Exchange City
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Thanks, HikingLady and CBK. It's good to know that 6 weeks is a good time frame for exercising. I'll see the PS on Wed for a follow up, so I'm sure he'll give me guidelines then. I was lifting light weights before this, and running, so I want to get back to them when I can.
HikingLady, I think I'm surprised that they don't look better right now, because I have an "augmentation" image in my mind rather than a 'reconstruction"image, if that makes sense. I thought they would look like "real" boobs, where these don't poke out as far as a real one. The PS wanted to do textured implants but I declined based on the lymphoma thing. I'm sure these will be fine in 3-6 months. Thanks for the protein suggestion.
CBK, a nausea patch would have been nice. They gave me hydrocodone for pain, but I only took 2, although that may have been what did it. I didn't have this problem with the BMX, but I was admitted over night so they were probably pumping anti-nausea drugs through my IV. Super glad I had Zofran left over from chemo. I'm glad to know you have two different sized implants, too. From what I can see, mine look even/symmetrical. We'll see when they finish healing. It's funny how the surgeons are all different - some wanting compression, others not. You'd think they'd all be the same.
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GAWarrior RE - the type of implants--I chose smooth not textured for same reason you mention--I wanted to minimize lymphoma risk. I think your comment about considering this 'reconstruction' not 'augmentation' is a good way to think about it.
The girls do not match....My PS knew that my right side (15 years ago radiation) would not look the same as the left side. Scarring, although not visible, is a fact throughout pecs and skin. He warned me "they'll be sisters, not twins." Even though the implants are the same size as each other, the right side looks smaller. Once I'm in a bra and clothes, it's not noticeable, and even real breasts are never exactly the same size on most people.
Comfort: The 'settling' that everyone describes is subtle, but certainly true. I feel very comfortable in the new foobs at this point. Which was NOT the case until 8 weeks after surgery. I think it's probably a combination of healing making the tissue feel comfortable, PLUS my brain getting used to the feel of them.
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My exchange surgery was a month ago. I am 5'5" and 125 pounds/ small-framed with a narrow chest and repeatedly told my plastic surgeon I wanted to be a C cup. I know doctors don't like to talk "cups" and it is difficult to gauge exact size outcomes. I don't understand "cc's" very well. And therein lies the problem.
Every time I was "filled", I would remind my doctor that I wanted to be a C cup (which is what I was before the mastectomy) and he kept saying I should go bigger with the fills. So, I ended up with 700 cc's of saline in my expander. My expander did not look that big to me...I guess because there wasn't much in the way of cleavage. But, boy oh boy, my implants seem VERY large.
When I went for my post-op visit, the doctor estimated that I was a DDD. I was floored! I went to the nearest department store and he was right. I could wear 32DDD and 34DD bras. After talking to the doctor and explaining that I just couldn't walk around with that large of a breast, he agreed to do a revision. I am meeting with the him next week to discuss implant size for this time. He thinks he can go down 200cc but maybe more. He is going to look at me and decide at this appointment.
I presently have ultra high profile Mentor implants. One is 750cc and the other is 700cc. Do you think going down 200 cc will give me the size I desire? (Of course, I will take what I can get at this point.) I just don't know what to expect.
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Are you sure you want to give him another crack at it? Have you thought about seeking another opinion before going through another surgery?
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GaGrandma, I am about the same body size as you 125 5’3”, small shoulder area originally C cup, 58 years old. I also asked for a C after double mastectomy with TE. He put in Mentor high profile 400cc because they fit the best. They made me a B cup. I felt flat chested under clothes. After 7 weeks swapped out for 500cc. Much better and now a C cup. The swap was nothing. Tylenol for a day. No real pain to speak of. 45 min surgery. I am two 1/2 weeks out and fully functional. They are still tight at this point but will loosen up in time. Going down should even be easier as you are already stretched. Good luck!
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GaGrandma, so very sorry that your PS did not listen to you. Going from C to DDD is unbelievable.
