BREAST IMPLANT SIZING 101
DISCLAIMER! I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon.
PLEASE NOTE: New information!!
Allergan now has a very easy chart to follow to help you see how sizing works in relationship between the tissue expanders and the ultimate style and volume of implants to be selected at the time of the exchange.
https://www.natrellesurgeon.com/Content/PDF/Matchup_Guide_FNL.pdf
INFORMATION WE NEED:
1. Your height, weight, ribcage circumferece (measuring under the bra line or under the tissue expanders with a measuring tape).
2. If you DO have tissue expanders already, we need to know the exact style of TE (Mentor, Allergan, Sientra, SSP) AND the volume - the mfr's recommended volume, NOT your current fill volume. So if you have Mentor TEs, they would be LOW HEIGHT, MEDIUM HEIGHT or TALL HEIGHT. If you do not have the "height" information, you might have a style "number", i.e., 354-6311 or 354-7114...etc. If they are ALLERGAN TEs, they would be one of six styles, with letters such as "MX" or "MV" or "SX" or "SV" or "FX" or "FV". They might have the number 133-V followed by a number like "13" or "14". TO SAVE TIME (FOR MOI) YOU COULD LOOK UP THE DIMENSIONS OF YOUR TISSUE EXPANDERS....
3. Also, please advise if your PS has told you that he/she uses one brand or style of implant exclusively so that we can save time in our research.
4. Your pre-mastectomy breast size is also important, because it does have some bearing on expansion, tissue expander volume and the need for good tissue coverage over your future implant.
5. OVERFILLING OF TISSUE EXPANDERS: There is no hard and fast rule regarding overfilling of tissue expanders. Some plastic surgeons overfill, merely because they always do for every patient. Some never or rarely overfill (my plastic surgeon was in that camp.) She felt that if the right tissue expander was selected, there was no reason to fill beyond that which the manufacturer recommended. In cases where the patient's skin envelope is very tight, and a larger implant is desired, overfilling would have some benefit. In the case of a unilateral breast reconstruction, where the future implant needs to mirror a native breast which has some ptosis (droop), overfilling can help achieve that needed symmetry.
6. CUP SIZES: There is no predictable way to tell you what cup size you will be with a specific volume of implant. Maybe with breast augmentation it is done, but it is all entirely different with breast reconstruction. Plastic surgeons cannot guarantee or predict cup sizes! Cup sizing is tricky, because you might be now wearing the wrong size bra. So you might tell me you wear a 36B, and you really could instead fit better in a 34C. Also, after reconstruction, there are only sports bras and European bras that we recommend as the best option for reconstruction patients. So you might tell me you want to be a "C" and end up in a European bra, like a "Freya" or "Chantelle" (my favorites.). So you might wear a D cup! But you will LOOK like a C cup or even a B cup. It is confusing, I know but you will see what I mean when you are on the other side of this.
UNILATERAL VS BILATERAL MASTECTOMY,
NOTE: IF YOU HAVE HAD OR WILL BE HAVING A UNILATERAL MASTECTOMY- REMOVAL OF ONLY ONE BREAST - THERE ARE DIFFERENT FACTORS INVOLVED WHICH MAKES IT DIFFICULT AND SOMETIMES IMPOSSIBLE FOR ME TO ACCURATELY APPROXIMATE TISSUE EXPANDER TO IMPLANT SIZING. THE REASON IS THAT SYMMETRY IS THE KEY. NOT IMPLANT SIZE. NOT IMPLANT VOLUME..NOT IMPLANT STYLE. YOUR PS WILL SELECT THE TISSUE EXPENDER TO CREATE THE TISSUE ENVELOPE WHICH WILL MATCH (AS CLOSELY AS THE SURGEON IS ABLE) THE HEIGHT AND WIDTH OF THE NATIVE BREAST VOLUME. THIS IS HIS FOCUS, AND ONLY THE PS CAN SEE THIS, MEASURE THIS AND IMAGINE OR CALCULATE WHAT IMPLANT HE MIGHT USE AT THE TIME OF THE EXCHANGE. REMEMBER…SYMMETRY - NOT SIZE. IN MOST CASES, THE TE WILL BE LARGER THAN THE FUTURE IMPLANT. SOMETIMES SIGNIFICANTLY SO.
SILICONE IMPLANT LINE UP:
MENTOR: www.mentorwwllc.com/global-us/...
ALLERGAN:
Page 33 breastimplantadvice.com/wp-com
ALLERGAN NATRELLE INSPIRA
"The new Natrelle INSPIRA™ implant is a silicone gel, smooth round implant. The smooth round implants are the more classic implant style as compared to modern anatomically shaped implants that mimic the natural distribution of breast volume. However, the new implant differs from other round implant options with its higher fill ratio.
The Benefits of Higher Fill Ratio
Higher fill ratio means that there is slightly more silicone gel filler per unit of volume. In the case of the INSPIRA™ implants, a more highly cohesive gel filler is also used. In my experience, I've noticed a slight difference in feel and lower wrinkle susceptibility in implants with a higher fill ratio. The denser volume of gel filler in the implant can result in a decreased chance of rippling and longer shell longevity.
BEFORE THE MASTECTOMY...READ AND DISCUSS WITH YOUR SURGEON!!!
http://www.forbes.com/sites/elaineschattner/2017/0...
https://www.sciencedaily.com/releases/2016/07/1607...
https://www.practicalpainmanagement.com/patient/co...
Comments
-
Hi ladies-
Dr Lloyd Gayle did my surgery and I am very unhappy both from a cosmetic standpoint and I am in constant pain from implants. I am sharing this because I think sharing our experiences helps us make informed decisions. He does arms, legs, hands and feet and everything else...yea and breasts..From my experience, I would now ONLY go to a doctor who only does breast reconstruction...A PS just cannot be an expert in all of these things and breast reconstruction in particular is very rapidly changing! If he or she is good, breasts should keep them busy enough.
-
Jessica...Have you made any decisions about where to go from here with revisions? I am going to PM you....
-
Ok Deborah I am a bit concerned I tried on several wireless bras and I have never bought one before I know why. I hate them! Well I tried a 40C BALI and it fit loosley in the band and the cup and I could not find a B cup so I gave up I actually was shopping for my 11 year old son and he was not into waiting for mom to try anything on. So the question is am I gonna end up exactly what I was? I was wearing a 38B or 40 B de3pending on the make but always underwire.
OMG I am gonna be crazy by next week.
Rebecca
-
Rebecca:
This is why I felt you might want to ask your PS about 800-960 cc fill saline implants. I just want you to be happy and for most women who come to me, size really seems more important than whether the implant is saline or silicone. I do know that you must have 800 ccs at the very least with silicone. I just want you to hash all of this over with your PS well before your exchange surgery.
Deborah
-
Ok this is my concern now. I have surgery on Wednesday. My PS is not in on Friday and I am nervous I wont get in to see her before she nneds to order the implant she actually uses.
By the way they are going to biopsy my liver druing my exchange surgery. Have you ever heard them do that at the same time before?
Rebecca
-
No, I have not heard of them doing that, but if you needed a liver biopsy, what a good time to do so. Why do you need a liver biopsy? Are your liver enzymes elevated?
CALL your PS or email her your thoughts.
I have another thought...perhaps a simple solution and this would be for your PS to also order the 800 cc Allergan Natrelle Style 45 silicone implant. It is an extra full projection implant. It might be an option for you. So Style 20 800 ccs and Style 45 800 ccs.
Rebecca....there is no mandatory edict that you must have the exchange next Wednesday. If you are not ready, you are not ready. I postponed my exchange one month because I was indecisive about the style and sizing. So please know you have this ability to postpone.
Deborah
-
I am a bit confused she is using the Style 45 800ccs. So should I have her get the stlye 20? I havea spot on my liver that was seen in my last PET SCAN also my enzymes were elevated.
I guess you are right I am not set in concreate that it have to get it done on Wednesada. That does help my stress I am in contrl of this.
Rebecca
-
Rebecca: We had overnight house guests yesterday and so I had to shut off my computer before your response. As you can see, I awoke at 3 a.m., sitting bolt upright in bed, REMEMBERING that you are already getting the Style 45's! Oh my gosh....I was answering to many private messages last night, I just lost it! Sorry for the confusion!! No, forget the Style 20...I was thinking of someone else when I wrote that. I think I am on implant overload right now.
Yes, there is no rush to complete this journey and if you need time to explore all options to get it right, then this is what you need to do. Let me go over all of your numbers again later this morning. I'm going back to bed now!
Deborah
-
Had the right mastectomy on April 14th.
I was thrilled when the PS said I had enough skin to permit immediate reconstruction with a gel implant, bypassing a tissue expander. One less surgery.
I did not ask for anything bigger than I was as I wanted to be close to the size of my remaining L breast. A nice B +. I expected the implant side to at least be close to that size.
The ace wrap came off on Tuesday. My implant side is nearly flat. I was so surprised that I had no response, nor asked any questions. I see no improvement as of this morning.
Is this it? The PS said *it is cute and perky*.
I see nothing cute, or perky. I see a fried egg after the yolk breaks.
Will see the BS later today, hopefully she will have some encouraging words.
-
ferretmom: Is this IT? No, it most assuredly is NOT it! And "cute and perky?" I am sure that is not what you wanted to hear. I need to know all about your TE - Mentor or Allergan, style and volume and you are going to need to email me photos. Well, one photo will probably do. I'll PM you.
Deborah
-
Deborah -- ferretmom did not have a TE (reread what she wrote).
Ferretmom... not sure if drop and fluff applies when there has been no TE... but everyone who gets an implant exchange (after TE) reports that it takes some time for the implant to assume it's final shape and that it does tend to drop a little and fluff... you might have just fluff (and no drop) since there is no pocket (if I understand right what a non-TE implant procedure is like). And fluff takes a while (sometimes a few months but certainly would not be evident right away... especially if you were wrapped with a tight bandage until yesterday). Did your PS use the one-step with alloderm?
-
Deborah,
I responded in a pm. I just wanted to say again THANK YOU !
I really am so happy to have found this website and someone like you who is so knowledgeable and willing to help out all the fellow sisters.
Rebecca
-
Oops...Lilah, thanks for catching that one...
ferretmom: Sorry....I mean your implant! I need to know the details regarding your implant - mfr, style, volume.
-
No Allerderm used, just my remaining skin (no nipple).
My implant is Mentor gel, round moderate profile plus 350.
Goal was to match my L breast (size B cup).
Thought I was being most reasonable, no need/desire for anything bigger.
Deborah, I can send photos tomorrow, any particular views?
Thanks to all
-
ferretmom: One frontal and then side views - one implant and one natural - would be excellent. Also, what is your height, weight, circumference around your ribcage measuring just under the bra/inframammary fold?
-
Deborah,
Thank ou for all your help! You have helped me enormously and you are a tremendous asset to everyone here especially during this really difficult time in our lives. I have to say, you are making the process a lot easier by providing the information we need to make decisions and by how you are showing us where we can take some control. A huge thank you!!!
Karyn
-
(((( ministry))))
( just repeating myself Deborah... just reminding you... it is true....)
xxxooo
-
LOL Laura you are so adorable.
-
Thank you waldo! And dear Laura.....thank you for the reminder....as there are days when I feel I am not doing ENOUGH!
-
Hello Whippetmom!
Well, I finally had my left side skin saving mastectomy--my oncoplastic surgeon was amazing and he said I should have little to no scarring. The plastic surgeon listened to my request for a more natural looking implant: He put in an Allergan Natural 133 MV-13 expander and he says we should be expanded to full size (over expansion is his goal) in two to three months and that the exchange implant will be smaller then the expansion size. I wrote to you prior to my surgery--I am 6' tall, weigh 156 lbs have a 38" band and I want to get to a C cup. I looked it up on your link and it looks as if this expander can go to 400 cc per side. Prior to getting BC I had a B-C cup on my left and barely a full A on my right so I asked to even it up to a C on both breasts. So far he has expanded me only 100 cc's and it looks like my right breast in width but like when I am wearing a push up bra, and it's also much flatter when I lean over--of course he only just started filling it. He plans to remove my drains and start filling 50-100 ccs at a time in about 2 weeks.
I read on Allergan's site that this is an aggressive expander. I would love your thoughts/input on this.
Thank you!
MBJ
-
MBJ: I am trusting that your PS used a tissue expander which is wide enough to match your natural breast. I think you need an implant significantly greater than the volume of your TE - or around 550 ccs to 600 ccs. But we will need to see how things look about half way through the expansion process. Send me photos when you have 300 ccs and let's see how you are progressing.
This particular style of tissue expander - the moderate height, variable projection - is one of the most commonly used styles. All is well here.
-
Thank you for responding so fast. It looks as if they followed the line of my former breast and he did a really good job of matching the original size as far as width goes. I have the Alloderm sling and the teardrop shaped expander only goes to 400 ccs. I was told he wouldn't know until we fill it how big I will be able to go.
Also, I understand tht this is an aggressive type of expander and from the time line he gave, it seems like he thinks we should be finished in 3 months. Is that common?
Where/how do I post pictures on here?
-
MBJ: There is a pictures forum where you can go to see photos of others and/or post your own photos. But you will need to contact Timtam, who is the photo site administrator. Some women email me their photos....if they are not ready to share with the community at large. I'll PM you my email address.
I just checked something you posted previously here on the sizing thread, and at that time you said your ribcage is 34 inches. So is your ribcage 34 or 38? That makes a difference to me in sizing - which is also why I was a bit concerned about the width of your TE.
Deborah
-
Contact Timtam to gain entrance to the pictures forum:
-
rib cage is 38"
-
MBJ: Why don't you email me photos when you have a chance...
-
I will send my pictures to you as soon as I can figure out where I put my download cord--I may have to purchase a new one. Chemo brain
By the way--you often recommend going larger with the implant and I am not very good about searching posts on this site. Why is it that you think it's better to go bigger rather then smaller? Is this because of the settling that happens after a few months?
Thanks again for your generosity and help! This is such a huge decision.
-
MBJ: Well, it is not so much that I advocate "going larger" with implants. I just feel that it is difficult to match the volume and appearance of the tissue expander to the future implant without actually looking at the dimensions of the TE in comparison to the implant dimensions. In most instances, this suggests that an implant larger than the TE is required in order to achieve a similar appearance one is achieving with the TE. We will need to wait until you are fully expanded to get an idea of what will be required to get you to the volume and size you hope to achieve with reconstruction.
-
You are doing enough just being here and trying to help... and you do help... so many!
-
{{{{{{{{Laura}}}}}}}}}
[This is a hug with good projection!]
-
During my research today, I came across this article. I do not know how this would aid women undergoing breast "reconstruction" in sizing out the implants, but I certainly will pursue it further. I ordered a kit today and I will report back and let you know if it would be of any benefit to us in determining implant size or volume. I have my doubts....
Natrelle Offers Breast Implant Trials
Posted by Cosmetic Surgery Review on May 13, 2009
Deciding to get breast implants can take time, and may involve several consultations with different doctors to make sure you are comfortable with the procedure, and know what to expect.One of the most common challenges women experience when choosing breast implants is selecting the right size; most women choose at least a cup size or above for breast enhancement, but a computer-generated image of the expected results may not be realistic. Allergan, the company that makes Botox and other cosmetic surgery treatments, has recently introduced a pre-consultation breast augmentation kit that lets women ‘try' breast implants before they even go to the doctor's office.
The Natrelle Pre-Consultation Kit is designed to educate patients about breast implants, and includes a sizing bra, and a set of implants that they can wear under their clothes so they know exactly what they will look like with bigger breasts. The Natrelle kit also contains educational DVDs that explain how to use the sizing guide and special bra that comes with the kit, and provides some basic information on what to expect from the implant procedure.
In a recent press release, Dr. Elizabeth Kinsley, a plastic surgeon from Covington, Louisiana, states that the Natrelle Pre-Consultation Kit is a valuable tool for the public. "The Natrelle® Pre-Consultation Kit is simply a tool to prepare women for the consultation and the surgery itself, providing reassurance and answering many of the questions they may have," says Dr. Kinsley.
Each kit contains sample implants and a profile bra, and educational videos so that the prospective patient can try different breast sizes from the comfort of their own home.
The Natrelle Breast Implant Kit is now available from Natrelle.com for $39.95, plus $5 shipping and handling. Buyers of the kit can also get over $170 in rebates for Natrelle and other products made by Allergan, including Juvederm, Botox and Latisse.
-
I am glad you are looking into this. I bet is does not factor in mastectomy patients.
BTW... are you going to use ALL the rebates that accompany your Kit?? If not......
you have my mailing address......... -
HEHEHEHE
-
Whippetmom--you are the BEST!
-
Laura: You are hilarious!!!!
I was JUST this morning, driving down the freeway, on my way to the dentist, and contemplating how I might spend those "certificates." I wondered what my lips would look like with Botox. I was puckering my lips and looking at myself in the rear-view mirror. The jury is out on that one...
I will bring my "kit" with me to Vegas, for any gals who have not yet gone through reconstruction to try out!
MBJ:
....thank you.... -
Deborah, you are so funny!! Lips dont get Botox--they get restylane or perlane or juvaderm...overall I think they look awful with restylane in them. I have seen the work of many PS and overall, they're awful!! Botox for wrinkles around the eyes, forehead, is great!! Juvederm and restylane for the lines that look like a puppet is doing your mouth! Thats great too.
BTW, I've seen the KIT and it is really meant for people who have augmentations, to try out with their bras on. It would probably work for us, up to a point. It doesn't go past a certain number - I forget what, but there is no way I could have tried out a 600 or so I think.
Judy
-
I was going to tell her that Judy.. about the botox NOT going into the lips... lol
WELL.. it seems.. our Deb is el natural.. natural beauty.. as she is not sure WHERE the botox goes...hehehehe...
Actually.. I want the filler that fills in the smile lines... I don't really have wrinkles yet.. but I think I am gettin' smile lines..bahhhhhhhhhhhhhhhhhhh
OK OK.... I will stop hogging this thread........
BACK TO 101 and learning......
Laura...... over and out...
-
I had a double masc. with immediate recon. on april 6th wtih te obviously.
I need help with ideas and advice on how to deal with this pain!!! April 22, Thursday I had my first fill, with one of the three tubes removed. I was filled a total of 60 cc on each side.
Today April 27, Tuesday she filled me 120 cc on each side and i am in PAIN!! the other two drains should be ready to be pulled out on Thursday April 29th. Any advice would be deeply appreciated.
they are rushing because of radiation.
-
SHARK...
They need to get you filled 100% before rads... if they continue to fill after rads... your skin is more"challenged" from what I have been told.
I was filled to 420cc's in 6-7 weeks.. then did 30 something rads...
I did this with minimal pain.. but I took Demerol every 6 hours for 5 weeks. Do you have to work? I did not... so tis was doable for me. I was in your place a year ago... PM me if you want to really talk about this.. I will share all I can with you....Laura
-
Oh you guys! Botox isn't just for breakfast anymore!!!!
Hey....do I know my Botox, or what? You see, I was offered a job by Allergan twenty years ago -to work with a new product they called Botox. It was developed and originally marketed to address ocular conditions such as strabismus or blepharospasm....and they thought pehaps spastic conditions such as spastic torticollis....Who knew where it would go!!
I wanted to take the job....but I had another offer which I took instead - and that was to marry my husband and move to San Fernando Valley - too far to commute. I have an extremely high regard for Allergan as a company....
So now you know.....the rest of the story!
-
I just want to fight the dreaded FISH LIPS phenomenon I see occuring!!!! Notice the downturned corners on these fish lips....
-
sharkness:
Let Laura help you out with this one. She is our rads expert. I think her time frame could get you where you need to be. Tell her how much your PS intends to expand to...
-
Hmmmmmmmmmm our Deborah seems to know WAY too much about Allergan... hmmmmmmmmmmmmmmm.. NOW I understand WHY her face is SO SO SO PERFECT... hmmmmmmmmmm...ROFLOL....hhehehehe, you are beautiful dear!
Shark.. let me know if I can help.. If I need to, I have a few people I call here to get answers.
Laura
-
OMG! Fish LIPS..LOVE IT. ROTFL..JUDY
-
Deborah,
Fish lips! Hillarious! You look as if you already have really nice lips--but if you have the Botox, I would love to see your before and afters!
I saw my PS and he said he wasn't sure which implant he would exchange out to until we see how far my body will expand, so it's wait and see on this one.
Question: How difficult is it to match the non-mastectomy breast to the expander/mx side? Will I need two different sizes? Will they look and feel differently? Of course, we are all coming here for your expert opinion because no one wants to go through a re-do so thanks again for the wonderful advice and help
BTW: .I went to TimTam's site and I only saw a few who had a similar size and only one breast done. I will post my before and afters as I progress.
Many, many thanks again
-
MBJ: Take a look at Sandysunshine's, NVDiane's and Nedeza's photos. It seems that the best results are achieved when their is either a lift or implant or both a lift and implant procedure performed to the healthy breast. Even just a small implant in the healthy breast can help with symmetry. In some cases, a Spectrum expandable saline implant on the healthy side has worked very well at achieving symmetry, and a silicone implant can be used on the MX side.
-
Thank you Deborah!
I know I will definetly need something! Even though my MX side looks larger it is still flatter then my A cup right side which protrudes twice as far as the MX side! Crazy!
Does it feel differnt/weird to have one saline and one silicone? Does the Spectrum expandable feel like a regular expander i.e. like an "iron bra"?
-
According to NAE and Sandy, they feel the same. The Spectrum expandable is an implant - it does not feel like an expander. It is just that the PS can add or subtract saline from the implant in order to get the best symmetry with the MX side.
-
Thanks Deborah! I looked at their pictures and they all look amazing although all of them look as if they started out much larger then myself.
-
MBJ -- to quote a famous Broadway lyricist: "It's not where you start, it's where you finish"
-
TOUCHE LILAH!
-
Why thank you Lilah--I'm gonna run with it and see what happens!
-
MJB...
I have felt SANDY SUNSHINE ( aka here... Rockwell_girl) up.
yes, I have felt her up.. in Vegas and here at my house a few months ago.. and YES.. her breasts feel the same. I never would have guessed that one was Saline and one Silicone.
Deborah, thank you for the detailed info on Cholesterol. I have normal everything.. actually.. with my background... NO ONE could imagine I would be the one to get BC. My hubby is the only one of us dealing with this.. and his family has the issues...
... Thank you again.. he says thank you too!Diana.. thank you for offering your support too. I have a lot of info, if I need anything I will let you know.. thank you again!!
-
I had BMX and lat dorsi on 3/29. I have very thin skin and was expanded at surgery to 250. I emailed Deborah pictures and she pointed out to me the PS did mastoplexy during thr BMX. Before surgery, I just told him I wanted perky. They were saggy and uneven- running and breastfeeding helped
Right now they seem wide and I feel sizewise I am large enough- was a 32 DD pre BC- and don't mind smaller & perkier. I am wearing a 36D now with the TE's and the fit is good- wearing a soft bra from JC Pennys but good support 24/7. I thought he was going to make them bigger so I didn't want to spend more $$ till I figured out where they would end up sizewise. I saw the PS yesterday and told him (as Deborah advised) I would like them even perkier- minimal to no droop, with more upper pole fullness and maximum projection. We did not expand. I showed him a picture (from playboy) and he was quick to point out she was 23 and I am 53-! It ruined my day. But he appreciated a visual of what I wanted and my ideal. But he said to get perkier- with less droop it would require an additional incision. Has anyone had a lift done at the time of exchange to get less of a droop? He said he would consider the Allergan 20's for me but not the 45. We did not discuss size. Any suggestions?
-
waldo - Is your PS stating that he CAN perform a lift at the same time as the exchange? I believe it is entirely possible to do so. I do not know what type of lift he proposes though? I think you need him to clarify how he will do this.
-
Deborah, yes, he said he can do it at the same time as the exchange he said he will use an incision perpendicular to my lat flap circle- lollypop incision. He wanted me to be aware I will have an additional incision but I think my old thin skin should heal well Do you know if anyone else has had that done at the time of exchange? Do you think it will get me the perky no droop result I am so coveting?
-
Yes, I like his recommendation for the verticle or "lollipop" lift. That would be the best solution for giving you some additional "perkiness" to the breast mound. You have not had any skin integrity issues to date - you "heal well"..and I would personally not mind a little extra scarring, if it achieved the purpose intended. I do not know of anyone, off the top of my head, who has had a lift at the same time as the exchange. You might start a new thread asking this question...or go on the pictures forum and start a thread asking this question...
-
Waldo -- my PS will be doing a lift (and reduction) on my healthy breast at same time as exchange. She said she preferred to do the lift/reduction with exchange to get a better match... I'll let ya know how it goes (I'm up on May 11).
-
Thanks Lilah, how exciting!!! I am imagining it to be like coming down the home stretch when the exchange is finally complete. The nipple and areolae must then be like icing on the cake and a cherry on top.
-
LOL Waldo -- a cherry on top -- cute!
-
Estepp: Thanks for sharing! It's good to know that I have options.
Deborah: Can you tell by looking at my picture if I will need a lift or do you think I can get pretty close to my new Barbie breast (as she is affectionately now called)? My PS doesn't want to risk going thru my aereola so he plans to cut under my breast and go under my arm. Since I am a fast healer it should dissapear in no time but I thought it was now standard to go through the nipple (though it sounds pretty painful). I would appreciate your thoughts on this.
As always, I am so grateful for all of the generous women who have gone before me and who are now here to help. I feel very, very lucky.
-
MBJ: I will PM you with my email address. I will be able to tell you what you might achieve, but the method of lift your PS describes sounds even more invasive to me. Going under the arm on your unaffected side? There are various lift procedures, but the most successful always address the nipple/areola complex in some form or fashion...
-
WALDO
I lady on here had a lift at the same time. Rockwell_girl is her screen name on here. Sandy is her real name. You could PM her. She is 100% willing to talk about anything, just as we all are. She is also on the picture page to look at. I do believe she had the lollipop , too.
Laura
-
Thanks Laura, I will PM her.
-
Hi Deborah,
Just wanted to update you...my exchange surgery is scheduled for 5/13 and PS 2.0 is talking about putting in 650! He said he will try the 600 and the 650 and see what looks best...he also asks the nurses in the OR what they think too...hmmm...hope I have a good team on that day!
I'm expanded to 640 now and they're very sore and tight....and the skin to the left side is ironing out nicely. I'm glad I don't have to deal with these much longer.
Thanks again for helping me get the courage to change PS's. It's really been working out fabulous! I will post pictures later today.
Have a wonderful Sunday!
Kat -
Kat: I will be so looking forward to photos after your exchange surgery! Congratulations!
-
I keep wondering now that I'm an Allergan gal, if they'll put me on their mailing list and send me some Restylane gift certificates. That would be an added bonus!
-
Mantra: Hmmm...good question. I do not think that Allergan would have access to our personal information. Allergan will maintain our implant ID number and the date dispensed to the specific medical facility, but at least here in the U.S., our HIPAA laws would keep that private. Unfortunately, the gift certificates, if any there are, might be going to your plastic surgeon's office to hand out to his or her office staff.
But I like the way you think! I would not mind in the least if Allergan had my name and address in case there were any extra gift certs laying around.
-
OK -- Research is done...thanks to all of you here!! Tomorrow is the exchange. THANK GOD I got the courage from you all to stand up for what I want!! I am going with Deborah's opinion of Mentor High Profile 550 cc's given my measurements. I also requested a pocket revision after reading up here. I have a really wide space in between my breasts. The PS did say that he will take several sizes into surgery, I only had time to expand to 500 cc's. If I wake up tomorrow smaller than 500cc, I will not be a happy camper!!
My case is a little more complicated since I do have to undergo radiation. But I just got back from Sloan Kettering meeting the Director of Radiation and the Plastic Surgeon...and they gave me a thumbsup. They just turned in a new abstract showing less than a 20% complication rate with having the implant exchange prior to radiation.
Its not for everyone, but I am comfortable with my decision in going this route. If it fails, I will know that I made an informed conscious decision that I thought to be in my best interest.
Wish me luck!!
-
geewhiz: I'll pray for you tonight! Hope to hear from you tomorrow evening or Wednesday. Look forward to getting photos.
-
I WILL BE OUT OF TOWN WITH LIMITED ACCESS TO THE COMPUTER FROM MAY 5TH THROUGH MAY 9TH. SO IF ANYONE HAS ANY EMERGENT CONCERNS, PLEASE CONTACT ESTEPP - LAURA - ON EXCHANGE CITY. SHE CAN GIVE YOU MY PHONE NUMBER. OTHERWISE, POST HERE OR PM ME AND I WILL CHECK BACK IN WHEN I AM ABLE TO DO SO.
-
I have never posted before although I have been reading through many threads over these last months.Thank you all for providing more help than you can know. I had a nipple-sparing BMX in Feb and am scheduled for exchange surgery on June 2. I love my PS and will see him for pre-op on May 21 but I am starting to obsess and worry about the final (hopefully final) outcome. Can you help me with the implant sizing? I am 5'9" about 130 lbs, 29" ribcage. I have Allergen 133MX expanders with a 400cc capacity. I am filled to about 420 (on the last fill I was just happy to leave and didn't pay attention to the exact fill amount). I will have fat grafting during the transfer surgery to deal with the significant step-off between my breast and ribcage. My PS is likely using smooth round silicone and will use an implant larger than the expander but we have not resolved yet the exact size. I really don't want to be any smaller than I am now with the expanders and I am worried that I will be disappointed. I'd appreciate any suggestions.
-
Ok a little late as I am fully expanded and a month or so away from exchange just wanted to check if I am close to what "the breast whisperer" would recommend
I am 5'3" approx 150 lbs a rather athletic build flat tummy and I carry all that weight rather evenly but alittle bit more in the thighs since chemo. Ribcage is 32.5 inches I was a 36C or 38 depending on bra style prior to bilateral skin sparing. I wanted to get close to that size not talking cup size as I know you don't like that Deb and maybe even a bit more perkiness foob greedy lady that I am. Before mx my left was a bit larger I mean 120 grams larger according to the pathlogy and the right sat a bit lower in the IMF - left was 700 grams and right was 580 grams.
My expanders are Allergen 133FV - 13 (500cc) yes my PS overexpands 20% so I am over expanded to 780cc . I got to the 650cc point and figured this was a good size my PS is very conservative. I was figuring allergen style 20 650cc is this a reasonable suggestion to the PS in a few weeks? I know he will be doing some pocket work as he is a bit unhappy with how far apart they are and a bit of rippling on the inside of each in the cleavage area. The skin has held up well I do have stretch marks but they were there prior to any expansions and I have one little pucker at the end of the left incision that he said he will clean up during exchange.
Thanks for any help
I have read these boards for well over a year from my time in the waiting room for biopsy results and thru chemo and surgery. One year anniversary of dx coming up in a few days what better way to top that off but with new squisy foobs!!!!
K
-
ref: I think you would be happy with Allergan Style 20, smooth round silicone implants with a volume of at least 500 ccs. If you could sneak in another 50 ccs and exchange to implants with a volume of 550 ccs, that would be a plus. So inform your PS of your preferred volume at the time of your pre-op or even earlier. We almost have to let them know they might as well put us back under unless they do everything within their power to ensure we wake up with the volume we desire....as long as this desired volume is within reason. The 500 ccs volume is assuredly within reason. For some, 550 ccs might be pushing it, but if your skin expansion allows it...it might work. For the most part, this is an unknown until you are in the OR and the PS has the sizers in hand. We do not want to test the limits our skin will allow, as it is important to maintain skin integrity. Keep in touch and let us know how everything goes for you!
Deborah
-
Thanks Deborah. That's about what I thought. I wanted to see how far I could go and still be reasonable. I will ask for 550s. Is there any reason to consider the Allergen 45's? My PS keeps saying that the issue is going to be projection.
-
Well, projection is always going to be an issue with breast reconstruction. You have the ribcage for Style 45's and I certainly think you could be a candidate. It is just that so few plastic surgeons seem to remember that this style exists and most do not stock this style of implant so it is rarely used.
On second thought....I just went back to your original post and saw that you have the MX - not the MV! So you have a 12.0 cm width rather than a 13.0 cm width TE. So indeed yes, the Style 45 would work for you. But I would venture to state that only if you could get the Style 45 in 550 ccs. This would put you at 12.4 cm width. I just think any narower and with the lower volume range, the implants could sort of look like bullets on the chest wall. Do you see what I mean? Typically, I see the Style 45 being used more with implant volume 600 ccs and greater. So I think 550 ccs is as low as I would want to go with that style. We tend to focus on projection, but width is very important also, because essentially the width helps us fill out a bra and width is necessary to give the appearance of fullness of the breast mound. Also, you need to have a nice healthy distance between the sternal notch [that hollow area just below your neck] and your nipple or imaginary nipple - 21 plus centimeters - I think, in order to pull off this taller style of implant. It will sit taller on the chest wall. Have you been to the pictures forum? Sandysunshine has her photos there. She has your height and weight and ribcage and she has 550 ccs in Style 20. You could get a good idea of what this would do for you.
-
K - Ohh...I think I want to send you to the top of the class! You are a very good student! LOL! Yes, I think that 650 ccs in Style 20 would be just about ideal for you. You know your skin integrity and I feel quite confident that indeed you could exchange out to this volume of implant, especially based on your 20% overfill status. I think you have to put this number in your PS' head and let him know your convictions about size and volume. If he is "conservative" as you state, he might not be movable to this volume of implant. You need to see where his mind is with this number. I have had some women come to me just this week, disappointed with getting implants with significantly less volume than they had "agreed" upon with their plastic surgeons. I think that he has to feel confident about that 650 number, and this is something you should know prior to going in for the exchange, so that you can know whether you need to manage your expectations. You need to know what number he feels confident with....prior to the exchange.
-
Deborah, thank you for this great information. I see what you mean about the width being important too. I have not been on the picture forum. I'm not sure how to get to it or if I can get approval yet since I only just started posting today.
-
Deborah...ha ha
I think I have read the whole exchange thread and did all my measurments SN-N , rib cage prior to mx. So when we were doing expansions and the PS said "well so are we there or almost there when I was expanded to 600?" I said nope 50cc more to go I am looking at style 20 650cc and his response was "and where did you come up with that" when I told him rib cage measurment, and my SN-N measurment - his nurse giggled and said trust her she knows more than me he shakes his head writes something down and walks out of the room. I had quite a bit of skin to work with seeing how much breast tissue they removed so the fills went smoothly and I did them weekly at first 120cc's and when I hit the 540 mark we backed off to 60 so my skin handled it all very well. See some of your students pay attention.
He is conservative in the aspect of being very anal about everything .. talking with some of the nurses who have scrubbed in with him they say you wouldn't believe the amount of antiesptic he uses if he could hose down the whole OR and make the whole staff bathe in it prior I think he would..lol . My breast surgeon had a fight with him the day of my mx as I had thrush and the PS was ready to call everything off till my onc and breast surgeon got a hold of him. I had 4 tumors all T2 bilateral and they were not going to let him hold out any longer. He stated he wouldn't let me go overboard with the fills and I did try on some old bras at 650 point in the fills and they filled up the best they could still with the empty nipple syndrome. Ok maybe conservative isn't the right word he is a perfectionist if it's wasn't for the tiny spider veins around my incision and lack of nipple you would never even know I had surgery and it looked that like 2 months out with no scar treatments. I guess I will have to try to get into his head next Wed... wish me luck !! Our inital consult I told him I wanted to keep my approx size and I know I will lose some projection but some nice cleavage and whatever projection I could get this 38 year old would appreciate .. so hopefully he paid attention to my wishes he didn't scoff at the 650cc so let's hope
thanks Deborah I am glad you are able to help so many of us understand the differences and arm us with the info we need when we meet with our doctors... big kudos to you !!
-
kw - Oh, you are too, too much! If this were a job, I would hire you!!! So it is sounding to me like he is on board as much as we could hope for him to be at this juncture. So I will be praying for you...come here and remind me before your exchange surgery please...but do let me know what transpires during your pre-op.
I think you have mapped this all out excellently. Kudos right back to you girlfriend!
Deborah
-
Hi Deborah, I know you will be missed and I'm wishing you a good trip if you are traveling. My PS agreed to the Allergan 20's along with a bilateral lollipop lift. He said an adamant NO the the 45's and I didn't question him. I am expanded without any fills to 250 and feel like a full C small D- which I find unbelievable. My goal is less big and more perky, As you were able to see from my pictures I emailed you, I had many years of big and droopy double D's. I still want projection and want to have some boobage with the coveted cleavage and high headlights while maintaining the integrity of my thin skin. I think with my LD reconstruction, I can meet that goal. Can you give me an idea of what size the biggest implant I can suggest to the PS to make sure he and I are on the same page? I aspire to be a star pupil too
-
Waldo: I need to calculate the dimensions of your TEs. While I am packing for my trip, could you get your TE information for me and give me the dimensions? I know you told me you have low profile Mentors, but I do not recall if you ever told me exactly which volume you have. Are they 250 volume or 350 volume TEs? You will find the links for Mentor at the top of this thread. I think that once you get dimensions of your TEs, you are going to find it will take at least 350 ccs in a Style 20 to match what you have now in volume with your TEs. I do not know how much your PS is willing to push the envelope with size. He might even balk at going from 250 to 350, that is, unless your TEs ARE 350 cc recommended volume.
This is something you really need to reinforce and discuss with him and be in agreement regarding prior to surgery. How much will he do? You need to find this out....
-
Waldo....Scratch what I just said....I just went through my emails and found that you do have 350 ccs....let me recalculate this...
-
Okay, Waldo...
I think at least 400 ccs in Allergan Style 20 - if he is using Allergan - would be the minimum volume. I am basing this on the width and projection of your TEs. You have sufficient width and projection with your TEs at the current volume for a 400 ccs high profile implant. You have sufficient width and projection for a 450 cc implant - but I doubt he will agree to this. Maybe I'm wrong...you can see what he says. It is all going to depend on how much he can safely place in the pockets after your lift procedure, because this will minimize the pocket somewhat. This is pretty tricky, as you know, because you have the flaps and it is not as easy to calculate how much they add to the volume at this point. Unfortunately, this will only be evident to your PS during surgery, and you will not know until after the exchange. So discuss these thoughts with your PS....
Your TEs....12.7 cm wide by 6.5 cm projection. With 250 ccs fill, you maintain the same width, but you do not have full projection. So if projection is diminished to 5.5 cm, you have with your TEs:
TEs: 12.7 cm wide by 5.5 cm projection
Allergan Style 20
400 ccs: 11.9 cm wide by 5.0 cm projection
450 ccs: 12.4 cm wide by 5.2 cm projection
475 ccs: 12.6 cm wide by 5.5 cm projection
-
Maybe I will push for 475 first and compromise with him on 450. I wonder if I can handle the 450- well lets see if he agrees.
-
Thanks Deborah, I am in 350 cc recommended volume but filled to 250.
-
Whippetmom wrote...about "reinforcing" something with your plastic surgeon...just like I did. On the cart as I was going in for my exchange surgery today I saw Mentor 500 moderate. NOPE!!
No mentor high profile 550's anywhere to be found as I requested. If he said my skin couldnt handle etc..ok. But at least try!! I REFUSED to go under until they sent the nurse to the office for what I requested.
I woke up...all the nurses were standing around beaming!!! Mentor High Profile 550's were in and voted on as looking most suited to my frame. I am so happy!! Thanks to Deborah, who performs a ministry to us all here...and thanks to all of you ladies for your knowledge and support. As soon as bandages come off I will somehow wrangle photos into this contraption!!!
Stand up for what you believe ladies...you have all earned that right in this process and deserve it!!!!!!!!
-
geewhiz: You are kidding me, no way, no way, no way!!!! I cannot believe you did that! You are just blowing me away with your moxie! What a story. I just love it! I am just so thrilled for you and so proud of you! Thank you for coming here and sharing and indeed I want to see photos when you have the unveiling! Congratulations!
-
Geewhiz, I am blown away too! Good for you- not sure I would have the guts especially then, to piss off my PS! But it worked for you and I bet they look spectacular. Have you posted your pics yet?
-
Deborah, I am dizzy catching up on reading your responses! You are the best! Enjoy your time off!! One thing, I have style 45's at 460 and LOVE how they look, so much better than my past implants, just a little self conscious of being a bit vavoom after years of being rather flat (but that's just me)! Think I can get used to it;) I know, I need to post on photosite.
Geewhiz, Good going!!! We're also beaming for you!
-
Hi Deborah, I know you are away, so no rush in getting back to me. I was just wondering if you could help me with implant sizing. I had BC 9 years ago, with a lumpectomy and 33 rounds of radiation. At Xmas time last year, another lump was found in the same breast. So on March 5th I had a bmx with Allergan 133V series tissue expander matrix put in at the same time. The catalog # is 133SV, short height, dimensions are 13 x 9.1 x 5.7. I am 5' tall, 105lbs, with a 32" ribcage. The TE 's are 300cc's, and my PS hopes to fill to 400cc's. I have had 3 fills so far, the left is now at 260cc's, and the right, previously radiated side, is now at 220cc's. Its a very slow process as the right side is very tight, only allowing 40cc's at a time. I am in Canada....don't know if that matters...lol! Hope to hear from you soon!
Cindy
-
Cindy....
Of course I can help you Canadian gals! But it is good you mentioned this, as I need to know if your PS is focusing on anatomical 410s or CPGs or if he will use standard silicone rounds. -
Katey...Darlin,. I stand corrected! Could you post photos on the pic forum?
-
Deborah,
I am not sure, so I will have to ask at my next fill. Which one of those would be better? My local PS is doing my fills only, as my PS who put in the TE's, and will be doing the exchange is a 4 hr. drive....so I haven't seen him for awhile. I asked at the beginning about saline vs silicone, and he said I could have whichever I wanted. Thanks for your help!
Cindy
-
LOL Deborah! I didn't think I was ready to join Austin Powers fembots!!
-
Torpedos Katey. I was picturing torpedos! LOL! No, but honestly, it would be great to see Style 45's represented in under 500 ccs....
-
Cindy: I personally think you would want around 425 ccs in a high profile silicone round implant, but that would require some pocket revisions quite possibly, as the 425cc high profile implant is narrower than your TEs - not by much though. You will have sufficient expansion for this size of implant. Many, if not most, plastic surgeons in Canada seem to be inclined to use the anatomical shaped "gummy bear" true cohesive gel implant which is not yet widely available here in the States. It is very important that you research the anatomical implant and know whether you want this type of implant, as sizing is much different for this implant than for the standard silicone rounds. Plastic surgeons are SUPPOSED to select the tissue expander, not only based on the chest wall of the patient, but also with an eye and a vision towards what style implant they intend to use at the time of exchange. So asking your PS these questions, even if by email or phone call, would be helpful. I happen to personally prefer the smooth silicone rounds for someone with your petite stature, but that is just my preference. So please talk to your PS and do a little research and let me know which way you decide to go.
Deborah
-
I just got a second opinion yesterday, over 6 weeks after I was DXed with a recurrence of DCIS, and the good news is my new BS at Memorial Sloan Kettering does not think I need a MX, therefore no recon!
I will have another excision, and I don't know what else as follow up, I wasn't able to ask, as I was still reeling from the news! I will email the nurse with followup questions.Thanks to whippetmom and all of you for sharing your experiences and special thanks to those who responded to private messages, and for the support on this site.
Lil
-
whippemom- I'm 3 weeks out from BI nipple sparing masc. with tissue 400cc allergen TE and I'm already worried about final implants. I know the Dr. is going to use the new gummie bear implants. I think they only come in a tear drop shape. I want to have a natural shape but I want projection and fullness too. I also don't want them to be too far apart. My friend had the GB and showed me and her breasts looked really far apart. Does this have to do with your natural body or the was the PS places the implants? Is there anything I need to know while getting fills and what should I ask him about future implants so I get the results I want?
-
Sweetie: I just bumped up the "All About Gummies" thread in the Breast Reconstruction forum. Go to the Active Topics and look for it and read through it. If you read my thread notes above, you will see what I state about plastic surgeons placing the tissue expander with the anatomical implant of choice in mind when they do so. Talk to your PS about his plans in this regard. The 410s are sized much differently than standard silicone rounds. Also, I would need to know which Allergan TEs - which style - you have and your height, weight, ribcage circumference to help you further as well.
Deborah
-
Deborah..
I have a question, when you have the time.
I talked to my PS a little about what we do here on BCO, and your role.. the TE and Implant info. He thought, over all, it is a good thing. He did add, that it is really important that " the skin" of the woman is also taken into the entire equation, not just the size for TE vs Implant... and size of woman. He said this plays a role in the future of the results.
Your take on this?
-
Laura: I agree! I usually always tell women that much is riding on the integrity of their skin flaps. If you so a search with the word "integrity", you will come up with a lot of posts where I mention "skin integrity." I usually see photos of most women who come here and I can discuss this with them privately. But yes, the skin flap coverage over the TE...and as I mentioned above, sometimes excessive skin coverage - can impact how the implants appear on the chest wall.
-
I have a question regarding projection. Like a lot of women, one of my breasts was larger than the other. When I came to my new PS, I had already had a mastectomy on the breast that was the larger one. So when she did all the measurements on my other breast just prior to my second mastectomy, she was basing my size on my smaller breast. I have Allergan 133 MV - 400 cc. I'm wondering if she should have gone larger. I have 320 cc and I see projection when I'm naked but as soon as I put my clothes on, I look flat. She will be using the Cohesive Gel. Am I ever going to see the size I desire? I don't want to go larger than before. My left breast was a B but my right breast was an A/B. I definitely do not want to go less than a B. Is this possible with the TE I have?
-
Deborah
It seems you always have a knack for guessing the bra size of a woman after exchange. Val61 says i may be not doing my self any favors with the bras i have been buying. My rib cage is 27'' and My implants are Allergan Natrelle Silicone 20-300ccs high profile. What would you think my bras size would be? I am currently wearing a 34 B.
Thoughts?
Kristen
-
Mantra: As long as your skin is doing well and you can handle it, I do not see any reason that you could not have a larger implant with your current TE. It is not uncommon at all to have one implant with larger volume than the other, in order to gain symmetry. It might require only 50 ccs to 75 ccs [or the equivalent in grams for the gummy bears] to do so and it is done all of the time. So tell your PS your concerns and let her know your DESIRES regarding size. This way, if she feels she needs to overfill you a bit, she can do so and get you where you need to be.
-
Kristen: I think your band size should be 30 inches and 32 at the most, but 30 is more appropriate. It does not calculate for everyone, because some women might have some ribcage protrusion or kyphosis or lordosis or some, what I call "MECHANICAL" reason for a bra band size not fitting within the "norm" on the sizing charts. But I would think a 30 D or a 32 C would be the two sizes I would want to try. You want to be hooking that bra on the hooks at the end of the straps and it should be nice and snug. You move upward on the hooks as the bra ages and loosens. Try these sizes and let me know what works for you.
-
Hi Deborah, I just sent you a PM. My exchange is June 3rd.
Karen
-
Deborah
Thank you. More peeved as i really notice how my warners 34 b is floating around me. Lilly of france runs pretty small and i wonder about a 32 on the last notch? No dept stores around me sell 30s except maybe macys and online it did not list that size. so i go back to shopping and checking on a 32 possibility or i go online. the only 30s i see online are $68. ugh. how about victoria secrets--do they sell 30s i wonder?
Thanks again for your help
Kristen
-
Kristen: I don't know if you have Nordstrom's in your area but they do have a selection of 32s(not sure abut 30s). They can be a bit pricey though. Victoria's Secret makes 32s also,but in my area they are not in the stores but can be ordered online. I'm sure Deborah will have other places to suggest. Good luck in your hunt!
TCK
-
Ladies, Thank you so much for making this your "ministry." It is so comforting to have an advocate here! Thank you.
This is just my second post but I have been reading, reading all I could for the last few weeks but just discovered this thread. I am a YOUNG 60 yr old grandmother who still pictures herself in her mind as she was at 30! That lady in the mirror reminds me more of my mother. LOL
I had BMX in March with TE and am in the expanding phase. I didn't spend a lot of time with my PS before my surgery and was just asked what "cup size" I wanted to be. After what I have learned here that just seems so inadequate! so now I am seeking your wise counsel.
Here is my info:
Ht: 5' 5"
Wt: 135 lbs
Ribcage: 29 1/2 "
TE: Mentor CPX 3 Siltex Med Height Model 7200
Width: 12.7 cm
Height: 10.8 cm
Proj: 7.0 cm
Cap: 450 cc
I am leaning toward a silicon implant. What implant would you suggest for me?
Many thanks!
Jan
-
Kristen: TJ Maxx and Marshalls very OFTEN have 30 band size bras. In fact, I bought a slew of Chantelle bras at Marshalls six months ago for $15.00 each and they sell for $60.00 at Nordstroms and the high end boutiques. I paid $68.00 for this bra and found the same one at Marshalls for $15.00! This one:
http://www.barenecessities.com/Chantelle-C-Chic-Underwire-Bra_product_Chantelle3582_,search,.htm
At the time I purchased my Chantelles, they had many bras in the 30 and 32 band sizes.
So find your nearest TJM or Marshalls and scour the bra section to see if you can find some 30 and 32 sizes and try them on.
Deborah
-
Jan: I am a young 60 year old grandmother also!!!
I would recommend a high profile silicone implant in 475 ccs or 500 ccs - either Mentor or Allergan. I think either size would look very nice on your frame. You also have the ribcage which could support an ultra full projection implant - but that only is available by Allergan - Style 45. I would say 500 ccs in that style as well, although the implants would be slightly narrower than your TEs are currently. It really depends on the look you are after. But also, some plastic surgeons are dead-set against using the Style 45 or ultra full projection implants. I think they are just fearful of the projection issue - putting tension on the delicate skin flap after MX. You could go over these two styles with your PS. See what he thinks!
Deborah
-
Deborah,
I love being a grandmother! It's a little compensation for getting older!
Your quick answer is much appreciated! I thankfully have an appt with PS tomorrow. I will ask him about the implants you suggested. I have always wished I had a bigger bosom (barely a b) and am kind of enjoying how these TE's are looking. I should have been more careful of what I wished for. This isn't exactly how I would have done it!
My skin on and under my cancer breast has been red and irritated since my last expansion last week. It actually looks more like a rash but is not hot or itchy. We are four hours away so this is my first opportunity to see my PS. I'm hoping this is not suggestive of a problem with the skin flap.
Thanks again for everything you do here. I think it is a great example of using your talents to benefit others.
Jan
-
Whippetmom:
It's been a while since i posted, but the last time we talked my PS was thinking about a using a 190-270 cc spectrum implants on me for exchange. I am a single MX, My ribcage is 29" i'm 4'11" and 100 lbs, Icurrently have a low profile mentor expander 265 cc on the right side only, very small framed.
Anyway, I went in to see PS again to dot all our I's and cross all our t's before surgery and now he is saying he thinks he needs to go with around a 225 cc saline implant. He is considering this size because he feels that he just can't get anything large enough on my left side to match the expander side if it is any larger, due to the small size of my intact breast. That being said, 2 weeks before surgery he decided to remove 40 cc's from my expander to allow the skin to go back before my surgery. Now, I understand my body has its limits to what it can do and still look "natural". I also understand that he will be taking sizers into surgery so he may go larger or smaller than planned once he see's what he can actually do. However, doesn't 225 cc seem kinda small, or does this sound right on target? I really like my PS personally, but I guess I need some reassurance about his decisions.
Don't get me wrong, I don't want to be unnaturally huge. Because I am such a small person, I feel acheiving a B cup would be sufficient. But can I acheive that with 225 cc? I was thinking more like 250 to 265 considering the projection will be less than what it is with this expander. What do you think? You can PM me or just respond right here, either way is fine. I've PMd you before with my stats if you need to look back at them.
Denise
-
Denise: I am going to need you to email me photos. I'll PM you.
-
Deborah,
I saw my PS yesterday. I asked about the Allergan implnts and he said he uses the mentor and they are comparable. I really do trust him. I am filled to 560cc and think this will be it for me. He said he doesn't necessarily need to overfill expandd if I am happy with my current size he will accomodate for the size of the TE and use a 600 or 650 implant. I have three weeks now to live with this size and see if it works for me. This will allow for the rest of the swelling to go down and then we can talk exchange dates. He is fully aware of my wants as far as projection. I left the office feeling like we are on the same page. Does this sound right to you given all the info I pM'd you?
Tracie
-
Tracie: Again, it depends on how much added volume you have to the mound with your LAT flaps. I would err on the 650 cc side of the spectrum.
-
Denise: I went back through your PM to me. Here is the issue: Symmetry is the key and focus when you have a unilateral MX. You have such an unusually small frame, I see your PS' dilemma about finding an implant small enough to augment the healthy breast to match the MX side. You can certainly tell him what your desires are relative to size, but ultimately, the "fitting" will all take place in the OR when you are under anesthesia. You can ask him to please try for 250 ccs, but your chest wall is probably quite thin and you want to make sure you have sufficient skin coverage over the future implant. You want the breasts to match - and so whatever your PS can do to achieve symmetry is what you should be focusing on at this point.
Deborah
-
whippetmom:
Yes, I understand exactly what you are saying. I just sent you some pics to your e-mail.
-
Denise, I am taller and heavier than you- 5'3" and weigh about 120. I am filled to 250 since my surgery and I am in a 34DD bra.
-
Waldo....Just want to make sure everyone knows you are talking about wearing a bra with your TEs. If you had implants with the same volume, your bra size would be much smaller...
-
Whippetmom - Can I just ask you to clarify your comment above. If I wore a B cup prior to my mastectomy and I try on my old bra and it fits, do you mean that I should continue to have fills until the old bra is too small in order to end up with a B cup after my exchange?
-
Mantra: It is just that the tissue expanders are rigid, shell-like devices which are immovable and implants are not going to respond the same as the TEs. Implants will be compressed by the pectorals and are movable and pliable. Fitting a bra to the TE is not a reliable measure or guide for what size you will be after the exchange. The TEs sit on the chest wall differently than do implants. You want to look at the dimensions of your TE [when you are happy with the size] and see how the implant size compares to same.
-
Whippetmom: You are in your 60's??!! I thought you were 35! You look good!
I just sent you a note via the exchange thread: I can send you an updated picture of my first expansion since my surgery, but I am concerned that maybe the PS didn't give me the right expander side. He says he can fix the bulk under my arm and the crease cutting into my side by the expander with fat grating and during the exchange. I would love your input on this:)
-
MBJ: Send the photos...you still have my email, right?
-
Hi guys, I am one week out from exchange from my te's.
Based on whippetmom's recommendation, I got the mentor 550 cc high profile. I am 5'8, 28" ribcage and weigh about 135-140 depending on how dedicated I am to diet and exercise in the previous weeks
I was really worried that my implants would look huge!! But on my frame, 550 is a very, very natural look. I really like the projection, and its not overwhelming. I am also surprised with how natural they feel coming out of the te's -hallelujah!!! My ps did some pocket revision - my te's had been so wide apart you could drive a truck through them. So its nice to feel like I have a bit of cleavage going on again. I have a nice little peek of upper pole fullness that makes me smile
but again looks very natural. Anything smaller would have been disappointing for me. I am still with tape across the incision lines, but will figure out how to post pics soon. What a simple process the surgery was! I was walking that night around the neighborhood, and driving the next day --nothing like the bmx at all. So ladies still staring down your exchange surgery - dont worry!!
A heartfelt thanks guys! There are always angels amongst us arent there? Thanks Deborah, and Laura and all who post their great support. You have been beacons of light in the dark.
-
What a wonderful thing for you to come back here and tell our other girls that they are going to be ok geewhiz! That is so helpful to them, to read something like that from you !! Thank you right back!!!! ((((((hug))))))
-
Geewhiz: I agree with Laura. Thank you for blessing us with your kind words and for encouraging others taking this journey. It is a message of hope!
-
Whipptmom, with your history of malpractice investigation, can you tell me what is supposed to happen with a 'failed' tissue expander when it is replaced with a new one?. I had one that had a tear; my 8 weeks of saline injections went for naught. I returned each week as flat as a board and no one noticed, not nurse nor doctor. (injections were done by nurses) I started complaining about the swelling in my axilla on week 3 or 4, evidently the leaking saline created it but no one wants to say so. They merely sent me to physical therapy. I now suffer from moderate lymphadema requiring manual lymph drainage by a professional, twice a week. And compression bras 24-7. It shouldn't have happened. I had reduction surgery on the other side with minimal swelling. I was told the compromised expander should have gone back to the manufacturer, Mentor, for investigation and a report should go to the surgeon. I have my records, no report in them. I have the serial number, etc. I want to contact Mentor myself. This isn't fair and someone should at least freaking apologize for either their defective product and/or lack of proper monitoring. Would like to know your ideas on this. Also, due to a bad staph infection after the second bag went in I could not get the proper size placed for the final silicone implant. So I'm lopsided with some contarcture on the side of the implant. Thanks for your time.
-
Dear Whippetmom, I have been reading your amazing posts with great interest and gratitude for your expertise and generosity in sharing it. Guidance is certainly lacking in this area, and yours is quite a gift! Thank you, in advance. My story briefly is that in November 09 I had a 6 month f/u to yearly mammo from spring previous when I'd noted the presence of normal looking lymph nodes , upper inner quadrant, but never visible previously. I am a physician ( has not helped much in understanding this implant sizing stuff) so I always review my films with the radiologist. I was assured that the nodes were normal, just newly visible bc they were using digital film for the first time. I pushed for 6 mo f/u and saw the nodes, unchanged again. Pushed harder and had an MRI. The nodes were indeed normal nodes, but a 9mm lesion lit up in the OTHER breast. Bx confirmed IDC with small area DCIS and LCIS. Had lumpectomy, clean margins, ER/PR+, SNB neg, oncotype 16, BRACA neg. Started Arimidex and was all tatooed up to start rad, but could not shake loose the idea that I needed bilat mx. I am 57, mammographically dense breasts and my mom had breast CA in her late 30's and died at 41. I felt so strongly that I had been lucky in dodging a bullet and might not be so lucky again. A feeling deep within had pushed me to keep nudging my caregivers this time and I just felt deeply, again, that this was not going to be the end of my breast ca story. I consulted with oncologists, radiologists, surgeons, plastic surgeons. TEN times I was told that bilat mx was extreme and radical, did not prolong survival, etc,etc. But TEN times, when I asked the doctors what they would do if they were me (the women doctors) or what they would want for their wives (the men), the chart was set down, the glasses came off, they leaned across the desk, looked me in the eye and said, "ME?? No question, absolutely, positively, without a second thought.. bilateral mastectomy...." Quite a remarkable difference in what they would have me do vs. what they would do for themselves!! And so I did! Mar.8 had surgery at MSKCC. I have expanders, have been quite miserable with persistent feeling of a barbed wire bra-band around my middle, and cannot wait for my exchange surgery in mid June. The path showed ADH and multifocal LCIS on the lumpectomy side, focal ADH and apocrine cysts with atypia on the "good" side and fibrocystic changes with microcalcifications bilat. Hmm
Here are my stats: I am 5'3+1/2 inches tall, weigh 142#. Circumference of my chest, under breasts is 34". Prior to surgery I wore a 36 D bra, with ptotic typical 57 yo-ish breasts (on path 780 g and 848g), nursed 3 babes, 5y each, tho two were simultaneous! As a skinny 20 yo, 30 lbs lighter I'd been less than a B. PS, at first meeting said, not going to be a D again, you'll be a big B/little C. I don't understand how he knew that, or why he had that as upper limit (??), but it is ok with me.
At surgery they placed Allergan style:133MV TE, 400cc (ref #133MV-13). Base diam 13cm.
The TE was filled with 300cc's and alloderm (4x16cm in size and 1.04 -2.28 mm thickness) was placed.
I had a lot of drainage, perhaps secondary to the alloderm and had drains for 3 weeks. Have been expanded 3x to a total of 570cc each side. Had been told the goal was between 500-600cc.
I went to MSKCC, partly because I trained there many years ago, and my surgeons had great reps, and I thought I would get top care, and also so I could get the gummy bear implants. I had thought that they were the latest and the greatest. SInce then, have read posts from many dissatisfied recipients. (In fact, I have been so miserable with the TE's that I am really wishing I'd had the autologous fat surgery. Though my tummy has always seemed quite abundant to me, the PS says he could maybe eke out a "B-minus" for bilat. I was so absorbed in the decision whether or not to have the mxs that I just went with what seemed to be the "simpler" reconstruction option. Now doesnt seem so simple...)
Anyhow, the PS' plan is to use the Gummy Bear 410, in either 410g or 445g mod ht, extra full projection (MX), or the 450 full height - tho he thought this would prob be too high.
So, what do you think about these possibilities, and what "size" can I expect that I will be with these? Do you find that women are more comfortable, physically, with smaller implants than larger? I am so uncomfortable with the expanders that I want to do whatever is possible to have the implants be comfy and feel natural.
Just one more question, is it true that I will not need to ever wear a bra, and would that be the case after DIEP reconstruction as well. Is the implant "perkier" than natural tissue, or, since the DIEP would be for such small breasts, would they be perky and not require a bra, either?
Sorry to have gone on and on. Probably most of my story is extraneous to the questions regarding implant sizing! Thank you, again. I am looking forward to your reply.
-
Ladies:
Whippitmom is out of town until tonight.
She will catch up on this thread when she gets back.
She did not want you to think she forgot about all you darling women!
Hang in there... she'll be back soon!
Laura
-
Mantra,
I have the same size expander as you, and I also look flat except when I am not wearing clothes. This is not my ultimate goal. My dr. plans to overexpand mine to get to a C and I imagine he would fill yours to 400 at least before doing the exchange.
-
Jerusha I just had exchange (at MSKCC) to gummy after unilateral MX in December... I was worried after reading that some women were unhappy but so far (one week post exchange) the implant is very nice! Not too firm, though firmer certainly than liquid silicone. I like the tear drop shape for the natural slope in the upper quadrant. Did they offer you a trip to one of their free breast reconstruction seminars? You can actually feel a sample of each kind of implant -- saline, liquid silicone, and gummy (or cohesive gel)... if you want to compare. They also go into a lot of detail about the various autologous choices. To me the disadvantage of the gummy is that the largest size I could get (and got) was the Allergan 410 MX 685cc (full height would have been too high)... but you are smaller than I am and so I think there would be plenty of size choice for you. Anyway, I'll let Whippetmom answer your questions but thought I'd add at least one positive two cents worth about the gummy.
-
KKT: The tissue expander is a registered medical device and so there would be a paper trail if the PS sent it back to Mentor for safekeeping. TE failure is not common but it can occur. It is one of the risks inherent with medical device implantation and is one of the risks we "sign off on" with our signature on a medical consent form. The limited warranties for tissue expanders would likely be similar to those of saline implants - and Mentor's website does specify what is covered in the event of failure of one of their "implant devices." Apart from that, if you believe you have indeed been adversely impacted as a result of medical negligence, you would want to present your case to a medical malpractice attorney in your area, so that they might evaluate your case and determine if it warrants pursuit via litigation.
I am so sorry you are plagued with so many complications and I hope you find some answers and some relief accordingly.
Deborah
-
Dear Lilah, Thank you SO much for your "two cents" which is, actually, quite valuable to me!!! So good to hear that you are liking your gummy. It is a huge relief to finally hear something good. I know that the size of implant can look different from woman to woman, but if you dont mind my asking, what bra size does the 685 put you at? Were you surprised by your size after surgery? They keep telling me that I will look/be "much smaller" after the exchange. BTW, how has your recovery been? Did you come home with a drain? Dressing of some kind or special bra? I'm trying to decide how long to plan to be home from work and from driving. (It took about a month for me to get back to myself after the bilat mxs). I didnt, unfortunately, attend the seminar at MSKCC as I live kind of far away. I wish I had. I think I would have chosen DIEP. I'm so not liking this TE deal, and wish I were done, done. Thanks again!
-
Jerusha: I am always fascinated to hear about the journey we all take to get to this place. I am glad you made the decisions which turned out to be the best. Thank you for sharing this for all of us - for women who come after you who need to make decisons regarding their breast cancer options.
The gummy bear implants are more "pocket specific" than the standard round saline or silicone implants. The pocket needs to be created with the style and volume of gummy bear in mind. The 445 gm MX looks more appealing to me just for the added volume, as well as the additional width. If your PS overfills as much as you mentioned, he is trying to increase projection with the TEs, as the width remains the same. If you opted instead for standard silicone rounds, I would recommend high profile implants with a volume of 500 ccs.
I think that it would be good to investigate further your implant options, as there are numerous threads in the Breast Reconstruction forums which discuss the true cohesive gel "gummy bear" implants vs. standard silicone round implants. There is one thread entitled "All About Gummy Bears" which you might want to find by scrolling down through the Breast Recon forum threads.
