Exchange City
Comments
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IMO: Terrible idea. things will change, foobs will drop..nips will not match postiion. No harm in waiting and all the good reasons to wait, JUDY
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Kristen, my PS said I'd have my final bra size approx 10 weeks post exchange. For me, that was two days ago. But they'd seemed to remain the same for about a week now.
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10 weeks is about when my PS wants to see me again! Anyone else in total denial like I am, even tho you're told how long process is, always thinking and expecting to bounce right back and heal immediately! Must be this ENDLESS winter! that or the brain thinking I'm still in my 20's and the bod not quite agreeing!!
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10 weeks for the final bra size? What happens in that time? Do they get smaller or larger or does it depend? I'm 5 weeks post exchange and I've not seen bra changes in the past 3 weeks. I've dropped, still have some dropping to do on one side but I don't think I've fluffed.
What is fluff anyway? Is it breast tissue, are we developing more of our own breast tissue that seems a little contradictory? Why do we get fluff and people who only had mastectomy doesn't (or do they)? I'm over analyzing again, but I like to know these things.
Judy, If I decide to have my PS do my tattoos, is it possible/realistic to have somebody else perfect them later?
Julie
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Hi Julie! Good questions! Even tho I've been thru this before, I haven't experienced fluff! Maybe because old implants were placed completely under muscle? Shall see. I think from what Judy said you can always get touchups to tattoos. There's a great video on this site from a tattoo artist in Asheville, it will relieve any anxiety anyone has about getting this part of procedure. I'll try to find it again, or anyone else know?
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Found it!
tattoo video0 -
Yes, you can get touchups later. IF THE TATTOO COLOR IS TOO DARK, it may not be able to be corrected. ... JUDY
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Hi all,
Ok had nips and areola done exactly 1 week ago. Now on old rad side the nip is having some trouble. There are areas of black, meaning the skin is dying. Not a lot but some if it is on the base. Now I worried tha that this side will lose the nip. I see PS on Monday. He did say he was worried about the old rad side and the nip having trouble. Oh well guess this journey will continue on.
Janet
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Good luck Janet. Hope this turns out to be nothing.
I just had my visit with my PS.
1. No fat grafts for me. She warned that the fat could calcify and look like breast cancer on mammograms. She's not a fan of the procedure. I'm disappointed about that.
2. I had an area on the rad side where the tissue had contracted/pushed skin up toward my underarm. I asked if she could get rid of the fold that it has created but she said the scar tissue would just re-form.
3. I asked about a lift on the prophylactic side to create a bit better symmetry. She said that doing so the same time as nipple surgery would compromise the blood supply to the nipple and could cause the surgery to fail. So that's a "no" on the lift.
All in all, I didn't get a lot of positive news. She's still expecting me to need the LD flap at some time in the future.
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Julie - excellent question, about "fluffing" - no, you're not overanalyzing - just trying to be as informed as you possibly can! We don't make new breast tissue, that's for sure, but what does happen ( at least in my understanding) is that the skin softens up a bit and the pectoral muscles relax, allowing the implant to "fluff" (fill out a bit more, particularly in the upper pole). Deborah probably has a better explanation than that, though..... How long that all takes - the 10 weeks that Texas and Katey mentioned, or 12 weeks for me - depends on several factors: implant size, skin elasticity, bra/no bra. There must be some consistency, though, because my nips were originally scheduled 12 weeks after my exchange - almost exactly the day that I noticed how my foobs had "dropped and fluffed." - so I know my ps had calculated that based on something.....
cs7777 - No, you're not being overly cautious. l second what the others have said - nips at exchange a bad idea.....too many changes occur after exchange......this is just a LONG process.....
Katey - like I just said, this is a LONG process! That's why we need each other here, because even our friends can't begin to really understand what a complete pain in the butt this can be sometimes! Yes, it may be an endless winter.....I thought last winter was long, too, trying to recover from my snb, then my bmx, then begin to deal with fills......and I'm still dealing with healing this winter.....it's enough to depress anybody, so we just need to be THANKFUL that the darn cancer is gone and for the gals on EC to get us through it all!
((((((Typhoon)))))) - darn rads! praying for you.....
