Exchange City
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Hi everyone. My exchange surgery is scheduled for June 4th. My four kids, husband and I are planning on flying to Florida for a week in July (10th). I can’t imagine not swimming or getting into the ocean. It will be just about 5weeks after surgery. Without compilations, how long did you wait to swim? Thanks for your input!
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christiekoe Your PS will have his guidelines. I followed my PS's very specific instructions, and I think it was 6 weeks for me. In fact, I waited longer, since I was so committed to not risking any chance of an infection, and I had an additional challenge. Right side had radiation 15 years before and was slower to heal after BMX and also after exchange.
By the way, with the way they dressed my incisions (steristrips) it was fine after about 24 hours to take a shower, just not immerse in a bath or go in a pool or swim anywhere.
Do you know what Tegaderm Film is? Easy to find online and in large pharmacies on shelves with other wound care stuff. It's a transparent bandage, which seals around the edges, and might possibly be helpful to know about. You might discuss w/ PS whether it would be safe to use this film as a seal over your incisions to get in the water, if you're still not quite to his "safe to go in the water" date by then. If it's applied correctly, it can be a waterproof seal.
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I also went to Florida recently, 6 weeks post exchange and was told by my PS it would be better not to risk infection by going into a pool or ocean. it's up to you, but IMHO it's not worth the risk of infection. I stayed out of the water.
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christiekoe- I was told 6 weeks, same as the others. At 4 weeks I still had some “internal sutures” that kept poking through the skin. They clipped them, but I wouldn’t feel safe swimming.
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christiekoe-- Not to pile on but I live in Florida. I would not get in the water. I only use a private pool and not the public one. Water in Florida can have some weird stuff in it besides alligators. I got an infection in my boob after exchange surgery due to lack of care during a hospital stay for cellulitis. I had to have an extra surgery. I was threatened that if the surgery to replace the implant failed I would have to have it taken out and start over at ground zero until all the infection was gone. The would be 3 more surgeries, One to take out the implant. the next to put in a TE and the third for the exchange, all the while not matching the other. I would not chance it. Stay out of the water is my advise.
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Thank you all for your advice!
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Hello everyone! New here with 2 questions.
First, after my last fill, my breast felt cold and the saline began to deep out of the spot where they inserted the needle. I’m thinking it’s a leaky implant?
Second, I’m doing a flap transfer instead of an implant. Any tips on how much to inflate the TEs with a flap
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I didn’t remember much if s cold feeling but one te did leak. They didn’t seem too concerned. Refilled it until I was ready for exchange
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Hello all, I'm a first time poster, but I've been reading the boards for several months now.
I have already gone thru my second surgery ,DMX with TE placement , don;t know if I will be needing Chemo or Rads or both yet
I have follow up this friday with my onco surgeon and he will have my Path report hopefully.
I had a follow up with my PS today and apparently the tissue on my R breast is not healing ? its not infected but a slightly larger than a quarter sized area is red and she said it wasn't closing all the way, so now Im scared it will open and I'll have to undergo surgery to cut out more tissue and try to get that to heal.. Any suggestions on how to get this spot to heal and start making it grow together would be appreciated.! I think I was doing to much and pulled it, I could feel a sharp needle like pain yesterday in that area.
*sigh* sorry or being long winded, Im just scared. Thanks for reading!
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Hello all, I'm a first time poster, but I've been reading the boards for several months now.
I have already gone thru my second surgery ,DMX with TE placement , don;t know if I will be needing Chemo or Rads or both yet
I have follow up this friday with my onco surgeon and he will have my Path report hopefully.
I had a follow up with my PS today and apparently the tissue on my R breast is not healing ? its not infected but a slightly larger than a quarter sized area is red and she said it wasn't closing all the way, so now Im scared it will open and I'll have to undergo surgery to cut out more tissue and try to get that to heal.. Any suggestions on how to get this spot to heal and start making it grow together would be appreciated.! I think I was doing to much and pulled it, I could feel a sharp needle like pain yesterday in that area.
*sigh* sorry or being long winded, Im just scared. Thanks for reading!
