Exchange City
Comments
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If you look fine in clothes, and don't cry when you look in the mirror without, it is good enough. So long as hubby agrees.
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I guess every PS has their own way of doing it. I will try to wait patiently for the 6 month mark. My non-radiated breast is 1/2 inch lower than the radiated. He even said the radiated side will not "droop" like the non. I thought it was weird that he didn't err on the side of caution and make the non-rad side higher or at least even to begin with if they tend to droop. I'm sure hubby would rather them look more "normal", but he will defer to me since he's not the one having surgery.
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Lalbo - I too had 6 months of slow fills between TEs and exchange for silicone implants. I thought most docs filled the TEs before radiation to hold the skin and then did the exchange. Even though my PS was the chief of surgery for a major hospital, I had cosmetic doubts and went to get a second opinion half way through. I didn't change docs but I'm glad I talked to another plastic surgeon before I finished.
I'm 10 years out now and the non radiated side has become droopy. My PS told me 2 years ago he could fix that. It's only evident without clothes and I'm not sure I want to subject myself to more surgery & drains & the risk of more lymphadema.
Do let us know what you decide.
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Lalbo - Not the same situation. I had my exchange to implants in July 2021, but was diagnosed with a recurrence a few days after. I did 25 sessions of radiation and finished on 10/11/21. PS told me back in July that I would have to wait at least 6 months before we could do any corrective surgery as it takes the tissue about that much time, if not more, to return to normal. I'm not happy with how my breast look either, but I was told from the beginning that I would require several surgeries to get them to where I will like them. I hope everything works out for you.
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Serendipity - I wasn't told about the chance of having several surgeries. My DH was in the room so there would be extra ears. There were several things I felt misled on. But, all I can do is go forward. My DH told me last night, whatever I decided to do, even if it meant going to New Orleans for surgery, he would back me up 100%. I am blessed to be with my husband, he's been my rock. I picked a winner the second time! I pay alimony to the first one (not a winner). But that's a story for another day.
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Lalbo - I'm so happy your husband is so supportive! It makes things a little easier to deal with.
I don't understand why the immediate exchange to implant after radiation. I'm a bit new to all all of this and learning a lot, but I would think that because radiation works from the inside out your tissue would have been too fragile for surgery. My skin reacted very quickly, I went into rads day 3 or 4 already a little pink. Again, I realize everyone is different (and my lack of knowledge), but never would've thought surgery so soon after rads.
All of my doctors and surgeons told me from the beginning that they wanted me to feel comfortable with myself at the end of all of this. My PS even went as far as having me go get a second opinion, even though I had already decided to have her do my surgeries. She wanted to make sure that I was being given all the information from different sources. The second PS confirmed everything my PS had told me, there were would more than one surgery.
Good luck and keep us posted.
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Serendipity - my PS said that he wanted to get the implant in before the skin started really reacting to the radiation. Of course, I had no reference so I only knew to go by what he said. I only found this site recently. Hindsight and all. I am putting a pad from my sports bra in the right side of my bra to even my foobs out. At least with clothes on I feel like I look better and more symmetrical. Otherwise I was super self-conscious walking around n the office. It was becoming distracting. That will make me feel better during the wait.
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My foobs came out too big IMO. I'm hoping the PS will agree to put smaller implants in. I lost quite a bit of weight during treatment and then had the fat graft grafting done during the exchange and cannot seem to gain it back. When I first met with PS I wanted to be as close to my size as possible, well I didn't take perkiness or weightless into consideration...I'm huge! The size I was when I had the TE's was just right, so I thought. I didn't realize that the aldoderm didn't hold up, literally, and both breasts were sagging (I didn't and still don't like looking at them too much) I actually like the way the radiated breast looks compared to left. Didn't you say that too?
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Serendipity- I had my TE to implant exchange done 2 years ago and felt the same way as you for a long time... TOO BIG! From the get-go I was planning on when I could go to my PS and ask for smaller implants. Then 5 months in I somehow contracted an infection in the left side- just as everything was shutting down due to COVID. I was very lucky that the PS was able to see me, but I was petrified that the oral antibiotic wouldn't work and I'd need to be hospitalized and lose the implant. Fortunately, the antibiotic cleared it right up, however I developed mild capsular contracture afterwards, so the left foob sits slightly higher and tighter than the right. Oh, and my nipples aren't really even either.