Please let me know if you have any further questions, and welcome to breastcancer.org. We hope you will also visit and join our happy little family over on Exchange City....
Deborah
-
I am about to go offline again and I might not be back on again until Wednesday. I am in Yosemite with no web service on my Blackberry and I did not bring my computer. So I am borrowing one for a couple of hours tonight. We head home on Wednesday.
Will one of you veterans tell Jerusha about the pictures forum and about posting here and on other threads over the next week so that we can get her on as early as possible? Jerusha, there are several gals on the pictures forum who have the gummy bears and you can read about their thoughts regarding same once you gain entrance to that protected website.
Deborah
-
Whippetmom -- have fun!!!
Jerusha -- I don't know yet what size bra I will be wearing as I JUST had my exchange surgery last week and am still healing, wearing a post-surgical bra, which does not have a cup size. I am sure much smaller than I was, which was DD... the 685 is the largest possible MX gummy made... and I would have liked something larger to be honest but I'll be fine with this. I think the advantage of regular silicone is that they go MUCH larger but I found the notion of the teardrop shape (much thinner in upper pole) more appealing. I'm not disappointed by that either... and think all in all I'm happier with smaller but teardrop shaped. I'm probably a C cup now, might even be a D (but I'm guessing).
-
If you want to get to the picture forum... you will need to PM a lady here on BCO named: Timtam
She is the only one who can give you all that you need to join this picture forum. She is the owner, and she keeps it very safe for everyone.
-
Hello, I was reading this forum for long time, but finally I need to make the decision. I have the Mentor style 2500 TE on one side and I was expended up to 440cc. I am going to have an exchange surgery in 2 weeks. We (my doctor and I) decided on Style 45 375 or 400 on reconstruction side and a Style 40 280 on other good side (it is so small now). However I am starting to worry because TE has 12 in width, but those implants are around 11 inches only. Would not they be too narrow for me? Thank you for all your help and great useful information.
-
Hi,
I have a question regarding alloderm. I have DCIS I am going to have sentinel node bx. next week. I am waiting to hear when my bmx and reconst. is scheduled it will be sometime in June. My ps has been out of town. I had a pre-op interview/history and physical today by a PA and then teaching by an RN that works with my ps in the office. She said she is not sure if he will use alloderm on me. I can not wait to talk to him regarding this because I thought this was state of the art. He is a well known reconstruction ps and only does breast surgery. I had a 2nd opinion and selected him because of recommendations and his experience and the vast amt of research he has done. He works out of the University of Michigan. The other ps that I saw had only done 30 breast reconstr. surgeries but explained how she uses alloderm. I guess I am anxious regarding this issue. Please let me know what the standards are.
Thanks so much this is a wonderful site.
-
Any implant done today is made with an Alloderm sling. It holds the breast in place after the implant replaces the expander and it gives your remaining breast skin some thickness that you would be otherwise lacking. Without it, the implant would move and you would see it through the skin and there would be a higher incidence of failure. Do find someone who is very experience in order to get the best cosmetic results. Good Luck!
-
MBJ -- actually my PS does not use alloderm.. so there are implants that don't use it.
-
Galya:
I will have access to a computer tonight and can give you further info then. Typing from my Blackberry no. IIn the interim, I need your height, weight and ribcage circumference. -
Pamcycle:...Alloderm iis not always necessary and not used by every PS. There are some pretty renowned plastic surgeons out there I greatly respect and they do not use Alloderm in their practice. The patient,s body habitus dictates the need in many respects. If you have nice, substantial skin flaps you might not need Alloderm. If you want to go over you vital stats we can discuss it further.
-
Thank you, Whippetmom. I am 5'4'', around 130 lbs and 34'' ribcage.
-
Galya...The Style 45 in the volume you mentioned would, I agree, be too narrow for you. Also, using the 45 for a uni might be risky, unless you can achieve the same height and projection with an implant on the native breast. I also fell you could use at least 450ccs...a Style 20 migh be more appropriate. Your PS is not going to know how much he truly needs for the other breast to gain symmetry until you are in the OR.
Sorry for any typos...I can barely see the BB screen ... -
Aw Deborah you are too much! I am picturing you in the middle of Yellowstone surrounded by nature's bounty and tapping away at your blackberry
Bless you. -
Whippetmom, I am so sorry, but I just measured myself more accurate and I am only 30.5'' ribcage. Does it make any difference? Thank you
-
No, not all Plastics use Alloderm. If you are in need of radiation, or have had it prior, then AlloDerm is almost ALWAYS used. If a PS was not going to use it in a radiation situation, I would find another PS. In regular implant recon., it is not always needed.
Personally, if I had not needed radiation, I believe I would not have needed the AlloDerm. I have very good skin and it is thicker than a lot of girls. ( I only know this because my rads. onco. and my ps told me so.
Hi Deborah.. welcome back! Is it raining there?? Lord have mercy on us... it is STILL raining...
-
Galya: I still feel the Style 20 is better. You do want 12.0 cm width implants - at the minimum. I am still on the road and it is too difficult to access the implant mfr websites w/o my computer, but you would need much more volume to achieve sufficient width, and my chief concern would be achieving symmetry with the 45. When I get home in the next hour I can look at the numbers.
-
Okay, I'm HOME!!! What a relief to see my nice, expansive computer screen, rather than that teesny, weensy Blackberry screen all week!
Gayla: Why don't you email me photos so I can see if perhaps you could use the Style 45. I just feel that it might be more difficult to match the opposing breast with that style of implant. But let me see photos. You would need a minimum of 460 ccs with some minor pocket revisions with the Style 45 and it would take 500 ccs in Style 45 to match the width of your TE.
Style 45 - 500 ccs: 11.9 cm width by 5.7 cm projection.
Your PS knows if your skin has expanded sufficiently to handle this volume of implant. I presume your PS based the width of your TE on the base width of your native/natural breast, which is typically what is done with unilateral MX's, which is why I feel that staying in the 12.0 cm width range is important. So I will PM you with my email info.
Deborah
-
Laura: Thank you for helping me out while I was away and temporarily without internet access. We came home to beautiful weather. I am so sorry you are under gloomy skies right now!!! Hope you will be wearing these
soon!Deborah
-
Lilah,
I had heard (from a friend who did her reconstruction 15 years ago) that implants that were done before without alloderm tended to be problamatic. I have heard that the implants with Alloderm are more "natural" looking and more supportive with less movement due to the sling. Since I am pretty thin, I am grateful to have the Alloderm, but I know it's not all that common yet. There are still many surgeons that don't do the procedure yet.
-
Lilah: I will explain over on Exchange City.....
-
HI everyone, I am having my PBM on July 1st and am very confident that my PS has my best interest in mind. He said not to worry yet about what implant I want until after my initial surgery is over and we begin fills. I would like to see what the difference of look is with different surgeries, TE, and implants. I PMed Timtam to view results and so I have an idea of what to expect, but no response. I thought maybe she is no longer in charge of this or maybe I did something wrong due to being a newbie here : ) Anyone that can help would be awesome.
Also, just reading through I have to say "Whippetmom" you are truly talented and such a wonderful person to devote so much time to helping others : ) I'm sure I will be asking you lots of questions when I figure out where to start!! This is all so overwhelming....
Thanks~
Jen
-
Deborah -
I'm in awe of your knowledge! I've been reading on EC for a while, mostly to try to make up my mind about whether I want to do reconstruction or not, and I'm going to start reading here now. I'm scheduled for a 2nd mastectomy and TE placement July 21, and while this is not something my PS mentioned, I'm curious about the Mentor product that's a combo TE & implant. How come no one talks about that? Is it a bad idea?
Tory
-
Tory: There are a few plastic surgeons who use the Mentor Spectrum expandable for single stage breast reconstruction, although we see this mentioned infrequently here on the breast reconstruction forums. You would need to have substantial skin flaps and/or desire minimal mound expansion after MX....small breasts. There is one plastic surgery group in San Francisco nearly exclusively using this implant after MX....
For those of you wondering what Tory is talking about....here is the link:
http://www.mentorcorp.com/breastsurgery/reconstruction/adjustable-breast-implants.htm
-
Jen: Welcome....and I am happy to help you when you are ready!!
-
Deborah - With all this conversation about Alloderm, I was hoping you could help me with a question I have. My PS used Allograft during my BMX with TE placement. Over these months of fills, I have developed a line running across one breast and bumps on the other where the edge of the Allograft is showing through. I was told that this would all be corrected during the exchange but I'm not sure how that is possible since my skin will still be thin. How do you conceal the line between the Allograft and the implant? I am seeing my PS tomorrow for my pre-op meeting and will discuss this again along with what seems to be a hundred other questions! Exchange just a couple of weeks away.
-
ref: You might be seeing/feeling the marionette sutures - where the Allograft is sutured into place. As long as there are no complications, I think you will be just fine. You also have the unfilled edges of the tissue expander which might be contributing to this "defect." Give it time but yes, do point this out to your PS. Incisional dehiscence would be rare but it has been reported.
-
Yes, this may be the sutures holding the Allograft in place. But, won't that still be an issue after the exchange? Doesn't the Allograft remain to the support the implant? I think at this point I am obsessing about everything that can go wrong. While I am excited to get to the exchange, I am nervous because I really want this to be the last surgery and I'd like to be happy with the result and not settle. I don't think I'll be happy with lines running across my breasts!
-
ref: The Alloderm is not supposed to be sutured under tension, and so when done appropriately, the Alloderm should be nice and relaxed in the lower pole. It is my understanding that the sutures should be absorbed after time. I frankly have not heard of this complaint previously....this sensation of feeling and/or seeing the outline of the Alloderm graft under the skin, and so hopefully your PS will be able to tell you what is going on. Please let us know what he tells you. This question might come up again down the road.....
-
I will come back after my appt tomorrow and let you know what he says. So far he has brushed it off as a non-issue which is fine with me if it is not evident after the exchange. I am certainly going to make it clear that this is my expectation.
-
ref- I don't know if we are experiencing the same thing or not but I have a trail of sutures that are coming to the surface along the lower curve of the breast. My PS said those sutures usually dissolve but, for some reason, they are instead working their way to the surface. My PS said sometimes it takes as long as 6 months for them to dissolve but that she will remove them during my exchange surgery next month.
-
MBJ - I posted a photo on the other website. I'm now filled to 440 on one side and 420 on the other. Definitely getting projection after today's fill. One more fill to go!! Yeah! My name on the other forum is Fore.
We don't have Alloderm in Ontario . . only available on a study basis.
Deborah, if you recall my photo from the last surgeon (the TE was practically growing in my underarm, you'll see the difference the new PS made. What a difference! Thanks
-
Kate - yes, this sounds similar... coming to the surface is a good way to explain it. Since my last fill more of these lines began to appear. My PS and his assistant both made comments how this will be corrected during exchange though they didn't explain how. That's something I'll discuss further when I see him tomorrow.
-
Kate: Thank you for sharing that with ref....and for anyone else who might experience this!!!
Mantra: So that was YOU! I commented on it but I want you to watch that medial migration....after the exchange wear a sports bra which separates and defines the implants...
Moving Comfort makes several...take a look at the Cara, Fiona or Maia:
http://www.barenecessities.com/Moving-Comfort-Bras_catalog_nxs,31,vendor,789.htm
I gave some additional recommendations on the pics forum. But you look fabulous and the size is really just perfect for you....
Deborah
-
OK, Whippetmom! I will give you all the dimensions of my body and TE's and if you could give me ANY advice about implants,i will owe you big time!! LOL
Height: 5' 10
Weight: 145.2lb
Waist: 31 1/2 "
Shoulder width: 16" (measured across the front)
Ribcage: 32"
Width of TE: 5" (straight line) 7" (going over from one side to the other in an arc)
Height of TE: 7" (going from top to bottom from chest wall,over the top,down to ribcage in an arc)
Projection: 2 1/4" (measured from centre of chest wall to furthest point) 3 1/4 " (measured from the outer edge under my arm to the furthest point).
Hips: 37"
Thighs:22.5" (gained over an inch since being off work with the surgery!!!)I am quite long in the torso also.
So there you have it! Layed bare for all to see! (kinda!)
Now you know my PS is recommending teardrop cohesive gel. Im happy to go with cohesive gel but if i stuck with teardrop,what size/dimensions do you think would suit my body size/shape?
And the same question for if i chose round ones?? Baring in mind i am currently at 330ml with another expansion in 2 weeks and HOPEFULLY one more after that. I will total either 390ml or 450ml at the end.
The overall look id LIKE is to have some kind of cleavage and projection.This is my dilemma as i'll get more cleavage with rounds but more projection with teardrop.My PS mentioned about not going too wide with my implants as she says i am too slim! But i'm not actually that slim as i am quite broad.
HELPKay
-
Kay: I need the data on your TEs. Mentor or Allergan? Which style? What is the total "recommended" volume of your TEs? I MUST have this information for the anatomical cohesive gels, as they must fit the pocket created as closely as possible...
-
oh no! i have no idea on the make/style! I do know the recommended fill volume is 300ml. I will try and ask the breast nurse when i'm at the hospital this Monday,but i don't think she will know. If she doesn't know,i will ask if she can get the make,style etc and email it to me.
My PS says i will be getting a smaller implant that what i look now with the TE's in to allow for shrinkage.Thats why they are over filling me. Will this matter if they are supposed to fit the pocket as closely as possible???If i have just 1 fill left, i'll be 390ml at the end,but i'm hoping for 2 more to take me to 450ml.
I took a look at the link to the Allergen implants you put on the first post here. I would love to be able to have the 410 FX or MX. But it looks like they may be too wide as again,my (female) PS said she wont put an implant in thats too wide as it wont suit my shape! =(
How much can you over fill a 300ml expander to safely? Or does that depend on the make/style also?
Feeling disheartened as each day goes by.......... I feel like i'm going to be really disappointed with my finished result,as i seem to want one thing and my PS seems to want to do another. -
Kay: Measuring the circumference under your TEs - you are 32 inches, correct? You can easily handle a 13.0 cm wide implant. Not that you are going to come close to that dimension, but just throwing this out there. Here is the issue: You don't want the pocket too large for the anatomical, as it can rotate and if the pocket is significantly smaller than the TE, it is going to possibly feel very restricted and rigid and tight in that pocket. We do not KNOW the width of your TE...which is why you need this info! It is a registered medical device and you SHOULD have been given a card - one is sent with the TE to be given to the patient by the MD. If they threw away the card, they MUST have the TE data recorded in your medical chart...
Mentor and Allergan do have "disclaimers" regarding overfilling....they know the PS is going to do it - well some of them do - yet they still need to mention this for liability purposes. I would say 50% overfill is more than sufficient.
-
Hi Whippetmom-
Hoping you can help me as well. I'm over 3 months out after a bilateral NSM. I met with my PS this week and she gave me a date for my exchange-June 29th. I requested all the info you said I needed, and why, and my PS kind of gave me some attitude about it which surprised me because she has never been like that. I almost felt like she thought I was questioning her judgement. Anyway, I'm not sure if I was able to get all the info you need so whatever guidance you can give me is appreciated.
Height- 5'4", Weight- 115 lbs, Ribcage Measurement-28", Waist- 29"
(I'm in the same boat as M-star- gained 2" in my waist since this all began! Yikes!)
I'm pretty short waisted as well.
TE's- Mentor CPX3 Low Ht Contour Profile Xpndr
Ref-354-7111 Lot 5960291 Sn 596029
Width- 11.4 cm Height- 8.1 cm Projection- 6.1 cm
I'm not sure what the recommended fill volume is because my PS wouldn't tell me. She said it wasn't important because they can be filled as much as you want. The only thing I could find was on the Mentor web site for this TE it said volume 250 cc's, but I don't know if that is what is recommended. I am currently at 365 cc's. My PS said I am right in between 2 sizes of implants. She said she would be using Mentor Smooth Round High Profile. She said if I want to go smaller she would use 350 and if I wanted to go a little bigger she would use 375. (She said if I go bigger she wants me to do one more fill of just 25 cc's per breast.) She kept referring to cup sizes which I know you don't really go by that. (She even had me put on different bras they had there.) I told her I was an A cup to start and wanted to be a full B. The web site said the 350's have a diameter of 10.5 cms with a 5.9 cm projection and the 375's are 10.7 cms with a projection of 6.0 cms.
I told her I didn't like the large space between my breasts (2") and could she move the implants closer together. She said how close they can be is determined by the location of my pec muscles but that she would do the best she could.
Like everyone else my TE's are practically in my arm pits and I don't want my implants there. I would like to go a little bigger to the 375 but they are a little wider, too. My PS said the difference wouldn't be noticeable.
Also, right now I feel like I have kind of a "linebacker" shape when my arms are down. I asked about the pooches of skin between the breast and the arm. (Not sure if this is the "dog ears" I've heard mentioned.) She said she could lipo it but wanted to wait a few months after surgery which means going under again and extra costs. Not sure what everyone else does.
Well, didn't mean to write a novel here. Like a lot of women I am more nervous about this surgery than my MX. Just want to make sure my PS and I are on the same page as far as size. Thanks!
-
Kate: Do you mean Style 354-6111?
So you probably have implants with a recommended fill volume of 250 ccs. As long as your PS feels your skin integrity is good, I think you want to continue with fills, because I recommend Mentor high profile smooth silicone round implants with a volume of 400 ccs. The minimum would be 375 ccs....
Go take a look at Val61's breast reconstruction journey on the pictures forum. She had the same TEs you have and she has 425 ccs, high profile silicone rounds. She is a bit taller than you and has a longer torso...but the HPs you still need because of your small ribcage circumference.
Deborah
-
Oh...Kate...yes, I would prefer to wait and see if the "mud flaps" or dog-ears resolve after the exchange. They can be liposuctioned later. But I had some worrisome pooching also and it all resolved on its own within four months after the exchange.
-
Kate - we seem to be on a similar schedule. I had a bilateral NSM in Feb and am scheduled for exchange in two weeks.
Deborah & Kate - I saw my PS today and he said that there is scar tissue that will need to be removed during the exhange. It seems that how much revision of the pocket is necessary he can only tell in the OR. I am fairly encouraged that the lines showing through will be corrected in this process. I am tall and thin so there isn't a lot of fat coverage so he is doing fat grafting during the exchange. My PS said he will also liposuction the extra skin flaps under the arms. Seems like lots to do and almost more of an art than a science.I guess at this point I am cautiously optimistic.
Oh, Deborah... my PS said he prefers Mentor silicone rounds. He said he will bring in sizers for 500cc through 700cc and go with what fits best after the work he needs to do in the OR. I'm happy we are on the same page with trying to get as much volume as possible.
-
whippetmom- The 354-7111 number is what the PS gave me. I requested a letter stating that I had TE's because I'm going out of town and I was worried I'd set off the security alarms at the airport. She gave me a letter with two stickers on it that had all the numbers I gave you.
Good to know the "flaps" can go away on their own!
Thanks for getting back to me so soon!
-
ref- Have you checked out the thread "Nipple Saving Mastectomy with immediate reconstruction"? Lots of good info on there, too.
My PS didn't say anything about fat grafting but she did say she may use more Alloderm on me. She said she'll have it on hand but won't know if she needs it until she gets in there. I'm hoping she is as much of a perfectionist as she was when she placed the TE. She said one of my nipples was just slightly angled so she straightened it out.
I guess at some point we just have to trust that our PS's know what they are doing but it is nerve wracking all the same.
-
Deborah,
I discussed my exhcange with you a few weeks ago and you suggested Allergan implants. I spoke with my PS and he uses Mentor and assures me they are both equally good. Would you agree? I am not sure if I should insist that he give me a better more detailed reason. He seems to just use the Mentor implants. Any thoughts?
-
Kate - Thanks for the suggestion. I have been reading the NSM thread but haven't posted there. It's taken me a while to jump in. I agree that we need to get to a point where we trust the judgment of our PS since so much has to be decided during surgery. The best we can do is let them know what we want and work with someone who is on board with those wishes. My PS is very reassuring and does beautiful work so now I just hope all goes well. But, yes, it is very nerve-racking!
-
Thanks Deborah
i will try and get some more info on my TE's if i can.....though its gonna be like trying to get blood out of a stone! They will prob just say "why do you need to know?"
-
tamgam: Mentor implants are just fine!
-
Hi Tamgam, My PS seems to use Mentor, primarily as well. My TE is a mentor. But I told him I want Allergan 20's and he agreed to bring a few of them into the OR. I worked for a pharma complany that makes medications but IMHO, I believe that the implant manufacturer's sales rep /physician relationship has a lot to do with the PS's preference. When I mentioned I want allergan- my PS said the 20's have a bigger projection. He also said they have a nice warranty. As far as I see the warranties are the same, but I think if you insist- he cannot refuse to give you what you want. Right now I am having more of a problem with him ordering the larger size I want. Bit I have decided (with Whippetmom's help) to remind him about my outcome preference and then to trust him and relax.
-
Kay.....Just respond, "I am asking because I know that these tissue expanders are registered medical devices and I have read that the manufacturer provides a card with the medical device information which is to be given to the patient implanted with these devices."
-
Ahhh...good thinking! sorry for being such a pain in the A$$ with all this! I will write that down and quote it word for word if they question me as to why i want to know
.Not sure why we don't get given these cards. Maybe its cus we're not paying privatley so unlikely to go off somewhere else for revision surgery or other procedures. I'm sure the card will be in my notes. Failing that i'll tell them i'd like to have it as a souvenir to go with my video's and photo's!
hey,i can now post unlimited!
-
Kay....you wrote:
"hey,i can now post unlimited!
"Let the fun begin!
-
Waldo's comment about the PS' relationship with the implant mfr's sales rep is spot on...It reminds me of what Dr. Steven Wallach [a famous NY PS] stated in response to someone's question re: whether Mentor or Allergan implants were preferred:
"I think they are all about the same. I use Mentor only because I like the sales rep." __________________
Steven Wallach, MD, FACS
www.stevenwallachmd.com -
whippetmom- I am kind of concerned that my PS is not having me do very many fills before my exchange. I am currently only at 365 cc's. She only wants me to do 25 cc's more per breast before the surgery where she is going to place a 375 cc implant. Everyone else seems to expand much bigger past their desired size.
She did say she might use more Alloderm for this surgery. Would that make a difference?
I'm worried there is going to be too much stretching of my skin.
-
So much going on--I haven't posted in a couple days and I need to catch up!
Mantra: I will go check out your pics on the other site, thanks! I have two or three more fills to catch up to you!
M-Star: wow, we really are very close in size! My expanders are 13 cm wide and so my volume right now is mostly width (footballs lol) not height or projection. Keeping my fingers crosses.
Deborah: How long do you recommend waiting for the exchange after the last fill? I found that if I massage the expander and take a muscle relaxer it's more bearable when I get the fill.
Val66: I am so jealous. I looked at your pics on timtam's site and your breast are perfect! You started out smaller then me so it makes me not feel that I am being overly ambitious trying to get to the size I want. My PS keeps asking me, so, how big do you want to go? nervous laugh. How long after your last fill until your exchange?
Thanks everyone for your wonderful help and feedback!
-
mantra: You are looking great! Do you know what size your PS is exchanging you out to? If you already posted this and I have forgotten, blame the late hour and chemo brain, lol. Even though I have only one side expanded, it feels to wide, but it looks just like yours, just less fill. Are they recommending a 3 month wait?
thanks!
Mary
-
Kate: It is entirely appropriate to not overfill....entirely appropriate to exchange you out to implants larger than the volume of the tissue expanders. I was expanded to 425 ccs and exchanged to implants with a volume of 550 ccs. You are just fine.
Mary: Waiting two to three months after the last fill - the longer the better - is what is recommended.
-
Kate33: I have those linebacker arm "pooches" between the expander and my underarm, too! My PS says that maybe he will have to lipo and it won't look like that when I am finished. I had an additional non cancerous lump removed there besides my two lymph nodes and it was incredibly sore and extra poofy for weeks but as long as it's gone after exchange, that is all I can ask.
Rebecca: I am so sorry--You have been in my thoughts for days and I just want to wish you a speedy recovery!
-
whippetmom- Thanks for the reassurance. I don't know why I am stressing so much about this!
MJB- The thing that worried me is when I asked my PS about it and she had this puzzled look like she didn't know what I was talking about! I have read, though, that those pooches can go away on their own. Part of it may be that I can't really put my arms straight down because my TE's are practically in my arm pits. I'm just wondering if having lipo there is covered by insurance?
-
I have fatty bits under my arms also ever since my TE's were placed. One side seems worse than the other,but i wasn't sure if it just FEELS worse cus its alot more numb than the other side,and therefore just SEEMS bigger.it feels quite soft and spongey.
-
I am new to this. I just had my 2nd fill on friday and in great pain and my PS suggested that he was not going to do another fill because my skin was getting too thin.He suggested to move forward with the implants in 2 wks. Is he rushing?
-
Mimi: Absolutely he is rushing! Pain is subjective but TEs are uncomfortable and painful for nearly all of us. But you need to let me know a bit more to see how much further you can go. You surely need to wait two weeks for another fill. For most of us, the fills progressively get more bearable...
-
Mimi...It might well be that you need to stop the fills, but wait at least 4 weeks to exchange. Longer is better.
-
First of all thanks a lot for replying so soon!
I fear he is rushing as well, I am not sure how much fluid he put every time but I think is way more than 50 cc (he uses a full syringe every time and it looks like a 200 cc syringe).
I just wanted to make sure i understood well your request (quote below)
"But you need to let me know a bit more to e how much further you can go. "
Do you mean if I can bear any more pain like this?
If that is what you meant, the answer is no, I can barely sleep and move now!
For me the pain from the last fill is stronger than the first time and it feels like burning and like is going to explode anytime...
should I just go for the implants in two weeks and (hopefully) put an end of the pain or should I wait for my skin to strech more?
I will ask the PS how much fluid he already put in my TE and let you know, so you can tell me if is abnormal or if is ok...
Thanks
-
I know, and i feel like i should wait ...but the PS keep insisting that i should not wait because the scar tissue from the MS would harden and lose elasticity. Is it plausible? Should i get a second opinion?
-
Mimi...I Am on my way home and I will respond when I can get to the computer...
-
Mimi: You can have some saline extracted from your TEs which might give you some relief. I have never heard of someone rushing to the exchange so that the scars would not harden and lose elasticity...
The standard period of abeyance between MX/TE insertion and exchange is two to three months.
When WAS your MX? What style/volume of TEs do you have? What is your height, weight ribcage circumference - measuring around under the TEs? Were you small-breasted prior to MX? Just wondering what degree of skin flaps your PS had to work with. Trying to figure out why you are having such a tough time of it after two fills. I mean, this can occur - but there must be some underlying reasons for this.
Deborah
-
I had MX on march 18th .I am about 5'3, 105lbs,ribcage about 28 1/2 ,breast size btwn B and small C. Not sure about the style/volume of TE's but i know they are bigger than my original breast.
-
Hi whippetmom. I have been cruising these forums since my diagnosis last october, but it's only now that I need to decide what type of implants to go with (scheduled for my exchange in July) that I find myself freaking out enough to need to post. Vanity, huh! I hate the look of my 400cc allergan TE's (filled to 660cc)-MUCH too much top boob, but my ps thinks I will be unhappy with the 410's -thinks the bottoms won't be full enough for me. I was a small-med C and requested a full C. I'm 5'6, 130 lbs. with a long torso. I'm considering having some fluid removed from my TE's because I'm afraid I'm going to have playboy boobs! It's very hard to find reconstruction photos on the web. I keep seeing references to a picture forum in these posts but I can't find one anywhere. Where would I look for it? Can anyone who has gotten the 410's tell me if they feel like a real boob? Will they take the shape of your bra, or hold their shape no matter what you put them in? Thank you all for being so open - reading posts from all of you going through the same things as me has really helped me to get through a tough 6 months.
-
Lee - Do not worry about having "playboy boobs". It "takes a lot to make a little" when it comes to breast reconstruction. You probably need high profile implants with around 550 ccs. You will have to read through this 101 thread to see all of the discussions re: 410s. The pockets need to be created for the 410s and with your PS' comments, it does not sound like he is creating pockets for the 410s. You will be happy with standard silicone rounds. What is your ribcage circumference?
-
I am so happy I found this forum!! In a nutshell, I has TE and implants mid 2009, after only 3 months my radiated side got hard and small. I am doing TE again on that side, this time he expanded me 120cc more than the 1st time. Plus, the TE he is using is more anatomically shaped with the lower pole projecting more. I am still getting the same size 425 cc implant put back in, just like my other non radiated side. I am so afraid of getting cc again and am looking for ways to prevent it. I plan on doing vigorous massaging and wearing this bra:
http://www.makemeheal.com/images/products/estore/10006/large/4510a.gif
Do you think it will help?? My exchange surgery is this Thursday coming and I've had the TE in for about 2 months.
-
Whippetmom - I'm not sure if you can help me. I had my double mx on March 5th and immediate reconstruction with the lat. muscle and he put in permanent implants at the same time. I was a small B and asked only to be slightly larger.
Well, my right side feels totally different than my left and is smaller. When I had my last apt. my PS right off the bat said oh your left side is bigger. He looked at his notes and said well there was more tissue removed from the left side. I told him yes that was because after 3 biopsies on my right they took out tissue each time. Which I know we discussed in earlier meetings. He never admitted anything and I have never been given or offered any information about what type of implants I have or their size.
One of the reasons for having the double was so both sides would match. Originally I was to go in for the nipples in June but he said I needed to be sure I was happy with everything first. He said perhaps there is extra swelling..... I could buy that as there is a lot more swelling under my left arm than my right but they just feel so different. The right side feels all of one piece and feels more like a real breast. The left is a better size even though I do not fill out my old bras and was hoping at least to fill them out nicer and be a little bigger not less. The left side I can feel the implant and it sort of thunks from one side to the next when I do the massages. Also I am almost 50 so no I didn't want 20 year old breasts but these seem to sag more - could it be because along with the muscle and implant they are just heavier - is this normal?
Any thoughts or advice? I think I'm more troubled by this as I broke my nose last Sept. and now I cannot breathe and it seems to get worse every week so I'm trying to figure out what to do about that as well. I had so hoped to be done with surgery!
Thank you so much.
-
Whippetmom: Thanks for your reply on the other site. I have a few questions and thought I'd post them here as well.
I wonder if Strattice is available in Canada (Ontario)? If so, it sounds like a wonderful tool to correct the previous surgeon's error. I'm really hoping that this can be fixed. If it can't, I'd be very tempted to sue my old surgeon but even if I have a case, money isn't going to fix the problem.
If Strattice is not available here, are you aware of any other options? I know Alloderm is not available here . . . only on a study basis and although I am part of the study, I am part of group B . . . the group that does not get Alloderm.
The new PS talked about an implant stabilizer from this company. http://marenagroup.com/store/entity/tabid/198/c-3-breast-support.aspx
I checked out the link you sent me for the V Panel Bra. They seem to be so different. Any idea which one is better? -
Hi Whippetmom, My ps said I could decide on my implant type at my preop visit. He's with MSK and they keep telling me to stop worrying...he knows what he's doing. I really hope so. My ribcage (the top - right under the TEs) measures 31 in. Thanks so much for your help.
-
Mantra: Strattice is also made by LifeCell - as is Alloderm. It might be available in Canada, because it is porcine dermis/tissue, rather than human acellular tissue.
I think that anything from the Marena Group would be just fine. The premise is the same with any good implant stabilizer band.
-
Lee: Excellent! A number of gals here go to MSK. Do you have Dr. Disa?
I think high profile 550 ccs would be just about perfect for your frame!
-
Stanzie:
Well, by now, the post-surgical swelling should be resolved or there should be very minimal residual swelling evident. I would like to ssee what this left side looks like. Your size discrepancy was an oversight by your PS. I think he so much as admitted it, right? I will need to see photos so that I can see what is needed for you, since you have the flaps. It sounds like another exchange surgery if you are serious about symmetry. It is ALL doable. Nothing has to be done until you heal from your nasal fracture and you are feeling better. But I will PM you with my email address so that we can go over all of the possibilities.
Deborah
-
whippetmom - I want to thank you for the help via pm. I now feel ready for my next fill on Wednesday and know what questions to ask my PS.
My question - Why do we need to wait a month or so after the last fill? I am just curious. I know my PS said at least a month.
Fat grafting - does it work? Is there another choice other then fat grafting? Do you get a choice where they take the graft from? Is fat grafting lipo?
Thank you!
-
Hi all! I am wondering if anyone knows who the best PS for reconstruction is near Boise, Idaho. Mine is in Meridian and there are only 3 in the valley who are supposed to be "the ones" but I am curious if anyone from this area has been happy with their choice of PS. He has never discussed with me what kind of implant or size or shape. I am plus sized - especially after going thru all of the ups and downs on this road - and was a 38C or D. He told me I cannot get anywhere near that same size and I said if I don't I am going to look like a huge human pear...but he does not seem to care about that. I have had 3 reconstruction surgeries and my implants are almost under my armpits. It seems like some on this thread have gone with the bigger sized implants. I am now going to go under the knife to do the back muscle to the front as my implants now looks like "rocks in a sock" his description. Nice!! Anyhow, I would love to hear about any PS's in my area.
Thanks, Tami
-
Whippetmom - Strattice is not available here in Canada and the only thing she can do is some heavy duty internal stitches.
I've read that the problem is not easily repaired and has a high failure rate. It says that if it fails, it has to be taken out, wait 6 months and start all over but with a smaller implant. I really don't want to go through this again. I'm wondering if you know if I could just leave the TE in place until such time a viable option becomes available? Are there problems with leaving TE in place for years? I'm just not prepared to deal with something that has a high failure rate. Why bother?
Mantra: Strattice is also made by LifeCell - as is Alloderm. It might be available in Canada, because it is porcine dermis/tissue, rather than human acellular tissue.
I think that anything from the Marena Group would be just fine. The premise is the same with any good implant stabilizer band.
-
Tami - I don't know how limited your choices are in the Boise area, but YOU NEED TO DUMP THAT GUY! It sounds like he is lacking any sort of sensitivity!
Whippetmom - I'm curious about the TEs themselves - it looks like Mentor has a couple different models and I'd like to know how much bearing what kind of TE you have has on what kind of implant you plan to end up with. How important is the TE? Or does which TE you get just depend on how much they expect to have to fill it?
-
I'll start at the beg
Stage 2 breast cancer in 2003 bilateral mx ( no reconstruction at this time)
Decided to have have breast reconstruction years later (2006 I think)
2006 went something like this:
II had expander surgery etc and had my exchange surgery and then had the nipples made
also had 1 session of tattoo to the nipples that were made. (1 more tattoo session still needs to be done)
had the best health insurance at the time!!!
Also at this time I mentioned to the surgeon that the bottom of the non cancer side breast
was sagging she told me that was extra skin and that she would have to back and fix it.
A year later our insurance changed at work (bad coverage and very high max of out of pocket) I could not afford to have the last tattoo done. have not been back since
fast forward to 2010 and it seems as though the left breast is sagging more is is a little & is more flat that the right side towards the cleavage.
I am not sure if this is all related to the sagging issue or not. or ?? or if it ruptured
If the silicone implants ruptured how would I know. I did fall on them once but they seemed intact at that time.
These are silicone.
Question if this needs to be fixed and or replaced will insurance cover this?
also if my cancer was ever to come back distantly would insurance pay for anthing related to my implants etc
Our insurance is better but I will be switching plans come Jan & our max out of pocket right now is almost $5,000 cannot swing that at this time.
The new plan coming Jan is that we pay 100% up to $2500 and then everything is covered at 100%
so my plan is this:
Go in and have her take a look at this before the new year since the co pay I have now is $45.00 rather than paying 100% for a office call. her office calls are $500+
Then after the 1st when the new insurance kicks in do what is suggested since we have to pay 100% up to max out of ($2500)and no deductable .
Any help or suggestion would be more than appreciated
-
Hope: You need to wait at least a month [frankly, I feel two or three months is even better] to give the skin time to expand and to retain the expansion. Otherwise, the skin will just retract when the TE is removed and all will be for naught.
Mantra: It is not really advisable to leave the TEs in for more than a year. Really, I think six months is what the manufacturer states in the literature, yet some women do have the TEs for up to a year or perhaps even longer, in order to complete rads/chemo or other treatment in the interim. I have done a lot of research on symmastia and I want to go over it with you, but I will PM you with this information later this afternoon.
Weezy: I think your PS has rocks in his head! Nothing like kicking you when you are down. Let me do some research for you....I'll get back to you later today.
Tory: It does matter what type of TE is inserted. The PS needs to determine the width which is appropriate for your frame and the volume which is deemed appropriate for the amount of skin flap remaining after MX. Based on my research and from personal experience, I happen to believe that the least amount of expansion in the upper pole - in the pectoral region - is better. You want to avoid damaging the pectoral musculature and also, I think it helps reduce the risk of step-off deformities, especially in thin patients or patients with a relatively bony ribcage. So this would mean the short height to moderate height TEs seem to be preferable.
-
Whippetmom- Thanks so much for all of your help. You're an angel! Yes, I have Dr. Disa...I hope that's a good thing?
-
Lee: It's a good thing. You are in good company. Seems like everyone I run into lately from NY has Dr. Disa.
-
anderson: Sorry....I missed your post somehow yesterday. I was looking for something just now and found it. I am going to ask you to email me photos so that I can see what is going on.
I think that with a silicone rupture [with a silicone implant of the generation you have] - if there is any deflation, it would be very gradual and probably minimally at that. So what you might be seeing is a bottoming out of the implant.
Will insurance cover it? I want to say "yes", but I suppose this might depend on the state in which you reside and the insurance you have currently, since the implantation occurred under a different carrier policy. The problem with going in NOW for consultation is fine, as long as you do not have to prequalify for the new insurance carrier you are switching to in January. I am not sure if the new "no preexisting conditions" edicts for insurance companies will stick without a fight, and so you want to be sure you do not need to divulge to the new insurance company in January that you have a "condition" for which you have not been treated and will require treatment with your new carrier. Sounds confusing, I know.
With that said, it might be that if indeed there is implant failure/rupture, you could be covered under Mentor or Allergan's lifetime limited warranty plan, which could also cover a portion of hospital/surgeon/anesthesiology costs for replacement. You would need an MRI to confirm a rupture, unless the implant is just so obviously deflated, ruling out the need for same. Warranty information link:
http://www.justbreastimplants.com/breast_implants/implant_warranties.htm
But send me photos and I can probably tell you right away what might be going on and we can plan out your revision to help you towards getting the results you hope for next year. I'll PM you with my email address.
Deborah
-
Tami: Why don't you obtain a consultation with this PS in Boise....
http://breastimplantcenterofidaho.com/breastreconstruction.html
-
Bump
-
Whippetmom- Just when you had me calmed down about getting too busty, I read your post about upper pole fullness in TE's causing damage to the pectorals! I'm ALL upper pole fulness, that's what has been freaking me out - all of my summer clothes are completely unwearable. Also I'm very bony in both the sternum and ribcage areas. What kind of damage? I was hoping to be able to do pushups again someday!
-
Lee: Don't freak out! My comment stated that some plastic surgeons - Dr. Kenneth Shestak, in particular, feels that it is better to use a lower height tissue expander, in order to AVOID damaging the pectoral muscles and to not over-expand and put undue pressure on the pectoral muscles during tissue expansion. He has seen evidence of pectoral damage, but I think he was inferring that this can occur...it is a risk...but he does not suggest it is a problem he sees regularly - he just wants to take precaution to avoid it in his own patients. I had full height tissue expanders. Tissue expanders can migrate and they do tend to ride upward towards the collarbone or laterally towards the armpits. It can be corrected at surgery. You have a highly experienced plastic surgeon. He knows what he is doing.
Referable to pushups: It is a very uncomfortable maneuver for nearly all breast reconstruction patients with partial-submuscular placement, e.g., under the pectorals. You will be able to do them, but you will hate the feeling when doing so. After breast reconstruction, and once you exchange to implants, the implants are controlled by the pectoral muscles and when performing certain upper body exercises, there is animation of the implants and it is not a pleasant sensation. You will see when you have the exchange. You just learn to find upper body exercises which do not trigger this implant animation.
-
Deborah - that's a really interesting explanation of the shorter height expander. Mine is a lower height expander and I have a crater above the expander to where it meets the bony ribcage. My PS says it will be filled in with the implant at exchange. I hope so. It makes it impossible to wear most necklines. We are also do fat grafting to fill in where necessary. One week to my exchange. Not going to lie, I'm nervous.
-
ref- I have that same crater. It's definitely made dressing in Arizona a challenge! My exchange is a month out and my PS said the implant will fill it in as well. We'll have to compare notes afterwards!
-
Kate - I never thought I was a provocative dresser until I realized that all of my v-necks and tank tops were completely not workable! My BMX was in Feb (and I'm in NJ) so I didn't notice how difficult it would be to find something to wear until it got warm. I'm one week out to my exchange and I'm hoping for the best but aI little worried I'll be disappointed. I'll let you know how it goes.
-
ref and kate:
Some women have a very difficult time "style-wise" with their TEs. They can take on an absolutely terrifying shape on the chest wall! You are not the first to complain of this making the apparel search difficult during the TE stage of reconstruction. But this has no bearing on the outcome, if you are in the hands of a skilled reconstructive surgeon. It really is sort of unpredictable, to some extent, what direction and shape these TEs will assume under expansion.
Hang in there girls! It will be over soon!!!
-
whippetmom- I'm not sure if you can answer this or not. I'm a month out from my exchange and am going to stay kind of small with implants of 450-475 cc's. (I gave you my info in an earlier post and you thought 475 at the smallest and suggested I see Val61's photos which I did.) Anyway, my concern is the gap between my breasts. I am very small boned (5'4", 115 lbs, 28" around). The gap is about 2 1/2". I spoke to my PS about this and she said she would try to put the implants as close together as possible but that it was based on where your pec muscles are. I was just wondering if this is considered a large gap and do you know of other women who had large gaps with TE's where the PS was able to bring the implants closer together? I've heard women referring to "pocket work" but my PS didn't say anything about that.
-
Kate: Did you look at Val's TEs? Hers were at least 2.5 inches apart. I have seen many this widely and laterally displaced and, at the time of exchange, the PS opens up the pocket a bit and brings the implants in closer to the sternum. You may need some lateral [side] suture/support to keep the implants from migrating towards the armpits again. Discuss this with your PS before the exchange and make sure she feels she is able to do this.
If you look at Val's photos, do you feel you have the same approximate width between implants? I do know that the structure of the ribcage has very much to do with the placement of the pockets, but I think that the skilled surgeon can overcome some of these structural hurdles. Ask Val if you can print out her photos to take into your PS....
-
Whippetmom: After seeing Kate33 post that 475 is small with a 28" ribcage I am starting to panic and think that maybe I'm going too small! My PS said that I will not get the kind of projection with the implants as I do with the expander, yet I'm not getting a huge amount of projection now!
Am I getting ahead of myself? Can my 32" ribcage can support a larger implant then you originally advised even though I have a bony chest? I know that when I started posting I said I wanted a more "natural" look but if natural requires a padded, push-up bra then I know I won't be happy. You have been so patient with my questions and I believe I only have one more fill to around 450 before scheduling for the exchange and my dr. wants to know what the goal is.Thank you in advance and I hope you are having a lovely weekend with all of this great, sunny weather we are having!
Mary
-
MBJ- I shouldn't post when you are going on no sleep. My implants will be 350-375 cc's not 450-475! Sorry if I freaked you out that yours are too small! I guess I need to proofread before sending! OOOOOOPPPPSSSS! I'm sure yours are fine!
whippetmom- I will ask my PS about the lateral suture support. Thanks!
-
Kate - I also have a gap of about 2 1/2" between my breasts. I'm quite a bit taller than you but also thin (59", 130 lbs, 29" around) and my PS says that he will move them closer together at the exchange. How close? I don't know. He is quite the artist and seems to have a great aesthetic sense so I'm trusting that those adjustments will be just right.
MBJ - I'm filled to about 450cc and I don't have huge projection either. I'm a bit concerned about the final results with the implants. My PS keeps telling me that it's completely different with the implants than the expanders in terms of shape. He is bringing sizers from 500cc and up to the exchange and wants to see what works best then based on what scar tissue, etc he finds. I think the goal is 550cc.
-
Kate33: Thank you! I was really freaking out! What's good to know is that my PS originally wanted to put in 350-375 cc's and after speaking with Whippetmom, I told him I wanted 500 cc's. I didn't sleep at all last night add my chemo brain and lord knows what I post sometimes LOL. Thanks again for clearing that up for me.
-
MBJ- Sorry again for freaking you out! I can't even blame it on chemo brain!
-
MBJ: I noted that over on EC you stated you and your PS were considering the moderate plus profile implant. Is that the style you and I discussed? Just want to confirm all of this before your exchange.
-
Hi Ladies,
This site has been so helpful. I originally didn't want reconstruction, but my breast surgeon insisted that I at least talk to a plastic surgeon and I changed my mind at the last minute. So, here I am and I realize the further I get along in the process and the more I read this site, that I am pretty clueless!
I'm still undecided on whether I want saline or silicone and my PS and I have talked about this; and he's left it up to me. I also didn't know that I had much of a say re what type of either I should get. I just thought that he would pick what's best for me. I was just curious on what you would recommend.
Here my info: 5'5" 109lbs, 28 1/2 inch ribcage.
I have an McGhan 133MV-11 (250cc) Tissue Expander.
I'm expanded to 290cc's and the last fill about killed me. It was so bad I cancelled my last fill b/c I needed a break. The left side always hurts more after fills and that particular one I had pain all the way up and down my ribcage for several days. I too have a wide gap between my expanders and I feel like my left one has migrated over to my armpit. I was a 32C (small C) before my dmx in February. I wanted to get there again, but I'm not sure I'm going to make it. I fear my body may be telling me I'm done. I like the size that I am now. But my PS likes to over-fill before the exchange. I'm not sure I'm going to make it.
Thank you for your thoughts. You all are so helpful, encouraging and knowledgeable. Thanks!
-
Dawne-Hope: Nearly all of us choose silicone implants. Currently, most of the women who have come through here who opt for saline, have done so because they need the largest implants available and saline has the largest volume currently available.
Based on where you are with your TEs, I think that you would probably be just fine with around 325 ccs to 350 ccs in a high profile implant. If Allergan, this would be the Style 20, smooth round silicone high profile implant. It would be an appropriate size for your frame. Aim for the 350 ccs if you are able....
-
Dawn-Hope- Our measurements are very similar and I had almost the exact same experience that you are having now. I got to about 250 cc's and the fills became extremely painful for me. I thought I was going to have to stop right there. My PS had me take a break for about 3 weeks to let everything settle down. In the meantime, I read several posts on here from women saying their PS prescribed the muscle relaxant, Flexeril, for their fills and that it helped immensely. I asked my PS if we could try it and she agreed.
I take it 3x a day and it has made a huge difference. I was able to continue my fills painlessly and am now at 400 cc's. I'm a month out from my exchange and am going small with an implant of 350 cc's. (Whippetmom recommended 350-375.) If you want to stop at the size you are now I say go for it. But if you wanted to go bigger just wanted to let you know what worked for me. Good luck!
-
whippetmom - thank you for taking the time to respond. I lost my mom to BC last Sept. and I've felt kind of lost going through this experience without her. Thank you for your advice. 350 is about one more fill. I can handle at least one more!
Thanks again!Kate33 - Thank you for your response. I've felt kind of whimpy when I read about other ladies and their experiences. Helps to know that I'm not alone. I'll try the Flexeril. That's what I used primarily after the BMX and it helped me far more than any pain meds. I have some now and I don't really know why, but I haven't taken it as liberally as I did after my surgery. I'm having to work now and I think I'm afraid it will keep me from being able to focus. Since I cancelled my last fill, when I have my next one, it will be a four week lapse between them. It is amazing how much better I feel now. Maybe I just needed some time off. Thank you for sharing!
You all are the best! Thank you so much!
-
Dawne-Hope: I lost my mom to BC many many years ago (45!), and not a day goes by that I do not think of her and wish that she were here to share in my life - and me in hers.. It does get easier. It does get less painful and less sad. But times like this are hard. You will find your way, even without her.
-
Dawne-Hope:
And there will be a lot of women on these forums just itching to take you under their wing. A lot of mothering goes on here on these forums. I am concerned that you might be getting too much saline fill at one time. For the gals who have a tough time with fills, 50 ccs at a time is suggested and spacing the fills out two or three weeks is also recommended. However, I think you probably only need another 50 ccs to get you where you need to be for a 350 cc implant. Canceling your fill appointment was probably the best gift you could have given yourself at this juncture.
MODIFIED TO STATE: In consideration of your low volume TEs and your small frame - even increments of 25 ccs per side might have been more appropriate.
-
Dawn-Hope - My first fill about killed me......I would have rather had the BMX surgery again over that fill. Then I read here to take valium which I was given at the time of my surgery and never took it. So the next fill I took one an hour before my fill and then continued to take them that night and next day. It really worked! So I am ready for my next fill and next.....I just needed to realize taking the medicin doesn't make me a wimp it makes me smart!
-
Dawn-Hope- Whippetmom is right about the 25 cc's. Towards the end that is all I was doing at a time. My PS taught my DH how to do the fills at home so we were able to do just a little at a time. I even saw a posting where someone was doing their fills at home, too, and were doing just 10 cc's at a time. Basically, my PS left it up to me to decide how much and how often and when I was stopping. Yours would do the same I'm sure.
-
Whippetmom: Yes, the Mentor 500's were one of the sizes you had recommended. I told my PS that that was the size I was thinking only because I noticed these seem to have more projection then the Allergans you had recommended. After looking at my last picture, are you still thinking the same sizes? I will probably get my (hopefully) last 100 cc's at my next fill (if I can take it). BTW--Between the rough and the smooth: I had heard the rough can prevent encapsulation but I notice many get the smooth. Can you explain the pros and cons of each? Thank you as always, you are a life saver.
Dawn: I am so sorry you are having a rough time of it. After reading many of the women's posts here, I had my PS give me a prescription for a muscle relaxer and I always take it 30 minutes before and usually into the next day or two after. I have a high tolerance for pain but when it comes to this, I prefer to be a "wimp". Heed Whippetmom's advice--go as slow as you need. I also massage mine just like I would massage any other sore place on my body and this seems to help. Of course, I don't recommend this in public LOL.
-
MBJ: Yes, I said 500 ccs, but I was referring to high profile implants with that volume. On EC, you stated you were looking at moderate plus profile. MPPs are wider and have less projection than the high profile style. Just wanted to clarify that I did not suggest MPPs for you. HOWEVER, you are a unilateral and this means that finding an implant with the correct width and projection to match your natural breast is going to take precedence over your desire for one implant style or another. Your natural breast dictates to a major degree, which style of implant your PS will choose.
You do not want textured implants. They can and will almost assuredly cause traction rippling. I think that textured implants should be the last resort for women who have recurrent capsular contracture. Apart from this, smooth silicone is the first choice.
-
The nurses told me the PS will sit me up on the OR table during the exchange as he is trying on different sizes to see how they look upright. I think he likes small and natural and I wish Deborah was right there in the OR telling him"NO-those are way too small- look at her wide shoulders- go with the 475's! " I hope to post pictures of this journey in the next week or so
-
Waldo: You have to remind your PS before surgery that he might like small and natural but that is not YOUR preference and you are the one who has to live with them.
-
I definitely plan to remind him. He's probaly still chuckling over the playboy playmate's picture I handed him at my 4 week post op appointment. He did say (after pointing out she is 23 and I am 53) that at he does get what I want and he knows where my head is at.
-
Whippetmom: Thank you! I must have read your post a dozen times and still I read it wrong-blame it on chemo brain. What I thought you said was the Mentor Plus 450 or 500 but when I re-read it right now you said at least a 500 in a high profile but my dr might be looking at a moderate plus. I am glad that I asked about the textured versus smooth because I sure wouldn't want rippling. God, I hope I am not repeating my questions-I really do have chemo melt down more often then I want to even think about. I guess I will have to see what is going to match my existing breast-I will have to ask my PS if he plans to do my natural breast first so we can try and match that not the other way around.
Waldo: Funny --my PS prefers really natural looking breasts, too! I think I told him in the beginning that I wanted a more natural look but now I just want more projection LOL! Good luck in your exchange and I hope you get everything you desire. BTW: I didn't know that they sat you up during the exchange--makes sense I just never thought about it. I can't wait to see your final results!
-
Can anyone tell me how to find the forum for the reconstruction photos? I am having my PBM July 1st and would like to see what to expect for expanders with 2nd stage implants.
I tried to PM TimTam as directed, but no response for weeks. I did hear she was not feeling well, so I completely understand, just wanted to see if anyone else could pass me the information.
Thanks~
Jen
-
i didn't know they sat you up in the OR while trying the implants until i watched a video on youtube a few months ago! lol
Thats another question for my PS tomorrow! The video i saw was done in the States so cant guarantee thats how our PS's do it here. Things seem to differ so much
Deborah~ what you were saying about textured implants and them causing rippling? Do they not help prevent CC though?And prevent the implant from rotating/moving in the pocket? I'm pretty sure my PS said my anatomicals are textured and i don't want rippling! But i don't want the implant moving either as it will distort my shape with it being an anatomical. I sometimes wish i'd not started finding out more info on implants! LOL The more i find out,the more it messes with my head!
Got my 5th fill tomorrow so may have a bit more info as to where im at and where im going re implants.
Kay
-
MBJ- I read in the OR notes that he sat me up during the BMX too. I asked for a copy of my OR notes and pathology report for my own records and recalled thinking that it was funny and wondering how many people he needed to hold me up when I was under anesthesia, but it does make sense.
-
How do you go about getting copies of your OR notes? I just had surgery to fix a prior recon and that surgeon told me he found things that I was NOT informed of. Needless to say I am not happy and want to see if I maybe misunderstood. The kicker is that I was supposed to have a followup with him while I was still in the hospital getting repaired from his surgery. I did not tell him I was having the redo because at the time I really felt he did all he could and I just needed a change (implants had to go). Now I am mad that I suffered and was lied to and if I call they will want to have a followup and I may loose my temper.
-
BTW this DR was NOT the one that fixed me. It was a prior Dr.
-
Sherry, All you have to do is call the facility's medical records department and ask for a copy. In the patient's bill of rights (one of the many papers that we all sign at every procedure), we have the right and can obtain copies of everything including reports as well as films and slides.
-
Waldo the actual Dr practice or the facility it was performed in?
-
For the OR notes, I would call the facility. For slides, etc. I call, the pathology (or the specific) department of the facility or radiology group and pick them up. I have a huge collection at home of blood test results, MRI's, Ultrasounds, mamograms, if I had it, it's mine and I have a copy. It is strange I know but I prefer it that way. The doctor's practice may get defensive if you ask for the notes, but I believe that you are entitled to a copy of your chart as well.
-
The flip side is that there will be a lot of information that you may not understand or may scare you and there will be a lot of terms used that you may not understand.. But after having cancer, there isn't that much more that can scare us and technically your medical records are yours.
-
Thanks! I am so nonconfrontational. BUT I am going to call.
-
I got a copy of my OR notes from my doctor. I think they have to give you a copy if you ask.
RE: textured and anatomicals. I believe textured is a must with anatomicals because it DOES keep the implant in place. I have textured and no rippling, for what it's worth.
-
Kay - No, we are referring to textured ROUND implants. The anatomical implants need to have a "textured" surface in order to avoid rotational problems. The texturing on the ROUND implants is much more pebbled - an entirely different issue...for you...not to worry about the anatomicals...
-
whippetmom- I am finished with my fills and am waiting for exchange surgery on 6/29. I just noticed that one of my breasts is larger than the other even though they both got the identical amount in fills. My PS is not over expanding me by very much at all so I was wondering if this matters. Do I need to do a little fill on the breast that is smaller or will the implants take care of that?
-
Kate: As long as it is around 25 ccs or less - the discrepancy - that should be compensated by the implant. If you think it is more than this - around 50 ccs - I would go back in for a fill. You just want to make sure your PS does not need to go down in size bilaterally, simply because one pocket is smaller than the other. But if it is minimal and only to your discerning eye that you see a difference, then do not worry about it. I just like getting as much symmetry as possible - especially for the smaller, thin framed gals - so that one pocket does not dictate over another which size implant is used at the time of the exchange. Because trust me, the PS will always err on the smaller side, which is not the way we necessarily want to go. Make sense?
-
Lilah: Which style of the 410 did you get? Do you have some upper pole fullness with that implant?
-
ocjen: I am going to respond with judgejaclyn's response to someone on Exchange City. It was said so eloquently:
"The picture forum is a different site. In order to protect privacy of ladies who post and bare all there - it is an informal "directive" that you should have been a member on this site first - and that you post and share somewhat regularly. It makes sense really. The goal is to keep the site for its intended purpose - that is to support and encourage one another. Once you have been around a while - you can gain access by contacting TimTam."
So spend more time on the forums posting - on other threads - so that we can get to know you. Timtam will be looking for your posts.
-
Waldo - you just made me giggle - wow that feels good during this process. I think if I gave my PS a playboy pic he would pass out! He is shy and blushes easy. That is why I am giggling more. I get a fill at 4pm today. I will probably still be thinking about this and won't be able to sit still laughing in side! It really is a great idea.
-
Deborah~ PHEW!!! Thanks
-
Kay, I am visual and the PS was asking me what type breasts I want to achieve, Just to make sure we were on the same page, I figured a picture is worth 1000 words. He still refers to the picture-5 weeks later so at least he and probably his other doc and PS buddies got a good chuckle.
-
whippetmom- Thanks for the response. I think, based on what you said, I'm going to try to even things out. I don't want to be locked in to the smaller implant. My PS lets me do my fills at home (my DH does them, not me) so I'll do a little bit more on the small side. Thank you so much for your input!
-
Deborah -- I have the Allergan 410 MX 685.... so medium height, extra projection. The slope, on me (I'm 5' 3" and need to lose 20 pounds), is completely natural in the upper pole... nearly identical to my remaining natural breast (perhaps slightly fuller but noticeable only if you are obsessively staring, which I try not to do
-
Lilah: Sounds like that moderate height extra full projection is the style of choice. I sure would like to see what that full height/extra full projection looks like on someone though - someone with a nice, long torso I am thinking...
-
Kate: Well, absolutely! If you are doing this at home - even up those puppies this week!
-
Deborah -- yes, I think a long torso would work well with the full height. I suppose the full height could have worked on me as well (if I wanted really bodacious breasts) if it weren't for the fact that I'm a uni... so I was looking to match my remaining one, which though large was apparently medium height
-
Deborah,
I am scheduled for the exchange morrow morning and had a chance to talk to my PS. He suggested the mentor memoryGel implant,high profile and maybe a C cup or bigger. He told me that i have more than 350 cc on the TE'S ??????? Will keep you updated and thanks for all your help!
-
mimi....I will have you in my prayers tonight...Send me photos this weekend...
-
Deborah,
Do you think i'll have the bandages out by the wknd ?? If so, you will be the first one to see .
-
LILAH, WHIPPETMOM; Hi! My TE's have a 13cm width so my PS told me that my choices for 410 gummies were either the 410 gram or 445g, as these are the two closest to same width (13cm and 13.5cm). That would be mod height and extrafull projection=MX. He said he would also bring to the OR the 450g full height that has the same width of 13cm.( Actually the 495g in FH is 13.5 but he didnt say he would bring that?) Interestingly, or actually confusingly, all four of those have projection of 6.1 ( the smaller MH) or 6.2cm(FH). I am 5'4". Or actually, I was- I've shrunk a bit and feel like the Arimidex is accelerating my shrivel. The PS said he was pretty sure the full height would be "too high".Hope that helps people (not you, two, since you already know way more than I do) who are thinking about the gummies.
But a question for Deborah, if the 13cm width seems about right...looks pretty good when I push my TE's midline to a more normal amount of separation, fits well in my old bras, does that mean that I need to hover around the same diameter for the implants? Is there some "formula" for chest circumference:TE diam; implant diam or does the PS just "eyeball" it? (We hope they have good eyeballs!) And how many cm. actually is a little or a lot in this regard? What if I got round silicone instead... Would the 13cm still be my #? In the style 45's the rounds from 550cc to 650cc all have the same projection, around 6.1or 6.2. The 650cc is the one with diam 13.2. Would the rounds still "look" like more projection even tho listed as same as gummies?
OK. sorry. Maybe too many #s!! Thanks, Deborah
Lilah, I missed you while you were away. I wasn't worried...knew you were off having fun!
-
Jerusha -- my PS said that the extra grams in a full height is all upper pole... which makes sense if you think about it. I'll let Deborah (she is the REAL expert) answer about the width... and aw thanks for missing me!
-
That interesting about the full height and moderate height. Now,im not sure till i go to the hospital for my fill later,bit i was looking on the Allergen pdf catalogue, and the full height extra full projection didn't seem to be as full lower pole as the MODERATE height XF proj. This was judging by the profile picture of the implants.
If my PS is thinking of Moderate height for me, i was going to ask for the MX but then if the extra grams in the full height X projection is in the UPPER pole,then that might be what i need to keep some of my current TE 'cleavage'.
Any thoughts?? or am i getting confused!
-
well i just got back from my 5th fill.
Up to the 390ml mark now =D
I found out that my PS uses Allegen implants and i asked if it was the 410's and he said yes.As regards to what size i will end up?We have no idea.He won't even guess right now as it all depends on how much my skin will stretch. He said that at some point the skin will STOP stretching, and the TE's will start pushing INWARD onto my ribs,causing them to dent and therefore defeat the object of carrying on with expansions, as the implant will then be filling the dent and not making me look any bigger.
I have another fill in 2 weeks time but will be seeing my female PS and she is more likely to halt fills sooner than my male surgeon i think.
I asked what height implant they're likely to use,and again,he really couldn't guess as we just have to see how the fills go due to the radiation.
I also asked what kind of size i may end up compared to how my TE's looked.He said to get a 500 implant i would need to be stretched to around 700 and that will never happen.My own tissue weighed about 180grams each side.And i lost some skin in the Mx also so they have less to try and stretch. so if i get up to 450ml with my TE then it looks like i may only get something like a 300 implant
.He said he knows that i want to get as large as they can do,given what they have to work with,so at least they DID listen! lol I forgot to ask what TE they put in (doh!) but he assured me i will have an appointment to see them BEFORE my exchange,to discuss what size i can get to and i will have some imput to an extent~but they can only do what they can do. Fair enough i guess. If i can look how i looked before this fill (at 330ml) when the implants are in,i'll be happy! But im not telling THEM that incase they can go bigger!
I'll take some photo's and update my thread on the pic forum shortly.
i've not looked at the video we took of todays fill yet,but will do so later.
-
Kay -- my PS did a similar thing (expanded my TEs to 850! but put in a 685). What I did was make a note (and take a picture) of how I looked when I was expanded to around 650 so I would know about how big I would be... then I told my PS: bigger is better
She luckily agreed and when I went in for exchange she knew I wanted the 685 and she was going to try her best to get it into me... but there was a chance it would be too large and I knew I might end up with something smaller. I was so happy I got the 685 in the end. If you are feeling pretty happy now with the size of the TE that is great! Means you have wiggle room As for your question about the full height giving more cleavage like the TE, that is possible. You should find out what height the TE is... and what width. It will give you some idea of what your options will be and you can browse the Allergan site for similar width implants (for example). That's what I did once I knew the model/size of my TE. -
i did ask my PS about height/width of implant etc,but he just said he couldn't say yet as it really depends on how much more i can be stretched.They will decide once i've reached my limit with the Te's. Makes sense i suppose,as they could say 1 thing now but have to decide on something else later.
I mentioned bringing the pockets closer together if possible and he said not to get too hung up on how things look NOW,as you very rarely get symmetry after the 1st surgery(BMx). He said anything that needed tweaking would get done during exchange.
I asked about the possible rotation problem with me being sporty and training in Tae Kwondo,and he said there is a small possibility that the implant could move,but thats why they dont have a HUGE pocket and a small implant. i then asked him that given my sport,would he still opt for anatomicals instead of round,and he said yes because of my build and the bonyness of my chest.Rounds would look like 2 balls stuck to my chest.
so i'll just have to wait and see what size my TE's end up,and then wait for my pre-op appointment to discuss the implants.Should only have to wait til Sept/Oct! lol
-
Kay -- it sounds like your PS knows what he's doing
It's good to have the info you get here -- it helps explain stuff (I think) when you are talking to your PS... I'm sure if you express to him your desires (how big, how much cleavage, but also desire to do sports, etc) he will do the best he can for you. There are limits to what you can have based on how much your muscle and skin is willing to be stretched as well as your basic size and shape, etc. -
Mimi: You should be able to shower by this weekend, [3 days post-op is about right] and so you should be able to see your results and get some photos for me!!!