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notarobot Healing can take awhile. Everyone's different. My husband is an RN---he says that the surgeon should assess to be sure that it's properly dressed, and that if there's any oozing, drainage or signs of infection, you do need to be seen immediately. Healing happens from inside out, so if you have it covered, moist, and appropriately dressed (for your surgeon's protocols), and if there's no infection, just give it more time but stay in close touch with your surgeon. Go in and be seen if you have anything that worries you. Surgeon should be giving you a timeline about when to have her look at it again. Yes, doing too much can move the tissue apart, so follow all instructions, and hang in there. Keep us posted.
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notarobot if you want to put your DX and TX in your signature under your post, you go to My Profile, set that information in, and then go to Settings to choose which information you want to set as Public or Private.
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I had a BMX in December of 2017. I had my TE's out in October 2018 and replaced with silicone implants. Last month I saw Vinnie Meyers for3D nipple tattoos. He said my L side was almost an inch lower than my right. He said it would continue to drop. He recommended reconstruction to fix it.
I saw my PS. He said it is lower and that he could lift it. He wanted me to consider if it was worth another surgery and general anesthesia to me. He said it would not continue to drop. I'm torn. Anyone w a similar situation or any advice? I'd really appreciate it. Thanks!
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thank you Hiking lady!! I hadn't changed the settings to public, I was wondering why it wasn't showing up,
noob, lol My PS said give it a week, gave me a bunch of bandages and some ointment, Im just nervous
I really need to get back to work, and definitely can't with an unhealed wound in my work environment.
I appreciate you replying so quickly. my DD said that putting some gently warm compresses on it over the bandaged area,,IE a small microwavable
heating pad, twice a day or 20 minutes would help open up the vessels some to get more blood flow to the area.She was an ICU critical care nurse,now a nursing teacher, so it makes sense to me.I'll give it a shot. I know Ive got to be patient, but Im anxious to start making a living again lol Never thought I'd be itching to go to work! haha.
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Krose - I had rads on my right side when I had a recurrence after my implants had been in two+ years. Because radiation tightens & shortens muscles, that right side is much more perky than the left. The left has drooped considerably. Two years ago the PS said he could fix it to match, but like you - I wasn't sure I wanted another surgery & general anesthesia. Seems to me my left continues to droop. I plan to see him later this year for more guidance, but am concerned about lymphadema, since my right side is already effected. It's not a win-win situation is it.
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Chiming in on the "should I fix the mismatched foobs" conversation. My right side is smaller because of previous radiation, so the skin didn't stretch as well. My PS said all along that they just wouldn't be exactly the same. In my case, the right bra makes them look Just Fine in clothes. I wear a swimsuit that doesn't have a low cut in front. I can live with my 'sisters, not twins,' and I won't choose more surgery.
I would ask these same questions discussed above: about healing and complication risks, and how good will the improvement be, etc. Hard choices, for sure...
Unfortunately, yes, as MinusTwo points out, lymphedema is a risk after all breast surgeries. My PS actually mentioned that risk VERY fleetingly before my surgeries. My friend who's retired from being a physical therapist who specialized in the treatment of lymphedema after breast surgery has been my main source of information about that. I don't have lymphedema, thank heavens, but it's something we do all have to be aware of.
In fact, since I'm on this topic, my PT friend recommends that I wear a compression sleeve on the cancer side (I had more surgery on that side because of axillary node excisions) for flying, for 1-2 years after any breast or axillary node surgeries. She says: put it on 1-2 hours before flight, take off 1-2 hours after flying; this is because of air pressure differences, which can affect the lymphatic system. I do this prophylactically. And, I wear heavy gloves if I prune roses, etc.
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Hiking lady - my problem is breast & truncal LE, so I have to wear a compression bra or vest 24/7. Unfortunately those garments do not 'lift' or conceal the difference in my droopy left side, which is why I'm still considering more surgery.
The sleeve advice is good. I always wear sleeves to fly - AND gloves or gauntlets so the pressure doesn't just move to the hands. For those who want more detail, there are 3 or 4 very comprehensive threads about lymphadema on the BCO site, in addition to the link below which was created with fantastic input by BCO members.
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MinusTwo Aw, I'm so sorry about your LE that you're dealing with. Thanks for the glove idea and the link.
