Exchange City
Comments
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So...about the bras...even if my PS does not reccomend one, it sounds like I will WANT to wear one. Especially since my shape now with TE is "football-esque" and I worry that they will always have the tendency to migrate back out to my armpits. I assume we need to buy this before surgery...what do I buy??? Now I really can't wait to speak to my PS next week - so many new questions! You guys are all so amazing, I worry for anyone that isn't armed with all this necessary info. Thank you!
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I've already posted my info so I might as well again.
I live in Sacamento, CA. I'm in an HMO, which means I have to go to a Hill's Physicans Provider. In the greater metropolitan area where I live, there are exactly four plastic surgeons.
Three of them have fancy schmancy websites but one is chief of plastic surgery at the hospital I will be having my mastectomy, and he specializes in breasts.
The one I saw is not board certified in plastic surgery, at least, on every single website I found on him (including Hill's Physicians own) there is no certification listed.
I fellt shocked. I have looked at many, many pictures online as I'm sure we all did after diagnosis. And, I've not seen many that look that bad. I did think maybe the ones online are not realistic though. I don't know. The weird thing is he thought they were fine and he said the women were happy. And, I was shocked.
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kerkle: I want to know why your TE's are football shaped.....are they low height TE's??? You mentioned something about one being displaced.....that concerns me...describe further what is going on with your TE's.
CoolBreeze: You have a legal right as a breast cancer patient to seek breast reconstruction by a professional who is experienced in breast reconstruction - NOT simply breast augmentation - EVEN if you have an HMO. So let's figure this out for you. Be right back.
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coolbreeze ~ The photos that I saw online shocked the hell out of me and my PS photos looked better. Figured my results would fall somewhere in between and I have been pleasantly surprised. The thing I like about my PS is that he does "breasts for the stars" in La Jolla and Del Mar, CA in addition to the Sharp Community health Group work so I feel that he has even higher expectations than I do. I would definitely find someone who is not looking to get an 'acceptable' result. In this day and age I expect the best. My 2 cents.
Having just got back from what I believe to be my last fill I was disappointed. PS felt like my muscles were not stretched enough (which I knew but didn't want to believe) so I have to reschedule for 2 weeks. Was relieved that he didn't go ahead and I would have "falling out of the pocket" issues (whatever that means . . . .) Am so looking forward to having my exchange date on the board . . . . .
Deborah ~ you were right (are you ever wrong????)!! He is trying to get me to 800 cc's and put in 700 cc implants. Silicone not saline. Will keep you posted when he lets me know what kind.
Love the "breast whisperer". Does that make Judy the "tattoo whisperer"???
Take care ~ Colleen
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CoolBreeze:
Okay, you are going to need to go to San Francisco for your surgery. You have to go to him BEFORE January of 2010 - as otherwise you will have to be in the SF network with Hills. This is the guy: I have heard wonderful things about him! I am driving from Long Beach to San Diego for portions of my breast reconstruction. This is a 3 hour round trip drive. You can do this. Also, Dr. Foster may very well know a PS in Carmichael who can do your fills for you or see you in between visits. All of this can be worked out. Finding a great plastic surgeon is HUGE!
Practice Name: Robert D. Foster, M.D. UCSF Medical Center more
350 Parnassus Ave #509 map
San Francisco, CA 94143
(415) 476-9238
Specialty: Plastic Surgery, Facial Plastic And Reconstructive Surgery
Accepting new patients: Yes
Wheel Chair Access: N/A
Only for Members with a San Francisco Region PCP
Effective Date: 01/01/20100 -
Whippetmom - I can send you a picture, I just don't know how. I have on my computer - tell me how to send it. I filled them to 230cc's and I can still feel the empty, folded over plastic inside. It is as if I had the TE inserted and because it is all crumpled up in there and was never fully inflated, I can feel the folds in it. On my right, I can press the point in and play with the bag as if it were empty. I thought that was normal since they are not fully expanded. Uh! oh! Maybe it is wishful thinking. I also have a huge space between my two TEs, they are so off to the sides that I can not put my arms straight down, I have to rest my arms "behind" them.
