TEs. A Beginner's Primer
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hi - so I have tissue expanders in (350 cvs). I've always been small chested and five with that. As I got older though, I thought it would be nice to be a solid "b" cup. Low and behold Breastcancer came and presented me with this opportunity. I am really happy with results so far, but I am worried about the effect it's havibg on my 14 year old daughters body self image. She's been admiring my new profile.... I wish she had been younger when this all happened... Any others in this situation
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From what I understand you cant tell cup size from cc fill. My doc said when I like how I look in clothes will be the size. Often they then overfill a bit, but that doesnt mean you will end up bigger. Try to schedule with the same nurse or talk to the office or dr about not liking different people giving different views or info, maybe that will be better, more consistent.
Itching might be nerves regenerating. Zings and pops of pain are indication also, and normal! Im over 18 months out and still get them once in awhile.
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so... I have been worrying about my right TE being so much smaller with fills than my left....
Well, this morning when I woke up the right breast was much fuller on top which has been pretty much flat!! Sooooooo weird! Even though it is still smaller than the left it seems to have shifted the liquid somehow while I slept (on my back for over six weeks!) and I woke up to two very hard mounds! A bit more symmetrical now, still not even but I am feeling a sigh of relief because I thought something was wrong for weeks, like a slow leak in the right one. I just tried on one of my REAL bras, LOL, Victoria Secret, and am wearing it now. It fits pretty good even if right one is still a bit too small. I am FINALLY feeling like I am on the right track!
You guys were right! Patience, patience, patience. All of the emotion wrapped up with the cancer diagnosis, surgery and a surgically morphed body added so much stress it really makes you not able to think straight at all. I am grateful to have found you wonderful people. I am grateful for your guidance and I'm sure I will need more in the near future. I also hope to be able to pay it forward to show my immense grattitude also!
Love and Light to all of you beautiful people.
Teri
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mdoc - it is unlikely that your PS will complete fills prior to starting chemo - many fill throughout chemo as long as your white count stays high enough, so that you are complete, and actually overfilled, prior to starting rads. Generally rads starts 3-4 weeks after the completion of chemo. There are a couple of ways PS handle rads with expanders - they can overfill the rads side to allow for shrinkage and muscle contraction, which is common with rads - or they can overfill to stretch the skin, then drain the TE during rads, then refill them. Both of these approaches work on the premise of stretching the skin prior to radiation since post-rads skin is very problematic to stretch.
falcon - because the TE has a hard backing and soft front, as it is filled it projects forward creating the pocket behind the pectoral muscle that the implant will fit into - as moon said. Theoretically, the more you fill the more the skin/muscle will stretch forward, so as you continue fills you should start to see more projection. In my experience you actually need to expand to a larger size than you want in an implant, because the implant will look smaller - even at the same number of cc's. The implant is soft all the way around so usually does not project as much, but rather fills space laterally and sometimes a bit vertically, although as the muscle relaxes a bit after exchange the implant will drop lower and forward a bit - known as the "drop and fluff" you may have seen mentioned. It is beneficial to speak to your PS and his staff about visual size, not cup size - cup size and cc's do not really compute since everyone's body is different. I am petite - wear a size 4 top or jacket, had 550cc total volume expanders, expanded to 650 on the right and 600 on the left (I had symmetry even though the size was different) and exchanged for the same size implants. I need a DD in cup size in an underwire bra, but visually I look like a full C cup. The same size implants on a smaller woman might look huge, on a larger woman might look small. It is important to note that the largest silicone implant is 800cc, and you can over-expand a saline implant to 960cc.
For those in pain - sometimes as you fill and the expander lifts forward you get relief if it has been pressing on a nerve - as if lifts off and expands forward the pain goes away.
moon - Hi! I have missed you!
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Okay question: I am getting TEs on July7th, and I have heard all the ladies describe a "suit of armor" feeling and tightness in the chest etc. I have sort of an anxiety about feeling like I can't breathe -- it sort of causes me to panic (great). So I'm wondering if you guys can take a deep breath, even though it feels tight? Or does your breathing feel constricted? Afraid to hear the answer to this....
