Exchange City

Hi. I had my implant swap on Monday (2/4). Just getting to surgery was a headache. My PS's RN, a nice young women but still learning her job, insisted I have more blood work done because she didn't like my WBC from lab work a couple weeks before that and she was certain it meant I had a UTI. She ordered the labs, I went and fed the vampires and gave a urine sample. (Wow! Still not pregnant!) WBC was in the middle of the normal range. But she forgot to order followup tests with the urinalysis to test and culture any bacteria, if found. She was then off for 7 days and then back for one work day before my scheduled surgery.

If I have a UTI, no surgery. So the PS needs to know if I do. One of her co-workers was supposed to send in additional lab orders. Fax busy; didn't resend. An order is finally sent on the Thursday before my Monday surgery. I go to the lab ASAP. RN is off on Fridays. A co-worker is supposed to call me first thing Friday morning. PS has decided that even if I have a UTI, he'll operate if I've taken antibiotics for 3 days, but he only wants me on antibiotics if I actually have an infection. I agree.

Friday morning ... waiting for the phone to ring. Run some errands. It's now noon and nothing. Start calling PS' office. No one knows what I'm talking about. Ask to speak to an RN, to someone on my PS' team; to anyone who might be able to help me. "Is Courteny available?" 'Which Courtney?' "Is Jillian available?" 'Which Jillian?' Um, maybe start hiring people with different first names, have employees wear name tags or maybe give out old school business cards?

I finally reach someone around 3 p.m. (antibiotic was supposed to be started no later than 1 p.m., if needed). She informs me that Jillian left me a vm almost 30 minutes ago. Since I apparently don't listen, my test was negative and I don't need to do anything.

No one left me a vm.

Jillian was supposed to call me first thing in the morning.

I got a letter from my health insurance company yesterday saying they were denying coverage of the surgery. As I read the details, I started laughing. The new girl who's doing billing because the old girl "just quit," asked for urgent medical coverage for the wrong procedure on the wrong date without getting anything from my physician's office. Today, I got an approval letter based on info sent by my physician's office. I saw her Wednesday for something completely unrelated, but mentioned the chaos at the PS office.

So, surgery done. I has TEs put in during my bmx and I've had them since July 2017. The road's been bumpy. I'm surprised at how large my implants are. We had talked about large B/small C. I'm at least a D. My expanders had 710 ccs in them. I thought that seemed like a lot, but PS said better too much room than not enough.

I'm supposed to wear a surgical bra 24/7 and until today, I did. It's so tight that it pulls my shoulder blades back several inches, aggravating back probs I have. So, for sitting and sleeping (today/tonight at least), it's a camisole with a built-in bra.

Severe pain didn't last long. I took Norco for 48 hours. I'm still icing the swelling. Steri-strips are starting to peel and bandages came off Wednesday, as instructed. Post-op appointment on Tuesday.

I'd like some boredom, please.

Had my exchange on Friday, 2/8, and follow up with PS today. I am so happy with how they look and feel! I've got Natrelle SSX495, round smooth, and they feel just like the originals to the touch (although of course I can't feel the touch myself) and although they are a little misshapen after being bound in Ace wrap since Friday, they are symmetric and as of right now, little bruising. I am now released to drive, shower, wear whatever bras feel comfortable, light lifting (less than 10 lbs) and starting back into working out. Still supposed to sleep on back for 3-4 more weeks, not because pocket could shift, but so I don't fold the lateral incisions on them selves for healing. He doesn't think I'll need fat grafting as I had good thickness of skin flaps, but he says he will reassess that in 6 months or so. After I left his office I met a friend for lunch, bought two new pretty bras, and 2 pink champagne cupcakes. Late this afternoon I culled through my 2" thick 3 ring binder and got rid of so much collected information I no longer need. Very cleansing.

I really want to thank everyone on this board! I joined late spring of 2018 and the information and support have been invaluable as I prepared myself physically, mentally, and emotionally to do this prophylactic surgery. I am a huge researcher, but medical reports and dr.s offices only give you a certain amount of information. It also takes having someone who's gone through it to talk with. I also give great praise to God, as my faith in Him, and knowing He had a plan for me and would be with me through all of this, helped bring me peace when the anxiety flared up. I had a great contemporary Christian music playlist I listened to and daily devotionals often gave me unexpected strength. Through this process I began making mastectomy comfort care bags for all MX patients at our local hospital, which include under arm pillows, seat belt pillows, drain bag pockets, and collection of tervis cups, hand sanitzer, chapstick, thank-you cards, face wipes, and lanyard to hold drain pockets. I have also expanded into making fidget quilts for dementia patients now. It brings me joy to "pay it forward", and serves as a way for me to express my gratitude for the blessings I have been given.