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Texas - sounds like you have a conservative, but thorough, ps. Sorry you didn't get the answers you want. Maybe Deborah or someone with more experience will have some ideas. I am intrigued about the fat grafting and mammograms, though.....my onc said "no mammograms, 'cause no breast tissue"......interesting..... Would she be willing to do a lift on the prophy side in the future? I know you're not wishing for another surgery, but if that's your best option, it might be worth it..... Hugs!0
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Texas: Val said it above and I echo it.....why would you need mammograms? Unless you have had a nipple sparing procedure, and even in that case, many oncologic specialists and breast surgeons feel they can monitor NAC sparing cases sans mammogram. There are many supporting articles and abstracts on this point, but here is one from bc.org medical files:
Mammograms after breast reconstruction
If you have reconstruction after mastectomy, you may wonder if you should have mammograms on the reconstructed breast. In most cases, the answer is no, unless you had a nipple-sparing mastectomy.
- If you've had saline or silicone implants for reconstruction, you won't need mammograms of the affected side. No breast tissue remains, and the implant blocks the view of surrounding tissues. With an implant, however, you and your doctor can still do a careful physical examination of the breast area.
I think that it is ridiculous to shun the notion of a less invasive procedure which could resolve issues in favor of a major surgery which has a significantly greater risk of complications. It warrants a second opinion.....a consultation with a plastic surgeon who is skilled in fat graft transfer.
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My fingers typed mammograms but I meant MRIs. (Wrapping my own knuckles! Bad fingers! Bad fingers!) Or, would MRIs be able to distinguish calcifications from cancer?
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TEXAS: According to my PS......and re: future MRI's - it is not going to be an issue.
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Well, you never know when the tears are going to hit again, do you? The tattooing video that Katey post has just about done me in. Judy, you makeup artists who work with bc ladies are just wonderful - you must have the biggest hearts.
What Val says is spot on. This process takes FOREVER, and really nobody can understand how trying every step is. I goofed last night and slept on my side (of all the terrible things to do), and the sharp pain woke me up. My foobs are still pretty sensitive.
So please send your wishes to a dear friend of minel. Jan is going in for emergency colon surgery right now due to a condition that has caused her so much pain over the years.
Kristen
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Now, I'm certainly not a medical expert, but it would seem that since MRI's can visualize muscles and bones beneath the fat, adding additional fat, especially in such relatively small amounts for fat grafting, wouldn't make much difference....... Texas, is your doc at M D Anderson? Maybe she knows something that we don't.......0
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Kristen - I'm still sleeping sitting up - per ps orders - and did so after my exchange for probably a couple months.....just wasn't really comfortable really lying down anyway.....I used to be a side sleeper before my bmx......certainly couldn't do that with the TE's......can't wait to do it again!.....though don't they say that sleeping on your side is bad for your complexion? oh, well......0
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Just wanted to add my two cents . . . My breast surgeon told me I will not need any more Mammograms or MRI's any more since I have had both of my breasts removed. She said they will just do a physical exam only. Personally, I think I would like to get a MRI at least once a year just to make sure there is nothing in the chest wall, etc., but my surgeon said I will not need them. Once it is all said and done, I might talk to her about it again.
Karen
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Kristen! I'm so sorry!! 3 weeks here and the bottom of my left foob finally doesn't hurt:)
Val, you sure have been thru it. A long time, but sounds like you are taking every precaution to be sure of a fabulous result!
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Scrapmom, My GS told me the same thing, he would do physical exams and that was it. I asked him about an MRI and he said they would not be necessary. I know from research, that it is recommended to have an MRI every three years with implants, to make sure there are no leaks. I'm sure he will be thorough with his exams, but I would feel better having an MRI.0
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Val, my PS has her own practice but completed a fellowship at MD Anderson. She's trained under some of the best from New York to Houston on breast reconstruction, focusing on microsurgery. I know she'd do an excellent job if I do end up needing an LD Flap, it's just that I'd go into that surgery fighting tooth and nail.
As far as her knowing something special, I think she's just ultra cautious.
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Janet and Texas, Bummer for both of you!
Val, Thanks for the explanation of fluff. So it's the implant that fluffs not more tissue, that's a relief. Any idea what we can do to encourage it? You're PS sure is strict with you but I tend to like his advice. Was he this strict the first go round or is most of this prevention of a third exchange? What's the purpose of sitting up to sleep?
Katey, Thanks for the video link, wow that is a tear jerker. Judy thank you for being one of those women, what a beautiful gift to share!
Julie
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Thanks Val, Estepp, Facecrafter and anyone else I missed for confirming my thoughts about waiting on the nipple reconstruction. I'll definitely wait.