Have you visited the Breast Implant Sizing thread by Whippetmom? She is the Guru of implant sizing. Read through the original post ans answer all the questions. She will make suggestions for implant sizes. She also has lots of links to articles that will help you work with your PS for sizing.
https://community.breastcancer.org/forum/44/topics/746448
She was spot on for my implant sizes. I went from DD native breasts to C implants. I am very happy.
Best wishes, Madelyn
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GAWarrior-
I’m telling you that nausea patch is outta this world. My third surgery some young guy used it on me... I was awake and eating within a half an hour. They tried to throw me out of the hospital before I was ready!!🤣. I was like hold on here I may be eating but I just had over a 3 hour surgery and I’ll let YOU know when I’m ready to GO!!
I was able to exercise way before 6 weeks after my exchange! I remember surgeon wanted me to keep it low impact but doing modified weight bearing activity pretty quickly. My PS was always in the camp of “get moving, stagnant energy is very bad for healing”. So I was able to do low impact cardio and modified yoga very early on.
GAWarrior and Hiking Lady- are either of you planning on nipple reconstruction? I’m supposed to have the cherries placed on April 5, among a lot of other revisions. My PS isn’t doing the oragami nipple reconstruction rather taking it from my belly to make them. I wonder why as it’s said, that this is an older technique. Any thoughts here are appreciated. Most of my friends think im nuts to go through another surgery. But hey, they don’t walk in my shoes now do they?
Wishing you a speedy and non- eventful recovery!
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CBK Best wishes on researching and having the nipple reconstruction. I'm 61, and do not want any more surgeries that are non-essential. I might do 3-D nipple tattooing. My husband thinks that's silly--why bother. But, I might do it. He has a silly and healthy sense of humor, so he started thinking of funny tattoos I could choose to put on, rather than 3-D nipples, but I want to look Semi Sort Of Normal again....
Every morning, I go to my city pool and take a shower in the common shower area after exercise. There I am, publicly displaying the huge horizontal scars on nipple-less foobs. I think having tattoos will make me feel a little less self-conscious. I've forced myself to Just Do It since that exercise (deep-water w/ resistance cuffs and foam barbells) is building my strength and fitness, and it feels great. I actually feel very brave, getting naked every day in front of strangers.....
For the tattooing, I'll wait until maybe 5 months, although PS said it's okay to do at 3 months. We're going to Hawaii for a vacation around 4 months (post exchange surgery), and I want to have no complications, and to be able to swim in the ocean every day. My right side had (15 years ago) radiation, so it's compromised on healing. Healing was very slow after BMX, but it went GREAT after swap surgery. This makes me a tiny bit nervous about tattooing, but PS said that I should expect it to be fine.
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Hi GaWarrior, Im pretty sure I am having the nipples put back on in the fall using the origami technique. My doc says it takes 15 mins and I can drive myself home. He’s really good, showed me a picture of one of his patients outcome. Also will have the area tattooed in his office. I’ll decide in the fall. Barbie boobs look a little strange without them, but it’s also nice to to have the option of not wearing a bra and not have nipples sticking out. As I posted earlier I’m two 1/2 weeks out from exchange of 400cc to 500 cc and feeling great. I was cleared to start walking on my elyptical and did so twice this week. I wear a comfortable lightweight sports bra during the day
Regarding a second opinion, changing physicians midstream is no picnic, I did so between my second and third surgery then again between third and fourth. (Had a total of six). For the third surgery I ended up with another doctor who was awful and had to change again. Fourth thru sixth time I loved both the breast and plastic surgeon. Like I said, for me, the exchange swap was a piece of cake. I also have motion sickness and always make the anesthesiologist aware. Always get the patch and anti nausea meds.
And someone mentioned the extreme cotton mouth, I found the best thing for this after surgery it to drink as much water as you can. This is also good for clearing the anesthesia meds from your system.