Hugs to each and every one of you as you continue through your individual journeys. I pray for all women fighting this battle every day!

Hi All. I had my exchange surgery yesterday. Surgery started at 7:30 am and I was home around 12:30 pm. I didn't have much pain, thankfully - just took one pain pill on time, then forgot to take one until bedtime. Haven't needed one today - yay! I was SUPER lightheaded and nauseous, though, and my mouth was so dry I could hardly eat (couldn't swallow). I needed DH to hold onto me whenever I walked and am still a little lightheaded this morning. The nausea was awful. I was given Zofran and really could have used it earlier than the 8 hour doses. Still somewhat nauseous this morning. But, if that's the worst, I'm happy. So far, this is much easier than the BMX was.

On a weird note, the PS said he put a different size implant in each breast because he took more tissue from the cancer side. It makes sense, but I haven't seen anyone mention that on these threads. Also, I have no compression bra or Ace bandage wrapping - just lots of gauze over my chest and abdomen. The foobs don't look too much different under the gauze than the TEs did, which is disappointing. I know I need to wait until they settle, but right now it looks like they are full on the top but don't stick out very far. We'll see...

GAwarrior

Yay!! Congrats on your exchange. I have two very different sized implants due to a lat flap on one side so it makes lots of sense you do with how the surgeon explained.

I was never told to wear acompression bra... only a breast strap...that may be the ace bandage you mention. In fact my PS hates them and says never to wear them. I have to ask her why she does not favor them

Takes a long time for the implants to drop in my case ...I'm over 4 months out from exchange and I think they are still dropping and shaping.

Did they give you any pain meds in recovery? Dilaudid does what you are describing to me. Makes me so sick and dizzy. I also insist on that patch they put behind your ear to help with nausea. Works very well.

I hope you have an easeful recovery!!!

GAWarrior RE - the type of implants--I chose smooth not textured for same reason you mention--I wanted to minimize lymphoma risk. I think your comment about considering this 'reconstruction' not 'augmentation' is a good way to think about it.

The girls do not match....My PS knew that my right side (15 years ago radiation) would not look the same as the left side. Scarring, although not visible, is a fact throughout pecs and skin. He warned me "they'll be sisters, not twins." Even though the implants are the same size as each other, the right side looks smaller. Once I'm in a bra and clothes, it's not noticeable, and even real breasts are never exactly the same size on most people.

Comfort: The 'settling' that everyone describes is subtle, but certainly true. I feel very comfortable in the new foobs at this point. Which was NOT the case until 8 weeks after surgery. I think it's probably a combination of healing making the tissue feel comfortable, PLUS my brain getting used to the feel of them.

Are you sure you want to give him another crack at it?  Have you thought about seeking another opinion before going through another surgery?

GaGrandma, sorry to hear that you need to go through that again. Thanks crossh for sharing your experience. VegGal does bring up a good point, on whether you may want to consult with another surgeon, as your other had not listened well to your original request. It's a hard call.

Keep us posted!

GAWarrior-

I’m telling you that nausea patch is outta this world. My third surgery some young guy used it on me... I was awake and eating within a half an hour. They tried to throw me out of the hospital before I was ready!!🤣. I was like hold on here I may be eating but I just had over a 3 hour surgery and I’ll let YOU know when I’m ready to GO!!

I was able to exercise way before 6 weeks after my exchange! I remember surgeon wanted me to keep it low impact but doing modified weight bearing activity pretty quickly. My PS was always in the camp of “get moving, stagnant energy is very bad for healing”. So I was able to do low impact cardio and modified yoga very early on.

GAWarrior and Hiking Lady- are either of you planning on nipple reconstruction? I’m supposed to have the cherries placed on April 5, among a lot of other revisions. My PS isn’t doing the oragami nipple reconstruction rather taking it from my belly to make them. I wonder why as it’s said, that this is an older technique. Any thoughts here are appreciated. Most of my friends think im nuts to go through another surgery. But hey, they don’t walk in my shoes now do they?

Wishing you a speedy and non- eventful recovery!

