TE TROUBLE
Comments
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wildtulip - sorry - it is confusing, I know! I am saying that filling to a pleasing size will usually result in looking smaller when the same size implant is placed. One should usually fill slightly beyond the pleasing size and hope that they end up with what they really are looking for. I don't think you can fill to an arbitrary volume or size because that can look different on each person, and can look different from TE to implant. Does that make sense?
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when I thought I was heading in to my exchange the surgical tech told me that they usually go with an implant 100-150 ccs bigger than the expansion volume to try to maintain the same projection that was obtained with the expanders. That made a lot of sense to me and took away a lot of my fears. What I'm concerned with now is that I had 450 expanders but now I have 650s. I'm concerned with that logic now.
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Thanks, SpecialK, this does make more sense. I'm not clear on where my PS stands on intentionally over filling or not. But I asked him if I had to be spot on in determining when to say I've had enough fills and he said it's easier for his calculations if I over fill vs under fill. He would rather hear me say I think we did one too many vs stopping at not quite there. When we discuss size again I'll be sure to throw in there that I know the same volume implants can appear smaller. At this point I'd rather have small and symmetrical instead of what I have now!
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I am 4 weeks post bilateral mastectomy. Just spent 4 days in hospital with infection in left breast. Got IV antibiotics (cipro and vancomyacin). Sent home with two week course of antibiotics. Feeling much better but nervous the infection is still there. Is there a chance I can save my TE? I want to be healthy but also don't want this TE to come out! Does it take a long time for an infextion to heal?
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Hi, amyspiegs. I'm sorry that you're going through this. Whether or not the TE comes out will depend, I think, on how you respond to the treatment as well as what kind of infection you had and what your doctor's standard protocol is in these cases. In my case I had a rather rare gram negative infection and so the infectious disease doctor insisted that the TE come out for at least three months saying it would never heal with a "foreign object" (meaning the TE) in there. It really depends on the diagnosis and how your PS usually handles things; it seems that every doctor does it differently.
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Revision was a week ago. Both Natrelle Style 20 700cc Implants were removed and work was done. Right had Capsular Contracture enough that the Implant was rigid Right now has Natrelle Style 15 575cc. Left had a problem staying up in place, despite Alloderm used as well. Now it has Style 15 659cc and extra thick Alloderm. Significant pocket work was done on the Left for which I'm still to baby and protect it. Dog ears on both sides were removed and thankfully didn't go near as far onto my back as expected. Small fat grafting was done on the concave area in the Left upper pole. Things look and feel SO very much better now!!!!!! Prayerful it all holds without problems!
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on 8/24/16, i had a bilateral skin sparing mastectomy with immediate reconstruction w TE.
I am 41 years old, 5'5", 150#, 32"ribcage.
My expanders are Mentor Artoura ultra high profile 650cc
My PS said we are shooting for 500cc implants.
I've had two fills so far and currently have 420cc in left and 440cc on right. I'm scheduled for another fill next week but I have been in so much pain I don't think I can bear the pain and discomfort anymore! It feels like my ribs are being crushed into my lungs and my muscles are ripping off my ribcage. I know that sounds dramatic but i'm really struggling. After the last fill it hurt to breathe so I was evaluated at ER but all tests were normal.
Is this kind of pain typical with TE? I'm grasping at straws to understand the reason for the pain, such as expanders being too large for my frame, fills too soon after msx? Any advice?
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traismom - what was the amount of your surgical fill, and how large have your fills subsequently been? Sometimes pain is caused by too large a surgical fill, or starting fills too soon, or making them too large. You post was made one month after surgery and you are already at a pretty large volume, I suspect that one of these scenarios is the reason for your pain. Are you taking a muscle relaxer - Soma, Flexiril, Skelaxin or Valium? Any of those may help - but slowing down the fills, and/or making them smaller, may be a good idea.
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what Specialk said^. I had no pain till my next to ladt fill. Whoo. That hurt. I skipped the next fill and he dropped the next one to 50. That was my final fill..it took over a week before i wasnt hurting just sitting. Hugs.
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specialk and moonflwr:
Thanks for your responses!
I was filled to 300cc at BMX (TE's are 650cc) and two weeks later, another 60 cc was added which I tolerated ok. The following week he added 80 on the right and 60 on the left. I was supposed to go in for another fill 2 weeks later but I refused another fill because of my high level of discomfort. So my last fill was on 9/14 and i'm still in constant discomfort 24/7. I have tried valium, flexeril, ibuprofen 800, tramadol. Nothing really helps but some improvement since my last post. Now It's like the underwire of a bra digging into your chest but I'm unable to move it away. They are so hard and heavy. I jokingly call my TE's a torture device created by men to torment women. I just try to remind myself that it's temporary. I wasn't sure if my experience is uncommon or not. Thanks again for responding. I agree that it was too much, too fast, and the expanders may be too large for my frame possibly
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yes. They are definetly not fun. But the squishy dide is a lot better. LOL.