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Ispy-I never have/had a feeling like I couldn't breathe or take a deep breath. Right after surgery however there was a short time where you feel like when you take a deep breath it gets "caught up a little" not sure how to explain it. They give you a thing, forget the name of it, that you do deep breathing exercises with.
The TE's, well, I just had my second fill so I am still a newbie. I have a total of 130 cc. It does feel like it is getting a bit more comfortable. It's not so much a tightness anymore as it feels like two metal "patties" attached to my chest...lol.
Not sure if I helped but good luck with your surgery.
Julie
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Ispy,
My TE's did feel like a tight band for a few months and if I thought about it too much, I felt claustrophobic. The key for me was to do something to take my mind off those thoughts. I also found that peppermints helped to ease my throat and stop the reaction. When I settled into my TEs after finishing fills, they stopped feeling so tight. Starting to exercise at 2 months out helped as well because I very slowly strengthened the muscles around the TEs i.e. my shoulders and arms.
I think the key is to find what works best for you. This board has been a wonderful support network for me.
Best wishes,
Scottie
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I remember trying to explain to someone what the expanders were like. I said it was like having on a bra that was way too small and you couldn't take it off. Here's the weird part though. With that tightness it SEEMED like I wouldn't be able to take a deep breath, but I could. It was one of the many odd things about this whole experience. Yes, sometimes I had kind of a claustrophobic feeling. I would get past it by remembering WHY I had the expanders, and sometimes I just had to distract myself by thinking about (or doing) something else.
Remember that this is doable and temporary, and the tightness gradually does let up.
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Ok thanks girls. I need to prepare to distract myself and get used to the new sensations. I've had three open abdominal surgeries and I know pain and weird sensations (still have numbness on my abdomen in some places which feels weird/hurts if you touch it), so let's get ready for the new normal with my foobs!
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I never really even thought about the te much after I was almost filled. I had 6 weeks between last fill and exchange and while obviously I knew they were in there and felt a bit tight, didnt really bother me much.
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ispy
I know what you mean exactly about feeling that way when you breath and a panic feeling. My mother has it too and I used to have it. We have both been through the breast cancer. I meditate and do breathing exercises a lot. I have found with the tightness and/or pain if I just sit down and take a very slow very deep breath for three or for times the body automatically calms down. I specifically pay attention to my chest muscles and how they are rising as I am breathing slowly in. You also loosen the chest muscles and relax everything else. It really works for me and I taught it to my mom who has all out panic attacks even if they close the door in the doctor's office! When she lies in the hospital bed I hold her hands and we deep breath together and everything relaxes. It has helped the tightness with my TEs tremendously! Good luck with your surgery!! I know you will do great!
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ispy,
Sometimes with my expanders, especially when I am nervous, I feel like I can't get a deep breath. I almost hyperventilated in the doctors office when I was nervous about my first drain tubes and fill. However, I found that, just like others said, I can distract myself from it and overcome it. That just shows that it is not a physical limitation but a mental one. If I relax or recline myself a little, it seems to alleviate some pressure and then I am able to take a few deep breaths and calm down.
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Falcon, I feel the same way about my TEs. I thought that there was definitely something wrong with my left one, but now as I'm closer to being "full" they look a lot more symmetrical. The left is still filled more up top, whereas the right is filled more at the bottom, but they don't look as off as they did before. I'll get another good-sized fill on Wednesday so I hope they are even more symmetrical after that.
Ipsy, Sometimes I find myself short of breath, but I let myself curl my shoulders in and then I can take nice, deep breaths. I try to keep my shoulders back for good posture generally, but if I ever start feeling claustrophobic I give myself a break until I get more calm. It's really been much better than I thought it would be. For me, the worst part is still getting comfortable enough to sleep. I finally was able to start sleeping on my side a couple of weeks ago, which is better for me than my back, but it's not entirely comfortable yet.
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SpecialK - thanks so much for the info on Fills & Rads - very helpful!! I go back to PS tomorrow for 2nd fill & will discuss more then!