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Hikinglady-
That is truly a bold and brave story! In time the scars will fade as hopefully some of the painful memories of this process will as well! You sound like you are well on your way to creating a stronger and empowered you. Thank you for sharing that
Nipple tattooing sounds like a nice finishing touch although I can understand why you may be nervous with rads in distant background. Sometimes I’m like maybe I should just do the same. I have other revisions though that need to be done so I really can’t get away with not going under again... so why I am entertaining the nipple reconstruction at the same time. Originally I was going to just be able to do nipple reconstruction under a local. Ugh decisions ... decisions. And the dread of having to be stagnant a bit during the healing process....and start all over again with ROM, strength and healing......
Again thank you for your story!!
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Wow, GaGrandma, I'm about your height/weight - I can't imagine going to a DDD! Sometimes I think these docs do augmentations as well as reconstructions and they think we all want to be huge. Men! I had 450 cc TEs (not sure yet what size implants were put in), the PS said I would likely be a C or possibly a D cup if he used extra-high profile implants (I told him not to do that). Maybe that "translation" of ccs will help... WhippetMom is definitely the person to look up.ask.
HikingLady, thanks for the info that I'll feel better about them in 2 months or so. You are brave to get naked in front of other women! RE tattoos - I have a friend who went through this 25+ years ago and got a nipple tattoo. She says the tattoo wore off and is long gone, so just know that you would probably have to have it touched up every so often.
CBK, thanks for the exercise info. As for nipples, I was able to have a NS BMX so I can't help you there. I DO think you should do what makes you feel best about yourself. For me, I would want a nipple, but that's me. (And, I'd want the 3D tattoo, but again, that's just me).
Not feeling so great today (Day 3). I'm more sore (to be expected) and tired. Zofran has totally shut down my system. Off to drink some Smooth Move tea...yucky, but effective.
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I had thought about seeing a different Plastic Surgeon about a revision and talked to a friend who works in a PS office. She said that docors would be hesitant to see me since my surgeon has agreed to fix the problem. She said I might be considered just someone who couldn't be made happy. Her thoughts are, since my doctor has agreed to do the revision, I should let him. I think he does good work cosmetically, but I am worried that another size mistake will be made. I was shown no implants sizes, etc before. I have asked to see them this time. I just have no idea what to choose. He definitely is a typical man who "likes them big". But I don't want him to go too much the other way either. You would think that someone could create a method to make sizing easier on us! We are at our most vulnerable and need all the help we can get.
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GaGran - I think you absolutely should go consult with another PS. Whether of not they are interested in a re-do, it's in your best interest to get some medical advice. My PS is technically excellent but i wanted to see what another doc thought about the size & style & etc. He was very gracious.
Remember that implants will ALWAYS be wider than natural breasts. That is part of what dictates cup size. That and the lack of projection are reasons it's very difficult to talk about cup size. It would be good to set up an appointment an appointment at Nordstroms with one of their fitters who is trained in breast reconstruction from cancer NOT breast augmentation. You might be surprised.
Mominator is absolutely right, you should go visit the Breast 101 link she posted, read everything in the header and post all the specs for Whippetmom.
Last but not least, you really won't know what your reconstructed breasts are going to end up looking like for several months - up to as long as a year. They will continue a slow change for some time. One of the hardest things to do is 'step away from the mirror'.
Edited to add - I thought mine turned out too big and was REALLY unhappy. Over time they have mellowed and so have I. I realize that they do fit my frame, I have really nice cleavage and they look great in clothes.
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GaGrandma I agree with MinusTwo-you should absolutely consult another PS. A PS should always listen carefully to the patient. That's baseline! I sense that yours really didn't. You deserve to talk this through, and you deserve another opinion to weigh in on how to move forward. My PS DID show me what the implants would be like, and talked through everything with me. It's very normal to get a second opinion before any surgery. All surgeons should support that and welcome your getting more information. Warm wishes from me to you.
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I am scheduled for a revision next month. That is only two months from the first implant surgery, but I have been pretty persistent. I know that breasts settle and look different, but these just seem too large for my small shape. I appreciate all your advice and now I am so confused. I really have no one else to talk to about this and I am a nervous wreck. Why did you say I might be surprised after talking to a bra fitter at Nordstrom? I don't think I can ever get comfortable in a DD or DDD. Thank you all for trying to help me!
