TEs. A Beginner's Primer
Comments
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LOL, SpecialK - I read "if I were your boobs, I would ask for a smaller fill..." Time to get my contact prescription checked
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grandmax3 - actually, either statement works, lol!
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Hi ladies, I'm new to this thread and have been reading and gaining insight. I got my TE's 3 weeks ago, with an LD flap on my right. I don't go in for my first fill until 7/8. I think I'm doing pretty well...I don't feel a need for pain killers during the day, but I do still need them at night. I've had pain in my sternum, but that is starting to ease. (My doc said my nerves are angry.) I have also have pain in my side/back from the flap, and have gotten input from others in the LD flap forum. I have two children, but fortunately am off work for the summer.
Monica, something you wrote stopped me in my tracks! You said, "Just because you can, doesn't mean you should!" When I was at my PS getting my 2nd drain removed last week, he said almost the exact same thing to me. He said, "Just because you can move around better now, doesn't mean you should." Yes...I'm getting the message!!
Anyway, I don't have a question right now, but wanted to introduce myself because I'm sure I'll be looking for input in the coming weeks/months!
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Just back from weekly PS visit...4 weeks post L-MX -- hopefully this week with give my boots/boobs a little bit of a breather.
Got him to agree to just 50cc this week...and he was able to aspirate over 50cc of seroma from the "pocket" ...I have the kind of TE with two ports, one to fill and one to aspirate out fluid that surrounds the TE.
No wonder I was in so much discomfort last week with a 100cc fill and the build up of 50cc of seroma!
I am now at 500cc en route to 700cc...was a 40D before surgery
I also just today had the final piece of surgical glue bandage removed, it was coming up at the ends but fully stuck in the middle, at least I couldn't get it off in the shower with soap, but the PS did it without pain or bleeding.
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trmtab - sounds like progress!
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Welcome wildtulip! trmtab, glad you are doing better. I am getting nervous even though I have been down this road before. I do not look forward to the muscle spasms and tightness.
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TrmTab, I hope you're feeling better!
Molly50, best wishes with the upcoming surgery! Any surgery is nerve wrecking, so it's completely understandable to be nervous. I would think it's helpful that you know what to expect and how to manage the pain. Stinks you have to go through it though!
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TrmTab wrote:
"Got him to agree to just 50cc this week...and he was able to aspirate over 50cc of seroma from the "pocket" ...I have the kind of TE with two ports, one to fill and one to aspirate out fluid that surrounds the TE. No wonder I was in so much discomfort last week with a 100cc fill and the build up of 50cc of seroma!"
Can someone explain how the seromas from the pockets are created? Im trying to figure out if I have a seroma (doc says no) or if my pain is related to muscle spasm. Any insight is appreciated.
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Tim- I have had 100cc fills every four weeks. The last 100fill gave me a lot of pain which I still have. That was 6 weeks ago. Two weeks ago I had my last fill and asked for 50 which I didn't even notice, as far as discomfort. Definitely try the 50 next time. In comparison, it's a breeze. Wish I had done that all along. 3 weeks and 5 days til I get these things out!
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fubc - an ultrasound should be able to delineate between muscle spasm and a seroma. Or, if a muscle relaxer relieves the discomfort that may be indicative of spasm rather than seroma. Basically anytime you have surgery the potential for a seroma is created by injury to the tissue. If drains are pulled the fluid can collect for some individuals, where others are more able to absorb it.
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Thanks SpecialK
I did take a muscle relaxer but it didnt help
a few days ago i did massage my cords i feel in my right arm pit and the swollen side of my right breast and a few hours after I felt something dripping inside me. I had felt the same the first week after surgery when I still had my drains on.
I also started massaging the are that hurts the most and the massage is helping a lot too. what can it be? How can I tell the difference?
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fubc - muscle relaxer not helping would make me lean toward a seroma, which can be visualized as a pocket of fluid with US. Why did your doc not think it could be one?
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I am not sure why not SpecialK. The nurse touched it and said its not a seroma. The doc said I dont even need to touch and feel it, I dont see a seroma. Can the fluid collect underneath the TE, so in between TE and chest wall?
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Had another 50 fill today...now at 550 total...and I get to take a 2 week break, yahoo!
I can feel the new fill, but 50 is soooo much better than 100.
My TE has a volume range of 600-720...so was surprised today when the PS started talking about stopping fills...."when you are happy with the size let me know and we'll stop, you already have good volume and taking on good shape"
I didn't have a response, but found the comment awkward given the previous rush to fill?, if he chose this size TE don't we plan to at least get to the lower fill end of 600? and the constant reminder that he won't be able to get me to the size I was pre-MX...??? (which is fine, I was a D and being a C +/- would be great)
So, I am happy for the break in fills and after the 2 week break (and I do expect a 50 fill at that time), the next fill would be a 3 week jump...so it sort of lets me get used to the size. I am still wearing the white surgical bra, hook front ABC style 100 that I left the hospital in. The thick cotton bra is a bear in the 106 heat index of southern VA, but I'm no longer using any padding on the MX side, and with a loose fitting top (a shell for under a jacket/sweater for work) the size difference is not noticeable -- at home/sleeping in a Louisa Louisa camisole that is "skin" tight/form fitting, it is clearly 2 different sizes and shapes.
