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New Implants - Not Satisfied

Hi. I had my exchange from expanders to implants 1 week ago. I can honestly say that I was happier with the look of my expanders. There is little to no projection with my implants and I have my post-op appointment tomorrow. I've done what research I know to do, but is anyone else in the same boat? I know there was a huge thread that used to be very active called "Exchange City" and I'm reading through it, but most of the posts are at least a year or more old. I'm sort of feeling alone and unsure of who to talk through this with. Can anyone else relate?

Christina

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Comments

  • needs.a.nap
    needs.a.nap Member Posts: 117

    That’s so disappointing @momgoose!! I’m not in the same boat … yet. But now I’m wondering if I’ll be disappointed too because I’m kind of happy with the projection I have now. After all the discomfort and effort of TE’s we really should LOVE our implants!! I’m so sorry for your disappointment. I wish I knew what to suggest!

    I looked on some of your previous posts and see you had 400cc TE’s that got filled to over 780. Mine is a 650cc only filled to 650 and I’m getting my other breast reduced and lifted to sort of match. I can already tell it’s not really going to match because it’s slightly concave above the TE which stands out as different than my other side (which would be noticeable in a tank top) and I’m not sure if I want to deal with fat grafting but I might need it.

  • momgoose
    momgoose Member Posts: 71

    Hi @needs.a.nap! I think that's what has been so disappointing. After everything that we've already endured, why can't we then get the reconstruction right?

    I had 800 cc Mentor moderate plus profile implants and they feel too wide and too flat. I could handle the width if there was more projection. My expanders were placed by one surgeon, who then left the practice and the new surgeon always said they were too narrow (I do agree they were, but now we've swung the other way!) I liked the projection I had with my expanders. I just really wish there was a way to make a 1-1 trade from expanders to implants. I don't like waking up to a surprise of what the surgeon thinks I want. We barely discussed it at all and while I believe he is a very talented surgeon, we should have had more communication on exactly what my goals were. I mostly met with his PA and showed her pictures of what I had in mind, but we're not there….yet.

    I had my post-op appointment with the PA today and expressed my concerns. She was very understanding and said that I needed to give it 2-3 months for everything to fully heal and settle and if I was still feeling that we needed to change things, we could exchange the current implants for some with a higher projection. So there's still hope, but after a full year of waiting (from mastectomy to implants), it's hard to wait longer. My advice, for what it's worth, is to be very specific with your surgeon on what is most important to you. If you like your current TE projection, make that very clear that you don't want to go any smaller. The surgeon may have what they prefer, but you should get what YOU want.

    I will say that I had a lot of what I called "hollowness" above the tops of my expanders, but the implants did fill that area in nicely. Of course, I still have swelling, so that may be what I'm seeing, but I don't think so. Hopefully, you will find that the area you are concerned about will be addressed easily.

    Thanks for your kind response. It's been hard to find people who get it in real life!

  • needs.a.nap
    needs.a.nap Member Posts: 117

    Hi @momgoose. I know, no one in my life gets it. Some family and friends genuinely are sympathetic but I know they don’t understand. I don’t really expect them to, that’s why I come here … it helps having someone to “talk” to who is living it. Thank you for sharing so many details, it’s very helpful. I type this as I’m propped up in bed having lovely hot flashes from the Tamoxifen, icing my aching lower back and my expanded breast is pulling in an uncomfortable way. Nights have become extra special, as many here can fully relate to! How are you healing from the exchange? I’m curious how limited I’ll be after that surgery and having the other side reduced. Hopefully not too limited for too long. Thank you again for your helpful response!! Have a good night!

  • momgoose
    momgoose Member Posts: 71

    @needs.a.nap - It definitely helps to talk with those who, unfortunately, have had to walk the same path. I have been fairly fortunate that I don't have many hot flashes with Tamoxifen, but I almost simultaneously started Effexor, which is supposed to help with hot flashes. I don't know if it did or not, but it might be worth asking about if they get too bothersome. Are you done with the fills for your TEs? I'm sorry they are bothering your back. I had back issues before all this, so having to sleep on my back for the better part of a year, has been a challenge. If it's any consolation, I did eventually get used to the TEs and probably could have dealt with them long-term (although 5 months does seem sort of long!) Hopefully, they will get a bit more comfortable for you.