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You can read on WHippetmom's thread that most people were always wearing the wrong bra size. Because of the lack of projection and the width of implants, you will be in a larger bra than you were before even if you are the same size.
Are you in an area where you can go for a consultation with another PS? I think that would be preferable before any more surgery to set your mind at rest. Two months gives you plenty of time. If you don't know anyone, your BS or MO can probably give you a name.
If you decide to stay with the same PS - insist that he shows you the type of implant he's going to and let's you handle it. Read everything you can about that implants Discuss any possible problems with decreasing the existing space that was created the first time. Discuss what will happen with the extra skin. Discuss why he thinks you should reduce to 200 ccs. I can not imagine going from a 700 to a 200, but the Breast 101 site might have more people who have been through this.
I know many men prefer to give us their ideal - big boobs. I was glad I argued for smaller. Try not to worry (easy to say - hard to do). Just do your homework before you go through another surgery.
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I respectfully disagree with your friend. There would be no reason for the new opinion PS to even know you are planning a revision.
I bailed on my first PS. Imagine my surprise when my 3rd opinion PS pulled out a tape measure and measured my ribcage and explained that the implants were wider than my ribs! Of course I knew that...but he actually measured!
Alas, I sought one more opinion, and that is who I went with ultimately. She knew I had been "PS shopping" and had no problem with it. She also let me handle all of the implant samples so I could make an INFORMED decision.
Good luck!
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GaGrandma, so sorry you’re getting so many opinions. All I can tell you is your PS probably put in the size he thought would fit best. But obviously you don’t want that size. After 6 weeks they can be exchanged for a smaller size. The exchange is nothing compared to BMX or even TE to implant. You should be under less than an hour and should not feel any pain the following day. I’m speaking from my experience, but we’re all different.
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Thanks everyone. I will try to find another plastic surgeon so I can get a second opinion. I am fairly new to the area, so I don't know their reputations. I will be researching. Thank you crossh for the reassuring words to talk me off the cliff! And, MinusTwo, he said he might could go down 200 (to 500)...not down TO 200.
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GaGran - whew. That makes me feel a whole lot better.
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GaGrandma if you go on Mentors website they have the actual measurements of the implants. This was how I decided what size to exchange to. I was worried about ending up too big going from 400cc to 500cc, but they were not that much bigger in size. I’m very happy with the new size. And like he said it was an easy surgery and recovery.
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GaGrandma, I read on Realself.com a Q & A about how to convert grams of breast tissue into cc of implant. It was my understanding you can gauge the size of the implant relative to your body by looking at your msx pathology report to find the gram wt of your breast tissue. Dr. Trevor Nodwell's response to the question was:
"When I weigh breast tissue and also use volume displacement to assess its volume, the numbers tend to be almost the same. That is 150g of tissue often takes up approx 150cc of volume. As far as how implant vol and breast vol relate, that is far more variable. Implant vol (whether saline or silicone) tends to be more firm or rigid than natural tissue. Any given vol of implant tends to increase the apparent size and projection of the breast more than the same volume of natural breast tissue."
Of course there are variables of how once cc of implant will look different on 2 different body types, chest width...height...weight etc. That being said, my 540g breast tissue was replaced with 470cc extra high profile Inspiras. They filled my pre msx bras completely giving me a 36D. I decided I wanted to be smaller. The downsize surgery proved not to be a piece of cake. I had to find a new surgeon as the 1st ps only wanted to go bigger. I had surgery Nov 2017 with the new ps and she only downsized by 30cc. She didn't reinforce the bottom of one of my implants with ADM. As a result, it ended up being 2" lower than the other. Rather than fix it, she stopped par with my insurance. I found another ps to revise. This December, he took me down where I wanted to be, 345cc Allergan Soft Touch moderate profile. 90cc less than what I had and a cup size smaller in a bra. Much less rigid and more comfortable. But....he totally screwed up with the pocket work on my good side!! I had a big flat spot at the lateral edge from him suturing too tight. I allowed him to revise THAT under local anesthetic in his office. He further screwed it up by making the lower pole to tight and creating a flat edge there!! He was obviously in over his head. Needless to say I am now interviewing for PS4 to fix this mess. My point is, please be VIGILANT and ask your prospective ps if they have done a lot of downsizing. It is much more involved than swapping out implants or even going larger.
