Exchange City
Comments
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kandyhunt I think you should phone up your PS office and describe the pain. Maybe there was some stitching inside that is just going to be sore for awhile as it heals. I had some soreness near my ribcage for a few weeks, but not severe pain, and by 5-6 weeks it only hurt when I pulled my arm into in certain positions or when I stretched my chest kind of extremely.
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CBK, the animation occurs with sub pec implants as the muscles flex they distort the implant. Aside from being a less painful recovery, the other reason my ps did the pre-pec was to avoid the distortion.
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Well that should have been very obvious to me- thanks for explanation. It is a one-sided situation hmmmmmmmmm!
I feel like my revisions could go on for years.
Thanks Shoregirl!!
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Hi all, I am seven weeks post exchange (BMX with lat flap recon, tissue expanders then implants) and I have an infection:( Feeling really down about it as everything was going so well. Then a few days ago, a spreading patch of redness appeared on my left breast skin. My PS has started me on antibiotics but no improvement yet. Anyone else have any late complications like this? I am feeling scared that I will end up having to have more surgery.
Wink
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Hi- I'm having exchange sx for my bilateral TE on 3/13, very much looking forward to getting rid of the TE. Any ideas of how soon I can fly afterwards (assuming no infections etc)? Kids have spring break 2.5 weeks after my surgery, wondering if we can fly anywhere. Have found this thread really helpful in making plans for post op, excited to try the pineapple, hasn't heard that one before!
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Westwick See what your plastic surgeon says about any restrictions after your exchange surgery. The main thing is to be sure that healing is going well, with no infection. There might be some lifting and exercise restrictions for awhile. My PS told me not to elevate my heart rate for 4 weeks, and no heavy lifting. All restrictions and care instructions are to maximize the chances of healing without any complications, such as wound not healing well, or infection.
First two weeks I was DEFINITELY extra tired. Healing is exhausting, of course, after any surgery. A lot of the stitching is inside---removing the TE's and their tabs, etc., so the exterior incision isn't the whole story---there is 'inside work' done. It's often called 'pocket work,' because the PS sometimes has to make the pockets be a good fit for the implants. In my case, he also took out some extra side-boob-skin on one side that had stretched more, but even so, this was a very comfortable recovery.
I think I would have felt comfortable getting on a plane at 2.5 weeks after exchange, if my doctor had cleared me to do that. If I'd had someone else to travel with who could lift everything and carry things for me, I could have had a trip, and could have walked around, just couldn't have done any hugely exerting activity until 4-6 weeks after surgery.
I was told to 'reduce activity level' for 4-6 weeks. Healing made me feel kind of low energy, but I was up and about, just had to sit down and rest more than usual. Also, of course no swimming. My PS said it was okay to get in a pool / ocean, etc no sooner than 5-6 weeks, to be sure that incision was totally healed.
I had very little post-surgery pain--just 2 days when I needed any painkillers. My doctor said to eat extra protein for several weeks for cell repair/healing, and drink a lot of water. I was very comfortable after just a few days, and didn't even have a lot of swelling. UNLIKE after the BMX w/ TE surgery, I was allowed to lift my hands above shoulders, etc. right away. That might be different with different PS instructions, but mine were relaxed on that stuff. It made everything SO much easier than after the BMX. Getting dressed, reaching for something in the cupboard...I was happy to have this surgery be super-much easier than the first one.
The new Foobs ARE more comfortable than the TE's. At first, I didn't think so, but now that everything's healed, I'm finding that I don't notice them much, so my brain is getting pretty used to the feel of them.
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Westwick...I had a business trip 5 weeks posts exchange, on my own and had to manage my own bags...that was okay with PS as long as I didn't hoist my roller bag into the overhead. At 2.5 weeks I would have been allowed to travel, but with more weight restrictions...like your family needs to hold your bags. You need to talk to PS...mine was concerned with where I traveled a month before and three months after...I had been in Canada a month before and am currently in Spain less than three months after...these choices were okay, but other places would have been restricted. Also no skiing or swimming...if those are Sprig Break destinations for you. TT
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Westwick, I had my exchange surgery on 3/1/19 and am getting on a plane for long (quiet, relaxing) weekend on Thursday. Definitely clear it with your PS before committing to a trip. My PS ok'd mine except for the luggage. No dragging it behind me and no lifting it into the overhead bins! So, DH will be the one lugging it around for me.