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Hi krose53,
I also had BMX more recently, November 2018. My right side did not drop as much as left due to scar tissue from three prior attempts to get clean margins. I went in for a fix Six weeks ago and it worked. He also added a small amount of fat sucked from my lower belly. Definitely an improvement! Right side is now even. It was a 45 minute procedure under general anesthesia. No real pain to speak of, took some Tylenol that night and was back at work the next day. I work from home on a computer, so that helps.
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my cancer side was radiated and also doesn’t have a nipple. On that side I have obvious cleavage, partly bc the skin is much tighter and the implant seems to sit higher, and a little closer to the center. The other (prophylactic side) has a slightly smaller implant and does not have that upper fullness; it also looks more natural, I think, but maybe bc it has a nipple. My ps suggested fat grafting to even the fullness but for now I’ve decides it’s not worth the additional surgery. The unevenness is not obvious to anyone except me.
I am planning to do nipple recon (go back and forth bw 3D tattoo and nipple recon, but for now I’m thinking to do the full reconstruction.
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Good Morning All!
Well I didn't sleep well at all last night, it felt like my right TE was going to poke a hole in the center of my chest inwards,it was my first night sleeping w/o my hospital issue mastectomy bra. PS said I could go w/o it the other day as long as the right incision was covered. no change as of wed. to the spot that wont heal on the right. My armpits and chest area near my armpits feel as tho I have rug burn. My SNB was performed back in april and had healed since before my mastectomy on may 30th. so I dont know why that hurts like that.
Anyways, I go see my onco surgeon today to see what was in my path report.He told me he would call if he got the report back and he never did..I'm nervous about that, my brain/imagination tells me he didnt want to tell me over the phone bad news.I Don't know if I have to do chemo or rads or both. I hope its all within the margins. my initial diagnosis was said to be a tumor of 2.4 cm , that changed during the lumpectomy when he started to cut, then cut again, then he stitched me up because he didnt want to keep cutting away without telling me it was bigger. that path showed cancer cells dotted throughout the breast tissue and a tumor at least 4 cm.I'm hoping and praying for clean margins. even if I have to do the chemo or rads, just to be safe.
ok enough rambling for now, wish me luck! Have a great day!
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well, my follow up with my onco surgeon was today..I might feel like I got hit by a mack truck, physically, but mentally... OMGGGGG I'm a 5 ft 2 105 lb cheerleader doing cartwheels across the parking lot ( my drains are gonna hate me for that)
I have been down sized on my stages, everything was well within the margins, this time,the tumor is GONE and the "little cancer cells" thruout my left breast tissue were merely "calcified sclerosive lesions" non cancerous.
my surgeon said NO RADS, might need a chemo or 4 to make sure if my chemo dr. thinks its necessary due to oncotype ,family history ect.
but im on to healing this chest mess, and trying to get my foobs,whether it be by implant or diep flap , I got time to breathe and think about it.
im not one to share much, but I've read alot of your stories,and I couldnt wait to figure out how to get back to my original post so I could tell you , I guess I just felt safe. thanks for that ladies.
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wonderful news, notarobot!
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I will be having my exchange surgery 7/18 on my left side. I have a leaky expander and my dr wants to fix it as soon as possible, we need to wait until Sept for my right side bc it's my radiated side. Has anyone had exchange surgery in 2 steps? How "off" will I look? I also sleep on my right side...could this have contributed to my leaky expander? Will I not be able to sleep on my new "squishy"?
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Jen2Mom It makes sense to do the radiation side later, because healing is so slowed down by radiation, and the tissue on that side will ready for more trauma when it's ready, and it takes awhile. I'm sure that your PS is following specific guidelines about that, to be sure that you'll heal okay on that side. Healing is slower because of scar tissue and blood supply being compromised. Definitely err on the side of caution, giving yourself the best chance to heal well on that side.
You'll be more comfortable on the side where the TE is taken out, because an implant is just more comfortable than a TE. Exchange surgery was SO MUCH EASIER for me than BMX, I can't tell you. So, even though you do have this ahead in two steps, they will each be manageable steps.
In my case, new shape w/ final implants was exactly the same size as TE size, and I could use same bras, etc., and my PS said it would be the case, and it was. If that's true for your PS's plan as well, you won't look lopsided in the interim.
I suspect that how you were sleeping, etc. is not the cause of leaking TE. I think they're very substantial, and that issue sounds like failure of the device, not something you caused!!! Ask PS about that.