Jerusha: I like the idea of tweaking at least just a couple of millimeters into that implant beyond the 13.0 cm width of the TEs - just to make sure there is no laxity which might cause some lateral rippling. If you decided to go with smooth round silicone, I would select the Style 20, 550 ccs for you. You have to throw the whole projection dimensions created by your TEs out the window when it comes to the exchange. The reason for the increased projection in the TEs is to stretch out the portion of the pocket which has the mastectomy defect. To get as much stretch as possible so that you can have safe closure over the implant and also, in the PS' mind, to get some natural droop or "ptosis" after the exchange. I would personally be a candidate for the Style 45 650 cc implants, because my implants sit lower on the chest wall, I have some extra laxity with my skin, and I also have a longer sternal notch to nipple distance. However, I also would be carrying around an extra 100 ccs, and so that is a factor I really have to consider, if I ever want to exchange down the road. Additionally, I would be carrying around 100 ccs for the same bra size I have currently. So it really depends on whether your torso can handle the extra height and where your pockets are situated on your chest wall. Go look at my photos and note where the TEs were sitting and where my implants are now seated on my chest wall.
Kay: In looking at your photos, I think you could easily handle the full height implants. However, you sacrifice width for the fuller height. With implants - after breast reconstruction - we need width to help with cleavage and width to help fill up the bra cup. If it is all height - all upper pole fullness ABOVE the bra cup - it is not filling up the cup itself. Make sense? And you need the width in order to get the implants closer together - bringing them in medially towards the sternum.
-
ah that makes alot of sense Deborah.So to get my desired cleavage (or close to it) and in order to get my implants closer together,i would be best to try and ask for the moderate height?
As for which projection i am "allowed" to have.....i guess thats the bit that depends on how much more they can stretch me.It sounds like they will be reducing the implant size a fair bit compared to the TE size.I will just keep pushing for more and more fills till they say "WHOA!WE NEED TO STOP!" LOL.
-
If you are limited to size, I would go with the moderate height anatomicals. If you could get the same width as the moderate in a full height anatomical, I would opt for that one. But that means more volume and I don't know if you should or would be able to get to that point. Since you need to overfill so much, I don't think it sounds plausible. So yes, I would opt for width over height. A common complaint many women have after reconstruction is not being able to fill out the center portion of a bra. The extra width of the implant, with the right bra, compresses medially and this fills in the gaps and provides cleavage.
-
Kate33 - I too, feel like one side is bigger than the other. My left side, to me, looks larger. I have fills on Monday, so I'm going to ask about it.
-
Is it bizarre to show up to my last fill wearing a bra I just bought so the PS can see that I need a top off . . . not quite filled to capacity? I've always been wearing a hospital gown but I really need to wear the bra so I can show he exactly how shy I am from a full B cup. Bizarre? Or not unusual?
-
Deborah.The xchange went fine and i very very COMFORTABLE , PAIN FREE..and glad that i got rid of the TE's.What a big difference... Will send you pic on sunday and can tell me what you think coz they are wayyyyyyyyyyyy smaller than the TE,s. Will see when i take off the bandage.
-
Dawne-Hope- I'll be curious what your PS says on Monday. Doesn't it seems strange that one is smaller when they both got the exact amount in fills?
-
Deborah~ yes i think i will see what they say about getting the moderate height. Took another look at the Allegen pdf last night and looked at the dimensions of the MX and the MF. Depending on what width they will be able to put in (not sure what width TE is in) ,if i get the MX,id like to be able to go for the 325gram which will give me 12cm width and a 5.7cm projection.If i have the MF then the 335gram giving me a 12.5 width and 5.1 projection. I'm not even sure they can even go THAT big with the implants.I'm figuring if i can get to 450ml with my TE,from what he was saying about having to go much smaller with the implant,i'll be lucky to get an MF 295gram or an MX 290gram.
I am hoping that the 325/335gram options will be my MINIMUM! What do you think?Im pretty sure its a moderate or mid range profile TE thats in now,with a 300ml/cc capacity.I am really leaning toward the MX 325 so i hope my PS can oblige!
-
Deborah~ yes i think i will see what they say about getting the moderate height. Took another look at the Allegen pdf last night and looked at the dimensions of the MX and the MF. Depending on what width they will be able to put in (not sure what width TE is in) ,if i get the MX,id like to be able to go for the 325gram which will give me 12cm width and a 5.7cm projection.If i have the MF then the 335gram giving me a 12.5 width and 5.1 projection. I'm not even sure they can even go THAT big with the implants.I'm figuring if i can get to 450ml with my TE,from what he was saying about having to go much smaller with the implant,i'll be lucky to get an MF 295gram or an MX 290gram.
I am hoping that the 325/335gram options will be my MINIMUM! What do you think?Im pretty sure its a moderate or mid range profile TE thats in now,with a 300ml/cc capacity.I am really leaning toward the MX 325 so i hope my PS can oblige!
-
Deborah~ yes i think i will see what they say about getting the moderate height. Took another look at the Allegen pdf last night and looked at the dimensions of the MX and the MF. Depending on what width they will be able to put in (not sure what width TE is in) ,if i get the MX,id like to be able to go for the 325gram which will give me 12cm width and a 5.7cm projection.If i have the MF then the 335gram giving me a 12.5 width and 5.1 projection. I'm not even sure they can even go THAT big with the implants.I'm figuring if i can get to 450ml with my TE,from what he was saying about having to go much smaller with the implant,i'll be lucky to get an MF 295gram or an MX 290gram.
I am hoping that the 325/335gram options will be my MINIMUM! What do you think?Im pretty sure its a moderate or mid range profile TE thats in now,with a 300ml/cc capacity.I am really leaning toward the MX 325 so i hope my PS can oblige!
-
oops i posted the same post 3 times somehow earlier!
-
Deborah, I was told I can shower today, is it better to take off the surgical bra, change to something softer and wait another day before showering?
-
Deborah,
I told you before that nurse told me the doctor can predict cup size by the amount of ccs. When I asked the doctor he said he can't do that because every person's body etc. is different. He will do "fills" until he thinks I look good to him, and then I can add or take away depending on what I want. So, I think I have more trust in him than before - you were right - they can't predict cup size!! I asked the nurse about the TEs, she said she sent 400cc, 500cc and 600cc with him and she would check the chart for next time and let me know - I will find out and send my measurements to get your input when I get closer to being done. I am at 230 cc now and PS wants to wait 2 weeks for next fill. Thanks for your help!! And too funny about the pine needles!!
Valerie
-
i have put my 3 lymphedema videos which i took yesterday,on the "Lymphedema After Surgery" section. Apologies for the wobbly camera work! I think my daughter must have been trying to swat a fly! LOL
-
Kay: I also hope your PS can take you to the 300 cc range. I think either the MX or MF would be fine for you - but probably the MX over the MF, for your frame and torso. Just make your desires known about being in the "300 Club"....that is about all you can do, short of taking your PS hostage and risking jail time.
Valerie: There you go. Cup size, schmup size.
Waldo: Shower today. Be gentle. Are you supposed to put the surgical bra back on? If your PS instructs the surgical bra be worn until he sees you for the post-op, it has more compression than a soft bra at this point so it is advisable to keep wearing it.
Mimi: A lot of what you are seeing is compression by the pectorals, which is why they also look so small right now. What size implants - style, etc., did he use?
-
mantra: Well, not bizarre, but youur TEs are not shaped like implants which are pliable and can mould and fill a bra cup and your PS might likely use that premise. But with that said, your implants need to be larger than your expanders in order to get sufficient volume. I think that you can SHOW your PS this, stating, "if I cannot fill a "B" cup with my expanders, how can I hope to fill one with my implants?" See what he says. Do you want to go over your numbers again with me before you go through the exchange surgery?
-
Deborah: If the implants need to be larger than the expanders, then why does my PS think we need to expand larger then the implant size? I am at 355 cc's which will put me around 425-450 cc at my next fill on tuesday. He did say to bring in a bra, which I will, to my appointment. I bought the Warners soft cup 36C. I was thinking this could be the last fill until my exchange.
Kay: Since I don't have a choice in the matter, I am hoping mine doesn't look like two balls stuck on my chest! It does sound as if you are in good hands. BTW: My one post also became three by accident on bc.org!!??
mimi: Congratulations on your exhange.
-
MBJ: Implants larger than the base, recommended fill of the TEs. Overfill does not count. So your TEs are less than 500 cc TEs, right? Your PS does not think in these terms though. Overfill is just getting some extra "oomph" with the skin stretch.
-
Deborah: Yes, my TE's are 400 cc's which he plans to overexpand. So if we expand to 450 is this considered overexpanded or do they expand even further? He also does a small expansion in pre-op.
Mayr
-
Yes, this is considered overexpanded. They CAN be expanded further, but do they NEED to be expanded further? That is the million dollar question. If your skin has stretched sufficiently, you should be fine with a 500 cc implant after being overfilled to 450 ccs.
-
Deborah: Can I go with the Allergan 45's? That would be 650 cc's but the width is slightly wider (13.2) compared to 13 and projects a bit more (6.2) compared to 5.6. Or would I be better with style 20 High Profile 20-550's which are 13.5 x 5.6? I also looked at the Mentor High Profile 350-5004 BC which is 13.2 x 5.3.
Thank you!
Mary
-
Your PS is not going to go for the 45's in 650 ccs. I can almost guarantee it. Once again though, your height and weight? Do you have a long torso? Let me go over your numbers again...
-
Height 6' weight 156-158. Pretty balanced but I am 2" longer all over not just in the torso. I also have the bony chest thing so we don't want the step off and of course matching my other breast with an implant. I figured I would get the ball on the chest look with the 45's but a girl can wish, right?
-
The style 20's go to 550 and the Mentor to 500 cc's. My ribcage is 32".
-
That is right - you are a unilateral. No, I would not go with the Style 45.
I think I have told you previously - 500 ccs, right? The problem is, you do not want the implant to be too round and tight in that pocket, because, as a unilateral, you need that extra stretch to get more natural droop. So your PS is going to use the implant which gives you symmetry with the newly augmented natural breast. It is entirely different than an approach for a bilateral.
-
That's what I was afraid of. Only the Mentor has 500 cc's. My PS was originally going to go for 350-375 cc's but I wasn't buying it. At least he knows I want to go larger. Thanks again for your help. I really wanted to do the 410's but I am not able to go to that dr.
-
MBJ: Hmmm? Mentor also comes in 550 ccs....the HP style? Is that the style you are thinking about? It comes in 550 ccs in the moderate plus profile also...
-
Deborah: I didn't think that I could go that much wider then the expander! I will just have to let him know that bigger is better, unless it looks horribly wrong. Thanks again!
-
Deborah~
hmmm....now there's an idea! Taking my PS hostage for a bigger rack!!!! Tempting.......
If i can get into the "300 club" i will be happy (i think). I will keep my fingers crossed for the 325/335 grams! But if i have a 300 TE,does that not mean he will HAVE to go for one in the 200's if he insists i have to have a smaller implant than TE? Even though i hope to be filled to 450? I am hoping that when they do the pocket work and bring them over more toward the middle,this might give me that extra bit of width needed for the bigger implant.As long as they don't then stitch the outsides up to compensate for moving them inward!!
I will ask this when i go for my pre-op appointment nearer my exchange.I want to know if they extend my pocket inward,will that give me a bit more room to take a wider implant.
I just hope they don't stich me up~in more ways than one!
-
My fills are done. I am slightly bigger than I intended but I do not mind that too much. How much smaller do you tend to look with implants? I kinda loved the size I was before my last fill of 70 cc. I am a large boned girl but pretty trim in my torso (lets not go into the lower region for size info!). I am still afarid of being too small.
Deborah- is it reasonable to expect to be only about 70 cc smaller? I really trust my PS and I look good in clothes even with my TEs but he was a little short my last visit and I felt rushed with my questions. This is unusual so I am guessing just a bad day and I can ask all my questions at my next consult. But that is when we'll make final decisions before exchange and there won't be time to fact check with the expert(Deborah). He did say I won't need a bra 24/7 after exchange because I have great cleavage standing up. They do separate about 21/2 inches when I lay down or raise my arms, but upright the girls look great. Just starting to get nervous and excited about exchange. Can we go over my numbers again Deborah?
-
MBJ: The key is: You do not want to go much wider, if wider at all, than the natural breast. You want an implant to match the width of your natural breast. Whether that is an HP or a MPP - I do not know. Your PS knows....and he is going to select the volume of the implant and the style of implant, in an effort to gain symmetry with the natural breast. It might NOT be 550 ccs...it might be less...
-
Kay: It sounds to me as though you are pretty vocal with your PS about what you want. So I think you have probably communicated what your desires are and hopefully, expanding you to 450 will allow him to get you into a 325-355 gram implant. It certainly sounds to me as though this is entirely possible.
-
Tamgam: Yes, give me your details again.....you had an LD flap, didn't you??? So that is going to factor here.
-
Kay: I just imagined you taking your PS hostage! So funny. I am crossing my fingers you can get stretched to 450--I am hoping to be there by Tuesday. I am thinking you are going to look amazing no matter what. Have a great weekend!
-
Deborah: I guess I have to just have alot of trust with my PS going in that he will not only match the natural shape but also make them larger. Thanks again for all of your help.
Have a great weekend!
-
Deborah, thank you for all of your help and patience. I posted my pics. Despite my best effort at communicating to my PS my desires for more projection and less width and cannot help but wonder how the larger projection and narrower implants would have looked, he put in the Allergan 15's 421 cc Although, on my frame, I think they look pretty large & full. He did the lift as we discussed. He and I also discussed sizes beforehand, and I told him I wanted Allergan 20's. He commented on their fuller projection, He is definitely not a breast man and I think it was hard for him to make me as large as he did. It's hard to tell how they are going to end up looking but it's only been 2 days. Now I have to wait for the drop and fluff cycle to kick in. I don't want too much drop so I'll be in a bra 24/7
-
waldo: Beautiful! The flap donor sites are just spot on perfect for creating your nipple/areola complex. I think you are going to be very happy! I am very pleased!
-
Deborah, I still have no idea on what size or implant he used... I tried asking him before the surgery and he could not tell.All he said was "will do my best". To make it worse, he was an hr late for the surgery and everything happend soo fast . The next thing i remember, was in the recovery room and by boobs looking smaller than the original.Danm! I hate it!! Next appointment I have with him is next friday and hope he will be able to give me all the details regarding the implants.
-
Mimi: They WILL change. Give them time...
Send me photos this weekend. Monday, call his office and ask for the implant details. By law, the information MUST be posted in your chart.
-
Thanks a lot Deborah. You are an angel and don't know what people like me would do without you!
-
Deborah, I echo Mimi, thank you so much for your kind words, patience, humor and support. I feel as though you have been there alongside me holding my hand thru this entire process helping to identify and encouraging me (and everyone here) to get the results we truly wanted.
-
(((((MIMI)))))
((((WALDO))))
-
Hi Deborah,
Here are my numbers: 5' 2", 114 lbs, ribcage is 30.5". My TE are Allergan 133 MV 400cc. One is filled to 440 and one is 420. She will be using the cohesive gel implants.
I went shopping for some new bras because I was tired of wearing sports bras. All my old ones that I wore before surgery had underwire and I was told I couldn't wear them. I picked up a new wonderbra 2404, (no underwire), size 34 B. When I tried it on, I saw that my TE didn't quite fill the bra. So I made an appointment to get another fill next week . . . hence the question "is it bizarre to have her see me in my bra so she could she how much more I needed to be filled?" The width was fine; it was the projection that was shy.
Thanks!!
-
Mantra: When you say "cohesive gel", in the U.S., for us this currently refers to the standard round silicone. You are in Canada, so I think you might be referring to the gummy bears or the "TRUE" cohesive gel implants, right? Does your PS have access to Mentor CPGs as well as Allergan 410's?
-
Mantra:
If the Allergan 410 is used, and if your PS has created the pocket specifically for the 410, your numbers are as follows:
TE: 13.0 cm width by 12.0 cm height by 5.6 cm projection. You could have up to 5.8 projection currently, with the overfill.
Allergan 410 MX: 410 gm
13.0 cm width by 12.0 cm height by 6.1 cm projection
Allergan 410 MF: 375 gm
13.0 cm width by 12.1 cm height by 5.2 cm projection.
I suppose your PS could use either of these two styles/sizes. You can certainly tell her you would prefer the implant with the higher projection.
-
Hi Deborah,
I know that she said the shape of the cohesive gels are anatomical so I guess they are true cohesive/gummy bear??
Mentor and Allergan are available here but I know that she said she uses Allergan. I will speak to her about 410 MX. Given the projection you stated above, I think this is the route I will want to go. In my mind, I want to be the size I was before the mastectomy. However, my left breast was removed last year and it was noticeably larger. She was not involved in that surgery and only met me post op. Therefore, her measurements have all been done on my right side just prior to my second mastectomy.
Geez, it takes a wealth of knowledge to know what you want when you get implants. Way more than I ever thought possible. I'm glad to know by what you said, my decisions have all been narrowed down to two possible implants. Am I correct in saying that since my current projection is likely 5.8 and I find it lacking, than the 410 MX is probably the implant for me?:
-
Deborah: Since they started the Foobville site, I think you are our only hope here! So ditto what Waldo and Mimi said. You are a godsend and I don't know what I would have done without all of your help.
Waldo: They did an amazing job with your surgery! I am sure they are only going to look better. Is it actually possible for a breast surgeon not to be a "breast man"??!! They are beautiful!
-
Waldo, I agree with MBJ -- I think your PS must be a closet "breast man"!!! You look really fantastic!
-
Deborah~ keep your fingers crossed for them 325/355 puppies!!!!
I'll cry,stamp my feet and throw myself on the floor in a hissy-fit if they say any smaller!! LOL
MBJ~i have the duct tape and gag ready for my PS if he denies my 'big-boobie' request! Only thing is......i have TWO of them to kidnap! (I may need an accomplice!)
-
Jerusha, He's gotta be a leg man- no way is he a breast guy, He likes delicate and natural and seems to love that natural droop. Honestly, I think it was really difficult for him to make me as big as he did. He told DH he put the biggest ones he brought with him to the OR and they were only 421 cc. I think his vision for me was a mid profile 300 something implant. He knew I wanted bigger, fuller and perkier. I think if he went smaller without more nip and tucking, I would have way too much rippling.
My problem is he is out of my insurance network and my out of pocker expense is going to be astronomical. I received the EOB from my insurance yesterday and my out of pocket (according to that) is a lot more than what I was told intially by his office's financial/ insurance specialist, These foobs may be a huge expense and more of an investment than I would have liked. I may need to find someone new to do nips and tattoo who is in network unless he decides to accept what BC/BS pays, It's a shame b/c I think he does nice work. I may need some of you NJ or NYC gals' recommendations for nips & tatts ladies!
-
hi my name is stacey and ive been lurking here the past few weeks. deborah u seem like an invaluable resource! i was hoping you can offer some advice. i just had a left mast with te 4 days ago and im feeling good. i have a cups and definitely want to be a c cup. im 5 feet 4 inches and 105 lbs. ribcage is 29 i think its hard to measure under this surgical bra. i used to wear a 34 a bra. dr. disa inserted the allergan 133mv-12 with 300ccs. is that too low? i want the high profile smooth silicon rounds. oh on day 2 after mast a 1 inch sized purple spot appeared on my incision line closer to armpit. doc assistant said this is thin skin and not to worry it should slough off. do u think this might affect how large i can expand? thx sooo much
-
stacey: Your TE style and size is just fine. I am perplexed about your ribcage to bra size though. Either your ribcage is larger or you have truly been wearing the wrong band size. You should be wearing a 32 band. But that aside, I think that 400 ccs - in a smooth silicone high profile round implant would be just about where you want to be.
The caveat here is this: Your skin integrity will dictate how far you can go with expansion. I also had that little odd patch after the surgery - after my first fill - the hallmark of thin skin. But my pre-MX size was larger than yours. So let's see how your fills progress and take them slowly and minimally - this is preferable. Let's see where you are once you get close to the 300 cc fill mark.
Deborah
-
Stacy: I think I already posted this earlier on here, but I am a left side uni, too. You are in great hands with Deborah the breast whisperer--she will provice you with excellent advice!
M-Star: I would love to help you kidnap your dr's and hold them for ransom so that you can get what you want! It sounds like a hoot! We are both tall and you are incredibly athletic so we could easily overpower them LOL!!
-
This is where Kay's tai kwan do should come in handy...or is it Taekwando?
-
Stacy: I just read MBJ's comments to you and I realize that I missed that you are a unilateral. So I need to revise my recommendations, based on the fact that Dr. D will be considering an implant which will give you symmetry with the natural breast. He based his choice of TE upon the width of your native breasts. It depends on what size of implant he uses to augment your natural breast....how much droop he needs from the MX pocket to match the natural breast. So it is safe to state he is going to remain in the 12.0 cm width with whatever implant he chooses, but then that could even be a 350 cc in a moderate plus profile style. I think you need to discuss with the PS your goals to get into a high profile implant with a 12.0 cm width. Based on your current A cup bra size - it tells me that you are very likely going to get a perky rounded look with an implant in the natural breast, because you have no droop in that breast, right? And there is very little tissue and so the high profile could be the implant which would work best for you. However, discuss this with your PS.
-
Hi Waldo, I'm not even at exchange yet (11 days, but who's counting...), so I do not have anything useful to say about nips,etc. I go to MSKCC, despite living 5h away. It is such a vast place, with patients from all over the world, that I would guess they take as many insurances as anywhere. I never had any issue with mine. In fact, the hospital took care of EVERYTHING. I never made a single call -- to them, or to the ins co. I was so crazed I actually didn't even think about it. I literally just showed up the AM of my BMX and signed in. A few weeks later got the (astronomical, of course) bills and everything was fully paid. Thank goodness!! I feel very fortunate. Please PM me if you want the details of who I see,etc. BTW, as I've said before, as far as the nursing care...they should have paid ME! In fairness, I should add that others did not have the same self-service nursing experience. Part of the reason I went there was that I was expecting superior care. They must have run out of room on the breast floor and stuck me in some weird place with nurse imposters, or something. But that was just 24hours. The BS and PS are what really matters.
-
LOL! Yes its tae kwondo! we'll kick ass MBJ!! Be like Thelma and Louise (but without the breasts!) lmao!!
-
Thelma & Louise, LOL! As long as we don't drive off of a cliff at the very end as I am afraid of heights. I want to enjoy my new foobs for awhile, thankyouverymuch!!
-
M-star- I would be happy to fly across the pond anytime to help! I'm not big (5'4") but I'm wily! They won't know what hit them! :-D
-
This is my second time of having breast cancer. My first time was in 2006; however I had immediate reconstruction with a tramflap. This time I'm having an implant, so my PS put an expander in. I go to him(he is the same one who did my other reconstruction) this Tues. June 8, for my first saline injection. I'm really a bit apprehensive since I've not done this before. I was Diagnosed with DCIS; however there was an invasive cancer embedded according to the pathology report. My surgeon said he took 2 lymph nodes for precautionary measure, but there didn't appear to be any cells present there. He said mine was a stage 2a. Not really sure about all of this, my previous in 2006 was stage 0 DCIS(size of grain of sand) this one was 2.5 . My PS told me he would make it symetrical to my other side and would do a lift to the other one. So I'm hoping that all will look good afterwards, but just a bit nervous; not knowing, how long does this process usually take total...he said he would be putting in 60cc every other week and it would take about 5-6 injections???????Hopefully I will find out more from him on Tues.
-
blessedtwice- The time frame can really vary depending on how you tolerate the fills. Some women can do large fills of 100 cc's at a time and zip right through them. Others (like me) have a harder time and have to do smaller amounts spaced farther apart. Also, once you are at your desired expanded size most surgeons will have you wait anywhere from 6 weeks to a couple months before they actually do the exchange. I tried to rush through mine thinking the sooner I got my fills done the sooner I could do the exchange but all it did was make me miserable for months. So not worth it. Also, my skin is very thin so it just made sense to do it slowly. Sounds like your PS is going to be conservative with only 60 cc's each time which is good.
-
blessedtwice~
i only get 60ml at a time and 2-3 weeks apart. I didnt have much skin to 'play' with as i was small breasted naturally,so fills of any more than that would have hurt,and given serious stretch marks.
I would much rather take me time and have less pain/discomfort.
MBJ & KATE~
woo hoo! I have 2 accomplices now! (is that even a word|??) lol
ok...here's the plan.....if i'm not happy with my exchange,we ambush them....bound and gag them BOTH until they meet my demand!! (Allergan 410's MX size 400grams !!! oh and a stack of gold bullion!!!) LMAO! <-----gold bullion is to live on after we move to a country where we cannot be extrodited from!!!
-
M-star- While we've got them can we force them to do a little lipo on my ass and thighs, too? Pretty please?
-
Kay: NOW you are wanting to be in the 400's??? Whoa...
You girls are too much! You are creating quite the hilarious scenario!
-
MStar: With all three of us, we must insist on other procedures!! A little lipo, a little lift and alot of gold so I can buy my home in the South of France!
blessedtwice: I am a uni also and I am tall and small like mstar. My PS put in 100 the first fill, 75 the second, 95 the third. He just does whatever I say that I can take but my skin stretches very easily and I am demanding and greedy as you can see from the post above LOL! 60 every 2 or 3 weeks is fine--if you are concerned about pain ask for a muscle relaxer and have someone drive you there and home. I take one a half an hour before and up until the next day but I have higher fills. They don't really hurt at the time, but mine ache a bit after. I just rub it alot and my DH seems to enjoy it!! I will be posting pictures soon, so you can see how they will try and match my natural with my mx--I am going bigger.
-
Kate33: Since we are both tall and you are petite, you will have to tie up their legs and torture them with the stilettos you have to wear to be as tall as MStar and myself!!
-
Deborah,
Thanks for the PM .You always put a smile on my face.I think they look bigger on the camera than with naked eyes and on top of that, they feel very light. I BET you they are a small C or full B. Hope they will not be a factor when i get back to running .Will give it a week and see if they change .Also, will wait for the PS to take off the stitches before i get fitted for the bra size.
-
LADY'S... THIS IS A TEST FOR BCO....
CAN YOU ALL SEND ME A PM.. JUST PUT ON IT..... TESTING
THANK YOU
-
Kate & MBJ~........GET IN LINE!!!!!!! MY thighs and hips need the lipo!!!! LOL
Deborah~ if i've got them hostage, im going for what i can get! ha ha! Even if that means putting bigger TE's in and grafting skin from my ass!!!!!
-
YOU GO GIRL!
-
MBJ- I don't own any stilettos! How about some kick ass black boots?
-
Went for my fill today and it is the last one. I asked the PS if we could try 25cc's this time and then another 25 in a couple of weeks. She said she didn't think so because my skin was getting too thin. She was concerned if we went bigger and kept trying that I wouldn't heal well from the exchange. *Sigh* I'm a little disappointed. I really wanted to at least try to get to 330. She put in 25cc's and then decided it was too much and she took out 5 So, after 20ccs in each side, I'm only up to 310. I'll be lucky at this point to even make the 300 club. Looks like I'll only be in the 200's. I hope I'm at least a b cup.
I am hurting tonight, so I'm glad she only did the 20. Just wish I could have gone a little bigger. I can't remember if it was on this thread or the exchange city thread that I asked about 'drop and fluff' but my PS actually did mention 'the drop.' My eyes got kind of big and I thought about what you all commented about that .... she didn't say anything about 'the fluff' but did mention that they would 'settle in.' So, in a round about kind of way she acknowledged 'drop and fluff.'
Made me smille and think about you all.My exchange surgery is scheduled for July 19. She said that we could schedule it for four weeks, but after reading your advice on these boards, I decided to go ahead and push it for six. Ugh. I'm hurting tonight even after taking the flexeril. Even though I'm going to be smaller than I wanted, I am grateful that this part is almost over.
Thanks ladies for all your advice!
-
Dawne-Hope
Your MV TEs: 11.0 cm width by 10 cm height by 4.9 cm projection.
Allergan Style 20:
280 ccs: 10.6 cm width by 4.5 cm projection
300 ccs: 10.9 cm width by 4.5 cm projection
Show these numbers to your PS and see if she order them both and see what works for you. They both have lower dimensions than your TEs...
Deborah
-
Kate: A little thing like you and you don't own any stillettos??!! if I weren't 6' tall I would live in them but at my height I would just hit my head walking in the door LOL! Combat boots, eh? I have a completely different image of you now. I thing you really can kick ass!
DawnHope: I hopefully am having my last fill tomorrow and so my exchange should be right around the same as yours. We will have to cheer each other on with Deborah's help!
-
Dawne-Hope
Well there may be a chance that i end up in the 200 club,so we can each other company
Its disappointing i know.
-
i must have bee wearig the wrog size bra! i've got a little bit of sag but ot much (2 years breastfeedig). so i'm a bit cofused - still try to get to 400 cc's?
What does everyoe here prefer as far as the overall look? high profile so called "fake look" or more of a moderate plus look with more volume i lower half? I almost feel like why would i wat the moderate sag look whe that will happe with age ayway?
(Sorry I am missig a key o my keyboard - hope you ca uderstad)
-
MBJ- My DH is also "height challenged" so I stay on the short side. But, believe it or not, I am the tall one in my family out of my sister (5'2"), mom (5') and other sister (4'11")! (I also used to have a Grandma who was 4'10"). It's probably a miracle I'm as tall as I am!
-
Stacey: You missed aspects of my second post to you a couple of days ago:
Stacy: "........Dr. D will be considering an implant which will give you symmetry with the natural breast. He based his choice of TE upon the width of your native breasts. It depends on what size of implant he uses to augment your natural breast....how much droop he needs from the MX pocket to match the natural breast. So it is safe to state he is going to remain in the 12.0 cm width with whatever implant he chooses, but then that could even be a 350 cc in a moderate plus profile style. I think you need to discuss with the PS your goals to get into a high profile implant with a 12.0 cm width."
So the choice of implant - HP or MPP - will be based on gaining symmetry with your natural breast. So you need to discuss this with Dr. D. He will be able to give you some idea of which way he intends to go at the time of exchange.
-
Ladies: I had a fill of 80 cc's today and the dr wants to at least expand to 500-550! It was a bit painful but it looks as if I'm going to be in the 500 club!! Guess I have stretchy skin though it doesn't feel so hot. I guess we will see over the next 2 weeks.
-
Sorry you're hurting MBJ... are you taking anything for the pain? I also found it helped me a LOT to get a massage to my shoulder blade (pain from the stretched pectoral seemed to radiate back to there). Gentle stretching also helps.
-
I am just sitting here massaging my breast. I am greedy, I always want more then pay the price! I couldn't figure out how to post my pics on timtams site. Maybe it's the muscle relaxers?? I resized them and they were still showing up huge. Is it me???
-
MBJ -- you have to "save as" in the new size so that you HAVE it in the smaller size? (Maybe you didn't save it?)
-
whao! well done MBJ! you go for it! must admit...i am a little envious =( but very happy for you!!!
-
My breast or should I say my pec is a bit angry about it all. It's screaming at me right now and it aches quite a bit. We shall see if it's even possible, but I have to admit I am a bit excited.
-
Lilah: I am going to try resizing it on my computer instead of on timtam's picture resizer and start all over again!
-
hi everyone i just got my drain out! yay! dr. said he overfills and will give me an impant smaller than the te. also said he doesnt use allergan 45 but suggested we do the allergan 20 high profile and see how high we can go i said maybe 200 cc,s he said maybe we'll see. if i'm in a 113_mv with 300 ccs and he wants to switch to smaller implant how i will i ever get big tatas?
-
Stacey: Are you on the pictures forum yet? Many of us have implants LARGER than our tissue expanders. There are some who had TEs with 300 ccs and switched out to 400 cc implants. It all depends on how your skin responds to stretching. If it is not too thin and if you do well with fills, you will just have to revisit all of this with your PS and show him the numbers. It all depends on your skin integrity. Go slow with fills. If he overfills, I see no reason why you should not be able to get at least 300 ccs in a Style 20.
-
Hi Sista's! Today is the first day that I found this thread and I am so excited! I have been out here floundering in pain with TE fills and thinking something was wrong with me or I was a big wimp. There is a lot to absorb here.
Whippetmom- the time and effort you put in here is awesome! Kudos to you!
Thanks to all of the rest of you for the laughs!
Well, here's my story (short version)- BMX with TE's May 4th. Came out of surgery with 110cc's, first fill in the PS office was 300 cc's. So painful for a couple of days. 2nd fill, 160 cc's and I was down for the count for 3 to 4 days...thought my sternum was going to rip out of my chest (not to mention the sore pecks). Last week, I went in and he wanted to add a little more - I said "uncle" and I wanted to wait until next weeks check up. Looking at the numbers people are talking about on here, I wonder if mine are just much broader and can hold more? Just confused, but I do know it has been very painful. I nursed 4 children (grown now), but my breasts did get large at that time. Other than that, I am a moderate B cup, 5'8" and 138 lbs.
I'll take any advice anyone wants to give me to get through the rest of this process! Exercises, standing on my head, tap dancing - whatever works- lol!
-
Wow Kimmie -- 300 cc's in each breast in one sitting? I found 100 ccs painful enough and even with that I was down to 60 cc's at a time pretty quickly. So you have 570 cc's now in each side -- what is the goal? What is the size of your TEs?
Gentle stretching, massage (on the shoulder blade was best for me), and advil was what helped me... but also ABOVE ALL what helped was much smaller fills.
-
Thanks Lilah. I am going to ask what size the TE's are when I go next Tuesday. I don't really know what the goal is. PS said, we will know when we "see it". I wouldn't think it would be much more. I'm thinking 75 - 100 at the most. A friend of mine had immed recon at the end of April with some gel implants. She is larger than I am but hers are 750 cc's which she says on her is a large C or small D on her. I would be so content with a moderate C. This is really all still a little Greek for me. I went through chemo treatments which began in Jan. Sad to say, but most of my research previous to now really involved diagnosis, chemo and an action plan. I just thought all I had to do was decide on was BMX and Recon. It's just been a really fast roller coaster, but I'm sure that holds true for most of us.
-
Absolutely Kimmie... I think if you reread the info requested at the header post for this thread, once you have all the info gathered Whippetmom will be able to help you. But she does need to know the model #of your TE -- which you can get by asking your doctor.
-
Deborah -
I got the information on my TEs. They are Allergan Style FV133, fill volume 400cc. (Which on Allergen's site is width 12 cm, height 12 1/2 cm, projection 5.3 cm The nurse said she sent 400cc, 500cc, and 600cc with to the surgery - I wonder how he decides which to use?
My information: I am 49 and had nipple, skin sparing masectomies on May 6th.
Height 5' 4" Weight 120 pounds Ribcage 31 inches Filled to 230 ccs after 3 fills.
I was a nearly A before and was thinking I would like to be a full B or small C - what do you think?
Thanks for you help -I soooooooo appreciate it.
Hugs, Valerie
-
whippetmom wrote:
K - Ohh...I think I want to send you to the top of the class! You are a very good student! LOL! Yes, I think that 650 ccs in Style 20 would be just about ideal for you. You know your skin integrity and I feel quite confident that indeed you could exchange out to this volume of implant, especially based on your 20% overfill status. I think you have to put this number in your PS' head and let him know your convictions about size and volume. If he is "conservative" as you state, he might not be movable to this volume of implant. You need to see where his mind is with this number. I have had some women come to me just this week, disappointed with getting implants with significantly less volume than they had "agreed" upon with their plastic surgeons. I think that he has to feel confident about that 650 number, and this is something you should know prior to going in for the exchange, so that you can know whether you need to manage your expectations. You need to know what number he feels confident with....prior to the exchange.
__________________
just an update for Deborah had exchange today and he used style 20 750cc's
instead of the 650's we had discussed much better than going smaller ..he said I was his first paitent ever who told him what style and size and he wanted to know where I got all my info so now there will be a new lurker..lolNow I have to wait till Wed for the unvailing :-)
thanks again Deborah for all your help to all the lovely ladies here.
-
LOL Kw -- a lurker! I love it. Deborah -- you're causing ripples in the world of plastic surgery!
-
yeah I think he was a bit befuddled with my talk of SN-N measurments, upper pole ect ect and wanted to find out what info his patient was reading . They only have so much time to spend with each paitent and I know he doesn't discourage being informed just wants to make sure it's not like some of the sites with BAD info.
-
Valerie: 500 ccs in a high profile smooth silicone round sounds like a good choice for your frame. I would not go much smaller than that - so I hope he errs on the 500 - 600 cc side of the implant spectrum for you at the time of exchange.
kw26: Thank your PS for me for being so darn cool about making sure you were happy with the size of your implants. I was not expecting 750 ccs...but if they are appropriate for the pockets and look good on your frame, I am very happy. I hope you will email me photos or post them on the pictures forum. Congratulations!
-
Just a note..
If there are any rads/implants ladies here.. I wanted to let you know that my rads breast DID drop about 1/4 .. WAHOOOOOOOOOOOOOOOOOOOOOOO
Now the non rads breast is only 1/2 inch or less higher that the rads breast!
Radiated breast with implant almost NEVER drop and fluff.. so this is a small but happy milestone!
-
Wahooo Laura!
-
Go Laura, go Laura, go Laura!!!!
-
Deborah -
So if my expander holds 400cc and you think I need 500-600cc implants does the PS need to expand to 500cc? or will they fit if expanded to 400cc?
Thanks, Valerie
-
Valerie:
It sounds as though your PS intends to overfill your 400 cc TEs. If the nurse ordered 400s, 500s and 600s for the exchange [I presume you meant these were the three sizes of implants he ordered, right??....or were you talking about the size of TEs he was considering prior to surgery???] then he probably does overfill. If you have pretty good skin flaps with expand nicely and stretch out nicely, exchanging to 500 ccs or 550 ccs would be doable, especially if he does overfill.
Clear up that comment you made previously about the nurse ordering 400s, 500s and 600s...
-
Deborah -
It was TEs that the nurse sent in 400s, 500s, and 600s for the original surgery. So he put in the 400s. Don't know if I have good skin flaps - was not quite an A cup before surgery, if that is what you mean by flaps. I only have 230ccs in now, next fill next week.
Thanks for your help,
Valerie
-
Valerie: I just went back a couple of pages and saw your first post with your vital statistics. So....475 ccs or 500 ccs might be as much as would be feasible then. It all depends on your skin and how well it responds to expansion - and also it depends on your plastic surgeon's willingness to use implants larger than the expanders. Let's see how your expansion proceeds and how well you do with fills. When you get to 400 ccs, let me see your photos and we can discuss this further. I think it is important to communicate to your PS that you would like for him to expand you out as much as your skin can safely tolerate, as you would hope to be able to exchange out to around 475/500 ccs. See what he has to say about this. Find out early on in the process what is in his mind...what his plan is for you....what he is willing to do for you....
Your skin will tell us what is possible. So take the fills slowly...
Deborah
-
I had an interesting chat with my PS, which provided some info on sizing of 410 gummy implants. Approaches may be idiosyncratic and vary from PS to PS but this explanation made a lot of sense to me. Unlike regular round implants where the size may be partially dictated by the woman's wishes for size/fullness/projection of the final reconstructed breast, the gummy implant size is a surgical decision. The implant must fit just right in the pocket. The pocket size has been determined by the TE size, which has been derived from the chest measurements and individual body habitus. The implant does not smoosh very much, so if it needs to be crammed in during the insertion process, it will both lose its nice shape ( one of the main reasons for the cohesive gel in the first place), and will also have a change in "feel" and be very hard. Overexpanding during TE stage allows for extra skin and muscle to close nicely over the implant which has a different shape than the TE. Hope this is useful. (So for those awaiting exchange to gummies (me), while losing sleep over your current TE discomfort, don't add to it with muddling about how big you want to be; as you probably don't have much choice!)
-
Jerusha -- very interesting! My PS only said she likes to expand by at leat 150 cc's larger than the implant... but did not go into that detail about it (I clearly asked the wrong question
She did say at our last meeting before exchange that she would try her hardest to implant the MX 685 but it would depend on the pocket... which, in light of what you wrote, I now see why she said that. Maybe the fact that you are a doctor makes the surgeon a little more forthcoming? I don't know. I have found with three surgeons now that unless you ask the exactly right question (no matter how nice they are) you don't always get all the answers. Anyway I found that very interesting indeed. My expansion to 850 cc's is clearly the reason why the 685 now sits so nicely in my body (no smooshing ... perfect shape). Thanks! -
jerusha~thats really interesting and explains alot!
after my next (and probably my last) fill,i should be at the 450 mark.Given what Lilah said about her PS liking to do a minimum 150ml overfill,i will be lucky to get my 300'S =(
I think the nearest to it is 290ml and next up is 325ml.Of course,this is without knowing fully what EXACT size/style TE i have in.Will hopefully clarify that next thursday.I want her to go to 500ml with my TE but 450 is a 50% overfill (300ml TE's)so im not sure how safe that is or if she'll even consider it. I can but ask.......I will also ask how many ml's she likes to overfill be in comparison the the implant.
-
For what it's worth, Kay, my TE was a 600 ml model and I was filled to 850 ml.
-
Kay - my TE's are 400cc and I am expanded to 570cc.
-
oops, wasnt done... my TE's :400cc, expanded to 570cc, will probably get 410gm or 445gm MX,possibly 450FX . Lilah had 600ccTE's, expanded to 850cc, with implant of 685gm. Both implant (Lilah) and implant possibilities(me) up 0.5 cm from diam of TE. Seems like about the same formula. Both at same hospital, so maybe an "institution" trend. Kay, I know you are trying to figure this out. (Me too!!!). Hope this helps with the mystery factor.
Lilah, hope you don't mind me re-iterating your stats! I think it helps to see there might be a pattern...
-
No problem Jerusha! I will add this relates mainly to the gummies (the differential) as far as I understand it. (Which, Kay, I understand you are looking at but am mentioning this for those ladies who are NOT getting gummies).
Jerusha -- I think you are up this week! Sending good wishes for happy results
-
lilah+jerusha~ so neither of you had a 50% overfill then?hmm......
im just trying to work out the % difference betwenn the final TE cc and the gummy weight in grams. I mean,my BS said to get a 500gram implant (gummy) you'd have to fill the TE to 700ml. But do grams and ml's equate to the same size?? So he's looking at reducing the size of the implant by about 45%,compared to what is in the TE?? URGH! my heads mashed with all these figures! I dont even know if im working that out right! so if i het to 450ml in my TE then i can be looking at bout a 250ml implant????????????????
noooooooooooooooooooooo!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Im gonna go cry now.............!!!!!
ahhh haaa!! unless that much reduction is only needed cus the 500grams implant is larger!!! Maybe the reduction will need to be LESS for a smaller implant.Maybe only a 30% reduction??in which case i would be bang on target for the 325gram!! (so long as i get the MX)
oooh i feel better already! **now just to convince my PS......**
-
Oh my goodness Kay -- I'm not a math person
My PS said 150 ml larger than gram size (she said gram to ml was equal). So I had 850 ml in TEs and 685 grams. 685 was as large as they come in the MX size or I might have gone larger. I think it entirely depends on the pocket and what the PS sees once they open you up and remove the TE. My PS said she would TRY to use the 685 but there were two smaller ones she also said she would bring in... just in case. I was relieved when I learned she was able to use the 685. So, it seems to me that if you have 450 ml in your TEs you may very likely fit a 300 gram implant into your pocket. If you want to be certain, go for 500 ml. (So yes it makes sense to me that to get a 500 gram you need around 700 ml fill in TE).
-
Whippetmom -
I had my TE (unilateral right) put in March 2010 Allergan 133MV-13 - filled to 120 cc at surgery then filled three more times (right now I am 360cc) - I am post radiation. My Ps would like to fill another 60 cc then exchange in August 2010. My rib measurement is 35 inches and I'm 5'8" 155 pounds. I'm fairly happy with how the TE looks now - although a little high, it has filled out the lateral defect well from my mastectomy and I have good cleavage. Can you PM me your email so I can send you my pictures?
Thanks,
Karyn
-
whippetmom: Thank you for your response. As you can see by my late response I do not get on the computer as often as I wish. I actually have a 1 year old and a 2 1/2 year old that get 99% of my attention. I appreciate you letting me know the system, and I do agree that it must remain private out of respect for the other women. I will continue to check in on the discussions and hopefully help someone else after my procedure. I am actually scheduled for July 1st, so I'm getting anxious to have my journey moving along. Thank you again for your answer!
Jen
-
Jen: Any time you need information, please let me know. You can always PM me as well.
-
Thank you whippetmom - I will be in touch! I want to make sure I get any info I can for my exchange (first surgery 7/1/10, so exchange maybe in winter), and girl you know your stuff!!! You should be very proud of helping so many women! I read a lot of your posts on here and am continually amazed at your dedication and knowledge! I send you a big {hug} for all your love and passion for helping others!
-
Jen: When you get some free time [like you have any, taking care of kidletts], let me know where and with whom you will be having your PBMX. I could give you some idea on implant sizing if you send me your vital statistics and ribcage circumference. PM me this information privately....
-
Deborah: I just had my fifth fill yesterday and I am now at 500 cc's and they plan to expand to 550. Should I send you my updated photos? I want to avoid too much step off because I haven't any curves 'cept the ones I'm a growni' and if I will need fat grafting I only have a bit on my belly to spare. Thanks,
Mary
-
Yes, MBJ, send me photos....
-
Mimi: Any updates? Tell me how you are doing.
-
well i had my 6th fill today and i thought it was my last,but no,i have 1 more in 3 weeks time!
Deborah~i asked my PS for the card that came with the TE and she said,what card! I asked if the TE's came with a card like the implants do and she said no (odd seeing as everyone elses seem to...).
I managed to discuss implants a little with her(still don't know exactly what style TE i have) and she said the extra fills now are just for extra projection.I asked what size implant she was going to use,and she said either low or moderate height.,and try and get good projection. I asked if the low height would give me no upper pole fullness and she said yes,and if i wanted that,she would try and go with the moderate.
Now trying to get her to commit to telling me a size(in grams)was nothing short of impossible! She said i have a narrow torso and therefore cannot go for anything too wide. i asked if it would be possible to go fot the extra full projection ones and it will depend what she can fit in me on the day.
I did ask if she would be able to fit an implant in out of the 300's and she said she should get a 300 implant in (was smiling at this point!).
So i was trying to work out-if she went for the MF,the smallest in the 300 range is 335grams,giving me 12.5cm wide, 11.6cm H, and 5.1cm proj..
if its the MX then the smallest 300 is 325 giving me 12cm W, 11.1cm H and 5.7cm proj.
If she only goes for the MM, then it'll be a 320gram giving me 12.5 H, 11.6 W and 4.6 proj~which i dont think i'd be happy with.
so if she ended up putting in the MF in the 335grams, do you think this would look ok?? I am secretly hoping she can squash the MX in!!!!!
-
Kay: If you can get MF-335 or MX-325, I think you will be happy with the dimensions either of these two styles provide. Just for comparison, I looked at the dimensions of the standard silicone rounds, to see how they might compare. Here we go:
Allergan 410 anatomical:
MF - 335grams: 12.5 cm wide, 11.6 cm H, and 5.1 cm proj..
MX - 325 grams: 12.0 cm wide, 11.1 cm H and 5.7 cm proj.
Allergan Style 20:
425 ccs: 12.0 cm wide, 5.2 cm projection
Allergan Style 45:
500 ccs: 11.9 cm wide, 5.7 cm projection
So, as you can see, you would require substantially larger implants in the standard silicone rounds, in order to match the dimensions of the anatomicals. Since they ARE anatomicals, we also have height to factor, which we do not have when we have circumference with a round implant, so we are not comparing apples to apples. But this should give you some confidence that the size of either410 implant will be just fine and you should be happy with the size.
-
Deborah~thankyou for that!
ok i just gotta keep my fingers crossed that she doesn't sneak in an MM!!! I will stress this to them when i get my pre-op appointment to discuss the implant exchange in more detail.I will point out that i KNOW i wont be happy if they put a moderate projection in me.
wow,see what you mean with the round ones.I would have to be alot bigger and with how much they're stretching me,i dont think i'd get near those sizes.Hoping i dont get rotation as she will switch them out for rounds and for the size i'll get,the projection will be rubbish i bet.
I think the MX would be my preffered implant bu realistically,i think she will go for the MF.ok i lose 0.6 cm proj,but it is only 6mm after all~but what i lose in proj,i'll gain in height and width.
Any idea why she might have thought about using a low height implant on me??? Would it have been a bad result aesthetically??? i visualise short boobs! Do you know of anyone on the pic forum with low height implants? I have a long body and i think they would have looked ridiculous!
-
Deborah~ ok im back again!
i just took another look at the catalogue,at the low height implants.Now comparing the height in cm's to the moderates,i would lose between 1.1cm and 6mm in height.This is providing they used the extra full projection. Anything less than that projection wise would not be worth sacrificing upper pole fullness for.
The LX 330grams have 12.5 W, 10.5 H and 6.0 proj.
The LX 365grams have 13.0 W, 10.9 H and 6.1 proj.
The MF335grams have 12.5 W, 11.6 H and 5.1 proj.
The MX325grams have 12.0 W, 11.1 H and 5.7 proj.
i only listed them all together for easier comparison. I was just thinking.....if she could only get an MF in and not the MX, do you think i might as well go for the LX in the 330gram and lose 1.1cm in height,but gain 9mm in projection????
Which of these 4 options (if they even ARE option for me once im in that OR!) do you think would be best. Would losing 1.1cm in height make THAT much difference to my upper pole fullness/cleavage?
-
Kay -- Val had low height TEs.
-
sorry,i meant low height implants at exchange.
-
Ah sorry Kay -- definitely NOT Val lol -- and that's a good question! I am thinking the low height implant is only good for someone who has a small amount of body from nipple to sternum (a very small person?) I know that for me the medium height was HIGH because I'm only 5'3" and if I had gone for a full height I would have looked like I was wearing a permanent push up bra (which I would not like).
-
Kay: I am hoping your PS realizes that your frame - your long torso - dictates that a MF or MX would work best. I doubt she would use a LX if she did opt for a low height implant. She would more than likely select the LF - because I do not think she is going to venture trying to get skin closure over an implant with as much projection as has the LX. I think that you just need to accept that your PS knows your desires. I think you have done an excellent job of communicating what you are hoping to achieve at the end of this reconstruction journey, and so much is going to depend on what your PS is able to safely get into the pockets and what looks best in those pockets - at the time of exchange.
-
I have to state that I have not known or heard of anyone yet who has a low height anatomical implant. I would be interested to see what it looks like, but I do not think I would want to personally be the poster girl for that implant. It sounds like no upper pole fullness to me and it sounds like it would come with the term " matronly breast" attached to the implant packaging.
-
LOL @ matronly breast!!!!!!
wouldn't want those! =D
well i'm not going to go with them then.I will push for the MX and see where i get. Aim high then if im lucky she may be able to fit it in. Still got 1 more fill and a pre-op appointement to nag her yet!!
-
Kay....Just realize that your PS will only do as much as your skin safely allows. I think the MF has its own merits, in that width is important and it would be a good choice for you as well.
-
yeah its just so hard to know whether to sacrifice some width for projection,or vice versa.
How would i measure what projection i have right now with the TE's? I tried holding a tape measure onto the centre of my chest between my foobs,then pulling it out straight,then laying a piece of card across the top of my foob to see how it measures. It was bang onh 5cm. But not sure if i measure from the centre or the OUTSIDE from where my armpit is-in which case,it would measure more.......
If the 5cm is correct,then she'll most likely have to go with the MF anyway.
Just got my next fill appointment thru the post. I have to wait til July 15th! That'll be 1 months since my previous! She wanted to do it in 2 weeks but its the day i fly back off hol.Then she said 3 weeks would be fine but when i went to the reception desk to make it,the BS is on vacation then and the PS is booked up solid.So i gotta wait 4 weeks =( This is gonna push my exchange further back now which i really didn't want. I cant go back to work til my fills are finished either and i have been off so long.
Feeling a bit jaded today...........
-
MStar: I know how you feel. I was told I would be done by the beginning of July-Ha! I will be lucky if I get my exchange done by September. Enjoy your time off and consider it a long holiday. It's not every day we get to have long, extended vacations. I was supposed to fly at the end of July for a 1 week holiday but I don't want to go anywhere with one boob and set off airport security or chance losing the stuffing on my other side. I can't wait until I am done!
-
REGARDING TISSUE EXPANDER AND IMPLANT IDENTIFICATION FOR PATIENT PURPOSES: .
Your TE is a registered medical device and it MUST be recorded in your chart. The reference number and SN number should be recorded in your chart. Well, this is the protocol in the U.S. and Canada - I don't know why it does not apply to the UK. A "Device Identification Card" is provided with every tissue expander device. On the back of the card, the identification label, provided with each single tissue expander, should be affixed to the back of this card. It is like a plastic credit card. It is mandated that this card be given to patients.
6.3 DEVICE IDENTIFICATION CARDYou will also be given a device identification card with the style and serial number of your breast implant(s). This card is for your permanent record and should be kept in a safe place. In the event you have a concern or problem with your implant you can use this card to describe the implant to your health care provider or to Allergan.
FURTHERMORE, THE FDA INSTRUCTIONS STATE:
6.4 DEVICE TRACKING"Silicone gel-filled breast implants are subject to Device Tracking by Federal regulation. This means that your physician will be required to report to Allergan the serial number of the device(s) you receive, the date of surgery, information relating to the physician's practice and information on the patient receiving the implant(s). This information will be recorded on the Device Tracking Form supplied by Allergan with each silicone-filled breast implant. Your surgeon will return the top portion of the form to Allergan following surgery. The bottom portion of the form will be provided to you following surgery. You have the right to remove your personal information from Allergan's Device Tracking program. If you choose NOT to participate in Device Tracking, please check the appropriate box on the Device Tracking form and return to Allergan. You also have the right to have your personal information withheld from disclosure to third parties who may request information from Allergan, such as the FDA. If you choose to participate in the Device Tracking program but do NOT want your personal information to be released to third parties, please also check the appropriate box.
Allergan strongly recommends that all patients receiving silicone-filled breast implants participate in Allergan's Device Tracking program. This will help ensure that Allergan has a record of each patient's contact information so that all patients, including you, can be contacted in the case of a recall or other problems with your implants that you should be made aware of ."
Here is the link to the above....device card info at end of document on Page 37...
http://www.accessdata.fda.gov/cdrh_docs/pdf2/P020056e.pdf
From McGhan/Allergan Canada's govenmental website:
PRODUCT IDENTIFICATION"Product labels are supplied within the internal product packaging of each McGhan
implant. The product labels provide specific information which allows product identification.
I M P O RTA N T: These labels must be attached to the patient and hospital/doctorsrecords to ensure product identification and device traceability."
RE: MENTOR'S INSTRUCTIONS ON "DEVICE TRACKING"8. Device Tracking
"Silicone gel-filled breast implants are subject to Device Tracking byFederal regulation. This means that your physician will be required
to report to Mentor the serial number of the device(s) you receive,
the date of surgery, and information relating to the physician's
practice. This information will be recorded on the Device Tracking
Form supplied by Mentor with each silicone gel-filled breast
implant.
Mentor strongly recommends that all patients receiving silicone
gel-filled breast implants participate in Mentor's device tracking
program. This will help ensure that Mentor has a record of each
patient's contact information so that all patients, including you, can
be contacted in the case of a recall or other problems with your
implants that you should be made aware of. Please inform Mentor
whenever your contact information changes."
Mentor breast implant "device" instructions: FEDERAL GOVERNMENT MANDATE
Recording ProcedureEach breast implant is supplied with two Patient Record Labels showing the catalog number and lot number for that unit. One of these pressure sensitive labels should be attached directly to the Patient ID Card, and one to the patient's chart. The implanted position (left or right side) should be indicated on the label. Patient ID CardEnclosed with each gel-filled breast implant is a Patient ID Card. To complete the Patient ID Card, stick one Patient Record Label for each implant on the back of the Patient ID Card. Patient Record Labels are located on the internal product packaging attached to the label. If a Patient Record Label is unavailable, the lot number, catalog number and description of the device may be copied by hand from the device label. The patient should be provided with the Patient ID Card for personal reference.Link to above:http://www.fda.gov/ohrms/dockets/ac/05/briefing/2005-4101b1_tab-3_01_mentor-insert%20Labeling.pdf -
wow that alot if info!
I don't know why we don't get given them in the UK. I did read in the booklet that came with me info pack,that we must ask for the card that comes with the IMPLANTS,but it never mentioned TE's.
I wonder if its because all our hospital notes stay with our doctors/surgeons/consultants,as we are not private patients and the records stay withtin the hospital?? We have family doctors here (GP/GENERAL PRACTITIONER) who we see when we are sick.Our notes are on their computer systems. Same at the hospital,but the surgeon also has a file of paper notes. We do not get our notes and until a number of years ago,were not even entitled to ask to view them!
When i go in for my exchange,i shall take the booklet in with me that says we must ask for our implants cards. Then if they question why i want it,i can point out that we SHOULD be given it.
Would it make any difference if my PS uses the TE's that can be sterilised and re-used? Would they still come with a card,as you can re-use them up to 10 times? sounds yukky and i dont even wanna THINK that my TE's have been in someone elses chest!
-
6.3 DEVICE IDENTIFICATION CARD
You will also be given a device identification card with the style and serial number of your breast implant(s). This card is for your permanent record and should be kept in a safe place. In the event you have a concern or problem with your implant you can use this card to describe the implant to your health care provider or to Allergan.
*****************************************************************************************************
This holds true for saline implants also. The number is also on the implants.
They had a "Jane Doe" murder case where they identified the woman by her implants.
Morningstar - I'm with you. I don't want recycled foobs in me. Never heard of that before
-
There are no tissue expanders or implants which are "reusable". They are all "single use only", which means, to be used only in one patient.
-
Double...yes, you are right! Here is that case:
-
Hi Deborah and to all of you awaiting your exhange - I am now 2 weeks past my exchange surgery and wanted to share my experience so far. Just to recap - I am 5'9", 130 lbs with a 29" ribcage - and was expanded to about 450cc. My PS brought Mentor HP silcone rounds from 500 to 700cc to the surgery and ultimately used the 650cc implants. They look great and I'm quite pleased. It seems that many of the PS overexpand and use a smaller implant but my PS had no problem going the other way. I don't know how he fit the 650s but they definitely do not look too big. They are well-sized for my frame. I'm still in the surgical bra but, trying out a Warner's bra I used during expansion, it looks like I'm a 34C. He was able to move the breasts closer together and eliminate that line showing through from the Alloderm. He also did some fat grafting because I had a quite significant crater between breast and ribcage. I wanted to do the fat grafting now in the hopes that I could get everything done at this one surgery. We used fat from my thighs. It looks good now but we'll have to see if the fat stays or get reabsorbed. I have to say that the recovery of my thighs has been the most uncomfortable part of this surgery for me. Lots of bruising and I need to wear a compression garment. I'm just now feeling a bit better but it's slow going. But it looks like I'm almost at the finish line!
-
ref: You obviously had sufficient skin flaps [for newbies: this is the skin which remains after the skin-sparing MX] and you might have had ample flaps prior to expansion. That is a good, healthy leap from TEs with a 500 cc fill, but it all depends on the laxity of the skin and often, this is something which can only be determined at the time of the exchange. I had 400 ccs in my TEs and my implants have a volume of 550 ccs. I actually could probably use 650 ccs, based on the laxity of my skin now - one year after the exchange.
So congratulations! I would love to see your results!!
Deborah
-
I really didn't have any idea that he would be able to go that far but rather than tell him exactly what to use, as per your advice, I told him what my concerns and goals were. He was great at listening to what I wanted and I was able to trust his judgment to determine what he could do at the surgery. I was very lucky. I haven't taken any photos yet but I should soon.
-
Deborah - if that wasn't clear... it was your great advice that I directly tell my PS what I wanted and you were so right. Thank you!
-
I copy and pasted this off the Allergan Natrelle pdf..........
The Natrelle® Collection also includes silicone-fi lled
intraoperative breast implant sizers. They are supplied sterile,
designed for re-sterilization* up to ten additional times, and match the
footprint of the Natrelle® silicone-fi lled breast implants with moderate,
midrange, and high profi les, as well as BIOCELL® textured designs.
What are these then?? Are "sizers" not tissue expanders?It says these can be re-sterilized up to 10 times.it then goes on to print this.....
Implant
Volume (cc)
Catalog
Number
A
Diameter (cm)
B
Projection (cm)
180 cc MSZ10180 10.7 2.9
240 cc MSZ10240 11.7 3.2
300 cc MSZ10300 12.6 3.5
330 cc MSZ10330 13.0 3.6
360 cc MSZ10360 13.4 3.7
390 cc MSZ10390 13.6 3.8
420 cc MSZ10420 14.0 3.8
450 cc MSZ10450 14.4 3.9
510 cc MSZ10510 15.1 4.0
600 cc MSZ10600 15.8 4.3
700 cc MSZ10700 16.4 4.6
-
i think i mistook the breast sizers to be the same as the TE's,but i am assuming the sizers are what they take into the OR with you when you go for exchange? To see which implant size is best for your breast pocket? Its THOSE that are re-sterilizable. Still sounds gross that they've prob been in someone elses chest before yours though!
-
wowee!
i just scrolled further down the Allergan Natrelle pdf and saw the price of the TE's and the 410 gummys!!!!!!!!!!!!
Is that per pair,or for each one?!
-
ref: It was clear and it was exactly what I want everyone to do! Let your PS know your hopes and desires...what you would like to achieve out of this reconstruction journey. Thank you for sharing this!
Kay: That is the price for one TE...one implant. Amazing, isn't it?
-
WHOAAAAAAAAAAAAAAA!!!!!!!!!!!!!!
The TE was more expensive than the gummy implant!!! And the gummy is more expensive than the regular implants also!!!
-
HI LADIES!!
There were a few of you that I had Pm'd a few weeks ago and I have not heard back on how you are doing. PLEASE check your PM's...:)..
-
Kay: You made me do it! I looked up the prices LOL. In comparison, a cleft chin is a steal!! Who knew there were 20 different kinds of chin choices??!!
-
MBJ~ LMAO!!!!!
I bet if they stuck 2 cleft chins in my chest,they'd look bigger than my pre-op boobs!
I was laughing my head off when i saw all the rst of the stuff in the catalogue!!! i was really suprised-i didn't realise they even did those things.
-
Ok, where are you guys looking and finding the prices? I know on my hospital bill each TE was about $4,000 - my PS couldn't believe they cost that much - of course that was before the insurance adjustment.
m-star - where is the catalogue?
-
They are in the Allergan Natrelle pdf catalogue that whippetmom sent me. Not sure how to attach it as it wont copy and paste. I imagint the prices on there are wholesale prices,before the surgeon adds on their fee for the surgery etc.
maybe if you ask whippetmom she could sent it you
-
If TE's give us rock hard boobs, can I get a TE for my stomach so I'll have rock hard abs? I would pay any price for that! :-D
-
Valerie: The price on the hospital bill is the outrageous mark-up/inflation they bill the insurance company...
Because the prices on this list are RETAIL prices - not the price they charge the hospitals or plastic surgeons...Scroll to the very bottom of this document...
-
Kate: OMG Rock Hard Abs with a TE!! That's absolutely hysterical. I am refusing to work out until after my exchange so that the little fat I have on my belly might give them a drop or two for grafting. I might be skinny but I sure as hell ain't rock hard anywhere but on my TE.
Kay: I don't believe you want breasts with a cleft chin though mine kinda looks like that right now LOL! I'm surprised they don't have butt TE's like the kind you can get in a Frederick's of Hollywood catalogue for those who were not visited by the Butt Fairy!!!
-
MBJ- You mean there are actually women out there who haven't been visited by the Butt Fairy? I can't get the bitch to leave! And don't even get me started on the Thigh Fairy!
-
Anyone reading this thread, Deboroh is the most knowledgeable person re: breast recon I have ever seen ,her input would and will help you through the process. Wish I found her before everything was done. sheila
-
Kate: LOL That's why we married butt men!! Sigh, I was only visited by the height fairy, the no waist or hips fairy and the spider vein fairy.
Sheila: We all worship Deborah--I am still expanding but I wouldn't be if I hadn't found her!
Ladies, hopefully today is my last uni fill. We are trying for a last 50 cc's so that I am at 550, which, let me tell you, is really pushing it as my skin is already super stretched. I just hate that a swimsuit is no longer an option with a uni expansion. I look like an alien is about to burst from my chest any second and it will be quite messy. I'm also bumping into things alot--every door is finding my turtle shell.
