes, I am believing 3 times is a charm for me!! ~ Shoregirl
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Hi Hikinglady-
First of all, I don't think this surgery is going to be like anything remotely like your BMX. For my exchange surgery, my PS had me set up with the same meds that I took for BMX and even tried to slip me some percocet. Not sure why, because I didn't even take that for my original surgery, HA!!. But I had some different revisions than you are describing. I was prescribed Kephlex/valium, since I really can't take much else without being dizzy and really nauseous.
My surgeon puts in a nerve blocker that lasts 72 hours after surgery; this may be pretty standard.. I'm not sure. But I had very little discomfort post-op except a damn knot in my neck....probably due to positioning me during surgery and me stressing about it in the first place....OMG, We all know how you are feeling, no matter how many surgeries we have each had.... this is a scary feeling. But really this should be a cakewalk compared to BMX!!
I didn't need anything but Tylenol and I developed a hematoma. That is not going to happen to you BTW, that was a situation that was due to my lat-flap and different revisions on that side that you aren't going to have.... so don't even put that in your head!! I just mention the that because I had a hematoma with exchange surgery, which alone is said to be quite painful... and with exchange surgery it was far and away, so much easier than original BMX.
Keep us posted on your quest, with PS!!
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Hi HikingLady: Best of luck to you on January 2. My TE,s gave me a lot of side boob too, felt like something under my arms, especially hard to golf, couldn't swing my arms thru. My PS did a lot of stitching on the sides to hold the implants in away from the arms, that was the most painful part. I had to sleep on my back for a good 6 weeks, rolling over from side to side was difficult, seemed like it was pulling on those side stitches. My PS gave me 40 oxycodone for pain. The first 3-4 days I took 1-2 about every 4 hours, then switched to just 2 when I went to bed, but usually woke up about 3 AM and took 2 more. After 4 days switched to extra strength Tylenol in the daytime, but occasionally took 1 oxycodone in the afternoon to help me nap if I hadn't slept very well the night before. I was totally off the pain meds by 2 weeks. Hope everything goes well with good healing for you. Be sure and post your experience.
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Hi HikingLady
I just had my exchange surgery this Tues the 11th. I am still very sore and taking the hydrocodone, but I am taking ibuprofen 800 mg in between doses to stretch it out. He only gave me 18 tablets.
My implants are also under the muscle. I think the reason that I am so sore is that he went with implants that are 100 cc bigger than the expanders were filled with. Expanders were filled to 375 and the implants are 475 rounds. So on top of the normal surgery pain I have the same muscle pains that I would get after each fill, but worse (feels like someone beat me a couple times with a baseball bat to the chest). Every day it gets better though. Thank goodness.
I am not telling you this to scare you. Your chest muscles probably won't feel like mine do. Every fill killed me for a week afterwards. I am just relating my experience to encourage you to make a stink about the painkillers. It's cruel of him to tell you that you aren't entitled to appropriate pain management post surgery.
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Had my exchange today and am resting in a hotel overnight as my home is 1.5 hrs away and didn't want the bumpy ride and the 83 y.o. mother who now lives with us and would be having a cow over my condition and not let me rest!
I am good. They only used a high strength Tylenol during surgery (plus anesthesia of course) and I am just taking Tylenol now. I do have the hard stuff, but if I can do okay with Tylenol (which I did at MX and first exchange) so much the better.
I am supposed to see the PS in two weeks...but that is New Year's Eve, so don't see her until Jan 2, Yikes! I do have emergency contact and my PCP at home knows I may reach out to her...but have all good thoughts so far!
Only walked 7K, so far, but that seems okay given the procedure...walking up and down the hotel hallway, and was okay enough to go into supermarket with DH on way home from hospital so we could have some food supplies...the room has a living area with wet bar so I am good with the lite fare we were able to get.
Take care all, TT
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Congrats TrmTab...rest easy and keep us posted.
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TrmTab You sound like Super Woman---be sure to also rest a bit! Thanks for the positive attitude and for sharing all this.