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Okay, that formatted really weird, but make an appointment with him - at LEAST for a consultation. If you just cannot handle driving to SF, I would trust HIM to tell you who he would want you to see in the Sacramento area. There are a number of women on these boards who have gone to Dr. Foster and just love him.
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kerkle: PM'ing you0
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What, what? Why SF? That means I'd have to do delayed reconstruction. Surely somebody is qualified in my area?
How did you get that name?
What do you think of Jason Solomon,MD? Chief of Plastic Surgery at Mercy? I'm thinking of asking for a referral to him.
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Okay, I just read his bio. 300 reconstruction surgeries a year - it's a lot.
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Wonderful Deborah!
CoolBreeze... really consider this PS. Also.. have you look at all of US on the TimTam sight? If not.. Please PM a lady HERE named TIMTAM.. ( screename).. tell her yo9u want to look at our recons. pictures.. this will let you see if we are what you we want...
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Why would you have to do delayed reconstruction? Maybe I do not understand how your HMO works. But you would go to SF for the mastectomy with immediate reconstruction. Jason Solomon is a PS, board certified yes, but his first specialty is that of being an ENT [ear nose and throat surgeon.]
This is how I found Dr. Foster:
https://www.hillphysicians.com/phydir/PhyResults.aspx
Is this the link to the area you are culling your info from?
https://www.hillphysicians.com/phydir/PhyResults.aspx
I'll check out the Sacramento docs and PM you tomorrow.
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I did PM TimTam, thanks. I hope she gets back to me soon.
So, let's say I do go to SF for reconstruction. How exactly would that work? Would I get my surgery here and then go there? Would I just switch all my doctors all together and start over?
This has been going on since May. A board of oncologists, surgeons and radiologists reviewed my tests and universally agreed that I need to get started ASAP. Surgery was scheduled for the 19th.....
I don't know what to do. This is such an important decision but I don't feel capable of making it or knowing what I need to do. I'm in such pain these days too. I kind of just want it out to get rid of the burning.
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Whippetmom
My surgeon, Dr. Thiru Rajagopol, is the one doing the mastectomy, then the PS comes in and does the reconstruction. Dr. Raja is acting as my primary care physican at this point, or is at least conferring with my PCP to get me the referral. He is the one who presented my case to the tumor board, and why it suddenly became something that couldn't wait.
So, being referred to SF for a plastics might happen but I don't know if at this point I can start fresh with a new surgeon.
So, yes, I am using that website you linked to. I put in all the cities near me; Sacramento, Carmichael, Orangevale, Citrus Heights, Folsom, Cameron Park, Roseville - and I get four plastic surgeons. In my other thread - my "shocked" thread, I listed all four of them, except the one I went to today,, whose name is Eugene Lee.
(By the way, I have greyhounds.
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Coolbreeze, Get answers! Get a second opinion, and Deborah is the "Breast Whisperer" for a reason, she cares and she is the cyber advocate for women dealing with BC. It seems to me that you should only have one surgery, a mastectomy with immediate reconstruction process started with tissue expanders put in. I think you have been dancing the insurance/physician tango, and it is time for you to take the lead.
Deborah, you knock my socks off!
Judy, another fill already? IWe need a new nick name for you , The fipple fairy? Nipcasso? Tats for Tits. . . . I better stop, it is going downhill from here!
Laura, I can't wait for you to get the newest exchange surgery and be ripple free.
Val, how is everything healing up?
Jan
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Cool Breeze: I understand your urgency! I was the same way and went with the PS my BS recommended. It was a big mistake! Half way through I decided this was not the doc for me. I had to start hunting for a new PS in the middle of my saline injections with my TE's. If I had to do it all over again, I would get the cancer out and then start searching for a PS. That way you can make a clear decision. My new PS is amazing and has done a great job but had to do a lot of repair work and now I have a strange flap of skin under my arm from PS #1. I am convinced if I had PS #2 the entire process I would not have to go back in to get the skin flap removed!!!!
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Laura - after the first revision the PS told me not to wear a bra. But, when the implant dropped and I required a second revision, he then said wear a bra. So, I wear one now almost all the time (except to sleep). I hope it will prevent dropping and it feels better to have the support.
