Exchange City

I look at pathology a different way. It gives you a chance to identify a problem, if it exists, much sooner, with a potentially better outcome. If caught early, more easily treated, and if it's something reallybad, it still can be treated more effectively than if you don't know about it and it grows for a year or two.

I have 4 different areas being sent to pathology.I understand its no fun. My doc will call me next sunday, of I'll see him.next week.

Hang in there scared67 ( you need to change your name to brave67, LOL)

Also - sorry to hear you have pathology being done as well...the waiting never gets any easier!

sadly, I am not even thinking of pathology report. I have no control over anything but how I respond to it. Being afraid just makes me feel horrible, so I'll just deal with it as it comes!LOL

jxmom, I have a pre pectoral implant with no rads, but I just had my exchange surgery last week. After the exchange PS did a lift on the native side so they would be closer to even.

I need your experience...

I went to my PS yesterday, my cancer side implant has some rippling, most noticeable when I move. I only had exchange surgery June 6 of this year, so things may still settle. The cancer side also is a bit flatter and wider than the non-cancer side. Has anyone had success with fat grafting for ripples or helping both sides look a bit more the same?

He said he could go back in and work on the pocket a little bit and maybe add Alloderm, I would like to avoid another surgery if possible.

It is not terrible but would love to hear your experience...

Thank you!

farmdream- I had fat grafting with my exchange surgery. It did (only 3 weeks out) definitely fill in the pretty large crater above my boob, but my nipple spot is pretty smoothed out. I guess the volume/projection is fairly similar but you can tell there is one flat and one regular side. I am toying with the idea of getting somewhat serious with the nipple prosthesis mentioned in the nipple thread, if nothing more than to keep necklines from going lopsided. I haven't researched it yet but there is a section that tells about how to apply for insurance coverage. Now who would ever thought we'd be thinking of this?'?

https://feelingwholeagain.com/patients

I haven't been on the board in awhile- had my exchange surgery yesterday afternoon. I now have Natrelle Inspira SCF's of 695 cc in each breast. PS also reconstructed nipples with skin from my hips. Sleep was relatively elusive last night. Kept waking up every hour or so. I'm looking forward to the day I can return to bed and side sleeping. Surgery went well but I was sad to learn I'd be wearing 2 drains!!!!Ugh. I'm hoping to get them out during first post-op appointment next Friday. Which reminds me I need to get baby wipes or something to clean up since I'm unable to shower until they're out.

Sorry I've been missing out on this conversation!

Question for anyone who has or had TE: Should both sides look the same? I had a nipple sparing BMX about 6 weeks ago. One of mine is nicely rounded (for lack of a better description) and the other sort of looks pointier? That's the affected side where I had my original lumpectomy so the scar is a large c right underneath the nipple. The lump was at 6:00. The scar on the prophylactic side, although the same size, is a little bit lower, so not causing the center to look so pointy. I guess my other question is whether this will likely be the same look once the exchange is made? Or will the PS remove the old scar and make a new incision in the same area? I meet with my PS in about 3 weeks and I will definitely ask, but just wanted to get some insight from all of you, the experts.

2FUN--great news!!

Hi ladies, its been a while since I have posted, I see some new gals on the thread. I hope all are doing well!! I am back on to get some thoughts on my latest dilemma. A while back, I had posted about how my smooth round Inspira UHP had flipped over backwards, flat side in front. The next night it flipped back on its own while I was sleeping. My PS told me to wear a bra to bed and no side sleeping for a few weeks. I followed his advice, and all was going well. I saw him a week ago and told him I am starting to get more comfortable with my (pre-pec) implants. We agreed I need some FG to address rippling and fill the upper pole so it is more gradual, and he cleared me for tattoos. A couple days later, I woke up at midnight this past Monday after falling asleep on the couch only to discover the OTHER side flipped over backwards!! I took pictures and emailed my PS on the spot. He replied at 5:30 A.M. asking me to come in later that day. After examining me, he said I have to have surgery to tighten the pocket. I had a 50lb weight loss several years ago (gained while taking Lyrica) and as a result now at my ideal weight (+10 lb) my skin is "loose". SOOO....He told me I could go bigger to fill the pocket. I immediatley shook my head no. I am already a full 36 D. If anything, I want to go smaller, they are heavy! He thinks it would be best to replace the smooth rounds, which are slippery, with Natrelle textured teardrop shaped only slightly smaller than my current implants. He said the texture almost acts like Velcro and my tissue would hold on to it better. Of course he would also tighten the pockets as they have to be super tight so the teardrops don't rotate. We talked about the Lymphoma risk associated with textured implants, and he assured me that only one brand (not Allergan Natrelles) had the incidents. I have tried to fact check that online, but to no avail.

I told him if I had my way, I would not have implants at all, but replace them with my own tissue. While I love the way the implants LOOK, he did a fabulous job, I don't love how they feel comfort wise. I am not a candidate for any abdominal flap as I have already had a tummy tuck. He does not do the only other option for me, the SGAP (love handle area), but referred me to Johns Hopkins as they do it there. Hopkins is 80 miles away, ugh. I called for a consult, they don't take my insurance. I was able to switch my insurance, but after giving it a lot of thought I started wavering to NOT have the consult and just let my PS put in the textured. implants. As I said, they look great! What will a flap look like? But now I am wavering again. I KNOW the SGAP is a very involved procedure, very complex 4-6 hour surgery per breast (they will most likely have 2 doctors, 1 on each side) and a lot of down time, a 3-4 night hospital stay, multiple scars, drains etc and that 160 mile round trip for follow ups. But I am just not comfortable with implants and my PS said if he does the swap, it is also a very major revision. And he told me the SGAP would also give me a bit of a butt lift which I desperately need! My main hesitation with the SGAP is I don't have much tissue in the love handle area either. The results will likely be a lot smaller than I have now, maybe he can lipofill too, I don't know. So I am struggling here. My new insurance that Hopkins accepts will be effective Aug 4. I probably should go get the consult. If I don't, and just go with the implant swap, I will always wonder "what if". Oh also, my PS said even after the swap there is no guarantee they won't flip or rotate, but are not likely to. He assured me he wouldn't be offended in the least if I chose to go with the flap. Sorry this was so long. It has helped though getting it off my chest (ha ha) has made me see I need to fully explore all options. And I was also toying with the idea of another consult anyway for nipple recon as my PS doesn't do them. Surely the doctors at Hopkins do them. So, I am nowhere near done, its a little discouraging

