Exchange City
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Hi everybody. This might be a silly question, but when people refer to the cc’s, are they referring to the cc‘s in just one implant or both together? So if someone says they are at 600 cc’s, does that mean 600 cc’s per breast, or 300 per breast?
Some people are talking about having 500 or 600 cc’s and that sounds like a lot. Mine are in the 400 range I believe and they look big on me even though I’m really tall
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In just one. Many mastectomies are one-sided.
I was always small, except for the five years I was lactating. Because plastic surgeons do so much cosmetic stuff, they naturally assume that most women want to look bigger than they were before. So they automatically rebuild us in their image of what they think we think is something better. Humor aside, it is nice to have my boobs protrude more than my belly.
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McBaker - I concur. Plastic surgeons are often men - and I think they pass their judgement that we want to be bigger. Or that men in general want 'bigger is better'. There is at least one active thread by women who want to be smaller.
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Silly question, but most google searches lead to "complications with implants" and do not answer my question. Are your implants softer than expanders. Yes, I know they are. But do they actually feel almost like real breasts? Not at all? Are they squishy? Do they bounce or move at all? Yes I can ask a PS but I want to know about an actual patient's experience.0 -
e32 If you feel comfortable putting your DX and TX info and dates on your posts (set them to Public), we can see where you are in decision-making and managing everything.
Complications usually means post surgical problems including infection and failure to heal. Complications later with implants include rupture. My PS says that every couple of years he can do imaging to see whether that's happening, and it's rare, but possible. The 'recommendation' is to replace them after 10 years, but in fact, it's often not necessary.
Mine are sitting in a pocket that is constructed by stitching Alloderm (webbing made from cadaver skin) to the top of my pectoral muscles, and that part was done first, during my BMX surgery. Months later, after TE's, and when my chemo was finished, the final implants were set in.
My final implants aren't particularly softer than the TE's, but there are no hard edges, whereas TE's do have rather poky sides, and I noticed them when I was in various positions that 'folded' my torso a bit. No poking with final implants---all edges are smooth.
My implants are silicone, and they're a bit firmer and more solid than my breasts ever were, even when young. They're rather like half-domes, which means that they rise up abruptly from my chest wall. With a regular bra on, that isn't noticeable. But, I don't have extra fat-grafting, and I don't think the look is great with low-cut tops. That's okay, they do look fine in regular tops, and v-necks look especially okay, because my port scar is covered up that way. The size I am is about 38B, which looks just fine. Not as large as I originally was (38DD), but they're fine. In my case, I had previous scarring in my pecs and skin on my right side from radiation 15 years before. The size I am is because, at a certain point, no more stretching was possible--too tight and uncomfortable--so I stopped with fills, and in fact, right side is slightly smaller, but Oh Well, it looks fine in a bra.
Mine don't bounce. They're well seated in their pockets. The pocket + pecs is the same location that the TE's were, and when I had my exchange surgery, the PS made sure that the permanent implants were a really good fit. He did this by actually having two possible sizes ready to go, in the OR, and the ones that were the best fit were what he used. Not sure if that's a common way to do that, but it was his system.
By working hard with free weights, doing "plank," etc., I did regain good upper body strength by about 6 months after final exchange surgery. What I don't have is comfortable upper body twisting---there are weird sensations because of the way things are reconstructed, but it's not awful, and I can do normal life.
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e32 - I agree with Hiking Lady. I have seen & answered a number of your posts on a bunch of threads - but no longer have any idea where you are in the process. I'm thinking maybe you haven't started any treatment yet? But forgive me if I'm wrong. Please do go to "my profile" and post your diagnosis and at the treatment plans to date. You can always update as time goes on.
I'll be happy to tell you more about my implants, but would like to know where you are coming from.
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Thank you! I will work on that! What is TX? I notice a certain format people use on here for that info.
Sorry for a quick reply bc I have very little time to be on here because I have small children keeping me busy 😁.
I meant that I tried to google "are implants softer than tissue expanders" and all I get is negative articles about complications.
So I kind of need something positive to look forward to I suppose. Hoping silicone implants will feel less like bricks and have some give if you grab them. I want to know how they will feel when we touch them or if regular bras (no underwire of course) manipulate them at all.
thank you so much for getting back to me!!!
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Nothing is worse than TEs. I'll post more relevant details when I see your info.
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I has bilateral mastectomy and have tissue expanders in. Fills delayed due to Covid 19. Had lobular cancer and on hormonal treatment.
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implants will almost certainly be softer than TE’s. Depending on placement and type, you will have more ability to manipulate them in bras, etc.
I had subpectoral at initial recon. While I had no complications, I did not like the look or feel of them. Three years ago I had those removed and replaced with prepectoral implants, along with fat grafting. Again, zero complications.
My implants are harder to the touch than natural breasts. I have the most cohesive (hard) ones there are and I chose that to decrease the chance of rippling. I have no ripples with these. They bounce a bit with me, and are comfortable.
Hope this helps.