I saw my PS today for my pre-op visit. Exchange surgery will be January 2. He is prescribing an antibiotic, and some Oxycodone to use for several days if needed (although I realize that pain will be much less than for BMX), and a stool softener for if I'm using the narcotics, and also an anti-nausea medication (Zofran) for post anesthesia. Sorry if this is TMI, but I usually vomit a lot after anesthesia, which is NOT FUN, so we have a plan for that issue this time. Another thing I know about my system is that the antibiotic will wreck my gut, so I'll also get myself started on a good probiotic when I start the antibiotic.
He is sending me out to buy a particular front-closing sports bra locally (with an Rx, so insurance will pay), which I'll use starting Day 2 after surgery. I'll have a post-op visit with him the next day after surgery, and he'll remove the Ace-type surgical wrap and I'll put on that bra, then I see him again two weeks later, and there will be a couple more follow-up visits after that at longer intervals.
TE's have been in me for 7 months, and I'm certainly looking forward to swapping for the implants.
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Doing well and while I was in bed from 9:30 until 7am, really only slept from 10-5...got up at 5 for bathroom and meds and then rested in bed until 7.
Taking another night at the hotel before returning home tomorrow...this was the plan. Feeling good, but going slow. Don't plan to leave hotel today, but do walk the hallway each hour for 5 minutes -- per Drs instruction to start walking day of surgery and that will be my main form of exercise, plus stationary bike, until released to arm exercises in 4 weeks.
All good otherwise, still just Tylenol, so I am very happy with that.
Even after five surgeries is always is a shock at the weight of a coffee pot or quart bottle of water that you don't think about...until you do.
My previous 2 big surgeries (MX and first exchange) I was wrapped in an ACE bandage, so saw the Dr the next morning to be unwrapped...this time I am in a post-op surgical bra with padding on the one side. Was told to leave it in place until tomorrow morning at which time I can remove and shower. Was surprised to wake up to find some blood spotting on the (thick) gauze pad, so took a picture of it so I could monitor. I did measure myself before exchange and now after with padding...only 1/2 inch different so okay for swelling.
Cool but sunny here in central Va, Happy Tuesday, TT
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Does anyone on this forum have experience choosing which style of implants between these two choices? My PS is giving me a choice: smooth round, or anatomical cohesives (textured, not smooth) made by Allergen--"Gummy Bears." My "swap" surgery to put them in will be January 2, 2019.
The 2nd type is his preferred implant for natural shape and no shifting. It also has a 1/30,000 chance of causing lymphoma. That's much less likely than my .05% chance of breast cancer recurrence risk, despite my BMX, for a little perspective. Still, lymphoma!
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Hello! New here and not sure if i know answer to your question but can tell you what my p.s has told me. Textured implants do not “shift”- tissue grows into them, and higher instance of the lymphoma (still low) . Gummy bears are highly cohesive- tend to be harder. Cohesive most natural feeling. Round implants, if they shift, do not show any misshaping. I’ve read that textured implants are not used as often but for certain circumstances. I am having my swap surgery in Feb.19 and am having issues with the size of my expander! 😩 I’m done but it feels way bigger than what i want! My p.s said that implant will be smaller but i hope it’s at least a cup and a half smaller! Just sent the office an email- i think i should show him pictures so we are on same page. There have been no visuals at all. Can you share with me your experience with sizing and whayour p.s. has told you regarding t.e. Size vs. implant size? Thx!
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Hello! New here and not sure if i know answer to your question but can tell you what my p.s has told me. Textured implants do not “shift"- tissue grows into them, and higher instance of the lymphoma (still low) . Gummy bears are highly cohesive- tend to be harder. Cohesive most natural feeling. Round implants, if they shift, do not show any misshaping. I've read that textured implants are not used as often but for certain circumstances. I am having my swap surgery in Feb.19 and am having issues with the size of my expander! 😩 I'm done but it feels way bigger than what i want! My p.s said that implant will be smaller but i hope it's at least a cup and a half smaller! Just sent the office an email- i think i should show him pictures so we are on same page. There have been no visuals at all. Can you share with me your experience with sizing and whayour p.s. has told you regarding t.e. Size vs. implant size? Thx!
