Exchange City

Hey all, been gone a while.  It's been a long "journey" but it's nice to hit these milestones.

My exchange is coming up - June 8th.  I  am a uni and will be getting a small implant on my real girl to try and make 'em even.  I have been told I'll have a drain on the mastectomy side, and I need to take a week off work.  

I'm a school secretary and the surgery is scheduled for the last week of school.  My only other alternative was in August when I go back, so I figured this year was shot already (4 months off during chemo and surgery), might as well go for it and come back next year with only herceptin to finish.

Is it true that recovery is only a week?  I didn't have an easy time with the mastectomy/expander.  (Fills were easy though.)  I absolutely positively HAVE to be back to work one week from the date, no exceptions can be made!  What is the consensus from you experienced ladies?  

Coolbreeze,

I had my exchange on a Friday and went back to work a little over a week later on that Monday. I'm a teacher's aide. The exchange surgery is so much easier. I did not have any drains and took meds for just a couple of days. I think if you rest and take care of yourself the first couple of days, you will be fine in a week. The main thing is to not over do it and let others take care of you no matter how good you feel. Good luck with everything. You will be so happy - no more expander.

Melissa

whippetmom, will you please explain the foob barts? How the heck do they make noise? I just can't even imagine! Is there no end to the indignity?

Thank you Facecrafter (Judy) for your thoughts on not being afraid.  I really struggle with fear and anxiety and I'm trying to not let it overtake my life.  Thank you!

 I have a question re what you all call 'drop and fluff.'  What does that mean?  My 'breasts' with these tissue expanders look lower on my chest than pre- double mx.  My PS told me it is because there is bone up above them, that they are where they should be.  He suggested fat grafting to fill them in.  I'm not sure I want to do that.  When you all say after the exchange that they 'drop and fluff' what exactly happens?  Right now I look like I go from bone to boob.  Will the implants have more of a natural slope to them?  Just wondering what that lingo means 'drop and fluff.'

 Thank you!

Morning all,

I am running way behind...just want to share a link that has some nice nutritional info in a nutshell

http://www.pinklotusbreastcenter.com/breast-cancer-101/2010/05/sheryl-crows-ultimate-breast-cancer-prevention-guide/ 

For those that twitter....for every 100 new followers on Pink Lotus, they will provide a free mammogram for an uninsured woman

http://twitter.com/pinklotusbc

Will sit down and catch up with posts this afternoon....getting ready to teach my class

Strength and healing,

Laura2 

Hi Coolbreeze~

 Yes, it has been a long time I have seen you post here. Glad to hear you are nearing the end of your  journey.  I am a uni & I went back to work 10 later.  No drains for me either.  Recovery was much easier than the MX.  My PS warned me that I would probably have issues with my augmented breast...discomfort...than my MX exchange side.  It turned out to be true.  It was actually not too bad...just soreness.  The key is to have a good support sports bra which I had to wear 24/7 for a month.  The one I used & have been recommending here & seems to work for many of the ladies is the Underscore Zipper Front Sports Bra from JCPenney (their brand).  It was the most comfy & easy to wear.   The key is to take it easy but no worries like the orig. surgery (MX). 

Good morning, ladies!  Just a quick check in before we head to the beach for a week!!! 

Kate33 - glad the pics helped.  I found the pics of others who'd gone before me SO helpful, that I couldn't help but "pay it forward."  Any questions, just PM me anytime!

Nip update - it's only been 23 hours since I took off the gauze doughnuts.....my ps wasn't kidding when he said they'd start to shrink as soon as I did!  WOW!  I SWEAR they're already smaller in projection, though I'm a bit afraid that they're doing that "turning" thing he said might happen.... I think I'll keep a tiny gauze doughnut around them for a few more days maybe....anybody have advice?   I will say that my dh is already completely obsessed with them........and he did make a very interesting comment last night.......he said it was the first time since my bmx that I felt "normal" when he hugged me.....guess those little things really do make a difference.....

Enjoy your holiday weekend everybody!

"Drop and Fluff" is not a medical term, so your PS, if he does exclusively breast reconstruction, will state he/she has no clue what you are talking about, and the cosmetic/recon guys will pretend they do not know, b/c secretly, they hate it when the patient asks this question, "When will I drop and fluff?" Try asking that question and see what happens!!!  LOL!  I am always curious. 

Sooo....the term was coined by the breast augmentation crowd over a decade ago.  In breast AUGMENTATION, no prior tissue expansion is used, and so if the patient has sub-pectoral placed implants, they nearly always ride very high on the chest wall initially, until the pectorals release and the implants DROP.  Since the pectorals cover the top 2/3 of the breast implant, once the pectorals release and the implants DROP, the muscle and tissues relax and the implants, which have heretofore been compressed, start to FLUFF out or gain projection and fullness. 

