Exchange City

I had the Sientra highly cohesive “gummy bear” implants InAugust 2016. One problem was that the particular implants were too large for my frame, but I absolutely hated them. I agree with another writer that they looked like flat hamburger buns and were very hard. Then, after the lymphoma story broke, my ps devised to quit using them. Five weeks ago I replaced them with the smooth round and am already happier.

Just back from my 2 week post-op appt...

Had a very good meeting with Dr re my recovery status and progress…had for me a disappointing meeting re removal of restrictions in the weeks ahead.

I see her in 4 weeks, +6 weeks from the surgery, at THAT time I will be lifted to start RE-INTROducing strength/weight issues into upper body as tolerated over a build up of up to a month or so after being away from such activities…yikes!

Her pre-op materials on Post-op procedure was first two week this and then up to 4 weeks that, then free to start building up again.Well, the grammar was off, 2 week this, the NEXT 4 weeks that…

I know it is silly but I am very disappointed and now need to clarify my business trip that is at 5.5 weeks post op…truly thought I would have been okay with that, but my next appt is after my trip to Princeton and my bags exceed the no weight bearing rules.

I can do the non-strength non-balance yoga classes (Yin Yoga) as long as I don't do chest/shoulder straining…ugh…still just a walking machine.

Hello All!

Thanks to all of you, for support and encouragement and good vibes, and for sharing all of your experiences and knowledge, and cheering me on through my anxiety about this.

Day One After Exchange: I had my exchange yesterday, January 2, at 12:15 p.m. Home by 4 p.m. Anesthesiologist was very thoughtful about working to reduce my wake-up nausea, which I've usually had; not this time! He said he'd use two meds during anesthesia that would help (Phenergan + Zofran). No guarantees, he said, because everyone's different. But, whatever he put in the cocktail, it really worked. I also super-hydrated the day before surgery, and anesthesiologist agreed with that being a help also for reducing nausea. Surgery was 12:15, and I didn't eat after midnight night before, but I was allowed BLACK coffee + water until 8:45 a.m. which was helpful morning-of.

Anxiety help: I asked for something to keep me calm--they gave me 5 mg Valium as soon as they took me to the pre-surgery prep area, and it was oral, not IV. So, for the next 45 min before surgery, I felt relaxed and much less anxious than I would have been without this nice assist! It's bad enough to go through all this trauma, and I decided that a tiny mood-assist would be appropriate, and both doctors and RN husband totally agreed.

Surgery and size: PS took out TE's and put in the implants. Also took out extra skin on left side to match right side's size. Right side expanded less, because of 2003 radiation, so I asked PS to make left side smaller to match right side. It's expected that, as PS describes it, "they'll be sisters, not twins." He has warned that contracture is more likely on right side than for other people--that's just a post-radiation surgery fact. I'm hoping for a sort-of match. They'll be rather petite; size is not something I can choose. Stretching just was limited on right side, and fills became horribly uncomfortable, so I stopped at that point. Probably will end up a B cup, possibly C.

Nausea: My husband is an RN, and he's guiding all of my med timing. We have Phenergan + Zofran at home, and I did use them for the first 15 hours or so, and now I think I'm past the post-anesthesia nausea. Throwing up + oral pain meds = a terrible plan, right? Anyway, so far, so good.

Bandages: Today I go to PS office for an RN to remove wrapping. After surgery, I was sent home with a huge ACE wrap around foobs. Today, that will be removed, down to steri-strips, I assume, and supposedly I'll be cleared to take showers now. No drains, yay!!! Lots of swelling, of course. I'm trying to sleep in a chest-uphill position, to help with that. Also, to be able to sleep on my back, I'm using small pillows under arms, and a travel pillow around my neck, plus a whole other assortment of possible pillow options!

Meds: There's an antibiotic for 5 days (every 8 hours). I need my Oxycodone for a few days, I'm also taking stool softener (Colace) + also Senna + also a few prunes each day because of that. I'm taking Tylenol every 2-3 hours between Oxy doses. Will eventually taper off Oxy, in 5 days or so is expected. We wrote down a schedule for managing all this, and that includes alarms a couple of times in the night. Not Fun, but that way I'm staying comfortable. Nurse-husband will take care of me for 5 days, then he'll go back to work. I'm up and about today. Still sleepy from anesthesia and a bit groggy because of Oxy on board, but pain level is okay with Oxycodone.

Hydration - I'm drinking as much water as I can get down for a few days. Helps to clear out anesthesia grogginess and helps with healing and helps all meds. be absorbed and work sooner.

Food: first 24 hours after surgery, easy-to-digest things, of course. For me, that was tomato soup + toast, and I had oatmeal for breakfast. Now I'll start adding extra protein + antioxidants for healing, and continue that for a month or so, as per dr. guidelines.

Implants: my PS says they're "smooth round," and although they're the "cohesive" version of Natrelle's smooth rounds, they're not the "textured anatomical," according to my PS and the online Allergan product catalog. The names of the Allergan models are confusing, but this is what I have in me:

Allergan Natrelle Inspiration Cohesive

SCX-400 (volume=400 ccs)

I chose to not have textured anatomical implants, for various reasons. One is (perhaps illogically) the 1/30,000 risk of an associated lymphoma. Obviously, that's practically zero, but not quite zero. The truth is, I listened to my DD. My daughter is a Nurse Practitioner, and she wanted me to choose lowest-possible risk since there was an option. All implants have risks, but that particular one is one I can reduce by having "smooth round." My PS thinks that textured anatomicals have a more "natural look," and that they settle in well. On the other hand, a writer on this forum was more comfortable when she switched from textured to smooth.