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I have had my implants in now for almost 1 1/2 years. My MX side feels weird. Not very squishy. How squishy should it be. Also went to PS today and found out that the implant I have on my good side to give me a little lift actually did move to the side. Now I have to go in and have it moved. He said he would go in through the same incision move it back and stitch where it moved to do it doesn't move again. Has anyone heard of this happening??
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I had a bilateral mastectomy November 2, 2015. At the time, no expanders were put in due to the possible need for radiation and my BS and PS wait on expanders in this case. I ended up needing radiation and completed 30 rounds April 11th. I handled the radiation really well and my PS did not need to do any fat grafting prior to placement of the expanders, which occurred on June 30, 2016.
My fills went really well and I was scheduled for the last one last Thursday. We did the right, non cancer side and put in 75ccs, which filled my 700 cc expander to 800, right where I wanted to be. However, on the left side, the cancer/radiated side, the nurse thought the skin was getting thin and after consulting with the physician assistant, we did not fill and I made an appointment to see the PS yesterday and he was supposed to make the final decision on if we could fill the left side more.
Over the weekend, things got worse and by Sunday there was drainage and by Monday morning, a small, less than dime size, blackish spot. The PS put me on 2 antibiotics, took out some of the saline from the left implant yo relieve pressure on the thinning skin, and had me schedule exchange surgery for November 11th, rather than waiting a minimum of at least 6 weeks, which is their usual standard.
He has me coming back in for a recheck tomorrow and if the spot is still draining, will remove that part of the thinning skin. Overnight, the left side was so painful, and I was not expecting this, Tylenol helped some, but still very painful this morning and draining a lot. Not sure how scared I should be right now! In all the treatment I have had, this is the first real issue Ihave had and it has thrown me for a loop. We were so close to done and I feel like it is all in danger of failing.
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Brenaj, I don't have any input, but wanted to send you a hug! I hope you are feeling better today and the antibiotics do their job.
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Brenaj, I'm so sorry you're having problems now, especially after things were going along so well. Keep us posted on what the PS says. Fingers crossed that everything goes well for you!
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Thank you for the good thoughts. They are working. I am feeling better and my PS doesn't think the infection has spread and is being contained, so will continue on the antibiotics. The black spot I was seeing was actually the expander (glad I didn't know that until after he took care of it) and the PS removed the skin around it until he got to thicker skin and then stitched it closed. I see him again tomorrow for a recheck. He feels there is a 80-90% chance we will get the implants in on the 11th, so fingers crossed.
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brenaj - make sure you are consuming enough protein - aim for 100g a day to help with healing. You might also consider a bromelaine supplement, or eat a lot of pineapple, and possibly some zinc - both help with healing. I have had a lot of necrosis and healing issues - this is what has necessitated the bulk of my numerous surgeries, and I did increase my protein and use the supplements.
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Special K, thank you for the recommendations, I will have to look into them, as the skin appears to be breaking down again. Really hoping I make to exchange surgery on the 11th. Not sure what will happen if I don't, a question for my PS tomorrow when I see him.
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I had to have my left tissue expander taken out yesterday. Though I was expecting it, it was still so disappointing. The skin was just to thin and was breaking down to much. I am still scheduled to have exchange surgery on my right side next Friday. Then we will let me heal and give me a break from reconstruction until after the holidays. We will pursue a latimuss procedure after the new year.
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Anyone have an implant move that required surgery
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brenaj - I am so sorry, this happened to me as well. Twice actually - initially after BMX before I had gone beyond the surgical fill, and then later an implant loss, two years after exchange, during a repair - you will get through this. You might speak to your PS about doing a couple of small fat grafts to the flat side to improve your skin integrity while you are waiting, maybe even doing one at your exchange surgery. It made an amazing difference for me and I was able to avoid the lat flap - for which I was not a good candidate anyway - weakened shoulder muscle on that side and skin cancer all over my upper back - didn't want to move that around to the front. After 18 months, and two grafts, I was able to have an expander placed, filled, and exchanged this past May for a slightly smaller implant than I had previously. My right side was downsized to match. I am sure you are disappointed and worried, it is a lot to take in, and if you would like to PM me anytime, please do.
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Brenaj, I'm so sorry that your TE had to come out on the one side. I know exactly how disappointed you feel. I second what SpecialK said about discussing fat grafting with your PS; I just had FG done a week ago and we'll see how it "takes" before scheduling an attempt to reinsert my TE on that side but hoping that the fat grafting helps to shore up the compromised tissues on that side. Good luck with whatever you decide to do.
ThinkingPositive, sorry.....not sure I understand your question?