In the breast reconstruction patient, the DROP feature is typically minimal, although a small percentage of women do have the higher riding effect, especially if they have had the low or short height tissue expanders, as the premise of the low height TE is to not expand or to only minimally expand the pectoral region and to expand instead in the lower pole, where projection naturally occurs. Those who have had the moderate or full height TEs, will have had sufficient upper pole/pectoral expansion sufficient to not see much of a drop, per se, but a settling of the implant into the pocket will occur. With  soft tissue swelling after breast surgery - after the exchange - and because the implants are now a pliable alternative to the TEs, the implants can seem compressed or misshapen until the tension releases and relaxes and hence the term "FLUFF"  Here was an old thread on this topic...

http://community.breastcancer.org/forum/44/topic/737498

Deborah

Thanks for remembering me Nedeza.    Once I went back to work, I lost any time I had to post.  My next "big" cancer thing is the exhange surgery and then it's just downhill - herceptin and maybe some revisions/nips, etc.  

I'm not liking the Tamoxifen SEs though, I have to say.

I got my packet from the doctor today - in my real side I'm getting a saline implant.  I had thought he said silicone.  I'm getting silicone on my mastectomy side, and I'm getting a tiny implant on the lift side just to try and acheive symmatry especially in the upper pole, which is now indented from cyst removals.  Is there any reason why saline would be a better choice than silicone?

 I prefer the softness but the PS nurse says they probably won't be soft anyway so maybe it doesn't matter.   

Deborah, you are so awesome!  Thank you for the information!  When I asked the PS's nurse about the dropping and fluffing of the implant over the phone Wednesday she said there is none, we put the implant in that we thought would get you to your goal a full C/D based on your size, she said it is purely a guesstimate!  I was so appauld by this how could she say that after all the expansion and things said during that time by her (all positive and now this!).  Well ladies I am planning on having a heart to heart with her one on one Wednesday and then I am going to kindly ask her to step out while I talk with my PS one on one.  I poured my heart and soul into believing in him and I still don't want to give up on him but to be told what she shared no way is that setting well.  I am a positive person who tries to help others as well as myself and that is why I love this site you and you all here.  Ok I will get off my soapbox but I am going to ask about the drop and fluff and see what the PS says LOL!

 Anna 

Anna:  When you ask your PS about "Drop and Fluff", prepare to get the following response(s):

1.  The evil eye;

2.  Eyes rolled back dramatically in orbital sockets;

3.  Denial that such a phenomenon exists;

4.  Denial that he has ever HEARD that such a phenomenon exists;

5.  A lecture on the dangers of visiting too many breast-related websites.

So tell me which one of the above occurs....  Or perhaps he will thrill you to no end and perform all of the above in rapid sequence!

Just had to pipe in one more time before I head to the airport....btw.....I'm pretty sure the reason my dh said our hug felt "normal" for the first time since bmx was because having essentially no breast tissue before bc, nips were probably all he felt!

HEY M-STAR, I am right with you - except for the stretchy waist pants..No fair, I'm at least 20  years older than you, with bad tummy genes and 3 kids(including twins); you need to cut me some slack! Anyway I mean sweats, etc, not those silly looking ones...  Ha-ha). I have all of your EXACT same questions and concerns, as well as the "picky -factor". My exchange is 6/17 and Im scheduled to get the 410 gummies. I am also very worried about size, and comfort, and not getting rotated, etc. I was a 36D before my BMX. My 400cc TE's are expanded to 570cc's and I "fit" exactly, though never wear them, in my old bras. Can't quite figure because I seem so much smaller. Though I never had radiation, I had Alloderm, my PS just likes to use it -- gives a nice IMF, and then 300cc's right at surgery. Only needed 3 fills to get to 570. My TE's have felt absolutely miserable, but the fills didnt bother me. In fact, I finally got some relief from relentless pain after my last fill -- as if the TE's had "lifted" up off of something they were sitting on. My PS says with 13cm width TE, as I have -- which is a # determined by your chest circumference, mainly, I think, that the gummies he will pick will be 410g or 445g, med ht, extra full projection. He will check out the 450g full height, extra full proj, but thinks it will be too high. It seems that the width limits the choice of size. In other words, next size up in mod ht, XF projection is 520 grams, but the width is 14cm, and the 550g goes with 14.5cm width,etc.  I think this is how it works, but I may be wrong. (HELP,WHIPPETMOM....)  I don't know why there seems to be more flexibility with the regular silicone rounds (WHIPPETMOM???), or maybe there isnt... just seems like people have more choice as to how big they go. Or maybe this just how my PS does it ???Anyway, my TE has a height of 12cm which looks kind of OK. Despite looking very creepy in the flesh, I look pretty much like my old self in clothes, even a tank or Tshirt. The TE projection is 5.6cm. The implant will have about same height and bigger projection-- 6.1 or 6.2cm, yet the PS warns I will look much smaller than current. VERY confusing and I don't want to look smaller!!! Hope I havent made this even more befuddling for you. If you haven't already, look at the Allergan/Natrelle website that has all the matrices.  I am also, with these TE's making me nuts, very focused on comfort and feel convinced that the bigger and heavier the implant, the more I'll be aware of its presence and more likely find it uncomfortable. Everyone seems to say that is not true, though...My PS is 5h away from where I live, so I do not have my pre-op visit until the afternoon before my surgery. Needless to say, I would like a chat with him sooner, and am hoping for a phone call next week. 