Like HikingLady said, I have been exhausted after this surgery, so don't sign up for anything strenuous (lay on a beach, but don't ride the jet ski, lol). Also, as she said, I can shower now that I am past Week 1, but was told no pool, ocean, hot tubs, etc for 6 weeks. Be aware that there can be late infections (as Wink22 mentioned), so watch your temperature (I ran a low grade fever a few times during Week 1) and have an escape plan (in other words, know where the nearest hospital is, be sure you can get hold of your PS, have a pharmacy located, etc).
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Wink22--- I got an infection in my right side thanks to bad care in a hospital stay for another infection. It was bad and it would not clear up so after about a week and a half I was scheduled for surgery. It was an easy surgery but it required me to accept a certain amount of risk. The first thought the PS had was to just pull out the foob and leave it and have me get better and than come back later and start all over again with the TE's and fills. I looked at him like I was going to cry and said, "and door number 2, is what?" He said that they could go in a "take out the foob clean me up by washing my insides with the same stuff they use on his hands before surgery, 2 times and than the third wash would be with an iodine type solution and put in a new foob. and that he would do a Voo doo prayer, make the sign of the cross and throw in some pixie dust and If I consented to a month of antibiotics", he would do it. I am one month out on Thursday from having the foob replaced. I am feeling really good. There is some pain but a whole lot better than having to start from scratch and having 3 more surgeries.
I sucks to have an infection. Take your antibiotics and hopefully you will avoid the extra surgey.
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Hi, this is my first time posting tho I’ve been reading posts since my bilateral mastectomy in July. I had implants put in 12/18 and the right radiated side opened up 4 weeks later. Had it replaced 1/15/19 and I still have a tiny hole oozing. It is 8 weeks. Has anyone had oozing this long & had it heal after 8 weeks? I’ve been pretty upbeat about it all but am getting really discouraged now.
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wdwxox Good for you to be your own good self-advocate. What you're experiencing is not usual. If you don't have an infection, maybe it's just going to heal super slowly. If there's any suspicion of an infection (red, sore, inflamed, hot to the touch, sudden change, running a fever, etc), PS needs to look and assess in person. Do not pass Go--be seen immediately. Also be seen if you're concerned.
I did not have this problem after my implant surgery. However, I DID have this happen to me last May after the BMX + TE surgery. My previously-radiated (15 years before) side took 8 weeks to completely close. My PS prescribed a much longer course of antibiotics since that side was open longer. The longer an incision is open, the longer you're at risk for an infection.
Wound care sometimes needs extra help. I would ask for a referral to a Wound Care Clinic. Also, I would ask about Hyperbaric Oxygen Chamber Therapy. Look up whether it's offered at any hospital in your city; it's becoming quite commonly available.
My friend had super good results doing this for a worrisomely long healing time after a foot surgery. She got into a device (like a tunnel) and lay there for 90 minutes, and they showed her a movie of her choice. DAILY, for 6 weeks, so this is a huge commitment, but healing often is at least 20% faster with this therapy. It's studied and credible, not quackery.
As I'm sure you know, tissue that's been through radiation has (invisible) scarring, and a compromised blood supply to the skin and the pectoral muscle, which is what you have left after a MX. My PS said "20% higher rate of complications after radiation than for people who haven't had radiation." "Complications" means either slow healing, or failure to heal ever, or infection. Good for you to ask about this, and it's time to have a plan with your PS. Ask your PS if s/he's seen this before, and how much experience he/she has with this, and 'what are our options at this point to improve healing?' It's time to find out if it's a problem with a new solution, or if you're just on a slow healing track. One thing to keep track of is whether you're seeing closure of the wound-- perhaps .5 cm per week, etc.? Keep track of the changes over a week or several days. Data on this will help you self-advocate as necessary.
Nutritional Support: To support your healing, be sure you're drinking 2-3 qts of water every day, and also try to eat a lot of food with antioxidants (blueberries, etc.) and 80-100 g of protein daily. Cell repair requires all of these things, and it's also important to rest and have a low activity level. I wasn't allowed to raise my heart rate or do anything vigorous until my incision was healed after exchange surgery.