Glad to have this surgery behind me, and the new Foobs in front of me. :-)

No VegGal, from what I've read, the risk is NOT that high. The risk depends on your age. From our own BCO site...1 in 35,000 for women age 50. 1 in 12,000 at age 70.

MD Anderson estimates from one in 30,000 to one in 1,000 - but is still calling the risk under 1%. While this does mean there is a risk, I hope we don't start 'scare stories' for those of us who have textured implants or those who are still making decisions. Read the reports. Listen to your doctors. Get a second opinion if you're still undecided. Most of us are in great shape!!!

Day Two after exchange--it's Friday, and my exchange was two days ago, on Wednesday. Goodness, I cannot believe how much easier this is than the BMX! Everyone (this forum, my PS, his nurses) had said that this surgery is much easier than the BMX, and I'm so happy to find that out for myself. I probably wasted some energy on anxiety, lol...

I am taking some Tylenol every few hours. I needed the Oxycodone for 36 hours and then I just didn't. Lying flat in bed, I had no pain, so I just stayed still, and felt okay and slept okay the 2nd night. I have some swelling, but I feel comfortable in the supportive front-hooking sports bra that I'm instructed to wear for 2 weeks, 24/7. Slight discomfort, no serious pain at all. Restricted activity level for 2-4 weeks.

I drank a LOT of water the day after surgery, to get the anesthesia grogginess gone. I'm on antibiotics for 5 days, which give me diarrhea, so I am also taking a probiotic. Seems like enough stuff coursing through me, so I'm happy to not need the Oxy any more.

My BMX was so traumatizing....axillary node excision through the right breast, attachment of the TE's, etc. and post surgical pain for quite a few days, and this exchange/swap surgery is truly SO much easier. The only additional "inside" work that the PS did was to make left side a tiny bit smaller (he removed some extra skin) since it had stretched more than right side, and he did that at the end of the main incision.

Day after surgery/yesterday, I went to PS's office for incision, etc. to be checked, and his RN took off the ACE bandage that was wrapped around my chest. When we unveiled my new foobs, they looked good. No huge bruising, no huge swelling. Who knows, maybe that will show up later, but so far, nothing like as traumatized as my torso looked after the BMX.

I have small new foobs, and they're quite spherical, since I have "smooth round," but they look okay, and they look to be the same size as each other, which was the main goal. I have nice clean Steri-Strips across the incisions (NNS), and it all looks clean and just quite good. PS will remove Steri-Strips in two weeks. Okay to shower starting Day 2, after ACE wrap was removed.

I have fewer restrictions on arm use than after BMX. Okay to lift hands above shoulders, can get things out of the cupboards in the kitchen, and I am not walking around with T-Rex arms for 2 weeks like I did after BMX.

Hi HikingLady: So glad to hear everything went well with your exchange and sounds like you are doing great with your recovery. Take care and get lots of rest. Goldfish4884 (Mary

Over three months after my exchange I ended up with a small abscess in my incision. I had to go to the emergency Christmas eve. I didn't even know it was there until it popped and I felt something wet on my belly. I took a round of anti biotics but it was a bit unsettling after feeling like I was on the mend.

I have my exchange surgery at 7:30 am

I am nervous I don't know what implant I'm gonna have for the size my doctor told me 600 or 650 cc

Thank you HikingLady’

Finally I had my exchange I feel ok not like my last surgery the pain is manageable

I’m not happy with my size unfortunately I didn’t have a choice on size mes boobs look small but it’s better than nothing.

I think you will be good. Mine are over 600 and don't seem too big or even fake unless I am in a swimsuit or naked.  It doesn't bother me. At this point, natural breasts look odd to me. 

Hi,  I am 5'11" and around 140. I was a 34C pre-cancer and am now a 34DD. I am pre-pec. I had fat grafting in the upper poles and to correct a "divot" in my anatomy on the left. 

I wear a bra ALL.THE.TIME. I had saggy boobs to start with and don't want any additional stretching. Your milage may vary. 

Hope this helps. 

Had my 6+ week follow up this morning...Yeah, all good. Can get out of the bra 24/7 and move back to normal bras and reintroduce more exercise activity.

Was given instruction to use Vit E oil on incision, that is new and this is my 5th surgery, but happy to give it a try.

See her again in one month... and then if all goes well, then next on the one year anniversary of surgery.

Happy February, TT

Hi ShoreGirl, what does "release" the implant inferiorly and laterally mean?

ShoreGirl, Wow, thanks for explaining. Hope everything goes well.Good luck.

Had my exchange surgery yesterday morning and I have no pain at all. Haven't even taken Tylenol! Not only no pain from surgery, but the uncomfortable aspect of the TE's is gone since they are gone. Haven't been able to see the results yet as I am wrapped in an ace bandage that PS will remove on Tuesday at post op visit. My TEs were filled up to 400 cc each side, and the implants he put in were Natrelle Inspira SSX-495. Can't wait to see them! Still can't believe I had surgery yesterday and feel so great today.