Hope you and everyone else is having a nice MD weekend, and that all recuperating are doing so, well. So far I'm still in my pj's and have done nothing! 

I have been lax about checking for PMs and just found one from Whippetmom (Deborah) asking me to repost here what I posted on the Bra site about not wearing a bra and having thin skin issues at exchange. This was my Post:

When I had my first implants, after the TEs, I was under the impression that I would not need to wear a bra. That was the implication made by PS and my Mother and DH thought the same thing. When I tried to wear a sports bra or any thing with built in cami shelf bra, everything rubbed on scars and was too uncomfortable so I just wore tank undershirts in fun colors. I never liked the implants (they were perhaps a B and I was used to being a D so nothing I had fit and 40 Bs are not easy to find. I went to the largest Moderate Profile Plus that Mentor makes with 960 max saline fill and now am full C to D depending on bra. At exchange surgery (I also got nips and areola) PS asked husband if I had been wearing bra to which he said "NO" and PS had a fit. Said my skin was too thin and I should have been. Why did PS not tell me this at first, I do not know. Anyhow I now wear one 24/7 and have found that some of the mastectomy bras fit me the best. I can wear some old underwires, but prefer some of my pretty mastectomy bras. They are more structured and without wires. New wired ones just plain hurt where he reconstructed the IMF at BMX. I will also be having some scar revision with alloderm slings placed to correct some of the thin skin at lower poles. I would check with your PS about your skin thickness and decide if you need the support for that.

Coolbreeze - I had an exchange to larger implants and nips/areola procedure late on Friday afternoon (Dec. 18, 2009) and was back at work on Monday (Dec. 21, 2009). My boss has been rather nasty about the time I have missed from work for all of my procedures and I could not take any extra time off. I do not recommend going back this soon. I had the donor site for the areola grafts open up while at work. (The site was between upper thigh and butt). Believe me this was scary and 2 days before Christmas. Luckily I work in hospital and could get to ER who got in touch with PS and he stitched me back up in his office with no nurse or anyone to assist. Take at least 1 week off, If you can.

Tory - you asked about the cause of "foob-Barts" well my PS says that the muscles are not used to being exposed to air and the oxygen that gets to them during surgery is well absorbed by the body, but the Nitrogen part of the air is not. It takes awhile for the Nitrogen to go back into solution within the body (Think "the Bends" as related to nitrogen narcosis in SCUBA diving) and this is what causes the noises you hear. We laughed at home during the first exchange because DH could hear them across the room. I had a QA person auditing some of my work during this noisy phase and she chose to sit really close to me. I was so afraid of lifting my arms to far because she might hear the  BFs. Luckily I don't think they made the sounds while she was sitting there.

Val - I know what you mean about your DH becoming obsessed with the nips. My husband has too, especially since my new ones are really nice and my originals barely existed and with the repeated biopsies and ductal removal were shrinking even farther. I wore an unlined Soma bra and a t-shirt to a function a few weeks ago and he asked me if I knew that just a hint of nipple showed through the shirt. I said yes and asked if it was offensive. He replied that it was just a hint and "showed that I was a lady" he really liked the fact that they showed, especially since we are so satisfied with the new breasts, areola and nipples.

Sorry this got so long. I hope it is helpful.

Best of Luck to those having procedures next week and speedy healing to those who had them last week.

Delilahbear 

Thank you M-star and Deborah for the info re 'drop and fluff.'  I'll ask my PS and see what kind of reaction I get!    Thank you!