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Thank you HikingLady! If this doesn’t heal, our plan b is a Latissimus flap. My PS is trying to avoid that if we can, prob partly because of me being 66. I don’t feel like 66 but my bod is. I’m supposed to go back to work on Friday but I may have to delay it. Tonight my breast is looking red. I will try to get in to see my PS in the morning. Thank you for your help & encouragement
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hey sisters! So glad I found this thread! I have Mentor TE (medium profile). Previously was a 34A/ 32B super droopy boob girl. I’m at the end of my fills and waiting for surgery to be scheduled. Currently weighing in at 143, 5’3 (trying to get back to my happy weight of 132). My goal was a full C cup. Right now I am sitting at 350ccs and curious if I need to go up to 400. My surgeon told me told me today that he would probably go with a slightly wider implant than what my expanders are...to me that means that I won’t have as much projection with the implants and i do with the expanders. Ian that correct? Going with the super gummy implants. Any thoughts? Should I fill up you 400?
Thanks!!!!
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Girl279 Answering your cup size question from my experience.
My PS said that the TE bra cup size would be approximately the same as my future/implant bra size. My final size ended up a wee bit smaller than the TE size, but he was fairly accurate with that prediction. When I had TE's in, I was between a B and C cup. Once the exchange surgery was completed, the foobs were a perfect fit in B cups. So, if you like where you are in what cup size fits on you right now, stay put. If you want them a little bit bigger, have another fill.
My PS had a certain number of weeks required between 'last fill' and implant swap surgery---I think it had to be 4 weeks, no less than that. I would trust the PS on width of implants, and if you don't like how that sounds projection-wise, then another fill sounds like a good idea. The width is a set thing, based on your rib cage, and implants that are too wide or too narrow on your rib cage would look weird, so that's why they come in so many (dozens!) of sizes/widths / projections, and I'm sure your PS has carefully measured your torso and is planning accordingly.
My PS said that he always goes into swap surgery with a couple of different implant options/sizes, and he sees which is the best fit in all ways, according to the pocket size and shape, and anatomy of torso. He customizes based on exactly which one will look best. Part of the art-not-science part of his job, he said.
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I am 5’3” 130 lbs and was originally a C cup before BMX last November. First implants after TE exchange were 400cc Mentor High Profile silicone. These left me a B cup. 7 weeks later had the exchange for 500cc. Much better, a C cup at last. The exchange was a piece of cake for me, 45 minute surgery, Tylenol for one day. I’m really happy with the size, very proportional to my size. It’s still early and they’re just starting to loosen up (5 weeks out)I have pre-pectoral (above the muscle), which is why both my implant surgeries have been without any serious pain. Highly recommended.
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I am 5'3" 144 lb now (regularly around 130 lb and trying to go back down now ) and my size before the BMX was C\D. I am currently at 400cc and the PS normally uses Allergan Inspira Smooth implants. TEs are under pectorals. He said he is thinking will fill one more time, another 50cc and that's going to be last time. Shall I ask for 500cc as final TE size before the replacement? I would like to be the size I was before the BMX, but apparently he thinks need to be smaller.
I also feel like the expanders are not symmetrical right now, one is higher profile and the nipple on that side is lower comparing to the other side. I asked today if the final shape, after replacement, will look more symmetrical and the PS said, because of the scar under one breast is more tight and did not soften, the final picture will look better than now, but he didn't say more symmetrical, and i think he did not sound very encouraging
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Shall I look for another PS? Did anybody go with another PS before the final exchange from TE to implants?I am obsessing over this, as the main reason i went with BMX was to be able to have both breasts look the same and to not see a major difference between them. Not sure what to do at this moment
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applejuice For your own peace of mind, maybe it's worth having a consult with another PS. That way, you'll have another opinion on board about the question of symmetry. Perhaps to get exactly what you want, you might choose more extensive reconstruction options, like Flap/DIEP, etc. and not all PS do all types of reconstruction.
As for how high on chest, that might have to do with where your pec muscles are. The Alloderm pockets for my implants are attached to the tops of my pec muscles.
My PS warned me that my two foobs wouldn't be identical. I had radiation in 2003, and that right side is tighter, and pec and also the skin didn't want to stretch as much. Final shape with implants is slightly different looking on the two sides. But, in a bra and clothes, the difference isn't noticeable.
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Girl279, I was a B cup before BMX. I was filled to 420cc and my PS put in 475cc Allergan gummy bear implants. It gave me about a large B/small C which was what I wanted. I am very happy with my results. No revisions, no infections, no problems. Follow your PS instructions to the "T". Don't do more than you should because you will feel like you can do anything, but don't. Just because you can doesn't mean you should. I am 4 years post EX. I have 3D nipple tattoos that are amazing! Take care and PM me if you want anymore support. Minus Two on this thread has the same implants and she has had them for about 10 year. She is also very happy. Your PS has to be very skilled with the gummy bears. They must fit tight and remain contained in a bra for a long time. They are very comfortable.