It really bothered me & I was slightly obsessed with how I looked for quite a bit. And then one day I realized that most 50+ year old women don't have perfect boobs and no one should be looking at my foobs anyway!! lol. I don't know why, but it just stopped bothering me. I don't love the foobs now and really don't like to look at myself undressed in the mirror, but otherwise I'm ok. I'm able to focus better on how amazingly strong my body is- it took a long time, but I'm finally able to do all of things I did pre-surgery, without pain. And for that I am very grateful. And also a little scared to tempt it.
Maybe someday, when/if these foobs need replacing, I'll think about a do-over, but for now I'm ok.
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Prepmom- thank you for the post. I feel like I have a tight bra on all the time. I'm glad they were able to take care of the infection. I was diagnosed the day of the shutdown in my state and was lucky to have started treatment nit even a week later. I was worried going in for the BMX as it was right in the middle of the craziness anreven more terrified of being in the hospital.
Nipples...that's the other thing; I don't have any. I think I wouldn't have such a hard time looking if they were there. I'll have 3D nipples tattooed on, but that's not going to be for at least another year to year and half depending on the how many revisions. SIGH!
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Prepmom - thank you for your post. I'm glad the oral antibiotic worked! My PS said "your breasts weren't symmetrical to being with" and they are more symmetrical now. They don't look it to me. After the surgeries and radiation, I'm tired of people messing with me. This is a good time for a break from all that.
Serendipity - My radiated side looks wonky to me. The non-rad side looks better. Straight line across the bottom of my foobs, the non rad side is 1/2" lower than the rad side. Plus the shape of the rad side is not really round, it's got more contour to it. Fine in a bra, not so fine braless.
They are also much larger than before. Basically went from A to D!! Thought it would be more like a C, but I don't feel like I look that much different in clothes. I did wear padded bras before, so maybe that's why. I would consider going smaller if/when I have to have surgery again.
It is nice talking with people about this!
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Update - I have a pre-consultation phone call with the Breast Cancer Center in NOLA this Friday. This is to get preliminary health information from me. They are out of my BCBS network. I believe BCBS will pay 80% after deductible. They will put it through their billing department to let me know how much it would be so I can make a decision on whether or not I can afford it. I wouldn't be having surgery until after 6/27 (when I get my vacation time). They specialize in DIEP flap, I have implants, so...
I have seen on here, or somewhere else, someone has had a combination of DIEP and smaller implants. I'd be ok with smaller FOOBS at this point in time. I went from an A to D. That's a big change, plus laying on my side is very uncomfortable. I thought I was going to get B, maybe small C.. I think I'm on the larger size of D (at least on the left side).
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Lalbo - good luck with the pre-consultation.I really hope everything works out and that it isn't too costly s that you can get the DIEP done. Can I ask, do you live in LA?
I see my PS on the 19th. I'm having severe shoulder and neck issues and someone, not sure if it was OT, PT or ortho (two fo them though), mentioned that my implants are probably too heavy which is not allowing me to progress.
Keep us posted!!
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Serendipity09 - I hadn’t thought about my implant being too heavy as a cause of my shoulder and neck pain. I did lots of PT last year. I don’t see my PS until next month, when I schedule my exchange surgery for my left side. I’ll have to ask him about it. I plan to go smaller in both breasts.
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Nsbrown54 - I hope everything goes well for you. I see you had your surgery a few months after me. I've been in PT for exactly a year this week and I think I'm worse off now than I was a year ago, granted I had radiation this past September/October which probably made things worse. I'll update once I speak to PS in a couple weeks.
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Serendipity - I live in Central Alabama, but I am willing to travel (not too far) to get good results, and New Orleans is not too far away. About as far away as going to the beaches in Mobile, AL. I just do not have confidence that my PS would do a good enough job. He and I kind of butted heads when I would ask him questions. He would say one thing in one appointment and something else in another and I would question it and I could tell he would get irritated with me. I even said something to the nurse about us being irritated with each other and that's not what I was trying to do, but this is very important and I wanted to make sure I understood everything. Then the next time I go in he was more understanding, roller coaster ride. Up....down....up....down. I wish I had gotten a second opinion on the reconstruction but it all was happening so fast. Dx 4/6/21, BMX 5/12/21, Radiation, then implant exchange on 9/22/21. If I had one week of no doctor's appointment during this time it would have been rare. The PS also said he was surprised I remembered so much of what he said, most people heard "cancer" and couldn't focus. Well, that's not me, and this was very important to me, so I had a notebook with notes and questions every time I went in.
