Exchange City

PNY

Suzanne, I thought the exchange recovery was going to be a breeze compared to the BMX. But i think each person is different and it depends on the amount of pocket work required. I ended up needing extensive pocket work. I also hd liposuction (belly) so that also has to heal.

So I would just say plan for that 1 1/2 weeks but don't push yourself if your not ready. I was surprised that my PS did not want me to go back at the two week mark but rather said I should ease back into it slowly.

Good luck

Scottiemom11

Suzanne. . .I would leave the window open just in case. I was out for 6 weeks for BMx and probably could have used 8. For EX I planned for 3, hoped for 2 and do to pocket work etc ended up taking 4 weeks. Good luck.

Scottie

Suzanne50

Thanks ladies! PS talked about I may need another surgery after this one - he doesn't know if he can give me a lift on my other breast and the saline implant. He won't know till he gets in there. He says it can be risky since it can cut off supply to nipple. So really not sure how that will play out.

PNY - just a question about your liposuction....did you have it related to your reconstruction? Meaning was it "fat grafting" ...I don't really know anything about that so excuse my ignorance. The only reason I ask is I would love to get a tummy tuck! I had two pregnancies and my belly just ain't the same. But I never brought it up to my PS. I don't really have fat there - just some excess skin where it was stretched. I never asked my PS about it. I have been so focused on everything else but it has been in the back of my mind. Wouldn't it be nice to have boobs like an 18 year old AND a flat tummy!

PNY

Suzanne, Yes, the liposuction was for the fat grafting. I suggested my belly. I am not a very big person but I too have a small belly from childbirth. I have seven children. the liposuction is by no means a tummy tuck and PS only took the amount of fat needed. I have to wear a binder (or a pair of Spanx) for four weeks. The soreness in my belly is pretty much all gone but i can't tell if it looks so much different:) I gained some weight from the steroids and chemo and I am hoping to get back on track and lose that Then I too hope to have the perky boobs and flat belly!!

Most of all I just hope to stay well!!

PMR53

Thank you PNY- 

Made it through surgery. Home now. It turned out to be a 4 hour surgery. We counted 9 stab sites/incisions due to fat grafting/fat harvesting, exchange site, drains (2) pocket work, new Alloderm. Port Removal too. My new implant is a Allergan Naturelle 410. Right side. Fat grafting only to left side for lift. I am wearing a body compression garment. Quite a feat to get up to pee. 

Nodding off. Night all! Glad it's in rear view !

Patty 

SpecialK

PMR53 - yay!

SummerAngel

Suzanne50, I have some loose skin on my stomach from pregnancies, too. Skin isn't fat, though, so my PS had to get fat from my inner thighs the first time and my inner AND outer thighs the second time. I guess I'd need a tummy tuck to fix the skin.

Suzanne50

Yeah...I think I need a tummy tuck and it seems awfully vain of me. I probably won't ever do it but on this road of trying to get myself back to feeling well body, mind and soul....my flabby belly is a bothersome part.

I am going to ask my PS surgeon about it but unless it's an easy, inexpensive fix...I wouldn't put myself through another surgery and long recovery.

SummerAngel

I've been wanting a tummy tuck for years, even scheduled it once about 7 years ago. I just couldn't see spending the money for it, though! I don't exactly want to deal with another big surgery, either.

robinblessed54

Summerangel,

My sister had a tt and it was horribly painful! You might want to go to the tram flap board. They would be able to tell you about the tummy part.

Robin

halee

I haven't been here in a while, but checked in tonight and just wanted to jump in and mention that I had a tummy tuck with my exchange. I had triplets (plus one) and my belly was wrecked. I was considering getting a tummy tuck at the end of this year anyway, so we just moved it up. For me, it was a far easier recovery than the BMX and TE surgery. My PS said it's a much easier recovery than TRAM or DIEP, too. It is really the only thing about BC that I consider good. I had my totally separated abdominal muscles repaired along with the tummy tuck, and now I have support through my core and can workout more effectively. I honestly wish I would have gotten a tummy tuck a long time ago. Anyway, I'm happy to share some pictures privately if anyone wants to message me.

I had some fat grafting and scar revision done today on my breasts. This should be the last surgery. . . .

Suzanne50

Halee- I have to assume that there was a separate cost to your tummy tuck?