    I can give you good news on the recovery from the exchange. It was a really quick surgery - maybe a little over an hour- and the pain was fairly minimal. I had more than some because I had to have quite a bit of pocket-work done to make room for the wider implants, but even with that, it wasn't bad. I took pain meds for about 3 days but probably could have just used ibuprofen. The PA told me that I should only have restrictions for another week (so 2 weeks total) and then I can go back to normal. Other than no heavy lifting, I've been basically doing everything I normally would do. It is definitely MUCH easier than a mastectomy. Maybe that will help reassure you about the exchange process.

    I am off to bed for the night. Hope you are able to get some rest this evening. It's been nice chatting with you! :)

  • needs.a.nap
    needs.a.nap Member Posts: 117

    That is good news and so reassuring @momgoose!! Thanks! I only had a single mastectomy and I’ve been done with the fills for a few weeks now. In a weird way, I think it helps having one original to compare the TE to … the TE looks pretty good in comparison! Ridiculously fake, but I don’t care, no one will see it, under my clothes it looks good. After reading your words, I can see I need to have good communication with my plastic surgeon, and not leave the end result up to chance!!!

    I wasn’t having any hot flashes with Tamoxifen until just recently (they started about 3 months into taking it) and although it’s winter and I’m usually freezing cold, they don’t warm me up in a satisfying way. Silly me was hoping it would. They are just annoying is all. My gynecologist is having me try Gabapentin for the hot flashes and insomnia. The insomnia started almost immediately and has been my biggest issue. The Gabapentin seems to be helping somewhat so I’m hopeful. I know it’s all probably normal menopause-like symptoms but they are new and sudden for me since I had never had hot flashes before and I was sleeping fine before now. I just wasn’t prepared for so many physical changes all within a few months!

    P.S. My backache is unrelated … I’ve had off and on lower back issues forever it seems. Nothing too exciting. Thankfully it’s been okay mostly since my surgery but apparently I’ve done something to aggravate it. I did have a bout of aggressive vacuuming and floor mopping the other day (it was pretty satisfying!) so maybe that’s what happened?

  • jonib
    jonib Member Posts: 85

    Having been on this site since 2007, I can say that there are many older posts with people saying they were unhappy with the projection of their implants and they preferred the look of their expanders. I know many did have the implants swapped out and were then happier. Just sucks that you have to wait.

  • momgoose
    momgoose Member Posts: 71

    Hi @jonib! I've been trying to read through the massive Exchange City post (I'm somewhere around page 72) and I even knew that I should temper my expectations, but I guess I kept hoping I'd be one of the lucky ones who liked their outcome. I know it can be tweaked and I do feel better after my post-op appointment yesterday. But yes, the waiting stinks!

    How are you doing? Dealing with this two times is simply not fair!

  • jonib
    jonib Member Posts: 85

    Hi @momgoose this will actually be my third breast cancer if my biopsy is positive. I’m doing a lot of research so I’m prepared for anything. Glad you are feeling better after your office visit .

  • momgoose
    momgoose Member Posts: 71

    @jonib,

    Oh my goodness. I didn't realize you were waiting for more biopsy results. Waiting for those results is absolutely awful. I will keep you in my prayers that the results come back with NO cancer. Enough is enough!

  • recoveringbelle
    recoveringbelle Member Posts: 21

    Thx for sharing. I'm sorry you're frustrated, but it makes me feel better to not be alone!

    I'm 3 weeks post-op from TE to pre-pecs for a 2nd primary 16 yrs later, and as I suspected, the outcome is pretty bad. Lots of rippling, plus a weird ridge, plus unevenness, a bad scar, etc. I tried so hard to get the PS to friggin pay attn during rushed appts, and to choose an approach that wouldn't result in this. Though at a top institute, they never showed me before and after from them or anyone, and advised me to remove a subpec from 16 yrs ago to match a new prepec after a 2nd primary dx after 16 yrs post 1st primary, mast subpec +mast implant symmetry.

