Exchange City
Comments
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Lisa: It's great to see you here! There are ladies here who could benefit from your experience. You are so generous and articulate when sharing your thoughts.
Geena: I also want to wish you well in your search to find a solution to what's hurting your radiated side. I am especially interested because I also have a radiated side, but I am still in TE's.
To Kimberly and the rest of the squishy ladies: When you say you feel they are not there, are you saying that you don't feel like you are wearing a bra even if you don't have one on (like you do with TE's)?? That would be really something to look forward to!!!
Deborah: How are the fipples? You have helped us so much, I wish there was a way I could help, but I don't even know when my exchange will be.
Speaking of droop and drape, after filling me to more than 600 cc's the last time, PS said we might have to stop at 700, not 800 which is the capacity of my TE's. My skin looks like it can take a lot more stretching, but I think it's my radiated muscle that is starting to complain. Like there's a spot near the fold that aches when you poke it. 600 may sound like a lot for a small person like me, but they are so spread out on my chest, the projection is not even too much. It's just right, I think. Should I ask for 600 cc's and not 550 like he planned for the exchange?
Take care.
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RE OVER-EXPANDING/OVER-FILLING
Per Allergan:
1. Inflation of the expansion envelope beyond the suggested fill volume should be undertaken with extreme care and increased attention to avoid trauma to the device or surrounding tissue.
2. Physiological and behavioral differences among patients and variations in surgical techniques and medical treatments account for a wide variety of responses to tissue expansion surgery. Revision surgery may be indicated to maintain patient satisfaction, but carries additional considerations and risks, and should be kept to a minimum. Revision surgery may be complicated by scarring, tissue deficit, and decreased vascularity from previous surgery.
3. Though the expansion envelope is easily stretched, expansion beyond the recommended volumeincreases the probability of deflation.
Another risk inherent with tissue expansion against the chest wall:
"Chest-wall flattening (deformity) has been reported with the use of tissue expanders and silicone breast implants. Pressure from expanders may cause deformation or resorption of underlying bone."
I am concerned that over-expansion of the TEs beyond the recommended fill, increases the risk of pressure on the ribcage and chest wall and this is one additional reason to be fully aware of how the patient is responding after each fill. Unfortunately, most plastic surgeons have their nursing staff performing fills and nursing staff are not necessarily looking for complications involving the chest wall. I have read case history of rib fractures occurring with tissue expansion. Certainly if you have had radiation prior to tissue expansion, I would not even consider overfilling or overexpansion of the TEs. too many cases of rib fracture after radiation.
http://www.springerlink.com/content/y841316537921883/
More to follow re: Julie's question and questions others have posed re: the implications of overexpansion.
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Brenda, I do still feel tenderness in my foobs (9 days from surgery), and it is not comfortable for me to be braless. I need the support. I have Allergan 15 with 397 ccs, and there is quite a bit of implant there on my chest. I never wore a bra with the TEs, so it's a bit of a drag to have to wear a bra all of the time. On the other hand, it looks so nice, and I'm enjoying the cleavage I never had. (and I do feel the bra holding me up and in)
Every woman is different, but I was actually underexpanded - only to 180 ccs. This made for a good cosmetic result after the exchange (no extra skin) but perhaps caused some extra pain as the muscle had to stretch a little more. It feels like a more gentle stretching since the implants are so much softer than the TEs were. I'd love to be able to forget about my breasts, which I can't do just yet.
Annie, you made me laugh! Best wishes on your scans.
best to all,
Kristen (the marked woman who was banned from Target for a year, and who still shops there despite the indignity)
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RESEARCH RE: OVEREXPANSION OF TISSUE EXPANDERS FOR BREAST RECONSTRUCTION
Based on everything I have read about "overexpansion" of the tissue expanders above the recommended fill levels seems to refer to women who have had unilateral mastectomies. I am reviewing material written ten to thirteen years years ago regarding preferred methods of tissue expansion. Ten years ago, most women were not opting for bilateral mastectomies. Additionally, the focus on cosmetic enhancement of the healthy breast was just beginning to be an accepted part of reconstruction. Previously, there was no suggestion of a lift and certain no suggestion of actually AUGMENTING the healthy breast! Heaven forbid! So, overexpansion of the TE was necessary in order to get the droop represented in what was then a healthy breast of a woman at the average age of 55. This is from "Reconstructive Surgery of the Breast" by Bohnert, et al. - 1997:
"Overexpansion facilitiates deeper fold development and modest ptosis." Ptosis means "droop." And I will bet they did not mean "modest" because I have seen photos in those old medical journals and they managed to create a really droopy breast to match the other droopy healthy breast.