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Shoregirl
That is what I have heard as well, downsizing is not an easy revision. I am weighing the decision to go down a size during nipple reconstruction and I’m not so sure I want to do it. I feel like my implants are definitely still settling in.. and hard to assess the needto go smaller at the 6 month mark when I have some revisions and nipple reconstruction scheduled. Thank you for this information ... I’m going to think this thru better.
Was your recovery more difficult than your initial exchange?
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Shoregirl, well that is terrifying. I had no idea that going down in size was so involved. My PS acted like it was a simple "swap out".
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GaGran - yes, back to my questions about what goes in the cavity created for the original larger expanders. And what happens to all the skin w/o cutting off the lymph system. Lots of questions.
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Yes, Minus Two and I are usually on the same page. I am very blessed that I was able to tell my PS that I wanted to stay about the same size I was and he accommodated me completely. I was able to hold and touch all the options as well. I am very pleased that I chose the Allergan 410 gummies. I was filled to 420cc and he put in 475cc. I am happy with them and I don't see a revision necessary. I am 4 years out tomorrow!! Hope you get all the answers you need.
Robin
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CBK, the 1st small downsize from 470 to 440 was a super easy recovery. If the ps had not neglected to add ADM to one side, I would have left well enough alone. She did a beautiful job and made the implants more secure so I didn't get that "implants peeling off my chest" feeling when getting up from a lying down position. But without the ADM, the implant which is pre-pec immediately dropped 2" lower. The 2nd downsize which was 95cc less to a 345cc was about like the TE to implant exchange recovery. I had a drain because he added ADM. Unfortunately, when he added the ADM, it bunched up beneath my collarbone so when he did the revision in his office later to correct the too tight internal sutures he had to remove the implant and the bunched up ADM, wash the cavity and replace the implant. Which just reminded me, during my 1st downsize PS2 discovered a bunch of ADM up beneath my collarbone that PS1 had put in on the other side. The bunched up ADM was causing waves of searing pain just beneath my skin.
GaGrandma, I don't mean to frighten you but you do need to know the possible complications. The ps never mentioned any of these possibilities to me prior to my surgery so when I saw ladies on here considering downsizing I felt I should share my story so they could be more aware of what can happen and discuss with their ps how to avoid or minimize the complications.
One other thing I forgot to mention re implant sizing. 100cc is equivilant to 6 tablespoons in volume. I filled baggies with different amounts of water to simulate an implant plus studied the size charts for Sientra and Allergan to come up with my desired size of 345cc. The extra skin was not an issue for me as I am having fg done to fill the void. I just wanted lighter weight implants for comfort and room to put fat in front for warmth and cushioning. If I had my way, I would have just fat and no implants!!! There is actually a place in Winter Park FL that does this. Bougainvillea Clinic.
Edited to add: CBK, If just downsizing and no additional ADM is needed, the recovery is very easy. With ADM drains are required (at least have been for me). Also to add for GaGrandma that 200cc downsize is roughly 12 Tbsp or 3/4 cup to help you visualize.
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Thanks Shoregirl
I’ll be sure to ask about ADM. My implants are behind the pec so less of an issue I believe. But very relevant information for me. I don’t have that “peeling off my chest” feeling but now that my non-lat flap side implant has settled in, I have a lot of animation with that foob. Any words of wisdom there?
I think I had that on lat flap side and PS may have futzed with the motor nerve and fixed it. I have to ask when I go back in a couple weeks.
Did you have NS BMX?
Thank you again
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My new foobs hurt. I had to have the right side fixed on February 14th and the first foob surgery on January 8th. Should I still be feeling pain? The pain is on the left side under the foob, sort a in the bra-line. But I am not wearing a bra. Is this normal? Thanks
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