Nipple Sparing Mastectomy with immediate reconstruction
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sweetie2040- Thanks for the great quote! It is SO true!
So here is what my PS told me about the different implants. The silicone they are using now also has the consistency of a gummie bear. If cut it stays intact. (The old silicone implants had more liquid like the saline ones and if they broke the silicone would be absorbed into the body.) She said putting an silicone implant in is no different than a knee replacement, which is also made of silicone, in terms of effect on the body. If you have saline implants, and have a rupture, your breast will deflate immediately. With silicone you would not be able to tell. (That is why they advise you to have an MRI to check your silicone implants every few years.)
The newer silicone implants, which are called anatomical implants, have a more natural breast shape. They are not approved by the FDA but some surgeons are participating in clinical trials so if yours is this is an option. They have been approved in Europe and Canada for years. (Come on, FDA!) The negatives my PS said about these is they are firmer than regular silicone and do not move as much. Also, as someone said, if they rotate you will get an unnatural shape so they have to be careful how they place them. My PS said they also have to do a slightly larger incision to place them but most of us have already had a large incision due to the MX so that doesn't really matter. I have heard the anatomicals are better for smaller chested women as there is supposedly less chance of rippling.
So, for what it is worth, that is what my PS said. If it is like every other subject on this site for every 100 surgeons there are a 100 different opinions!
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Hi Kate33-thanks, that was actually very helpful! I am learning the same things, just debating about which will give me the look I want keepig in mind I will never look like I once did. I think at my next appointment I will have to discuss it more with him. I saw pictures of a woman he did with the tear drop and it looked great. I did have a smaller chest before but at lot of that was weight loss after the kids and sagging. So that's why I'm concerned about "fullness". I guess I still have a few months to decide. I heard the same things you mentioned, about firmness, rotation,etc. I thought I heard though that you don't need an MRI with the gummie and you do with the other silicone. Not sure though. My PS does mostly gummies but he said he had a very few woman who didn't like them and wanted them switched out for the rounder kinds. I heard when you stand a round implant on it's side it turns into a tear drop because of gravity, but the gummie definitely is firmer. Your right about the many opinions, I just wish I knew what I should do!
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Hey sweetie2040!
I asked my ps who is from Stanford and her "resident surgeon" who is from Stanford and what both of them said at separate times to me was that visually they didn't see much of a difference between the new anatomical gummy cohesives vs. the smooth round silicone implants. I read from reviews that what women don't like about the gummies is the firmness, the ability to rotate, they don't move at all when doing things like running and when you lie down, they are still there pointed towards the ceiling!
They look good though but my surgeons said that since it wasn't such a super "noticeable" difference if any, that they still use the squishy round gel silicone implants. I met with another ps who ONLY uses the Allergen gummies and he bragged about how only a handful of surgeons are part of the study—I felt it and saw the interior. It's cool how it is just a goopy goppy blob of gook that isn't runny but I must say that it was pretty firm and I ended up not choosing this ps. Maybe you could ask your ps to show you pictures he/she has comparing the two used for reconstruction? The Allergen site shows some picts with the usual round gels and there are other sites out there that show the gummies. The term "cohesive" is a misleading term because all of the silicone now is considered cohesive however some, like the gummies, are truly cohesive in that the goop isn't just thick goop, it is more solid goop! None of the goop/silicone now is like it used to be back in the day when it was very super runny..I am totally repeating you Kate! I have a gel silicone implant that my ps gave me as a sample...I should cut it open and post an update as to what exactly is in there and how "cohesive" it is. Regardless though...I am still choosing the most squishy! By the way, my husband was TOTALLy wanting me to do saline before I brought the sample home. The night I brought it home, he stomped on it, tried to rip it, sat on it etc.....that sucker stayed together! He changed his mind after his little experiment... 0 -
Thanks Ladies, I'm soaking up all this info regarding implants. I did watch some big burly men trying to break those implants on YouTube, it was hilarious & it looks like they are indestructible! My last fill is on June 28th & then I don't know how long I've got to wait until exchange surgery. Does anyone know what the approximate wait time is? Hope everyone is having a nice weekend - the summer has finally arrived in the San Francisco Bay Area... WhooHooo!