Ispy - I had my TE's put in on 5/28 with 200 cc's to start & had 1st fill last week! I have never felt like I could not breathe - it was more like you don't want to take deep breaths due to the initial BMX pain! I found that to ease within 1st 10 days - for me now the most pain is under the arms & when TE is sitting on nerve! They are not fun but they gradually get better & you find which positions sitting and lying down are best! Good luck - you will be fine!
Mary
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Hi all, have had these expanders since April 10 surgery. They are getting SO uncomfortable! Ohhhh, just venting, I guess. No one else knows what we go through. Still in chemo, so it will be a while. Am filled to 500. I don't think I can go anymore, even after chemo. I was hoping for 650 or 700 cc implants. Does anyone know if that would be possible with no more fills? I think about women who go in for augmentation with no expanders and they get implants. Is that comparable
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mysunshine48 - Never make the mistake of comparing your situation to anyone with a breast augmentation, because it's not even remotely the same thing. The basic difference is that those women are putting implants on top of existing breast tissue, while our breast tissue has all been removed. So in other words, we're just putting implants inside of skin pockets with nothing behind them for projection - which is why reconstructed breasts appear flatter - because there's nothing behind them.
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We are putting implants behind the muscle, just like it is done with augmentation. I know we have no Breast tissue now, but that was over the muscle. So, with regular augmentation, the implants go under the muscle with tissue over the muscle. My question was why would I need more fills
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mysinshine48, my understanding is that the pocket will not be large enough to stuff that size implant into. They can put a slightly larger implant in but not that much of a jump. From reading whippetmoms posts, it does seem that it relies a lot more on implant dimensions than actually cc's so I would ask her. People in that discussion group can probably speak from experience on what they did.
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Eee3, Thank you. I was thinking of asking her. I guess I need to talk with my PS too. My expanders hurt so much now, and chemo is so rough, I just did not want to have to go through more fills. All of this is taking a toll on my body and my psychological well being. The days are so long and painful
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hello ladies
I thought I had read s post earlier about increased pain with TE's & can't find it..
I woke up this morning and as I was getting up I was sort of stretching at the same time - chest out & all of a sudden got this really horrendous sharp pain - left breast on edge of expander toward the middle! The pain literally takes my breath away! Fortunately today is a fill day so I saw PS & he seems to think I just stretched the area to much - ice & ibuprofen should help.. Then he filled them with 90 cc's - now at 350!!
Anyone else do this?? Or have similar pain... I have to live with these expanders for 6 - 7 months and a little freaked out by this pain
Also have a small Seroma right on incision - looks like a water bed moving when you touch it LOL
I normally do not complain so thank you all for listening
Mary
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Mary, I think I've been experiencing a similar pain, but mine is very obviously (at least to me) caused by the location of the edge of the expander. I get sharp pains at times at the lower edge of the expander right next to my sternum. I've only experienced it in the last week, only since my PT gave me new stretching exercises to do. I think the exercises are moving the expander to the very inside edge of the "pocket" where it's sitting. If I slightly shift it away from the sternum with my hands the pain goes away. (I'm currently at 300 cc's.)
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I had my last fill on the 24th, I'm up to 400cc now. All through this process I've read along with you gals. The weird tightness with each fill, gradually easing off after a few day. With this final fill, it was the first time I wanted to go home and curl up into a ball! I knew with the last 10cc that is was full, but Hard and Tight too. So very sore.
Now, almost a week later, I still have a rock hard boob, but the pain has diminished. My exchange is on July 13th. PS'll do a lift on the native side, then try to find an implant small enough to match for the MX side! I'll be home with my teenagers for a week and then helping out with Band Camp the following week. I'm in charge of uniforms, so I just have to organize the ladies coming in to size the kids, and press hems. They already don't let me lift anything, I can't wait to see how much they mother-hen me!
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mdoc524 - Those sudden pains are affectionately known as 'nerve zaps'. During BMX many nerves are cut and those zaps are one end trying to find its other end - and sometimes they succeed! Some of them will stop you in your tracks, but they do eventually go away.