My right shoulder is "acting up". I cannot reach back behind me as far or as easily as I used to. I read something about rotator cuff problems from laying on the operating table with your arms out for an extended period of time. I haven't seen anyone about it yet.
My thoughts are racing all over the map on any given day. I'm not happy with my foobs, looking at them can cause me to be depressed because they look so wrong. I want to get them fixed so they look better. I'm pretty much over my surgery pain, do I really want to go through that again? Will something wrong happen this next time, should I leave well enough alone? ETC....
I'm an overthinker to the max. Then I read horror stories on here and get scared of possible problems with additional surgeries.
I will take it one step at a time. Next step is conversation on Friday...
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Lalbo - I understand completely about wanting your foobs to look better and it is your right. You keep advocating or yourself!
Nothing worse than second guessing your doctor. I was very lucky to get such a great team of doctors. My MO is great, a bit intimidating, but nonetheless, a great doctor. We've butt heads a couple times, but nothing where she would get TOO irritated with m. In the end, she knew I respected her and I was just stressing over the situation. My BS and PS work so well together, both of them are perfectionists. I know my PS will get me to where I'm comfortable and feel good about myself, at my first consultation with her, she made it very clear that that was the goal.
I think you're right, some doctors don't realize that we do retain the information after hearing the word cancer. I didn't focus on the diagnosis as much as I focused on treatment.
I'm an over thinker too and like you I've read and know of horror stories. My surgeons are very up front with me and will always explain the risks and possible outcomes. I believe Mentioned this somewhere, but I don't think I'll have he option of smaller implants after rads and will have to get a DIEP. I'll know more on the 19th.
I think all the appointments get as draining as treatment. I remember during rads, I'd cry on my way to the hospital because it just became too much.
Regarding the shoulder, I'm having the same issue and in PT, nothing is helping and am seeing the ortho for that, he's given me cortisone sots we take care of the pain temporarily. PT recommended an MRI, waiting to hear if that will happen. At one point I was not able to tuck a shirt in the back of my pants, I couldn't even pull my pants up, my son had to help me, lol (funny/not funny)
Hoping all goes well with your consultation. Keep me/us posted. And I'll do the same.
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Serendipity… - I think I did well emotionally all the way through radiation treatments and the fill of the left TE, it hit me right before the implant exchange surgery. Now that I think on it, during one rad treatment near the end I remember having tears run down my face. I was just tired of it all. After the exchange surgery, when I tried on real bras for the first time (and nothing fit right)..I went home and sobbed for a good long while.
Nsbrown54 - please keep us updated on your progress!
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Lalbo - NOLA is a good bet. It's unlikely most docs would replace your implants until 6 months after your last surgery. But at least you can set up a consult.
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Lalbo - trying on bras triggered me. I really don't have to wear them, but I feel awkward at times. I've become more accustomed to not wearing them lately.
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MinusTwo - I'm not planning on having any surgery until July 2022 or after. I'll be at 6 months post last) surgery in March 2022. I'm waiting until I get my next round of vacation time. ;-)
Serendipity… - if my foobs were semi-symmetrical I wouldn't have to wear one. I really was looking forward to not wearing bras. I have to "stuff" mine to make them more similar. I put on a tank top with no bra and the line was diagonal. Whee!!! Not that I planned on wearing just a tank top, but that also translates to other tops. I felt more symmetrical when I had my TE's in. Now I really droop on the left side and am super perky on the right.
The last time I talked to my PS (6 weeks post surgery) he said he wouldn't touch the wonky right because of the radiated skin. To make the left more symmetrical with the right, he would open it back up, cut a football shape out of the capsule formed around the implant, sew it up and put the implant back in. He said that would lift it up to the "height" of the right side. Even if this is the way I would go, I think I would still go with a different PS, since I've lost confidence in the original PS.