Blessings,Robin
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Hey Robin - HI. Robin is correct in everything she says. My TE's were placed in February 2011. Then exchange to Allergan 410 anatomical cohesive gel implants (the original gummies) in September 2011. I was a D or DD before the mastectomy, and I was SOOOOO grateful to be able to go smaller to a C. I'm very happy with my implants, the cleavage, the lack of side flaps, etc. You really do need a very experienced PS to do anatomical implants since the tolerances must be precise. And after the surgery? JUST BECAUSE YOU CAN DOESN'T MEAN YOU SHOULD.
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Thank you, kandyhunt! I am glad that you are doing well post infection and replacement. Your post made me laugh...sign of the Cross and pixie dust! I finished my course of antibiotics and things are looking quite good. Fingers crossed. Thanks for your reply :
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Wink22- I'm still on my antibiotics. One more week. But I am feeling really good. The the proof comes in two weeks when I have been off the antibiotic for a week. The pixie dust was added because we are in the Orlando area. So everything gets pixie dust. My PS says he is an atheist but was raised Catholic. We have some very interesting discussions. He came to my hospital room the day after the BMX and spent about a half an hour just chatting as he was ahead of schedule. He also loved my ducks. the last few surgeries I brought little rubber ducks and handed them out to all the people that helped me as I was getting ready for surgery. They are crazy looking from holding surf boards, sand pails, some look alike animals(sort of) they are too funny.
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I got my exchange on Monday, March 25, 2019. Originally it was supposed to be April 2014! Had this expander in me for about 5 and a half years. But I got pregnant while off my mirena. So couldn't have surgery. Breastfed for 3 years on the breast I still had. So finally got the exchange on left side and a small implant and lift on the right side. I'm on lots of medicine for pain but still have quite a bit of soreness. It's mostly in my upper chest right above my "foob" and "boob" almost to my collar bone. Hard to go back yesterday morning to get bandages removed and am now in one of those lovely surgical bras. Go back in 2 weeks.
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allebasi Thanks for this update. Glad you're finally finished with having the TE---I felt the implants to be more comfortable, starting maybe 2-3 weeks post exchange, than the TE's. My discomfort was very short-lived after my exchange surgery (this January), and I wish that for you. I felt better and more comfortable very soon. Wonderful that you still had one breast over these years, and could breast feed your baby; thanks for sharing that. You've been through a lot. Take care and don't overdo it--there's plenty of healing, even though most of us found the exchange to be easier than the mastectomy. Get your rest! Wishing you good healing and smooth sailing.
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Thank you, HikingLady! Yes, I'm getting as much rest as I can. Have freezer meals ready for reheating and paper plates. Hope I'll feel better soon. I poked a bit on the implant side and it's just so nice and soft compared to that awful expander.
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Hi All,
I was reading through some of the more recent posts and some amazing information. I was curious if anyone has gone down in size and been pleased with their results. Before diagnosis I had 13 year old saline implants (going strong) and size 36DD. One ruptured after my last lumpectomy and without clear margins I ended up with a unilateral mastectomy as well as both implants removed. I stopped having fills back in August of 2018 because I told my PS I was trying to lose weight. She said get as close to your goal and then we will revisit sizing. Well a 50lb loss later and my frame is substantially smaller and she was close to actually draining some off my expander. She’s now mildly concerned the expander is too big for my frame. I said I’m ok with going smaller in size but I wanted something there. So far I believe my last total fill brought me to about 490cc. Im also going silicone which will be a (hopefully good) adjustment. Mentally I’m ok with being substantially smaller I just want to make sure I don’t come out of surgery (5/2) shocked and wondering where everything went. I opted for no lift at this time and hoping it’s enough implant on my good side to not be so lopsided.And good grief I can’t wait to get this expander out! Also any feedback on recovery times - I like to be prepared ahead of time - is greatly appreciated. TIA 💗