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I do not post often but visit this site often, Thank you to everyone for all the valuable info.
I am wondering if anyone is from the Toronto area and being treated at Princess Margaret. I debated having reconstruction surgery but 2 years post op and radiation I had Dorsi flap surgery with expanders.I am so happy with my decision. My exchange and lift is scheduled for the 16th.My PS has done a beautiful job so far but has not mentioned what type of implants he will use. I will not see him again until the day of the surgery so I am wondering if anyone else has had surgery with Dr. Hoffer.He has wonderful credentials and am not worried,only curious.
Again Thank You for the amaxing support and info here.
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I am glad we are helping CoolBreeze. No one should have to go through that crap. Cancer sucks but at least we can make it as good as it gets!
Jan, I'm cracking up at nipcasso... the fills are finally done..done..done..DONE!! Now wait a few days for the pain to subside, and wait a few months(like 6 or so) for the exchange.
Thanks for your suppoet...JUDY0 -
Ladies, thank you so much for your help and advice.
Each step of the way I have had to readjust my thinking - and I guess this is another time. I really didn't want to wake up with no breast at all - but I guess if I have to do that in the short term as opposed to a bad long-term result, than that's what I have to do.
I'll have chemo and rads though - WHEN would I start recon if I had to delay? Should I do that before rads?
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Sorry.....I had a mini crisis to take care of with my MIL this morning....
CoolBreeze: Please call Dr. Foster's office and make an appt as soon as you can. I am not seeing any other plastic surgeons I would feel comfortable with at this point. I mean - one of them has a practice called "Chrysalis Cosmetics"!!! WHAAAT??? You want someone who does as many breast reconstruction cases as he does augmentations! Today call Dr. Raja and tell him what you want to do - that you are going to get an appt. with Dr. Foster. Who knows...Dr. Raja might have surgical privilages at UCSF Medical Center - let him know that you need to feel absolutely comfortable with the plastic surgeon who performs the reconstruction. Getting the right PS is HUGE....HUGE...wish I could make these letters HUGE to emphasize how important this is to the end result.
Some plastic surgeons do not like to start reconstruction until AFTER rads - chemo is not an issue - just rads. However, there are some studies which support that performing expansion with TE's and then doing rads has been successful. Laura [Estepp] did it this way....and on the pictures forum I posted a link to the article regarding rads following tissue expansion. But you would need to talk to Dr. Foster to see how he prefers addressing radiated skin expansion. Let's see what you can accomplish with some phone calls....
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Just my .02
If I were to have implant only recon... I would get 100% filled in the TE prior to ANY rads..
If you want any type of tissue Reconstruction, you can wait until after rads.. and it will look great.
I was 100% full prior to Rads starting. My Rad. Onco wanted me to fill after rads. I said no way! My PS and MD Anderson Protocol is to fill before. You can get 1/2 filled and try to finish fills after is the NEED is there for this... ( Judy did this and is doing well).... but it is in your best interest to fill up first. There cn be mucho pain in filling after... ( Judy has not had this much.. wahooooo)
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I called my insurance company, and they gave me names of other PS in my area. But, they are the ones I found before, with a couple that are in Elk Grove, that I didn't look at.
I asked about USF and with Raja's auth, I can go there.
So, I guess the next step is to call Raja's office and tell them what I'm thinking.
Some of what you've said I don't get - I will have to have rads - I should do reconstruction first then?
It makes me sick to think of one breast. I know you ladies have done it and I can get through it, but today is the first day I have cried over this. At all. And, I'm at work. Great.
So, the SF surgeon is so good because he's done so many reconstructions? It's a long, painful drive....
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If you want an implant only.. you will need to have your Tissue Expander (TE) put in at surgery. Then... about a week after surgery... start your fills. You will need to have those TE's filled to where you want them... THEN start radiation,
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About six months AFTER radiation, you can have your "exchange" to your real implants ( silicone or saline.. your call)
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CoolBreeze: You would need to see what Dr. Foster's preference is for rads PRIOR to expansion vs. with expanders. We know your feelings about this now...about waking up with SOMETHING that resembles a breast....we all ache for you with this angst you are going through. On this thread, we are almost all on the other side of it....we have the end result. You will be on the other side of this also - you just need to hang in there....The mastectomy will someday be a distant memory... But in answer to your ? about Dr. Foster: Yes, he has done many reconstructions and he has a lot of happy patients - many on these forums.