    I'm enraged. I'm enraged because no matter what I do—and I'm trained friggin' researcher w/ plenty of prior clients in high level science, med, acad positions—I'm invalidated & dismissed. A lot of it is being an older woman. Before, I was still youngish blonde w/ a career. It's exhausting to get there due to a disability I have—like going on a camping trip—which makes me feel hopeless anyway. And I think the staff just act like, you're over 50 so you're lucky you're still attractive & wanting nice breasts at your age is SOOO demanding. (Why do young people think they'll never grow old?) So they were invalidating after initial TE misplacement too. Told me this was about "what you look like in clothes." As hubby said, if that's the case, why do surgery at all? Why not just wear a prosthetic? I'm a feminist w/ 3 adv degrees, & these younger female PAs talk to me like I'm an idiot.

    Given DEA's draconian new opioid shortage mandate & policy of flagging anyone w/ 3+ prescriptions in a year, having a THIRD SURGERY w/in 12 mos, after I was deliberately invalidated & dismissed by his staff for precisely the concerns I predicted mighth appen, means I've got to be careful about pain meds. Might get dropped by pain mgmt person for bogus situation. You'd think Cancer Center would have a hotline to these dolts, but no. And another surgery. unpredictable outcome. Angiogenesis, a known recurrence risk factor I explicitly told him I wanted to avoid. Where will it end?

    Why didn't he consider the "P1" subpec/pre-pec approach instead of rushing w/ me? Why did he rec I get rid of the animation deformity anyway if I was going to have an even worse cosmetic outcome afterwards and endless surgery that'll never get it right?

    They'll try to claim "Oh, rippling's inevitable when you're thin," but they never said that to me, never showed me before & after despite my asking, encouraged transfer from subpec to prepec. And, thinness isn't the key factor accg to recent research—it's surgical approach. Plus, if they really believed that, why didn't they say it up front so I could give informed consent?

    What's maddening is that I cannot get a second PS opinion around here—not at his institution, and not from the now private, high-repute guy who did my 1st cancer work, because it has to be a year AFTER the last surgery before they'll see you. Since my career is shot I don't have the connections i used to have, which would have frankly enabled me to pull some strings. And also, male surgeons were nicer to me when I was still a "babe." Now, it's like I'm in some new category of shut-up-disabled-middle-aged-woman-you-have-no-value-anymore.

    I'm SOOOOOO ANGRY. I refused radiation and estrogen therapy anyway despite a positive node, because I cannot handle the side effects. I didn't need this. I tried so hard to prevent it. And w/ this guy it'll be an unending cycle of surgeries where he'll barely improve it, and he and his staff will badger me into thinking my demands for a good outcome are unreasonable & selfish.

    I'm not going to post-op there yet. I'll send him photos & citations directly & ask for next steps.

    Something about when you get in that chair, haif naked, gives them an unearned authority & makes you "difficult" for speaking, however respectfully, about things like studies and f-a-c-t-s. That's why I always try to write doctors & pay them for responses, wherever possible.

    It generates a document trail & evens the status. I think that's why many don't like it. It's less challenging to read & answer for them than a one hour exam, but only if you're humble & really want to help patients—and learn. But those who don't like being accountable & being communicated w/ as an equal get very irritated by it, which is a helpful tell.

    Thx for starting this thread.

  • jonib
    jonib Member Posts: 85

    @recoveringbelle I am so sorry for your pain and I hear you. I will have Diep reconstruction because of my new primary and prior radiation and I expected the doctors and their staff to be dismissive of me because I’m an older woman. I expected them to not understand why I still want to look good even though older. Instead I’ve been told I’m a great candidate for the surgery and have been treated well at consults so I am pleasantly surprised. I may not be happy with my reconstruction at the end - I am worried about that. However I think we deserve to get the best cosmetic outcome we can and I hope you fight back and get the results you want and deserve.