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hey, a local (to me)- you're right about the summer, my little SF apt is an oven!
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Hurleygirl-thank you so much for all the information! At first I was thinking the gummy bears were safer,but now I understand all the new silicone implants are just as safe.It is good to know they are practically indestructible. There is a video out there, I think on youtube where it shows the surgeon cutting the gummy in half. That is really what got me sold on them,thinking they were the safest, however I think the firmness could be a factor. I will need to feel the different textures to decide. I do want them to feel and move naturally. It is good to know they they don't look much different. I am still concerned about fullness and don't want anything that looks sloped in anyway. I am still waiting impatiently on the first fill. It has been 8 weeks since initial surgery and 4 since revision to change out one TE due to the open wound. He said I have to wait 5 weeks for the first fill. When did you get your first fill? It seems like some ladies got them really early. Your PS sounds very helpful. Mine showed me a pic of a woman he just finished with the gummy and NSM. I have seen a ton of pics online with regular implants and have been on the Allergan website too. I am going to go over all the things you mentioned when I get the first fill. How far a long are you? I think we had surgery around the same time, mine was 4/20.
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IrishLass and jessamine, I too am a fellow Bay Arean! I have no idea if that is a word nor not! It is crazy hot down here in San Jose. I used to live in SF and usually Junes are cold so I bet you two are enjoying a warmer than usual weekend in June! IrishLass, I think surgeons all have their own belief about how much time you should wait before you get the final exchange. Some feel months as in 4 months and some don't think it really matters and needs to be that long. I think my surgeon follows a 4-8 week rule after the last fill. I can ask her nexttime though and report back to you!
Sweetie, My surgery was on May 6th and 60ccs were placed in at the time of surgery. 18 days later was my first fill of 100 ccs. Two weeks after that I had another 60. I go in every two weeks, so I will have another one next Monday the 21st. I was a 32C or 34B before surgery and wanted to go a tad bigger. Currently with 220, I look like I did prior to surgery so I don't know how much we are going to go in the end. I will keep you posted!
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HI everyone. First of all I am sorry to hear how many of us have lost our fathers: Kate, IrishLass, fairportlady. Thanks for everyone's kindness. Fairportlady, I'm glad you are happier with your results - I am trying not to only focus on the rippling, but it's hard. I think (no, I know!) that I have a tendency to focus on the negative and once again I am doing it with the rippling. I remember Fairportlady that you had a hard time after the exchange and I am too, I think it's what you and others have said about adjusting to the final step in the reconstruction - there are more expectations in the TE stage. I think I was in some denial during the TE stage, they were annoying but I don't think I fully grasped that my original breasts were gone, now having silicone in there I am very aware. I might as well share another personal tidbit here (where else?) I used to have dark stray hairs on my nipples and I used to tweeze them for years. Then as I hit my 40s it was harder to see them so I have been less than vigilant. Well, I can't believe that those pesky hairs have continued with a vengeance! After all my poor breasts have been though the hair growth remains. I don't even understand it. I guess in a way it's kind of cool how the body manages to keep on, sort of what Sweetie was saying in her quote about appreciating the body and it's wonders.
Hope you are recovering well, bcincolorado!
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gulp-hang in there, your very normal to feel the way you do. I over analyze everything to a fault. My husband keeps telling me "give it time, give it time". We have all been through a lot having to "trade in" our former body for something with a "form" of your old self but yet quite different. I think that does take some getting used to. I kept my nipples but lost half of one,so I already had to adjust to an odd looking pair. I'm still in the TE phase and I think your right, at this point you can imagine what you think your going to wind up looking like, but until you get there, you just don't know and know how your going to feel.I have to admit I had a few hairs in that area too, maybe because I'm a brunette. I haven't seen them since surgery, but the areola area is all stretched out from where he put the incisions, but I think your's growing back is a good thing. It means your body has memory and wants to go back to way it was before surgery.
Hurleygirl, I came out of surgery with 250 on each side! No wonder I was in sooo much pain after surgery and it felt like a ton of bricks was on my chest. I think your Dr started you slower in smaller increments. Anyhow, now I have to catch up 250/150 and get the 100cc's back,sigh, it would be tank top weather!