The Natrelle 410's (teardrops) are exactly the implants that are having the problem. It is prevalent in textured implants that use Biocell technology. I have 410's...for a few more weeks.

That being said, my new PS got me up to speed on the whole ALCL mess. She just went to a seminar about it and every case had these two findings: 1. A colonization around the implant of a specific bacteria that is found in drain pipes and other common surfaces. The bacteria is easily killed with betadine, by the way. 2. People with ALCL and implants all have a specific gene mutation. I'm sorry I don't remember the specifics, but she said it is a rare occurance.

My PS, who had stopped placing textured implants, now has begun again as she flushes the pocket with betadine before placing any implant. It is her opinion that even if someone has the mutation, her meticulous care negates the risk.

Good luck with your decision, Shoregirl.

shoregirl, I have Narelle 410 2 1/2 years out. I love them. I haven't heard the Lymphoma deal?? Mine are Under muscle and I don't have any rotation although I know that is a possibility. But, if you follow post op instructions to the T you will have great results. I was bound for a week then wore a sports bra 24/7 for at least 6 weeks. No side sleeping for a while.

Get your PS opinion and go from there. Best wishes, Robin

Pepper45, hooray for drains out!!! Yes, squishies feel so much better and they will feel even softer after a couple months as your swelling subsides. The more I think about it, I am now certain I will go through with 2nd opinion at JHU. But I feel like you, enough surgery already! But I don't want to just live with it so I wilI just keep trekking on. I don't specifically think they flipped bc they are Inspiras (I have the SCX 470cc), but bc my pocket is too big. It would probably be ok if my doc just went back in and tightened down my pocket and kept these implants. But honestly, I just don't like the feel of them. When I do certain things like shut a window in my house, or put the liftgate in my SUV down, it hurts, like a pulling, squeezing pain. And laying down is not super comfortable. I wake in the night to change position and there is a tightness and heaviness that aches. I am what is known as "hyper aware" of my implants, probably due to thinness of my skin. I asked if FG would help cushion them, he said yes but not likely to the extent I would like. The FG is more for aesthetic reasons than comfort.

CarlaEM, my PS said he is on some board of a 7 surgeon panel reviewing the ALCL. But I thought he said Mentor was the brand associated with all the cases, maybe I am wrong. I should have taken notes. But what bothers me is, before I got ANY implants, still in TE phase he was going to use textured anatomicals. About a month after my BMX, he told me about the ALCL risk and told me they were moving away from the anatomicals and would instead use the smooth round Inspiras. I was happy he was on top of things. I guess now he is ok with the anatomical bc he found out the brand they use in his practice is not the brand with the problem. But its a little unsettling nontheless. I would even hesitate with the Betadine rinse knowing there is a risk. So you are having yours swapped in a few weeks, is that correct? If so, good luck with your exchange! Won't it be so nice to be done done???

Like Robin, I have Allergan 410's. I'm 6 years out and have always been very pleased. My doc was the head of PS at a major hospital and had done a bunch of reconstructions with these. I do understand there is now a risk with textured implants, but I too followed the PS instructions exactly and have never had any problems. Used to be that they thought implants would have to be exchanged in 10 years. Now I understand they can stay in considerably longer.

Thanks MrsB, ImKopy, Robin, MinusTwo & Leslie for your input! I AM considering just some major pocket work and keep my implants along with fat grafting, but will get that 2nd opinion as well.

Leslie, I have not had PT. My ps gave me a script for it, but I didn't feel I needed it as I have great range of motion. I will ask for another script and give that a shot as well.

Robin, I remember you have the 410s and are very happy with them. I was disappointed when my ps informed me they wouldn't be using them before I got my exchange. Honestly, he emphasized the lymphoma risk is VERY small, I think he said 1 in 50,000 and it is very treatable if caught early. I am not ruling out that option either. That is why it is best for me to have the 2nd opinion consult. There are so many options to consider.

Carla, I asked my ps if being sub pec would be more comfortable and he was emphatic that pre pec is much more comfortable and way less pain in recovery. I hope you get your fat grafting during the swap. I wish he had done my fg during the swap, not sure why he didn't. With pre pec, only our skin and maybe some alloderm covers the implant. FG seems like a no brainer for pre pec.

MinusTwo, I am so glad you are happy with your 410s even 6 years out, that is FANTASTIC!! My ps did tell me the old thought that implants are only good for 10 yrs is false. They can last much longer with good care, maybe a lifetime! He told me to do a vigorous squeeze from the bottom forcing the implant up 5 times each side every day for life and that would greatly reduce the chance of capsular contracture. I don't know if you can do that with the shaped implants.

Pepper, thank you for the info on the picture thread. I hope you are recovering nicely and get wonderful results!

I really dislike having to make all these heavy decisions again, but it helps a lot hearing from you ladies, I really appreciate each and every one of your comments and suggestions!!