I'll add 2 cents about the fat grafting & future exams. I don't want to scare anyone, but I've also been told and read in various places that the grafts can calcify and look like lumps on MRIs or be felt as lumps during physical breast exams. So while some PSs like them because in a lot of cases they help smooth out edges, a lot of onc surgeons and oncologists don't because if they calcify into lumps then they feel obligated to investigate them as possible BC. Luckily the techniques seem to be improving so this problem is lessening. What seems like a reasoned article on this is here: http://behindthemedicalheadlines.com/articles/lipofilling-a-role-in-breast-reconstruction-surgery. For rads patients with significant skin issues, the next to last paragraph is quite interesting. I used to do research on blood vessel growth and the procedure they describe there makes a lot of sense.
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Hi! So glad I found this thread because I sure do need HELP!
It is such a long story - but I am about to undergo the 5th surgery for my reconstruction.
I had delayed reconstruction. Bilateral mast. Tissue expanders - one that collapsed. The PS at the time would not put in a new one. He said he did not need to that he could fix it in surgery. So he did his thing and the results were awful! He was mean to me ..... another story.
I do not want to have the invasive process of flap or DIEP.
I left and found a top notch surgeon and he took those out and replaced them with Allergan 410's. He thought theywould help with the place where muscle was taken away and be better for my thin upper body construction. They have not worked either. He said that some of the pocketing that was done (or not done) the first time around is difficult to deal with. One side is fine, but the other has turned. He went in and put it back in place and it has turned again. So, now on March 19 I am havinbg the 410's taken out and round Mentors put in. He suggested high profile and I said no. That is what I had the first time and they stuck out like coconuts. So it is under discussion and I am hoping to get some insight here.
I am 5'4 1/2". A thin woman. Lean in the upper torso and there was some muscle taken away when my tumor was removed. It left a kinda divot in that area. Weigh about 120lbs. My real breasts were always a 36C cup. That is the bras size I wear now with the 410s. I asked for smaller. My chest size is 27" around under my bra line.
I do not want to be flat, all I want is a little something sticking out front saying "female" to myself and the world. But, I am pretty much at the point that if this does not work this time, I'm done. I'll have them removed and go flat. The whole experience has been exhausting. I like my new surgeon and think he is competent. I know he is. But I want to put in my two cents as much as possible.
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Thanks cs7777. I've bookmarked that study in case I decide to push the issue with my PS. I think if I absolutely insist down the road, she will do it.
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Hello everybody.
I am scheduled for my exchange on March 11. I have a question. Is there anyone out there that also had abdominal Lipo or a tummy tuck at the same time? I will be seeing my PS next week to discuss my options/needs. I would love to have input from others who have done this.
Thanks
Navy
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I've gotten the okay to schedule my appointment for replacement surgery!!!! Surgery will probably be in April! Yippee!!! I want to be sure that the implants won't sit as high as these goofy expanders!! Whippetmom, you had advised me to go with the Mentor Round High Profie 600 or 650. You don't believe these will sit too high on the top?
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Welcome, Victorious! Wow, girl - you've sure been through it! We are quite similar in stature - I'm 5'7"/115# and also with a very thin upper torso - and my ribcage is 27 1/2". Almost twins, huh? (I just noticed you had ILC, too, and were diagnosed on the date of my bmx....weird.....
) I will tell you that I have the Allergan Style 20's (their high profile), and for me, at least, they're not very coconutty.....so, perhaps your first ps put in the wrong size for your frame? There's a pic site (not here, but related) where several of us have pics posted, but I'll also be glad to send some of mine to you if it would help. Just PM me if you want..... Julie - I don't think there's really anything you can do to encourage fluffing....it happens, when it happens. Now, I will say that wearing a bra more than likely lengthens the time....but that's not necessarily a bad thin, because maintaining the integrity of the pocket is truly paramount. When I asked my ps if my new implant would take as long this time to drop as the first time, he said no, but wouldn't commit time-wise (kinda like when I asked him how long surgery would be, to which he replied,"as long as it takes."). He did say I could loosen my bra strap a bit to speed the process - I decided against that, though - so from that little exchange I know the bra is a bit of a deterrant..........And no, my ps was ultra conservative the first time, too.....even more so this time......he "requires" (like he could really control it) the elevated chest position while sleeping because there is less gravitational pull on the implants. You know how when you lay down, they want to slide laterally?.....that's what he tries to prevent until the pockets are well-healed.
Texas - sounds like you're in excellent hands.....
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It has been 1 1/2 yrs since my exchange. I have no feeling in my breasts , and under one arm wher I had several lymph nodes remove, My "good" side has limited feeling...I don't think it will improve now..0
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Mehere - Congrats on your exchange date! Don't worry, once the high profiles are in and under your pecs, they won't sit too high.....mine (Allergan's, though) have a nice slope...0