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Does anyone have any factual information about heat and its relationship to degradation of the plastic shell?
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Hey, I too am interested if there is any information about heat damaging TEs or implants. We have a hot tub and my PS said I am free to go hot tubbing with the TEs. Any info would be appreciated.
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Sweetie and hurly girl - I too had surgery around the same time as you - on May 6th with 50cc put in TEs. The first fill was 2 weeks later at 60cc and then the next week 60cc, then PS wanted to wait 2 weeks because it was really tight - currently at 230cc and I go this Thursday for another fill - I'd like to go to a B or small C cup - I was almost an A before. The plan is to put in silicone implants - I will ask how long after last fill he likes to wait before implants.0
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Just for everyone's information on the TV show "The Doctors" on last Thursday they showed a NSM surgery - but they immediately put in implants - you can go to their website and watch the video. Does everyone here have TEs or did anyone get the implants immediately. They kind of talked like the NSM is a new technique. My doctor (in Utah) has been doing them for 3 years, but said doctors have been doing them for 10 years - I feel lucky I was told about NSM - apparently they do more on the east and west coasts compared to other locations. If anyone checks out the video - let me know what you think.
Hugs to all, Valerie
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Vmudrow- Thanks for letting us know about the NSM video. I will definitely check it out. I am so glad that the word is getting out more about this procedure. This site definitely helps. I was just contacted by a member on here that's interested in NSM but can't find a surgeon in her area. She said she may go out of state to have one done. I wish every BS was trained in this. It shouldn't be so hard to find someone qualified!
Just wanted to tell everyone I'm going out of town tomorrow. One last pre-op appointment with the PS and then my DH and I are heading to Catalina for 5 days! Our first get away since my DX. We are off to celebrate my 50th (GASP) birthday and then 10 days later Kate gets some new boobs for her birthday! Woo hoo!!!
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VMudrow-It looks like we will be having are exchange around the same time. It will be interesting to see where we all end up. I watch that show from time to time and am definitely only to look up that episode. I know NSM has been around for years, but I think acceptance of it is just coming back. They do a lot of them in Boston and New York. I had a hard time finding a Dr. in my area and he just started doing them.
Kate33- Have a wonderful vacation! Happy Birthday! I hope you love your new gifts! You go girl!
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Kate33 - Congratulations on the big 50!! You look too young and skinny to be 50. I also turn 50 this year in December. I'm so old I can't figure out how to post a picture....Have fun in Catalina - you deserve it!!
sweetie2040 - Where do you live? I live in Utah and am so glad my BS suggested it!! Let me know when you get a exchange date.
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vmudrow-I'm in CT. I had to find someone to do the NSM, no one suggested it and there wasn't anyone in my area. I had surgery in April so not sure about exchange date yet since I haven't even had my first fill. A wound problem set me back a bit, but I'll get there. Everything is looking healthy now, I'll ask more at my next visit next week.
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Oh, I never thought of heat damaging TE's... I developed a fungal infection in the days following surgery & was told by 2 of my surgeons (PS & OBYGN) to use a hairdryer to make sure the creases/wrinkles on my boobs & my belly button were dry. I still do cos I'm still very wrinkly!
All us Bay Area (I'm East Bay) sisters should celebrate together after we all have our new foobs!!!
Kate33: Happy, Happy Birthday! Enjoy Catalina.
vmudrow:Glad to hear that that your wound has healed! I'm having a skin issue, my PS hasn't a clue what it is so I made an appointment with a dermatologist. It's this Thursday so I'm keeping my fingers crossed that he'll have a clue! I'm going to check out YouTube too.
Jessamine: I'm in the BRCA club too! So far 5 out of 9 siblings that have been tested are positive, lots of cousins have been tested too & this week the 1st one has tested negative - there's hope for all the others at last! How come you waited 8 months between diagnoses & surgery?
whitedove: I must remember to ask my PS about the degradation over time due to heat. And, a pair of white doves frequent my back garden...
Hugs to you all, does anyone else feel conscious of hugging with such hard foobs?
