Exchange City

Hiking Lady - a lot depends on your PS & your body type & the extent of your surgery, etc. I have Allergan 410 anatomical cohesive gel implants - the original 'gummies'. I've had them since 2011 after a double mastectomy and I'm very pleased.

Go to the Breast Implant 101 forum, read the header and post your personal specification as listed and ask Whippetmom. She is truly the breast whisperer. You can read tons of implant choices there.

https://community.breastcancer.org/forum/44/topics...

The risk for ALCL is a bit higher than that as more is being learned about it. If you are the type who wants to do everything possible to prevent another run in with cancer, then smooth is the way to go. 

I initially had the textured anatomical and absolutely hated them. They looked like big flat wide burger buns. They also felt "scratchy" on the inside of my skin.  The whole ALCL stuff came to light a few months after their placement as well. After 15 months I had them exchanged to Natrelle Inspira SCX and all of the above problems disappeared. I hope my chances of ALCL are reduced as well. 

Good luck with your decision. 

Thank you for all these stories and insights. I'll keep doing my research on textured anatomical vs smooth round.

VegGal thanks for sharing that smooth round are more comfortable for you than the textured were. That's helpful for my decision making.

JM1965 size/too big/your question: My PT who works with breast surgery patients says that if the pocket is a bit larger than necessary, that means you'll be more comfortable once the implant is set into it than the reverse problem of having it too tight. My PS says that he can remove extra skin to match and even things up on me if there's extra skin due to uneven stretching on the two sides.

Size: I have no choice on how big. My foobs will be small. The only choice I have is between the textured anatomical Allergens and the smooth round--those are the two types that my PS has offered, for my size and shape and his preference, etc.

I had radiation in 2003 on my right breast after a lumpectomy. Because of scar tissue (invisible, but affecting blood supply and skin and pectorals and all connective tissue) the right side incision took much longer to heal than the left (8 not 2 weeks). Stretching after tissue fills has been fine on the left and super uncomfortable on the right. I am at 350 ccs, and I have a pretty wide chest and large rib cage. They're currently filling a B or C cup. I used to be DD, but now I don't care how big. I do worry about the right side's healing.

If there's eventually contracture on the right side (higher probability than for most people because of the radiation history), it will be smaller than the left. My only "size" guidance for my PS when we recently met was to say that I'd like them both to be the same size. Which means that he'll probably reduce the left side's extra stretched skin to match right side.

My exchange surgery is now scheduled - Feb 8, 2019. My PS will not do the anatomical implants for 2 reasons - the texture issue with ALCL, and he says they can sometimes rotate and therefore cause breast to be misshaped. In fact a friend of my had that happen from surgery in 2012 and had new round ones put in just last week. He says at the pre-op appt next month we will talk about level of cohesiveness and he'll determine if he wants to use Allergen or Mentor implants. I have one more small fill and will be at 400 cc on each side, and he said he usually puts in a final implant about 100cc larger so they fit snug into the pocket. I've only had these TEs since MX surgery on Nov. 12 but I am already tired of the weird feelings going on in them - saline "swishing" movement when you move around and the way they stick out into under arms.

while I feel great I am actually at the PS now. I have never stopped bleeding from one spot along the incision...like a small weeping that will stop but then starts again. I have switched to a firmer compression bra and that seems to be helping plus the PS put in 2 stitches. She says it isn't internal bleeding as there is no swelling or bruising...just the two sides of the incision not coming together. Hope the two stitches work.

Shoregirl does that mean a full anesthesia surgery to remove some of the stitches you have? Sounds like those are internal.

my exchange surgery is now scheduled for Jan 18

My surgeon didn't tell me which brand of implant I will have

I'm not happy with TE size now I have 600cc in right side and 500cc in left

He told me he will put implants 650 cc is that normal ???

HopefulAC I haven't had my exchange yet. However, after my NNS-BMX, the previously-radiated side (15 years before) was 4x as slow for healing, due to that scar tissue. 2 weeks to close incision on left, 8 weeks to close incision completely on the right side. So, I expect that at exchange, same thing. It will be slower to heal.

As for more bruising on the radiated side, that's what I experienced after the BMX. The radiation causes scar tissue in the skin and in the pectoral muscle, and that compromises the blood supply, so it is more challenging to heal. Be vigilant about watching for any signs of infection on that side; that's, unfortunately, also a higher risk after radiation.

My PS has also said that the radiation makes it more likely that there will be contracture, and then a tighter fit and smaller size on that side. Some of this is unknown until healing is complete, he also said.

Keep us posted, thanks--I'll be curious to know how it all goes, because my exchange will be in 12 days.

I am doing okay no more bleeding

Can't imagine someone pushing on me to brake a stitch

Take care

TT

I drank 3 quart bottles of sparkling water per day for the 2 days before surgery and 3 days after

Hydrated for procedure and then flush system afterwards

I hydrated like hell, still woke up puking. 

Always ask for a scop patch. It makes a magical difference. And yes, talk to the anesthesiologist. I'm not sure if I had TIVA - but whatever concoction I had for the exchange & later ALND surgery meant no nausea - compared to the BMX where I couldn't stop throwing up in ICU for hours.

is the scop patch the thing they stick behind your ear? I had acupuncture patches behind my ears and it seemed to work. I realized they were still on a few days after I got home (after DIEP) and pulled them off. Very pointy.

Pineapple had bromelain which is an anti inflammatory enzyme. And it is yummy!!

14 surgeries in my life, only puked once after my tubal ligation. I mentioned that to my anesthesiologist for this recent surgery. She said gyno surgeries usually DO cause nausea. Something about a big nerve that gets disrupted. I always request a scop patch regardless. I don't ever want to experience puking in surgical recovery again!

Hikinglady- thank you for responding! merry Christmas Eve! In terms of healing there is some definite tightness in the radiated side but the biggest difference is bruising in terms of healing. Right after surgery I didn’t have any and now my radiated side is all bruised it began near armpit and now it’s basically all over. My other breast has no bruising at all. I just hope it gets better soon

BEsides the awful bruising I like the way they look as surgeon did really well making them look even. I stayed close to my size big B small C bc doc said that would yield better results since radiation and couldn’t go bigger.

Hikinglady- best to you