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Hiking Lady - a lot depends on your PS & your body type & the extent of your surgery, etc. I have Allergan 410 anatomical cohesive gel implants - the original 'gummies'. I've had them since 2011 after a double mastectomy and I'm very pleased.
Go to the Breast Implant 101 forum, read the header and post your personal specification as listed and ask Whippetmom. She is truly the breast whisperer. You can read tons of implant choices there.
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Hello! So happy i found this place! I just went for my final fill (right side) which was just for the last “stretch” i was told by my PS. The fill prior was just about how big i would like (b+, small c) However, it seems REALLY large now. I asked my PS to show me an implant (he uses allergen Natrelle- i will get model number) and i was shocked at how large it was. He explained that after my mastectomy, my chest is a bit concave and that it will sit lower in my body , so it will not look that large. I’m really nervous that we are not on same page and emailed his assistant that i would like to send a few photos of my desired size for my file. I am awaiting my last consult. I’m glad i am nipping this in the bud now. Thanks for any feedback!
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The risk for ALCL is a bit higher than that as more is being learned about it. If you are the type who wants to do everything possible to prevent another run in with cancer, then smooth is the way to go.
I initially had the textured anatomical and absolutely hated them. They looked like big flat wide burger buns. They also felt "scratchy" on the inside of my skin. The whole ALCL stuff came to light a few months after their placement as well. After 15 months I had them exchanged to Natrelle Inspira SCX and all of the above problems disappeared. I hope my chances of ALCL are reduced as well.
Good luck with your decision.
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JM - do get your specs together and post on the Breast Implant 101 thread.
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Thank you for all these stories and insights. I'll keep doing my research on textured anatomical vs smooth round.
VegGal thanks for sharing that smooth round are more comfortable for you than the textured were. That's helpful for my decision making.
JM1965 size/too big/your question: My PT who works with breast surgery patients says that if the pocket is a bit larger than necessary, that means you'll be more comfortable once the implant is set into it than the reverse problem of having it too tight. My PS says that he can remove extra skin to match and even things up on me if there's extra skin due to uneven stretching on the two sides.
Size: I have no choice on how big. My foobs will be small. The only choice I have is between the textured anatomical Allergens and the smooth round--those are the two types that my PS has offered, for my size and shape and his preference, etc.
I had radiation in 2003 on my right breast after a lumpectomy. Because of scar tissue (invisible, but affecting blood supply and skin and pectorals and all connective tissue) the right side incision took much longer to heal than the left (8 not 2 weeks). Stretching after tissue fills has been fine on the left and super uncomfortable on the right. I am at 350 ccs, and I have a pretty wide chest and large rib cage. They're currently filling a B or C cup. I used to be DD, but now I don't care how big. I do worry about the right side's healing.
If there's eventually contracture on the right side (higher probability than for most people because of the radiation history), it will be smaller than the left. My only "size" guidance for my PS when we recently met was to say that I'd like them both to be the same size. Which means that he'll probably reduce the left side's extra stretched skin to match right side.
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I decided to go with the smooth rounds bc of the lymphoma risk. It’s low, but I didn’t think the aesthetic differences would be that noticeable.
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My exchange surgery is now scheduled - Feb 8, 2019. My PS will not do the anatomical implants for 2 reasons - the texture issue with ALCL, and he says they can sometimes rotate and therefore cause breast to be misshaped. In fact a friend of my had that happen from surgery in 2012 and had new round ones put in just last week. He says at the pre-op appt next month we will talk about level of cohesiveness and he'll determine if he wants to use Allergen or Mentor implants. I have one more small fill and will be at 400 cc on each side, and he said he usually puts in a final implant about 100cc larger so they fit snug into the pocket. I've only had these TEs since MX surgery on Nov. 12 but I am already tired of the weird feelings going on in them - saline "swishing" movement when you move around and the way they stick out into under arms.
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