I think overexpansion serves a purpose in some instances. Where the inframammary fold is disrupted and requires fold revision, certainly overexpansion could be of benefit. But how much....the PS should know what is required. Another instance where I can envision overexpansion being of benefit, is for the very small woman - with a small ribcage and very little tissue covering. Overexpansion would enable the PS to use the smallest TE available and overexpand by 30 to 50%, thereby allowing the insertion of an implant with the appropriate volume to satisfy the patient and allow for good skin integrity. Additionally, there are women of all sizes who might present with minimal skin flaps, or might have had a non-skin sparing mastectomy and later decided to have reconstruction. In such cases, you can see how overexpansion beyond the recommended fill volume might be warranted. According to the manufacturers, overfilling is not for all patients.
But now that bilaterals are becoming so common - I am not sure why overexpansion is considered by some plastic surgeons as "something we ALWAYS do." It is not an ideal option for every patient. Deen had problems with overexpansion - her skin stretched significantly. She was not happy with her results [although I think she looks fabulous...] Some of us just have nice, pliable skin and if I had been overexpanded 100 ccs over and above the recommended volume, I would have been very unhappy with my results. In fact, my PS felt that she would need to overexpand my TEs from the recommended total fill of 400 ccs - just 25 ccs, in order to get the 475 ccs we both thought would be right for me. [And SHE is the one who told me, "in modern practice, we almost NEVER overexpand any longer." I woke up with 550 ccs instead of 475 ccs, because my skin had stretched so much - the 475 cc's just hung like puppy dog ears. She said she knew I would have been really, really ticked off if she sent me home with small droopy breasts. 550 ccs turned out to be just right for me. But some women HAVE gone home with small implants and lots of drape....more drape than they wanted.
So our hope is that we communicate to the PS what we want and even take in a couple of photos you can print off the internet. Take in photos of droopy breasts and photos of nice natural looking breasts and show your PS. Point to the droopy breasts and say, "if I wake up looking like THIS...you might as well put me right back under!!!" Unless, however, you WANT to maintain the same appearance as your former natural breasts...or do not care to lift or augment the healthy breast. I did have one women who came to me, very disappointed because her MX implant was "too perky" and she wanted it to be droopy, like her healthy breast. So everyone has an idea of what they would like to see at the end of the journey. It is such a subjective thing...how we look....how we picture in our minds we will look at the unveiling after the exchange.
This is a really long dissertation. I hope it is not confusing. It just opens the door for further discussion with your plastic surgeon. Make sure you are on the same page. According to the manufacturer's specifications, overfilling is not for all patients. Reconstruction is not a one-size-fits-all process.
Julie....in final answer to your question....you do not have a lot of extra skin. But the mere fact that your PS is suggesting removal of skin, just resounds with me....so then WHY did you need to be overexpanded to begin with? Taking skin is no picnic!! You have nice, pliable skin flaps and you will experience gradual modest ptosis..... When, how much....we just don't know and we will have to wait and see whether revisions are in order. Droop does occur with time and gravity....so for those of you two months post-surgery and beyond who desire more droop, go braless as often as possible....
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Brenda: I am getting used to the fips and I think they will be fine. One is dead center on the breast and looks like a stick-on....but no one but me would know. Oh...and the forty of you who will see my nips in Vegas, of course.
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Hey Deborah, I can't go, it's my 25th anniversary in October that weekend. Will there be a billboard?
. I think I will put on my red sequin pasties and send you girls a boob sisterhood shot. At least I'll feel like I'm in Vegas.
xox
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Annie... I am here...:)... thanks for looking for me..:) I am about finished with the update on my Salon. ...