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anyone on this thread had gummis? (the NEW cohesives)
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IrishLass- I had chemo first because of the large size of my original tumor, and it was very successful, I'm hapy to say. But it was hard and took forever. We should have a bay area get together (and foob showing, if folks aren't shy)! There are a lot of us! I guess if they only do the NSM in a few plces it makes sense...
9 siblings! Wow!
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jessamine:I'm up for a get together ANYTIME! I'm off for the summer (work for a school district). Seeing as you're an activist why don't you set one up... you're so young to be going through all this (I graduated high school in '76!)... a big hug to you! And, yeah 9 siblings, I got it from my dad & he was one of 10! It's a genetic researchers dream...0
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ha! not so active lately, that's for sure... but maybe so. Anyone else interested?
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I was there was a group of NSMs in Utah - am I the only one out here?
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vmudrow: That's why this forum is so great! Even though there are a lot of us from CA on this forum we have never met so we might as well be here all alone too. Hang in there!0
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Vmudrow, just watched the Doctors segment. It was the first time seeing the show and I went down the list watching procedures. TN and I both had the immediate implant without the expanders. Hearing how all of you are doing with the pain control with the increment fills you can imagine how painful having the implant all at once. The segment didn't mention building a pocket from a mesh to help support the implant. I would like to see the PS before and after pics, maybe he has a website at his private practice to check out.
Kate: Happy Birthday. I too turned 50 during the recovery from the bmx so didn't get to celebrate the way I had wanted to.
Gulp: I see those hair growths as a sign of good blood flow to that area. I too, lost my father 4 years ago, am am sorry for what you have been going through.
Welcome Glo53.
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whitedove-go to the "all about gummies" thread. The lady who started it had a NSM with gummies and there is a lot of information on the gummies and comments from women who have them.
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I can't remember where I read about exercising, so I will post here and on Exchange City. Just got back from the PS - it's been 6 weeks since NSM, TEs expanded to 300cc. I am ok to exercise - but let pain be my guide. PS said there were three exercises he never wants me to do again - push-ups, butterflys (arms out to side), and bench pressing. He says these strengthens/pulls on the pec muscle, which we have worked hard to get the TEs/implants in the right spot and these exercises cause the implants to migrate toward the armpits. There are some ladies that do them anyway and are ok, but he has seen too many where their implants end up under their armpit. Just something else to think about - I plan on taking his advice.
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Valerie thanks so much for posting that! I work out regularly and my PS was very vague, kind of said I can do anything, but what you posted makes sense an I plan to follow that!!!
Hope everyone in the fill process is tolerating it well....... thinking of you
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Hi Ladies! I haven't been on much or posted in a LONG time... I am finally trying to catch up with what it going on with you all. I have learned so much and appreciate all that you ladies share! It is so nice to know I am not alone in all the crazy changes my body is going through!
I wanted to chime in on this exercise issue because it has been very confusing to me. I went to PT for a few sessions for a lymph edema assessment and for some soft tissue mobilization. My PT told me I could do anything per tolerance once the drains came out.. Contrary to this..at about 5 wks after Mx's....I still was having that sensation like my pec's were being ripped off my chest whenever I would use them so I asked my PS about whether the expanders would move with exercise and he said yes and told me I could NOT do any pectoralis mjr strengthening. I was sooo confused! My PT told me that the different doc's have different protocols based on what techniques they use to place the expanders...
Then, at about 10 wks I asked my PS about it (cause I really need to be stronger to do my job) said he said that things had scarred down enough then that he thought it would be okay to strengthen them with low resist.. carefully. Now reading what vmudrow says... this doesn't make sense. What has everyone else heard on this?
I agree with vmudrow says! It freaks me out to think I can move these things into my armpits more than they are! I surely DON'T want to mess anything up!
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vmudrow- That makes complete sense about no longer doing those exercies ever again. My PS said that I could do what ever I wanted after a few months had past, but push ups just felt too weird, I did however do the other two exercises. I wonder if that has played a part in some of my problems? Thank you so much for posting that. I HATED push ups anyways and now you have given me a great reason to never do them again, lol.
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