-
MBJ- LMAO!!! Turtle shell! That's it exactly! I was always an A girl. I'm not used to anything protruding from my chest! (Except when I was pregnant, but then my big belly ran into everything first!)
(And don't even get me started on the spider vein fairy! I swear she's like the house guest that will never leave!)
Good luck on your last fill!!!!
-
MBJ -- you know they make silicone inserts (for sale on Victoria's secret) to enhance cup size... you COULD try buying a set and inserting into your swimsuit to try to even out with the TE... just a thought.
-
Kate: She's the guest that never leaves and looks as if she's kicked me!! I ranged from a B to a small C when I was 20 pounds overweight. I was barely a B before my MX. My old bras no longer fit and my new ones don't now eaither due to the odd shaped TE. Unfortunately I wimped out today--I could only get in another 40 cc's :=(.
Lilah: I have all sorts of padding inserts. I thought I could use the silicone inserts, but they hang too naturally compared to my turtle shell! I also have a stick on peice of padding that's supposed to push you up and sticks to the fabric in your clothes, not your skin, but I am beyond being able to look natural in a swimsuit anymore. It's too obvious with my distorted, football shaped TE (why a sideways football I ask??!!) and my barely A cup side (yes, I had an B & an A cup before MX). So the padding works in clothes but not a swimsuit so much. I am too overstretched and lopsided and obvious that I am missing a breast on one side.
-
Aw MBJ bummer -- when is your exchange?
-
MBJ~So your done with your fills now? Im so jealous! lol
so how much do you have in now? 540ml? Thats good! If they put the full 60ml in my next one i'll be up to 510ml and that will be that-all done. Are you having augmentation on your good side at time of exchange?
i still loook down at my chest and laugh! i was in the kitchen making breakfast earlier and my hubby came up behind me,reaches around and got hold of my foobs! Funny thing is....i didn't even feel it!! LMAO!! talk about killing the moment! i have been bumping them more and more lately. Got a nice,low cut halter neck top on today.Making most of them while they're this size! =D
-
Lilah: I meet with my PS next Tuesday to see if they want to "top me off" or schedule my exhange date, so we shall see. I am thinking it won't happen until August.
MStar: As soon as I get my pictures up and you can see them then you will see that, yes, you are darn tootin' that I am getting the other side done or else I will be lopsided for life!! My remaining breast is a little A cup that never could. For some reason the breast fairy favored my other side, which was a full cup larger. I am up to 540 cc's now and I think that this is all that I can take. It is the most pain I have been in since I started getting fills. I took two Flexoral beforehand but I felt the needle go in and it felt too tight immediately upon starting. We were trying for 50 cc's but we only got in 40 :=(. If I had both sides done I could be out showing some cleavage, too, but I just look insanely lopsided. One big "Barbie" boob in the shape of a football and one natural boob that never agreed to give me cleavage no matter how much I pushed her up! That is so funny and sad at the same time that you couldn't feel your hubby feeling your foobs! I bang mine all of the time, poor, bruised thing. I am sure I can get used to bigger, though.
-
I have a question for ladies who have had their exchange or anyone who knows. WHen you have your exchange do they put drains in again? I thought I read where someone had them. I'm hoping not!
-
Some surgeons DO use drains, some don't; some make a decision in the moment (I believe). My surgeon told me I would definitely have a drain (I'm a uni, so only had one). Best plan is to ask your surgeon what he/she plans.
-
I am looking for some peace of mind. I am 5'2", 115 lbs. At time of DMX, the PS told me they removed about 850cc from each breast. I had told her prior to surgery that I wanted to look the same before as after and she said she could do that. What I'd like to know is: do implants normally replace cc for cc the amount removed during mastectomy? If not, is there a way to estimate what a replacement amount should be? I'm not very good and looking at photos and being able to visualize how other breasts would look on me.
-
scarecrow: I can help you with this but I need some additional information, as outlined above in my header post. I am posting it again here:
If you are interested in discussing implant sizes, e.g., how large or small you want to be, how much projection or lack thereof you want to have, make sure you compile the following information:
Ribcage measurement - [measuring the circumference of your ribcage under your tissue expander(s) or under your bra line]. Also, if you have TEs [tissue expanders] - we need to know about them. The style - Mentor or Allergan most likely - and whether they are short height, moderate height, full height if Mentor and style number if Allergan. We also need the recommended fill volume of the TEs - the number of cc's. This information should have been given to you on a card by your PS and if you did not receive it, it will be recorded in your chart and you can obtain it from your doctor's office.The style and volume of your TEs is important data!
Deborah
-
MBJ- Towards the end of my fills I started feeling the needle going in, too. It hurts but the good news is you're starting to get some sensation back in the breast. I started saying, "Yeah, that hurt!!!"
-
Kate: The larger and more mishapen the TE gets the more sensitive to the needle and to the fill. OUCH!!!! I think I've reached my limit. I walked into a cupboard again today, so I don't think I should go any bigger. I also bumped into someone today at the hospital and I was sure I broke his arm. I tried not to make eye contact and made a beeline for the door before he could figure out what hit him.
-
MBJ- LOL!!! I keep trying to squeeze through small spaces thinking I'm still that A cup girl! I'm amazed I haven't ripped these nipples off that I worked so hard to keep since I go braless all the time! I'm thinking I should be wearing a chest protector! Wouldn't that be attractive! Oh well, it will be the dreaded surgical bra soon enough!
-
Hi,
Thanks for agreeing to help.
Ribcage measurement - [measuring the circumference of your ribcage under your tissue expander(s) or under your bra line]. 29"
TEs [tissue expanders] - style - Mentor Smooth Round Spectrum®Style 1400
We also need the recommended fill volume of the TEs - the number of cc's.
Sizing Chart Catalog Number Nominal Volume Temp. Min. Volume MINIMUM FILL MAXIMUM FILL Min Final Volume Min Min Max Final Volume Max Max Projection Diameter Projection Diameter 350-1485 525 cc 450 cc 525 cc 15.0 cm 4.4 cm 630 cc 14.4 cm 5.6 cm -
Hi,
Thanks for agreeing to help me. Before my surgery I was 36-26-36. That's what I'd like to be again. I was a 32DD.
Ribcage measurement - 29
TEs [tissue expanders]
Smooth Round Spectrum®Style 1400
Catalog Number: 350-1485
Nominal Volume: 525 cc
Temp. Min. Volume: 450 cc
MINIMUM FILL
Min Final Volume: 525 cc
Min Diameter: 15.0 cm
Min Projection: 4.4 cm
MAXIMUM FILL
Max Final Volume: 630 cc
Max Diameter: 14.4 cm
Max Projection: 5.6 cm
-
MBJ - I'm still LOL! That's hilarious and I totally relate! I keep bumping into things and they feel like foreigners.
During my yoga/tai chi class last week, it was my first class since my last and final fill, my body was moving around but my foobs were not! They were totally getting in the way.
Ugh. So ready for these TE's to get out. At least it is comforting that we know we have weapons while we still have 'em.
LOL!
) -
Dawne-Hope- Who knew our boobs would become lethal weapons some day, huh, in more ways than one! LOL!
-
scarecrow: You have expandable implants being used as tissue expanders, which is not commonly done after breast reconstruction [I think you are perhaps the second person I have talked to in the past two years], but is perfectly fine, considering your prior breast size, body habitus and your desire to retain the same appearance after BMX. This means you can keep the current implants, which are saline-filled, and then the port is closed off when you reach your desired size, or you do have the option of exchanging out to silicone implants as well. I presume though, that your PS intends to keep the Spectrum and not perform an exchange surgery, right?
So here is the connundrum with implants after mastectomy. You will probably want to expand up to 600 ccs volume to achieve the look you had prior to mastectomy. At 600 ccs, you will likely wear a larger bra size than you did previously - perhaps even a 32 F - but because the implants are sitting only in a pocket with a skin covering - no fat or connective tissue - you will note that you look no larger in actuality - no larger in clothing - than you did prior to MX. I know this does not make sense now and it is difficult to explain this phenomenon, but you will understand this eventually. You do not need to match the ccs you lost with the MX - fat and connective tissue weigh more than saline or silicone. You will fit into this elevated bra size because of the width of the implants, which creates the ability to fill up the cups of the bra.
Let me know your thoughts. Are you aware that these expander/implants can be left permanently? Does your PS intend for you to keep them or have you discussed exchanging them out for silicone implants?
Hope this helps!
Deborah
-
My PS and I chatted quite a bit during fill #2 yesterday. I'm currently at 300 cc. He's been trying to convince me to get a 400 cc implant eventhough I only wanted 300... I was a 34A prior to cancer... Anywhoo, after "talking" to Deborah and to my PS, I think I'm OK with 400 as my goal. That means I'll need to be over-expanded to 500 according to my PS. Generally speaking, I like where the TE's are but they seem so wiiiiiide. The diameter seems so huge. My PS tells me that he used a relatively small one and that with a high-profile smooth, round 400cc implant, I'll be happy. 'tho he said that he couldn't predict the cup size...
So, Deborah~ Ideas?? I'm 5'0" and 110lbs with an 80cm ribcage. I know that cup-size can't be predicted but could you give it a shot (at 400 cc)?? LOL! He says that he either uses allergan or mentor implants but thinks I'll do better in allergan. FWIW~ I feel a little tightness but no pain at 300cc. The TE's are rock hard though...
-
Michele: I like the way your PS thinks! My kind of guy! I agree with 400 ccs for you, because although you are small, you do have a 31.5 inch ribcage and you need the width of the 400 cc implant. I would predict - and this is just a prediction because I have not seen pictures of you; I do not know how much tissue you have overlying the chest wall, and I do not know what your ribcage looks like, but I would take a wild guess at a "C" cup. Do not let this freak you out though, because a "C" cup after MX is not like a C cup in a natural breast. It will just look nice and natural on your frame. You will look fine in all of your clothing and you will probably look better in some clothing - like swim suits perhaps.
-
Hi,
Whippetmom: Just like so many others I wished I had found this site 3 weeks ago. With that said any info you can give will be helpful. I am having a bilateral mast. next week with tissue expanders placed in immediately. I will be having radiation after expansion. Is there anything I should ask or do now that will help me to have a good outcome. I am overwhelmed with all of this info. I am not familiar with some of the terminology etc... I am 4'10" AA woman. I weigh 147lbs and currently wear a 36D. I would like to be smaller maybe a B or C "cup" with a mid or high profile? Please help.
-
Kate: LOL!! You are right--Who would have guessed that our breasts would become bullet proof weapons!! Soon you will be turned back into a princess by the boob fairy and then you will have to resort to your bulletproof, kick-a** boots!
Deborah: Thank you for clearing the exchange sizing and how it's so different from how they will finally look! You just reminded me why I am expanded so much larger then what I thought that I would originally go with. So, maybe just maybe, I will end up with a D cup but look like a C except in a bikini?? Wouldn't that be grand! Although my 540 cc uniboob looks very odd and hard right now, hopefully she will become soft and squishy and I will fit into clothes for the first time in my life!
-
Dawn-Hope: I just realized you were the one referring to them as weapons!! There is no way I can do yoga until I get this TE out--My PS sewed it down to keep the shape of my old breast and to prevent it from going to far under my arm, so I can only raise my arm so high until the exchange. Also, everytime I get a fill, I am back at ground zero and have to retrain my arm to work properly.
-
whippetmom: My PS is intending to do an exchange with silicone because we think they feel more natural, but she (as well as my surgeon who is following me still), suggest that I don't fill past 400cc. They think I'm fine at the 300cc I'm filled to right now. I know that my skin is thin and that the surgeon had to cut very close to the skin at the bottom of the right breast because of the location of the tumor. My PS has decided now that she doesn't want to do interim fills as we had planned, but wants to have me look at photos and decide at the time of the exchange what size implant to use based on photos I like. What is your impression of this plan? I have to say I'm not comfortable with it at the moment.
-
I wonder if I didn't measure my ribcage wrong... based on what others are posting, 30.5 in seems big for a 5'0" person?
Regardless, I think I'll listen to my PS (and Deborah- LOL!). I trust him and he's been spot-on so far (except for these wiiiiide TE's).
-
scarecrow: Why don't you email me your photos so that I can see how things look at 300 ccs. I just want to make sure you have sufficient skin flaps to exchange to implants with a volume of 500 ccs, which the is volume I personally think would look nice on your frame. I sort of have the same impression you have about the idea of searching through breast photos. I do not know how you can look at photos of augmented breasts and know what volume of implants to use in a reconstructed breast. For instance: An augmented patient with your same frame and size might have breasts you like and the chart may reflect that she has implants with a volume of 325 ccs. However, it might take 500 ccs or more for you to have the same appearance, because the augmented patient is starting out with something - some degree of tissue in the breast and an unadulterated chest wall off of which no breast tissue has been dissected. It just ain't apples to apples, if you get my drift.
Also, you know, just thinking off the top of my head here, I am not sure how much a Spectrum expandable establishes the width of the pocket. If it does it in the same manner as a TE, you have at least a 14.0 cm width to work with and, if your PS wants to stop expansion at 300 ccs, you want to make sure your PS is going to be doing some pocket work to narrow those pockets, since she will be using a narrower implant. You would need a 600 cc high profile implant in order to meet the 14.0 cm width requirement. Currently, your Spectrum has you at the underfill status - less than 525 ccs - and that even is establishing a wider base width - around 15.0 cm. But again, I am pretty ignorant about what the Spectrum does regarding forming the size of the pocket. So discuss the width issues with your PS also. Again, you can email me photos so that I might be able to help you further. PM me if you want to do so.
Deborah
-
Clarity: What is your ribcage circumference? Measure around the ribcage, just under the bra line. It should be around 33/34 inches if you are wearing a 36 band bra.
-
Michele: You are probably correct with your ribcage measurements, if you wear a 34 band bra.....I would not recommend implants any smaller than 400 ccs....if your skin permits.....
-
Whippetmom: Yes I am 34.5 around the bra line.
-
yep, 34 bra. a 36 when I was fatter (or PG or nursing). I guess I'm just short and squat...er.. "solid". LOL. so 400 it is. I'm pretty sure I'll have enough tissue. at 300 cc I'm "tight" but not thinned out. does that make sense?
-
Clarity: I am going to share with you what I personally think will work well on your frame and get you to a place where you are happy with the size. My recommendations only. Your PS will be able to see you, take measurements, determine if there are any ribcage issues, determine your skin integrity, see how much skin is overlying the chest wall, et cetera, and so he will select the TEs based on the aforementioned, as well as other parameters. Okay, so with that disclaimer read, I think that TEs with a width of around 13.0 cm would work well - and because you are petite - and because it happens to be a good TE style - the low height TE would be a good choice for you. It all depends on what style of TE your PS favors and whether it will work for you. I think that implants with a volume ranging from 400 to 475 ccs would be nice on your frame. However,in order to achieve the necessary width, this might dictate that the implants would be a moderate plus profile style, as opposed to a high profile style. HPs and MPPs are the two most common styles used for breast reconstruction.
So this gives you some idea regarding sizing. I would refrain from telling your PS what "cup" size you hope to be, because it is too difficult to make this assessment and you might end up being smaller than you like. The goal is, skin permitting, to have implants which look nice on your frame, fill up a bra cup and give a nice profile in clothing.
-
Whippetmom: Thanks. I will be in touch.
-
Hi Deborah (whippetmom)- I have my exchange on Tuesday and I am going with the Mentor Smooth Round High Profile 375 cc implants as I didn't want to go too big. I had sent you my measurements (5'4", 115 lbs, 28" ribcage circumference) and you had concurred with my PS that this would work for me. One thing my PS said is that your implant is always going to look about 25 cc's smaller than your TE. Just wondered if you agreed. I'm o.k. with that. Just want to know what to expect. I just posted my photos on the picture forum if you want to see. Thanks!
Kate
-
Hi there, just met with the plastic surgeon I've decide on today for the first time. He said he uses Half Moon TEs. I'm 5'5", 125 lbs., petite frame, 32C/D depending upon the day ;~) Wondering if anyone else has had Half Moon TEs recommended or implanted them. He said that they provide a great pocket for a nice inframammary fold, without pushing up the slope where it looks unnatural. He also performs a neurectomy on the primary pectoralis to decrease or eliminate spasms, "jumping," & rippling. Anybody had that procedure, either?
-
Kate: You do have sufficient expansion to exchange out to a 400 cc implant. Why don't you call your PS on Monday and ask him to use a 400 cc HP instead? Frankly, I think even a 425 cc HP would be nice on your frame. Forget about cup size....it is all about what looks good on your frame.
I just looked at your photos and you could easily use the 400/425 cc volume at the time of exchange.
-
orchidgal: I have read clinical studies of the use of crescent-shaped tissue expanders for breast reconstruction surgery, but you are the first I have personally encountered on this forum whose PS will be using same. The premise for avoiding expansion of the pectoralis/upper pole is a good one - and so the low-height or short-height tissue expanders by Mentor and Allergan are very popular, as is a less commonly used SSP tissue expansion system developed by a Michigan PS. I will be very excited to follow your expansion process. The only question I have is referable to the width of the crescent or half-moon shaped TE. What volume would your PS be using? Are you having a BMX?
I would think you might want high profile implants with a volume ranging from 400 ccs to 500 ccs - something around the middle of those numbers could be a goal. It all depends on the size of your skin flaps after MX, skin integrity and your PS' "plan" for your end result. Are you also having a nipple-sparing? That would come into play with sizing also.
Referable to the pectoralis neurectomy - I have not heard of this. I certainly know all about implant "animation" - and so this is, again, a "first" for me to hear about. I will be excited to follow up on this also. Does your PS have any papers published on this technique? Please keep me in your posting loop so that I can follow your progress after surgery. Thank you for sharing this!
Deborah
EDITED TO STATE: I do see that in older literature, the low height tissue expander is referred to as "crescent-shaped." So yes, we have seen a number of crescent shaped tissue expanders used on members of these forums. It is a popular style of TE. There is a crescent or half-moon shaped expandable implant [Mentor] which is used for reconstructive procedures, although presumably not for breast reconstruction. ]
-
Deborah,
Thanks for your informative message. Early in my DX I was in so much shock that I did huge amounts of research, and found Dr.Marchi Rigotti's work on this. Seemed logical, and since I have smaller breasts, and am put off by large upper pole recons, it felt right for me. The three PSs I interviewed before didn't use them. I was willing to go with one, but due to a number of communication issues, I chose to cancel her, then my BS suggested Dr. K., a man. Supposedly, a perfectionist. While he doesn't take my insurance, and it will cost a lot, he has a much smarter approach, I think. I met with him on Friday, and he laid out his first phase surgery plan that takes about 4-5 hrs. I will ask him what type of TE's he will use, the brand and size. I am having a skin-sparing BMX w/ SNB. A recent bi-lat. lumpectomy revealed that there is abnormal tissue in the nipple 2 cm margin, so they're gonna go, boo hoo.
He does procedures to remove the fat pocket left in the front of the upper arm, and fills in the SNB hollow.
I've only found one or two papers online re the neurectomy and semilunar TEs. None that he has written on the subject. Some docs are using botox, a cheaper route, and just as effective, but when I asked him if he would do that he told me about the neuroectomy method he prefers. He also makes a different type of dermal matrix pocket on the side rather than underneath. He doesn't cut pectorali muscle, nor does he suture the matrix to the serratus, (relief!) but does so onto the chest wall. All these things make sense to me even though I'm not a surgeon, I'm into anatomy, have been very physical and active my whole adult life, and intend on keeping my body as intact as possible. Hoping that opting for this more refined surgery will leave me with greater integrity in the recon, and thus less complications. you never know, though, but this is the horse I'm placing my bets on ;~)
Here's a list of what he'll do in the first phase of surgery, during the eight hr. BMX & recon:
Assist BS w/ BMX
Recon anterior axillary fat pad
Thin axillary fat pad
Pec muscle advancement to fill axillary hollow
Placement of TE
Incorporate Dermal Matrix
Neurectomy of Pec Major Nerves
Shortening of MX scar
So, let me know if you have any more thoughts on this. You are such a gift to this board in offering your expertise, wisdom, humor and support. I'm so grateful to have found BCO so early, and now to be having the benefit of your advice in this.
Best,
Melissa
PS I think he is probably using on of the "short" ones you mentioned, as he calls them "half moon" but will see him week after next and find out for sure.
-
Melissa: A very interesting approach. But WHEW!! Out of pocket? We are talking $100K plus! This is the average cost for implant-based reconstruction.
I love the notion of filling in the axillary hollow! Shaving the SNB side armpit is a nightmare for many of us.
It is interesting that I am familiar with Dr. Rigotti's work in trials of stem-cell rich fat transfer for improving the outcome for the radiated breast, but I had not heard of the neurectomy studies.
Keep me posted!
Deborah
-
Clarity: Also, discuss with your PS the use of fat grafting in the radiated breast after rads and prior to the exchange. And then at the time of the exchange as well. I posted the information above but I am copying it here for you to share with your PS...
If you are undergoing radiation and have tissue expanders or if you have had radiation in the past with delayed mastectomy and plan to have tissue expanders, please ask your PS about fat graft transfer during the expansion process.
Fat graft transfer to the radiated breast after reconstruction:
http://www.ncbi.nlm.nih.gov/pubmed/19484176
And one more:
-
Bump
-
Deborah,
My PS does these as a service to the women who must go through reconstruction, and he seems to love his work. He says he has successful results working with irradiated tissues as well. PS takes whatever my insurance pays for each surgery, and then is charging me 5k for the 1st procedure, then probably =/<5k each for the other two following procedures, so it will be 15k max, not bad for such thorough work. My decuctible & co-pay for my insurance is 12k, so in all, this episode of BC will probably be cost, 24-30k, not counting holistic healings. My hospital is fully covered by my insurance, as is the BS. I'll ask him what possible side effects can be expected from neurectomy of the major pectoralis muscle. As for armpit hair, have been getting waxed since '79, so hardly any hair there anymore, luckily. Having SNB both sides. Would advise those who will have SNB to get waxed there so it will be a while before the hair grows back. </p>
Melissa
-
Melissa: What a wonderful surgeon to do this for bc patients! I will be so eager to follow your reconstruction journey!
-
Okay Ladies: I finally figured out how to reduce the size of my pic's on TimTam's site and I called it "The unifoob that could!".
Deborah: Thanks again for all of your help-I added a few more pictures to the site that you haven't seen yet---let's see what he says today and if I will finally have an exchange date!
-
Hi Whippetmom. I've been reading this forum for a while. During the time I've been getting my "fills" over the few months, I've been trying to figure out what size I want to be for my exchange. My exchange surgery is scheduled for 9/1. I would love your opinion on what size silcone implants would be best for me.
Out of this whole journey, it's been kind of interesting and fun getting my fills but, at this point, I'm worried that I won't know when to stop! :-) Anyway, I'm now 500 cc's and would like to go a little bigger for my final exchange. My PS does overfill prior to surgery. My expander ID card says Allergan 133MV-14. I don't see anything on the ID card describing the height of the expanders. I'm kind of interested in having implants in size 550 or 600 cc's. Do you think either size would be good for me, or if you have a different number in mind?
My ribcage is 30". My height is 5' 7", weight is 131#. I hope I gave you all the info you need, but if you need anything else, let me know. And...thank you SO very much! You mean so much to all us gals! Diane
-
Deborah: I had my meeting with the PS and his team today. They were all impressed with how much I knew but I of course gave you 100% credit!!! He most likely is going to go with a 500-550 high profile, or at least that is what we talked about. He said he might do some lipo/fat grafting at the time of exchange but that I would need to do more, later. He said he will probably use maybe a 400 on the other side. We are aiming for the end of August for the exchange. Thanks again!!
-
Diane: I think 600 ccs in a high profile style, smooth silicone rounds, would be very nice on your frame. You need at least 600 ccs to match the width of your TEs in an HP implant. Make sure your PS is going to use high profile implants. The number you gave me tells me the width of your TEs - 14.0 cm. So I personally think that 600 ccs would be an excellent choice for you! Your PS could also order 650 ccs and he could determine, at the time of the exchange, which volume would be best for you.
-
MBJ: I am sure your PS will revise and tweak these numbers in the OR - just to get the right volume in the native breast to match the MX side. It all sounds good to me! I am excited for you! Excited to see photos after the exchange!
-
here's the new avatar ladies, me on the right, hubby (catboy) in the middle, daughter on the left....better?
Nope, I'm a girly girl
even if I am a 54 year old Disney princess.Yes, the cat (Emma) weighs 19 pounds and has a ginormous crush on Charlie, my husband.
It's both disturbing and hilarious. She'll climb up on him and when we ask her to give him a sweet kiss", she does. All this while holding him still with her arms around his neck. He's 6'1", and he can barely breathe when the little porker does it.
I'm used to women chasing him; but the cat is too odd.
Laughed so hard at you guys thinking that was me!!!
love ya
a
p.s. I'll try to find a bigger avatar, not great with doing this, but will try.
-
Deborah: I modified my post on timtam's site--The PS team asked me if you had your own website and if this is what you did for a living!! I told them we should pay you, but that you do this out of the good of your heart. They were taking notes of everything you told me to do!! I was channeling you today, that's for sure. I am so lucky to have found you, this site and all of these women here!! I feel very luck indeed. Thank you from the bottom of my heart
-
crap, deleted, I'll try again tomorrow, I found a bigger photo (without the catlove)
-
Annie.. your killin' us with the photo thing....heheheheehehehe
-
There, me with my nephews...whew...I suck at computer. Hi my Ta Ta Tiny buddy!.
-
YOU STILL CANNOT SEE YOU TOO WELL... grrrrrrrrrrrrrr
go outside tomorrow... put on some sunglasses ( like me)... this keeps you hidden from icky stalkers....LOL... and TAKE YOUR PICTURE UP CLOSE...
THEN have your DD upload it for you.. SHE WILL KNOW HOW....LOL LOL..... I was ALWAYS calling my DS... ALWAYS.. to help me figure stuff out...
-
Laura -- oh my! Should I be taking a pic with sunglasses???
Annie -- well at least I can see you are NOT your husband
-
Ah, Laura, come on, I'm trying...I'm bad at this, but I'll give it a try, girls...don't expect miracles, tho. I would ask my kid, but she'd kill me if she thought I was posting my photo online. She'd scold me about internet safety, the little cyber girl that she is.
i think we ALL need sunglasses so we can be the "cool Ta Tas"...eh?
(laura, blow it up as wallpaper, then you can at least see me. I look the same, just older and fatter and of course with a new hoot. Photos like 3 years old. )
love ya
a
-
I have a question ladies: For those of you who went bigger: would you go medium profile or high profile? My PS leans towards natural, but I am afraid I won't have enough projection. any thoughts?
Thanks for your input!
-
Hi Deborah,
Several weeks ago you were kind enough to do your magic with the numbers and recommended I go with 475-500 cc high profile implants. I am now expanded to 420cc. My PS left it up to me at the last appt as to whether I stop or have additional ccs. I have very little fat on my upper chest and am feeling a bit uncertain about going any bigger. PS said he will be injecting some fat to even things out but what can I expect? Would it be beneficial to go a little smaller in size or to moderate profile implants? Thanks once again for your assistance!
-
Thank you so much Whippetmom for your advice. I told my PS about a month ago that I want high profile since I like that look, but now I'm going to make sure he orders this types of implant. I'm glad to know the width of my expanders too...very helpful. Have a wonderful evening.
-
whippetmom - I met with my PS on Monday b/c I was still undecided on saline vs. silicone. I typed out 13 questions and he took the time and answered them all to my satisfaction. I asked him what size and kind of implants was he thinking and he wrote down exactly what you recommended for me at my final fill: Allergan 280-300cc's high profile. It made me smile. I went in there armed with questions that I've learned from you ladies. As I was leaving he said, "Good questions." Made me smile. Thank you, whippetmom, for your help and guidance. I was going to ask about the ones you recommended, but he said the same. Thank you! Appreciate you so much!
-
janleigh:
Here is your TE data which you provided previously:
TE: Mentor CPX 3 Siltex Med Height Model 7200 - 450 ccs
Width: 12.7 cm
Height: 10.8 cm
Proj: 7.0 cm
At 420 ccs, you are nearly at maximum fill. Your width will be the same - you might have a few millimeters [not centimeters] off in height/projection - no more. So at this point, as long as your PS is in agreement, you have sufficient expansion to exchange to a 475 cc/500 cc high profile implant.
Allergan is the only mfr with a 475 cc high profile silicone implant. The dimensions: 12.6 cm width by 5.5 cm projection.
If your PS can use a 500 cc implant - he might prefer Mentor: The dimensions: 13.2 cm width by 5.3 cm projection.
I think you have sufficient expansion, skin permitting, to exchange out now to either of the above two volume implants. You have a pretty narrow ribcage, which is why I would stick with the HPs. But you could go to the MPP profile, but you would at least want 450 ccs. You would lose projection. It depends on the look you want. The MPPs give a more "athletic" profile, which fits certain body types very nicely. Discuss these options with your PS...and perhaps he will be willing to take the HPs and MPPs into the OR and he can determine which works best at that time.
-
MBJ: The style of implant your PS uses is going to be based on the width of your natural breast. You want an implant which matches the appearance of your native breast, after it has been augmented. When I look at your photos, I do have the feeling that you would look better with a moderate plus profile implant. Your TE is sitting up pretty high and I just fear that a high profile implant is going to lend an appearance which will be more difficult to replicate with the augmented native breast. You have more of an athletic build and I feel that the MPP lends itself as being the implant which works best on someone with your body habitus. An HP might be too Pamela Anderson on the MX side, while the other side is natural. Your PS can certainly order both styles and see which works best. Remember, your goal is gaining symmetry and this is going to mean more of a natural, lower profile appearance overall.
Just my 2 bitty cents.
Thank you for all of the nice comments!
-
Deborah,
Thank you once again. Now that I am so close, guess I just need a little hand-holding! When I saw my BS last week she commented on how thin I am and then the doubt started. I had told my PS that I would like a little more than my original barely "B." And while I don't want to be disappointed, I also want what will look best on me! I know you understand and I appreciate so much your generous help! When I go in next week to see PS we can discuss these options.
Jan
-
Hi Whippetmom- I need some advice from you on my progess. I am 9 weeks out from a bilateral nipple sparing surgery and filled to 250ccs now. I have Allergan 133FV (400cc) TE's in. My Dr said he could fill them to about 450cc's and doesn't like to over fill. My ribcage is 30" and I am 5'7" 125pds. I was planning on going with gummy bear implants but am undecided.My PS think they look more natural but I'm not sure if they will look too droopy. From what I'm reading here I feel like my TE's seem small and I am worried now that my result may be too small. I have read everything you say about cup size and variables. I just want to have a nice moderately full appearance for my ht,wt and size, what do you suggest. Do you think with gummies I would have to go smaller? I looked up the allergan cataloge and if he fills me to 450, the implant size for style 410FF was like 375, that seems really small! Do you have to get an implant that is the same width of your TE? I don't really understand what my options for an implant would be with the 133FV 400 size, can you help me wit this. If you need pictures of my frame I can email them you.
-
Deborah: Thank you! I really didn't want the Pamela Anderson look but I really don't want to lose projection, either! I am going to look up the sizes again and realy the info to my PS, since he listens to me and to you! Thanks again--Have a great 4th of July weekend! I hope that it's clear at the beach so that you can see all of the beautiful fireworks!
-
I finally have my exchange date: August 19th at 12 noon! thanks again!
-
Woo hoo!!! PM Mykidsmom MBJ so she can put it in the top of the EC thread.
-
MBJ: Here is the schtick: You are expanded to what....500 ccs? You are not going to want an implant which has the same dimensions of the TE, as symmetry is the issue - not size. So I do know that your PS is going to need to use a smaller volume implant on the MX side, in order to get a nice, natural appearance. You want an implant which will give the appearance of fullness in the lower pole, rather than the upper pole, because in the natural breast, fulllness lies below, not above. So let's say your PS uses a 450 cc or 475 cc implant on the MX side, the width of the MPP implant might better match the width of your native breast. Additionally, it is the width of the implant which helps fill out a bra - especially where there is a mastectomy defect. So let your PS make that determination. He may very well decide an HP works better, but you need to let him have the final say in this regard. You want everything to balance out nicely.
I am excited you have an exchange date!
Deborah
-
janleigh:
Again, it all depends on your skin - how much your PS feels he can safely use - volume-wise. Once you talk with him and get his views on sizing, come back here and we can discuss it further...
Deborah
-
sweetie2040:
Do you have a fairly long torso? Just wondering, as you have a tall height TE. I personally think that you would be happy with the Allergan or Mentor high profile smooth round silicone implant. 475 ccs or 500 ccs sounds like a very good size for you - just based on your vital statistics and the width of your TE. You might even be a candidate for a Style 45, which is an extra full projection style implant - 500 ccs. I am going to PM you with my email address...
-
MBJ- So happy you have an exchange date now! I know for me it made all the difference in the world. It's great when you can see light at the end of the tunnel!
-
MBJ - Yes, congratulations on your exchange date! The 'weapons' are coming out and soon!!
-
Thank you Lilah & Kate! I already PM'd mykidsmom with my exchange date! Now it's just 2 months of waiting!
Deborah: I am expanded to 535 and when I go to my pre-op, he might put in a bit more to get a final stretch. That's so dissappointing to think he won't be able to go very big:=( I just couldn't stand to be stretched any further. The side where they tacked my skin down to ge the shape was pulling to much and so painful. I agree that I have to trust him to do his thing and make the best choice to get a match. Wait a minute--it's your birthday! You should be celebrating!
-
Hello Ladies, I'm new to this site. SO GLAD i found it.
A little background- was diagnosed with stage 0 cancer , ductal carcinoma in situ DCIS 12/09. It was in the right breast, multifocal (3+ locations). Chose to have bilat mastectomy 1/20/10, with TE placed at same time. Unfortunately , once pathology results came back , the margin free of cancer was less tahn 1 mm in 2 areas. Half the specialists i saw recommended radiation as well, half were against it. Out of fear , i ended up getting radiation as well.
PS placed TE with max volume of 450 cc. I am now almost fully expanded , but they look small to me.
My questions is: Can the PS place final implants larger than the TE, or do they have to be smaller.
I read so many of the comments about 'gummy bears" . I have Kaiser insurance, so i believe those are not an option for me. Anyone else who is going thru this process has Kaiser insurance? What was your opinion?
-
woo hoo MBJ!!!!! Thats great news! hopefully i'll be hot on your tail! lol
-
trytostaypositive:
I have Kaiser insurance also and I am very happy with all of my care. I do have implants which are larger than were my TEs. Absolutely it is possible....skin viability permitting.....as it does require a larger volume of implant to match the dimensions of the TEs.
But here is what I need from you: Your height, weight, ribcage circumference [measuring just under the TEs] and the style of TE you have - I need to know the width of your TEs. You can PM me with this information if you like.
-
MBJ:
Your PS will likely not be able to make a decision re: the volume of implant until surgery. I know your PS has a desire to make you happy and this is "a very good thing", as Martha would say.
-
dawnhope: LOL! Yes, my uni-weapon will soon be kicked to the curb for soft & squishees!
kay: Yes! And then of course we will rule the world!!!
deborah: Thank you Birthday Girl!!!
-
Thank you, whippetmom-- I realized I forgot to supply my ribcage circumference. It is 29 1/2". And, I just found my little card and it reads: Mentor Smooth Round High Profile Gel, Ref 350-4504BC for each breast.
About Breast Cancer Symptoms, If you have had radiation and want the reduced CC risk with saline or if you have some other reason for being against silicone, I understand.
-
jones:
Your post is somewhat confusing. I have not spoken with you previously, have I? I am happy to help you if you have a specific request for information...
Please describe your link included with your post...
Deborah
-
Whippetmom: Thank you so much for your quick reply.
Here are my stats: height 5'5, weight 145 pounds, rib circumference 32 inches.
I have tisue expanders that are Mentor, Siltex style 6200, medium height contour profile, and their model number is 354-6213. I looked up online their dimensions: volume 450 cc, width 12.7 cm, height 10.8 cm, projection 7 cm.
Since I needed radiation on my right breast, it has become a little smaller compared with the left one, and it also sits now a little higher. The skin has recovered very well.
Thanks for your help
-
try....
Your skin and PS permitting, I think that 500 ccs to 550 ccs in smooth round high profile silicone implants would be nice on your frame. You need to find out what is in the mind of your PS though. We might need to tweak those numbers and use a moderate plus profile implant, if he will not place you in implants larger than the expanders. We need to be careful, because of your history of rads, and so it might be necessary to be a bit more conservative. So at this juncture, it is key to start asking these questions. You would do best in an implant with at least 13.0 cm in width and the 500 cc HP is the lowest volume in this style with that preferred width. See what he/she is willing to do and then we can go over the numbers again.
Another issue to discuss with your PS is the subject of lipofilling during expansion. Studies have shown that it improves the texture and integrity of the irradiated breast and it can possibly lower the risk of capsular contracture. It is worth investigating further...
http://www.ncbi.nlm.nih.gov/pubmed/19471898
If these links do not work, let me know and I will PM them to you in text version. I just would be interested to hear what your PS thinks about this.
Deborah
-
Ladies -- avoid that Breastcanceraware link... it appears to be some sort of bogus site where OUR posts are being copied! Check out this link to a thread on this subject from elsewhere here in BCO (I am very disturbed by this):
http://community.breastcancer.org/forum/67/topic/754912?page=1#idx_6
Apparently this site is copying our words (not our pictures or our names as far as I can tell). Someone on BCO thinks there's a virus there but I don't (I looked at the link posted by Jenn, who started the thread and who I know from another thread here). I don't know what to say except to boycott that site.
-
Deborah if you roll your mouse over that link (without clicking it) you can see what it is a link to...
www.healthegg.com/women-health/breast-cancer-symptoms_symptoms-of-inflammatorybreast-cancer/
-
Deborah,
The info you provided is SO helpful. For example, I do not actually know what 'overall' plan the PS has. I told her from the beginning that I would like to be larger than I was (of course not Dolly Parton type). I used to have a B cup. Initially the PS almost tried to convince me to go for a one step procedure (to place,I can only guess, small implants at the time of the mastectomy). I signed for both that and the 2 step procedure, but told her clearly I want to go with TE and then gradual expansion. Thank God I insisted on that. She placed TE with max volume of 450cc.
I think, my PS likes to go with small implants. I felt her pushing me in that direction. Without actually having had a chance to ask her yet, I believe her plan is to go with implants smaller than the TE. But of course, as you mentioned, the fact that I had rads on the right breast is a big factor.
From several of your posts, I see that the width of the final implants is very important. I understand that the width would give the fullness at the base. Do you believe the width is more important compared to the Moderate profile/HP choice?
So, based on your advice, I will discuss the general approach with the PS at my next visit in 3 weeks. Too bad I did not know all this before the TEs were placed. Maybe the PS should have put in 500 cc TEs or about.
One more question. With the TE sort of pointing outwards, my old bras do not fit any more. I remember reading you have Kaiser insurance, just as I do. Is Kaiser covering bras, or what is a good place to buy them from. I'm thinking especially after the final exchange. Hopefully the TE period will end in a few months.
THANKS AGAIN !!!!!
Happy 4th of July to everyone!!!
Donna
-
Donna: I am also glad you had TEs instead of the one-step. That would not have been the outcome you would have wanted. There are specific candidates for the one-step and with everything you have described, you are not a candidate.
I think you are fine with the size of the TEs....it is just a matter of changing your PS' views on the exchange we have to work on a bit. My own PS [Irvine, CA] nearly always exchanges her patients out to implants larger than the TEs. For instance, my TEs had a volume of 425 ccs and my implants are 550 cc HPs.
I do feel that the width of the implants is important - as they relate either to the chest wall/ribcage or, in the case of unilaterals, to the opposing, native breast. I would much rather see an implant sitting wider on the chest wall than I would one where there is ribcage exposure laterally, because the implant is too narrow. You do have TEs which give maximum stretch/projection...7 cm....and if your skin does well, there is no reason you should not be able to exchange to an implant with only 50 ccs greater volume than your TEs. However, here are my three choices for you....
I like the 500 cc HP for you [Mentor] : 13.2 cm width by 5.3 cm projection.
The second alternative would be the 450 cc MPP, which is: 13.6 cm width by 4.2 cm projection.....the third, the 400 cc MPP, at 13.1 cm width by 4.0 cm projection.
Where are you located in the Kaiser system? You can PM me if you like with this information.
Deborah
-
Is it common to lift the real breast before the exchange in the other breast? My PS will not lift mine until 10 months after the exchange.
-
Dear Deborah-I'd like to ask your help. I've had a single mastectomy, and I'm very worried about issues of symmetry. How do you match the two sides?
So far, the expander side is way higher than the natural side. Pretty much all the volume is above the nipple, while on the native side it's mostly below, given age (56) and gravity. I'm wondering how much of this will get resolved with the implant exchange. Right now, it doesn't seem like there's much hope of matching the implant to the real breast.
So that leaves the question of what to do with the other breast to match it to the implant. My question to you is, what is your advice regarding the timing of lifts--to do them at the time of the exchange or to wait, and if so, how long. And what do you find people's experience is--I'm worried that what you gain in symmetry, you lose in sensation.
(One wrinkle on this is that I had breast augmentation three years ago. It was a regrettable decision for several reasons, among them, size-- I started out as a small 34B and ended up a 34D--larger than I wanted. So one thing I hoped to accomplish in all this would be to get back to a a happy-medium size of 34C. What I've talked about with my PS has been to size down the cosmetic implant and have the reconstructed side stay smaller.)
I would like to ask your opinion about what size implant I want to get to a 34C, taking into account all the caveats about bra sizes. I have two more appts scheduled for fills, and I would like to be able to ask the right questions as I prepare for surgery. Also, I feel there's an expectation that I should have an idea much I want to be expanded.
I am 5'7", weigh 140, my chest measures 31". I'll need to get you the model # of my expander. I believe it has a capacity of 550 cc, but maybe 500.
How do I go about sending photos--through the picture forum? I have been on, although not lately, and I'll have to figure out how to post.
I'm so grateful to you for your help.
Best, Joan
-
I just realized Claire asked a question about lifts just ahead of me. Please forgive the repitition.
-
Deborah,
Thank you for the information. I have saved your email. When the time comes to talk to the PS about the final implant I will make sure that she goes along the lines of you have mentioned.
I am at Kaiser Downey in Southern California. I work there, this is the reason all of my physicians are at Downey. Well, actually the oncologist is now at Baldwin Park, since I was dissapointed by the one at Downey.
Anyways, this PS was highly recommended by my collegues. She is very good, but I find her somewhat rigid. I prefer to have had someone else. However, I cannot go anymore for a second opinion to another PS at Kaiser. Since i am familiar with the Kaiser computer system, I know that the current PS would be able to see the other note. So, as you mentioned, I will have to work with this one.
-
Claire and Joan -- I had a lift/reduction on my remaining breast and implant on my BC side. My PS did my lift/reduction at time of exchange. So during TE phase I had one very large natural breast (DD-DDD) and one TE. I was able to wear my old bras but did have to remove the wire from my TE side (PS is anti-wire). I was uneven for sure but my MX/TE was in December and exchange in May so I was able to wear sweaters and other things to disguise the difference. Most of the women who I've seen posting here on this subject had their lift at exchange (not at MX) though a few have had it at MX. I believe that questions about evenness can be addressed by the PS when the exchange (and lift) surgery is done. Although my final results are CLOSE they are not identical. I am now a D cup, which for me is a much better size for me (and looks much smaller than a natural D or even an augmented D).
-
Dear Lilah--thank you. What kind of incision did your ps use for the lift? Did you have drains for the lift? How has your recovery been? Did you ever consider doing it as two separate procedures?
Also, can you tell me what you mean when you say you're a D but it looks smaller than a natural D?Is it that your breast fills out a D cup, but there's less fullness underlying/surrounding the breast?
Thank you so much for sharing. Best, Joan
-
My lift/reduction incision is the lollipop (they cut around the areola and move it up, then an incision that goes straight down from there to the IMF. I think it's going to heal really well. I was reduced from a DDD to a D (which is probably half the size it was but still a good size). I still have feeling in the nipple too, which I was pretty happy about (apparently you CAN lose feeling there). If you don't need a reduction, if you just need a lift, I think some doctors JUST cut around the areola without the incision from the base of it to your IMF... THAT surgery leaves you with no visible scars. Since I needed the reduction as well I had the lollipop. I did not have a drain on the reduction side (which I HAD because I ended up bleeding and bruising a LOT on that side post-surgery and now have a longer healing period there). I did have a drain on MX side and so recovery from exchange was very easy. I did not consider doing it as two separate procedures because (a) my PS said this is how she does it and (b) I wanted it DONE! I did not not want two surgeries if I could have one.
Re: size... I find that a lot of the women here who wear a D cup and know women with natural D breasts say that though the D is the right size for them, they are not as large as the natural D. My implant fits the D cup bra and my lift/reduction breast also fits but without a nipple on my implant some bras can bag a little where the nipple should be. I think width-wise we are definitely D's but it's more to do with projection. Natural breasts will always have more projection than implanted breasts. Since my natural breast was reduced at time of implant, my PS was able to get a very good match in that regard... my implant is pretty much the same projection as my native breast (and I think once there is a nipple it will be exact).
-
Thanks, Lilah--you sound very happy with your results. You have more nerve than I do right now about surgery on the other breast. And my PS has been kind of vague about a lift, maybe because he sees I'm anxious and doesn't want to push it. But his PA didn't pull any punches about it the last time I was there! I have 8 weeks to go, so we'll see. Best, Joan
-
Joan -- I really did not have much choice about surgery. I could have had a bilateral MX, which would have made matching easier (and would have removed MORE worry I suppose) but I found it really hard to decide to even remove the one breast... in retrospect the MX was far less traumatic that I thought it would be. That said, I'm glad to have kept one breast -- especially since I do have feeling in the one nipple. Anyway, once I decided on a unilateral MX it was imperative that I do the reduction because the size was way too large. In truth, I had considered reduction at other times in my life but was always reluctant to have scars -- ha! All in all, I'm lucky because my scars are relatively minimal. It sounds like a reduction/lift is not an absolute necessity? If I were you I'd really grill my PS on the subject. Even with all that I've had done my two sides are NOT the same but close enough. My PS said I would look good in a bra (in clothes) and that is certainly true. I also think I look ok without clothes... and fortunately I have a partner who doesn't care (he's just glad to have an alive, cancer-free me
-
Claire and Joan:
I see Lilah has addressed most of your questions. I would agree that most women have their lifts/augmentation in the native breast at the time of the exchange. Some have waited a few months after the exchange, as sometimes the PS wants to wait for the implant on the MX side to drop and settle, because they feel this is the best way to achieve symmetry.
This will address the use of an implant in the native breast - something Joan inquired about: Go to the pictures forum and look at sandysunshine's photos and Nedeza's photos. I have already bumped them up for you. If you want to send me photos privately, you can email them to me. PM me if you want to do so. The most consistent results at symmetry seem to be achieved by the use of an expandable saline implant in the native breast and a silicone implant on the MX side. The MX side implant is inserted first and then the expandable implant can be placed in the native breast and saline can be added or extracted during the surgery. Joan, in your case, I would need you to get your TE data - I need to know the width of your TEs - to discuss implant sizing.
-
Question: Deborah, since I don't require a lift, should I be concerned with the height of my TE? Or is this natural? Will it come down with the exchange and look more natural or is this something I am stuck with? Thank you!
-
Copied from my answer on EC:
[But I will add that you are perky enough and this is why you do not need a lift!]
MBJ: RE: the height of your TE: Well, the height corresponds to the style of the TE and the more projection you have, the taller the TE on your chest wall. But it is the projection which will be used to give you some "droop" or "ptosis" to match the native breast, and I am sure your PS will use this to his benefit at the time of the exchange. It is just fine...not to worry....
-
Thanks Deborah! Perky, I like perky! I hope that they can get a good match with her!
-
Whippetmom or ladies- I have a question I have 133FV TE allergan (full height) and the port which is supposed to be on the top has slipped to bottom on the right side. Is this ok or can the TE rotate out of place and if it does can this be easily fixed?
-
Wow that's a lot of movement Sweetie! Since the way they find the port is with a magnet, I imagine that they can continue to access it wherever it is. You should see your PS about the rotation though...just in case there are other issues. (Or wait for Deborah to respond
-
Lilah-thanks hon! I just got off the phone with the nurse. She said she is going to talk to the Dr. As you imagine this week is busy for them! She said all TE are round so it should be ok, but he may try to move it, but she has to check. Sigh...i just want to get the fills going! How are you doing? Is your gummy settling in nicely?
-
It is! I am doing well... even getting (I think) a little droppage and fluffage
-
Lilah-I am glad you are doing so well and liking your result. It's encouraging for us "gummy girls" Do the gummies drop and fluff a lot? I'm still sooo undecided about size and need a serious talk with my PS!
-
I don't think they drop and fluff the way regular silicone does, Sweetie... because they already have their shape, for one thing, and because of the way they stay put in their pocket (due to textured surface). So the changes are smaller. Regular silicone drops because of gravity moving it's round shape... and that gives the appearance of fluffage
(At least that is how I understand it -- Deborah?) -
Yes Lilah!
Sweetie...just as long as it has not rotated or changed position in the pocket to the extent that it is impacting the pectorals or putting your skin at risk. I would like for the PS to see it though....
-
Whippetmom-just heard from the nurse. The Dr. said it should be ok as long he can still access the port. He thinks when he starts to fill it it may move more into correct position. It doesn't seem to be bothering the skin or pecs,but it just feels weird like it's backwards!
-
Hi Deborah--I did see the photos of sandy with the expandable implant--they look great. In my case, though, I already have a cosmetic silicone implant. I don't know if I'd be a candidate for the expandable since I already have the pocket for the silicone. Do you know?
I actually want to go down a size, so what we've talked about was swapping that for a smaller implant--probably all the more reason I'd need a lift. It really is a moving target!
In any case, I want to show you pictures of what's happening so far with the expander, so I'll get to work on that.
Thanks, Joan
-
I'm a little confused about something. Some women say they come home after exchange swollen so they are bigger than they thought they'd be. Then others say they are smaller than they thought they'd be and are told they have to "drop and fluff". So am I going to get bigger or smaller or is there any way to tell?
-
Joan: You could go with a smaller implant and it could indeed be silicone, but the expandable implant would work just fine as well. It is your choice! I think that perhaps because you already have the capsule formed for an implant, you might stick with silicone. I have a question re: that augmented breast though: What size and style of implant was used? It might be that the style of implant is giving you the unwanted appearance, so before you start decreasing in volume, let's go over what you now have and see what might give you the results you want to achieve.
-
Sweetie: Keep me apprised of how fills and the shape of your TEs are progressing, okay? Send me photos anytime you like if you have questions.
-
Kate: Some implants do not change much in size at all after the exchange. Some change quite a bit. You can post photos and I can take a look...
-
Deborah~ i was watching a video on youtube yesterday,where a woman had a cap.con-but only very slightly- and she was having thr existing implant and capsule removed. It was pretty gross,but i watched it out of interest.
So judging by what i just read in your above post,when we eventually need our implants exchanging for new ones,do they KEEP the original capsule and just pop the new implant back in it?
Also something else that has been 'bothering' me......when you have nipple recon,what happens when,again,the implants need replacing? If the nips are where the scar is,and they open up the same scar,wont the nips get cut? I wouldn't want (or afford )to lose that amount of skin. Wouldn't be so bad if the nips were below the scar somewhat.
-
Kay -- good question re: what happens to nips when you replace your implants... I've been wondering the same thing!
-
Deborah- I get my drains out on Thursday so I will try to get some new photos posted after that. Thanks!
-
Kate - can't wait to see pictures post exchange - I'm sure they look great!!
-
Deborah--I should clarify--I had a great result on my augmentation as it goes, it's just that in hindsight, I liked my natural little small-B boobs better. To answer your question, I got 250 cc Mentor round smooth implants, which made me a D cup. Since I had second thoughts about size, this seemed like my 'opportunity' to 'fix' things.
As a pair I would never have considered lifting them. It's just that I can't imagine my remaining breast matching up to an implant without a lift.
-
Kay: In answer to your question:
What Are The Surgical Options For Treating Capsular Contracture?
1. Open Capsulotomy
This is an open surgical procedure involving gaining access into the implant pocket and cutting or "scoring" the scar tissue in multiple areas to release its contracting forces. This is the least successful of the surgical approaches.[In the above procedure, the same capsule is retained and the implant placed back into the pocket or replaced with a new implant. I think this is a rather archaic method of addressing CC.]
2. Capsulectomy
This is the total or subtotal removal of the capsule. Capsulectomy was long felt to be the most successful treatment of capsular contracture. Unfortunately, even patients undergoing capsulectomies still have a very significant rate of recurrence. Recurrence of capsular contracture after capsulectomy leads many surgeons to advise no further surgery and/or removal of the breast implants.[The above is the current, recommended method of addressing CC, but taking this one step further, many plastic surgeons recommend also replacing the implant with another style and size of implant entirely - to do something "different" than was done originally.]
There are a few plastic surgeons who perform a third method of addressing CC - which follows:
3. The "Capsule Switch Procedure"
There is nothing particularly magical about this procedure. It is based on some factors well known to cosmetic surgeons. For a capsule to contract, resulting in a hard and/or distorted breast, the scar must be continuously circumferential around the implant. If only half of the implant is surrounded by scar, a contracture generally does not occur.We have all known, for example that breaking up the capsule by squeezing it very hard (closed capsulotomy) results in a softer breast - until the scar recurs and resumes its contracting forces. Next, e-PTFE (Expanded Polytetrafluroethylene) is an FDA approved material known to inhibit the formation of a contracting scar.
The "Capsule Switch Procedure" consists of a subtotal or total capsulectomy utilizing meticulous control of bleeding, with the placement of a very thin (0.35mm) implant of e-PTFE, which replaces strategic areas of the former scar and prevents circumferential scar formation and a resulting capsular contracture. E-PTFE is used in many fields of surgery for multiple surgical applications and has an outstanding safety profile. The 0.35mm thickness allows for inhibition of contracting scar formation while being essentially non-palpable."
The "implant" described above is called a "Pocket Protector"....
http://www.ascbs.org/pocket_protector.htm
Aren't you glad you asked?
-
Wow, Deborah, everything I ever wanted to know about implants! As always, you provide a wealth of helpful information! Thank you!
Lilah, maybe they go under the implant when they change them out? I would almost prefer they do this then reopen my existing scar for the exchange. It looks almost healed now and then it's going to feel like I'm starting all over!
-
Oh...forgot about part deux of Kay and Lilah's question:
A revision on a previously reconstructed breast with nipple in place: I believe there would be two preferred methods - both utilizing the previous MX scar/incision and then curving up or under the constructed nipple and then that nipple becomes part of either the lower or upper flap. The second, and probably what mine would do [especially if I required a dfferent size or style of implant which would malposition the existing nipple], is excise and discard the nipple, insert the implant and close. The nipple would need to be recreated once again. I cannot imagine that many plastic surgeons would use an inframammary approach - would create a new incision - but it is something to ask your own PS.
-
Wow, I never thought that you would have to get another nipple done. Lots of maintenance, these new breasts!
-
Deborah -- I'll bet cutting around the nipple and along the old MX scar line is the way they do it more often than not (similar to a lift -- where cutting around the areola and reattaching does not leave much in the way of scars long term). I will look forward to that day many years hence
MBJ -- when they do the exchange they don't reopen the entire MX scar... only just enough to put the implant in. So much of what is healed will stay healed. The rest will heal again!
-
Hi Deborah,
Thanks for your response to my last message. I had my pre-op with the PS and he said he would use Siltex Low Height Style 7100 TEs that hold 350cc. How much of a variation in ccs is there between TEs & implants is there usually, or at all? I asked what type of implants he would use and he said he didn't know yet, that is is a work in progress. He insists that the pectoralneurectomy wo't affect my upper body strength, and gave me the number of a patient of his who is an aerialist who had a single MX w/ Immed. recon using implants. I spoke to her at length today and she had a good experience, yet said something about how he told her he didn't do a procedure on her that he usually does on most people. So I'll call his office tomorrow to get clear on this. Very frustrating as I just want to let it go as I have two weeks to prepare for surgery, not hash out how many nerves I'll feel okay about letting him cut. The result is a smooth non-ripply, non- spasming chest, but I work out with weights 3x a week and don't want to not be able to do a push up anymore! Any ideas? Comments?
-
Man Deb.. I mean.. Deborah...
I love reading here just due to the fact... you are LOADED in info!
TY for that Deborah!!!
xxxooo
-
Man Deb.. I mean.. Deborah...
I love reading here just due to the fact... you are LOADED in info!
TY for that Deborah!!!
xxxooo
-
Hello ladies,
I also love reading here just because you have so much information. I stumbled across these discussion boards only a few days ago, but now I find myself reading them daily.
Also I found a quote thatt I hope you will like:
"When the Japanese mend broken objects, they aggrandize the damage by filling the cracks with gold. They believe that when something's suffered damage and has a history, it becomes more beautiful". Barbara Bloom
Good luck to all of you.
Donna
-
Hi pretty Kate, whom I am SO GLAD is feeling well again!
It all depends on your skin, your muscles, etc. Everyone is different as to how their body takes to the surgery or if there needed to be more pocket work done, etc.
There's no way to tell this early on. Wait at least 6 months before you buy any expensive bras, as you will be different sizes, or at least this was my experience. I'll leave this to the floor to help you further.
....ladies?....
xoxox
-
Donna, I am going to print that out and paste it to my bathroom mirror so I can see it every single day.
Thank you, it's beautiful!!! I feel the same way about laugh lines.
xoxo
-
Here's one that I've wondered about also....when we "swap" out our exchanges in 10 years or so, what happens to the nipples?
How do they do this?
-
I'm glad I popped in here today, cause I think I can answer some questions. I had original mx and implant in 90 (one side only) with nipple done in 91, exchanged the original implant in 2000, and again this past year after cc (and new dx in other breast) . Original (fake) 19 year old nipple is still in the correct spot!! With third implant! And my new 3 week old nipple on the recently dx'd side matches!!
The incision doesn't have to be opened up the full length as the mx one to exchange the implant. No new incisions are necessary. This past time I had cc, the ps had to remove much scar tissue and started over again on old dx side (along with new side) with te's. And the nip is still in the right spot!! And each implant has been totally different than the previous, double chamber, shaped and textured and round! You'll all be okay!!
Kate, so glad you seem to be feeling better.
-
Katey - thanks for that info!
Kate -- if you have gummy implants (sorry I don't recall what you had) I would say it's safe to buy bras now as I don't think there is much drop and fluff for gummies. If you did not, then buy one or two comfy/stretchy type bras now (you NEED to wear a bra) and wait til the final drop and fluff to go wild
-
Katey: Thank you for sharing your own experience with this very subject!
-
Donna- Love the quote as well. Thanks so much for sharing with us! I like Annie's idea of pasting it to the bathroom mirror.
Anniealso and Lilah- Sad that the consensus is hold off on the expensive bras for now, but glad you probably saved me all that money! LOL!
Katey- Yes, am feeling much better. I think it helped that my recovery has gone so well and was able to get off the pain meds within a few days. Thanks!
-
Kate -- oh I meant to add: see what your PS wants you to do as well... some require wireless... others (like mine) forbid wireless! My PS wanted me in a "soft supportive" bra for the first several weeks... and approved a sports bra for me.
-
Lilah: I PM'd you....
-
Dear Deborah--I found the card for the implant I have--it is Mentor smooth round mod (moderate?) 350-7250BC. As far as I know it was 250cc, although I realize you can't tell that from the ID card. What are you thinking about changing it--it sounds like you think it's not a matter of the volume, but maybe something else.
I've been disappointed with how my clothes fit--I still have things in my closet from pre-aug. I think it makes me look fat and matronly--not the look I was going for! (Although I feel about a million years old right now.)
-
Katey - thank you for chiming in. It's nice to hear from someone who's made it farther down the line, though I'm sorry you're back again. Sometimes I feel like I get so wrapped up in the now I forget there's a future.
-
Orchid: The 350 cc low height TE style sounds good to me. A very popular style of TE. You are pioneering territory heretofore not discussed on these boards, with the pectoral neurectomy technique your PS will be using. You are going to be our resident expert on this, when the time comes....
-
Joan: A moderate profile implant is a pretty low profile implant. I know, for augmentation, the moderate plus and high profile are the most commonly used styles, and uniquely, they work best for reconstruction as well - as far as the smooth silicone rounds go, that is. I just think that 250 ccs does not seem like a lot of volume for an augmentation and it could very well be the profile or "style" of implant which is giving you the unwanted appearance. I sort of liken a moderate profile implant as being like a frisbee in shape. And you used our dreaded word here on the recon forums - "matronly"! Horrors!! But I must say, when I see a moderate profile implant, the word "matronly" does come to mind....
-
Deborah -- just got your PM! Sorry I took a break from the keyboard today -- figures.
-
ANNIE...........GREAT QUESTION! KATEY........Great story shared!!!!
It is a thought.. down the road. After replacement is needed.10-15 yrs.. hmmmmmmmmmmmmm
LOL.. just a thought....... how many of us will still be on BCO.. helping newly DX and implant girls?????????????? How many of us will there be... after so many passing years...:)
I can see it now... 15 yrs later.....
Annie:.. " So, Deborah, did they have to pick your nipple up off the ground..?"
Deborah..." No Annie, I discovered a new technique called.." nipple uplift".. let me do some research on it.. and get back to you."
All BCO girls..." Wonderful Deborah... let us know.. we cannot wait.. Thank you...etc......"
Laura and Lilah..." WAHOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO"
Val....." But Deborah.. will the cascading nipples look good in a Chanelle?????
Denise " oh please girls.. the Nordstroms2 associates will pick your nipple up off the ground and fit you into a G bra.. then...Like Deborah... You can get these bad boys on EbayFuture for only 75.00.... .. ...."
End.
OR........ is it just beginning????????????????????????????????
-
Laura: I want what YOU'RE having! Must be some good stuff...
-
Honey.. I have been at a GARAGE SALE for 24 hours.. I WAS BORED OUT OF MY MIND!!!
NO Laptop... .. only sweaty 1$ bills.. and strange people.... LOL............I am JUST now talking... after 24 hrs of quiet... EEEKKKKKKKKKKKKKKKKKKK
DH is lucky HE is not here... but at his fathers.. helping with the yard... LOL......
-
Laura- LOL!LOL!LOL!LOL!LOL! Girl, you are hysterical!!!!
-
persistent red marks don't know what to make of it
Hi all and sorry as this is probably off- topic but don't know who elso to ask and much thanks to Deborah
Am all done with Exch and things seem to be settling down but still get this skin irritation (not sure what it is) thought it was TE's pressing on skin pre/ Exch as I went up in size so stopped jogging but now am still getting it every time I exercise which has now been fast walk 5 miles/day I am so frustrated as before BC I loved to work out anyone have this ?? I do have lots of skin probs/allegies also so don't know if this is related? PS has not been much help in this area
-
Laura -- LOL you ARE a riot tonight! Love that image of us in 15 years
Winter -- it only happens when you exercise? Sounds like your bra is rubbing against your foobs -- the skin is thin and can be easily irritated. Maybe a better/tighter sports bra?
-
well i hope they cut AROUND the nipple as taking it off and recreating another would mean a loss of skin and the possibility of a smaller implant.
If they open up my existing scar to plave the implant,will it have to be a larger incision (with it being a gummy)than a regular implant? I read somewhere that they cant squish it into the whole as easily with it being so firm, so have to have a bigger incision.
And do they drain the saline out of the TE's before they remove them?
-
thanks Lilah-I will go to the store today and buy some difft ones;hopefully that will be it
-
Worth a try Winter, especially since your PS has nothing to offer
Kay -- my PS did not reopen my entire scar. It might be that the gummy needs a little more of an opening than a squishy silicone... but not much more. It DOES have a good amount of squish/give
Good question about the TEs! I have no idea (and couldn't care less -- was just glad to have it gone!). -
Deborah and fellow sisters--I just had a chance to look at some photos on the picture forum. thanks to sandy sunshine, Nedeza and MBJ for being so generous to share their journeys. It's very helpful to a uni like me! I'm glad to keep one (God willing) healthy breast, but it's concerning to need more surgery on it to maintain symmetry. It's nice to know how other ladies faced this.
Thanks Deborah for bumping those photos.
Lilah--I believe you are the keeper of the bra photo thread. I'll have to post mine--It's a Hanro stretch bra, back closure--not wires, no adjustments on the straps. Very comfortable.
But like a lot a ladies, I've had to rig up something to look symmetrical. Since I've gott all my volume up top, I'm using a falsie to give me some volume below. It's one half of a NuBra--the silicone-ish bras they sell that stick to your breasts--you hook them together to get cleavage, and then you wear them with strapless/backless dresses. I put baby powder on to eliminate the stickiness.