GEENA... your rads breast is gonna ache.. I hate this!... YES.. A PT that has knoweldge in lymphedema is who you should speak with. You will get excersises that can help . She/he will show you how to massage the scar tissue you have. Some of what they teach you will work. You and ladies like you and I will be doing these excersises for life. It is doable. I am sorry for any gal who suffers with this. For those who donot suffer from the rads pain... feel blessed!
KittyCat.... I will pray for your sister. She CANNOT have mets already...So sorry for you family...:(.... let us know...
I hope this finds you well...
Jean... how are you ?
MOORETENNIS will have NIPS in two days...WAHOOOOOOOOOOOOOOOOOOOOOO!
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Thanks everyone for the feedback on my ovarian cyst. It has been there for about 5 months. I had one on my right side, but it went away. The left one is staying there and growing very slowly. I'll update y'all tomorrow on what the onco says!
And, thanks for the prayers for my sister. She only had one spot light up on the PET scan, so hopefully if it is mets, it is more treatable. But PRAYING IT'S NOT!!!!
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Brenda - When I say I can't even feel them (my gels) I am speaking of the weird feeling of something inside me. With the TE's I always KNEW there was something there because I could feel them, and they were uncomfortable.
I woke up this morning on my belly. It is so good to feel normal. It has been 10 days since my exchange and I do not constantly think about the implants. I love them because I sometimes forget they are in there. I get a muscle twinge if I do something stupid (usually really stupid!) but have not had the tight bra feeling since the new girls arrived.
That iron bra feeling went away instantly! I am wearing sports bras or the surgical bras right now, but my PS said I could go bra-less for an hour or two if I feel comfortable. Even a tight sports bra does not compare to the iron bra feeling of TE's.
Just sitting here quietly, I can not feel my implants. It is a wonderful feeling! NOW, if I squish them - it's fun to squish them - I feel the muscles press against them but it is not painful or uncomfortable at all.
Hope this helps in some way. You will love them!
Kimberly
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Thanks everyone for the words of wisdom re: aching rads implant side. I did call the lymphedema therapist at my hospital -- she's away on vacation til the 10th - left her a message.
ESTEPP - I soooooo wish doctors would tell us this stuff (or that mine would tell me). I don't like the idea that I will have chronic pain as long as I have these implants in. I so want more physical comfort. I think over time, if this keeps up, I would consider explantation. We'll see. I know the biggest practice with all of this is a "wait and see attitude" and patience. Practice makes perfect?
Lilah - I'm looking for something to throw.
Off to work!
Geena
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{{Wabiwoman}} I'm so sorry you are dealing with all of these issues, but may I just say that you appear to be handling everything with tremendous grace, humor and style. I hope you find some relief soon.
Brenda - when I had te's, I thought I could feel every edge, and the hardness of the "shells" was so uncomfortable - maybe I just got used to the feeling so most of the time I wasn't in pain, just discomfort.The implants feel lighter, and of course, softer. I'm 1 week post-exchange, so still in my surgical bra (which I despise) but I really do feel like implants are not even there.
And I was SO looking forward to NOT wearing bras (after healing), but I definitely don't want time and gravity to do their number on my new girls so soon. *sigh* go ahead & sign me up for the BraMania Club - I'm in.
Erika09 - I'm right there with you on bridge & I think we're almost across
And re:antidepressants, please find one other than Prozac, Paxil, or Zoloft - I think those are the big 3 that interfere with Tamoxifen's effectiveness. Google "Tamox and antidep" for more info if you wish. I wish you the best with your decisions.Anniealso - you crack me up! "like I had an ass in my clavicle" - best laugh I've had in while!!! Sending best wishes for good scans {{hugs}}
Target-Banned-Kristen - also lol. Have to say that you're the second person I've heard of - another friend of mine is banned too!
Health and happiness, xo, E
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Dear Sweet Geena - I am so sorry you are still having issues.
Let me tell everyone that I have not had rads or chemo. That alone makes my recovery so much different than anyone else's.
I know how lucky I am. But for the women who read here and don't know where they fit in because (like me) they have not been through Chemo or Rads - there are good results! I also did not have any kind of pocket work or revisions done at my exchange. It was a simple procedure and I went out to dinner on the way home from the hospital.
Feel better soon Geena!
