My Exchange Surgery – From Tissue Expanders to Implants

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I only had a few day’s notice that my exchange surgery was going ahead but I wasn’t at all worried or nervous. At least not about the surgery itself, I was finally getting rid of these uncomfortable tissue expanders and getting my implants. I was both worried and nervous that my surgery would be cancelled and not go ahead though.

I was originally booked to have my exchange surgery on April 23rd. But late in March the Australian government announced that all elective surgery would be cancelled until further notice to preserve medical supplies for the corona virus emergency. I initially thought my surgery would be cancelled, but I was luckily able to be rescheduled for the very last day before elective surgery ceased – 1st April. I was hoping this would be no April’s fools joke.

Two days before the exchange surgery I got another call from my surgeon’s office. Originally my surgeon was operating on seven people that day but it had to be reduced down to three (for reasons that weren’t explained to me) but I was still scheduled. I would be the last elective surgery my doctor would do for months.

I had to be at the hospital by 1pm, the earliest of any of my surgeries. Since this was happening in the time of Covid-19, it was a little different. No one was allowed to come into the hospital with me, so I was dropped off at the front doors and waved goodbye to my husband and daughter.

One step inside the door and I was met with hand sanitiser and a staff member checking my temperature and asking a pile of Covid-19 related questions. I was directed to a particular chair that was set away from any other people to wait until I was taken to my room. I had called up earlier to pay my insurance excess over the phone so that I didn’t have to interact with anyone for that.

I went up to my room and relaxed. Again I had a private room. I noticed how quiet the hospital seemed (I was later to learn they only had about 50% of the usual number of patients that day). I had about 45 minutes wait until a nurse came in to do all the pre-op checks. Just as she was finishing, theatre called and wanted me down there. I had just a couple of minutes to get changed into my gown and lovely compression socks before I was on my way.

I then spent about 45 minutes in the holding bay outside of the operating theatres. I met with my surgeon, his assistant, my anaesthetist and his assistant and a whole pile of nurses. It seemed much more relaxed than my previous surgeries. Maybe with a much shorter operating list there was no need to rush as much as they usually do.

I actually quite like this part. I get “warmed up”. I’m sure there is a proper name for it, but basically I get a special hollow blanket put over me which has a machine like a big hairdryer with a hose attached to it blowing hot air into it. I am always cold, especially if I am tense or nervous, so this warmth always helps me to be calm.

By 3pm I was being wheeled towards the operating theatre. As always, I got off the bed and walked over to the operating table myself, climbing up and getting myself into the right position. I was joking with the nurses, telling them I wanted them all to make sure I got good boobs. The last thing I remember is a discussion about home delivery meal services, like Hello Fresh and Marley Spoon. Yes, totally irrelevant, but I guess that’s just how it is.

About an hour later I woke up again – still in the operating theatre. Luckily the exchange surgery was finished and I was meant to wake up. I was then taken out to recovery, and I noticed it was full, so I think maybe they had to keep me in theatre a little longer to wait for a space to open up.

I was again wide awake and eager to get back to my room, but first, the important things – how were my boobs? The first thing I checked for were drains. Woohoo, no drains. That was a big relief because I knew immediately I would only be in hospital for one night. The second thing I looked for was waterproof dressings. Unfortunately these I did not have, so I resigned myself to another two weeks without a proper shower.

I managed to convince the nurses and orderlies that I should be the next to go back to my room, so by 4:30pm I was back relaxing in peace. Unsurprisingly the first thing I wanted was food, but I was told I would have to wait until dinner was served in an hour or so. I also needed the bathroom, so got them to disconnect the drip that I still had in my arm. I would have been out of bed by 5pm going to the bathroom by myself.

I know that during exchange surgery there is a local anaesthetic used to help with pain afterwards that usually lasts a few hours. At this stage I had no pain at all, all was good.