Ah,. the joys of uni-hood!
-
Joan -- very creative! I also am a uni and have a thread that shows (somewhat uniquely) a uni implant (gummy) on one side, reduction on the other; I must say Sandy and NAE have awesome results though! And MBJ I have no doubt you will as well when you are done.
That bra is not one I've heard of! Can't wait to see what it looks like. I love bras like that. My Slimpressions bra is similar (or sounds similar) and I find it's the one I most want to wear (in spite of it not being QUITE as supportive as the traditional bras).
-
Joansf: Thanks Joan! It's a very personal decision and you have to go with what makes you most comfortable. I have heard of the NuBra--don't know if it would work for Lilah--but for us smaller cup girls, it could be a good solution. I was going to order the NuBra but I wasn't sure if it would work! I guess I will have to re-investigate it. Although, I have my exhange in a few weeks so the thought of spending any more money on temporary solutions isn't very appealing at this point in time.
-
Hang in there MBJ -- a few weeks and you will have better symmetry!
-
Lilah--I'll look for your pictures. I'm definitely studying up on uni-ness. Thanks!
-
Ladies--I have a question--I got a bruise from my expansion last week--it's never happened before. Has this happened to you?
Do you know...is exchange surgery overnight or outpatient? What proportion of people end up with drains?
-
Don't know about bruises -- always check with your PS when it comes to changes in the skin.
Most women have exchange surgery on a day surgery/outpatient basis; I think the exception is if something unusual happens (like Kate's overdose). I had exchange on one side and lift/reduction on the other and even that was day surgery.
-
Winter: Hmm...could be something akin to a heat rash, or due to friction, but since you have a hx of skin allergies, it could be you are predisposed to this problem. Many skin allergies are due to contact dermatitis, and the tissues on your breast are thin and not padded with fat or connective tissue any longer. As Lilah recommended, try another sports bra - a breathable sports bra - one which specifies it is breathable, e.g., allows good air circulation- and pre-wash before wearing only in Dreft or some other hypoallergenic wash and see if this helps. Oh, and make sure that sports bra is a Level 4 or something which ensures "no bounce" and it should be wireless. Val on the Bras 101 thread might have some recommendations. In the interim, why don't you see your dermatologist, because you certainly do not want any inflammation to result - or anything that might threaten the skin integrity or the implant. And let us know how you are doing. Nothing is OT when it comes to protecting the dual investments on your chest wall!
-
Lilah....you have awesome results also! Your latest photos prove that!
-
Laura: No more garage sales for you honey....
-
NO PROBLEM..
Have you ever had a garage sale.. They are horrific. .. I had to work today and tomorrow.. so not helping my friend. sitting there for 8 hours with NOTHING to do.. and you HAVE to stay there.. or someone could take off with your JUNK without paying...lol... horiffc.
I will never do that again...
The deduction is WAY better that garage sale money.. I'm and accountant/before business owner.. so I even KNOW BETTER.,,,hehe
Hey Deborah. I am trying franticly to get my curls back..:(.. What do you put on your hair AFTER shampooing and conditioning? A Gel.. foam... cream..?? I need something I can scrunch and HELp my curls come back alive. I do not have the amount of curl you do..
-
Hehe Laura -- yeah I make regular trips to Salvation Army during the year; they give out a form you can fill out to record your donations.
Thank you Deborah
)) -
laura: Take the deduction--I hate yard sales, now I just write the darn stuff off! You can have my curls--ever since chemo my fine, wavy hair has now become kinky!! I can't even tell if it's getting any longer it's so thick and kinky--I really don't know what to do with it!
lilah: thank you!
joansf: my husband said that mine got bruised after an expansion but I personally think that the bruising that is still there from surgery just became more obvious the bigger my breast became with the expansion of the TE. Deborah, any thoughts on this?
-
MBJ I think you are right about that -- the bruising showing up as you expand.
-
Laura~ i have an amazing curl cream i use on my hair. It's bu OSMO and its just called curl fluid i think.It encourages natural curl or permed hair.Not sticky. not crispy. just a nice,soft,seperated curl.
Used to be a nice one by NEXXUS also,but cant remember tha name.That was a spray one and had pink writing.oh wait! Rejeuveperm! but it enhanced the curl on naturally curly hair brilliantly too.
-
Laura~ i have an amazing curl cream i use on my hair. It's bu OSMO and its just called curl fluid i think.It encourages natural curl or permed hair.Not sticky. not crispy. just a nice,soft,seperated curl.
Used to be a nice one by NEXXUS also,but cant remember tha name.That was a spray one and had pink writing.oh wait! Rejeuveperm! but it enhanced the curl on naturally curly hair brilliantly too.
-
Re bruise--this is a bruise immediately over the port. Black and blue.
-
Laura: I like this product the best:
http://www.frizzoff.com/5-Curl-Keeper.aspx
I have a regimen I follow when I go curly...very strict....I'll PM it to you this afternoon when I get back from babysitting. For instance: No sulfates - nothing with the word "cone" or "xane" at the end of the ingredient.
-
Deborah: Did I hear you mention that moderate profile implants are MATRONLY!!?? OMG, am I going to look like a granny when they are through????
-
MBJ: Moderate profile is not the same as moderate PLUS profile. It is the "PLUS" which we discussed as an option for you.
-
joan: I know some women have experienced some bruising - temporarily - after fills. Why some more than others, I do not know. It might be referable to the thin skin in the area of the port. How much volume are you getting with each fill and how often do you have fills? Go slowly - small amounts and space out every two weeks if you can.
-
Thanks, Deborah. As far as I can tell, it had been 2 1/2 weeks since the last fill, and it was 60 cc's. Ten days before they had done 90 cc's, which was miserable, although there was no bruising, nor with any earlier fills.
I guess what worried me was: Was I starting to bruise because the TE was getting full and the skin was more stretched? They tell me I'm 120cc's away from full on a 500-550 cc TE.
Anyway, it's reassuring to hear that it does happen. Thanks.
-
My PS says the Mentor moderate plus is the same as the moderate in Allergan, so I am confused.
-
Am still waiting to speak to a former patient of my PS who is extremely active who had the neurectomy. I just can't trust a Dr. telling me it will be okay, so will let you know. I did speak to one of his former patients who had a LMX and who is an aerialist by profession. It took her some work but she is back on the trapeze after the single MX w/ neurectomy. I want to speak with one more though. The TEs are new, model 7100. They have tabs for the PS to suture them onto your body so they don't migrate!
-
MBJ: Do not go by the "description" of the styles. The MPP in Allergan is Style 15. Look at the dimensions, not the description. The moderate profile in Allergan is Style 10. I do not know of any PS who has used the style 10 on a MX reconstruction. Style 15 and Style 20 are the two most commonly used styles, followed by Style 45.
-
Oh Good!! I imagine I will get the most projection from the 15 or 20's! All I could think ofthe last two days was matronly--I have never been that LOL!!! And neither have you, BTW!! Thank you for clearing this up!
-
joan: I would not do more than 50 ccs every ten days. There is no rush to finish this process. Because the bruising is right at the port site, it seems more likely it is the mechanics of the pressure of the needle in that area. Perhaps if the needle does not go in at the right angle, there is more pressure on the tissues...I do not know. Make sure the PS or technician is using the magna-finder external locating device to find the injection site, and not just palpating the area with fingers to find the injection site Wait until the bruising/skin discoloration is resolved before you get another fill.
-
Hi Ladies,
I have question- I am about 12 weeks out from BI MX with TE in. My left side has been itching under my skin and feels sort of irritated. It's been like this off an on. I can't scratch the itch because it's inside. I feel quite frequently. I don't feel any of this on the right. Is this normal and part of healing?
-
orchid: I will be very interested in knowing how the pectoral neurectomy ameliorates the implant animation most of us experience after MX. It is uncomfortable enough trying to scoop icecream out of a carton, and so I cannot fathom trying to swing from a trapeze after MX. Of course, the latter could be deadly anyway, at my age.
-
Deborah: You would look great in the Trapeze Leotard though
-
Only if it was a hoodie/footie, MBJ.
-
Deborah, LOL!! You are too cute!
I just went to Timtam's site and Fumi is shutting down the picture site!
-
joan- There is a product called Arnica which can help with the bruising. You take it a day or two before until a few days afterwards and it can prevent or even lessen bruising. Hurleygirly and I have both used it with much success. It is available at most health food stores and maybe even drug stores.
sweetie2040- I had that same under the skin itching feeling with my TE's and have had it post exchange as well. It's maddening sometimes isn't it? I haven't done much research but I think it has to do with the nerves regenerating just like the phantom pains that some women have. I don't have it nearly as much as I used to so I do think it gets better with time. I don't know why some of us get it and some don't but I can definitely empathize with you!
So sad about Timtam's site!
-
Thanks for the tip on arnica--I've heard of it, but I always forget about it.
I was given neurontin for nerve pain--mainly stinging--it helped sooo much. I wonder if that would help with the itching?
-
joansf- That's so funny that you brought up neurontin! I was just reading about it yesterday. They are actually prescribing it to help with hot flashes for those of us who cannot take hormones. I was going to speak to my GP about it as BC seems to have pushed me head first into menopause. If it helped with the pain from the nerves regenerating as well what a bonus!!!
-
ARNICA WORKS!
I grow all my own herbs and am kind of a geek in my own naturals world here... I had outer eye surgery... some bruising.. lasting a week and only a week. It should have lasted 2-3 weeks.
Arnica works!
-
whippetmom: The PS said he cuts usually three out of five or six nerves of the Major Pecs. Now you've got me concerned, as I teach healthy cooking classes publicly and privately, and do some catering as well, which is all very dependent upon upper body strength. Didn't realize that recon w/ implants would affect my work to that extent. Does everyone with recon implants have this experience, such as when scooping ice cream? Not sure if I mentioned I spoke to the PS assistant and these Siltex Low Height 7100s are new. They have tabs that the PS uses to suture them down so they won't drift. If you want to see the aerialist, who had a SMX, send me a PM and I'll send you the link to her site. They perform regularly around the south land.
-
kate33--I was skeptical that neurontin would help hot flashes. I went from using hormone replacement therapy to having to stop as of my diagnosis and now I'm on an aromatase inhibitor.
Meanwhile, I'd had night sweats for years despite the HRT. They have stopped--completely!--with neurontin, and so far I'm not having a problem with hot flashes. I think it's just a miracle drug.
-
orchidgal: The "animation" issue is a sensory and cosmetic issue rather than a functional issue. It feels strange and looks strange, but most women who have undergone breast implant - based reconstruction recover all upper body strength they had prior to MX. I think that the purpose of the pectoral neurectomies will be to ameliorate if not eradicate the animation aspects aforementioned. So this will not be a concern for you.
-
Hi - You seem smart as a, well, whip(pet) -- very smart!
I don't know how I'm supposed to get the sizing info (I didn't see where to go in Exchange City) so I'm writing the info to you here if that's ok.
Under my braline I measured 31". I am almost 5'4" and about 130 but i'm plan on losing weight...I'm up to 330 ccs already. And my TEs are Allergens, Ref. 133 FV -12.
I'm scheduled for one or two more fills but think this may be big enough but it's so hard to judge -- they are so ROUND and HARD right now. What size would I be? I'd be happy with a B (I used to be a DD). Can you figure it out or direct me to how I can ? Many thanks and god bless, M.
-
Thanks Deborah once again for the good advice. (dreft great idea didn't think of that) I just bought this months Real Simple magazine which has an article "road test sports bras" for anyone who is interested' so I'm going to try one of those. (Fortunately the redness has cleared so may have been bra or dermatitis as you suggested as I have had that before.).
Joan I also had a bruise once after expansion where needle was inserted and it went away.
-
mint - I have the same TEs as you and am filled to 360ccs - I think I'm going to get one more fill!! Good luck - no idea what cup size that will be.
-
mint: If your skin is doing well with expansion, you should fill up to your recommended capacity of 400 ccs with your TEs and perhaps a little overfill. Do not focus on bra size, because if you tell your PS you want to be a "B" cup, you will end up with tiny little nubs on your chest. Here is what would work for you:
High Profile
450 - 475 ccs [and this would be Allergan Natrelle Style 20 as Mentor does not have this latter size] or
500 ccs Either Allergan or Mentor
Moderate Plus Profile
421 ccs - Allergan Style 15
457 ccs - Allergan Style 15
[NOTE: Mentor also has the MPP style, but the dimensions of Allergan are better - better projection]
You need more implant volume after MX in order to get a sufficient breast mound. The MPPs give a more athletic appearance because they are lower in profile than the HPs. Go over these options with your PS. The majority of us who have smooth silicone rounds have implants with greater volume than were our TEs. You and I have nearly identical statistics - same ribcage circumference, same height, I am only 5 pounds less - and I had the same TEs. I was filled to 425 ccs [25 ccs overfill] and my implants are Allergan Natrelle Style 20 high profile - 550 ccs. But my skin was very responsive to expansion. I imagine you have pretty sufficient flaps also, since you were a DD cup prior to MX.
-
Whippetmom: I'm basically the same body size as you, mint, and vmudrow. I have 330 ccs on one side and 360 ccs on the other. They do not look like "little tiny nubs" on my chest. You might want to send a picture of yours to mint and vmudrow so that they can see what 550 ccs look like. If mint was previously a DD, then that could well be a size she will like.
Did you ever get your tfeather? Hope all worked out well. Mine are faded, especially the right side. I think it's from abrasion from the pec animation.
-
Double: If mint tells her PS she wants a "B" cup, she could end up with implants with a volume in the 300 cc range and this would be too small for her chest wall. A natural or augmented DD cup is just not the same as a reconstructed DD cup. Not the same at all. You will look smaller as a reconstructed DD cup. Much smaller. I was a C cup prior to MX and I wear a DD cup now. However, my clothes fit the same and, in fact, some fit better because I have a lower profile and no spillage over the cups. I look smaller in clothing than I did prior to MX. It is a connundrum, but one we want to consider.
I have not done anything additional yet to the tats. I think I am going to have Judy touch them up in Vegas.
-
I'll second what Deborah said... I was a DD-DDD prior to reconstruction. Now I'm a D and look MUCH smaller (like half the size). I even still fit in a few of my old DD bras and it is definitely NOT the same (though only the stretchy ones, otherwise the cup wrinkles). In fact, my reduction/lift side fills the D cup better than my implant side. It's like I'm a full D on reduction side and small D on MX side.
And I've got 685 cc's on the implant side.
-
whippetmom & orchidgal
I've had trouble finding information on working out after all this is over and you all have helped me. Thank you. It's especially encouraging that "most women will gain all upper-body strength prior to MX." My plastic surgeon assured me of that back in November when I saw him the first time, but I've begun to doubt it. The whole weird pec.movement thing concerned me too. I feel better reading your conversation. Thank you.
-
Dawne-Hope: I want to add though, that there are things I can do but I do not want to do after MX - e.g., push-ups. Push-ups were part of my exercise routine prior to MX but I don't do them now because it is such an odd sensation.
-
Dawne-Hope: I've been searching for information as you have - what effect can I expect Mx + implants to have on what I do now? Whippetmom says push-ups produce an odd sensation but that she has the same upper body strength as pre-Mx, and I've heard the same from others. Still, I wonder if there is anything I can ask my PS to do or not do so that I can optimize my post-Mx life, e.g., so that I will still be able to push up from the floor into a backbend. Or, do I actually consider no implants because of the potential loss of strength and mobility? Thanks for anyone's advice.
-
yogamom - At first, I was totally against having reconstruction simply b/c I wanted to do everything (weight lifting, yoga, pilates) that I had been doing. I was assured by two different doctors that I would be able to. Since then, I've had A LOT of trouble finding information for BMX ladies. Hope someone can help you. Best of luck to you.
-
yogamom: Why don't you PM orchidgal, whose post is on this page, and ask her about the procedure her PS will perform in order to address this issue of pectoral animation.
-
A quick update and a question: I'm at 365cc and am planning to be over-filled to 500cc. So, the plan is 2 more fills of ~70cc each. I have finally settled on 400cc high profile implants. (Both my PS and Deborah agree so I feel like I should listen! LOL!) So my question is: if my PS uses Allergan (which he tells me he likes better than Mentor for recon patients), which style will he be using (at 400cc HP)? He told me that at the next fill he will order my implants for exchange in Sept and that if I have an opinion on what I want, I should come prepared to talk. So, Deborah~ do I have an opinion?? LOL!
Glad to see that everyone is doing well. FWIW~ I don't have ice-crm scooping issues but getting into my xanax bottle is a nightmare.
-
Michele: It would be Allergan Natrelle Style 20, 400 ccs. Here is the link. Disregard the description as being "midrange profile"....it is confusing. This is the high profile style and the Style 45 is actually the "ultra full projection" style.
http://www.justbreastimplants.com/breast_implants/natrelle20.htm
-
Deborah - So I'm confused on Michele why do they fill to 500 ccs and only put in a 400 cc implant? Whereas my PS is filling to 400 ccs and putting in a 450 cc? What style (its Allergen) of implants should I ask for the high profile or the ultra full projection? It gets so confusing!
-
Forgive me ladies for being lazy, but this is a new forum for me and I thought I'd just throw my question out there and if someone can answer it, that will save me from going back over 30+ pages of posts to see if the answer is already here.
I had skin sparing (skin saving?) BMX with TEs last Thursday. After reading in this forum, I was curious about how much fill I had/will have; so at my f/u appt with PS today I asked the nurse. To my surprise, my husband answered (apparently this was all discussed in the hospital while I was under the influence of morphine and I don't remember it). Anyway, he says I was filled to 500cc at the time of surgery and the PS says he may go up to 600cc before the implants are put in which would be done with one later fill. I was a saggy D before surgery and had told the PS I was tired of big breasts and a B would be fine with me; he said a C would suit me better and we sort of left it open.
So, what will a 500 fill make me? A B or a C? After reading these posts, I don't want the nubs a couple of you mentioned, but I really don't want large breasts either. And does all this sound reasonable to you all? If' I've already got 500 in me, I don't know how much different 600 will look. I'm not very big now.
I got a good report, the nurse said all looks as it should; they took out only 1 of 4 drains but I go back Monday and they'll take out another that was still draining just little too much to come out today. Thanks for any help you can give me with this; or direct me where I can find out my answers. You ladies are a godsend!
-
Regina -- you need to send info about your body (see the header of this thread) to Whippetmom -- either here on the forum or in a private message. Size is not based on cc's alone but also YOUR size. No one can tell without knowing some basic facts (again, see above).
Valerie -- some surgeon's overfill and then put a smaller implant in; others will put an implant in that is larger than the TE fill amount. I think it depends on a lot of different variables (most of which I don't know). The only thing I DO know is that my PS always overfills and then puts a smaller implant in... I thought it was to get ptosis (a natural droop) but I don't have much droop so I guess I need to ask her next time I see her what her reasons were. In my case though I have a gummy (Allergan 410 cohesive gel) implant and these are firmer than regular silicone... so would have a little less play when being inserted (so would need more space for placement). I am sure Deborah can elaborate
-
Valerie: From my original post above:
QUESTIONS FOR YOUR PLASTIC SURGEON:
In the interim, here are very important questions to pose to your plastic surgeon. Ask your PS if he/she tends to place you in an implant with a volume larger than the TEs, or if he/she prefers to place you in an implant smaller than the TEs. If your PS likes to overexpand - overfill - ask about this. It is important to know what is in your PS' mind about where he intends to go with your reconstruction, because this will assist us in calculating to what extent you require expansion in order to exchange to the desired implant size and dimensions.
Michele's TEs are actually 300 cc volume TEs and so her implants will actually be 100 ccs greater than her TEs. The only thing which is added with this overfill to 500 ccs is projection and the assurity that the expansion will hold with minimal skin retraction when the TEs are removed. Some plastic surgeons just feel they need to overfill every patient and some only overfill when it is needed for some specific reason, and some just do not overfill at all. Not all adhere to the theory of "overfilling." Mine does not. It also depends on the patient's skin flaps. The PS alone can determine the patient's skin integrity and so he or she will determine what is needed to get a patient to a certain volume of implant. You do this long enough and you see how many different approaches plastic surgeons will take to arrive at the same size of implant.
There are three different roads people in our community can take to get to our neighborhood, and everyone seems to take the route they are most familiar with or which consistently seems to get them home without traffic obstructions.
Your implants: Ask for Style 20 - 450 ccs - NOT Style 45 - which would be too narrow for you.
-
Regina: I extracted this from the instructions at the top of the page:
If you are interested in discussing implant sizes, make sure you compile and provide us with the following information:
Height, weight, ribcage measurement [measuring the circumference of your ribcage under your tissue expander(s) or under your bra line]. Also, if you have TEs [tissue expanders] - we need to know about them. The style - Mentor or Allergan most likely - and whether they are short height, moderate height, full height if Mentor and style number if Allergan. We also need the recommended fill volume of the TEs - the number of cc's. (NOTE: If you have PMT Corporation tissue expanders or any other unlisted manufacturer, please see if your PS will provide you with the dimensions of such devices.]
"WHAT CUP SIZE WILL I BE?" OR "WHAT SIZE IMPLANT DO I NEED FOR A "C" CUP?"I CANNOT PREDICT CUP SIZE. PLASTIC SURGEONS - THE SMART ONES - ADMIT THAT THEY CANNOT PREDICT CUP SIZE WITH ACCURACY!
It is very difficult to determine cup size with breast reconstruction patients, as volume does not easily translate to a specific bra size. There are so many factors which determine how implants will look on any one individual, e.g., your ribcage circumference, whether your chest wall is bony or if you have a fair amount of adipose tissue surrounding the chest wall.... if you have any ribcage deformities or other structural issues which might impact implant placement. We can sort of "project" where you might want to be...or estimate the implant volume which you could "aim" for - so that you can sort of look at the prize ahead of you. Most of us have found though, that it is better to continue with tissue expansion until you have reached a desired volume and appearance, and then compare these dimensions with the breast implant dimensions found on the links at the top of the Exchange City thread in the Breast Reconstruction forum.
FOR MORE INFORMATION RE: IMPLANTS VS. CUP SIZE, READ WHAT THE EXPERTS HAVE TO SAY:
http://www.realself.com/question/Breast-implants-size-full-b-cup
http://www.breastsurgeondallas.com/breast_augmentation_faq.html
-
Wow, lots more complicated than it seems. I'll ask all this Monday when I go to have my drain removed. Thanks so much for the help ladies. It's a shame that we blindly follow "doctor's orders" without having all our info up front and not really understanding all our options.
-
Thanks Deborah! I'll ask him 1st which he was planning 20's or 45's... I'm curious. My ribcage is wide but I'm a small person. (5'0" tall, 110 lbs, size 2) So, it is strange...
-
Michele: The Style 20's - not the 45's. The 45's are too narrow and would be too tall on your chest wall.
-
Oops Lilah....there we go cross-posting again!
-
Whippetmom- I am now filled to 300cc's which look huge on me! The question I have is I feel there is a very large gap between my breasts yet they are under my armpits which to me gives a very wide look. I have looked at pics on here and elsewhere and see it seems wider than most. Also I noticed some pics with TE are far apart. Can this be fixed at the time of exchange and is it is big deal to do so? I asked my PS about it and he said he can't really move it over because it wouldn't look good but he could use a wider implant but it wouldn't make a big difference in the gap. Oh I had a NSM so don't know if that means anything as far as location but to me it seems it wouldn't change the postion very much. I am going to email you my recent pic too.
-
sweetie- I know Deborah will give you some great advice but just wondered if you saw my pics on the picture forum? I was expanded to 365 and went with 375 implants. I had a huge gap between my TE's. I asked my PS if she could bring them closer. She told me since we don't have breast tissue it's kind of determined by where your pec muscles end, and everyone is different, but that she would do the best she could. She did tell me to go with 375, vs 350 implants, for the little bit of extra width needed as well. If you see my after pics you will see she was able to bring them very close together without having to go with a much bigger and wider implant.
-
Kate33- Actually I was just looking at the pic forum earlier today and I did see your pics and mine look a lot like your TE's did. Your final result did look much better than your TE and when I saw that it gave me hope. I will ask my PS about the width because he did mention that. I feel huge right now at 300cc's! I feel like I don't want them any bigger just wider and closer. Also I can feel bumps through my skin which he said are stitches but I feel them all over.
-
Hi Deborah and other wise women of the recon/exchange forum,
I have finally finished chemo, 2 weeks out and looking to the future. I'm ready to start thinking more about recon, although I have asked my PS if we can delay it until November so I can have a few months of not being a patient and building myself up. Deborah, I've PM'ed you my dimensions, and I'd be very grateful for any advice you'd have on implant sizing. Thank you so much for all the information I've gained already reading back through lots of the previous posts,
Lisa
-
Regina: I just went over your original post again and I have a few comments. The fact that your PS was able to get 500 ccs in the TEs at the time of surgery, is because you had sufficient skin flaps to do so. The droop of the maternal breast - or just vis a vis gravitational pull, if you have not had children - makes for a lot of skin to be filled up by TEs and later implants. I agree with your PS about size and I just do not think you can accurately predict cup size with breast reconstruction. The key is to continue expanding until you reach a point where you can say you are happy with the volume in your TEs - happy with the size. From that point, implants can be determined by dimensions - attempting to approximate the dimensions of the TEs.
-
Sweetie: Email me your photos. Unless you have some type of ribcage anomaly, I do not understand why the implants could not be placed more medially towards the sternum. You would likely require some lateral revisions to keep the implants from migrating again, but this is honestly done all of the time. When you send me your photos, remind me of your ribcage circumference again.
Kate...I had no idea you posted your post-exchange photos! I'll go there right now and look!
Deborah
-
sweetie- I had the same issues with the stitches. They're supposed to dissolve but mine didn't either. My PS was able to remove them during exchange, though. I felt pretty big with my TE's, too, but lost a lot of projection with the implants. See what Deborah thinks, but my PS said the implants will look at least 25 cc's smaller than the equivalent cc's in TE's. I think it feels like more than that but maybe not after I drop and fluff. Deborah thought I should have gone 400-425 and now I am kind of wishing I had. I was afraid of being too big but the implants just don't feel as big as the TE's. My DH is happy, though, so it's all good.
-
Lisa: I have PM'd you back with some additional questions...
-
Deborah- I was going to wait until my stitches were out but some of the girls wanted to see what 375 cc implants looked like since their last fills were coming up. Please let me know what you think. I think you were right, though, that 400 cc would have looked better. I should know better than question the implant whisperer!!! LOL!!!
I do have a little lump that showed up yesterday next to one of the stitches my PS put in for the Alloderm. I was freaking out but BS thinks it's just an inflammation from one of the stitches after I stretched too far. I will see my PS on the 21st to have them out so we'll see what she thinks.
-
Thanks Deborah, I've replied.
Being a UniMx, I have realised that, for me, it's all about the symmetry. My TE fill progress was a little up and down. I had skin sparing Mx, and started chemo 1 month after surgery. Then I started developing mild flap necrosis, and required 2 minor re-excisions of the incision line, and a "deflation" of the TE. It's been gradually re-expanded, and I've been only occasionally wearing a soft kind of training bra so as not to disturb the healing process. So the discovery this week that with a proper fitting, and the right bra, I not only had cleavage, but symmetry was amazing and emotional.
My 400cc TE sits up high in my right chest sub-pectorally, and my poor little lefty hangs quietly. Hopefully my PS can work some magic.
-
Sweetie - my TEs are a little far apart, the PS said he will put the implants closer together - so no worries.
-
hereandnow: I'm a uni too. I will have my exchange on August 9th and I am hoping my PS is going to work some magic on my sad right side so that they are a closer match. I am on the picture forum if you would like to have a look.
-
thanks MBJ, I'll have a look, and will figure out how to post my photos too.
-
Deborah~ well my expansions are finished! I have 500ml in and i updated my pics on TimTams site!
I love how they are looking when i wear a vest,although the roundness looks abit too fake lol.
Got a meeting with my PS and BS around 9th August to discuss my exchange in more detail.She said i WILL have drains after which is a good sign that she will be doing the pocket revision i asked about. Can't wait to see what size and style gummy i'll be getting. This will be one of my 1st questions! =D
I really would like to keep as much of the width as possible.
ok......so.....i know we dont know the exact style of TE i have.....but are you going to say which size and style of gummy you think they are going to go for! LOL Lets see if you guess correctly! It will be fun.
-
Whippetmom-thanks, do lateral revisions require a lot or can all of this be just done at the exchange and is that same thing a a pocket revising like M-star is having? I emailed you my pics.
VMUDROW-thanks. so for you it is something simple your PS can do at the exchange?
Kate33- I will remind him about the bumps. I think he mentioned he can remove those. I see them everywhere! I will consider what you said about size since you are petite and although I am tall 5'7" I have a thin frame. I am afraid of going to big but I think it is just because I am not used to it and it feels so different. I mean really right now it is not that big but to me it seems huge based on what I was before. I think I mentioned it to you, but your final result looks very good very natural and I can imagine it will even look better over time when those darn stitches are out!
-
sweetie- I think all the smaller women do worry about going too big, thinking it will look fake, but what we think of as too big most will think it looks perfectly "normal" I think. I think you're right- we're just not used to it. I've been small chested for 50 years! So now I am kind of wishing I'd gone a little bigger. It would be nice if you could take your implants out for a test drive first! LOL!
-
Ha! Kate33 - Yes, it certainly would be nice to go for a test drive first! As much as they cost, you'd think we'd have that privilege!
-
sweetie2040 - My PS didn't seem to think it was any big deal to put the implants a little closer than the TEs are (during the exchange surgery), in fact I didn't bring it up - he just said now when I do the exchange remember that I will move the implants closer together than the TEs are. I feel HUGE too - just not used to having boobs I guess.
The TEs are a little, tiny bit like taking a test drive (maybe?) - the PS can add or subtract saline until you think the size is right and then he puts in a bigger size implant so they look the same volume as the TEs.
-
vmudrow: I wish my PS could go bigger then my TE's. Being a uni, he plans to go smaller.
Deborah: I hope I haven't asked this before: Even though I am a uni, do I still need to go smaller then the TE so that my other breast matches? I know that this is true about me not going with the Full Profile, but does this apply even with the moderate profile?
-
MBJ: It is a matter of using an implant which will give you the same amount of natural drape/droop/ptosis as the native breast. You do not want round, upright and perky on the MX side if it means that you cannot achieve that same appearance with the native breast, right? It also depends on how much your skin has expanded and more often than not, the PS does not even know how much volume he can truly use until he has you on the OR table.
-
Kate33-your right Kate, I'm only a full B and it seems huge to me. Your right about the test drive, it's not like it's so easy to go back into surgery if your not happy. 50 years? Your can't be older than 35 right?
vmudrow-I'm going to ask him when I go in two weeks and make sure I know for sure his plan. When is your exchange?
Btw ladies I put my pics up on the forum under bilateral nipple sparing pending gummies-let me know what you think. The first oneg I dow loaded to big and I don't know how to delete it so I hope I don't get in trouble!
-
Kay: It is a complete mystery to me! You are the only person who has been unable to obtain info on their TEs....and with gummy bears....the dimensions of the TEs are critical for selecting the proper anatomical implant style and volume. We do not even know the recommended volume of your TEs, right? In looking at your photos, it does appear to me that you have full height TEs most definitely. They appear taller than they are wide. If that is true, then something like the Allergan 410FF @ 425 gms would be nice - 13.0 cm by 13.6 cm by 5.2 cm. Or the 410FM @ 395 gms - 13.0 cm x 13.5 cm by 4.8 cm. You do not want the combination of an anatomical too much narrower in width and shorter in height than the pocket created by the TEs, or you run the risk of the implant rotating in the pocket. If your ribcage is 32 inches, I do think you could use the width of a 13.0 cm implant - in order to not have too much of a gap medially - in the cleavage area. So I have to say I favor the 425 gm implant in the FF style for you. However, I am pretty sure your PS is not going to be willing to use that size of implant. 395 gms might even be pushing it. But let's see what you end up with!
Deborah
-
Kay: In looking again at the options...the 410FF @ 375 gms would work - 12.5 cm width by 13.0 cm height and 5.1 cm projection or the 410FX @ 410 gms - 12.5 cm width by 13.0 cm height by 6.0 cm projection. I just do not think that you have the projection with your TEs for the latter style, but again, you might.
-
thanks Deborah! I guess we will find out on the 19th, won't we?
-
Yes we will and that day will be here before you know it!
-
sweetie2040- Aaaww, you really are a sweetie!
-
Deborah~
its just ME that doesn't have the info on the TE's, but they will be in my medical notes. My PS did say she would either use a low or moderate height implant but i said my preference would be a moderate height. Was pretty shocked she suggested a low height! She wont be using a full height for definate.
I know my TE fill volume was 300ml and its overfilled to 500ml.
Yeah you're right-there's not a hope in hell she'll use anything out the 400 range!! LOL I'll be lucky to get a 350ml!! i really would like to get the MX in about 370ml. But not sure if i'll get that projection so may have to go for the MF 375 ml. She MAY even be more reserved and go for the MF 335ml or the MX 325ml.
If she gives me a choice ,what should i go for? if i have to choose from the 2 higher volumes but MX or MF.....or between the smaller volume MX or MF??? i like the width of my TE's so would like to stay as wide as possible,but i also want as much projection as possible too. I know i will have to sacrifice one for the other,but dont know which way to go.
How do i measure my projection right now? do i measure it from the centre of my chest,out to the furthest point of my TE? Or from the outer edge of my TE where my armpit is? If i could tell how many cm of projection i have right now,i could work out my option better for my implants. This is assuming i even get a say in it!!! LOL But better to go prepared.
-
Dear Whippetmom, Thank you. Your information is so helpful, and I wish I would have found it sooner. What a blessing you are to so many. Here is my brief summary -- In February of this year, I underwent a prophylactic mastectomy for breast cancer prevention. Two weeks ago, my TEs were removed and were replaced with Natrelle 410MF 335cc implants. (My TEs were filled to 360cc, and I told him at my final visit before exchange that they were way too big.) I am 5'2", 115 lbs and a size 4 Petite. My chest measurement just under my breasts is 29.5".I had repeatedly asked my PE to please just give me full A cups. (I was an empty A before.) Well...I think I am least a full B - maybe a C. At my post op appointment, I expressed my concerns to him, and he encouraged me to wait ot 6-8 weeks for swelling to decrease and for implants to settle. He said we could talk at that point. He took 3 sizes into surgery and said that he tried the 295s during surgery, and he went with the 335s becasue the 295s looked too narrow. He said that he thinks I will be happy. But, I strongly doubt that these will decrease to an A. So...can 335cc 410s possibly be an A on me? (They seem to be way too wide.) How do I know what to ask for in the exchange? Will I create new problems if I now go for the smaller size that I asked for? Should I try to get him to exchange them sooner? I would appreciate any feedback that you (or anyone else) might have. Gratefully, Catchturn PS - I am glad to send photos if that would be helpful.
-
Kay: Well, there so many options in the 410's - So I suppose my preference would be the MX @370 grams or the MF @ 375 grams - probably the MF - because your TEs do not look like they have the extra full projection aspect. Also, I recall that you mentioned on the pictures forum that your TEs are completely submuscular - which means partially under the pectorals in the upper pole and under the serratus and abdominus rectus in the lower pole. I seem to recall one BCO member telling me her PS always added another 10% volume with this type of placement, because the implant is compressed more than with the partial placement [pectoral] only and the implants have a tendency to appear smaller with complete submuscular placement. Something to discuss with your PS. This is an excellent placement method, by the way....if this is what you have....it is like having an internal bra to help support the weight of the implants.
Deborah
-
Catchturn: You do want to wait at least 8 weeks before going back for revisions. It would be helpful to know what style and volume of TEs you had...so that we can compare dimensions.
With your specified desires, the 410 ML @ 220 gms would have been a preferred size...enabling you to maintain the same width...12.5 cm...but with significantly less projection. But it all would depend on whether the style and volume of TE your PS used would have accomodated that style/volume of implant. I am going to PM you so that you can send me photos. Also, please try to find out what style of TE your PS used.
Deborah
-
DEBORAH~ yes as far as i am aware they did the full submuscular on me. That's what they planned before my Mx anyway.
Hmm.... i will mention to my PS about the implants being compressed more with this method. And i will ask for either of the 2 sizes you mentioned above. May as well start high them try and barter!! LOL If i ask for that size and then explain my concerns about it being compressed and losing projection! I will let you know what she says and what she aims to use.
If it ain what i want she'll be in the boot of the boobmobile!!
-
Yes Kay, and little does she know, but a crazy-woman will have the boot key!
-
Thank you, Deborah, for your feedback. Wow! You are suggesting that I needed 1/3 less to get what I wanted. I am very concerned now that a revision will mean that I have saggy breasts that have been stretched too much -- far beyond what I asked for all along the way (both surgeries and the expansion process). I asked my PS this at my post op visit, and he assured me this wouldn't be the case if I decided to go smaller. It seems like, if I am certain that these are too big, then I would want them out asap instead of waiting 8 weeks. As you requested, I will send you pictures. I would appreciate any feedback you might on have on what problems I might have with decreasing the size by 1/3. Thank you for so generously giving your time and knowledge. What a valuable resource you are.
-
Catchturn: I am concerned about the pockets being too big for a smaller gummy also, now that the 320's are defining the pockets. I think I would need to research this a little bit more - because you do not want to run the risk of implant rotation if the pockets are predetermined for a larger anatomical implant. I personally do not know of anyone who has exchange out for a smaller anatomical. Your pockets would not be too large to downsize to a standard silicone round - I think that just maintaining the same width would work for you.
I do not know that you would necessarily need to downsize to a 220 gram implant either - it sounds pretty small to me actually - but that was the one style/volume implant I pulled from my list which had the same width as the implant you have currently. We can refine this once I see the photos.
Deborah
-
Whippetmom, I will be having right side mastectomy June 30th. Already had my first visit with PS but was upset because I had just been informed by my surgeon about a third mass so I did not ask many ? of PS. He told me I would have TE because of previous OR's. He will not do left breast until later. Is it usual to wait until reconstructed side is done before doing other breast? I am hoping to talk to him again pre Or and ask all of the questions that you suggest. Thanks so much for this forum cause without it I would be LOST!
Carol
PS- my daughter just rescued a whippet! They are great dogs and cute too!
-
Odinsmom -- what are you having done to the other breast? For what it's worth, I had MX and TE in December on right side.... then exchange on Right and reduction/lift on Left in May (at time of exchange, in other words). Though some doctors do reduction/lift at time of MX, most don't. If it's an augmentation it can also be done either at time of MX or at time of exchange... it really depends on what you are doing. Women who have augmentation of healthy breast with a specific saline implant (one that has a port and allows for adjustment of size of implant) DO have that done at time of MX/TE but that is because of the adjustability. My PS said doing reduction at time of exchange had a better chance of matching. With TEs they don't always know for sure how large you can go until you go through the process (limitations can happen due to skin and/or muscle having limits, etc). I'm sure Deborah can write something more intelligent and specific but thought I'd comment since I did have this experience.
-
odinsmom: I had an MX on my left side in March with a TE and I will have my exchange to silicone implants in August. I will have my natural side done with an implant to match. As I am small breasted and don't have any sagging, I will not require a lift. This is pretty standard unless they use the saline, as Lilah stated above.
-
I chose bi-lat without rads but with chemo. I was given this choice due to staging. I had a bi-lat and was left with a concavity of my chest on both sides. Because the chest wall was sunken, my implants needed to be larger than what would eventually be seen on outside. I had expanders with pain that I suffered through for six months. Despite the pain, I would do it all over agin. In fact, I may have to have them replaced in twelve years, or so. The expanders were blown up with saline to be 30% larger than the final implant size. I then had permant ones of 425 put into one side and 370 on the other ( if I remember ). This is due to the fact that I was uneven to begin with and perhaps due to the original tumor site high on the chest wall. Also, due to the "divit" after the tumor, I chose the tear drop shape gummy bear implants instead of the round size to fill in the "hole" in upper quadrant of breast. The breasts are the same to look at after healing. I was not fully comfortable with the implants until a full year and a half after the final surgery. I was still very active, but not fully comfortable during that time. I did do the tatoo nips. I recomend them! It gives the eyes something to focus on to make the scars less visable. I wound up with C cups and I never wear a bra and I enjoy wearing a bathing suit. Pics can be found on Dr. Letteri's website in Spartanburg, SC. I get top billing as of this week. I love my doctor. He was a perfectionist and it shows. I am very grateful. Good luck and God bless.
-
Odinsmom: I think Lilah and MBJ addressed your questions above. I think referable to specific questions, I would ask, do you feel comfortable with this PS? With a single MX, it is key to achieve symmetry with the native/natural breast, and so the surgeon's focus should be placing a TE which mirrors the base width of the native breast. The size and degree of expansion required will be based on a number of parameters, referable to your desired size, within limits, and what will be done with the native breast. Reduction and/or lift and/or augmentation with a smaller implant. So I would definitely communicate to the PS what you hope to achieve from this. Let us know if we can help further.
-
Lisa: Simply amazing! I am not sure exactly which photo was yours though....was it the first one which comes up on the recon photo page? But the whole issue of concavity and how it occurred is a medical marvel to me. I am surprised that the TEs did not compromise the problem by compressing the ribcage even further. Well, this surgeon's name just went on my "preferred" list and for that I am grateful also!
My family for many generations hails from the Greenville/Spartanburg area. My ancestors are all buried at the Tyger Baptist Church cemetery in Taylors. My first cousin, Bennie Lee Sinclair, was the poet laureate for the state until her death ten years ago. I was born in Rutherfordton, NC - just across the state line...
Back to the breasts: Could you explain further why it took a year and a half to feel comfortable with the implants? Others who have the anatomicals and are questioning their choice would be happy to hear of your experience. Also, since your PS has access to CPGs and 410s, does he have an opinion regarding which version of anatomicals he prefers? Thank you so much for sharing this with us!
-
Lisaellen: Beautiful job! Thank you so much for sharing!
Deborah: I would have preferred to get the anatomicals, but since none of the dr's I am able to see do it, when I need to have these changed out in 10 years, would I be able to switch then? Will I still get a good look without them? I'm kind of freaking out about the round implants and being a uni.
-
MBJ: You are going to be just fine! You could use the Mentor Spectrum expandable in the native breast which would give the doctor more control over symmetry....
-
Thanks Deborah. I'm just scared of ending up with two completely different looking breasts. Too much time on my hands and I see how great these women look with the gummies and I just wish it were the standard instead of being something only a select few can do. I just wish I had the option and the waiting is making me crazy and I just feel so out of control of the outcome.
-
Thanks all for answering my questions! Now I understand why the native breast will be done later after TE on mast side. I'm not sure how comfortable I am with PS as I only saw him once and was an add on to his schedule. It seemed like he was quite disappointed that he could not do a DIEP flap and seemed to be taken aback by my previous surgical scars. I hope to be able to talk to him regarding questions I have but feel awkward about it. Does the PS measure the base width of the native breast prior to OR or during?
-
Mine must have measured in the OR because I don't recall being measured prior... but then of course since you (like me) are a uni... they can always measure the remaining breast and match it.
Did I miss or forget something you posted earlier Odinsmom? What are the previous surgical scars?
-
arrrrgh...
I can't take this... I'm soooo sick of being confused. I saw my PS today (I'm now at 445cc) and after an exam, he declares that he thinks I should go for 350-375cc implants?! WTH? *I* had asked for smaller implants and then he convinced me that 400cc would be better. Deborah agreed so I went with his advice. Well, now, he said that I am "smaller than he thought" and that I'll look like I've had a boob-job with 400cc. If I want to look natural, I need to go smaller. (Just to jog ya'll's memory, I'm small: 5'0" and a size 2. HOWEVER- my ribcage is freakishly big for my height- 31 cm...)
He also said that it would be "safer" to go smaller than 400cc... That my skin is really stretched. Well, duh... this is delayed recon...
I get what he's saying but I am so sick of thinking about all of this. Up, down, up, down....
So thoughts? Ideas? FWIW~ He did say that up to 400cc, he'll do whatever I choose. I just need to let him know at the next visit so he can order my implants...
And, Deborah~ He was planning to put Allergan 20's in me. He mentioned that he almost never uses 45's... Almost always 10's or 20's. So, yet again, you were on the money!
-
Michele...I had to laugh a little....your ribcage is NOT "freakishly big"! Let me look at your numbers when I get back to my computer this afternoon...I will get back to you.
-
Deborah- LOL! But, it *does* look big for my height (and lack of hips). My mom even commented on it several times when I was totally flat. I had that lovely starving-child look about me... wide ribcage (with all of the ribs showing) and rounded belly. Not cute. But now... I look like a porn actress so it's all good!
-
Hello Deborah,
Thank you for the advice you gave me about 3 weeks ago. Just to remind you, I have Kasier insurance as well , and go to Kaiser Downey.
I would like to run somting by you. My PS just told me today that she can go with the expansion as far as I want. Initially I had understood that my expanders had a max capacity (so to speak) of 450 cc. I was worried since I was already over 300 cc with the expansions , and looking small.
Today she told me that she can expand as much as I want. My stats are 5' 5" , now 145 lbs (but as always planning to loose about 15 lbs) and circumference under breasts 32".
So , is it true what the PS said about the expanders?
Thanks,
Donna
-
Donna: I can answer your question. I am tall (6') but I have a 32" ribcage also. My TE's are 400 max but most PS's over expand. Mine is at 535 cc's and he may go a few more at my pre-op to get a little more stretch in before the exchange. We were trying to get to 600 but mine is sewed down on the side and it started to really hurt. I hope this answers your questions.
-
MBJ: Thank you for the info. So the TE can be overexpanded. What does then the for ex. 400 cc max mean then?
I have another question. Are there websites where I could buy online bras ( I have TEs). About one month ago , I saw this information somewhere on this site, but I cannot remember where. I know , it might be better to get fitted in person , but I do not have the time now ( a licensing exam coming up, full time work, young child).
Which are good brands for postMX bras?
I appreciate so much your help!!!!!!
-
Donna: Your PS can overfill your TEs. I would recommend no more than 100 ccs, because of your hx of rads. If she is willing to help you get where you want to be, then let's shoot for 500 ccs at the minimum and 550 ccs preferably, in a smooth round silicone high profile style implant. Let's see what you look like when you are filled to 450 ccs. From there is is really height and projection which changes - the width remains the same. We still have to keep an eye on your rads side though and make sure it can handle all of this. That dictates how far you can go because it is not worth overfilling if there are complications. So talk to someone like Estepp on Exchange City and ask her what she used to soften the rads skin during expansion.
Deborah
-
Oh, and re: the TEs....the implant volumes do not state "maximum" but instead state "recommended" fill level. There are some caveats in the literature about being mindful of overfilling the TEs and to make sure skin integrity is maintained, yadda, yadda,, yadda.
-
Michele: I just went back and looked at one of your older posts and saw where you stated that your TEs are very wide on your chest wall. So do you have quite a large gap in the sternum area? How many inches between TEs in the sternum? Do you feel that your TEs have migrated laterally - towards the armpits? Trying to get a visual here....
-
trytostaypositive: There is a thread for post exchange bras. I purchased a Warners soft cup bra on line (did a google search and then looked for the best price) in the size that I hoped I would end up being but now it's too small with the TE. I also purchased from Nordstroms a Spanks bra. I ordered a B or C but it stretches to accomodate either and it works with some of my clothes. I also bought stick on breast forms & silicone inserts to even me up as I am a uni from JC Penney. I hope this helps!
-
Bras 1010: The Great Post Exchange Debate.
-
Deborah- There's only an inch between the TE's. They extend laterally further than my ribcage but not by much. They are in a decent position and are symmetrical. They don't move AT ALL. No motion. None. I have an alloderm sling in there too...
I just showed DH when I got home from work and his eyes 'bout popped out of his head! LOL! I have serious cleavage!
-
Michele: I am just trying to understand the ribcage issues. Do your ribs protrude at all underneath the TEs? I am just confused when you state that the TEs look wide on your chest [or maybe they do not any longer?] but you only have a one inch gap in the sternum. Now, take this measurement for me: Measuring tape - circumference around the top part of your chest with the measuring tape going under and around the armpits...like this...but WITHOUT a bra on....
-
well, the te's extend that high... but it is 33in with some te underneath. under the te's (~1in below where a natural bra-line would be) I measure 31in. my braline has te on it currently. the te's themselves are 8X8in but that's a measurement across the mound. my te's look like huuuuge hamburger buns: very round with some projection. I feel like the te's are too big (the diameter) for my frame and my PS has said the same thing but that the implants won't have the same diameter. does that help?
-
Michele - The width of your TEs again are?......
-
unfilled- I don't know. But when I just measured them, from top to bottom and side-to-side was 8in each. But, they are filled. They are Allergan.
-
whippetmom and/or M-Star - I don't know if it was on this thread or on exchange city, but somewhere you two were discussing submuscular (sp??) implants vs. what is normally done. My question is this: Aren't all implants for reconstruction purposes submuscular? If not, how does that work?
I'm wondering about exercise post reconstruction. And from what I understood (which I may be thoroughly confused) it seemed that if it was submuscular there were potentially less problems for the implants to migrate over to the armpit?
Just wondering. Sorry if I've posted this in the wrong place.
-
Michele: We need to go back to Step 1 which I guess I never pursued with you and that is: The style and volume of tissue expanders you have....yikes...how did we bypass this???
So call your PS tomorrow and ask his nurse/staff to look in the chart and tell you exactly which style and volume of Allergan TEs you have and then I can look up the dimensions. The dimensions of the actual TEs is key here - especially the width. Measuring with a tape measure does not work...
-
Dawne-Hope - In nearly all cases, and preferably, for local recurrence detection purposes, yes, nearly all are "submuscular." But most are partial and some are complete "unders"...
Partial:
http://www.justbreastimplants.com/placement/partials.htm
Complete:
http://www.justbreastimplants.com/placement/complete_unders.htm
-
Thank you, whippetmom. As usual, I'm behind, I should know what kind I'm getting, but have no idea. Thank you for the links and your response.
-
Donna~ my TE's are 300ml recommended fill but i am expanded to 500ml.
Dawn-Hope~ i have the FULL submuscular (or so i was told before surgery!). I will find out for sure if they still did that when i have my nxt appointment. It feels like they did,as i can feel the 'grainy' muscle on the bottom outer edge of my TE's (yuk).
-
Kay: Is your next appointment the pre-op?
-
No i don't think so. my PS said she will see me around Aug 9th to discuss the exchange in detail and to answer any questions i may have (boy oh boy is she gonna regret saying that!) lol.
So i think it will just be a talk about what will happen in sugery,which implants they may use,what to expect afterwards etc.Mind you,that might be what you guys call your pre-op. Our pre-op is a series of blood tests anD swabs(for MRSA).
This will brob be the last time i see my BS and PS before surgery So anything you think i should ask,please let me know. Thanks
-
Kay- The only thing I asked my PS beforehand was how much to throw in some liposuction, too! (LOL! JK!) (Well, just kidding about it being the ONLY thing I asked!)
-
LOL Kate .you are so funny! If i need fat grafting i will def ask them to take it from my love handles!
-
I know.. I am debating on whether to have fat grafting or not.? I would LOVE to get lipo's in some spots...lol...
Seriously, I feel I could deal with the boob dents and such... but I REALLY want the lipo since I FINALLY lost all the weight.. and still have some fatty areas I did not have prior to Chemo.. and Herceptin..
OH.. should I pay the rest of my deductible ( 900.00) just to get the lipo and breast dent filled in???
-
Kate: I'm right there with you! I sometimes feel as if I have aged 100 years since chemo and surgery. I'm hoping my PS can use more Alloderm with the fat grafting. I asked him to take it all and then he can use the rest of it later anwhere he wants. I don't think he realized I wasn't kidding.
-
Kate33-You mentioned some where about your PS lasering the scars. Do you know if this is covered as part of the reconstruction or is it extra because it cosmetic?
-
Sweetie: It might be considered "cosmetic" by some health care providers, such as Kaiser Permanente, for example. I suppose it all depends on how the surgeon's office codes the bill to the insurance carrier.
-
Deborah.. I just wanted to share a weird fact with you.
Here, in the Midwest.. Kaiser Permanente was here... for a few good years. It was known.. that if you have this insurance... you got the most HORRID care. NO ONE here wanted it... it was an HMO... where you did not have nearly the out of pocket other insurances had... BUT the catch was... you got the Kaiser Doctors... which were terrible..
it was a joke that all Kaiser doctors got their diploma from Mexico...
NO ONE here wanted Kaiser...
It still amazes me... how in other states... like Cali........ Kaiser is so great...!!
I LOVED the HMO and no out of pocket with Kaiser... but the doctors were SCARY!...
-
So I'm thinking since everyone complains that they put on weight from BC (chemo, hormones, stress) that every mastectomy should come with free lipo! What do you think, girls? We could storm Congress demanding this new law! The BCO LIPO bill! Who's with me?
sweetie- I'm not sure if the scar lasering was covered or not. I can e-mail my PS and ask her.
-
Sign me up Kate! LOL
But my extra pounds have come from sitting on my a$$ at my pc for the last 5 months!
-
Hmmm, I'm going to have to figure out how to burn calories while still being tethered to BCO.
-
FIDGET!!! LOL
While ever you're fidgeting you're burning calories
Tap your feet,move your feet about etc. -
Don't even go there! First I lost 20 pounds during chemo and now it's all coming back right around my belly. Bleh!
-
Kate33-I like the free lipo idea. I mean all those follow-ups where they just look at you and say our ok, we should get something for forking out those co-pays. I lost 10 pounds after surgery from laying around and being tired then I starting walking again and guess what 10 pounds right back on! Exercise actually makes me starving all the time, go figure!
-
whippetmom - I had my exchange surgery yesterday and guess what? My PS discovered a bigger pocket than he anticipated. I was only filled to 310cc's but he was able to put in 325ccs.
And that size is what you originally thought would be good for me! You're amazing. Allergan, style 20, high profile, 325cc's. I have yet to look at the new girls but just wanted you to know that you were spot-on. Thank you!!
-
Dawne-Hope: Very nice! Of course the pockets were sufficient! I look forward to hearing about the unveiling. Keep us posted and share your photos on the pic forum if you feel up to it....
-
Kate- if you figure that one out PLEASE pass it on sister!
-
OK, this won't burn calories but it's supposed to be great for your abs according to Dr. Oz. While you're on your computer feverishly posting on BCO try to suck your stomach in as if you're trying to get your belly button to touch your spine. Hold it as long as you can. Repeat until you cry uncle.
-
Kate: Ok, I am doing it right now, ouch!
-
I do that when im at work usually! lol it does work some.
-
Hi Ladies--I have a question: to anyone who's finished reconstruction, and to anyone who knows someone, is in a support group etc....Is it true you feel better once the expanders come out and the implant goes in? I am officially miserable and I'm counting the days--it's a month from tuesday--till the exchange. But last night, I had a moment of panic--what if I don't feel much better?
I know there's more info on exchange city, but I haven't gone there yet.
And yes, I'd like to graft 10lbs of fat and stick it elsewhere after welve weeks of Taxol/Herceptin. When all this started, the ps said I was too thin for diep flap--now I think he could make me quite a knocker out of all this blubber
-
oh shoot .... I hate reading about the weight gain w/Taxol
Whaa..... I don't wanna! -
Ginger--Let me tell you what I wish I'd done. Slow down! when I was eating. I had a voracious appetite, and I was stuffing myself. 2. Not eat all the goodies--dessert-wise--that people brought. 3. Followed my surgeon's advice and walked half-an-hour a day--they say, paradoxically, that exercise is good for fatigue. Good luck--I hope you benefit from someone else's regrets...
-
Finally took a peek today at my new foobs. And they look good! I was surprised that they look so natural. They're not too big at all ... if anything they're a little small. But they look great!
I tried to PM tTimtam but I can't PM anyone. I'd love to post some pics .. but cannot. I'll keep trying.
-
Joansf
Yes, you will feel much better after the exchange. Someone wrote they were so miserable with the expanders that they felt like cutting them out themselves. I felt they way at times myself. Taking deep breaths was so uncomfortable.
My exchange surgery was May 18. As I was being taken from the OR to recovery, I took a deep breath and noticed how much easier it was to breathe. The difference is that noticeable and that quick.
Feeling panicky is normal before surgery. You will be amazed at the difference between how you feel and look after the expanders are gone and the implants in place.
-
Dawne-Hope - This is why I said 325 ccs. I knew it was pushing it for your PS...so I am glad he could at least get you to 325 ccs.
-
Dawne-Hope -- yay!!! So glad you're feeling good about the new girls!
Joansf -- I woke up in recovery after exchange operation and I was ELATED because I knew instantly that the constant pain I had been in (not just hard to breath but back pain that travelled down my arm) was GONE. I hope you get the same relief.
-
Hi Whippetmom,
I need your advice. I had my exchange on Wednesday July 21, and am really unhappy with the results. I see the PS this Friday. I have Mentor 450cc Smooth Moderate High Profile. Prior to the surgery I had asked to be a full B/Small C, but I am lucky if I am an A. There seems to be more implant laterally, and there is a 3 1/2 inch space between the two (no possibility of cleavage here). I am petite and have about 15 pounds to lose so I don't know if that will make a difference. Am I being unreasonable in my expectations? Will they change appreciably. Is there any suggestion you could make as to what to tell him I want when I see him on Friday. Also will insurance cover the revision?
Thank you so much for your advice and sharing your expertise.
Nancy
-
Nancy: Insurance will cover the revision/exchange. I do not believe I helped you with sizing issues before the exchange, did I? I need the info re: your TEs - style and volume and how much you were expanded and/or overfilled. Height, weight, ribcage circumference also. You can PM me info if you wish. Also, you can email me photos privately so we can see what is going on. I'll PM you.
-
Hi Deborah~ I called my PS about the te size/catalog # and am waiting for a call back from the nurse. Will let you know! thx
-
OK-- it is an Allergan 400cc 133MV-13. Right now, I'm at 445cc. The TE's stretch around my ribcage but are only ~ 1in apart in the center.
Just to remind you, I'm petite (5'0", 110lbs) but have a wide ribcage (31 1/2cm). PS's 1st recc was 400cc smooth, round, high profile. Now, he's saying 350cc because "I'm smaller than he thought" and my skin is really, really stretched. However, he says that it is up to me and he'll try for 400cc if I want him to.
I must say, I'm really hating this 445cc. It looks ridiculous. My 1st impression was to be small but (was a 34 A before Mx) but I like having cleavage. So, what do you think? Will 350 be OK or should I push for bigger? I don't want to look like I've had a boob job but I don't want to be out of proportion either... help!
edited to add that I have a short torso...
-
Michele:
Your TEs have the following dimensions: 13.0 cm wide by 5.6 cm in projection. I think I would recommend the following:
Either 371 ccs [12.9 cm wide by 4.1 cm projection] or 397 ccs [13.1 cm wide by 4.2 cm projection]- Allergan Natrelle, Style 15, moderate plus profile implant [it is called something else on the website, but it is a MPP for all intents and purposes.] Not the Mentor MPP, but the Allergan. If you indeed have a 31.5 inch ribcage, AND, because your TEs are 13.0 cm wide, it would be preferable to stay as close as possible to the 13.0 cm width - because why go through pocket revisions to narrow the pocket if it is not necessary to do so. I am having a difficult time understanding though how you only have 1 inch gap in the cleavage and the TEs are wrapping around your ribs, as you stated, with a 31.5 inch ribcage. If you go with a 350 cc high profile implant, the width is only 11.4 cm....so you can see how this will differ significantly in width as compared to the TEs. If there are no pocket revisions and you go with a narrower profile implant, you are more likely to get rippling laterally. Additionally, if the pocket is wider than the implant, the implant is going to tend to migrate laterally, towards the armpits and you would have a pretty significant gap between the implants in the cleavage area. The 400 cc high profile implant has the following dimensions: 11.9 cm wide by 5.0 cm projection = which is, as you can see, quite a bit smaller than the dimensions of your TEs currently. You would need pocket revisions. You also are overfilled and this adds more height and projection to the implant and this might be what you find looks sort of "ridiculous", as you say.
You can send me photos Michele...just so that we can nail this down, because your ribcage issue is perplexing to me. PM me if you want to do so.
Deborah
-
just took pics. will send you a PM. thanks!
-
From inspecting myself in the mirror (LOL!), I think that my ribcage is very round. Kind of like a great dane. LOL!
-
Michele: That is pretty funny. But you paint an interesting picture. My dog has a ribcage like a Great Dane and I certainly would not want to try to fit him for a bra....
-
Deborah- LOL!!! Now there's a picture!
-
I don't even want to think about bras yet! Now, that will be an adventure!
Deborah~ Thanks so much for your help yesterday. I'm making my list of questions for my PS now.
Regarding "pocket revisions"- does anyone have a BTDT? Does it prolong recovery from the exchange surgery? How 'bout drains? My PS told me that he doesn't use drains at exchange but would a "pocket revision" make me need a drain?
xxoo
-
No, pocket revisions does not imply drains...ask the question on Exchange City Michele...quite a few there....
-
michelle: I have that same large,round ribcage, my under bra measurement is 32" and ! also have the same expander. My breast feels as if if's going under my ribcage, but I think that's because even though my breast always had that width, it never had any projection to speak of! BTW: My left breast does look a little bit like a "Porn Star" breast, but I am sure after exchange it will look a bit more normal. Whatever normal is, as I do live close to Hollywood where Porn Star is more the norm then not LOL!!
-
Deborah: Good thing I am just waking up and not just falling asleep because I am sure I would be dreaming about Great Dane's in bras! LOL!!
-
Deborah - so I had appointment with PS today to discuss exchange. Just to refresh your memory I am filled to 400ccs and you suggested 425 or 450 implants, style 20. He is planning on putting in 450ccs implants and I asked the style # and he said 20 - that he thinks that works best for masectomy patients - gives more projection. I told him he is good - because that is what you suggested. So I am glad he was on the same page. So I must thank you and tell you that you are great at what you do!! I told PS before about this site and he thinks it is great!! So thank you and keep up the good work.
He did say my skin was still stretched really tight since the last fill - so wants to see me in 3 weeks. I wasn't planning on exchange until middle of Sept. anyway so I think it will be fine.
-
Valerie: Excellent. I think that will be a good size for you and also probably the maximum you can go if your skin is pretty tight. So glad everyone is on the same page!
-
Hi Deborah - I am 2 weeks away from exchange (yay) but I am a little worried because my left expander has never caught up with the right one. I have always suspected that there might be a slow leak. I saw the surgeon yesterday and now he agrees. It is easily half the size of the other one. When he asked me again about size, I said, "I want to be bigger than the left but smaller than the right". Is he going to be able to do that?
-
Sunny: Look at the top of this thread for the information I need from you. Let's calculate what needs to be done. Your height, weight, ribcage - and re: TEs: Mentor or Allergan and style and volume of same. Call your PS tomorrow and ask his office staff to look in your chart and give you this info. It must be recorded in your chart. You can PM me with the info if you prefer. You might want to email me photos also.
Deborah
-
Whippetmom- I saw my PS today and he filled me to 400 capacity. He said he doesn't need to really overfill very much and the next appt will be to talk about the exchange. What is bothering me though is the big space between my TE. He said he can't really move them closer together because it would risk them migrating together. I just can't understand this when everyone else seems to be able to have it done. He mentioned my chest was bony and there would be nothing holding the implants if he opened it up medially. I saw Kate33 pics and she had a wide and space and she is thin and her's go moved together very nicely. I will email you a pic from today. I'm wavering about the gummies also, they felt REALLY firm and I'm not sure I'll like them. On the flip side my DH thinks I am looking unnatural in the TE and he is afraid the rounds will look like that on me. GRRR I don't know what to do!
-
Sweetie: I emailed you with some thoughts and recommendations.
-
sweetie - whippetmom knows her stuff and will help you, I'm sure! I just wanted to encourage you that your TE's are going to be nothing like the implants. I am about one week out from exchange and cannot get over the difference in look from TE's to implants. Mine were far apart, lopsided, half-softballs on my chest with a shelf I could have set a teacup on each one. Now, they are closer together, even, natural slope and SOFT!
You're in good hands with whippetmom!
You're going to be OK! -
Thanks Deborah!
Dawn-hope-thanks for the inspiration. What style and size did you end up with? Did you Dr. have to revised the pocket to move them closer together at all?
-
sweetie - I had Allergan, high-profile, style 20, 325cc's. He did pocket work on the rt side. The right was a little higher than the left and now they're even. He told me he couldn't bring them closer in because of my sternum and if he did, it would look like I had a uni-boob. I don't know what he did, but they're not as far apart and they look very normal.