I am a slim person but skin on my stomach is like elephant ankles. There just seems nothing I can do to get rid of it. My exchange is scheduled for 3 weeks and I never mentioned to my PS. I kind of wish I had. But I do think I will mention it next time and see what he says. My reconstruction on my healthy breast may take two surgeries anyway. Maybe I can get a tuck then and rock a bikini in the summer. LOL

SummerAngel

Halee, now I'm tempted again to go ahead! Ha! Suzanne, my skin is just like yours - it's skin that's wrinkly but without underlying fat. Surgeons who take a look say, "Yes, there's some laxity there..." When I had originally scheduled a tummy tuck, the PS told me that my abdominal muscles were fine and wouldn't need any work, the surgery would just involve the loose skin. That was reassuring. I still can't get past the expense, though. It's about 10k in my area and I'm a single parent with one child in college. I feel ridiculous even considering it!

SpecialK

Often plastic surgeons will not combine a cosmetic procedure with a breast cancer reconstruction surgery because it offers your insurance company an opportunity to deny the entire claim.  If you are using the OR, anesthesiologist, etc., for a BC related surgery the insurance company can't suss out which part of the charge is their obligation to pay, and which they will not cover due to a cosmetic procedure.  Unless you are using the tummy tuck for the breast revision most won't combine, and this is not only to be sure they are paid their professional fee, it is so you don't get stuck with a larger bill than you bargained for.

Suzanne50

$10,000! I can't consider that either. I have two kids to put through college and it just seems awfully vain of this 50 year old woman. If I won lotto then I would consider.

Ok- well I will just keep doing my stomach crunches and keeping my weight down. No more bikinis for me!

katykids

Suzanne, I took 2 weeks after my exchange. That being said, my docs said I only needed to take two days off after my BMX. I took 9. I wish I had taken more. 2 weeks was okay for my exchange though. Best of luck!!! As everyone says, each of us are different!! xox

halee

Yes, there was an added cost to it. I had a hernia, so insurance covered the hernia and the muscle repair. I paid for the lipo and skin removal. The total was $5750 ($4000 went to the PS and the rest was anesthesia and hospital fees).

I am fairly slim but with a huge belly. It sat on my legs when I sat down and would trap my panties under it (so yuck). I was a size 10 before the tummy tuck to fit my waist, and I couldn't wear most pants because if it fit my waist it was too baggy through my rear. Within a month of the tummy tuck, I was in size 4 pants because my tummy size matched the rest of me. The difference for me was shocking. And because of the muscle repair, I have a lot more core strength and can workout more, can run again for the first time since I had children, and am generally stronger. It was very worth it for me, but I know it's not for everyone. . . .

Suzanne50

katykids - 2 days off after BMX???? WTH? I had drains for 3 weeks! I had mine in the summer so I was off anyway but I would not have gone back to work with drains!

Thanks for all the info ladies. Thanks halee for the tummy tuck info. It sounds like it was well worth it for you.

PMR53

Hi All!

2 days Postop from exchange. I would say for me it's been less painful than MX but I had extensive pocket work done and liposuction in 3 places. My surgery actually took 4 hours. The pain is mostly in the drain/pocket area and the Lipo area which is really bruised. The incision over right breast is numb. Getting the tight compression garments on and off for showering and going to the bathroom is painful too. That being said, I have to stay up on pain meds q 4 hours. I am not working now but I would think at least 2 weeks off.  I wanted to say also I am really pleased with result and it looks pretty even on both sides. The implant feels so much better compared to TE. Excited for everyone of you ladies to feel difference!

Tina- your up next !! What day? Will you get fat grafting? I noticed my pooch disappeared from fat they sucked out. 

PNY- how are you doing? Is Lipo area less painful? Are you wearing compression garment 24/7? I feel like I got ran over by a truck. I think we both had similar experiences. 

Will have my drains until they are bone dry my PS said due to my fluid/Seroma problems in past. 

Mominator- is your infection cleared up? I started taking Keflex postop right away. 4 x a day. Did you start antibiotics as part of post op or only after you got infection? That is my biggest fear. To go this far and have infection. I can handle pain. 

Katydid- I think your doctor way underestimated recovery time. I can't imagine anything less than 2 weeks. I was tired after shower and slept 3 hours today. 

Goodnight All. Xoxo

Patty

Tina1969

Hi Patty,

Only 3 more sleeps for me. My surgery is Monday the 22nd. I'm excited to feel the difference too. No fat grafting for me so hopefully I will have a pretty easy recovery. I'm taking 2 weeks off work just to make sure I give myself enough time.