Kimberly
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Geena, I'm so sorry that you're hurting. Hope the throat problem will be relieved in time. Good to have a lymphedema specialist nearby. I have a great PT that does the IMT method, it is wonderful for releasing pain. Thinking of going back soon, shoulder issues after surgery! I bet someone like that could release muscle aches around implant. It can take awhile to find the right person.
Deborah and kittycat, guess we both have sisters going thru this. Hope yours is okay kittycat! I have a daughter who is now 10 years younger than my first diagnosis, always thought when she was little there would be a cure by now!! Have to start researching her next moves.
Lilah love those books also! If you haven't read it yet, you might also like 3 Cups of Tea!
Kimberly, every time you mention how well you did after surgery I am amazed!! Let's hope everyone this week and with upcoming exchanges feel as good as you! How it should be!! But if you have a little slower progress, hang in there, you will get there!
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Good morning, ladies! Hope you all had lovely weekends of healing and hopefully relaxing! I finished The Help last night - loved it!
Deborah - Your dissertation on overexpansion was wonderful - and we can never too much information! Funny....when I did that bc fashion show on Saturday, I met a woman who just had her bmx in Jan, and she was proudly commenting on how she was overfilled already....maybe more ps's will eventually see the beauty of the short height TE's that don't require overfilling.......I also was surprised to learn that some ps's have nurses do their fills. My ps always had one hand on the syringe and one hand on the foob feeling how the skin was responding and almost "sculpting" (or so it seemed sometimes) where the saline was going.....so many different practices out there.....
Kimberly - your cheerfulness is always inspiring....so glad everything's turned out so well for you!
Grakenmom - congrats on one week of softness....and welcome to the 'bra mania club".....I should probably appoint myself president since my ps is such a bra fanatic....
Mooretennis - tomorrow's your day, girl - yippee for nips!
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I turned the calendar today. March 1st..finally, the same month as my exchange...Wow. What a long wait and it's almost over. For the longest time I had my name on the bottom of the list. And now It's my month!!
Now, the countdown starts.. 29 days...WAHOOOOOOOO! JUDY
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congratulations, Judy!!!! I am very happy for you!
Kristen
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Lisa -- I'm Northern NJ... I PM'd ya
Brenda -- ask your PS how much he likes to overexpand... so that you can mark the spot / fill point (as it were) of the size you like and then continue fills past that mark according to how he likes to work. That's what I did. I find 660 cc's to be a nice size for me and so I am having two more fills (of roughly 100 -- 120 cc's) because my PS said she likes to overexpand by about 100 cc's (I may do JUST 100 more but may also add the extra 20 and see if she wants to put in a 680 cc implant, for example). That said, given all the wonderful stuff Deborah just posted about overexpansion (which I thought referred NOT to overexpanding the TE so much as overexpanding the capsule for insertion of a smaller implant?) -- perhaps you need to discuss with him why he is doing it at all! In my case as a uni, it seems warranted: I have very large breasts and though I will have a reduction and lift of my healthy breast, I don't want it to be made so small that it doesn't have some natural droop (which I've had, frankly, since I was 20).
Annie - LOL at the thought of you sending us a photo of your red sequin pastied boob while we are in LV next fall!
Deborah -- glad you are getting used to the fips!
Kimberly -- I can NOT wait to get rid of that tight bra feeling from the TEs! Alas, I have to wait 2 1/2 months. Sigh.
Katey -- oh I haven't heard of 3 Cups of Tea! Will check it out
Thanks!Mooretennis -- NIPS!!!!! Woo hoo!!!! Hope all goes well this week.
Reeltchr -- EXCHANGE AT LAST! I am sure you're a mass of excitement and anxiety. Hang in there and good luck! (Also do you teach film?)
Hugs to all!
Lilah
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ANNIE:
My photo will be on the first billboard when you enter the Las Vegas City limits. There is always some nearly naked woman on that first billboard so I think they will probably let me rent it. The nip looks like a bulls eye on the left side and so it will serve a dual purpose. Military personnel in the area can use my billboard as target practice.
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You crack me up, Deborah! Just think if we ALL posed for that billboard - scary thought, huh?
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Val....Is there a billboard LARGE enough for your 30 E's?