So...the question is, when/how did folks decide to stop? Should I try on one of my old bras and see what this actually looks like in a real bra? I am just a month post surgery, so probably still have swelling, I do still have some seroma build up that is removed with each fill. Two more fills will get me to 650 and 3 months post surgery...is that a reasonable time for initial MX swelling to go down?
Given my teaching schedule, I don't plan an exchange until the December semester break, so no rush on my end, just new questions.
Thanks, TT
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trmtab - in the vast majority of cases your implants will be smaller than your expanders. Without the hard back of the expander an implant cannot provide the same amount of projection - and thus visual size, as the expander. Liking how you look at an expanded size does not translate into the same aesthetic at exchange - some people look up to 50% smaller. I hate it when plastic surgeons say to stop at the expanded size you like, it is almost a guarantee for disappointment and surprise at exchange. If you are concerned about being too small I would recommend that you keep going. Have you posted on breast implants 101 and received whippetmom's suggestion for fill amount and desired size? If not, I would.
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Thanks SpecialK
I did post a question to Whippetmom and she suggested 700cc round saline implants...so I was thinking I would continue fills into the 650-700 range.
I do feel like I have a grapefruit (or perhaps better yet a softball given how hard the mound is) in/on my chest and said this to the PS...perhaps he was thinking of that when he talked about stopping??? Don't know, just thought I would continue to fill as long as it seemed reasonable pain wise and given it is still smaller than the other side.
If only I could get consistent sleep...it's not pain keeping me up, but just awkward sleeping positions from what I prefer and after 54 years I guess I know how I want to sleep...so I get 2-3 days of 5 hours of sleep which isn't enough, then one night of 8 hrs, to be followed by another 2-3 nights of 5...
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trmtab - if you elect saline and are matching a native breast that is also helpful as your PS can add saline to match in the OR - and permanent saline implants can be overfilled. In your shoes I would continue fills until your expander side is somewhat larger than your native side, unless you are also planning a lift/reduction on that one at exchange. I hear you on the sleeping - aromatase inhibitors are probably not helping you either - I am still in that sleep pattern and I am almost six years from diagnosis, but with periodic surgeries so often in recovery mode
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trmtab, what Specialk said! My saline round was supposed to be a 900. So my TE was stripper boob size. I actually walked into doors. LOL. I ended up with 700'S because the fit across my body wouldnt take the 900 or even the 800. So my PS went with 700s over filled to 850. STRANGE things happen in the OR! I ended up just able to fill a C cup.
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For a MX person is it usual to have the "native" breast "lift or reduced" AT exchange??? I really have been thinking that we would leave Ms. Right alone and see the final outcome of Left after exchange and swelling gone...and only if necessary have more surgery to have better matching...3-6 months later perhaps.
I'm okay (or at least think I am) with a little asymmetry -- they weren't identical to start with!
And...every surgery is another risk of infection, complication, etc.
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I was supposed to have my first TE fill today, but it didn't happen.
Yesterday (Thurs) I woke with a fever over 102, was tired and had a severe headache. I thought of infection, but my skin looked fine. I called my PS office to see if I should come in for my scheduled appointment today (Fri). My Dr was in surgery, but they wanted me to come in to the office yesterday to get checked by one of his partners. That Dr said I did not appear to have an infection, and to come in today. When I woke today I still had a fever, but it was lower..a little over 101, headache was less intense and I had more energy. My PS said my skin looked good and there wasn't any excess fluid, but he didn't want to do the fill. He said he didn't want to confuse things...meaning if he did the fill and I was uncomfortable, but still had a fever, we would question if it was an infection or a virus and discomfort from the fill. So, I get it and I didn't object with him, but I am bummed. The soonest I could get in again is next Friday. I really want some shape and I'm tired of trying to camouflage, especially with it being summer. On the sweet side of things..my PS and his nurse communicated about me, while he was in surgery. The nurse called him to see how to proceed initially, then after the partner saw me I was in the lobby getting things together with my kids and I heard the receptionist tell the nurse that my Dr was on the phone from OR. I then heard her give a summary, and even though she didn't say my name, I knew she was talking about me. I believe I have a PS that is skilled, concerned about aesthetics, and really cares!
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TrmTab my PS has suggested a small implant or lift for my native breast. I asked about risk and recovery and he indicated it would not add any additional time to the exchange recovery. The risk is minimal but of course there is always risk with any surgery.