I hope your pain gets better.

robinblessed54

Tina, I took 2 weeks and it was plenty. I had some pocket work on one side to even them out. I didn't have drains or fat grafting. I have Allergan 410 gummies 475cc. I live them! Almost a year now.

Robin

Suzanne50

I know this sounds stupid but what exactly is "pocket work". I have no idea if I am having it. I do know that I am getting a silicon implant on mastectomy side. Other side he is doing a lift and then hopefully putting in a saline implant to even me out. But he isn't sure he can do both same surgery. Something about the blood supply to the nipple being cut off and he won't know till he gets in there. So is that "pocket work"?

PMR53

Suzanne- I had more pocket work done because my tissue expander and Alloderm had moved under my arm and stretched out the skin. My PS inserted my new Allergan 410 Implant and also had to replace Alloderm and get that whole area tightened up and resutured. I had 2 drains placed also and fat from my stomach injected to the upper pole area. I know that there is more to pocket work than this explanation, but I can't remember much that was said after surgery. I will learn more at first postop. 

Please chime in with additional comments on pocket work for any of you that understand it better. 

Patty

Newgirls

pocket work is the surgical techniques a doc uses to keep the implant in place under the muscle. Stitches I assume or just their magic!

LoriWNY

When the TE's are placed, the PS creates a "pocket" within the pectoralis muscle to hold the TE and eventually the implant. Most of time, during the exchange from TE's to implants, the PS simply opens the breast mound, opens the pocket, removes the TE, inserts the permanent implant, sutures the pocket, and sutures the skin in the breast mound. However, sometimes the pocket itself requires adjustment. Maybe the pocket stretched into the armpit (too lateral--implants in your armpit) or is too close to the sternum (too medial) in which case, "pocket work" is performed which may involve more cutting to open up the pocket in a certain direction or suturing to close/change the shape of the pocket. This "pocket work" is obviously more invasive surgery than a "simple" exchange and therefore, recovery MAY be longer and more painful. The medical term for "pocket work" is lateral capsulorrhaphy.

I had my initial exchange without pocket work and a revision to a different set of implants with pocket work. For me, the revision including a lateral capsulorrhaphy on each breast was only slightly more painful and the recovery was slightly longer BUT definitely worth it.

Suzanne50

Thank you LoriWNY for that explanation! And for everyone else sharing their experience. It is all very helpful. I guess my PS won't know what kind of pocket work I will need until he gets in there. This whole surgery is going to be a "wait and see" how it all goes. He said he will have to make decisions during the procedure and we won't know if I will need another one after this or if he can get it all done in one shot.

Looking forward to this being behind me! Getting closer to the BC finish line

PMR53

Thank you LoriWNY- 

That was a great explanation. Right on the money.  My TE and Alloderm migrated under my armpit and I had extensive pocket work. It still feels better now after exchange than with TE. It feels firm and in place. It hurts like $!&@"

Patty

PNY

PMR53, yep we sound pretty much the same. Now 3 1/2 weeks out I am doing much better. I went back to work last Monday but only stayed in the office half a day. Then went home rested for about an hour and finished up my day from my computer at home. I still have pain under the implants but not all the time. After I reach to get something or crunch as I sit at the computer or try to lie on my side for too long. I am wearing SPANX when at work and the compression band PS gave me at the surgery when I am at home. Not sure i even need it anymore but figure it can't hurt. I must say the lip area feels fine at this point:)

Suzanne50 - pocket work is just the work the PS does to have the implant sit properly. In my case my TEs were so far apart you could fit a truck up the middle of my chest. PS had to get the implants to sit closer together which required alot of internal stitching. But i have to say, they look pretty good. I would have even liked it a drop closer but PS said they would not have looked as good on the outer side.

Good luck Tina

Katykids, I can't believe a BS could say all you need is 2 days for a BMX. WOW, the drains are in for 7-10. Glad you did not listen:)

fipjoemom

Hello to everyone. So ready to have my exchange surgery tomorrow. One more sleep night for us Tina1969! I'm having exchange surgery, fat grafting, and right nipple reconstruction.

Thanks to all for sharing info and personal experiences. It has really helped me to get through this journey

new__me

Hugs and prayers for all having surgery this week my date is inching closer (march 16)