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e32 the implants are much softer than TE’s, those things were like cement bricks. Do they feel like real breasts? Not quite, but mine are much softer and “squishy” than I had expected. I have Natrelle Inspira SSX pre pec. I am very happy with them and they feel very much a part of me. I don’t have that foreign feeling some people talk about or the feeling of TE’s where you are aware of them 24/7. The only thing I hate is the rippling! Hope this helps
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e32 My permanent implants are soft on all sides. My TE's had hard edges--that's cuz they are attached with tabs. Implants are definitely more comfortable than TE's. The abbreviations are explained on this site, and you can look all this up, and also how to set your information to Public from the main page, in Settings and Help and other places on the menu options. The abbreviations just save everyone time when we're discussing things, and a lot of them are actual medical terms, like these two...
TX = Treatment
DX = Diagnosis
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e32:
I never had TEs though have “exchanged” my implants twice. I will say after having three different types squish depends on the implants.
My gummies (the Allergan 410s that are recalled) were the least squishy. Though it was more after switching them out I realized how less squishy they were. But they were designed more to be that way as they are highly cohesive and shaped (like a teardrop). They still did not have a hard back like expanders do though.
I have Natrelle Inspira SSX’s now. I really like their squish factor. I had rather dense natural breasts and these while still not as squishy come far closer to replicating what I feel is a more natural squish. Overall while I did not really think of my 410s very uncomfortable when in I find these far more comfortable. They do move more (ie give me more jiggle), can be shaped more with bras etc (ie give me some cleavage), and have a more - for my body anyway - natural drop than my 410s did
I am subpectoral FYI, so that may affect some of the touch to the skin/fingers compared to someone someone prepectoral (my sister is prepectoral so I have a reasonably good real life comparison as we are similar body types/skin thickness).0 -
Hi,
I hope to have my exchange surgery soon. Could you please help me to understand what are "internal sutures"? My TE are mostly under the muscle. My PS mentioned that he will use internal sutures to tighten the pocket. What does that mean? He will attach my muscles to the chest wall near the implant? What are long term side effects? I am relatively young (39) and keep telling my medical team that I want to be active. Unfortunately, they ignore my preferences sometimes. I like Pilates a lot, I like stretching and barre workouts. Will I be able doing this activities after 2 months recovery? My PS told of course I will, as well as push-ups. Honestly, I am not sure.
Is it better using Strattice or similar mesh instead of sutures to have more flexibility?
Please, help me being prepared for my appointment.
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MikaMika I feel your worry, and completely empathize. If you have the stomach for it, you can google images and videos of similar surgeries, and diagrams that show how the pocket is created, and how it's attached. Once you see how the muscles are arranged, and understand how the pocket is constructed (usually with Alloderm), you might have some specific questions that you can be sure to ask your PS. Have a list of questions ready.
For my surgery, the pocket-construction at the time of my mastectomies was a big deal, but the 'exchange' surgery was really quite easy to recover from.
"Internal sutures" and "tightening the pocket" are pretty standard. The idea is to make the permanent implant be well seated and fit in the pocket without moving around. TE's and the pocket and the final implants are usually constructed behind/under the pectoral muscles, because there's more support there than on top of them (for attaching the pocket), and more tissue to hold everything in place and protect the implant and keep everything connected well. There is also a type of reconstruction that's on top of the muscle ("pre-pectoral), and some surgeons can do that depending on size and skin thickness and many other things, but mine is below the pecs, as you describe yours as being.
It is certainly true that my pectoral muscles are DIFFERENT than before all the surgery. But, not terrible, and I've built back strength quite well.
My breast surgeon (who performed my mastectomies, not the plastic surgery part) had breast cancer at age 32 and then reconstruction just like mine. She, at age 36 when she operated on me, was living proof of good outcomes, and was happy to talk about how she recovered, and what she could do now, and how it all went. She was extremely positive about moving forward, getting used to a new torso, and she gave me a lot of support and good cheer about facing it all. I wish to send you those same vibes!
Maybe 3 months after my implants were in, when I was fully healed, I was able to do most torso strength exercises. Maybe 6 months after the surgery, I was regularly doing daily Planks and other upper body Pilates workouts, working out with bar bells, and doing the breast stroke just fine. I think pushups are, for some reason, a little more challenging for me than plank position, and since I can do plank and other arm exercises just fine, I don't worry about pushups, and I worked up to everything I'm mentioning slowly and carefully, since I'm 63 years old.
Lingering "issues" are very minor. I feel some tightness, some positions cause a little 'kink' in things when I fold one arm over when lying on my side, but these are pretty minor irritations. Overall, I have good flexibility and movement and strength. I have an added challenge, because my right side had radiation 15 years before (previous cancer, my bad luck, considered cured and unrelated to #2 cancer which was more serious), and that makes my right pec muscles feel a bit more uncomfortable than the other side. But, I'm MUCH OLDER THAN YOU, and that unique challenge on my right side is not anything you'll have to deal with.
I predict a comfortable and strong and good outcome for you! Sending warm wishes.
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HikingLady,
Thank you so much for the kind words and warm wishes! 💚
I appreciate you taking the time to share your experience with implants and encourage me.
I also have some challenges: my right side was radiated (with TE) and my torso is thin. Despite all preconditions, my new PS is very optimistic and promises a beautiful result.