I had my first fill on Thursday - 60cc. I had no idea what to expect since they were not able to do any fills during surgery. The process was simple and quick. I had some strange muscle twitching on the way home (rather like the involuntary twitching you get with your eye occasionally) No pain but I was definitely uncomfortable during the night and yesterday. Today I am much better. My nurse tells me that we are only going to fill to 200cc so I am well on the way. I am scheduled for another fill next week if my skin continues to tolerate the process.
I am cleared to go back to work (light duty, part time) next week - 4 weeks post op. I am a bit worried although I have had minimal pain, I still get tired so easily and have periods of discomfort. I am hoping this will improve. I am running (slowly) on my treadmill but hope to have full clearance to run at 6 weeks post op.
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I got my first fill today!
I got 50 in my left, now total of 200 and 40 in my right (ld flap), now a total of 100. The process went fine and now I just have a little tightness . Between med side effects and small breasts, I definitely feel like I'm in puberty !0 -
TE fill-up update...
I was soooo happy with the two week break since the last fill up. Just back from Dr office had 50 more put in, now at 600.
...and he wants to see me next week. Ugh!
His argument is that the longer we take on the filling process, the larger the opportunity for scar tissue to build up. Have others been given this argument or had this experience???
After next week he said I could have another two week break...but due to his schedule as he is gone the week after...
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Nope - I had the right TE in place for nine months before it received anything other than the surgical fill. I had my left TE removed prior to chemo and didn't have it replaced until that point, and it was replaced with zero surgical fill. I filled at 25ccs weekly, only on the left until it matched the 200cc surgical fill on the right, so that alone took 2 months. I continued to fill weekly at 25ccs all the way to 650ccs, so this took a long time. I did not have any issues with scarring and this was never discussed. I have a different PS now and had to re-start the process on the left again after losing that implant in 2014, and again no rush or conversation about scarring and that TE was in for 6 months. I always hate to bring this up, but I will - for the vast majority of reconstruction patients who do expander to implant the fill process costs are tied to your original surgery. In other words, your plastic surgeon is not being paid for the office time devoted to fills, so they try to rush the process. I am not saying your doc is doing that, he may feel that his point is valid, but it is good to be aware that this happens. Fills should not cause you excessive pain, you are in control of the process - you are the consumer and your feelings about fill size and frequency should be made collaboratively with your physician. If you are in too much discomfort from fills you should either space them out or go with smaller fills.
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Thank SK...I have been very fortunate in this process...I have not been in "pain" for several weeks/several fills...but do feel "awkward" for 48-72 hours post fill so the two week routine allowed for a nice break from "awkward" and I had hoped it would be the new normal.
I realized when I went in this morning that given vacation schedules I would actually be asking for a 3 week break...and like a kid going into the principal's office, thought up front I would be told no...and I was. He actually said he would be willing to wait for the three week break, but would insist on a 100 fill if we did wait (and that was when he added the scarring comment)...and I'm not willing to do a 100 fill again -- that was the only time I had real pain and muscle spasms that were like having a charlie horse in your chest!
I left the office with an appt for next week under the condition that I was only going to show up if I was actually "recovered" from this fill. I also have to fly next week for the first time since surgery and really wanted to have my focus on being safe with the travel, not feeling awkward for the first couple of days of the trip.
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trmtab - excellent! Have a good trip!
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Special K, good information for everyone!
TrmTab, my experience is different. My PS will do fill of 50cc max, and I can go in every 1-2 weeks, my choice depending on my comfort level and schedule. He specifically said some want to go in every week and get it done, while others space it out. He also told me from the get-go that the exchange surgery is 6 months after the TE surgery. He said he finds this to be the sweet spot...I don't remember for sure, but I think he was talking about scar tissue.
When I got my first fill last week the PS did one side, while a nurse did the other, at the same time. He then said he is happy to continue with doing it the same way, but that he has complete confidence in his nurses and if I wanted more flexibility with my appointments I could see the nurses a few times, and then schedule with him. Next Monday I go for my second fill with nurses. Initially I told my PS that I wasn't in a hurry to reach my final size, that I just want to be able to live my life during this process. However, now I am a little anxious to fill out my summer tops. Since I'm small and I'm not going too big, it won't take long, though!
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trmtab, have a good trip!
Wldtulip, good thing its going better.
Much love to all.
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Hi ladies,
Has anyone else experienced any neck, shoulder or back pain during the expansion process?
I had delayed reconstruction, and have had two fills now. I'm trying to figure out if my pain could be drug SE's, or perhaps a posture thing as my body changes.
Thank you!
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Wildtulip-I experienced lots of pain in my back between my shoulders. Particularly my right shoulder blade. It temporarily went away after my exchange surgery. It came back and was as painful as ever. I started going for Myofascial release massage and it has helped immensely. I have to make sure I do lots of stretching to keep my pec and upper back muscles loose. As soon as I stop and let things get tight I have pain again. I have started going to Pilates as well and that has been a very positive experience. It has helped keep things stretched out.
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