-
sweetie- My PS kind of said the same thing that Dawne-Hope's did. She said how close together she can bring the implants is based more on your own anatomy than what the PS can do. She said in augmentation they have a little more room to play because of the breast tissue. But in post MX it's kind of determined by your sternum and where your pec muscles lay. My PS did recommend I go a little higher in cc's to get the width she needed to bring them as close as possible. I know you can't print out the photos on the picture forum. I'll see if my PS has her website up yet (she's using my photos) and maybe you can show those to your PS and see what he says?
-
sweetie- My PS kind of said the same thing that Dawne-Hope's did. She said how close together she can bring the implants is based more on your own anatomy than what the PS can do. She said in augmentation they have a little more room to play because of the breast tissue. But in post MX it's kind of determined by your sternum and where your pec muscles lay. My PS did recommend I go a little higher in cc's to get the width she needed to bring them as close as possible. I know you can't print out the photos on the picture forum. I'll see if my PS has her website up yet (she's using my photos) and maybe you can show those to your PS and see what he says?
-
Kate33-yes that would be great. PM it too me if you can. I am just confused how he is saying he can't do much. Deborah thinks it's lateral displacement (over to far to the sides) which is fairly common and can be fixed. He may not be able to open up the middle due to my anatomy but when I lay down it's awful, like a huge 2" gap. I need to really push this issue with him at my pre-op visit to see what can and can't be done otherwise I know I won't be happy. It's better to fix it now even if it means some type of revision than later.
side note-do you know how to post add.pics on the forum-I can put some up of this but don't know how to add them to the tread.
Dawn-Hope-that's great! I happy you got a good result. It good be too that TE look so hard and odd that just the change to a soft implant makes a huge difference. I hoping to get a good result like your's and Kate's.
-
Sweetie -- To add pics to the thread just make a new reply at end of thread and attach them to that post. I think you may be right that the change to the softer implant from the hard TE will help with the spacing.
-
Sweetie and all,
I am not an expert in the expander to implant as I had the direct to implant but I had the same issue of there being too much space inbetween especially when lying down. I had the 375cc implant mentor high profile and the divot on top where the biopsy was. Both problems were resolved with the 550cc implant exchanged. If you compare the measurements of each implant a little wider took care of the problem with an adjustment in the pocket.
I am understanding that the implant correlates with the expander sizing. My question to anyone is then, Is there a problem if sweetie requested a larger implant than the 400cc she is filled to. Did her PS already build the sling or is that coming at exchange time so he can adjust to a larger implant. During my recent PS visit this week I asked him how big an implant can he go with direct to implant and he said as long as the woman has skin he can go as big as 800cc.-was asking that question not for me just to know. So, for that .5 in width sweetie wants and if he builds the pocket at exchange why can't it be done. It appears that the PS puts in less than the fill amount most of the time from what you all share, and I went direct to implant with 375 with no stretching from an expander why couldn't she tolerate, an greater than 400cc implant.
My feeling is that if sweetie gets the implant her PS suggest, than after wants the revision to fix the gap that it could be done by her PS or another PS. I know its frustrating sweetie as I was there when I was discouraged with my space, but I am hopeful you will be happy in the end. Keep the faith.
-
PB22-thanks for asking those questions. I have thought about them myself. I have a TE that goes to 400cc and is now full to capacity. It seems to me like that's all the space I got and I wonder how would he put a wider implant in there when the pocket has a specific hgt, width and projection to it. I thought it seemed like an easier solution to just put in a wider implant. In fact they actually don't look bad on the sides, they just need something to fill in the gap. I'll try to post a couple more pics on the forum so you can see how it looks now.
-
sweetie2040 - where are you measuring the gap from? The very bottom? Just wondering how large my gap is. My TEs are filled to 400cc (capacity) and the PS says he will exchange with 450cc implants and move them a little closer together.
-
Correcting lateral displacement...
Lateral capsulorrhaphy
Click on link and scroll down for photos...
-
ok, I put my pics on the forum so you could see how big it is!
vmudrow-I measured right in the middle and also when I measured laying down it was even wider almost 3"
Whippetmom-thanks I'll check it out. If you have chance look at the last photo I put up on the thread of me laying down, its very obvious in that one.
-
An interesting article published by Lilah's doctor. She is a highly renowned NY plastic surgeon.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884731/pdf/sps18071.pdf
-
Sweetie:
I just took a look at the photos. Please consider a consultation with another PS to discuss this.
-
Deborah-ok, but I am going to email him everything first and see what he says. Maybe when he really sits down and looks at he'll realize how bad it is. He is always rushed at the appointements and I just don't think he is thinking it through then.
-
Thanks Whippetmom for the links. Made me think that the first article on revision was of augmentation and how things can go wrong even for that. My second thought was that these augementations had 450cc put in with their breast tissue , no wonder I felt flat at 375cc. I like how they photographed the patient lying down.
I have to pm you regarding the sitting up pics.
-
Deborah: Thanks for the great article! BTW: I saw my friend Jody last night and she mentioned that you two have been in contact!
-
Deborah -- what a great article by my PS (and her colleague)! I have to say, where it applied to me, everything in the article is as she described to me... she is very consistent AND thorough. Although I did not ever ask her about being sat up in the OR (I just did not want to know lol). That is all SO interesting to read in one place like that... and the pictures are all great!
Going to go check your new photos now Sweetie...
-
What is interesting, in Dr. Chasan's link, is that he appears to use Style 45 implants quite frequently. Just something worth noting for those who might be candidates for this ultra full projection style of implant.
-
Deborah~ that 2nd article showing how they sit you up was really interesting. Was good to read about how they perform the exchange surgery and why they make the decisions they make. Helps me understand a bit more about why they choose a particular size implant etc and how sometimes you can't get what you want just because you want it
lol!Thank you!
-
I'm guessing that answer doesn't always sit well with you Kay
(Teasing) -
Deborah--that article was great.
Lilah--how fortunate you are to have such a wonderful plastic surgeon!
The photos were great. I knew they raised your body in the OR, but I pictured them rotating the whole table somehow--sort of a Frankenstein effect. I feel a little better knowing they just move your upper body!
Happy Sunday ladies!
-
LILAH~ LOL, yep,when i want something,then i want it! =D Not much fun when you then can't get it!!
I dont mean that in a bratty way,but i know what i want and will do what i can to obtain it-whether that be working hard and saving up for an expensive pair of jeans, or deciding how i'd like to shape my body!
Some things you CAN get,some things you can't. The fun is in the trying! -
Kay -- I'm the same way!
I really love my PS and though she doesn't always tell me what I want to hear I always feel that she is doing everything she can within the limits of what I gave her (my body) to start with
-
MBJ: Yes, we are trying to work out a time to meet. I am interested to see what she is doing and to share some of my thoughts as well...
-
Deborah: I am so glad that you two are getting together. I tried starting a thread to see if anyone would like to give their imput, but I didn't get any response, so when she approached me again as to who to speak with, I told her you were the expert! I really want to see what she is going to design. We could be her models!!LOL!
-
PECTORAL EXERCISE AND THE RISK OF IMPLANT DISPLACEMENT
I have been doing some research into this issue, as I am finding it increasingly uncomfortable when attempting certain upper body strengthening movements at the gym.
According to Otto J. Placik, M.D., a Chicago plastic surgeon:
" In general, I do recommend that my submuscular breast implant patients avoid pectoralis strengthening exercises because this can cause lateral (outward) displacement of the implants over time."
From another source:
The constant muscle activity over the implant inherent to a submuscular placement has often led, in the late follow up (1-2 years), to implant displacement (with loss of medial cleavage), inferiorly (bottoming), or superiorly (wide chest look or snoopy breast) . These late displacements are, unfortunately, not totally predictable or preventable and more likely to happen in people with large implants, loose tissue, or intense physical activity."
-
Thanks, whippetmom. I really want to get back into shape, but I'm ignorant of the dangers. Thank you for posting this information.
-
When I attended a seminar on breast reconstructions last fall at MSKCC in NY they did say, when discussing implants, that basically you must cease working out pectorals once implants are placed as you don't want to build that muscle (it is a better container of the implant if it is flabby, basically). I of course, being the Queen of Avoiding Exercise, was rather thrilled to hear that lol. But in all seriousness that does leave a great many options still for exercise that does NOT build up the pecs.
-
woo hoo! At least i have a good excuse not to have to do push ups at my tae kwondo training now! Not that i ever did them before anyway lol. It kinda stood to reason that it could displace the implants really. Just nice to see 'written proof'.
-
Thank you for the above information on the pec workout. Was just inquiring that of my PS who encourged it. It just doesn't feel right physically or make any sense to. The pecs are involved in so many other exercises that we don't need to isolate them to keep healthy. Is there anything written that I can bring to my PS for his review and perhaps persuade him not to be recommending this to others.
-
Hi Whippetmom, I'm new to this forum and found your post...THANK GOODNESS! I have concerns and a very passive (to say the least) plastic surgeon. I'm concerned my reconstruction is not going to be proportional with my body. I'm 5 ft 6 in, and 40 inches around my ribcage. My PS says we will end up w/800cc implants but my tissue expanders are Allergan 600ml w/6X16 AlloMax sling. He says I'm at 660 cc's on either side and I look like an A+ cup...and not a very good one. He said my body frame could easily accomodate a 1200 cc implant but they don't make them anymore. He said the best he could do is 800 cc silicone or overfilling a 800cc saline implant to about 950 cc's. I know my weight is the problem but I'm certain I'm not the first with this issue. He assures me the finished product will be "better than nothing"!!! I don't want just better than no reconstruction at all! I want a nice finished product. Do you have any suggestions?
-
Sandy -- you should look for and PM a woman here named MooreTennis (I am pretty sure that is how she spells her user name)... she had 800 cc salines overfilled to 1200 cc's and is very happy. Not sure why your PS says he can only go to 950.
-
Lilah- You're Queen of Avoiding Exercise? I'm Queen of the Couch Potatoes! (And all you others had no idea you were surrounded by such royalty! LOL!)
-
-
Sandy: You are not going to be happy with only 800 ccs and so you are a much better candidate for the 800 cc saline implants which can be over-filled to 960 ccs, which is Mentor's maximum recommended fill volume. Lilah mentioned Moore Tennis, who immediately came to my mind also when I saw your vital statistics. I just checked and she has 1100 ccs. I would not go any further than this in an over-fill - and actually, I would prefer to stay at 1000 ccs, just to ensure the integrity and safety of the implants. I also believe that Moore Tennis' TEs were larger than yours...Within the next few years, the Sientra true cohesive gel [gummy bear] silicone round implants will be approved [crossing my fingers and toes] and this implant will go up to 1000 ccs. So if your salines need replacing in the future, the Sientra implants will be a great replacement alternative. But for now, it is saline for you missy.
-
Kate- you are hysterical, girl!
-
Kate<-------she is hysterical.... she has kept me in stitches on more than one occasion! Keep the giggles coming sister Kate!!!! God knows laugher is the fruit of something...hehe!
-
Whippetmom
Thanks for the post about exercise. I did lots of upper body stuff using TRX straps and push ups etc and I just can't do it now, it feels so uncomfortable and its been depressing to me. My PS insists I will be ok (I still have TE that hasn't moved a smidge in 8 months) but my muscle feels like its going to tear. I guess I should just find another mode of exercise...ugh like ...running
Diane
-
Thank you Whippetmom - not that I wanted to do push-ups - just good info for all of us! Kate and Lilah - can I be a lady in waiting? Waiting for you to get off the couch so I can get on it!
-
Ugh! I have never been one for pushups, so I won't be missing much of that one. Just weights and reps for the arms and biking occassionally. And, of course, the Wii--I'm addicted, I must admit. But then there are those days, when getting off the couch just isn't going to happen anytime soon. I'm with you Kate and Lilah! LOL! All hail to the couch queens!
-
My doctor gave me six weeks after exchange before he even wants to talk about exercise. Now I am worried about what restrictions he will hit me with. I am going stir crazy here and after reading Whippetmom's post I am feeling pretty sad. Weight lifting is been a part of my life for 18 years. I love it and my YMCA has been my place for socializing for years.
I am interested about the Wii. Does it really give you a workout?
-
DiDel~ Be careful with running... I started back too soon and my TE became inflamed and possibly infected. And, mine are COMPLETELY immovable.
-
Giselle: Yes, the WiiFit does give you a workout. Kind of like having your own personal trainer. Not great for social networking, but it will keep you in shape. My legs are still sore from doing Yoga a couple of days ago. I like to switch it up. I purchased less heavy, 2 lb weights so that it wouldn't feel like I was lifting much, but I still get toned from these. It's a challenge but there are many who do fitness for a living on these boards who could maybe help you.
-
Giselle: Do not despair...it is only certain exercises you really need to avoid. I am not a body builder or true "weight lifter"....but there are some upper body exercises which I can perform and feel safe about doing so, e.g., curls, because I can keep my arms close to my ribcage while doing so. Just avoid: bench pressing, butterflies, wide-stance pushups. Actually, I avoid pushups now period, because it feels so annoying. I was so buff in my 30's and 40's. I am just a marshmallow now and I cannot blame it on anything but sheer cussedness, menopause and refusal to work out like I used to. But I am getting back into it...and I am toning up my arms again.
-
Outcome assessment of breast distortion following submuscular breast augmentation.
Spear SL, Schwartz J, Dayan JH, Clemens MW.
Department of Plastic Surgery, Georgetown University Hospital, 1st Floor PHC Building, 3800 Reservoir Road, NW, Washington, DC, 20007, USA. spears@gunet.georgetown.edu
Abstract
BACKGROUND: Animation deformity or breast distortion during pectoralis muscle contraction following subpectoral breast augmentation is a known entity, but its prevalence and significance remain unclear. The purpose of this study was to identify the incidence and severity of animation deformity as well as its effect on patient satisfaction and interference with certain activities. METHODS: All procedures were performed by the senior author using a variation of a previously described dual-plane technique. The first part of this study was an evaluation of breast distortion by a group of independent observers in a series of 40 consecutive patients who underwent primary subpectoral breast augmentation. The second part of the study was a questionnaire sent to 195 consecutive patients asking about overall satisfaction, degree of animation deformity, and whether there was interference with any activities. RESULTS: Of the 40 patients' photographs that were evaluated, 9 (22.5%) had no distortion, 25 (62.5%) had minimal distortion, 4 (10%) had moderate distortion, and 2 (5%) had severe distortion. Of the 195 questionnaires, there were 69 responses, a 35% response rate. Fifty-six (82%) described mild to no distortion, 7 (10%) were moderate, and 5 (7%) were severe. According to the survey, the most common activities that were problematic were lifting weights and exercising (24 and 19%, respectively). Only one (1%) patient stated that she would not recommend subpectoral positioning. CONCLUSION: Although animation deformities do exist, nearly all patients in this study would still choose subpectoral positioning. Patients who may be better candidates for subglandular placement are those for whom exercise is central to their daily living. As a result of this study, surgeons and patients should have more accurate and reliable information regarding the significance of animation deformity after subpectoral breast augmentation.
-
PB:
My information is not extracted from scholarly articles, but from a smattering of recommendations [including my own PS'] made by various plastic surgeons. Some feel it is not an issue and some take serious issue with the topic of upper body strengthening after submuscular implant placement. Here is one doctor who agrees with yours and responded to the following question:
Is it safe to exercise chest muscles after breast implants?
By Peter A. Aldea, MD - Memphis Plastic Surgeon
Yes. After you are completely healed.
There is NO point in having a breast augmentation if it will change the way you live. Once the surgery is completely healed in a few months you should be able to resume all your previous activities.
A few years ago, Dr. Baker, a senior member of The American Society of Plastic Surgeons, from Florida, presented a memorable paper on the negligible effect of (subpectoral) breast augmentation in PROFESSIONAL female body builders. The ability of those women to lift large weights was studied on Cybex machines and was proven not to be significantly changed by the operation.
If they can do it - so can you.
EXERCISE AFTER MASTECTOMY/EXCHANGE IS IMPORTANT:
http://www.realself.com/question/pectoralis-exercise-after-breast-enlargement-augmentation
Comments made by the breast augmentation crowd re: exercise and submuscular implant placement:
-
Whippetmom - What can I say but thank you so much for all the info in your last posts. Very giving of your time. Clearly it is important to let your body have a opportunity to heal itself. I will continue to sit on my hands while I recuperate! I will take a look at the sites and discuss this with my PS.
Oh yeah, my husband would rather hug a marshmallow than a buff bod and day of the week!
MBJ - Thanks for the input. I think I will check out the Wii.
-
Thanks for all that great info Deb. (And for getting the accurate number of cc's to which Mooretennis was expanded
LOL re: Lady in Waiting Hope!
-
Whippetmom, thanks for the links. It makes me wonder that if there are alot of PSs who don't recommend it, and these forums are mainly augmentation patients. My concern would be that we have no fat or breast tissue over the muscle, how distorted would it look for us mastectomy pts.
-
Thanks for the info! I will be talking to my PS about the overfilled salines. I'll keep you posted!
-
Hi Nancy -- I'm in the same boat..... was mentally fine through the mastectomy surgery, infection surgery with TE exchange and two weeks home IV (argh), and then my final exchange surgery on June 5 for the implants. Hate them. My PS stretched the TE to 600 cc and only put in 475 style 20 high profile. So, I have significant rippling on the top half of the breast and edge of implant is visible. It feels as if there is a gap at the top of the implant and the chest wall. Wonder if the pocket is TOO big causing the rippling. On my augmented side, he used style #15 213 cc and it is way too small.... absolutely no upper pole fullness. It is a finger width smaller all the way around. It has been extremely depressing for me. I thought I was done with all this -- NOT. I've consulted a few other PS and two have suggested going bigger to fill out the upper pole. Definitely going bigger on the augmented side.... but I think I would prefer the style #20, high profile, rather than the 15, moderate. Any input would be greatly appreciated. Oh, one surgeon recommended Alloderm on the top for the reconstructed side to correct/hide the rippling......what are the pros/cons of this?
-
vanderlady- I had Alloderm for both the TE placement and the exchange surgery and, yet, I too have rippling on the tops of the breasts. I know some PS are doing fat transfers for the ripples.
The cons to Alloderm is a higher rate of infection and it is very expensive. A lot of insurance companies won't even cover it so make sure you check to see if yours does. Some people don't like it from the aspect that it is donor tissue. I have heard some women say they feel achy after exchange when it is used but I haven't had that experience. Sorry you are not happy with your exchange. I hope they can correct everything for you. Whippetmom is a great one for advice on implant sizing.
-
Hi Kate -- Funny, I just responded to one of your posts in another thread! Guess we have a lot in common!
I had the alloderm placed on the bottom at the time of MX.... I did in fact have an infection....staph epi which required a TE exchange. My personal feeling is that it was because my single drain stopped output rather quickly and I began to swell. Staph epi is common where there is fluid build-up. Interesting though that it may have been due to the allograft.
Did you have the allograft placed up top where your rippling is?
-
vanderlady:
If you want me to help you with sizing info, I need for you to obtain your TE info - style # and maximum volume - if Mentor TEs, just whether they were low height, moderate height or full height and volume. Also, your height, weight, ribcage circumference.
-
vanderlady- I think the Alloderm is up top but I'm going to confirm with my PS on my next appointment and see what she says about the rippling.
-
Dear Deborah - I sent you an email with updated photos of my reconstruction. i am hoping that you received it. Thank you so much for all of your help. - Catchturn
-
Catch....I responded to your email!
-
Hi Whippetmom -- That sounds great.... I have a request in for my medical records and will find out the height of the TEs. Where do you measure the ribcage circumference...at the IMF?
Hi Kate -- I had the fat grafting at time of exchange.... not sure that I would want any more, besides, the rippling is pretty big (on three sides) and it would take a lot of fat!!!
-
vanderlady- Mine are pretty subtle right now. I'm just worried they might get bigger. My PS did say she doesn't like to do fat grafting until at least 6 months out from exchange so I'm guessing she's going to take a wait and see approach.
-
vander: Yes. Measure just under the bra line....just under the IMF.
-
Well i saw my PS today to discuss my exchange.
She said that she will order both the 325grm and the 370grm in th MX and see which she can get in! I have to say,i was pleasantly suprises that she was thinking the 370grm!! That is what i was hoping for but i may still end up getting the 325 if the 370 wont close up properly.She wants to give me the best chance of a good 'finish' if you like.
I think i am quite happy with what she suggested.As long as i get the MX i think it will be ok.The MF loses too much projection,and she did say projection was what she'd like to keep for me.
Re:the pocket work.Her plans are to get me as symmetrican as possible,but she did explain that the pectoral muscles would play a major part in how much the pockets can be moved inward. They may just want to pull the implants outward laterally so they have to be careful.
Because my left side is further out to the side,they said they may move that side slightly in and the other side slightly out to even them up some.Sounds good to me as i do like the width! She says its very common for the woman to get used to the size of the TE's and that i would def be smaller than now,but bigger than i was.
I have to buy some firm support sport bra's to take into hospital with me,and wear them 24/7 for a few weeks.
I didn't realise they kept and used the capsule that is already formed around the TE.
I was told i MUST NOT massage the implants for at least 6 weeks,maybe longer.
I will be in hospital about 48hours and will have drains in ~boo =( ~!! My exchange will hopefully be around 2nd week in October but i will get my appointment thru the post.
-
Kay: The sizes sound good to me. I have heard some differing views regarding massage of textured implants - gummy bears included. Here is a thread which finds many gummy bear "owners" discussing their views and their PS' edicts re: massage...
http://community.breastcancer.org/forum/44/topic/725487?page=1
-
i just took a read of that,thanks.
Yes my PS did say that with the gummy being anatomically shaped ,massage should be avoided due to the chance of it rotating.
-
Hi everyone:
I'm going to cross-post a question here because this thread gets more traffic. My original thread is "red te" if you want to see my OP and the comments. I need advice! (edited to add that I didn't have radiation)
Here's today's post:
bumping this up because the redness is back. I haven't even finished the 1st round of abx. I'm wondering if the following could be resulting in inflammation (not infection), thus resulting in redness but no fever. (FWIW~ That side is slightly more sore but not by much.)
1. I volunteered at the animal shelter yesterday and scooped 30+ cat litter boxes. I'm left-handed and my affected side is the left.
2. Missing LN on the left. (I had 7 removed.)
3. Seroma on the left... behind the alloderm so it can't be drained.
4. Lefty is bigger (445cc+ seroma while rt is only 445cc).
5. I started exercising again today but only took a 2 mile walk (no jogging as per PS).
I really, really, really want to avoid calling the PS. I so don't want to deal with him today... Do ya'll think I can chalk this up to benign inflammation? ugh. I need your advice!
xxoo
Michele
-
Michele: There could have been some friction from the skin rubbing against the TE as you were scooping litter boxes, but again, it could be a seroma or hematoma. Why don't you email me a picture?
-
Deborah~ I'm at work so I can't right now.
But, it looks pink, like a sunburn. It blanches out when pressed and returns to pink very quickly-- like a sunburn. The other side has a small area that looks the same over the center (has been there since the beginning) but the left side is more widespread. I *do* have a seroma on the left. PS can't drain it because it is behind the TE/alloderm.
Thanks!
-
Deborah~ I just looked at the TE pics I sent to you before and you can see a redness on that left TE then (though I didn't know it at the time). It is more pink than in those pics but not strikingly so... If you didn't know there was something going on, *you* or the rest of the recon thread might notice but most people might not. I'm sooo frustrated...
-
If the red area has grown larger (and sounds like it has) you could have an infection. You should see your PS Michele. I developed a redness around 4 weeks after my MX / TE placement and I never had a fever. The area, moreover, seemed redder at end of the day and less red in the morning (so I thought it was from friction); but antibiotics made the red area shrink dramatically after a few days and then it disappeared. You don't want to fool around if it's an infection... early attack with antibiotics will keep you out of the hospital (away from a 24 hour IV drip of antibiotics) not to mention the risk of losing the implant due to infection.
I also had 'slightly more sore' as part of what I felt... and I walked around like that for a week. My PS was pretty annoyed with me for not calling her immediately. Also: I did not have radiation either.
I'm sorry -- I know you don't want to call -- but please please call your PS.
-
Lilah~ I'm on antibiotics. I've been on them since 7/30/10 when the redenss 1st popped up. The redness got better but now is back. However, I stopped exercising and really limited movement from 7/30 to this past weekend (SUnday actually)... Still think I should call? I'm so sick of dealing with him because he wants me to go in the hosp at the drop of a hat...
-
Yeah I hear you... try drawing a line around the red area with a pen now and then take it easy (exercise wise) for 24 hours and see if the area of redness grows larger or smaller. If it grows larger, I would call PS and take it like a man re: trip to hospital
(Or is that take it like a woman?) Because if it is an infection that isn't responding to the antibiotics, then you need something more drastic; and if you don't treat it right you might lose the TE and have to start all over. Sorry to be a bummer -
Michelle -- I too had an infection with my TE....it was staph epi. It was redder at night and less in the morning. Took a while before the fever came. Had to have the TE exchanged and two weeks of home IV. After that, I was paranoid about infection coming back. They wanted to keep me on Bactrim for 3 months...... started having some reddening of the skin but it turned out to be sun sensitivity to Bactrim. So.... it could be something as simple as that. The infection hasn't returned and that was in March.
-
Michele: I am in agreement with the above. You don't want to mess around with anything which could put you at risk for losing the TE.
-
Mstar: That's great news! I am so happy that your PS seems to be on the same page. Yay for you!!
-
Hi, I'm new to this thread (and also to this forum), but saw that you may be dealing with an infection and had to chime in because this hits so close to home. Don't mess around. Draw that circle around it, and take pictures if you can to see if the color is deepening or if a pattern emerges. Mine hit so quickly that within hours I had a raging fever, convulsive chills and went into toxic shock syndrome with my BP dropping to 69/35. It was staph. I had to have my right TE removed in the ICU because they didn't have time to get me to an OR. I'm sorry to use scare tactics, but I don't want what happened to me happen to anyone else. I definitely don't want you to lose your expander, but more importantly, I don't want it to advance to the point that your life is in jeopardy.
-
an update~
I called my PS and spoke to the nurse this morning. My PS said that he wants me to finish out this course of abx (will be done thurs) and see if it gets worse. It is still slightly pink and pretty diffuse. He wants me to take my temp too (which I have already been doing). So... still playing the wait-and-see game. I have an appt to see him in 1 week, assuming that everything stays the same (or gets better).
-
Yay Michele! Here's hoping it gets better!
-
Hi, Just checking in. Had my first fill today and asked the PS how much the TEs fill to. He said their capacity is 250, that he put in 120 at surgery, and 50 would be added today. He expects that another 50 will be added, so I have another, supposedly the last, fill appt. for the 25th. The nurse said that he doesn't always fill them to capacity. Counting surgery, plus two 50cc fills, it would finally total 220cc.
Just measured my IMF and it is 28.5". I'm 5'5", 126 lbs. My TEs, as mentioned before are Mentor Low-Height 7100s. Strangely, I feel much better after this fill, as it seems things have spread out and there's no more pinching. Guess I'll need to ask the PS next time what size implant he intends to use, as according to what you all are writing of, I'd end up really small. My bra size before surgery was between 32C & 32D, depending upon the brand.
-
Some PS's put implants in larger than the TE... and I think especially with those low heights that is usually the plan (at least from what I've seen posted by others). I'll be curious to know what he says!
-
Michele: Make sure you call Thursday if there is no resolution/change, because you do not want to be dealing with this over the weekend.
Melissa: I think around 350 ccs [at the minimum] or 375 ccs in a high profile silicone smooth round would be nice on your frame. It sounds as though that is about as much as your PS will do - he sounds uber-conservative referable to fills and he might feel the same about implant sizing. So get your desires made known....
Your TE has a width of 11.4 cm and a projection of 6.1 cm. I believe the 350 cc implant HP has a width of 11.7 cm and a projection of around 4.2 cm....something like that...
-
Deborah: I had my pre-op today and it looks like they plan to bring in a whole army of sizes when we go in, both high and mid-plus profile, all Allergan. The range is anywhere from 300 cc's for my non MX breast to 600 for my MX side. Guess I won't find out until I am done, but at least he listened to your advice and he seems to be going in that direction! I also won't know until I wake up if they plan to use Alloderm or ft grafting for the step off. One more week from Thursday!!!
-
MBJ - Yay! I'm so happy for you!!
Orchidgal - I too had 250cc TE's. My PS filled them to 310 and he was able to get 325cc implants in there. He overfills and I thought for sure I'd be lucky to get to 300, but I was surprised. Hopefully he'll be able to give what you want.
-
Deborah~ What's the rationale for over-filling? My PS says he likes to fill 25-50% over what the implant will be. That seems like a lot...
-
ugh~ Just showed a coworker/friend my foobs. She looked at it 2 weeks ago when this began. She said the area is much bigger but not as pink. My foob is uncomfortable today (psychosomatic?)... I called PS and made an appt for tomorrow morning. <sigh>
-
MicheleS- So sorry you are having complications. I'm glad your PS is getting you in earlier. Hopefully they can get it all resolved for you. Good luck!
-
Michelle: I truly hope that nothing is wrong with your implant! I am glad that you could get in to see your PS so fast. Best to be safe with these things. Hugs!
-
MBJ - It's exciting knowing your PS is going into surgery with myriad sizes. Nice to have a little surprise when you awake! It has been 2 wks today since my exchange and I am feeling good. Will go for my first walk today although it's hot and humid here in the Chicagoland area.
Michele - Good luck with your appt. tomorrow.
-
Giselle: I have many friend who live in or are from Chicago! I am really looking forward to the exchange. Being a Uni, I have been walking in circles from being so lopsided! I was thrilled to see how big they were considering going. I think that the worse thing is going to be the ugly surgical bra they may send me home in!
-
MBJ - I was out of that ugly bra the day my drains came out. It was so exciting! You have been through more than I so I can only imagine the nervous energy that's been building up. Am sooo excited for you!!!!
-
MBJ~ I had a uni mx from 1/09-11/09. HATED IT. I had my prophy thinking I'd get used to being a boobless wonder. I didn't. However, it was sooooooo much more comfortable to be flat than lop-sided. So happy for you that your exchange is near!
-
Michele -- sorry to hear that it's not better but glad you are seeing your PS. Better safe than sorry!
-
Michelle: I never wanted to go boobless. Never crossed my mind. I am surprised at how lopsided I am though. Especially when I try to do the balancing excercises on WiFit! Good luck tomorrow.
-
Deborah - I haven't posted in awhile... you helped me find a PS for revision. I'm going to exchange the crunchy asymmetric saline implants for silicone on 9/01 (along with some pocket work). Wondering if you can help me with sizing.
5'7" 135#
thanks to tamox ribcage is 30.5" and I'm wearing a 32D with my current Allergan Natrelle saline round/full height 450 cc (filled to 485 cc). One implant is currently under my arm a bit, and both could be shifted toward center... PS will work on this.
I'd really appreciate your opinion, oh wise one!
EDITED TO ADD: I think my new PS uses Mentor. Looks like you usually refer to Allergan sizing. Are they better?
-
Gail: I feel you need at least 500 ccs in a high profile smooth round silicone implant. The width will be fine and with the pocket work, they will be in a much better location on your chest wall. 550 ccs would be fine also - depending on if the skin flaps can accomodate this. Definitely high profile and Mentor is fine - the dimensions are very similar to Allergan's Style 20.
-
MBJ: Therein lies the benefit of going to a mega-hospital - they can afford to keep a lot of sizes on hand. I like the idea of having access to that varied a volume - especially for a unilateral. Cannot wait...that day is almost here for you!
-
Deborah: I had no idea this made a difference, but I am happy that they are doing this! One more week!!!
-
Thanks, Deborah.Had my pre-op today. I started at 500cc (didn't want to be too greedy) but the PS negotiated up to 600! She says I have extra skin right now and she will be doing some "trimming" on the inside which will make the pockets a bit larger. It was like being fitted by a seamstress! I should end up about the same size but without the ripples and the shelf. She's going to try 550's too and see what looks best but she wants to go with 600cc silicone. I'll try to post some before and after pics. Thanks for you help!
-
Hi Everyone,
I'm from the August Mastectomy group - had my surgery on August 4th and am really starting to get concerned that the tissue expanders that were put in are too big. I am at a large teaching hospital and using a very good PS. I was originally a 34 DD and said I wanted to go a lot smaller - B. We only talked once and I expected to see him again before the surgery but he had gotten stuck in traffic the day of the surgery so one of his assistants marked me. My sister used the same PS last year - hers turned out great so I probably didn't ask as many questions as I should have.
Here are the stats: He put in Mentor Siltex med ht texture contour - style 6200 - 550 CC. At the time of surgery he filled 300CC of saline. He used an alloderm sling
I am 60yrs old - 5'3" tall, 132 lbs. The measurement under my arm is usually 33" but with swelling it is 35. My rib cage at the bra line under the TE is only 31" I have always been petite with small shoulders and rib cage and my breasts were always too big for my body.
Do I have reason to be conerned? Can this be fixed?
Thanks.
-
Gail: That sounds great! I did not want to push the envelope...but 550 ccs or 600 ccs would be ideal! I am excited to see what you end up with!
-
Nbb: The size of your TEs will be just fine. They are only 11.7 cm in width. I think that implants with a volume of 450 ccs to 500 ccs would be nice for you - standard smooth silicone rounds in a high profile style. You might not need to fill completely with your TEs - depending on how sufficient your skin flaps are since you were larger pre MX. Do not ask for a B cup - because this will be far too small...you probably need a large "C" cup to look like a "B" cup. It is a connundrum - this whole "cup" sizing issue. Do not focus on cup size but focus on what volume will look best on your frame. I believe it will be within the size range mentioned above. Let's see where you are once you are filled to 450 ccs...
-
just wanted to update since ya'll have been so helpful!
I saw the PS yesterday and both he and I are stumped. The redness is still there but no heat or swelling. That side *is* still bigger from the seroma but the tissues aren't swollen at all. The skin looks healthy (aside from being pink). I have no fever and no pain on palpation. The area *is* more uncomfortable but again, it is stretched more (AND this is the arm I use most AND it is my BC side so I'm missing LN, etc). So, basically, it hasn't gotten worse or better. He said (and I tend to agree), if it were an infection resistant to the abx I was on, it should have gotten worse. And, if it were an infection sensitive to the abx, it should have gotten better.
I'm done with the abx as of yesterday and he wants to see what happens. I hate that it is the weekend but, thankfully, he is on-call. We have a plan as to what to do and where to go if it looks worse at any point. I just HAAAATE playing the "waiting game". Plus, it is my DD's 1st day of kinder on Monday. I really, really, really want to be the one who takes her. I will be soooooo POed if I'm in the hospital instead. In any event, that's the deal, just wait and see if it gets worse without abx on board. My last dose was at lunch yesterday and so far so good. (although I slept on the wrong side last night and I was sooooo uncomfortable this morning. I must have flashed myself 10,000 times already this morning but it isn't any more pink than before...)thanks for listening.
oh, Deborah~ I asked a couple of pages back about overfilling and the rationale behind it... can you shed some light on this? I just don't understand... My PS swears by it but I've heard from so many on this board who have good results without having to deal with overfills. thx!!
-
Whippitmom - Thanks so much for your prompt reply! I feel so much better now! They look wide on my body which was the original concern. Thanks again for your great advice.
Nancy
-
Michele: Extracted from my July 15th post. Valerie asked a question about sizing referable to her fill compared to yours....
Michele's TEs are actually 300 cc volume TEs and so her implants will actually be 100 ccs greater than her TEs. The only thing which is added with this overfill to 500 ccs is projection and the assurity that the expansion will hold with minimal skin retraction when the TEs are removed. Some plastic surgeons just feel they need to overfill every patient and some only overfill when it is needed for some specific reason, and some just do not overfill at all. Not all adhere to the theory of "overfilling." Mine does not. It also depends on the patient's skin flaps. The PS alone can determine the patient's skin integrity and so he or she will determine what is needed to get a patient to a certain volume of implant. You do this long enough and you see how many different approaches plastic surgeons will take to arrive at the same size of implant.
Overfilling also is performed by some to achieve a natural droop or "ptosis",....or to ensure that there is sufficient skin to cover the implant without risk of implant exposure.
-
Michele -- oh I just answered your PM and didn't realize you were done with the abx. As long as it's not getting worse or redder... maybe it's ok? That's the thing to watch for. My red spot hurt and hurt increasingly before abx... then the color disappeared progressively over 10 days... and was gone. So though I had no fever it was clearly responsive to abx. You can only do what your PS advises... and just decide it's not going to interfere with your daughter's day, regardless
That's what I would do!Re: Overfilling -- what Whippetmom said
I will add that my PS overfills when using gummy implants because they are firmer and so not quite as flexibile as regular silicone when it comes to placing it in the capsule. She likes to have a bit more room. -
thanks Deborah! chemo brain~~ I had forgotten that I had asked and you had answered before! ha!
Lilah~ Thx for your help. I really appreciate it.
-
No problemo -- and oh yeah I hear ya re: chemo brain
-
Hello everyone,
I have some questions. Thank you in advance for your help.
Is it true that breast implants of a certain size , lets say 500 cc look smaller in a person post mastectomy compared to one who has regular breast augmentation? By that I mean - if I look up online pictures of women who had breast augmentation with lets say 500 cc implants , and I am looking into having final implants , 500-550 cc - THANK YOU WHIPPETMOM for your help ! Would mine be smaller?
Also , how are the final implants compared to the tissue expanders of same size. For ex TEs filled to 500 cc look the same as final implants of 500 cc? Or woul dthe final implants look smaller?
I am currently filled on both sides to about 510 cc. Can I compare how I look now to how I would look with 500 cc fianl implants? Or would those be smaller.
I apologize if the questions might not be clear enough. English is not my first language.
Thank you !!
-
WHIPPETMOM,
You have helped me in the recent past with questions regarding implant sizing, which was SO, SO helpful. Just a quick reminder, I have Kaiser insurance and go to Downey.
You had recommended 550 cc final implants. My PS always overexpands. If I want final implants 550 cc , how much does she need to expand? Knowing that my PS does not like to take any risks, I would guess that she would like to expand to 650 - 700 cc, in order to put in 550ss implants.
What is your opinion ?
I am VERY HAPPY so far with the results of expansion with TEs. I hope to be just as happy with the final implants. I have read here how quite a few ladies were dissapointed with the final size.
Thank you,
Donna (5'5 1/4" , 145 lbs, 32 " rib cage)
-
Trytostay -- breast augmentation is not the same as reconstruction; women who get augmented still have BREAST tissue -- women who have had an MX do not. So you can't compare. Search the internet for pictures of RECONSTRUCTION if you want to see photos. But I will say that 500 cc's on me will look quite different than 500 cc's on you... so really even looking at others, unless they have the same body type/shape as you, might not be all that helpful either. I'm sure Whippetmom will be able to answer your other questions (or guide you anyway) but thought I'd throw in my two cents on what little I do know
-
Lilah: Thank you for answering
-
hi trytostay~ I agree with Lilah. I have a friend who is bigger than me (frame-wise) and she has an aumentation with 400 cc. I'm filled to 465cc right now and look smaller than she does. The lack of breast tissue makes a huuuuuuge difference. Whippetmom will be able to help you... I'm sure of it!
-
Hello Whippetmom, I'm new to this forum... I wish I'd have seen it sooner... Thank you so much for all the info, I started going through this thread but there are so many pages so I though I better post my specific question... my bilateral mastectomy surgery is on August 18th with TE's and Alloderm, and I've already seen the plastic surgeon last time before the surgery on last Thursday... I left his office feeling a bit down
a little about me - I'm 32 years old, diagnosed with cancer on my left breast, BRCA1 positive.... I now have 34D breasts, they hang a bit low when I'm without a bra, but I love how they look in a nice bra and love how I look in clothes... I'm pretty devastated about loosing them now
... I'm 5'4", 134lb, I measured right under my breasts (I guess its the rib cage?) and got 31"-32".... I asked my PS if it will be possible to bring me back to D and he said that I will probably be a C..... then I asked what size TE's implant he is going to put in and he said 400cc... which sounds kind of small, but then he said he uses the highest profile implants for breast reconstruction, and that it goes by the size of my chest and body frame and that he doesn't want to put a too big of an implant because he doesn't want it to be sticking out on the sides of my body and he doesn't want me to look like a striper.... now I'm worried that I will end up with small and flat breasts... there is not much I can do now since the surgery is in less them a week and I cannot change PS, I didn't have many options in the first place, I could only see two PSs which are under the Cedars Sinai medical group and accepted my insurance... please let me know what you think, according to my sizes and measurements, will 400cc be too small or is it enough to bring me up to at least a full C cup? Thank you so much for your help... -
Venus: It's never too late! If you feel you need to make a change you can always postpone surgery! Whippetmom will help you and don't let the PS rush you into surgery doing what he/she wants! They are supposed to return you to a reasonable shape and size compared to what you had before and also give you what you want, within reason and if it's possible. I am a 32" rib cage but I was a small B, my dr's expanded me to 535 cc's and my exchange surgery for next week I will get anywhere from a 300 cc for my non-mastectomy side to a 600 cc for my MX side. I wanted to go bigger and to get more symmetry with my remaining breast There are always things like skin integrity involved in the decision of how big you can go. Did you have radiation and did your skin stretch easily? Also, how long have your expanders been in for? My 400 expander was overstretched 135 cc's and was put in 3/20 and my surgery is on 8/19. You;ve come to the right place for help!
-
Whippetmom, I was wondering if you could help me. June 10 I had a bilateral mastectomy with tissue expanders. I'm currently filled to 600 cc. Not sure what type. My rib cage is 31 inches, I'm about 5'4" and 150 lbs (trying to lose weight, but it's so hard!). Measured from outside, the base width of the expanders is around 15.5 cm, projection about 7.5 cm. My PS doesn't think I should go bigger; I'm not sure. I don't want my foobs to be obviously fake, but I was barely a B cup before and would like to be at least a little bigger. Plus, I have a big booty and would like to be more hourglass shaped than pear shaped!
I like the fullness and projection of my expanders. I'm worried implants the same volume will look smaller and I'll be very disappointed. Can you give me a rough guesstimate on what size/style of implant to ask for? Also, what's the difference between high profile and mid profile? How does it affect the finished 'look'?
-
Donna: Lilah answered your question re: implant sizing with augmentation vs. reconstruction. With regard to your second question, #2: You have had rads and so much of how far you go depends on the integrity of the rads skin flap. You have a 450 cc recommended fill TE and so I would think that you would not need to be overfilled more than 600 ccs in order to exchange out to a 500 cc to 550 cc implant.
-
Venus: I think that your PS is perhaps quite conservative and does not understand that the end result - the cosmetic result - has as much to do with our "healing" as does the pharmacological aspects of treatment. You will not be happy with 400 ccs as the ultimate implant size. You will want 500 ccs or 550 ccs in a high profile, standard smooth round silicone implant. Either size would be appropriate for your ribcage/chest wall. With your ribcage and current breast size, it seems he could use a 500 cc tissue expander, but if he feels he can only fit in a 400 cc, perhaps your PS could overfill and exchange you out to the larger implants. Especially since it sounds as though you have the skin flaps sufficient for the larger implants. Your role in this is to let him know exactly what you want to achieve. Tell him you would like for him to do what it takes to get you to the implant volume specified above. Give his office a call on Monday and clear all of this up before the surgery.
Incidentally, I am 5'4" tall, weigh 125 pounds, have a 31 inch ribcage. My TEs were 400 ccs, overfilled to 425 ccs and I was exchanged to smooth silicone round implants - 550 ccs. As long as there are not extenuating circumstances, e.g., the need for radiation, It can be done, especially in light of your current breast size.
Check back with me after you talk to your PS.
Deborah
-
buyo: It does not work to measure your TEs in this manner. Ask your PS' office to give you the data on your TEs - the manufacturer, style and volume. But I think, based on your stated vital statistics, implants with a volume of 650 ccs or 700 ccs would be just right for youv- high profile style implants. This all depends on the style of TEs. You might have 500 cc TEs which are overfilled to 600 ccs and you might require less implant volume - say, 600 ccs. So the key is to get the exact TE info and get back to me and we can nail this down a little better for you.
Deborah
Edited to add: Moderate plus profile implants have a wider base width and less projection. High profile implants have a narrower base width and greater projection.
-
Thanks Whippetmom! I'll get the info on Monday.
-
whippetmom,
With my DMX on Sept. 23rd the PS will reconstruct w/implants at the same time, no need for TE since I'm going smaller. He was guessing on the sizing though? My currently cosmetic implants are (if I remember correctly 345cc?) which makes me about a large D or DD, I now want to be a C. He said he will probably put back in the same size implants since the BS will be removing all my tissue? Does that sound right? I do have an appt. w/him to go over questions before my surgery so will he just have several implants "on hand" during surgery? I'm wondering how that works. They will be saving my nipples so I'm thrilled with that! Thank you for all of your help on all the boards! Robyn
-
Robyn: Refresh my memory again - your height, weight, ribcage?
-
I h
This is for Whippetmom
I had my new expander put in on Friday August 13th
I had 120 cc put in. It looks very flat at this time, but if all is well, I plan to start with fills on Sept.1st. I am now wondering what implant size I would need to match the other side, since my PS says he only uses Mentor. I have Natrelle style #20 with 475cc's. They are silicone. If he cannot use the same kind as my right side, what would match in the Mentor?.Thanks for your input..
-
Deborah, You are amazing, Thank you so much for your help... I never had radiation and the BS said that if I remove both breasts I will not need radiation... I'm young, no kids, and I think my breast skin is in good shape and I do have a lot of it, the PS even said he will have to trim some of the skin off.... now I'm worried he will take too much skin off... the surgery is on Wednesday and I'm so stressed because of it I can't sleep at night I will call on Monday and ask again what size implant he is going to put in and if he overfill them... and, what if they say the PS said 400cc and thats it, he already explained that he decided on implant size by my chest size, ribcage... how do I then say I think you can make me bigger without sounding rude...? like telling him how to do his job... I'm shy, I know its lame but I have a problem with insisting on what I really want... how do I say it in a nice way without sounding rude... please help... and, one more question, since you are close to my size, may I ask what size bra does the 550cc makes you? Thank you so much
-
joie: Mentor now has a 475 cc high profile implant. The dimensions are close enough - a few millimeters difference - to the extent you will not notice.
-
venus: I think you can tell him that you have done some research and that this is the volume of implant you feel you will be most happy with. Tell him that you know that it takes more volume to get a good mound on the breast after MX and that you will not be happy with only 400 ccs.
You do want some skin excised - it is like having a mastopexy - because if you don't have some skin taken, you will end up with too much droop. You want them nice and perky again, right?
I am a 34 DD cup, but I look like a 34C in clothing. It is entirely different and not easy to explain, but there is no spillage over in the cups as with the natural breast or augmentation. I fill the DD cup because of the width. I have far less projection than I would have if they were natural or augmented. It is so difficult to achieve projection with the reconstructed breast, and so we need the extra volume and width to fill out a bra properly and give the illusion of projection.
-
Deborah, your knowledge continues to amaze me. Even though I have had my exchange, I continue to learn so much from you here and all the sharing gives me a better understanding in knowing I am not alone. Thank you!
-
Oh great, Thanks much for the info. One more question: Would you happen to know the style # of the Mentor implant in the high profile smooth 475cc. Thanks again for all your help
-
Hello Deborah, I was wondering if you might have a second to go to the photo forum and check out my new photos. I posted a question in there to you also regarding size of implants. Thank you so much for all your sharing of knowledge!!
-
joie: Print this out and take it to your PS, because the 475 cc is a new volume implant for Mentor....it might be something he needs to order and it might not be readily available..
Smooth Round Gel High Profile
Sizing Chart8.3 cm 3.5 cm 8.8 cm 9 350-2004 BC 200 cc 9.7 cm 4.0 cm 350-2254 BC 225 cc 10.1 cm 4.2 cm 350-2504 BC 250 cc 10.5 cm 4.3 cm 350-2754 BC 275 cc 10.8 cm 4.4 cm 350-3004 BC 300 cc 11.1 cm 4.5 cm 350-3254 BC 325 cc 11.4 cm 4.6 cm 350-3504 BC 350 cc 11.7 cm 4.8 cm 350-3754 BC 375 cc 12.0 cm 4.8 cm 350-4004 BC 400 cc 12.2 cm 5.0 cm 350-4254 BC 425 cc 12.5 cm 5.0 cm 350-4504 BC 450 cc 12.8 cm 5.1 cm 350-4754 BC 475 cc 13.0 cm 5.3 cm 350-5004 BC 500 cc 13.2 cm 5.3 cm 350-5504 BC 550 cc 13.6 cm 5.5 cm 350-6004 BC 600 cc 14.0 cm 5.6 cm 350-6504 BC 650 cc 14.4 cm 5.7 cm 350-7004 BC 700 cc 14.8 cm 5.8 cm 750 cc 15.2 cm 59 cm 800 cc 15.5 6.0 cm -
Whoa...that did not come out right. So joie, click on this link, scroll down to the smooth round high profile style, click the sizing link and then a new window will pop up with the catalog numbers and sizes. I would print out that sizing page and take it to your PS to make sure he knows the 475 is available. His catalog probably does not have this updated size, which was brought out as it is a popular size for Allergan.
http://www.mentorcorp.com/breastsurgery/reconstruction/silicon-gel-breast-implants.htm
-
Venus: Check your private messages - I PM'd you....
-
Misty: Going there right now...check over there for my comments...
-
Thanks mucho for the info. I will bring to my surgeon. It seems there is a slight difference in the diameter in the 475's between the Mentor and the Natrelle. , but noy significant. Thanks again.
-
Deborah, I called and they said the TE I have is the the Allergan 400 cc Integrated TE. Does that sound more right? The PS is planning on taking Mentor Mod. plus 450 and 500 into surgery. This was in his notes, but he did not tell me that. I like him, and know he does very good work. I was spoiled I think with my BS who explained everything very fully to me. I asked to have the nurse email me to answer questions on what he plans to do for the asymmetry. I agree with you that I don't need to be any wider. I really like the width I have. (My ribcage is 31 not 29...I messed up the first measurement) I think it gives me good cleavage and still does not interfere with my arms at the side (does that make sense?)
The volume I have right now is good too. It is funny though that the longer I have them the smaller they seem to me? I wanted to make sure also that you thought I looked proportionate as far as volume? I can't get a straight answer from my hubby....I think he does not want to influence me. If I come out having both of them look like my left side I think that would be good. Thanks Thanks Thanks! Misty
-
Fat Grafting in Postmastectomy Breast Reconstruction with Expanders and Prostheses in Patients Who Have Received Radiotherapy: Formation of New Subcutaneous Tissue
Serra-Renom, Jose Maria M.D., Ph.D.; Muñoz-Olmo, Juan Luis M.D.; Serra-Mestre, Jose Maria M.D.
Abstract
Background: In secondary mammary reconstruction in irradiated patients, the use of expanders and prostheses is controversial, given that radiotherapy increases tissue fibrosis and capsular contracture. The authors assessed the usefulness of tissue expansion, prostheses, and fat grafting in patients who had received radiotherapy.
Methods: The authors conducted a study of 65 mastectomized patients (age range, 34 to 62 years) who had received radiotherapy with a 6-MeV electron accelerator. In the first operation, they inserted the Natrelle 133-MV expander (Allergan, Inc., Irvine, Calif.) endoscopically under the pectoralis major at the end of the mastectomy scar and performed total immediate expansion. The authors injected a mean quantity of 150 ± 25 cc of fat in the upper quadrants between the skin and the muscle and also inside the muscle. After 3 months, they removed the expander through the same incision, inserted the McGhan Style 410 cohesive silicone prosthesis, and injected a mean 150 ± 30 cc of fat in the lower quadrants. In the third stage, the nipple-areola complex was reconstructed.
Results: Mean follow-up was 1 year, with controls after 1 week, 1 month, 3 months, and 12 months. No complications were recorded with the fat injections. Patients' mean satisfaction rating was 4 on a scale of 1 (low) to 5 (high), and the capsular contracture was never above 1 on the Baker classification.
Conclusion: In mastectomized patients who received radiotherapy, fat grafting in addition to traditional tissue expander and implant breast reconstruction achieves better reconstructive outcomes with the creation of new subcutaneous tissue, accompanied by improved skin quality of the reconstructed breast without capsular contracture.
©2010American Society of Plastic Surgeons
-
Interesting MBJ -- I'm sure that will be useful information for those who have had radiation.
FYI -- McGhan 410 is the same as Allergan 410 (for some reason McGhan, Allergan and Inamed are all the same company and I have seen each name frequently associated with what is, to most, the Allergan 410 -- could be that Allergan bought the others out? I'm not sure). In any case, the 410 under any name is the gummy; so they used the gummy in this study.
-
Lilah: I have a file on my computer with all of my photos and supplements and anything to do with cancer, including things that I saved for later in case I would need the information later. I had saved this back when I though I was going to have to have radiation. I hope that it helps other women here who have had radiation.
I reall wish someone would get on board with approving the gummies for all!
-
It will come Mary -- I think the so called trial (though they've been widely available in Canada and Europe for 10 years now) is close to the end.
I think I have seen that link posted before (by Whippetmom?) but it's worth seeing it again
-
Misty: Okay, with a 31 inch ribcage, the 450/500 cc MMP sounds fine. However, the TE info they gave you was lazy, lazy lazy! Is it a 133FV, MV, MX, SX or LV? The key question to ask: WHAT IS THE WIDTH OF THE TE? IS IT 12 CM WIDE OR 13 CM WIDE? The LV is 15 cm wide, so I am pretty much excluding that, but you can see that they did not give you the complete information you requested. So your PS uses Allergan TEs but Mentor implants?
I think you could also use a 475 cc or 500 cc high profile implant and it would look just fine and would not be quite as wide on your ribcage. But your PS sounds as though he is not going to budge off of his MPPs.
-
Whippetmom-I am reading what you have been writing about width and projection. You have also helped me out personally. I have an appt with my PS this week. I wondering how much input do we really have with our PS. I mean when we go to them and say can I be this size and width do they really listen or does it boil down to what they think will fit best. Also don't we have to trust that they really should know what they are doing when picking out sizes for us? I'm just feeling confused that I have to tell him what size to put in me when in reality I'm not really sure what I'm talking about. I am going to ask him about the sizes you recommended but I am feeling under expanded at only 400cc's and he said he doesn't like to over expand too much. I know I need more width because of the wide gap and some lateral work to address it as well, but I'm not sure if by going wider I will sacrifice projection.
one more question-does over expanding make your skin thinner? Are ripples just part of reconstructed breasts, I hear ladies who got gummies or reg silicone say they have ripples so it seems like no matter what kind you get ripples seem to be an issue.
-
sweetie - what I did with the information that whippetmom gave me was listen, a lot. She recommended how far I should go with my fills. And as the fills went along and we got closer to that recommendation, I asked if we could go there. It wasn't possible because my skin was too thin. I wasn't pushy, I just waited until the proper came to ask those questions. When we discussed the implants, I asked what size was he thinking and he told me. It was smaller than whippetmom's recommendations and I asked if it was possible to go a little bigger and he said he would try. I was never pushy, I only asked the questions that I did understand. And he appreciated it. I came in with a list of 12 questions one day and he sat with me and went over every one. At the end he said, "Good questions." Ha. Little did he know that I'd done my homework!
I don't know how everyone else does it, but that is how I handled it. Hope it helps.
Good luck,
dh
-
I think the issue with ripples tends to happen with thin skin. I have no ripples but I have, shall we say, thick skin
Maybe it's my being a little overweight, but I'm not sure, as some thin women also have no issue with rippling (and some heavy women as well). So it comes down to how thick your skin is to begin with whether you will have issues with rippling (or so it seems to me). -
Hi Sweetie~ This is just my opinion but I asked TONS of questions of my oncologist (and breast surgeon) so I figured that my experience with recon wouldn't be any different. BC patients are positively inundated with data and opinions on how to handle chemo and radiation. There is also a wealth of information about lumpectomy vs mastectomy and I know I discussed my options at length with my breast surgeon... But, when it comes to recon... there's a whole lotta nuttin' out there. I think that asking questions SHOULD BE the norm for any medical procedure. But, for some reason, PS's tend to be tight-lipped. I just don't get it... I interviewed several PS's before choosing mine. I like mine because he *will* discuss things with me. For example, a couple visits ago, he and I discussed the width of my TE's and what I would like as far as width for the implants. He definitely has the final say... he can only do what he can do with the tissue he has. But, I want him to know what the best case scenario would be in my mind before he makes any decisions... With all of that said, I think that it is important to realize that your (my) PS *is* the expert and that they went to school for a long, long time to learn their art/craft. I always phrase my questions such that I am respectful and I certainly don't argue. For instance my conversation with him about TE width went something like this:
Me: "I'm finding the width of these TE's to be a bit uncomfortable. Will the implants be more narrow?"
PS: "Yes. I can choose ones that are more narrow."
Me: "Do you mean 'high profile' because I read somewhere that HP can be a good option for those of us who are thin."
PS: "Yes. Allergan has a HP that I like. I usually choose MP or HP depending on the patient. But, if this width is bugging you, I'll definitely go for Allergan 20's."
Me: "Would the final volume change from what we discussed previously?"
PS: "Not really, but based on your skin I think we should back off to 350 or 375 cc."
Me: "I'd like to shoot for 375 cc if we can. I don't want to lose projection."
What he didn't know was that I had already talked to Deborah and she and I were thinking 375-400cc. She and I had ALREADY talked about Allergan 20's and I had ALREADY looked at the dimensions of the implant. Soooo... I had done my homework and felt comfortable asking the questions I asked and was happy with the answers he provided.
Does that help?
-
MBJ: I have shared that same data on a now defunct thread - and have the link above in my header post. I wish someone would come along whose PS is willing to try this, because I think it sounds fantastic and could lend such promise to women who have had radiation - if only to significantly reduce the risk of capsular contracture. It is not some new study either - so why we are not seeing it done is perplexing to me. This would pertain though to women who are having delayed reconstruction - rads first and recon at some later point down the road.
-
Sweetie: Your questions have been answered quite well above. I think everyone has a way of approaching their PS, but we have every reason and RIGHT to tell them what we hope to achieve and to ask them if they would be able to do this for us. I mean, the question..."I am really feeling that 400 ccs is just not quite enough for me, and I know I would feel better if we could expand a bit further. Is it possible to do so?" Then your PS, who HOPEFULLY wants to please his patient, while working within the confines of your skin flaps, can tell you whether this is feasible. Better to let your desires be made known NOW, rather than after the exchange. My skin is pretty darn thin and my PS preferred to keep me under 450 ccs. But I asked if she could continue fills, skin permitting, and she agreed. My skin did just fine. I made it very clear that I hoped for an "augmentation" out of this train wreck of cancer. My pre-op paperwork states, "Reconstruction/augmentation following bilateral mastectomies." I have 550 ccs.
Deborah
-
All your input is very helpful..all of you..My problem now is with the expander on one side and a great looking breast on the other side, I am worried that he won't be able to make it look as good as it did before. My implant had to be removed because of infection.I gave him the measurement of the expander I wanted which was 133MX 400 with a width of 12.0 and a projection of 6.3. This was a Natrelle #. He said he doesn't use the Natrelle, but could possibly find a similar measurement in the Mentor. Well, surgery is done, and I find the expander, besides looking like a big flat pancake, is too wide for my chest. It seems to be encroaching over the middle line in the cleavage area,and is almost touching the good breast. I don't know what he used, but I think he didn't listen to me. According to what Michelle is saying, she has a similar issue with the expanders. But, is that a concern, or at the exchange, with the right implant, will things go back to a normal position, or will the the implant fall in the overly wide opening?Would the pocket have to be closed in that area at the time of the exchange? I wish our PS would listen to us more. We do know what we are talking about. I had a great PS, but I had to pay out of pocket each time which amounted to thousands of dollars, so I decided I had to go with one the insurance company approved..I am interested in your input, and what is your opinion on this..Thanks Whippetmom, you are a doll..very caring
-
Whippetmom-
I have the info you need. My tissue expanders are Allergan style 133mx, moderate profile, width 13, height 12, projection 6.7. Recommended fill 500cc; I'm filled to 600cc.
My rib cage is 31in, and I'm 5'4" and 150 lbs, and I was a small B cup before. I'd like to be bigger, but not humongous.
Can you explain the difference between moderate and high profile? I'm still very confused how it affects the finished look. I think I remember him saying something about trying 560cc high profile implants. Can you get projection and cleavage, or do you have to choose one or the other?
.
-
joie: Call his office today or tomorrow and find out EXACTLY which style and volume of TE he used.
-
buyo: Okay, so your comment about your PS using 560 cc high profile implants has me a little concerned. Unless you need implants larger than 800 ccs, there is no reason in this day and age a breast recon patient needs saline implants. Saline only comes in those "odd-number" sizes. So you want smooth round silicone implants. Clear that up early on.
I would state that if you like the size you are currently, you will want at least 550 ccs and preferably 600 ccs in a high profile implant. The MPP style would be a bit too wide for you in those ranges. The HPs have more projection and a narrower base width. The MPPs are wider and have less projection. The HP in the volumes above-mentioned will be sufficient width for your chest wall and will provide enough cleavage.
-
I probably misheard him on the cc's, as I remember him stating that he only does silicone implants. How far can you overexpand tissue expanders?
-
Well, there is no specified rule for the degree of "over-filling", but the manufacturers, in our case, Allergan and Mentor, do specify that there are caveats to overfilling - tissue integrity the most important. Just ask your PS if you can exchange out to 550 cc vs. 600 cc HP implants with your current volume. If not, ask him what he needs to do to get you there. I would say you are just fine where you are with near certainty for 550 cc implants.
-
IWhippetmom,
I'm 5'6", about 145-150, right now I wear a 34DD, I'd like to be a C cup. Before cosmetic implants (25 years ago) I was a full B cup. Is that good??? Thank you so much!
-
Dawn-Hope, Lilah, Michele and Whippetmom, thank for the excellent advice! Very well put. I am jotting down notes from what you have posted so I can ask in the ways you suggested. It's funny when I go to see him I get nervous like I'm on a job interview or something. I guess it's just nerve racking trying to find a way to convery what I want,think and feel about all of this to him. You gave me some excellent pointers and I feel much better about asking now. I'll let you know how it turns out.
-
Robynkk: You will want implants with a volume of around 450 ccs/475 ccs. This would be the minimum. The old implants will be too small and besides, why would he want to use old implants? If your ribcage is around 31 inches [you did not state] I think that the high profile style should be fine. He could use the moderate plus profile also - especially if you stay in the 450 cc range.
The volume for reconstruction is entirely different than augmentation. You will have no fat or connective tissue - it is like trying to fill up an empty pita pocket. It takes more to make less.
-
Whippetmom,
I just measured and yes my ribcage is 31 inches. He didn't mean to use the SAME implants
just the same size. I dug up the paperwork from 1986 and my old implants were Oval High Profile, one was 345cc and one was 365cc. The PS said since I was going from a DD to a C he would put in the same size, if he does that I'm going to be too small aren't I? Now I am not confident with him. I think I will make an appt. to drive down and discuss this with him. I remember he did say something about putting it in front of or behind something??? Thank you so much for your help. Robyn -
You also do not want saline implants - which is what it sounds like you have now. You want smooth round silicone implants. He will be placing them partially behind the pectoral musculature. 345/365 ccs would be small. Don't focus on cup size - it never pans out. Focus on what looks good and appropriate for your frame and you can go up or down from there. If you are hoping for a C cup - you are going to want to stay around 450 ccs to 475 ccs - and this is JUST a wild guess. It all depends on your body habitus. You will NOT be too big with that size of implant on your frame.
-
Robyn: Incidentally...are you having a NSM by any chance? If so, the size of the implant would be also predicated upon achieving the proper nipple location. You might get a better nipple placement with one implant volume vs. another.
-
No I have silicone implants now. I read somewhere if I fill a baggy full of rice and put it in the bra size I want that will give me an about size to compare to the implant? That does sound over simplified but he acts like size determination is no big deal and it's a HUGE deal to me. I'm going to try and see him next week, now I don't think I trust him. Yes NSM.
-
Whippetmom -- When you recommend high profile implants, do you mean the Mentor or Allergan brands? Or, are they pretty similar in size? I have the sizing charts for both and would assume that the Allergan Midrange profile (style 15) is comparable to the Mentor Moderate Plus, would you agree? Has anyone on this site had experience with the Allergan Full Profile?