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Not a chance, girl! Between the two of us, we'd take up the whole thing.....
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Perhaps we could use the billboard that rotates photos and we could all be on it ~ one at a time!!!
Sitting in a meeting in my office, they are at the table negotiating a shopping center sale and I am on BC.org. May have to put myself on probation . . . .
Gotta run! Colleen
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OMG. The thought of us all on a rotating billboard..I'm in stitches!!
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Dear Musiclovermom, Thanks so much for your post about how good you felt once the te's were removed. As I sit here with my iron bra under my skin I cannot wait for the day when this is all a distant memory
I look so forward to feeling more "normal"...you make it sound possible
Healing and strength to all,
Laura
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I think we all need to be on one of those billboards...with pasties.
Now Deborah, it cannot be that bad, come on! Are you satisfied with it? Are you getting revisions? Cuz you have to know (of course) that I tried on every one of my fake nips including the glow in the dark ones. And when you've been used to having her um.."eye" shut, it does stand out like crazy. Because you are used to a blank canvas, so to speak.
You are so gorgeous and vital and wonderful a person, come on, tell me if you don't like it, you will fix it! Are you just not used to it? I hope you are not unhappy, that I could not bear....
Laura, little Laura, hello sweetpea!!!
xoxo
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to Laura..(jizogarden LauraO .two years out, she feels like mine. My adopted "girl".
. Very comfy. We, like all people who adopt, had a get to know you stage. Both of my cousins are adopted, so it was a helpful reference. They celebrate "gotcha" days, along with birthdays. So my exchange date is my "gotcha" day. New filling for my little princess (little ha!)If I sit at the computer too long, I do get iron bra, but I can stretch it out these days.
Happy days are coming for you my dear, and comfort too.
love and light
annie
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the billboard banter made me think of that lovely book, Reconstructing Aphrodite (http://www.reconstructingaphrodite.com/)
we could do some kind of group project, maybe an open website (maybe a billboard), where we post tasteful shots of ourselves in clothing. I've loved seeing all the foobs in pretty bras and clothes on TimTam's site - that really gave me hope during the long TE stage.
Kristen
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WITH CAVEAT NOTED BELOW:
Kristen....That book is FABULOUS! Who would not want to have reconstruction performed by one of these women? I will keep this in mind for all of the Northern California women...
http://www.womensplasticsurgery.com/
AND.....a VERY helpful explanation on "getting the best reconstruction possible"....I am posting this on the Breast Implant Sizing 101 thread!!!
http://womensplasticsurgery.com/reconstruction.html#best
EDITED TO STATE: Okay, I retract my comments above. Kristen just PM'd me about some things I missed. Nipple sparing surgery is not for everyone and this treatise advocates this use with the majority of patients. Most importantly though, and I missed it TOTALLY, is that they are advocating implant placement subglandularly - OVER THE MUSCLE! I would never want to advocate that type of placement. It would be very difficult to detect local recurrence - any palpable findings - if the implant is NOT under the muscle. So it is a beautiful book and there is some good information....but there are some reservations.
There you go...thanks Kristen for bringing this to my attention!!
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jizogarden - I hope you have great results too! I am amazed daily at how wonderful life is after the torture of TE's.
How are you recovering from your surgery? Are you enduring the fills with much pain?
I love my PS and wish I had told him how much I needed pain meds sooner. I was fine until I got over 500cc's then it got very painful and I would take my pain pills for three days after a fill. Now I have plenty and don't need them!
I ended up getting permission for massages and that helped so much with my shoulder pain and when the shoulder pain was gone, the tight pectoral muscles eased up too!
I highly recommend if your PS allows you, get a massage from some one who knows what they are doing!
I had 4 months of TE's and it's been less than two weeks without them - it seems like so long ago!
Love your pict - what is it? I can't figure it out...
Kimberly
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As Laura said: WAHOOOOOOOOOO - nips tomorrow. They even moved my procedure time from 3:00 to 1:00 - now I just have to get through tonight and half a day tomorrow at work. A little nervous and excited at the same time.
Deborah - we will have to compare in Vegas. Glad to hear you're adjusting to the cherries on top (as Teresa calls hers).
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