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Hi Blackhawk41, congratulations on your weight loss!! I had a 50lb weight loss too after putting on 50lb while taking Lyrica. I had 470 pre-pec ultra high profile Inspiras at 1st. I felt they were too big and heavy, too much projection as well. But the worst was they kept flipping over in their pockets, flat side facing out!! The PS wanted to put BIGGER implants in to remedy this. And since he doesn't do a lot of fg nor will he do nip recon I realized we needed to part ways as we were not on the same page. I went to a female ps next. She was on board with downsizing, but told me it had to be done in stages. She did the 1st downsize and a lot of pocket work to prevent flipping. She only dropped me by 30cc to 440, but we went from ultra high profile Inspiras to full profine Sientras. I really liked them. Soooo much more comfy! The Inspiras were way too firm for my liking and very ripply when I lean over. Sientras were more squishy and no ripples. Unfortunately though she didn't add alloderm to one side as it appeared there was already enough from the initial exchange. As a result, that implant bottomed out pretty quickly (within a few weeks) and ended up 2" lower than the other. We were going to revise to go smaller again anyway in a 6 months so I didn't worry about it. But I had to have a lumbar fusion suddenly which delayed our revision and her office stopped par with my insurance. I found another ps that was on board with the downsize and fg. It was 13 months after the 2nd set of implants. We settled on 345 cc Allergan Inspira Soft Touch Moderate profile. They are cohesive like the Inspiras, but squishier like the Sientras. I really like them!! I chose that size because it was important to keep the base width of the implant the same size as what I had. There are size charts online that give you all the dimensions. Even though my projection went down I still have a small C. I was a full D with the 470s. But that is all relative to each individual's body frame. I didn't have a good cosmetic result with this surgeon. He tightened the IMF on the side he had added alloderm to so much that the implant is distorted flat on that edge, jacked way up higher and inward medially. He revised it again in his office 2 months later (Feb) but did the same darn thing AGAIN!! Too tight sutures. I endured that revision in his office with just local anesthesia for nothing. Needless to say, I moved on to PS4.
He has lots of reconstruction experience and I felt very comfortable with his plan. He did some fg to my "good side" today. Wants me to wait until late summer for the botched side revision so it has had a good 6 months of healing time. Sounds like a good plan to me!! I know others have had successful downsizing and hopefully some will chime in. I don't mean to scare you. But it is much more complicated if you are considering a major size difference (mine was 125cc downsize all together). I do feel the female surgeon I had or my new ps would have had no problem though. Research ps very carefully and find out if they have done a LOT of downsize reconstructions. I wish you all the best!!
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Went back for my 2 week checkup after exchange surgery and PS said everything looks fine. Having a bit of a weird rug burn sensation on my right side, guess it's the nerves regenerating. He said everything would continue changing over the next year but everything looked good. Don't have to see him for another month, and he cleared all my restrictions after next week. Can't wait to sleep on my side again!
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allebasi, Be careful sleeping on your side. I didn't sleep on my side for a year. You need to heal. It looks like you had a Uni so sleep on your right side. Did your PS say you could sleep on your side? Just be careful, you will have lots of time to get into your "new normal". If you had a lot of pocket work, it takes time for that to heal completely.
Blessings, Robin
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Wow, thank you Shoregirl! It’s excellent info. Yes a little intimidating. I don’t even know what type of implant other than it’s silicone and not textured. My P is out of Brigham and Women’s in Boston and is well known. My nurse navigator used her as well. She’s very particular and definitely was on point guiding me down but now I do wonder on the pocket size. No one wants things flipping around in there. I was pretty big before diagnosis too compared to now! You are one brave woman and you’ve been through so much. I’m sorry it’s been such an ordeal for you but hopefully you are on the right path now and healing! Thank you so much for your help and information ❤️
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Blackhawk41 thanks for your kind words. I am super please with my new ps. He called me the day after procedure to check on me. I had minimal bruising and pain and am already seeing nice contour results from my fg donor sites and grafted sites.
It sounds like you have a great ps too. As for recovery with TE to implant exchange make sure you talk with your doctor about restrictions and specific instructions. So many women on this thread report this recovery is so much easier than msx. Of course everyone is different but even with extensive pocket work I was out running errands and off pain meds 3 days post op. Just not lifting, pushing/pulling anything over 5lb. Please don't get the notion I was back to my normal routine though. You do have to take it easy and give yourself plenty of rest and time to heal. For reference I am in pretty good health (not on any rx meds). I eat pineapple like crazy after surgery and supplement my diet with vitamins and take Milk Thistle to detox from anesthesia. I feel I bounce back pretty quickly thank God!!
Best wishes on your upcoming exchange
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