Also, I have one side reconstructed with Allergan HP 475 and the augmented side Allergan Midrange 213 which I feel is way too small. On second consults, one PS recommended the augment be the same profile as the MX side and the other said "no, you get a different projection and it should be a lower profile.' I personally don't agree with the latter and feel the profiles should be the same as my main complaint on the augment is that there is no tissue/ fullness above the nipple. Any thoughts on this? p.s. I'm still waiting on my medical records and when I get these, I'll get you the TE info. Thanks, Pam
-
Oh me too, I have NSM on the MX side.... interesting comment about size of implant and nipple location if NSM, I think this is why it was a challenge for my PS and he didn't get it quite right. I'm told it is an easy fix though.
-
vanderlady: If you really want to nail down symmetry, your PS could use a saline expandable implant on the native breast and silicone on the MX side. Two others on this forum have done this and really liked the precision of the match. And the difference in consistency was not an issue for them. The saline is fine with the native breast because there is fat and connective tissue to add to the volume and suppress any rippling. It is the Mentor smooth round Spectrum expandable implant....and there is also the Becker 50/50 - half silicone half saline - expandable implant also. You can PM rockwell_girl or Nedeza and ask them about this.
Deborah
-
Lilah - I appreciate the information on rippling. I haven't found much or read much on here about it . Is some skin just naturally thin or is it because of the MX? Maybe that's the reason I've been so sensitive all of my life! Thanks!
-
Sorry Dawn that's where my knowledge (if that is what it is) ends... but it seems to me that being skinny is not a prerequisite for this issue nor is being on the heavy side necessarily a free ride when it comes to rippling. But it does seem to have to do with thin skin. Perhaps it's a matter of where we pack on the pounds (thin or not) and where we don't? Individually, that is.
-
Hi Dawne - I agree with Lilah that there seems to be no correlation between a thin or heavier body type. It all depends on the thickness and integrity of the skin itself and your personal medical conditions. I too have a thin upper body. Tomorrow will be 3 wks since exchange. I notice rippling when I first take my bra off and when I bend over and after I shower. I was a 34B and am now barely a 34C. It's all my skin could handle. Before this BC experience I had no idea that I had thin skin.
Are you doing your massages?? I'm finding it a good exercise cause it's getting me reacquainted with myself. I have to say that the difference in temperature between my body and foobs takes some getting used to.
-
Deborah, Thank you again so much for your help, I sent you a PM
-
vanderlady:
In answer to your other two questions: Mentor and Allergan both have comparable style implants - just different names. Yes, we have a number of women who have used the Style 45 in Allergan - which is the ultra or extra full projection style of implant. It works well when you need to achieve the most volume possible - in the 800 cc volume - and on tall women with nice long torsos or women who need the extra height the Style 45 provides. Mentor's equivalent "ultra" is not available in the US to date which is fine with me because the dimensions of that implant are really bizarre.
-
i talked to my BS today, he's going to have 450cc high profile on hand just in case! thank you whippetmom!!
-
Giselle7 - I'm having the same experience with rippling that you are ... when I bend over, if I hunch my shoulders, I've noticed the shower thing too. My PS told me today that I'll probably experience even more as the implants settle and the swelling continues to go down. I was just instructed today on the massage. I've heard you all talk about, but no docs had mentioned anything about it to me. I asked my PS today and he gave me a sheet on how to do it. 3x a day? Are you supposed to take 15 minutes during lunch, hide out in the bathroom and do it?
I was surprised it was so often! And the temperature ... funny you'd mention that, they're freezing! I touch them and they feel like ice cubes. Re thin skin ... they told me today that because the skin is thin ... if I chose nipple reconstruction, there could be some healing problems. Are you going to go for the nipples? I'm not sure at this point ... -
Dawne-Hope - I am to massage once daily by slowly pinching each foob left to right and up, down 10x. That's it. I decided to use a little vitamin E oil on my fingers so they glide more easily. I'm still a little sheepish about doing too much touching. I like the idea of doing it in the shower as well.
There will be no fipples for me. Skin just too thin. I will be a 3D tattoo girl. I have already been scoping things out.
Funny, the bathroom thing reminds me of pumping out my breast milk at work. That was a long, long time ago!
-
If I may interrupt...
Deborah or anyone...
at the gym... is it OK to do push ups or chest press? My body does this easy... BUT... will this hurt my implants? I am finally able to do training again... ( my medication takes care of my pain now.. wahooooooooooooooooo) I love being able to work my pecs again.. and build my chest.. like I had two yrs ago. BUT... I just wonder if it is bad for the implants.
-
G7 & DH - Funny that you mention the temperature of the foobs..... that was definitely a shocker to me when I first felt it too. I thought.... gee, they didn't tell me about this. It is especially bad after working out and then you get cold. I worry about how it is going to be in the winter because I have Raynauds and if I get cold, I'm down for about 3 hours.
-
Whippetmom -- Interesting thought on saline on the native side...... I'll have to think about that and I'll discuss with the PS. When I was bra shopping yesterday at Macy's (in another part of the county) the saleslady recommended I see this one PS..... this was the second time his name was referred to me. As it was a spur of the moment decision to go shopping and I'm not usually in that area, I took that as an omen. So, I made an appointment to see him next week. I figure, I'll go see the two best PS in the county and decide between the two. Although I have to say, with my new bra, I'm a lot happier with the position..... funny how something as simple as that can help. I'm going to a local support group meeting tomorrow night for my first time.... I'll be asking them who to go to as well.
-
Estepp - I'm not sure if it was on this thread or the exchange thread but there has been a lot of discussion about pectoral exercise after exchange. Whippetmom included some good info on the topic. Make sure to look into this issue before you go any further. You don't want to wind up having to have a revision due to exercising your pecs.
-
Giselle... good advice! TY!
I was going to call PS tomorrow about this... but wanted to see what you all say, too. Due to my LE, I cannot lift heavy ... but I was hoping I could do push ups ( " man kind") and Chest presses with about 20pds. ( this is light)...
I am here to take in all advice and info. I will run this past PS...
-
Hello whippetmom,
I was in touch recently as I'm gathering information for my recon after a R skin sparing Mx with TE- surgery has now been booked for late November - I PM'ed you my information a month ago, but to recap - I was/am 36C cup, height: 68.5 inches (5 foot 8.5 inches), weight: 154 pounds, rib cage: 34.6 inches.
I've now had a chat with my PS and he is suggesting I go with Mentor 322, moderate plus profile cohesive III, 330cc. I would love to have your feedback. It's 12cm wide, 11.3cm high, and 5.1cm proj.
thanks,
Lisa
-
Deborah, I just wanted to say thank you so much for the pics, you look amazing, look like you do have very nice volume and very good projection. now I have a positive image in my mind of how I hope to look like when all of it is over.... thank you for that. Surgery is today, I'm about to go to the hospital in a couple of hours, wish me luck... I'll be back in a few days and let you know what size TEs implants my PS used on me.
-
I had BL Mast in 4-2010 then my exchange was in 9-2010. I have had pain ever since. Mostly on the right side. I have been talking to my PS about having my implants replaced. I'm wondering if they are too heavy they seem to big. I'm 5'2 156 and my rib cage is 32. I have Allergen Mx-410 size 685. I have had nipple surgery too and just a few months ago had the areola tattooed. My PS just keeps telling me give it time. I think I look way to big. They are very wide also. He said we will have to wait at least a year and do some documenting first to get insurance to pay. The right one is lower than the left too. I was Diagnosis 2-2010 DCIS Insitu. ER/PR/Her2 Triple Neg. No radiation and no nodes removed. On exchange city a few Ladies said I should be checked for LE. I'm afraid I know nothing about LE. My BS has told me over and over I have no worries about LE because she removed no nodes. I did see a PT for a while for my lower back after sleeping in the recliner for days my siatica was really bad. Any thoughts and help would be appeciated. Not sure what to do. I'm going to make an appt with my BS today and see if I can get a referral to some one about the LE. I have not seen her in almost a year. I'm wondering about my nipple placement if I have another exchange. Has anyone come this far only to have them exchanged again???
Thanks Di
-
Di: There are a number of issues you have to address, and first and foremost - the discomfort with the right breast/implant. It is not uncommon at all to have what is called "Post-Mastectomy Pain Syndrome"....there is an active thread on this topic in the Surgery forums. It might be PMPS and again, it could be something to do with the pocket itself - perhaps a slight rotation of the anatomical implant - some displacement? At some point, when the pain and discomfort is sufficient to disrupt your life...it is worth going in for a revision/replacement. Because of your pain issues, I would advise to switch out to a standard silicone round, because it will be softer and there will be no rotational risks. That would be my recommendation. That 410MX has a width of 15.5 cm, but with your issues, I would hate to recommend to much in the way of pocket revisions, which might cause more discomfort. So, in order to stay within the realm of the same width, it would probably be an Allergan Style 15, 616 ccs - which would not be too much volume for you.
Referable to the time constraints for a revision, I do not at all understand your PS' premise that you need to wait a year. I do not know what type of insurance you have, but I have never heard of that sort of moratorium on submitting a request for a revision to an insurance company. I cannot think of any one of us who have had revisions, having been told we have to wait that long and that there is an issue with insurance covering a revision from a "time" standpoint. You also can get a second opinion at any time and your insurance should cover this. There might be a few exceptions with some carriers, but it is the exception, rather than the rule.
-
Laura: On some page of this thread, I supplied some links which showed that too much load or taxing of the pectorals can lead to implant displacement and/or implant distortion. The premier risk appears to be lateral displacement of the implants, with pectoral contraction continuing to push the implants laterally towards the armpits.
EDITED: Laura, we had a discussion re: pectoral exercises on Pages 36 and 37 of Foobville...
-
venus: Good luck with your surgery! You are in very good hands with Deborah, the Breast Whisperer! My exchange is tomorrow and I can hardly wait!!!
-
venus: Praying for you today...please check with us to let us know how you are doing once you are able to do so!
MBJ: The big day you have been waiting for for so long is finally here! You will be in my prayers tomorrow....
-
Aw Di -- I was one who suggested it might be LE but I DID also say only IF you had nodes removed. Since you did not have any nodes removed, it is extremely doubtful that it is LE. Post Mastectomy Pain Syndrome could be a possibility. It could also be, as Deborah said, that it's the gummy you have -- that it may not be sitting right in the pocket (which can only be addressed through surgery and which you should NOT have to wait for).
By the way: the Allergan 410 is aka the "gummy" because it has the firmness/feel of a gummy bear. I actually have the exact same implant as you: Allergan 410 MX 685. Since I am a little heavier than you, it is not too big for me. But it is snug in how it fits in the pocket and I'm looking around for a good PT myself to help loosen things up (although to be honest my problem is mainly in my shoulder and, I suspect, is to do with having had surgery in that area and not to do with the implant itself). Any implant can feel tight; the gummy maybe especially because it has a textured surface designed to adhere (internally) to your skin and your body.
Some women, both those with gummies and those with smooth rounds, have found relief through Physical Therapy. If you have not seen a physical therapist, it is worth investigating. That may relieve your pain.
If it does not -- and you feel the size is too big -- then I think Deborah is right that you may find a smooth round more comfortable because it does NOT adhere to the body internally and does not have the issues of placement that can happen with the anatomicals shifting.
Certainly, it's worth finding out if PT can help relieve the pain short term. You may still want to replace the current implant with a smooth round, long term, but short term relief helps
Others with gummies who experienced pain or discomfort have reported relief after PT (check out the All About Gummies thread). -
Laura -- for what it's worth, I was told by my doctors at Sloan Kettering in NY that I should not do push-ups or other exercises designed to strengthen the pectorals. You want your pecs to remain flabby, basically, because empowered pecs could flatten out the implants or otherwise press on them. Of course, do what YOUR doctor tells you.
-
MBJ- Want to wish you all the best tomorrow, your in my thoughts and prayers! Can't wait to hear about your success! Hugs
-
MBJ -- WAHOOOOOOO YOUR DAY IS FINALLY HERE!!! Good wishes for an easy surgery and a fab outcome.
-
And, of course, Lilah and I, sloth-like creatures that we are, have no problem being told we should keep our pectorals flabby. Eh Lilah?
-
LOL -- you betcha!
But weirdly for some reason the past few days the top of my implant/foob has been sore (to under the arm)... am wondering if it's the bra I wore for two days in a row (none today) or what the heck? Maybe I'm just feeling more normal and doing more reaching/stretching.... not enough slothing. I did go to an Anthropoligie sale yesterday and tried on something like 30 tops! (Bought two). Yeesh! That's almost like -- exercise!
-
There you go Lilah, all of that arms up action - pulling things up and over your head! And 30 times! Whoa! You da' woman!!! LOL! I LOVE Anthropologie tops and tees. I have to stay away from that store...danger, danger...
-
Love Anthropology! Reminds me of all the european clothes I wore as a child. So bright and colorful!
-
Whippetmom - You were kind enough to offer recommendations for my implant sizing in recent months. My expansion has been ever so slow in that I am 4 hours away from my doctors, I had one of those "mystery rashes", was on antibiotics and then discovered another lump which had to be biopsied. All is well now and I am expanded to 480cc. Exchange is scheduled for Sept 1. I am wanting to make the most of my pre-surgery appointment next week. I have some concerns but am not sure if I am expecting too much. I would so much appreciate your input as far as what issues to address with my PS. Would it be presumptious of me to ask you to take a look? I can PM you with pictures.
Ht:5'5" Wt:130 Chest: 30"
Mentor Med Ht Style 7200 TE 450cc W:12.7 Ht:10.8 Proj:7.0
Your recommendation: Mentor HP 500 cc smooth silicon. He was talking more in the 450cc range. Now that there is a 475cc, perhaps he will agree to try that.
Thanks so much!
Jan
-
Jan: That sounds good to me. See if he can use the Mentor 475 cc high profile implant. If he is stuck on 450 ccs, then at least get him to commit that, skin permitting, he will not go any lower in volume. In Mentor, the 450 cc and 475 cc implants are wide enough to match the width of the TEs. Let's see what he has to say!
-
Thank you, Whippetmom. You are always so willing to help and very much appreciated!
-
Hello whippetmom, I'm reposting from yesterday because I don't think you saw my post
I was in touch recently as I'm gathering information for my recon after a R skin sparing Mx with TE- surgery has now been booked for late November - I PM'ed you my information a month ago, but to recap - I was/am 36C cup, height: 68.5 inches (5 foot 8.5 inches), weight: 154 pounds, rib cage: 34.6 inches.
I've now had a chat with my PS and he is suggesting I go with Mentor 322, moderate plus profile cohesive III, 330cc. I would love to have your feedback. It's 12cm wide, 11.3cm high, and 5.1cm proj.
thanks,
Lisa
oh and my TE is mentor siltex med height, contour profile expander,450cc - I think we're up to 450ml now.
-
Ladies: I should be sleeping but I am too excited!
Deborah: Thank you so much for all of your help! I hope I can finally get to sleep because the morning will be here soon!
Lilah: Since you are a Uni, you probably have a good idea of how I feel. I cannot wait to have my breasts even out. I sure hope he does as good of a job as he says he can!
G'nite all!
-
I'm sure he will MBJ! Can't wait to hear from you when you are done
-
good luck mbj, I hope everything goes smoothly in the morning
lisa
-
I had my last fill on Tues and am still so sore. It is really bad this time.
I've had to leave work early each day so that I can take pain meds... Motrin isn't cutting it.
I'm at 550cc on the right and less than that on the left (but I look symetrical because of the seroma). My exchange is scheduled for 9/13. So, the end is in sight.
He agreed to 375cc Allergan-20's. At first I wanted smaller and he wanted bigger but then we flip-flopped! LOL! Last visit, I was trying to get him to go to 400cc and he wanted 350cc. So, the compromise was 375cc.
So, that's my update!
MBJ~ Good luck today! -
Aw Michele I feel your pain! (Well, I DID feel it) The good news is it gets better after exchange. See if you can get a loved one to rub your back (around the shoulder blade) -- I found that gave me great relief. Also do some gentle stretching, that also helps, on top of the Motrin.
-
Ya know, it's funny, because I had virtually no pain with the TE's.... didn't take pain meds at all. Now post exchange, I hurt everyday..... just doesn't seem right, does it? All the more reason I should go with revision I guess. Have to get some answers first though.
-
Lisa: I am so sorry I missed your post yesterday!
I just looked at your numbers and I just feel that the Mentor 322 in 330 gms is small for your frame,and the width is less than the TEs. However, you are a unilateral and the PS is hopefully going to use a cohesive gel implant which will match your native breast. THAT is the conversation you should be having with your PS. Is he focusing on symmetry? It also depends on whether you are going to lift or lift/augment the native breast. I have a hard time believing that your native breast has a width of only 12.0 cm....and that is my concern. Ask your PS "what is the width of my healthy breast?"
Actually, the Mentor 322 in 375 grams matches the width better - 12.5 cm width. I would prefer that size over the 330.
But again, symmetry is the key here and you need to go with the style/volume of implant which will achieve the best match.
Deborah
-
has anyone ever heard of a leak in the tissue expander? i am not sure, but i think mine might be getting smaller on one side.
-
Webstermom - I had a leaky expander. I noticed it a few days after one of my fills. I looked down and it looked like one side was smaller than the other which wasn't like that the day before. When I went in to the PS he said it definitely was leaking and that it happens sometimes. He might have nicked the expander when he did the fill. He said the body absorbs the saline and not to worry. I had to go get refilled more often until the time of my exchange. I even asked him maybe it should be replaced and he said it wasn't necessary. I went back every two weeks until my exchange. I would call your PS and tell him what you think and see what he says. He might say something totally different than what mine did. Each individual's PS does things their own way so I would definitely call to make sure that all is OK.
-
Webstermom: It depends on where you are in the expansion process I assume. The breast reconstruction journals and the TE manufacturers suggest that the TEs should be replaced if they deflate - especially early on in the process - such as during placement at the time of surgery, or with the initial filling post-surgery. Of course, it all depends also on how much expansion is required. It is a tough call, because typically you would need to wait at least two months to go in and replace the TE after it deflates, which delays everything, and repeat surgery carries its own risks. But if NOT replacing it means I must accept a smaller implant - significantly smaller than planned - I would have the TE replaced. That is just my personal opinion on the matter.
-
I saw my PS yesterday,and he said he put in a Mentor MX13. I had asked for a 12 since my ribcage is only 26.He said he cannot get the Natrelle, he has to use what the hospital offers. But, on the day of surgery, he said I got the same thing we talked about size wise, but yesterday, he said it was a 13. That is why it is intruding over the middle line.But, he said that as we expand, it will pull in as it lifts, but we will watch it. If it is too much over the middle, can we go on with the expansion, and make the adjustment at the exchange? Or will I have to stop the expansions and get a smaller one put in? ...What is your opinion.??
-
joie: I am a little confused, as the MX-13 IS Allergan - not Mentor. "Natrelle" is just the collection name for Allergan. The Mentor "13" is actually a 550 cc TE with a width of 13.5 cm. Could you clarify which mfr and style of TE you have?
-
joie: I do not quite understand the doctor's inability to obtain an Allergan implant for you at the time of exchange. You should be able to request a match - manufacturer, volume and dimensions - for your opposing reconstructed breast. You are in SoCal and Allergan is right down the road. I would just make a point of lobbying for this issue....
-
I just had my pre-mastectomy appt with my PS and I'm feeling kinda disapointed. At the first visit he was all gung ho on how I could go bigger if I wanted and all went well and being a barely B, I had decided I liked that idea. (btw, I am a uni and have a planned ss/ns mast, and I'm getting a gummy) Now he was saying that if we can save the nipple (never a sure thing) we could maybe go a bit bigger, but if we don't, we will be lucky to even make it to the same size as now and probably a bit smaller!! Also I would have less skin, cause they have to excise the scar below my nipple that was from the 2 lumpecotmys cause the skin would not survive) I was crushed since so many things can go wrong with the nipple sparing - could have cancer found during the mast, in the pathology later, or necrosis. Here I was thinking that at least I could have a nice pair of perky bigger ones as a prize at the end of this nightmare. (I was thinking to upgrade the "good" size to match)
Has anyone else faced this? I know it is early yet and the nipple may pull through, but my bubble is burst and I'm feeling down.
-
Thanks Whippetmom for all your help: I just talked to my PS office, and she said they put in a Mentor 550cc At one point she said it is 13.2 and in another sentence she said it is 13.8 x 6.9. I am a little upset with this insurance PS, since it seems they don't listen to the patient. I had showed him I wanted the Natrelle 133MX 400 width 12.0 projection 6.3, so I am baffled at the huge amount of increase he put in me. He had agreed that was a good size, and the morning of surgery, he said I got the same dimensions in the Mentor. Now, come to find out, that is not the case.
The girl said they have to expand at least 100cc more than the implant they will put in, otherwise there will be no movement, and that the expander seems to gravitate towards the armpit, and not the middle. She says I need to expand to 575, in order to fit my 475ccNatrelle style #20 implant. At this point, I am confused, and worried about mega ripples.... Confusing at the least. Thanks for all your input Whippetmom..Your knowledge really helps us all tremendously..
-
heebie-Jeebie-hang in there, try to take it one step at a time. I know they like to be cautious about what they say they can do, in case it doesn't go as well as they'd like, but I'm sure if it is possible they will try to give you the look you want. They will definitely be perkier and may look bigger than you may think.
joiedevivre-Now I'm confused. My PS says he doesn't like to over expand too much and it isn't always necessary. In my case he will put a larger implant in than the cc's I am expanded to. When I asked him why he wouldn't fill it some more he said it wouldn't really be necessary and he didn't want to put any more pressure on the skin. I know Whippetmom says PS's have different methods of achieving the same final results.
-
Sweetie: I agree with your PS. I will definitely NOT let my PS expand me that much. I am very thin and already have thin skin there, and he was even considering a latismus muscle to help the skin , but I refused because I did not have any issue with the skin when I got the first expander, and did not want to go through all that. My implant on the other side is 475cc high profile, so I will not let him go more that 420 in the expansion. I am just wondering if having an expander that is too big for my frame will cause a problem if I do not over expand as he intends.Breast reconstruction is no fun.......
-
Joiedevive_ I don't think you have to fully expand a TE either, but I'm not positive. I think it has a maximum fill recommendation because of skin integrity but it doesn't seem like under filling it would be an issue if it was too big of a TE and that's all he had to use. I had to have one of TE replaced due to a wound problem and I remember the nurse saying he would use whatever TE was available if he couldn't get the same one I had. I was surprised at that but she said it wouldn't hurt things. In the end though he was able to get the same one I had. I don't blame you for not wanting to do the LM thing, that seems like a lot more to have to go through. What size do you want to end up being? You said you are petite and thin? I'm 5'7" 130 and I only have a 400cc TE in.
-
There is no requirement to expand fully. The size (mine was a 600 cc TE) is a "recommended maximum fill" -- which is to say anything UP to that amount -- though in fact my PS filled mine to 850 cc's... so clearly it's all whatever the PS wants to do (within reason).
-
heebiejeebie: Well, another consideration with a nipple-sparing MX is that you are limited by size and dimensions of the implant, by virtue of where your nipple-areola-complex ends up on the mound. I do not understand your PS' premise about size if you do not have a NS procedure. Many of us were smaller prior to MX than we are now and as long as your skin is viable and responds to expansion, I am not sure why he is sounding so dismal about your sizing options.
-
joie: Can you obtain the data regarding the type of TE you had on the other side - and the amount of volume in that pocket? You want pockets which expand similarly. I PM'd you....could you check your messages?
-
Whippetmom: I think I was expanded to 480cc at Kaiser 10 years ago. Doubt I could retrieve the info as to what TE I got. I know it was oblong and she said it was the smallest one they make...Then I went to a 400cc implant with a low profile..the hamburger look because I did not know the difference, and that is all they could offer me at the time. I went to a seminar, and all the girls had the same low profile which looked like big flat pancakes..But, that was 10 years ago. I since had them changed to the high profile which is much better, but I want them to match..So, worried that this TE will make a much wider pocket than necessary. I have the style #20 475cc Natrelle on the good side.
-
I PM'd you back to discuss what will be required. I guess this new PS does not think he can get you into a 475 cc implant without using a much larger TE.....
-
Just checking in. Surgery went fine, they did a bit of lipo on my tummy and fat grafting on my left MX side. He put in Allergan 20-550 High Profile on the left and 15-397 Moderate Profile on the right, which is a bit high right now. I will be in a surgical bra for the next week and then I will post pictures.
Meds are kicking in-goodnight everyone and thank you for all of your help Deborah.
Deborah: Do you see any problems from the two different implants used?
-
MJB.... So glad you are home and well!
Ladies. I HAD to post this.
You CAN get LE without a single node removed. You can have a mast... with nor further treatment and get LE. There are a few sisters on BCO that have extensive LE and had a mast only and no nodes touched. I personally was told all the " myths" about LE. So, I never fear getting it.. until the day my arm felt.. heavy.. and I " thought" I had back fat. WELL.. it was LE in the arm and truck of my body. It sucks.
Binney on BCO is an amazing resource into the world of LE and the myths of LE. I personally am in denial most days.. as LE SUCKS... but she is not.She has a website dedicated to LE. I would contact her if you thought you might have LE.
-
MBJ - Glad you're home and things went well. Praying that the new girls settle in nicely, are even and absolutely beautiful!
-
Welcome home MBJ! Rest up and be patient
I am so excited for you!Laura -- thanks again for this -- I thought it was only an issue for those with nodes removed. Wow.
-
Thanks Deborah for that information and food for thought, I'm going to take that away and chew on it for a while. I'm not booked for surgery until Nov 26th, and will certainly see my PS before then and have a bit more of a chat.
MBJ, I hope you are comfortable, and all is going well.
Lisa
-
Whippitmom: Thanks for your answer. I was so thrown off balance yesterday that I never questioned him on it. He made is sound as if little to no skin stretching is possible, so If I don't get enough skin I am out of luck.
I think right now I'll just have to wait and see what next months surgery brings and address the expansion later.... while keeping up with what everyone here is going through.
-
Hi everyone! Exchange took a bit longer then expected--3 instead of 2 hours--plus my anesthesiologist wasn't as good as the last one. Of course this time they let me drink a ton of water and juice so that I would pee and they could send me home. I woke up from my MX within an hour and felt euphoric, but I woke up from my exchange in pain and grouchy and incredibly woosie. I was told they were going to use the same meds as last time but I suspect they used morphine after all, even though I asked them not to! I only have pain a bit on my right side and I also paniced when I woke up because it took awhile before I could use my arms, but they are fine now, just a bit of pain under my left are because they fixed (hopefully) the drooping skin and took out a remaining bit of scar tissue that still remained. It looks as if my right breast is larger then the left, but I won't really know until they do the "unveiling" next week.
Meds are kicking in, talk soon!
-
MBJ - Yeah! I am happy you are back with us and that your surgery went well. I'm with Lilah as patience is needed at this time.
-
Hi MBJ! SO glad to *see* you this morning!
-
MBJ -- if the PS did more work on your right breast (is that the MX side?) then there could be more swelling there. Regardless, remember that swelling IS a part of the healing process and each side can be at a different place with regard to that... so you need to give it a few weeks before you can be sure that one side is bigger (and not just more swollen).
-
MBJ -- if the PS did more work on your right breast (is that the MX side?) then there could be more swelling there. Regardless, remember that swelling IS a part of the healing process and each side can be at a different place with regard to that... so you need to give it a few weeks before you can be sure that one side is bigger (and not just more swollen).
-
Lilah: My right side is my "natural" side. I think it's because I just have more breast tissue up top and he mentioned that he may have to do some more fat grafting. I really won't be able to say anything until I get the bra and bandages off, but they look to be a close match and that's the best possible outcome. I personally think he could have gone larger on my left side because even though it's 550 cc's it's being squashed by my pectorial muscle. Much bigger then I used to be, though! Funny how the longer I had the TE in the smaller my breast looked! I can't believe how greedy I have become! LOL!!
-
BTW: I did get a drain on my MX side only.
Thanks again everyone for your well wishes. I can really feel the difference on my MX side. My right side aches though.
-
MBJ: Congratulations! Just remember that the MX side is going to go through a myriad of changes over the next two weeks to a month - and that what you see at the first unveiling will not be representative of how you will look down the road.
Cannot wait to see them!!
-
Deborah: I can't wait to see them, too!! The curiosity is gonna kill me! I don't know how I can thank you more for all of your help--I never would have known what to do and I would have hated being any smaller then this. According to my measurements, I should be a 36C, but I will go get a professional measurement when all the swelling goes down. BTW: How long should I wait before I get measured? I am very pleased and excited that he was able to get me to this size. If I hadn't been sewn down on the side, I probably would've gone bigger, but I think that this size makes me perfectly proportioned: 39-30-39! It's going to take some getting used to but I am glad they don't feel heavy.
-
Ah MBJ - well for what it's worth my good side was VERY swollen for weeks after surgery -- partly due to a lot of bleeding. So the whole swelling thing may be a factor for you as well (with or without bleeding) there is simple more tissue there that CAN swell.
And yeah what Deborah said about MX side dropping and fluffing
-
MBJ: I would wait two or three weeks before going to Nordstroms to be measured. You want the benefit of settling and healing to take place. Has your PS prescribed or provided a compression type bra or recommended a sports bra to wear post-operatively?
-
Deborah: They just sent me home in this awful compression surgical bra with no mention of anything else. It's lovely and stained with some antibacterial stuff and attaches with velcro. Almost looks like a sports bra, but not quite. He mentioned early on when I brought it up, no underwires. Should I post a picture of this contraption on the Bras thread LOL?!
-
MBJ - A contraption it is! Sounds like the same bra I was sent home with. Couldn't wait to get out of it. I went bra shopping a week after exchange. Quite honestly, it was too soon. I had to be so careful not to hurt anything and maneuvering around to get the bras on was not that much fun. I went back a week later and it made the world of difference. It is hard to be patient!
-
Giselle: Not much that I can wear in this 90 degree weather with this surgical bra being larger then most of the summer tops I wear LOL! I am hoping they will take me out of it next week when they remove the drains. I will bring my Spanks wireless to see if they will let me wear that one instead. This bra is so tight my neck is sore!
-
Yep, I had the same surgical garment. I think it is a disposable surgical bra frankly. Don't bother washing it....it will self-destruct.
I knew you before I formed you in your mother’s womb. Jeremiah 1:5.
Diagnosis: 10/15/2008, IDC, 1cm, Stage I, Grade 2, 0/1 nodes, ER+/PR+, HER2- -
I was checking with my PS's office to see if I needed to take some kind of bra with me for my exchange and his assistant said I would be sent home in a tube top! Yikes! After these months with my turtle shells I'm thinking I will feel a little... VULNERABLE. Have you heard of other doctors doing that?
-
Believe you me, it is a marvelous thing to be 60 years of age and able to wear a tube top! For once I have breasts which will hold up a tube top. Count your blessings Jan. Don't look a gift-horse in the mouth! LOL!
-
MBJ - glad to hear you made it through okay..... I always have trouble with the anesthesia too. Your neck might be hurting from the position it was in during the operation. rest! Pam
-
Whippetmom: Well my daughter has been after me to update my image a little... I wonder if the tube top would be the direction she has in mind. LOL!
-
Jan - Yeah, that's it..... we want to see the tube top on your updated profile pix!!!
-
Whippetmom and Vanderlady:Thanks for a good laugh..lately I have been taking everything far too seriously!
-
Thanks for this thread WhippetMom!! I meet with the PS on 9/6 and am clueless!!
-
My nurse was surprised that they sent me home in the surgical bra--she said that usually they send everyone home in a blue or pink tube top. Maybe I wouldn't be having so much neck pain if they had put me in a tube top intead. I haven't worn a tube top since I was fourteen, and I didn't have a thing to hold it up then!
-
Very Important: voting started today on Timtam's site to move forward with the new one or stay with the old. Please vote as they need at least 50 interested to proceed with the picture forum and the poll ends the 28th!
-
Hi, I am new here, and not sure where to post this question...so, bear with me if I am posting this in the wrong forum:
I am going through breast reconstruction after having double mastectomies (one due to DCIS grade 3, the other one profylactic due to several cysts).
The problem is: I really, really regret my last expansion.
I am filled to 350 cc...and I wish I had stopped at a smaller size. I feel that I became too big, and that my new large expanded breasts just remind me of cancer...I am devastated, and on top of it I feel really guilty: this was my own choice after all, and I feel so stupid.
Is there anything I can do? Is it possible to put in smaller implants even if the skin is expanded? If there is anyone out there who could give me any advice I would really appreciate it.
-
Maria~ Lots of surgeons OVER expand. Mine likes to have the TE's 25-50% bigger than the implant size. Right now, I'm filled to 550cc (no more fills!!!) and will get 375cc implants at my exchange. So.... I don't think it is a big deal at all to go smaller. Maybe that's what your PS is planning anyway? {{{{HUGS}}}}
-
Dear Maria -
I agree with Michelle. Do you know if your PS overfills? You could PM your stats listed in the introduction to this thread to whippetmom and she could tell you what size impant would look good on your frame. There's no need to worry! No damage has been done. The pocket they create with the expanders shrinks a little after they put the implant in. No worries, you'll be OK.
-
Marie: keep in mind the expander is also larger then the cc's becouse of the port so if they were to put in a 350 cc implant, it would actually be smaller then the expander. I expanded up to 535 and they put in a 550 cc implant, yet it looks a whole size and a half smaller then the expander was! I agree. give whippetmom your measurements and she will give you the size that will look best on your body. You came to the right place--Big, gentle hugs!
-
Anne: Stick around and keep learning~!!!
Maria: I need your height, weight, ribcage circumference....and yes, even if you were exchanged to 350 cc implants, they would be smaller than the tissue expanders. You are just fine where you are.....you did nothing wrong.
-
Marie - If you were just expanded in the past couple of days, it could be the pressure of the expanded size which will go away in a few days and it won't feel so big anymore.
MBJ - Interesting comment about "size and a half" smaller. Do you think the 500 cc expander "size" is equivalent to 550 or 600 cc in an implant?
-
vanderlady: You want to compare the dimensions of the TE to the implant. For instance:
Allergan 133 MV 400 cc TE - 13.0 cm wide by 5.6 cm projection
Allergan Style 20 500 cc implant - 13.0 cm wide by 5.2 cm projection
-
Whippetmom, thanks so much for offering help!! Are the 350 implants actually smaller than the expanders? That gives me hope. My height is 5'7, weight 132 Lbs, ribcage 31, 5 inches and I am 44 years old. The tissue expander is an Allergan 133 MV 400cc
Michelle, Dawn-Hope, MBJ and vanderlady - thanks for all of your support and good advice! I don't think my PS overfills. I haven't been researching enough (another thing I feel slightly guilty about...), but will make sure to ask.
Hugs from maria
-
vanderlady: the dimensions of my TE above are exactly what I had in me. The 400 TE was expanded to 535cc and replaced with a 550 implant dimensions 13.5 x 5.6, but without the TE the implant looks smaller as the chest muscle presses down on it. Not quite the same amount of projection as a TE. If I just had an implant without losing any breast tissue there may not be such a dramatic difference. Hope this helps rather then confuses you!
-
Maria: You know, with your height, weight and ribcage, I would have placed you in a 475cc or 500cc high profile implant! Because you have a 13.0 cm width TE and you want to be smaller, I would recommend a Style 15 in 371 ccs. You would be at 12.9 cm width and 4.2 cm projection. This is compared to the 13.0 cm width and 5.6 cm projection of your TEs. Certainly less projection. You will look quite a bit smaller than you do now. But you need the width.
Deborah
-
Maria: If you are limited to 5 posts daily, you can always PM me with questions. That goes for any of you newbies who are under the temporary probationary period on bc.org.
Deborah
-
I posted a question in Exchange City and was directed here... I'm pretty excited having new breasts but am eagerly concerned about getting the right implants to make it a one-shot deal. My bilateral mastectomy was last year and just recently completed my last fill on Thursday with 475cc in each breast. I spoke with my PS and we are going to put in 400cc implants as I was happy with the size. My question is---what cup size is it? My PS wouldn't give me any specifics and as my natural breasts were 34AA, I don't really know how big 400cc's are. I am 5'3" with broad shoulders. Weight 108 lbs, ribcage 34". The Style of Tissue Expanders are 133MV-13 tissue expander matrix-Moderate Height-Allergan. I just need to know approximates. Projection looks good and I've got a cleavage! But will this entirely change with the implants?
-
Here in Canada you do get the reconstruction for free. I had a lovely doctor lined up before my recurrence. You don't get subsequent operations if you are not happy but you do get to complain to the College of Physicians and Surgeons if you are not satisfied with your care or you can start with the head of the hospital. There must be someone in Australia that overseas the medical profession or if this is private practice how about a lawyer.
-
This is my first post and I'm pretty scared of the reconstruction. I truly want it. Two women I've spoken to used my PS and told me horror stories. Both had the same as me. Unilateral mastectomy and both complained that their girls were asymmetrical. How do I find other patients? I have 4-6 weeks before mastectomy and I'm getting really nervous. I'm 5'6" 175# and Ribcage 37"
-
GrandmaBubba: You came to the right place. I am a uni recovering from my exchange surgery. I had the 133MV-13 TE's overexpanded to 535 and they put a 550 high profile on my MX side and a 397 moderate profile on my right, natural side. I think he got pretty close in matching them but won't know till next week. Whippetmom can help you get you to where you need to be! She's a genius. My new foobs appear to be in perfect proportion to my body now and I hope they are a good match and I couldn't have done it without her!
-
GrandmaBubba: Why do you have to go to this particular plastic surgeon who has such a negative history? I have the names of a number of good plastic surgeons in Ilinois. I really would prefer that you get a consultation with someone else. I am just leaving for a number of hours and I will get some information together and send you a private message later this afternoon. So check the upper right hand dark navy box later on today. There is no reason you should be looking forward to a dismal result with breast reconstruction!
Deborah
-
Iam - I have sent you a private message....
-
I have decided to NOT get any fills in this monstrous gigantic expander, which will only serve to make me freak out more each time I see more volume in this football shaped monstrosity, and stretch me in the wrong direction.As a matter of fact, when I see him on Sept. 1st. I am thinking to ask him to remove some of the 120cc he has already put in at the surgery.I also have an appointment to see my wonderful PS on Sept. 30th, whom I have no insurance for and have to pay out of pocket thousands of dollars each time he does something for me, but he does good work.I want his opinion on this before I proceed any further.
Also, I was thinking to see my regular family doctor, and show her what he did, and ask her to give me a referral for a different PS that Health Net would pay for to get his opinion also.I want this expander taken out and the proper size put in. I think what happened is that he did not have the right size. I asked him that morning, and he said yes, I got the same thing we talked about, except in Mentor instead of Natrelle, but the same size. When he got to the surgery room and started working on me, he found out that the hospital did not have my size, so he put in what they had available. He said" The hospital orders it for me...but apparently they did not..What is your opinions. Am I right to hold off on the fills, and start all over again.?
-
Hi ladies, I'm reading your comments about the final implant being smaller than the TE, now I am feeling nervous. My PS stopped my expansion at only 400 ccs and said he will put me in a 450 implant and that he doesn' t like to overexpand. I kept telling him I don't want to be any smaller than my TE and would like to be a little bigger. He said I would be bigger. Now I'm confused at what your saying here, but he doesn't seem to want to add any more cc's to what I have now. Deborah suggested a 475 implant and I agree but it seems he doesn't want to go that big and I am not sure why.
-
Hi ladies, I'm reading your comments about the final implant being smaller than the TE, now I am feeling nervous. My PS stopped my expansion at only 400 ccs and said he will put me in a 450 implant and that he doesn' t like to overexpand. I kept telling him I don't want to be any smaller than my TE and would like to be a little bigger. He said I would be bigger. Now I'm confused at what your saying here, but he doesn't seem to want to add any more cc's to what I have now. Deborah suggested a 475 implant and I agree but it seems he doesn't want to go that big and I am not sure why.
-
Hi ladies, I'm reading your comments about the final implant being smaller than the TE, now I am feeling nervous. My PS stopped my expansion at only 400 ccs and said he will put me in a 450 implant and that he doesn' t like to overexpand. I kept telling him I don't want to be any smaller than my TE and would like to be a little bigger. He said I would be bigger. Now I'm confused at what your saying here, but he doesn't seem to want to add any more cc's to what I have now. Deborah suggested a 475 implant and I agree but it seems he doesn't want to go that big and I am not sure why.
-
sweetie: I do remember feeling that I was a fair amount smaller after the exchange.I was either expanded to 420 or 480.. I don't remember for sure. This was 10 years ago. I felt I was a little too big at that size of expansion, but when I got the exchange to a 400 cc low profile, I was very disappointed. I looked a lot smaller, but part of the problem was that they used a low profile. implant on me. When I exchanged to the high profile 475, it looked great.The low profile had a low side profile like a hamburger, but the high profile made all the difference. And, I think you can go to a 475cc high profile with being expanded to 400cc. If you go too much more in expansion, you will possibly have ripples.But, I was changed from a 400cc low profile to a 475cc high profile implant with no problem.
-
sweetie: I do remember feeling that I was a fair amount smaller after the exchange.I was either expanded to 420 or 480.. I don't remember for sure. This was 10 years ago. I felt I was a little too big at that size of expansion, but when I got the exchange to a 400 cc low profile, I was very disappointed. I looked a lot smaller, but part of the problem was that they used a low profile. implant on me. When I exchanged to the high profile 475, it looked great.The low profile had a low side profile like a hamburger, but the high profile made all the difference. And, I think you can go to a 475cc high profile with being expanded to 400cc. If you go too much more in expansion, you will possibly have ripples.But, I was changed from a 400cc low profile to a 475cc high profile implant with no problem.
-
joiedevivre-Thanks for the insight. I will call the office this week to schedule my surgery and I am going to see if it it is possible to get me into a 475 HP, those dimensions are actually a little smaller than my TE so it seems possible. I already see ripples now with my current expansion so I wonder if thats means I will have those same ripples with the implant or if he uses a bigger implant will that help? Did you just have the revision to the new size and was it because it was time to change the implant out?
-
sweetie- whippetmom is the expert on here but I wanted to tell you what my PS told me. She said the implants will appear about 25 cc's smaller than the same volume in your TE's. I was expanded to 365 and went with 375 implants. At first I thought I had gone too small but as they've been "dropping and fluffing" they seem bigger now. I just got measured at Nordstrom's for bras and I was a 32D. Definitely see what Deborah (whippetmom) thinks. She really knows her stuff!
-
joie: There was another woman on this site who changed out her expander and it made a world of difference, so if he messed up he should correct it! Deborah?
-
sweetie: You will lose about 25 ccs however, the high profile will give you more projection. Being a uni he used a high profile on my MX side and a midrange on my natural side. I was expanded to 535 and he put in a 550 HP. It looks smaller than the TE. My PS asked me right before we went into surgery if I liked the size of the TE and I said yes, bigger please and he just laughed. It will take a couple more months before I will truly know how big they are but they feel light, not heavy at all, and because of Deborah, they fit my frame perfectly! I did not have any rippling but he used fat grafting when he did the exchange. This should help with the rippling. So will Alloderm.
-
Hi Deborah, Ladies, I'm back.... Thank you so much for praying for me, the surgery went well, I'm a bit dizzy and tired so I will just update you and go back to bed... Deborah, the PS put in 133FV-13 TEs... that what it says on the little card that he gave me after the surgery. he also said he was able to fit the larger implants (I guess larger then 400cc?...). what do you think?
-
Kate and MJ- I understand what your saying. I am just concerned because I am at 400cc's and he won't expand anymore and is saying he will get me in a 440-460 range. I just want to make sure at that size I will at least look like I do with the TE. If not I am going to have to push him to see if he can go up to 475. I did mention to him several times about over expanding and the how the implants look smaller and he just said it's not always necessary to over expand. I know he basically does a lot more gummies and I know with those he doesn' t like to over expand either because the pocket has to be tight. At this point though I am considering the rounds and when I told him that he still didn't want to over expand and just stopped me at 400. I asked about fat grafting and they are not yet doing in his office but are looking into to for the future. I do see ripples now already so I wonder if a larger implant takes care of that or not.
Kate, I'm glad you looking and feeling good. 32D, really!! Your pics encouraged me a lot about the rounds!
MBJ so do you know what cup size you are now?
-
Sweetie: I am guessing I am a 36 C or D but I need to drop and fluff still, plus, I m just peeking inside the bra which has a ton of gauze everywhere, so it's a bit difficult to measure with all of this stuff in the way. I will get a pro measure at Nordstroms as soon as my 2 week wait is up. Many PS's don't overexpand but can still get a larger implant in. My PS said he overexpands then does a much smaller implant to get a natural look. But I think with reconstruction this doesn't always work and going bigger is better. I was very pleased he went to 550 because when we first met he was talking 375 cc's! I would have been an A!
-
Sweetie -- some PS's overexpand and some don't. Does your PS use allergan (I can't remember). I also wonder whether he does partial or full submuscular implantation -- if partial, that might explain why he doesn't need to overexpand.
-
venus: So glad you are doing well! You have 500 cc TEs! That is excellent! It will be no problem getting you where you need to be volume-wise at the time of the exchange.
sweetie: Show your PS the dimensions of the TEs vs. the dimensions of the Style 20, 475 cc implant. Ask him..."what do you need to do to get me to a 475 cc implant?"
joie: PM me with a list of all of the Health Net approved plastic surgeons and I will help you find one. In the interim, why don't you email me a photo of what is going on with your TEs so that I can verify that they might or might not be a problem for you. I do not want you to go through another surgery needlessly.
-
Whippetmom, Thanks so much for all your great info. Is pocket revision necessary when you go smaller? Will there be a chance the implant can move more with out pocket revision? I know the nipple placement will probally be off if I go smaller. I have appoinments next month Sept with PS and BS. I guess I will start there. Thanks again for all your help.
Di
-
I am so confused about all this... I WAS a 36D/DD depending on which brand I bought. All I want is to look the same as I did pre-BMX. I had initially thought I would do the DIEP, and still am thinking I would like to.. Except the nurses, and even my BS looked skeptical. Apparently I "too thin". HA! I don't think so! And my Onc. told me he'd like me to lose 15 lbs in order to achieve my "ideal wieght".
Anyways, I have an appt with the PS on 9/6 for an initial consultatation. And would like to appear as tho I have at least *some* knowledge about reconstruction. My BS told me "the 410's are beautiful". I have no idea what cc I should be thinking about, how that correlates to approx breast cup size. Nor do I completely understand the whole projection vs. round.
I will keep reading... I'm slowly trying to get thru this whole thread, but those listed above are my questions so far! I will have more time to read once the kids go back to school! haha!!
(((Hugs and Healing thoughts to Everyone)))
Anne
-
Anne: What is your height, weight, ribcage circumference - measuring under the bra line?
Personally, I would get at least two consultations - and one with someone very experienced in the microvascular procedures - and then one who does a whopping amount of implant-based breast reconstruction procedures. There is no reason you should not be able to return to your same size prior to MX - especially if you have the skin flaps. Did you have rads - and this is why you have a delayed reconstruction? If you had rads, there are some other thoughts and recommendations. But post your vital statistics and let's see where approximately you should be volume-wise with implants.
Deborah
-
Di: Yes, unless the pocket is narrowed to accomodate the smaller implant, it will move around in the pocket and will naturally tend to migrate laterally, towards the armpits. You want to have your nipples in the right place after all of this...after going through the effort to preserve them. Otherwise, you might as well have had them attached to your forehead. So allow your PS to get you to the volume necessary to permit the proper location of the nipples on the breast mound.
-
Hi Whippet!
Height is 5'3", weight is 140lb (or was pre BMX...so about that or a little less), and ribcage is 33in.
I waited on recon, because the wait for BMX w/recon delayed my surgery minimum 4 mos, possibly to 6. And I just wanted to get it over with and deal with the recon later. It was too much for me to even THINK about reconstruction, when I was still wrapping my mind around having cancer... and all I wanted to do, was to get it out, beat the cancer. My breasts took a backseat.
I may be undergoing chemo, but I won't know for about another 2 weeks when I get the test results. So those results will determine whether I can start recon right away, or wait until after chemo.
-
Anne: So you are going to need tissue expanders with a width of 13.0 cm, with a recommended fill volume of 500 ccs or even 600 ccs, depending on the style of TE. I believe that high profile, smooth round silicone implants with a volume of at least 500 ccs or preferably 550 ccs would be nice on your frame. This would be a high profile smooth silicone implant. If you are opting for the anatomicals and your PS has access to same, a different formula for expansion will be required. You would then want anatomicals in the mid to high 400 cc range I believe.
-
Thanks Whippet!!
And that would put me about the same size? Thanks so much, this helps me narrow my research.
P.S. what are anatomicals?
-
Anne: The "410s" are anatomically shaped implants - the true cohesive gel gummy bear implants. Your BS mentioned them to you. Not all plastic surgeons have access to them, as they are not yet approved by the FDA. Those that do have them are involved in clinical trials with the Allergan 410s.
Deborah
-
MJB-that sounds like a perfect size. I tried bras on today just to see where I was at in the TE and I was less than a full B in some of them and in a lacey stretch one I was a C. I am thinking now I really wish I could be at least a full C. I can't wait for you to see how you look too! Will you be posting pics?
Lilah-he uses Allergan with alloderm. I don't know how he placed it. Should I ask him?
Whippetmom-I wish ask him. I think I will schedule another appointment before surgery to go over this. I kept telling him I wanted to go bigger but he didn't want to add any more cc's.
-
Sweetie -- I was thinking that if he uses alloderm he may only do a partial sub-muscular placement (and uses the alloderm to hold the implant in place), which is why he doesn't need to expand larger than the implant. JUST a guess. You could ask if YOU are curious. I know my PS expands TEs around 150 cc's bigger than final implant so that she can get it into the pocket; she said she needs the extra room because gummies, being less squishy, are not as easy to slip into place.
-
Lilah-I think I will ask the nurse when I call. I like to ask her a lot of these type of questions and then save the "major" ones for him so as not to take up too much time. My impression is that he doesn't like to over expand very much. I know he said he doesn't even for gummies which is different than what your Dr. does. That makes me worry that in a gummy I would look even smaller. I don't really feel very big now, just about a B. Another questions is that I see ripples now. Does a bigger implant take care of the ripples? Will the skin retract after the implant is placed or is where it is stretched to now the way the pocket is going to be. If that is the case there seems to be room to put a bigger implant in right now, but so much if it retracts.
-
I think the skin retracts. I was expanded to 850 cc's and have a 685 cc implant and my skin is tight.
But my basic reaction to your list of questions is: you should bring them to your doctor. They are all reasonable questions and he will be able to answer them best.
-
Deborah! Bandages are off and they are lovely!!! I posted my new pics with an ace bandage at the top, but you can see they are a close match. Have to wear one of those sports bras with the band across the type for a few weeks, which stinks because it's 100 outside, but the size is perfect and I (and my husband) cannot thank you enough!!! There are minor issues to be addressed but he did a great job matching them, it's just going to take longer for my MX side to take shape!
Sweetie: Go look at my new pictures on TimTam's site. I am either a 36C or D cup right now but we shall see after the "drop and fluff"
. I had to order a compression bra so in the meantime I am wearing a soft, wireless C cup with an ace bandage at the top to hold my breasts down. This old bra is slightly small but I loosened the straps and the band isn't tight so it will do for now until I can get a proper measure and my bra in the mail. I measured one inch bigger around my breasts before the exchange and before my right side was augmeneted to match the left side. Right now I am 38" across and 9" from side to side and look like a full C in clothing (I have a 32" ribcage). -
MBJ: They ARE lovely! You are so very welcome....I was glad to help. I am just thrilled you got the results you hoped to achieve...
-
Deborah: I never would have spent the money to just have a "boob job" but since I didn't have a choice, thank you for making it so I had the best possible outcome. They really are pretty and they look smaller with the ace bandage on, too! They are much fuller without the huge step off and my PS says if I am religous about wearing the compression bra they will lay more naturally when they settle. I am so happy I could just cry and they are soooooo soft!
-
whippetmom, This is my first post, but I want to tell everyone on these discussion boards that I could not have made it this far without knowing all of you were out there... some days I feel like I may be going insane.
I had my first surgery in June,2010 a lumpectomy without clear margins. My IDC turned out to be not 1.8 cm but, instead 6cm Stage 11, grade 3. Becasue I live in a small community I went to the Mayo Clinic in Rochester MN. for a second opinion and found that my cancer was ILC, 3 nodes of 20 were positive. The also found a very smal DCIS when doing an MRI. My PET scans came back clean so my diagnosis is ILC, 6cm, Stage IIIa, Grade 2, ER and PR +, HER2-. My course of treatment is a skin and nipple sparing mastectomy, 2 step recontruction with tissue expanders and hopefully implants. I am also having 5 weeks of radiation therapy and Arimidex for 5 years.
Sorry for be so long winded, I was hoping you could give me some advice on size of impant. Pre cancer I wore a 34 d to dd depending on the quality and cut of the bra
I am 53 yeras old, weigh 128 pounds, 5'5" tall. My chest diameter is 29 inches. My tissue expander is a Mentorr medium height 650 cc, 14.6 cm width, x 12.6 cm height x 7.6 cm projection.(they will be filling to 650cc) I hope to be a little smaller than I am now (perkier also after having 4 children). After reading all of the discussions I'm confused about how to explain what I'm hoping for and also what to do with my healthy breast that will need some revision to get symetry. Any help would be greatly appreciated.
-
Deborah,
You were right. As soon as I called one of the doctors you suggested the anxiety was gone. I'm told I'm a doer and since tomorrow is my last chemo I'm not going to have anything to "do". I'm not comprehending the TE's and implant lingo yet, but I would like to hear your suggestion. I'm 5'6" 175# and Ribcage 37".
-
Hi Flippy -- I too am a uni with NSM done in Jan with two-stage recon. Had my normal size augmented. Am currently deciding on a revision. Wish I had been on this board before my exchange so I could have educated myself and asked all the questions. But, I'm learning now and I'm so thankful for everyone here.
-
Grandmabubb - Hey, I notice you're from Southern Illinois! PM me because I'm down in that neck of the woods too!
-
Flippy: Welcome to the group and you have come to the right place! Whippetmom helped with my exchange size and they are perfect for my height and frame. Even better then what I started with. You will find so much support on these threads! Hugs.
GrandmaBubba: So glad Whippetmom could help you! You are in good hands now.
-
GrandmaBubba - I am so happy you are finding help here. You should never go into surgery questioning the competence of your physician. As you can see, even those of us who feel we have been in capable hands wind up questioning why things weren't discussed prior to surgery. Good luck!
-
MBJ- I saw your pics! Your looking wonderful! Your PS did a fantasic job. I'm so happy for you and every time I see a good result like yours I get excited about how mine will look. It gives me lots of hope!! hehehe. Enjoy them, you really look great!
-
Hang tight...all of you with questions...I have committed to help someone paint today and I am running late...I'll get back to you this afternoon. I have implant sizes in my head for all of you!! LOL!!
-
LOL Deborah -- I think you are like a Good Boob Fairy
-
Lilah! LOL!!!
Deborah! You ARE the boob fairy! I knew it. I totally forgive you for messing up when I got my first set of breasts! You totally made up for it with my new set!!!
Sweetie: Thank you! what you don't see in the pictures because of the ace bandage is that my natural breast with the moderate implant is high and round right now, but the new compression bra should take cre of that, hopefully, in 6 weeks!
-
whippetmom - That's funny I am going home soon to help put siding up on our new house... I have to paint the cut ends of the siding, sounds boring but the weather is beautiful and I can get out in the sun (Vitamin D). Friends that help friends paint are true friends...
-
I am scheduled to get reconstruction in Nov. 2010 and I don't know what to do. I went to a doctor and he talked about saline/gel implants. They are supposed to be natural. But I know alot of people who have had the gummy implants but everything I have read says that have a problem with being really firm? I don't know if the gummy implants are safe for cancer patients? They say the gummy implants can fall over if they are not the correct size and fit exactly in the boob pocket. Well then why can't the saline ones do that also?? Plus how do you pick a size? People that get inhancements are adding to what they already have. I am having a masectomy so I am starting fresh. Is there somewhere that shows you the sizes??
-
flippy: You will likely want to have a lift of the native/healthy breast, in order to get better symmetry. I would suggest at least 550 ccs in a high profile implant on the MX side - perhaps 600 ccs. You will require some minor pocket revisions to narrow the pocket .5 to 1.0 centimeters. Tell your PS that you would like to do whatever is necessary to have symmetry, which means you are open to a lift [and a small implant, if needed ] to match the MX side. Ask him if he is willing to use an implant with a volume of 550 ccs. Frankly, with a 650 cc TE, I cannot see any reason he should not be able to get you to that volume of a smooth round silicone implant. You could probably use 600 ccs also, but you state you would like to be a little smaller this time...so the 550 cc seems appropriate.
-
vanderlady - Thanks for saying hello... I'm sorry to hear you are having to consider a revision. Did you have radiation? I know from my plastic surgeon and reading on here it does happen often with implants. I'm glad your here and finding the information you need. I have radiation to go through, which scares me... but what I don't know always scares me the most. Hope you find what you need to help you make the right decision.
-
MKD3 -- Are you sure it was saline/gel and not silicone/gel? Saline is water. Silicone CAN come in a gel form (called cohesive gel) -- there are a variety out there. The gummy -- which is the Allergan 410 cohesive gel silicone implant -- IS firmer than other silicone implants; it is anatomically shaped and has a textured surface so it adheres inside the body and tends not to move. I have one of these. To me it is soft enough but since it doesn't MOVE at all it's a little odd. I like it though because it is a good match with my native breast (I am a uni). Many women here at BCO have been very happy with the Mentor CPG, which is another gummy-like cohesive gel silicone implant but much softer/squishier (as I understand it) than the Allergan 410.
-
GrandmaBubba: I think you could probably use a 15.0 cm wide implant and the Style 20 in 750 ccs would meet that criteria. If you want to have as much fullness as possible, I would even consider the 800 cc Allergan Natrelle Style 45 implant - which has additional projection - and I believe the width would be appropriate. It also depends on how large you want to be and where the implants sit on the chest wall, because the Style 45 is a taller height implant and you need the chest wall to be of sufficient length to carry it off. This is important to communicate to the PS, and you don't want to mention a cup size, because this is too unpredictable. It also depends on how large you are currently. If you are large busted, your skin flaps might be sufficient to require minimal expansion.
-
MKD3: Read the intro to the thread at the top of this page and most of your questions will be answered. Then provide your height, weight, ribcage circumference and we can give you some sizing options.
-
whippetmom - Thanks for your help... Hope the painting went well.
-
Painting went well. I painted a pine armoire burgundy/barn red....her color choice...
-
Dear Whippetmom -- It is amazing to me that when you are not serving us on the BCO website you are helping friends with their painting projects. Really? You are a gift. It is truly touching to read the posts from all of you. I never knew that I could feel so connected to friends I've never met in person. I am grateful for all of you -- and expecially for you Whippetmom.
-
flippy,
Why did you have to have TE's when you are going smaller? My DMX is in 3 weeks and they are doing reconstruction at same time since I want to go smaller, no TE's. I'm currently a D or DD and want to be about a C. They won't need to expand any tissue since I'm already larger than I want to be? I'm trying to understand all of this!
Robyn
-
LILAH-
i guess it was a gel and not saline. i am just concerned that the gummy form is not approved yet in the US so do they have studies to say it is ok to use with cancer patients?
-
Whippetmom- I did read the info at top and got some information. Thank you. My height is 5'5-1/2" and my weight is 125. My ribcage circumference is 32.
-
The gummy has been used for 10 years in Canada and Europe. There are many trials in the US that are going on right now. It has been at least 4 years that the trials have been going on. The only ones getting the gummies are cancer patients. They are the ones that need the tear drop shape.
-
whippetmom (a.k.a. The Boob Fairy) (Oh you are so getting a t-shirt that says that for your next birthday! LOL!)- Someone (Lilah?) thought you had done fat grafting for rippling. If you did, just wondered if it was effective. Also, have you heard anything about the gummies having less rippling than the regular silicone implants?
-
Actually, anyone - breast augmentation patients included - can get the "gummy bear" implants as long as the PS has access via clinical trials to same here in the U.S., and as long as they are a candidate for this style of implant.
-
Thanks girls...about the Boob Fairy.....I guess.
LOL! I think rippling is just inherent in some women no matter what style of implant and I suppose it can be due to thin skin, post-mastectomy defect, bony ribcage, the way the size of the pocket...who knows. I have heard so many theories about rippling....I am hoping there will be a better fix for this in the next decade.
-
MKD3 - Well, a TE and ultimately an implant with a width of 13.0 up to 14.0 centimeters would be appropriate for your frame....IF you are having a BMX and not just one breast only. If a BMX, around 550 ccs to 650 ccs in a high profile round silicone implant would be nice on your frame and would maintain the 13.0 to 14.0 width for your ribcage. It depends on your skin integrity and size prior to MX....and unfortuantely, the sufficiency of the skin flaps is not known until after the MX. The PS will base the width of your TEs upon the current base width of your natural breasts and also based on your ribcage. But certainly you can discuss these sizes with your PS and ask him or her what it will take to get you to this size range. That is, unless you prefer to be somewhat smaller - on the small side - and then you could use a moderate plus profile in around 450 to 500 ccs...
-
Flippy - No, I was very very lucky -- no radiation, no chemo, not even Tamoxifen. Actually, my choice was lumpectomy with radiation or mastectomy.... so I chose the latter. It was IDC tubular type which is a lower grade, only 1.2 cm. Plus the nipple sparing so lucky again. Now if I could just blink and have the revision done.
Saw another PS today and he too thought 550-600.... then repeated 600.... funny cuz Whippetmom was leaning that way too. He wants me to wait until Dec for redo. He was even thinking 400 for the natural side.... he's a generous guy.... the bra lady at Macy's did refer to him as the boob guy. Ha. He also said for me to use a front-close sports bra --- he said the front close helps to hold them up and towards the middle where the regular sports bra pulls them down and out. Playing my first full blown tennis match tomorrow.... hope it stays under 90 degrees!
-
Thank you for all of the great info on this thread. Here's my story: Uni MX July 2009 and delayed reconstruction. Chemo and rads were all finished in Jan2010. I had a Free tram and tummy tuck w/ lipo done on August 12 and am recovering now. I am going back to meet w/ PS to discuss stage 2 in a couple of weeks.
I want/need a lift on the non-cancerside and I want implants on both side to make them bigger and even them out. The free Flap looks great so far - very healthy but is a little wide under my arm. I know that a little lipo can fix this problem. I would say I am a B cup, maybe a small C right now for both boobs.
I want to be a D. I am 40 years old and I just think it would be fun to have bigger boobs. lol So I will need implants in both sides.
I am 5'5 and weigh 145. My ribcage below my boobs is 32 inches. Any advice or suggestions is greatly appreciated.
One more consideration - I have to wait 3 months from Aug. 12 to get Stage 2 done so that puts me at mid november. I have already purchased a trip to Mexico leaving on Feb 5, 2011. Do you think I will be ready to travel by then?
-
Deborah,
Just touching in to let you know I saw Val61s photos - very beautiful! She had the same TEs as I do, Siltex low height. Got my 2nd fill today, so am at 220cc. Will have one more of 30cc to bring them to capacity at 250cc. My exchange date is December 7. PS said he could place an implant of 350-400. What do you think would be best for me? I think you mentioned 350-375 in another email. I'm 28.5 rib cage, 5'5", 126 lbs. Want to have someone take a photo soon so I can post on the (TimTam's) photo site, yet want to wait until they decide which site to use, if any. She said it would happen by the end of August. Reminder to everyone interested to vote or the photo site may go away if enough people aren't interested in being involved.
Thanks, Melissa
-
Aw Deborah sorry we should go back to Breast Whisperer... it was the image of you with ideas swirling in your head that had me flip over to a Good Boob Fairy
MKD -- yeah what Claire and Deborah said. My PS, formerly of Canada, told me she has been implanting gummies in cancer patients for 10 years.
-
Thanks for the reply. It all makes sense. The only thing that is confusing it if I were getting an enhancement I would be adding to what I have. Now I will be starting from nothing so it is hard to gauge the size. I went to the doctor and he didn't mention when I pick the size. Do I just go and as he is filling them up each time I decide then or do they give me something to pick from?? I wanted to end up being around a C. I just don't know how much that would be??
-
Another question... Where do I find the pictures pages?