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raven4mi... sorry. Should have been a little more clear. I had reconstruction on my non mastectomy side in May of 2015 during my exchange surgery. The implant seems to have moved to the side of my breast. I always thought it felt weird when I put my arm down. Told the plastic surgeon about it a great times but he kept saying oh it's still swollen healing maybe scar tissue. The last time I went in he Agreed and said yeah the implant moved. He said he would have to replace the implant with new and stitch up where it went into and put new implant in the correct position. Just wondering if that is common. Thought I would get through 2016 without a surgery. Just a little annoyed. But glad it's just an implant problem!!!
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Ah, gotcha. Well, I personally have not had that problem but I have seen a couple of other people post about something similar. Hopefully someone iwll chime in for you!
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i tried to post and lost all of it . I will try one more time. I had 6 rounds TCHP finished in May. Bilat mastectomy with tissue expanders in June. Complete response to chemo and negative sentinel nodes x 2.Had large and fast fills to be ready for radiation. Did fine with all of that and only had drains for 2 weeks. I started having some fullness and arm pain and numbness in august . I had a sonogram which showed a seroma. i was decided to leave it alone. noticed more fullness and pain when trying to stay in postion for radiation. Radiation onc. said was not due to radiation and sent me to surgeon. He looked at axilla with ultrasound and we decided to leave it alone for now. Made it thru radiation. Suddenly had decreased range of motion and pain in armpit. sent to physical therapy. over 3 weeks time the stretching of my arm in physical therapy caused increased pain beyond what i could stand also discovered solid mass completely filling armpit with pain that became unbearable also range of motion getting worse with physical therapy. went back to surgeon who sent me for ultrasound and aspiration of seroma. he only found a small seroma very deep in arm pit, could only get drops of fluid out. he said the hard mass was swelling which i have a hard time accepting as it is hard solid and i feel the borders. Pain is much more increased. i was told the aspiration would help alot. Wrong! Cant lift my arm and the pain and inflammation tenderness is spread to the top part of my tissue expander, center back, should blade, top of shoulder and into neck, feverish and just feel all around awful. I had called my plastic surgeon and cancelled upcoming fat grafting procedure as i just cant stand to be hurt anymore right now. Her staff informed her of the problems i was having and she called me back and thought taking some fluid out of tissue expander might help pain, inflammation, and help range of motion. She wanted me to go back to physical therapy also (i quit because the last time i went and she stretched my arm i left in tears and almost threw up). plastic surgeon also said this is likely from radiation. So i set to have fluid taken out on Tuesday. I got a call yesterday from breast surgeon that said the fluid had grown Staph. I started on antibiotics this morning. i will call the plastic surgeon on Monday and tell her about the infection. Not sure what will happen next. I am so afraid of not being able to keep this tissue expander. Do they always take them out with infection? I wonder why it took so long for infection to appear after surgery? My scar lines have been perfect and i had no trouble at all with them except the normal uncomfortable feeling. my problem side is cancer side. I am now noticing tenderness on chest wall on the other side. Any advice welcome. I thank all in this group for listening and understanding. I hate to burden my family with all my complaining. I am usually pretty tough and never even took all my pain meds after mastectomy and expanders fills. But i have to say this the worst pain i have had thru this whole year long process. I have an appointment on Tuesday with Medical oncologist and for herceptin and perjeta. I want to get a CT . Pretty scared and somewhat defeated feeling. I thought i would be feeling great by now. Again so sorry this long and so much complaining. Any and all advice is appreciated. Thank you !
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Mena, I don't have any experience to offer, as far as infection, but please do not feel bad about talking with us about what is going on. That is what we are here for.. support and advice for each other. Continue to advocate for yourself and look for answers until you feel better. The Dr 's work for you, and should be working with you to find a solution and ease your mind. Be sure to bring notes with timeline of your symptoms to upcoming appointment. If you go alone, record appointment..there are phone apps you can use. Sometimes there is so much info it's good to refer back to conversation. Good luck, and hugs, sister.
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Thank you Wildtulip, Great idea to record the visit. Most of the time I go alone now and cant always remember exactly what was said.
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mena - I am wondering if you have radiation fibrosis in addition to an infection and this is why you have such a firm area in the axilla that is not yielding fluid like a true seroma. It is possible for you to keep the expander, but you may need IV antibiotics to do so. Infection can appear anytime after surgery - even years out. Definitely talk to your plastic surgeon asap. Wishing you the best.
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Thank you SpecialK for your response. Two full days of antibiotics and am no better so far. Actually in more pain and more swelling. I am gonna call Plastic Surgeon first thing in the morning.
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Hi Everyone, Quick update. I went to see plastic surgeon . She deflated my tissue expander by 150 cc. It looks really weird. But I think it may be helping a little. . She also added another antibiotic and told me to take Gabapentin. Went to treatment for Herceptin yesterday and am going to have a CT of the mass in armpit.
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