I had very few restrictions of any type after my implant/exchange surgery, including use of arms, and position to sleep in. I'm sure that this varies by surgical technique, skin, type of implants, size, etc., and each PS gives really specific restrictions to support best outcome. The big deal was the first surgery at time of BMX: creating the pockets (Alloderm pocket stitched to pecs). During my implant surgery, there was much less inner 'work' done, and my recovery was very smooth and comfortable.
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Jen2Mom,
I had my exchange done in separate surgeries because my mastectomies were done separately. My two sides are different, with slightly different sized implants (25cc difference, so not much). The real difference is caused by the fact that one side is radiated and has no nipple. The implant sits higher and differently on that side and the skin is much tighter. The difference is not noticeable to anyone but me.
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Also, I also had a leaky expander with no clear explanation. But the PS never suggested it could have been something I did.
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My right side had radiation 15 years ago, to treat breast cancer #1, which was TOTALLY CURED, yay, and it was just my bad luck to get a new primary bc 15 years later. New primary bc, with a very different pathology, etc.
Anyway, after my months with TE's and then the final implant surgery, my right side is slightly different. Tighter pec muscles and slightly smaller look, even though the implants are the same size. In a bra, they look like twins. Without a bra, they look like sisters. My PS explained from the beginning that this would be the case. Skin and pecs that have had radiation just aren't as elastic. My implants are behind/under the pecs, as was the only option, because of thin skin due to (invisible) radiation scarring on my right side, etc.
I had my TE's in for 7 months. Did not love them---they have kind of hard edges. Final implants are quite comfortable. It's now been 5.5 months since exchange surgery, and I have regained upper body strength, and all range of motion, and feel okay about my new smallish but Just Fine foobs.
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I was unable to do bilateral DIEP as originally planned and a bilateral SGAP would have delayed some further imaging by months, that I could not have with the expanders in, that I did not feel comfortable delaying so I had to switch the expanders out for implants, hopefully temporarily.
This was supposed to be an out patient thing but I am laying here in a clinic in a hospital bed right now because I'm having a lot of pain on the cancer side even with the IV pain meds. I can't move my arm much on that side without my pain shooting to a 9 and it feels like my ribs on that side under the implant are bruised and I'm getting burning, stabbing, aching pains on that side even in areas that I am technically numb. For comparison, on the other side I currently have no pain what so ever.
Is this normal? What on Earth could have happened to the cancer side during the exchange surgery to cause so much pain? I first thought maybe there was a miscommunication and they did post pec implants instead of pre pec but nope. The surgeon says they were both pre pec. The resident doctor said it was a big surgery, but it was just an exchange with a few extra stitches to close armpit pockets, and I had a bigger armpit pocket on the non cancer side and a lot less sensation in the armpit region on the cancer side due to nerves being severed there during the mastectomy so this pain would likely be excruciating if I had normal sensation there to begin with.
Has anyone experienced this problem? Is this normal? I suspect something is not right
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With my exchange, my initial post-surgery acute pain was controlled with meds, and I didn't have to stay extra time in the hospital. I DID have acute post-surgery pain for a couple of days, for sure, and needed opioids. I was much more comfortable in about 3 days, and went to Tylenol and off the Rx pain meds at that point. The fact that your pain isn't controlled, and it sounds as though you stayed in the hospital after what was to be a day surgery does sound unusual. Unusual might mean 'in the normal range of what can happen.' That inside work on the pocket can mean a lot of stitching, and 'inside pocket work' means tissue that's disrupted that has to repair.
At my exchange surgery, I felt pain INSIDE but not OUTSIDE. The severed nerves after the BMX spared me from the outer incision pain during healing, but I did have some pain on the inside for quite awhile as I healed.
If I were in your shoes/hospital bed, like you, I'd also want an explanation for why your initial hours after surgery are so rough this time. I'd want my pain controlled. I'd ask about what the next week should be like, as far as comfort and pain. It might be that you're having a super tough first few hours after surgery, but that you'll feel much better in a week. Keep asking a lot of questions. Ask whether a nerve could be affected, ask why the pain is this difficult, and see if your surgeon or the resident or your surgeon's PA, etc can explain the cause of your discomfort.
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