SummerAngel - It sounds like your TE is sitting on a nerve. My ribs hurt so bad during my TE fills that it felt like someone had whacked me with a baseball bat. I convinced myself that I must have costochondritis - but as soon as I got more fills, the pain went away. LOL! I also had corners of the TEs that jutted out and jabbed me and I feared they might poke right through my skin. But as sore and painful as they were, they never did.
tress29 - The TE's one and only job is to stretch that skin to make room for the implant - much like a mother's belly expands to make room for the baby. That's why they have a had back and a pliable front - to make that skin stretch - which also brings on the tight feeling across your chest. They are rock hard at the end - and the most painful - because they're supposed to be. As your skin gets used to its new stretched shape, the pain lessens.
Your exchange surgery, in contrast to the TE phase, will feel like a vacation. The most difficult part of exchange is remembering to take it easy. Because you feel so much better, you'll need to make a conscious effort to take it very easy for at least the first couple of weeks. This is because you'll not only be healing outside, but on the very important inside too. If you do too much, your body will tell you. And if you do way too much, you might end up doing this TE phase over again....so please be careful.
Fun fact: Most TEs have a magnetized port (to make it easy to find for the fills). Have you tried to stick magnets on your chest yet? It's kind of weird, but mildly entertaining. You might as well get some fun out of this, right? Good luck to all of you!
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Just so nobody is alarmed if not receiving fills with a butterfly needle, my PS filled with a 100cc syringe that looked like it was for an elephant. A normal injectable syringe is 1/10 the size.
Also, to add to AZ85048's post about fun things to do with your TE - you can also shine a flashlight up from underneath the TE in the dark and see them! It also works with implants.
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Hey, SpecialK! The flashlight trick never worked very well for my wonky TEs, but it works great for the implants - and it sure is fun!
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Thanks AZ85048 & Summerangel - as the day went on it has been feeling better - I think the fill moved the expander out & helped! In the last 4 weeks since surgery that pain today was the worst - WOW!
I am now at 350 cc's - PS put 90 in today!! He advised he will not make the exchange until 2 months after rads which is looking like next March/April - UGH 😟👎👎
Thanks
Mary
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I have a fill tomorrow and I'm hoping the expander will move off of the sensitive spot! I also notice that if I try to sleep on my left side the expander on that side gets pushed towards the sternum and I can see (and feel) the outline of the edge of it through my skin. Makes me nervous at times, but it sounds like it's not uncommon. I'm going to have to try the magnet and flashlight tricks! I've been joking around a lot about this with my (teen) kids, I think that will amuse them!
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Ispy,
I've had my TE's since Thursday. I do sometimes feel as though I can't take a deep enough breath to satisfy me, but I think this is due to surgical pain and will hopefully resolve. I find that changing positions helps out. I have a feeling of an elephant sitting on my chest a lot of the time. My PS (as well as other posters in the forums) tell me this too is normal and will eventually go away as my muscles expand. My PS hasn't armed me with as much information as I had hoped (despite my carefully chosen questions) so I've found these threads extremely helpful. I have no idea what type of TE I have, nor how much he initially filled me with in the OR. Just feeling my way in the dark. I'm assuming my PS will eventually give me the answers to my questions, else I will have to resort to plan B.
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Thank you pavlovsbell and everyone for sharing your experiences with the breathing thing. I figure, if I get to anxious that's what drugs are for haha. I'm going to be on painkillers so I'll just take one and go to sleep. Eventually I'll get used to the feeling. In for a penny, in for a pound my grandmother used to say. One week from today I'll know how it feels!
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Question for everyone-
I'm feeling so sad and worried. I'm six days post op BMX with TE placement. I saw the PS yesterday and he wasn't happy with my incision lines. There is a bit of purple/blue bruising above and below the lines. I assumed this was normal due to the nature of the surgery and because I'm fair skinned and tend to bruise easily anyhow. He mentioned I may have to have a debridement and mentioned that I always have the option of having the TEs removed. This caught me really off guard. Then he turned around and said that he doesn't normally see BMX patients until 2 weeks post op, so "maybe" I was fine and normal. Needless to say, I left there confused and I'm very worried. Did anyone else have bruising? It's not like my breasts are purple, but I have about 1cm of bruising above and below the incision.
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