Your message was like a good therapy session! Now I'm more calm and confident, and it's all about you.
Thank you again for all the positivity and good vibes!
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Hi - I had a question, hoping someone might have a similar experience? I had my exchange 2 weeks ago and all went well except on my radiated side, I am getting sharp pains that feel like they are getting worse. They usually come about if I reach for something even if it's not very much movement. I wondered if anyone had the same thing and if it went away or if there ended up being complications. Did anyone have to have their implant removed because of the radiated skin not playing nice with the implant? It's a silicon implant (natrelle) and 415cc I think - doesn't look that big. I had fat grafting too so wondering if that is affecting things. Thanks so much - any feedback appreciated.
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Hi! I had my double mastectomy with TE placement about a month ago and am beginning fills now. I'm starting to think ahead to the exchange surgery and am having a hard time finding a clear cut answer on what recovery time is following the exchange surgery. I know everyone says it's a much easier recovery than the first surgery (thank goodness!!!) but just curious how much time I should plan to take off of work? I'm a teacher and will be working remotely so commuting and lifting won't be an issue - it's just a matter of when will I most likely be physically, emotionally and mentally ready to begin working (from home) following the exchange surgery? (Apologies if I'm asking something that's already been answered somewhere in this post! There were so many pages I wasn't sure how to easily search to find the answer). Really appreciate hearing about others experience following the exchange surgery and when they felt ready to return to work, especially one with no physical strain/requirements.
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Everyone is different - and the recommendations of each PS is different. So first I'd ask your doc. Personally I had drains again with the exchange. But it was such a relief to get rid of the horrible TEs, anything was a celebration. If I remember, it was 10 days before I felt like doing much. Hopefully someone who had a more recent surgery will chime in.
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No drains. Prepectoral. Three days for work like that.
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My PS said 2 weeks and that’s what I did. My job required being on my feet all day and active. Yes exchange is so much easier than MX! I mostly was in pain from fat grafting. It is instant relief from those dreadful expanders.
Ask your PS and take as much time as you need. No need to rush, our bodies have been through a lot and let’s not forget the emotional roller coaster we’ve been on! Best of luck to you.
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Thank you everyone for your replies! Yes, it's under the muscle for me & I believe the plan is to do fat grafting. Is that part painful? I honestly don't know much about fat grafting! (Also, yes I am HATING these TE. Like two tennis balls strapped under my chest).
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Fat grafting produces impressive bruises and deep stinging pain, especially when moving. Fortunately, all of that fades away surprisingly fast. I went back for a second round, so obviously it isn’t horrible.
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Pretty sore and painful, lots of bruising but nothing like MX. I would do it again. Just need to get some fat on me lol
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VegGal, surprisingly fast is 2 days...7 days ____ days?
My exchange surgery is on October 7th. The plastic surgeon told me I can go back to work a week after the surgery. I will not have dreams.
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Has anyone felt worse after the exchange from TE to implants under the muscle? I read on another board about someone who had gone from normal physical activity with the TE to barely having any strength after the exchange with UTM implants
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Emily - I'm sure since our bodies are all different that some people feel worse. I couldn't do much with the TEs since they hurt all the time for 6 months before exchange. I'm not sure when you had your exchange. Remember it takes awhile for everything too settle AFTER the internal stitches heal. Most people seem to say 6-8 months.
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Ladies, how big are your scars after the exchange surgery? My plastic surgeon promised relatively small scars under the breasts, but what I got is significantly longer.
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InfusionConfusion You asked your question about discomfort on the radiated side a whole month ago, and I am just now looking at this thread.
My previously radiated side has never played nice with anything. It took a LONG time to heal after the BMX, it took a long time to feel okay after exchange, and that side did NOT want to stretch much during TE months.
I am, overall, Pretty Comfortable---I'm now 1.5 years past the exchange surgery. Maybe 5 months after the Exchange surgery, I felt pretty much okay. I think that what you describe sounds a bit like some of that 'nerves waking up' and sending those zings. If you have ongoing serious pain, absolutely talk to your PS.
Even though healing is completed, I have little zings in my ribcage sometimes--months go by, and one occurs again, so it's infrequent. I feel bits of cramping, certainly where the stitches that connect the 'pocket' to my pecs probably pull, when I fold myself into certain positions. So, I sleep cradling a pillow, lying on my side. It makes me be thoughtful about reaching across my chest to the opposite side quickly. These are not horrible handicaps, but I must say that my torso doesn't feel the least bit like my original one. However, I'm used to it all at this point, and on the whole, am glad I did reconstruction.
I can do normal things. I can do Plank position. I went kayaking yesterday. My previously-radiated side feels tight. The implant isn't completely comfortable, because the pecs are scarred, and they are just more rigid. However, this is okay. I can live with it. I'm comfortable in a bra that's fitted well to me. My previously-radiated side is a cup size smaller. That's because stretching over the TE just only went so far on that side, so I stopped at B cups, and they're petite but just fine.
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Had my exchange yesterday. My implants feel fine. The only pain I have is from the fat grafting . I'm hoping that'll go away soon enough.
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