Here is information on Dr. Foster:
Biography
Robert D. Foster, M.D., is currently an Associate Professor in the Department of Surgery and currently holds the position as Chief, Plastic Surgery Service at Mount Zion Hospital and the UCSF Breast Reconstructive Service. A physician for the past 20 years, Dr. Foster received his plastic surgery training at UCSF, where he has worked since 1997. He is a member of the American Society of Plastic Surgeons and a Fellow of the American College of Surgeons.
As Director of the breast reconstruction service at the Carol Franc Buck Breast Care Center, UCSF Cancer Center, Dr. Foster performs more than 300 breast reconstructions each year. His clinical practice includes a broad range of reconstructive and cosmetic surgery.
Dr. Foster's research interests include outcome studies to evaluate and optimize breast reconstruction techniques and developing improved methods to help patients through their decision making process at the time of breast cancer diagnosis and treatment. He is the author of more than 75 publications and a guest reviewer for seven scientific journals. He has frequently been invited to lecture both in the United States and abroad.
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CoolBreeze: I know, I hated crying at work too (and I did it much more often than I wanted to). But if the thought of one breast makes you sad (I know it made me sad), if your expander is put in after your mastectomy as one surgery, you will wake up with a little "baby breast" which will get bigger each time you get a fill. When I woke up after surgery and looked down, my husband says the first thing I said was, "I've got cleavage!" and I did! It really helped.
Please, please, go to a PS who does a lot of reconstructions. Reconstructions are much more difficult than plain simple augmentations! My PS specializes in reconstructions, and I'm very happy with my results. Check me out on the picture forum, if you like.
Do this for yourself--you deserve it!!0 -
((((CoolBreeze))))) (((((kerkle))))) Hang in there, sisters!! Sounds like you're getting excellent advice from the experts!!
Just got back from another post-op visit with ps, and he removed the "reinforcement" sutures on the area on my lower left foob. He checked me and said in the bra the foobs looked good, but he thinks my left one has migrated a bit - which I actually thought I noticed last week before I was in the underwire bra. So....perhaps that helps answer anyone's questions about wearing a bra after exchange........... Whippetmom summed it all up quite perfectly, I think..........
Also, he still has me on restricted arm movement - no shoulder movement, elbows at waist - and no exercise yet - nothing more strenuous than a "leisurely stroll." Since I'm finally starting to feel better, I was hoping he'd let me at least do some lower body exercise (I miss my pilates class!). He said my skin is so thin that there's very little holding the implants in place (except for lots of internal sutures), and we can't risk any excessive movement to compromise that. I certainly don't want to mess up his handiwork - or my "new" body - so I guess I'll be a good little patient......
CoolBreeze - do check out the pic site as soon as you get access - it was a true blessing to me and to so many of us here.
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Whew... So much going on. Coolbreeze - my heart goes out to you. But I would agree w/ the other ladies - implants can look great. Make sure you have a PS that you are comfortable w/.
For what it's worth - my PS is of the school that doesn't feel that a bra is too important after the exchange. I had my exchange in April, wore a surgical bra for a little while afterwards and now only wear a soft sports stretchy camisole. So far so good for me.
Has anyone had nip surgery and grafting here? If so, what is the recovery like?
Thanks. - Jean
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Okay - I am now convinced that I must have the biggest chest wall in the world.... My TEs are at 840ccs and the silicone implants (smooth) the PS has chosen are 800ccs - I am not tall - only 5'4" but I am not thin like all of you - I measure 39" around where my bra would be if I could wear one right now - my TEs are not the same - one is up under my collarbone and the other is where a breast should be (although it slides under my arm) - I can only hope that I will look ok when this is all done....I am embarassed to go out in public these days - the difference is soooo noticable. I was going to have a tummy tuck at the exchange - but my work was giving me problems with the time off - I decided against it.... I am tired of looking like a freak and angry that the only "good" thing I would get out of this whole thing (the tuck) isn't going to happen.
Allison
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