Hi GaWarrior, Im pretty sure I am having the nipples put back on in the fall using the origami technique. My doc says it takes 15 mins and I can drive myself home. He’s really good, showed me a picture of one of his patients outcome. Also will have the area tattooed in his office. I’ll decide in the fall. Barbie boobs look a little strange without them, but it’s also nice to to have the option of not wearing a bra and not have nipples sticking out. As I posted earlier I’m two 1/2 weeks out from exchange of 400cc to 500 cc and feeling great. I was cleared to start walking on my elyptical and did so twice this week. I wear a comfortable lightweight sports bra during the day

Regarding a second opinion, changing physicians midstream is no picnic, I did so between my second and third surgery then again between third and fourth. (Had a total of six). For the third surgery I ended up with another doctor who was awful and had to change again. Fourth thru sixth time I loved both the breast and plastic surgeon. Like I said, for me, the exchange swap was a piece of cake. I also have motion sickness and always make the anesthesiologist aware. Always get the patch and anti nausea meds.

And someone mentioned the extreme cotton mouth, I found the best thing for this after surgery it to drink as much water as you can. This is also good for clearing the anesthesia meds from your system.

Wow, GaGrandma, I'm about your height/weight - I can't imagine going to a DDD! Sometimes I think these docs do augmentations as well as reconstructions and they think we all want to be huge. Men! I had 450 cc TEs (not sure yet what size implants were put in), the PS said I would likely be a C or possibly a D cup if he used extra-high profile implants (I told him not to do that). Maybe that "translation" of ccs will help... WhippetMom is definitely the person to look up.ask.

HikingLady, thanks for the info that I'll feel better about them in 2 months or so. You are brave to get naked in front of other women! RE tattoos - I have a friend who went through this 25+ years ago and got a nipple tattoo. She says the tattoo wore off and is long gone, so just know that you would probably have to have it touched up every so often.

CBK, thanks for the exercise info. As for nipples, I was able to have a NS BMX so I can't help you there. I DO think you should do what makes you feel best about yourself. For me, I would want a nipple, but that's me. (And, I'd want the 3D tattoo, but again, that's just me).

Not feeling so great today (Day 3). I'm more sore (to be expected) and tired. Zofran has totally shut down my system. Off to drink some Smooth Move tea...yucky, but effective.

GaGran - I think you absolutely should go consult with another PS. Whether of not they are interested in a re-do, it's in your best interest to get some medical advice. My PS is technically excellent but i wanted to see what another doc thought about the size & style & etc. He was very gracious.

Remember that implants will ALWAYS be wider than natural breasts. That is part of what dictates cup size. That and the lack of projection are reasons it's very difficult to talk about cup size. It would be good to set up an appointment an appointment at Nordstroms with one of their fitters who is trained in breast reconstruction from cancer NOT breast augmentation. You might be surprised.

Mominator is absolutely right, you should go visit the Breast 101 link she posted, read everything in the header and post all the specs for Whippetmom.

Last but not least, you really won't know what your reconstructed breasts are going to end up looking like for several months - up to as long as a year. They will continue a slow change for some time. One of the hardest things to do is 'step away from the mirror'.

Edited to add - I thought mine turned out too big and was REALLY unhappy. Over time they have mellowed and so have I. I realize that they do fit my frame, I have really nice cleavage and they look great in clothes.

I am scheduled for a revision next month. That is only two months from the first implant surgery, but I have been pretty persistent. I know that breasts settle and look different, but these just seem too large for my small shape. I appreciate all your advice and now I am so confused. I really have no one else to talk to about this and I am a nervous wreck. Why did you say I might be surprised after talking to a bra fitter at Nordstrom? I don't think I can ever get comfortable in a DD or DDD. Thank you all for trying to help me!

I respectfully disagree with your friend. There would be no reason for the new opinion PS to even know you are planning a revision. 

I bailed on my first PS. Imagine my surprise when my 3rd opinion PS pulled out a tape measure and measured my ribcage and explained that the implants were wider than my ribs!  Of course I knew that...but he actually measured!

Alas, I sought one more opinion, and that is who I went with ultimately. She knew I had been "PS shopping" and had no problem with it. She also let me handle all of the implant samples so I could make an INFORMED decision. 

Good luck!

Thanks everyone. I will try to find another plastic surgeon so I can get a second opinion. I am fairly new to the area, so I don't know their reputations. I will be researching. Thank you crossh for the reassuring words to talk me off the cliff! And, MinusTwo, he said he might could go down 200 (to 500)...not down TO 200.

GaGrandma if you go on Mentors website they have the actual measurements of the implants. This was how I decided what size to exchange to. I was worried about ending up too big going from 400cc to 500cc, but they were not that much bigger in size. I’m very happy with the new size. And like he said it was an easy surgery and recovery.