I had known beforehand that my surgeon would again use the same scars I had previously. I was pleased to see that this time the incisions were only half as long and both are towards the outside of each breast. The implants themselves are still firm but not hard, and immediately more comfortable than the expanders. I was curious as to what size my surgeon ended up inserting, but I would have to wait until I saw him in the morning to find out. All in all, I was thinking that these new boobs were already shaping up to being better than the originals.

With no visitors allowed in the hospital it was a quiet, peaceful evening. I relaxed, read, and chatted to people on line. I had one-hourly obs for the first four hours, then it went to four hourly. This means that I could have had a good nights sleep, only being woken once.

But it wasn’t to be. I don’t know if this is a legitimate thing or I am making it up, but I’ve decided that surgery must cause adrenalin or something to run through our bodies, because after each surgery I have not been able to sleep that first night. I have been wide awake, like I’ve just had ten cups of coffee (which I’m not drinking at the moment). It doesn’t help that I am a very light sleeper and every noise or light wakes me up. I spent most of the night with my headphones in, laying in the dark, listening to podcasts. I finally drifted off about 5:30am, to be woken up again at 6am.

I was comfortable enough to even be able to lay on my side. I tucked my mastectomy pillow under my lower boob, and there was no pain at all. I really struggle to sleep on my back due to previous back issues, so being on my side was so much better.

In the morning I was eager to get up and get going. I knew there was no chance I would be kept in hospital, mostly because I didn’t need to be in there, and also because with the corona virus they are trying to get people home as soon as possible. I just had to wait until my surgeon came past to give the all clear.

When he eventually arrived we chatted briefly. I asked him exactly which implants he had used, but without his notes he was not sure. He *thinks* he ended up going with 415ml, but I guess I am going to have to wait until my appointment in a couple of weeks to get the exact details.

The other thing he required was a tighter compression bra. He didn’t want my boobs to move at all for the next few weeks. Luckily there is a lady that comes to the hospital each day to sell the appropriate bras for all the patients. I would have to wait until she arrived before I could leave.

I then made a comment about the lack of waterproof tape over my wounds, and my surgeon agreed that the nurses could put some on for me. Yay, I would be able to shower!

While waiting to leave I also had a visit from the breast care nurse. We discussed all the restrictions I should have on movement. Basically it’s the same as my mastectomy, no reaching, no pushing or pulling, no lifting anything over 2kg, no raising my arms above my shoulders. She did say I can be a little less strict, such as it would be okay to brush my hair, but don’t do anything like hanging washing on the line.

Eventually the bra lady turned up and fitted me for the type of bra she knew my surgeon wanted. (It’s this one here) Let me tell you it is very firm. Nothing is moving, no matter what I do. The idea is to make sure everything heals in exactly the right place, and I think that will not be a problem with this bra on. It does feel a little like I am being strangled around my chest, but I can cope with that 24/7 for a few weeks. These bras were not cheap, and of course I needed two, but apparently they work well as a sports bra once I’m back exercising, so I suppose that’s something.

And then I was free to leave the hospital. Up until this time I hadn’t had any painkillers at all, and the worst sensations I had we a little pulling if I reached or stretched too much, or occasionally a bruised type of feeling if I layed the wrong way. That’s it.

As I write this on day five, I can honestly say I’ve still not had any real pain from my exchange surgery. In my normal day to day activities I don’t feel like I’ve had surgery at all. I’m struggling to remember to keep my movements limited because there is no pain to remind me. The lack of sleep has been the hardest, so I have rested a lot. During these Covid-19 times, it’s not like I can go out or do much anyway. Instead I have managed to get through another of the Game of Thrones bricks, I mean, books.

Next is my two week appointment with my surgeon, and then the decision as to what to do about nipples. I can’t do anything until the ban on elective surgery is lifted anyway, so I am thinking it will be much later in the year.

To read about my recovery from my exchange surgery see this post

• Two Weeks Post Exchange Surgery

Want more? Try these posts

• The Day this Journey Began
• My Bilateral Mastectomy with Tissue Expanders
• What to Take to Hospital for Breast Surgery