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I talked with a nurse at the CENTER FOR RESTORATIVE BREAST SURGERY in NOLA. She was very nice and informative. I felt much better about having a follow up surgery after talking with her. She said she thought the surgeon would most likely recommend the APEX Flap procedure:
The APEX FlapSM breast reconstruction is a highly sophisticated microsurgical technique that is used to rebuild the breast lost to mastectomy. Like the DIEP Flap, excess living fat from below the belly button is transplanted to the chest to restore volume and shape. The APEX FlapSM differs from an ordinary DIEP however, as it allows for the natural anatomy and blood vessels to be rearranged to perfectly preserve the abdominal muscles and improve blood flow to the tissue transplant when necessary. This technique is an advancement over the DIEP procedure and has very specific indications and benefits. Link - https://www.breastcenter.com/breast-reconstruction...
I sent my insurance information to them and am waiting to find out how much I would have to pay for the surgery. They are out of network, I believe my insurance would pay 80%, but if I get the results then I would be willing to pay that.
They did say they have worked on people with radiated skin, so that was not an issue for them.
Overall, very positive.
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Lalbo - thanks for the information. I'd be interested in the APEX FlapSM. Do you know if it's only offered at the Center for Restorative Breast Surgery? I see my PS next week and am going to ask about this procedure.
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Serendipity… - I'm not sure if APEX is offered anywhere else, but I sure would ask my PS (well, not mine lol) about it. When I did a google search there was a place called PRMA in TX that looks like they do it, but how well I don't know. The NOLA surgeons pioneered the surgery in 2012. I don't know if they train other surgeons to do this type of surgery? It looks like it takes the DIEP flap procedure to the next level in protecting the abdominal muscle. Did you click on the link to read about it. It is pretty interesting. They would remove my implants and the capsule that formed around them, move the muscle back to where it was originally and then do the reconstruction. The muscle is on he top right now with implant underneath. I wouldn't mind the foobs being smaller than what I have. Their before/after pictures are impressive. I will also consider doing the 3D tattoos. They have a particular artist come in every so often to do the tattoos..from Boston or Baltimore. He did all the tattoos you see on their website. She said that could be a long weekend in the area.
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Lalbo - I did go the link and I'm impressed. I see PS next Thursday and am going to ask her. I wish I lived closer to NOLA, I'm in WI so a bit of a ways, but hey if insurance covers it or most of it I'd be willing to travel. My son would be more than willing to go with me. Definitely something to think about for me. My PS is amazing though, but I like the idea of not having the stomach muscle cut.
I plan on eventually getting the 3D tattoos, I wonder if the artist is Vinnie Myers? He's supposedly the best and in high demand in the US. I thought I read he travels out of the country as well. When it's my time I am willing to travel to him in MD. However I was just introduced to an artist here in the midwest known for doing 3D tattoos and his work is amazing. He goes by Mr. Pink so I may just go that route. I have a little time to decide though.
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Serendipity.. She didn't tell me his name, but if they are bringing him in from that far, it very well might be. I wasn't sure where you are located. I'm lucky it is within driving distance. I don't know if NOLA would recommend someone closer to your area??? At first I didn't care about the tattoos, but I think I would like them, if they are done well. Another way to look "normal" in all this.
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Serendipity.. It is Vinnie. https://vinniemyers.com/news.html
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He is regarded as the best and so it doesn't surprise me that he works with NOLA. He is in high demand, booking way out. I believe there's thread on here about him.
Thanks for the information. Like I said, going to ask PS and see what she says. In the mean time I'll reach out to NOLA to see if what they say and find out about insurance. It'd be nice just to know if it's an option. Thanks again! I'll keep you posted.
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Hi - I have exchange surgery on for my left foob March 15 and at the same time will get a smaller implant for my right foob. I’m currently at 650cc Mentor Memory Shape - medium height, moderate plus profile. I hope to decrease by 200cc. My challenge is trying to figure out my new bra size. I’ll go home in a bra and have an appointment a few days after surgery to get fitted for new bras, but would like to have a spare or two. I’m currently in a 38 EF. Will I still be a 38 and go down a cup size? Thanks. Nanc
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nsbrown - I initially had implants in the 600's and now have them in the 400's, with some stops in between... to answer your question my bra band size did not decrease, but the cup size did, although not as much as you would think - at least for me. I was a 34DD with the 600's and am now either a 34C or D, depending on the bra manufacturer. A number of the bras I purchased initially still fit, particularly the underwire ones. A lot of this has to do with the width and height of the implants and that they are not as malleable as normal breast tissue. My implants are the most cohesive of the Inspiras though, if yours are less cohesive you may find it is different. I often wear non-underwire soft bras, like Coobie or Genie type, and like them to fit pretty snug. Good luck with your surgery!
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