-
Hi Whippetmom!! I wrote for advice some time ago, but didn't have all the information you needed until now..lol! I am 5 feet tall, 105 lbs., 32 in. ribcage. I have Allergan #133SV TE's., short height, 300 cc's, (13 x 9.1 x 5.7). I had previous BC in 2001, with lumpectomy and radiation. New diagnosis in same breast Dec., 2009. Had BMX on March 5th.with immediate TE's. I am now filled to 300 on the prophy side, and 365 on rads side. I have CC on rads side and just couldn't take anymore fills. He will have to lift prophy side as there is lots of skin there. He is going to use Allergan 410's anatomical textured, but doesn't seem to want to discuss which sizes he is going to try. My exchange date is Oct. 5th. I don't live in the samecity as him, so communicating has been hard. (got most fills at local PS's office). But he is considered to be one of the best PS's in British Columbia......I'm in Canada. Let me know what you think.
Thank you,
Cindy
-
jc3win: Well, if you were starting from "scratch" - without the flap - I would say a high profile smooth round silicone implant with a volume of 600ccs to 650 ccs. But I have no idea how much volume is provided by your flap. So the PS is going to need to calculate also how much room he has to insert an implant without prior expansion. So your goal is to communicate to your PS that you would like to, with your flap plus implant, approximate an implant with a volume of 600 or 650 ccs. So whether that is a 300 cc implant or a 400 cc implant, I do not know. And then the implant is selected for the opposing native breast to achieve symmetry accordingly.
-
PICTURES FORUM IS BEING TRANSITIONED TO A NEW WEBSITE AND IS CLOSED TO NEW MEMBERSHIP UNTIL AFTER SEPT 1ST.
-
Deborah, this is starrting today??? I was going to post a new picture sans ace bandage since I can finally shower today.
-
Kate: Sorry, I missed the first part of your question to me...Yes, I have actually had two fat graft transfer procedures. The first really did next to nothing. The current benefits of the combined procedures, I would say, made it worth the dual procedures. I do have some areas of indentation - especially in the superior medial region, which was entirely resolved with fat grafting. I still have some rippling, but only noticible to moi - standing in certain positions. I had a step-off bilaterally and the prophy side is much improved but the MX side step-off has minimal correction. The most appreciated benefit was the little bit of tummy "tuck" I received as a result of the liposuction. After menopause - or MENOPOT - I developed a little tummy which would not budge with diet or exercise. So it is nice to have this out of my life for good.
-
Robyn: Having a one-step is fine, but you want to make sure that you have a sufficient mound after all is said and done. If you have signficant droop, you will at least want implants to fill up the pocket, and after MX, your skin is going to retract and you will have far less skin than you have currently. Telling a PS that you want to be a "C" cup does nothing, unless he plans on taking your C cup bra into the OR. It simply takes more volume than you can fathom, to create a sufficient mound on the chest wall after mastectomy.
-
The emphasis on the word NEW membership MBJ....you are an OLD member!!!
-
saskabush:
Your PS used a low height TE for some reason. Since the pocket is to be created with the implant in mind, I can only presume he planned for a low height anatomical. That would infer using the following:
410 LM - 320 gm - 13.0 cm wide by 10.9 cm tall by 4.8 cm projection
410 LF - 310 gm - 12.5 cm wide by 10.5 cm height by 5.1 cm projection
I think that you might be able to possibly achieve more volume with a standard silicone round implant, but since you have had radiation, the gummy affords you the lower risk of capsular contracture. It all depends on what the PS is able to achieve. Of the two above, I like the dimensions of the 410-LF better...
-
Melissa: Sorry....I thought I responded to your post but I see I did not! I think I would like to see what you look like at this point. You can always email me a photo.
I think that the difference between 375 ccs and 400 ccs would be miniscule, but if your PS is willing to use a 400 cc implant, that would sound great to me. But I always err on the larger side of the implant spectrum when the PS is willing and the skin permits.
-
Deborah: I went to Macy's today because I couldn't resist even though I can't wear a regular bra for 6 weeks: 36D in the Warner's This Is Not A Bra!!! I am hoping that I can get a wireless in the same look (the Satin Tuxedo Wireless Bra). They didn't have this size in stock:(
-
I have a question. Once you get the TE's, approx how long until the exchange? And how often do you get fills?
Thanks.
-
anne: I am no expert and I am sure whippetmom will be on here soon to help you, but it depends on the ability of your skin to stretch and how much skin was left after MX. I had a UniMX on March 20th and just had my exchange on August 19th, just five months total. I woke up with 150 cc's already in but wome women have to wait for the first fill. I had my first fill after surgery 3 weeks later and subsequent fills at close to 100 cc's every two weeks but as it progressed it was lower cc's, three weeks in between, and it started to hurt towards the end and then I said no more when we reached 535 cc's! after this it was about 2 months waiting. If you have large breasts and lots of skin leftover, they may be able to do this in quite a short time. If you have had radiation this time can extend much more. My skin was thin, however, it stretched quite easily. I hope that this helps. If you give all of your details oulined above, whippetmom can assist you better.
-
Anne: MBJ answered above. I would add that every PS has an approach to fills, but there is no need to rush through this process. Most of us waited an average of three months after the final fill before going through the exchange.
-
MBJ: I wager you will be a different size at Nordstroms though.....
-
Deborah: Bigger????
-
Well you typically go down one band size and up in the cup with Freya, Chantelle and European bras in general. What is your ribcage again?
-
Deborah: My ribcage is 32".
-
34DD
-
Wow! Who woulda thunk LOL!!! I haven't worn a 34 in years. Maybe I was just compensating with a 36 to get a bra that somewhat fit! Thanks Deborah!
-
SEPTEMBER 13th! Whoo-hoo! Exchange date is set! He ordered Allergan 20's -375cc for me. Thanks, Deborah!!
-
Michele: Wonderful news! That day will be here before you know it!
-
Deborah..i am gonna ask your advice before I go for the last fill next Thursday..as I will have to decide by then and get an actual date. If you remember me..I had my TE replaced with a new one in July. My photos are also on the photo site..but if you would like a newer one, Please let me know
I am 5'1' weight 125 lbs. My ribcage is 32. I now have a Mentor Siltex med ht 354-6214
w-13.5 / h -11.7 / proj-7.4
fill size is 550. I am at 480 right now and I am happy with size, projection etc.
my PS thinks I have approx 200 cc of tissue in healthy breast. he told me to choose a size on the MX breast and he will augment the other to match..
what's your opinion ??
-
The problem, T&C, is that your PS would never be able to match the projection of your TE currently. The TE projection is exaggerated - there is no implant to match the projection and it is solely to aid in expanding the breast as much as possible so that the skin has good implant coverage and to allow for retraction. The closest you could get to the dimensions you have currently would be with a 650 cc Style 45 in Allergan, which is an extra full projection implant. But getting symmetry with the native breast is key and that Style 45 is a really tall implant and I just think it is safer to use with bilaterals. So I think you should stay with the high profile implant. It would take at least a 500 cc HP - or a 550 cc HP implant - to match the width you have currently, and it is a good width for you, BTW. Now your PS could use a Mentor Spectrum expandable implant in the native breast, so that he can get as close as possible in symmetry with the MX side. Nedeza and SandySunshine - see their pics on the forum - had their PS' use this method for unilateral recon. I am not sure how much droop you are going to have with your native breast, once he has that implant inserted, and so he will want a little droop with the MX side which means a smaller implant possibly. I definitely feel that the high profile implant is the one you would like best. So I would ask your PS to take in two sizes at least - 500 and 550 HP - since you are happy with the projection you have currently and you want to retain as much as possible. The PS could use a smaller HP or MPP implant in the native breast if you want to stick with silicone. The Mentor Spectrum expandable is saline. Hope this was not confusing. Just wanted to give you all of your possible options.
Deborah
EDITED: I went back and looked at your photos. I feel that you also need some lateral pocket revisions at the time of the exchange - just to make sure that the implant does not migrate towards the armpit. Between your 360 cc to 460 cc fills, the pocket seemed to widen quite a bit. Are you sure your ribcage is 32 inches? You are measuring under the TEs? You look smaller in the photos....
-
Kate and Deborah, I, too, have ripples. My PS says he can take care of with fat grafts which he does a lot of. He'll do at the time of areola/nips (next Friday!). I feel like I need a lot of fat on my prophy side to cover not only the ripples which are not too visible but the feel of the implant is my biggest problem. Can you guys actually feel the skin of the implant easily? I actually have a place where the implant skin comes to a point near my arm! And if I put my palm on the foob, it feels like a baggy of jello, but I can feel the baggy. I am wondering if fat grafting can take care of this? Interestingly, when I am laying on my back, or even a little reclined, the prophy side feels firm, no baggy feel. Thoughts?
Related to another sister's question, I had flap surgery and my PS expanded me the same on each side and put in the same size implant. The difference for me is the flap side is much firmer. deekaay
-
Can you get TE's while undergoing chemo? Or do I need to wait?
-
You have to wait Anne. They don't like to perform surgery on you till at least a month after finishing chemo. (Or: prior to starting chemo).
-
Thanks Lilah. That's kinda what I figured!
-
Whippetmom,
This is the first time I'm posting although I've been reading messages for a couple of months. Last summer I had ovarian cancer, had a hysterectomy, and went through chemo. I found out I'm BRCA 2 positive and the genetic counselor told me because of my family history that I had a 65% chance of getting breast cancer. So, at the end of June this year, I had a bilateral prophylactic mastectomy with LD flap and TE reconstruction. The PS put 200 cc of saline in at the time of surgery and so far, I've had 2 fills. Right now I'm at 370 cc and we're thinking that is all I will need. I was a 36C before surgery and would like to stay the same, if possible.
On the TE card I was given, it says Allergan 133MV-12 Tissue Expander 300cc. I am 4' 11" and weigh approximately 128 pounds. My ribcage measurement is 32.
Even though I've had the same amount of saline put in each side, I don't think I'm the same size in each one. I put on the bra I used to wear, and right now the left side fills the cup completely, but the right side doesn't seem to be totally filled. Is this something I should be concerned about?
I would appreciate any advice you could give me about implant size. I know at my next appointment which is in a couple of weeks, I will be discussing this with the doctor.
Thanks,
Ann
-
Ann: If you are happy with the TE volume you have currently, you will need an implant with a base width of 12.0 cm most certainly, and I think that the Allergan Style 20 [high profile smooth round silicone] implant would be best, at 425 ccs preferably, but certainly at least 400 ccs in the same style. At 400 ccs, you would have 11.9 cm width and 5.0 cm projection. Another recommendation would be the Allergan Style 15, which is a moderate plus profile implant, in 339 ccs. The dimensions would be: 12.4 cm width by 4.2 cm projection. This would reduce the projection quite a bit...but allows you to maintain the width, which you need. It all depends on whether your PS is willing to use the higher volume implant. But rather than volume to volume, we are comparing TE dimensions to implant dimensions and the 400/425 cc volume should be attainable. Talk to your PS about this...
Deborah
-
deekaay: I have some thoughts about your implant....but my brain is just fried tonight and I am going to hash over these things with you tomorrow when I have a fresh perspective...
-
Deborah, you are amazing! You give so much, rest my dear friend!
-
deekaay:
Does the prophy side implant feel like it has less fill than the MX side? I just wonder if it is leaking. This would cause more rippling to be evident and also, would create folds in the implant which might protrude laterally or medially...as what would occur with a ball as it deflates. Another thought is that the prophy pocket is larger than the other and permitting the implant more movement. I think I would get this addressed before getting nipples.
Deborah
-
Anna...((((((((thank you)))))))),,,all rested...
-
Deborah, geez, I hope it's not leaking, I don't think it's smaller, but it is less poofy since swelling went down. I posted 3 more pix on the forum that give a current look at me-can you take a look?. Actually, they look pretty decent and the ripple doesn't show until I raise my arm. My theory is similar to your second thought--I wonder if the pocket is bigger than the implant. I asked the PS when I went in 2 1/1 weeks ago if I needed a larger implant on the prophy side and he said no, I just have very thin skin and muscle coverage. He said a larger implant would still show ripples. Too me, it seems a little loose. Maybe it's w/i normal limits but with no experience in this area, I don't know. If I pull the skin tight at the bottom of my foob, everything tightens up nicely and looks and feels good. That makes me think it could be tightened up. PS felt fat grafts would take care of it. My left bc side is firmer since I have Lat flap there and rads which keeps things firmer.
I appreciate your help with this. Thank goodness for you experience and that of the other women on here! Glad you got some rest, deekaay.
-
deekaay: I posted comments over on the pictures forum...
-
Deborah- Thanks for the feedback on fat grafting. I do think it is something I'm going to look into for the rippling. If nothing else, maybe I, too, can get rid of my MENOPOT! LOL!
deekaay- I swear I can feel the implants, too. It's not a smooth feeling like I thought they would feel like. My rippling seems to get worse when I lean over or move my arms a certain way.
-
FYI... from little me..
I did get 50cc larger implant for my minor rippling. It fixed the entire problem. My surgeon is in favor of a bigger implant if there is rippling. In sever cases... it won't work as well, due to thin skin.. but it would help enough for the fat grafting to finish the job.
-
Laura, so you had a revision for the sole purpose of getting a 50cc larger implant? And that fixed the ripple problem? May I ask if insurance paid for this? Did you get the revision on both sides? Did you ever have to have fat grafts after? So many questions from me tonight!
Hope you had a nice vacay and that your son's dr. visit goes well. deekaay
-
I had ALL intentions of getting a revision...due to ripples and the non rads boob falling. But then I said to myself, NO... that is just your vanity speaking Laura. Well.. I had my check up... and my Plastic said... You need a revision, your implant has fallen out of the pocket..
So I told him I wanted the fat grafts while I was HAVING to do surgery anyway. He said that a bigger implant would fix my rippling about 90% ( I think he said)... and it did.
My insurance covered... BCBS.
I have not had fat grafts. I will make up my mind on this in Oct. It all depends on my sons health, and .. a few other things. I do not need fat grafts for ripples, only for under the rads boob . It did not drop and fluff like a normal implant will. so it is about 1/2 higher than the non rads breast. SO.... do I go under the knife for this?? Knowing me.. I will not be having Fat grafting. I think anyone whose PS thinks it will work 90-100% should go for it.
-
deekaay and kate33 - I can feel my implants too, especially on the sides. I can see the rippling when I bend over or hunch my shoulders.
-
Estepp: Good luck with your son and the endocronologist. May it be an easy fix.
-
Where did I miss the post about Laura's son and seeing an endocrinologist?
-
I'll PM you Laura!
-
Deborah - I think she posted that on EC thread lol.
Laura -- prayers for you son! Hope the Endo solves all and puts an end to his discomfort and misery.
-
Yeah, Lilah...I saw it there. I have done the same thing...I have answered questions on the EC thread, thinking I was on the Sizing 101 thread. VEWWRY, VEWWRY INTEWESTING!
-
I blame it on my chemo brain LOL
-
I'm going to have my implant removed in a couple of months and have the TE put back in to stretch the skin on my lower pole. Has anyone had the natural breast lifted when the TE was put in? Pros and Cons to this?
-
Claire: Wouldn't do it. It is like giving you a lift while blindfolded. Why not do the lift when you have the exchange - the second exchange?
-
I blame everything on chemo brain and, if needed, add 6 gen. anethesias for good measure. Basically, I can be responsible for NOTHING in my house! lol Plus I have cats. You can always blame something on the cats. Gives them a sense of pride!
My favorite was the study that said chemo brain has been shown to last up to 10 years. I figure I can milk that for a decade!
-
thanks Esteppp...... I too am trying to decide on a revision for several reasons one of which is rippling. 3 out of 4 BS in consutation felt a large implant will help with the rippling. I guess I figure is I never do the revision, I will always be slightly disappointed. Whereas if I give it one more try, perhaps they can be where I want them to. Then the other side of me says.... well, what if they are not, what if there is a complication. Thanks for your positive words, that certainly helps. Pam
-
deekaay- LOL!!!
-
deekay: You said a mouthful LOL!@!!
-
Another question on TEs. One PS said she would put the TE lower than my natural breast so that when she does the exchange, there will be enough skin for the breast to have more of a natural droop. I don't think she used the word droop - but chemo brain made me forget her exact terminology
Does this sound right? -
Claire: When my dr. did my MX he underlined where my natural breast line was, and matched an expander to this exact size. Being a Uni, it was important for him to match it with my natural breast. When I had my exchange, he underlined my natural breast in the exact same area and he used a High Profile implant on my MX side and a moderate profile on my natural side to get symmetry. I have never heard of putting them in two different places. Have you recieved any help from Deborah yet?
-
Claire: The PS probably used the term "ptosis". I do not at all agree with the recommendation to lower the inframammary fold. I think it is a bit archaic....a technique sometimes used a decade or so ago, but not currently - especially since the advent of products such as Alloderm. I know that the plastic surgeons I respect [Louis Strock, M.D., Scott Spear, M.D., Kenneth Shestak, M.D. and others, do not advocate this at all. The way to create ptosis is to overexpand or give additional stretch to the skin beyond the size of implant you ultimately intend to use. I would not even think of lowering the IMF....I can show you a photo of what happens when the IMF is placed lower than the natural breast..
Take a look at the photo on Page 558...when you get to the page, type in "inframammary fold" sans quotes and then scroll down until you come to the link to Page 558....
Institute of Reconstructive Plastic Surgeron, New York University - 2007
"There are several important points to note when creating the pocket for the tissue expander. Firstly, when creating a pocket for the tissue expander it is important that the pocket dimensions match the expander width, so that the expander edges do not roll up. Secondly, the inframammary fold should not be altered. Thirdly, if the native breast skin flaps are thin, it is best to provide complete muscle coverage over the tissue expander and subsequently the permanent implant. This can be achieved by mobilizing the serratus anterior muscle laterally.
Once the expander is placed, it is then filled immediately to a volume that does not jeopardize the circulation to the overlying skin flaps. Two to three weeks following placement of the expander, when the breast incisions are healed, expansion may begin. Expansion proceeds on a weekly basis with 50 to 100 cc of saline added each visit, depending on how the overlying skin changes with expansion (e.g. tightness, erythema) and patient comfort. The expander is usually over-expanded by 25-50% to improve skin drape over the permanent implant. This redundancy in skin envelope size allows for differences in profile of implant versus expander and also allows for skin recoil post-expansion. After expansion is completed, an additional 2 to 4 months is allowed for tissue equilibrium to occur prior to implant exchange with either saline, silicone or biluminal (saline/silicone) permanent implants."There are a plethora of such edicts regarding leaving the IMF unaltered. The concensus appears to be: Don't mess with the IMF.
Deborah
-
vanderlady - I had rippling on one side only and it appeared smaller. MY PS did a revision and put a larger implant on that side only. I have two different sized implants-left side is style 20-700cc and right side is 20-650cc. While that did not completely fix all the rippling it is definitely better than it was. When I stand up straight I don't see the ripples-just in certain positions. I was like you in thinking that I would always be disappointed if I didn't try to look better. I decided to get it done. I figured I couldn't be any more unhappy than I was. The PS told me it could end up looking worse. Well I'm here to tell you that I am pleased with the results and happy I went with the revision. I have an appt. with him on Thursday to discuss nipples/aerolas and maybe fat grafting.
I also want to add that Deborah helped me tremendously in making my decision on the revision. Thanks Deborah!
-
don...I am glad you are happy with your results!
-
Whippetmom-I read your comments on the IMF. The question is if my Dr. places an implant larger than my TE what happens in my case? I will not get a droop? I can see if you are matching a natural breast it would be even more important but if you are bilateral does it change the way they do the expansion at all?
Also does seeing rippling with your TE mean you are more likely to get rippling with your implants?
-
sweetie: How much droop do you want? I have a bilateral and I have a lot of droop - because my skin expanded very well and very quickly to expansion. But my TEs were 400 ccs and my implants are 550 ccs. It depends on how your skin responds to expansion. For a unilateral, you want more drape over the fold, to approximate the appearance of the native breast. So let's say claire's PS uses a 400 cc volume TE: He could overfill this TE to 500/550 ccs and then use a 400 cc or 450 cc implant, depending on the level of drape he needs to match the native breast. Most of us do not want droop...most women have lifts performed on the native breast so that they can reduce the amount of droop. I don't think this is necessary in your case.
-
sweetie: Forgot to answer your second question...and I guess you cannot go to the pic forum....it is down and being transitioned to the new website...
RE: TE ripples inferring you will have ripples with implants: No, not necessarily, especially if you are seeing ripples because you have a lot of loose skin overlying the TEs. But if the rippling is secondary to thin skin and thin skin alone, it probably means they will be present with implants. It depends on the size of the skin flaps after MX...large skin flaps, small TEs usually can equal ripples.
-
What are skin flaps? My understanding was that the skin flaps were when skin was taken from another area (tummy, bum, or back) and TE's expanded the skin so a flap was not necessary. In other words, it was one or the other, not both.
Am I incorrect?
-
Deborah: Thank you for the info on the inframary fold--I didn't think that sounded right when Claire described it. Question: Being I am a Uni, would you recommend the "origami" method of making a nipple or are there better ways? My nipple seems bigger then the size of nipple they make with this method, and that is what my PS plans to do. there is also an implant that they can use and I am not sure if this comes in different sizes or not. I would appreciate your input. Thank you!
-
Thanks Don, that is very encouraging. Did you just go up in size by 50 cc to the 700 on the left? That to me seems like a minor change for pretty good results. I'm definitely leaning that way. Yes, Deborah as already enlightened me on very critical points.... Thanks Deb.
-
MBJ
I will tell you that getting a larger nipple to match your larger nipple.. will be tricky. Rockwell_girl had the same issue. Her natural nipples were good size.. she had the origami style.. and no, the nipple is not close to her other one. I think Deborah might have a better kind for ladies like you...
-
I went up 50 cc... and it made a good difference. IF my PS could have gotten 100cc in there.. I think I would have gotten 100% perfect.. but he could not due to my rads muscle..:(... I was radiated in 4 fields...
-
Anne: Breast skin flaps....it is the terminology also used for the breast skin envelope.
MBJ: Well, first, let me ask....is your PS going to graft your areola or does he tattoo?
-
MBJ:
As an FYI: From one of my links...cannot remember which one...
"The technique that involves the least alteration of the overall shape of the breast mound is the skate flap. The skate flap involves cutting some of the skin and soft tissue on the newly reconstructed breast and folding the tissue like a Japanese origami puzzle to create the nipple. A skin graft from a remote location such as the upper medial thigh or abdominal scar is then used to reconstruct the areola. We prefer the upper medial thigh as the donor site because it has the closest color and crepe-like texture of the native areola.
Other techniques such as a C-V flap, Arrow flap, or Bell flap involve some distortion of the breast mound as they require primary closure of the local site from where the tissue was taken. These procedures are performed on an outpatient basis and take about an hour to reconstruct each nipple areola complex."
-
Deborah: He just does the origami with tattoo. I have seen pictures of the scate flap but I don't think he does this--I will ask at my next appointment. sounds like a lot of pain though--I read about it on the picture thread. I don't see why he couldn't as he is a micro surgeon. Is there any other procdedure where you can get the size larger? My aerola is small but my nipple is large.(at least to me).
-
Whipptetmom-thanks for the explanation of the IMF. I think I should be fine because I don't think I want too much droop. After all these years I would rather have lift and perkiness. Not sure about ripples. I am filled to 400cc and it seems as tight as a drum right now, however the area where I see ripples there seems some extra skin so maybe with the larger implant it will take care of that.
When you say thin skin can reveal ripples does that mean it wouldn't matter kind type of implant they used, ie. gummy, round, would they still be present because of the thin skin?
-
Deborah,
Have you heard of anything one can do to push only 1 implant down? My rads side is about 1/2 higher than the non rads side. On the top, it is not really noticeable.. but on the bottom, it is. I cannot just wear a tank top without a bra. To me, you can see the non rads side being lower. This bothers me. In the grand scheme, I am VERY lucky this is all I contend with. I will be talking to Dr. R. mid September about some thing which I will share later, and on the picture forum and will get his advice on this also. I was hoping, besides massage, you had heard of something that I can do to lower the rads breast...:)
...... Signed,
Wishful thinking
-
Deb - I originally had the same size implant on both sides - 650cc. He only changed out the left side with the 700cc and did some additional pocket work. Besides having the rippling, the left side always looked smaller to me also. I now feel they match as good as they are going to. There was no way the 750cc would have worked on that side only. That would have been way too big. I am happy with my results. I know that this is as good as it gets for me and I'm OK with it. I can't wait to get the finishing touches on and be done with it all!
Donna
-
Dear Wishful: I would not want you to do anything to put undue pressure on that rads breast though. I suppose you could use the compression band - the one that MBJ uses - and see if you can wrap it around so it is pressing down on the rads side, but then torque the band on the non-rads side down under the implant so that it is actually gets lifted a bit. MBJ, could you try that maneuver with your compression band and tell Laura if it would work? The other recommendation is just to, whenever you think of it, manually press down on the implant during the day. I personally think that fat graft transfer is what will ultimately soften the skin - change the integrity of the skin - and allow the implant to drop naturally.
-
sweetie: If you have thin skin, it is likely you will have rippling with any type of implant - especially saline and the textured silicone rounds. It might be that you would see a little less with gummy bear implants, because of the anatomical shape.
MBJ: I do not know of any other nipple procedures. I do know that if I had been given the option, I would have liked a grafted areola, because it gives a little bit of elevation to the center of the breast - like a natural areola. Areola grafting used to be the standard, before tattooing became popular, less expensive and probably more favorable from a cost standpoint for insurance companys and HMO's.
-
Deborah & Wishful: The only way this would work is by using an ace bandage as the one that comes with the compression bra can't be manipulated in this way.
-
Wishful: I am constantly pressing down on my side that is high whenever I think of it. Hope no one is watching LOL!
-
Deborah: I read where a woman had fat grafted into the end to get this natural look. Would this work with a tattoo only? I doubt that MediCal will pay for the other rocedure.
-
I don't know MBJ. You would have to ask your PS. I remember asking my PS about this and he said that it really does not work in this area of the breast. He would recommend Alloderm.
-
Thank you Deborah! I guess I will just have to wait and see what he says on the 20th! I doubt MediCal would pay for the Alloderm for a nipple, either.
-
Well, the Alloderm is not used to form the nipple, it is used to give some additional projection of the area - underneath the nipple-areola complex.
-
I think I am going to facecrafter's tattoo artist in Maryland. LOL
After reading all this stuff about how to make nipples and areolas, I'm getting a little grossed out.
-
Claire82: At this point, I think I'm un-gross-outable. LOL
-
Whippetmom - ladies
I have been following this thread for some time and now I need some help. Stats first 5ft 5 1/2 inches, 152 lbs, rib cage 33. BMX on 6/21 - no rads.
Currently getting filled every 2 weeks. 133mx Tissue expander, 400 cc type, Allergan.
I am currently at 290 cc's in each. I was never a big girl before, 38 barely B on a good day. I do not want to be big when this is all done. After this last fill, I tried on one of my old bra's just to see, and it fits. I really don't know what to do. Keep getting filled, stop now ?? Help.
I know my BS said that when I get to the size I like, to get one more fill after that to make sure she has enough material to work with. I really can't see myself filling these te's up to capacity.
thoughts?
-
stlcardsfan: Well, 290 ccs seems pretty small for your frame. I would have said that you were a candidate for a 450 cc implant - at the least -[moderate plus profile implant - Style 15] if you want to be in the "B" cup realm. Sometimes the TEs give a false impression of size - because they are rigid, immovable, protrude out from the ribcage and are not compressed by a bra. I frankly think you need to fill all of the way to 400 ccs. Don't focus on cup size - it takes more volume to fill a bra cup after MX. You can always post photos on the pic forum or email them to me if you want me to see how you are looking at the point. You also probably have a MV style of TE and need an implant with a width of at least 13.0 cm.
Deborah
-
Whippetmom
Thanks for the reply. I don't have access to pic forum, and hearing I can't until it gets moved.
Originally BS was going to use 300 cc te's based on my pre-surgery measurements. I told her I did not want to go bigger at all. Found out I got the 400 cc's when I woke up. I am fine with that, she is a really good BS and came highly recommended.
Forgive me, not up on all this lingo - what do you mean by MV style of TE?
Thanks
-
Cindy..I'm a BC gal too Kootenays. Where are you?
-
stlcardsfan: Allergan: http://www.allergan.com/assets/pdf/natrelle_catalog.pdf She is referring to the 133MV-13 400 cc Tissue expander in the catalogue. I had this same one.
-
Hello to all! A great thread...I've been reading it all day. I'll be under the knife on Sept 8th for BMX right side will be propho. I'll be having skin sparing on the right side with nipple removal and have enough tissue on my left after the modified radical. Doc says he will be placing 450 cc silicone (Mentor) sub muscular, I'm pretty sure he will use a moderate profile. I told him to make me look pretty!!
My question is...has anyone had radiation after implants? Can't seem to find a thread thus far that addresses this issue.
-
Hi PitPat! I am in Campbell River on the Island. These ladies here are amazing....a strong support system!!!
Cindy
-
Thanks MBJ!
stlcardsfan...The new pictures forum is up and running. Send another private message to Timtam and you can get in...
-
MBJ and whippetmom - thanks.
-
Okay.. quick question. My reconstruction is on hold... I have to go thru chemo first then wait 6 mos. But I was curious (don't know why I just now thought of this) but can you still get TE's AFTER the fact?
I mean, since I didn't get them at the time of my BMX, is it too late? Is Flap my only option? Or can I still have TEs done 9 mos from now?
-
Anne: You most assuredly can still go through tissue expansion with exchange to implants nine months from now. A number of women undergo delayed reconstruction after treatment regimens are complete.
-
Thanks WhippetMom! That eases my mind!
So, (looking at the bright side) I have plenty of time to research research research!
Yay for me. In the meantime I get to be the flat-chested bald chick. Que sera sera.
-
Hi There! I'm having surgery on Sept 8th. I'm having immediate reconstruction with implants, not two stage but thought i'd ask anyways.
Height is 5'6" Weight 150 lbs Ribcage is 35".
PS has stated he is going to place 450 cc sub muscular.
Does this sound about right?
Thanks for the any input.
-
Hi Whippitmom,
I wrote to you on last month for help on sizing and you really helped me quite a bit. However, I think I gave you some incorrect measurements and since I am getting close to being filled to 450cc (your recommendation) I would like to check again with the correct measurements.
I am 5'3" and 130lbs. Under my arm is 33" and ribe cage is 29.5". I have a small frame and narrow shoulders. I have a Mentor Siltex Med Ht Texture Contour 6200-550cc TE (which according to the specs is 13.5w x 11.7htx 7.4 proj) I will be getting smooth silicone rounds in high profile as you suggested. I am so afraid of being too big (I was a 34DD) and it is so hard to tell since the PS left so much skin and it looks really horrible.
I think 400, 425 or 450 but I am really confused. Please help. I had a BMX on Aug 4th.
Thanks so much.
Nancy
-
PitPat.. For a one-stage, it all really hinges upon how much of a skin envelope you have after MX. If you are large breasted currently, you probably have sufficient skin flaps. Have you communicated to your PS what size you would like to be? If it is 450 ccs, a moderate plus profile implant would be best.
-
PitPat.. For a one-stage, it all really hinges upon how much of a skin envelope you have after MX. If you are large breasted currently, you probably have sufficient skin flaps. Have you communicated to your PS what size you would like to be? If it is 450 ccs, a moderate plus profile implant would be best. But you are in Canada....is your PS using a standard silicone round or an anatomical implant? Best check. A width of at least 13.0 cm and up to 14.5 cm would be best for your ribcage.
-
Nancy: I am concerned when you say the PS left too much skin. I want to make sure there is not going to be too much ptosis or droop. Could you email me photos? I know you need a high profile implant, but now I am concerned about the excess skin issue and too small of an implant. I think you need at least a 550 cc implant to fill the envelope. The other option would be to use 450 ccs [457 ccs, or something like that if Allergan Style 15] in a moderate plus profile implant. Or, because of your projection currently, an Allergan Style 15 in around 500 ccs, but you would need to have some pocket work laterally for this narrower profile implant. Maybe you should send me photos or post them on the pictures forum. I will PM you my email address.
Deborah
-
Thanks for the reply whippet...PS is using the silicone rond as he believes that I would end up with an upper edge if he used anatomical. He did explain the profiles, but I didn't write down which one he said. I know he is not going withthe high profile and he says there will be lot so skin. I'm just surprised that he is going sub muscular as with the reading I'm doing it seems as if the muscle shuld be stretched first. I asked that I be about the same as I am now. Large breasted? I'm not small and I'm not big I'm an average C cup at the moment and for the next 3 and a half days.
-
Submuscular placement without expansion is done all of the time in the breast augmentation realm. So your PS has calculated approximately what degree of skin envelope he will have, which is why he recommended 450 ccs. Just make sure you ask him for only the moderate plus profile, the moderate profile [without the plus] would be too round and flat. It is very rarely if ever used for breast reconstruction.
-
Deborah
I printed out your response to me about sizing and all. He took the paper and placed it in my file. before I left the office..he said "Carm-who is this lady?..she knows her stuff."
he agree's with your recommendations and said you are a gift to women. Thank you again.
Oct 5th is my exchange..cant wait. I also love love love my PS.
-
T&C: Well, KUDOS to your PS! He sounds like a great guy who wants you to be happy. What more can I ask for? His thoughts about me are so very appreciated. I will keep doing this as long as I have the ability to do so! I look forward to seeing photos of his handiwork in October!
Deborah
-
PitPat: I read your post again and saw that you would like to be the same size you are currently. In order to do so, I believe you will need at least 500 ccs - 550 ccs. So talk to your PS and let's see if he can assess the ability to use one of these two sizes at the time of surgery. You will have some skin loss due to surgical excision and retraction, so please clarify with your PS your desires as thoroughly as possible. With the one-step, it typically means that the patient will be smaller than they were prior to MX...it is one of the trade-offs for having a single stage reconstruction.
-
twirl --- that's so cool.... isn't it a great feeling when you can come to an agreement with your PS!
Whippetmom -- Yes, you are a gift to ladies --- and invaluable .... thanks!
-
NEW YORK HAS SIGNED INTO EFFECT A NEW LAW....
Stating that breast surgeons must inform a woman of breast reconstruction options prior to performing a mastectomy....
http://www.nytimes.com/2010/08/19/nyregion/19surgery.html
It is difficult to believe that there still are women not being informed that insurance will cover breast reconstruction, but apparently this is all too sadly the case. Hopefully other states will follow suite...
-
I met with the plastic surgeon... we are tentatively scheduled to do a DIEP with TE's, so a DIEP and TEs with an exchange .... has anyone else done this?
I haven't read this anywhere else?
-
Anne: There was a thread last year referable to DIEP plus implant reconstruction.
http://community.breastcancer.org/forum/44/topic/737114?page=1#idx_18
And I remember reading an article about how use of an implant could enhance the cosmetic results of a DIEP flap procedure. I'll look for it....
-
Anne: Here it is...
http://www.jprasurg.com/article/S1748-6815(08)00457-9/abstract
Let me know if the link does not work and I will cut and paste it to you in a private message...
Deborah
-
Deborah, that is fantastic about NY. I hope every state will do this also. I was told from the get go that I could reconstruct and have an amazing outcome . I was not told about Flaps from my BS. She just told me that in a few years down the road... I could go topless in the Virgin Islands, on the beach if I chose to. I could look that good.
..... -
bumping for newbies
-
Deborah, just wanted to update you on my progress. Had my last fill on Tuesday, and he chose to overfill my 250cc TEs to 270cc. Exchange date is Dec. 7. He didn't say what type of implant he would use, but that he would use either 375 or 400. I have asked a couple of times if he could create a "point" or an approximation of nipple tissue, I guess you'd call that ptosis. He said he was interested in that, and would do what he could to achieve that without using another flap. The BS took more from my right side above the breast as that side had a small amount of invasive BS, so he said he would do fat grafting there, and also said that the implants would go higher than the TEs. Recall my TEs are the low height ones. I am going to have photos taken and put up on TimTam's site, hopefully by next week so there will be a before and after. When I asked him what size I would be appt, before this last one, he said a medium C. I said I wanted to be a bit larger and I think that is why he chose to overfill. He emphasized that we don't by any means want to lose the width, and also said that I wouldn't have much of an inframmary fold. My natural breasts had a fold, yet according to the PSs I interviewed who measured me, zero droop. You'll see what I've got so far when the photos go up. Thanks so much for all of your detailed attention to our questions and cases! Plus, your wonderfully researched advise is well appreciated.
-
exchange is Monday!!
-
orchidgal: Ptosis is "droop"...what you are referring to is creating an elevation of the nipple areola complex to approximate what occurs with a natural breast. I think MBJ asked me about that recently, and I did find one bc.org member who said that her PS was going to use fat grafting to plump up the NAC. Since your PS is going to work on your step-off issue with fat grafting, I think it would be great if he could place some under the NAC bilaterally.
Referable to size, I am hopeful that he can use at least 400 ccs for you. That would be the preferred volume.
Deborah
-
Michele: Wonderful! I am excited for you! Please let us know how you are doing and all of the details - when you are able to post!
Deborah
-
NEW NIPPLE RECONSTRUCTION TECHNIQUE:
Poppy just posted a new thread about this cutting edge product from Cook Medical Biologics. It is a biograft cylinder used to maximize nipple projection either in consort with a nipple flap or without a nipple flap. It might be the answer for women who do not have sufficient skin to create a nipple via the traditional mound flap method - due to having had rads or just not enough tissue coverage over the implant. Worth discussing with your PS...
http://www.cookmedical.com/sur/datasheetFeature.do?id=5161
Deborah -
Deborah, O Great Breast Whisperer, I come seeking your wisdom! :-)
I've seen how much help you've been to so many women here, and I'd really like your opinion. My situation isn't really all that complicated, at least, but forgive me if I'm long-winded (long-worded?).
Here's my story: I am 55 years old, height 5'7", weight 190 lbs, and ribcage (bra band under TEs) of 36". Before my surgery I was at least a 42DD (my PS says I was more). I had a BMX on August 12, no rads or chemo or Tamoxifen (yay!), and had immediate TEs with an initial fill of 250cc each. My PS placed the TEs partially under the chest muscle and used an Alloderm "sling" on the lower part of each breast. Since then I've been expanded to 400cc in each side (with a lot of muscle cramping after each fill), and I think we're taking it up to about 650-700cc before exchange. I'm thrilled to end up anything smaller than I was before, but I'd still like to be maybe a small D. So what do you recommend for my implant?
I will say that it feels really weird right now to be able look down and see my stomach without boobs in the way! And my shoulder that was hurting for years is now pain-free because the bra strap isn't putting pressure on the collarbone any more! (Big boobs are not as wonderful as some people seem to think.)
By the way, I just noticed today that the TE wallet card I got says I have a "Style 133V Series Tissue Expander Matrix" and it has the Natrelle logo on it (which I know is Allergan). However, I asked for a copy of the stickers they took off the TEs (in my PS's medical records), and they say "Style 133MX Tissue Expander, Allergan, 700cc, Ref 133MX-15". My card has two serial numbers on the back, one of which matches the sticker (the left breast), but the other doesn't match the right breast, and actually on both stickers the "L" box is checked! Not a big deal, I guess--I looked it up and the TEs are essentially the same--but it still bothers me that the card isn't accurate.
OK, I'll quit typing now. (Told you I was long-worded...) Thanks!!!!
~ Amy
-
Amy: So glad you asked!!
So you have moderate height, extra full projection TEs, volume 700 ccs, width 15.0 centimeters. Very good. Since you had large breasts prior to BMX, did the PS reduce skin or do you have pretty substantial loose skin overlying the TEs? All of that loose skin has to be taken up by implant eventually. It may be that at 400 ccs expansion, you have sufficient skin envelopes for a 700 cc implant. However, I would say 750 ccs would be the preferred size for you. Using Allergan - the Style 20, 750 ccs. This volume matches the width of your TEs and you want to maintain the same width with the implants as well.
It takes SUBSTANTIALLY more volume to form a breast mound in reconstruction. Also, women who are on the plus-size end of the spectrum often have more adipose tissue - thicker covering over the chest wall, which can obscure, or as Kenneth Shestak, M.D., would say, "tend to swallow up the implants." We have a lot of bodacious women on bc.org and they have all learned by trial and sometimes first time error, that it takes more implant to give them the look they want. Sorry for being so clinical about this, but the goal is to get you where you need to be and get it right the first time. We avoid implant switching whenever possible. So I don't want you to be disappointed after the exchange. You will not be too large with this volume of implant. If you want to email me photos, PM me. I might revise my thoughts a little with photos, and I might see something else to address.
I do want to make sure you talk to your PS about your goals to reach 750 ccs...you certainly have the TEs sufficient to get you to that volume.
Deborah
-
Believe it or not, I forgot a question. My PS says he likes to do the exchange one month after the last fill. I know this is a shorter time than is often recommended. What are the pros and cons of this?
-
Well, we typically see that the longer the better, in order to achieve retention of the skin expansion process. However, in your case, since you were larger-breasted pre-BMX, it might not be an issue at all for you. Did your PS tell you how far he will take you with fills prior to the exchange?
-
I Had my last fill to my TE's and will have my exchange surgery in about 2 months. How do I get into the pic forum?
-
Oops, just saw your reply! To answer your questions, my surgeon appears to have removed most of the excess skin, so it's tight over my TEs--but I do have an uncomfortable bulge on either side under my armpits.
Thanks so much for the recommendation! My PS is easy to work with, so I'll look up your suggestion and see what he says. I also don't think he'll have any problem with 750cc, since he was considering 800cc at one point in our early discussions.
-
Amy: I would be happy with 800 ccs for you also....I just did not want to push it. So ask him to take in the 750s and 800s and ask the nurses to be your advocates to help the PS determine what looks best. Good thing about the skin. Yes, the dog ears or mud flaps under the arms is common. They can be liposuctioned and revised either at the time of exchange or as a third procedure, once everything settles. The reason it is most often done after the exchange, is that in many instances, the "bulges" resolve on their own - at least in whole or in part - and so the PS only needs to address the residual. If it is done after the exchange, it would be three to six months post-exchange - it takes that long for everything to settle enough to know if anything further is required by way of revision.
-
brokendreams: You need to PM Timtam - hit search above right corner of the webpage and under "member name" type Timtam. Her profile page will come up and you can PM her to request the pass code for entrance. You have been on bc.org since June so you should have no problem getting on right away....
-
Deborah,
Thanks so much for your response. I also wanted to ask if you info on alternative techniques of replicating an areola without taking skin from somewhere else on the body. My PS asked if I didn't have any "extra scar tissue" for that, and I don't, and don't wish to offer any skin up, but certainly want him to make nice areolas. I asked him if he couldn't manipulate the skin around the reconstructed nipples to give the appearance of areolas and he smiled and rolled his eyes, as if anything might be possible. Not the most talkative guy, yet agreeable, it seems, to trying things. Wondered if you knew of anything, as I haven't found any in my searches yet.
Best, orchidgal
-
Deborah, I also meant to thank you for your delicate reference to "women who are on the plus-size end of the spectrum". I've been starting to wonder if everyone here is so much smaller than I am! I kept reading about exchanges at 400-450cc -- I'm already there, and I need to wear pads so I don't look so flat in my current clothes. Interesting thought about the fat on the chest wall--sure doesn't seem to provide much padding to me (ouch!), and I thought the BS had probably scraped most of that out, but that wouldn't have been necessary, would it? So the chest wall fat maybe squooshes up around the implants a bit and makes it harder to judge the volume needed--hmmm, that makes sense!
Glad to know these lovely "dog ears" will eventually be gone. Makes it so hard to sleep on my side like I want to, and they look really odd, too. So, OK, patience, Amy, patience!
And thank you again SOOO much, Deborah!
-
Hello Whippet Mom (and others who have contributed to this thread).
I am so happy to have found this site since I had a unilateral tissue and nipple sparing mastectomy in May, 2010, have tissue expanders in place and need to make decisions about type and size of perrmanent implant. My PS is involved with a study on gummy bear implants and suggests that would be best for me (so I assume he made the "pocket" compatible). I am definitely not happy with the way the TE looks, and am hoping the final implant will be better. The TE is higher, rounder, and more full on top than my natural breast and looks very uneven when undressed or when I am wearing a bra and clothes. Nipple height is signifcantly different. Any suggestions on type and size for the final implant would be very welcome.
Height 5'7", Weight 119.5 lbs, ribcage measurement about 29.5 inches. The tissue expander is a Allergan Style 133MV Series Tissue Expander Matrix. The plastic card says is printed as 400 cc, but the fill volume record written in pen says "cc volume fill 240 cc" and "cumulative fill volume 240 cc. It got further injected with 50cc at a later appt.. I don't know about the height.
My medical situation: 4 separate IDC spots in the right upper outer quadrant of my right breast, all < 1 cm, Stage 1, Grade 1, ER+, PR+ (on two of three tests), 0/5 nodes, Her2 -, BRCA -, Oncotype 20.
Thank you in advance for any help you can provide.
Shelala51
-
Thank you so much for all the wonderful information. This website has been such a wealth of knowledge and I have referred to it since I was diagnosed with breast cancer on June 27, 2010. I will definitely talk to my plastic surgeon about the type of implant he will use. I'm just now at 300 cc's, so I guess I have a little ways to go
-
ChattaChick - I'm very close to your size and I agree, it seems like there aren't quite so many plus-sized women here. I'm also at around 400ccs right now, though I will probably only go to about 600ccs with my implants. I was large before too and don't feel the need to go back there again. I hate being able to see my stomach, but I'm working on getting rid of that and am surprisingly comfortable in my smaller breasts. That doesn't mean I don't worry about being too small once the implants are in, but I also worry about being uncomfortable too. It's so hard to know what you're going to look like, especially when the TEs are so bizarre. Anyway, I just wanted to let you know that you're not alone. Not everyone is teeny weeny and not everyone takes this opportunity to go bigger than they were, which is how it sometimes seems on here.
Tory
-
orchidgal: I did find a photo of a breast reconstruction which indicates that the nipples and areolae were created exclusively from skin from the breast mounds, exactly as you discussed with your PS. Click on the link and scroll down to see the photo...
http://www.breastreconstruction.org/bilateral-mastectomies-tissue-expander-alloderm-case.html
If I come up with anything else...I'll post it here..
-
My DH just got home from a trip and I need to spend time with him...
I promise to get to the other new posts tomorrow!
Deborah
-
Tory: I sent you a PM. I'm very glad to meet you!
-
Some of you know that my exchange in June came out with an implant higher than my natural breast. I need to start over from scratch so that the skin in my lower pole can be expanded. I've been struggling to choose a PS and have it down to two. I'm meeting for the second time with both this week. I'd like to ask them about TE and implant sizes.
I'm 5'8", weigh 160, my bras were 38 BC but I'd like to be a full C. My ribcage is 35" if I measured correctly.
I'm still not sure if I am going with silicone rounds or gummies. I love the feel of my implant now which is silicone round. Do I need a different TE for different kinds of implants?
-
Shelala: Because you are a unilateral, the focus for you is chiefly gaining symmetry with the native breast. It depends on the size of your native breast - and if you have ptosis - significant droop, very little droop, you are small or large breasted. Your PS will want to select a profile to match the native breast. It also depends on whether you will be having a lift and/or augmentation of the native breast. The anatomical gummy which most closely matches the dimensions of your TE, is the 410 MF in 375 gms..13.0 cm wide by 12.1 cm height by 5.2 cm projection. This would infer you would need to be overfilled - possibly to 500 ccs or more. But your PS may be looking at a much smaller volume and a different style of implant, based on the characteristics of your native breast. Your TE does not represent how your implant will look after the exchange, as long as the right implant is used.
I would suggest you email me your photo or post a picture on the pictures forum so that I can give you a better idea of what to discuss with your PS regarding the ultimate outcome.
Deborah
-
Did anyone have anatomical TE's? The ones with two ports. The manufacturer starts with an S. I don't have my info in front of me.
Do these give a good result?
-
Hi Whippetmom,
Just thought I'd update you. I had my surgery on Sept 8th. All is good on my 4th day post op. I had a good deal of blood loss so feeling pretty woosey still (HGB went from 141 to 88). I have 250 cc implant on the left side "to hold the space" and an expander on the right side. The surgeon will begin expansion in two weeks. Apparently I was one of the most difficult cases they have had due to the bleeding and the density of the breast tissue removed (he described it as like cutting through rock). The surgery was 5 hours instead of the planned 3. So for now I'm sitting her with drains and incisions. The hardest part is over (waking up from the surgery knowing I can't go back) now I'm ready for anything (mind you I'm still on pain killers!! LOL).
I'll definately take your recommendation to the PS as he is awesome and listens to me. For now it is all about recovery from this first stage.
Thanks for your wisdom.
-
Claire: I personally think that this time you need a low height TE, which has the specific function of leaving the upper pole alone, while expanding in the lower pole of the breast, which is where projection naturally occurs. That would be my choice. Your issue with the implant also sounds like the inframammary fold is higher than the native breast's IMF....is that true? Did you email me your photos? If so, PM me and let me know what name they are under. If the IMF is too high, it needs to be recreated. I would highly recommend that your PS use the new style of TE, which has suturing tabs for increased stability - keeping the TE from migrating laterally or superiorly in the pocket. Mentor makes this and it is called the CPX3 - Siltex low height Style 7100. There are other styles also - moderate and full height versions. So discuss this with your PS. Referable to implants, your PS would need to be part of the clinical trials in order to use the anatomical gummy bear implants. I have mixed feelings about the use of an anatomical shaped implant after the pocket has been shaped by a round implant for some period of time. It would be like fitting a square peg in a round hole. Read this article and see what Grant Stephens, M.D. [the PS who coined the term "gummy bear" implant"] says about the anatomical implants. On page 3 of this article, he mentioned that the anatomical gummy bear is not the implant of choice for a woman who has previously had round implants. Now this is Steven Teitlebaum's opinion as well, and these two plastic surgeons probably have inserted more gummy bears than most plastic surgeons in the U.S.. You probably will not hear this from other plastic surgeons, but the reasoning makes sense to me. Refresh my memory and tell me what style and volume of TE you had and what style volume of implant was used.
-
lovesnature: Do you mean Silimed? Well, it is Sientra in the U.S.
http://www.sientra.com/datasheets/tissue%20expanders%201.pdf
Jaimieh, who is often on Exchange City, had this style of TE. I think she has pictures on the pic forum... I think it is a perfectly fine TE. It is more expensive than the Allergan or Mentor TEs, and not as readily accessible probably, which is why we do not see it often.
-
Whippetmom, yes it is the silimed 20799-470AGU.
-
Does this typo of TE require a certain implant? Also I don't have access yet to the picture forum.
-
No, your PS could use any type of implant following expansion with the Silimed TE. Did you PM Timtam to request entrance to the pictures forum? Look in the upper right hand corner of this webpage and click SEARCH. Then enter the name Timtam in the members search box and send her a private message.
-
Thanks Whippetmom, I'll pm Timtam.
-
Whippetmom - yes I sent you pics in June - you said exactly what 3 PS said about my fold. One of my choices is the PS from Sloan Kettering that Lilah has. Both of the plastic surgeons have access to gummies. I wondered also about my present implants being round and the gummies not. it was going to be one of my questions.
I don't know what kind of TEs I had but I do know he filled the 400s to 550. My implant is a silicone round 500 natrelle style 40 - i think they are moderate height but it doesn't say. REF - 40-500 SN 14058583 - don't know if these numbers mean anything. I love how it feels - although I think it is too small, but its hard to tell because it is so high on my chest.
Can you give me the link to the article?
Thanks so much!!
-
got home a couple hrs ago and changed into my sports bra (PS told me to get out of the hosp "bra" asap... it was literally hanging off of me... they have 1 size: large!). foobies are sooooo cute. the perfect width (thanks Deborah) and perfectly symmetrical. I love them!
-
Michele: I am so very happy for you! Hooray! This is good news indeed!
-
Claire: Oh my gosh, I forgot the link! Here is it...
http://www.marinaplasticsurgery.com/article-gel-implants.pdf
Remember to look on Page 3....
I cannot fathom why your PS used that Style 40. It is so archaiac....I mean...WHY use it? It is essentially a moderate profile implant which has a very low profile. I don't think you need much more volume - just a higher profile implant and the IMF revision. I think 550 ccs or 600 ccs should be fine.
Claire...PM me and tell me what email address you used. I have searched my email in June and cannot find your photos...so you never mentioned your screen name in the email....
I want to see your photos again and I might have some other thoughts...
Deborah
-
Claire....also, PM me and tell me the other two plastic surgeons you are considering...
-
Claire -- if you love the feel of the regular silicone I say stick with that. The gummy is definitely firmer. It has some squish but it is not "yippee squishy"
I also found as a uni that although my IMF is exactly right -- even with my natural breast -- the natural breast does hang lower than the gummy. I'm not sure it has anything to do with the gummy though... I think it's just a skin thing and a volume thing. In my case, as someone who is NOT slim (let's just say voluptuous my natural breast has more volume than the implant. I don't know your stats so this might not be an issue for you, but the gummy does not go as big as the regular silicone. That said, it really does depend on your situation. It sounds like you have two doctors in mind who both want to lower your IMF (which sounds necessary). Was your remaining breast left alone completely or did you have a lift? These are things to consider as well. What I'm saying is: your issue with the current reconstruction is NOT about the implant but about it's placement... so since you know you love how it feels, stay with what you like and get them to put the new one in the right spot
-
Michelle: Congratulations on getting your new squissies! Such relief. I had the opposite probelnm: they sent me home in a too small bra OUCH!!! Heal quickly and let us know how you are doing.
-
Dear Whippetmom-
I am desparate and in need of some advice and have been directed to you. My exhange surgery is Thursday (9-16-10) and I cannot decided what size to go with. Here is my info: I am currently 5'7" and carrying more weight than I should be. I am back at the gym and hoping to take off approx 30 lbs once this is all over with. I had a bilateral masectomy on 5-4-10 and had tissue expanders put in at that time. Previous to BC diagnosis I was a DD cup size and hated it. I currently had 620cc's in my TE and am measuring a D Cup. There are still too big for me, although I was able to make use of all of my old 36D bras again.
My PS is bringing Allergen Naturalle High Profile Smooth implants to surgery in 500cc and 550cc and he wants me to tell him that morning which size to use??? My first instinct was to go with the 500cc because when I lose weight my boobs will look bigger. I am nervous that I will make the wrong choice. I just want to be a standard C cup and my PS is not much help. I have never been able to wear those cute tops because my boobs were always in the way!! Am I really going to notice a big difference between the 500cc and the 550cc?? Please share your opinion with me. I tried measuring out the sizes in water and it is impossible to make a decision when you are looking at water in a measuring cup??? HELP!!!!
-
Hi,
I had my bmx 3-25 and finished rads the beginning of July. My skin did very well with the radiation and my ps is thinking of doing my exchange in November. I just don't want to 'rush' anything and want to be sure my skin has had enough time to heal. I had an allergic reaction to the glue in the stickers they placed over my marks and still have the 2 round spots where the stickers were. My rads onc assures me the marks will go away.... My skin is very thin on the cancer side and I do have the rippling from the TE. My question is do you think that is enough time to heal? I need to measure my rib cage but I am 5'5 and weigh about 118. I was a AA (at best) before all this and do NOT want to be big. I was always fine with my small chest. I do feel my ps understands this but I don't have a clue about sizing of implants..
thanks,
** just measured my rib cage and it is 28"....implant sizing suggestion for someone who wants to be no larger than an A?
-
mom3band1g- I'm sure whippetmom will give you all the guidance you need but wanted to tell you I am 5'4", 115 lbs with a rib cage circumference of 28" also and went with Mentor Smooth Round High Profile implants that were 375 cc's. My photos are on the picture forum under "Boob Fairy Came For Me..." if you want something to compare (though I am larger than an A cup).
-
mom3band1g: Okay busy lady! Yikes...4 kiddos...
I would really like for you to go to the pictures forum and take a look at Kate's and some other photos of women who have your height/weight/build. I think it will be immesurably helpful. I would like for you to navigate around and look at photos before we discuss final sizing. I personally think that the appearance you seek might be filled by implants with a volume of 300 ccs to 350 ccs - but probably in a moderate plus profile, which lends somewhat of a more athletic appearance on the chest wall in the lower volumes - for women who do not want full and perky, but still need to fill out a bra.
Referable to the radiated breast, I am telling every woman who is eager to do whatever they can to protect the integrity of that radiated skin, to talk to their PS about fat graft transfer to that breast - simply for the purpose of enhancing the skin integrity and perhaps by doing so, reducing the risk of capsular contracture. It also has been a technique shown to allow the skin to respond more like a non-rads breast. Please discuss this with your PS....
http://www.ncbi.nlm.nih.gov/pubmed/19484176
If you are not on the pictures forum, please send me a private message. You have been a bc.org member long enough....
Deborah
-
thank you, thank you Kate33 and Deborah. I am able to see the picture forum so I will go take a look ...after kiddos are in bed! I will ask my ps about fat grafting as well. Where does the fat come from? I like the idea of a more athletic look. In my former life I was a ballet dancer and while I am no where near as thin or muscular as I was I do prefer that 'look'. For all my body hang-ups (and there are many!) I was always happy with my small breasts. Figures that would be the thing that had to go.
Thanks again for your help and giving me some guidance.
kathy
-
mom3band 1g- Just had to say hello! I check this thread a lot even after my exchange! Deborah and all the other ladies are unbelievably helpful! I hope you get all that you hope and odds are you will with Deborah's insight! Hugs to you♥
-
mom3band1g - I'm about your build too if you want to check out my pics on the forum. I'm 5'5", 109#, 28.5 inch rib cage. I have 325cc silicone round implants.
DawneHope.
-
mom3band1g- I believe they typically take the fat from your stomach or thighs like they would during liposuction.
-
kate33 - I like that! After 4 pregnacies my stomach could donate a little fat! I was too chicken to do the tummy-tuck surgery!
tamgam -Hi!
thanks again ladies and I will check the picture forum (dawneHope)!
k
-
do you know of anyone else on the pic site who wanted to remain small? I haven't found anyone who had an exchange and turned out an A. I really don't want to be a B or a C cup....like it scares me!
-
mom3band1g - whippetmom is the expert but I'm not sure it is possible to be an 'A' cup simply because of the width of the implants. Maybe, though. My new foobs are different than my old ones. The bra's I'm wearing now are D and DD cups, but it does not look like it in my clothes. I was a small C before and my clothes were much more filled out than now. You're not going to look like Pamela Anderson, the implants alone are not going to give you that much projection.
-
mom3band1g:
Call your plastic surgeon's office and obtain the details on your TEs. The style - Mentor or Allergan - and the style number or catalogue number - essentially we need to know the volume and the width of your TEs.
Deborah
-
Where is the picture (photo) forum and how do I get access to it? Thanks in advance!
-
JoyKK
You need to PM Timtam - hit search above right corner of the webpage and under "member name" type Timtam. Her profile page will come up and you can PM her to request the pass code for entrance.
-
The card I have says Allergan 133sx-13 400cc. I do not think they are full to capacity.... Does that help?
thanks so much,
k
-
Yes, that helps. So I think you do need the width of a moderate plus profile implant, since your TEs are 13.0 cm wide. If you went with a MPP between 325 and 350 ccs, it should give you the appearance you want, but your PS would need to perform some lateral revisions to narrow the pockets a little - to ensure that the implants do not migrate laterally towards the armpits. The implants will have significantly less projection than that which you have with the TEs, even at their current fill status. Dawne-Hope has 325 ccs in a high profile implant, and so you would have just a little more width than she has, but you would have less projection - so they would appear smaller. Make sense? And if your skin can tolerate it, I probably would have him fill you to 400 ccs and then exchange you out to the smaller implants.
Deborah
-
Hi ladies,
First of all: thanks for all the great information and support on this thread! I wonder if you could give me some suggestions on implant size? I have had a double mastectomy, and have TEs filled to 300 cc at this point.
I would like to be a full B cup (I know, I know, I shouldn't focus on cup size, but still...). I am 5'7, weight 132 Lbs, ribcage 31. My last fill was threee weeks ago and it was pretty horrible (posted about this earlier): a lot of pain, a lot of anxiety, and my expanders looked weird after that fill...very wide, very "in my armpits". It made me question if I should just stop where I am with the fillings...? Just not sure how large the TEs need to be to get to my desired size.
-
maria: Can you obtain information regarding your TEs? I need to know the volume and the width. You might have been given a little credit card with this data...if not....call your PS' office and they will have it in your chart. The style number will suffice and I can look it up. But off the top of my head here, I think 500 ccs in a high profile implant - smooth round silicone - and if the volume is any lower, switch to a moderate plus profile - 450 ccs. I would not go any lower than that though.
Deborah
-
Thanks Deborah! My TEs are Style 133Mv-13. It says "400cc" on the information card, but currently they are only filled to 300 cc. Do you know how much more I need to fill them in order for the PS to be able to put in a 500 or 450 high profile implant? Thanks, maria
-
maria: I think you need to talk to your PS and ask him why the implants migrated laterally. It could be that the pocket was overdissected a little bit laterally and this is often [usually] why the implants head east and west. If you can tolerate smaller fills - even 25 ccs at a time - getting up to 400 ccs would be good. All hinging on your skin integrity though. Talk to your PS and let me know what he says about the TE migration.
Deborah
-
Thanks so much for your advice Deborah. I will ask my PS about the migrating TEs. And smaller fills is probably the way to go, 25cc sound tolerable.
-
Whippetmom (Deborah): Thank you so much for your response about sizing of a gummi bear implant for me. I have been reading other posts about some unhappiness with gummi bears so am wondering about cohesive gel implants too. Do you think that, given my unilateral situation and need to try to match my natural breast (and, no, I don't want to have to do any lift or procedure on my healthy breast), that one type or the other would be most successful? I wonder if you could give me an opinion on size for cohesive gel implants too. I would be glad to email you a photo (don't know how to email you though) or post a photo (not sure how to do that either).
Thanks so much again. This feels like a lifeline in a very confusing issue.
Shelala51
-
lifeline - the perfect word - i wonder if you guys really know how much...
-
shelala....I have sent you a private message...
-
Lifeline is so correct! I don't know what I would have done without you Deborah! Still waiting for my drop and fluff on the MX side but I hear it can take 3 months, so I am waiting on doing anything else until then.
Deborah: Feel free to share my pics that I sent you to shelala!
-
Does anyoune know how to get access to the picture forum? It would be a huge help to be able to compare and see what the end result of this expander journey could look like.
-
marie: PM TimTam on this site to get permission.
-
maria: I think you will be approved soon for the pictures forum. I told Timtam that I vouched for you...
-
Yippee, I am approved for the picture forum! It is SO helpful to be able to see some of the results when you are in the middle of this journey. Thanks Deborah and MBJ. All of you ladies here are so generous, and this site is such a blessing in so many ways.
-
Deborah, Thanks for the info on the PS's in my area. I love the new one I'm going to use. I showed her your suggestions and she was impressed. She measured me and apparently I measured incorrectly. We also discussed that there is a PS in St. Louis using gummies and there is a possibility that she will do the TE's and then if I choose gummies the other PS could do the exchange, but I have a long time until I have to worry about that. The first PS I talked to said that he wouldn't do anything until after radiation. This PS said she likes to have the TE's filled before radiation. Does anyone have any experiance with this they could share?
-
My understanding, Bubba, is that you have a better chance with rads if you have the TEs filled prior to the start of radiation so that the skin is already stretched. It makes sense if you think about it: stretching radiated skin vs. stretching NON-radiated skin.
-
I had radiation with TE's. I had all my fills, I didn't want to be very big, before rads. I did very well and am now just in the healing process before my exchange. My ps originally said 6m after rads but I did so well we are looking at 5m! If you need anymore info I am happy to share.
kathy
-
whippetmom :It was reccommended that I ask you about my situation. Here it is I had my BMX on June 23rd. I am scheduled for my exchange this Thursday, Sept.23rd. I was supposed to get Mentor CPGs but the hospital where it was to be done is outside my insurance's network. Because Mentor CPG is still part of a study it is only approved at certain hospitals. My approved hospital is on a waiting list. I am now scheduled for Mentor High Profile. I really like my PS and he is confident this will be good for me. I am getting nervous...I do trust him BUT i don't want to be high and fake looking. I think I SHOULD be happy the cancer is gone and I will have new boobs. I liked my old boobs. I was a B-C most of my life, at 51 I grew to a D. I'm hopeing for a full C.
Thank you
-
kitwe: Extracted from the top of this thread....need some additional info!
If you are interested in discussing implant sizes, make sure you compile and provide us with the following information:
Height, weight, ribcage measurement [measuring the circumference of your ribcage under your tissue expander(s) or under your bra line]. Also, if you have TEs [tissue expanders] - we need to know about them. The style - Mentor or Allergan most likely - and whether they are short height, moderate height, full height if Mentor and style number if Allergan. We also need the recommended fill volume of the TEs - the number of cc's. -
Yay Maria!!!!!
Stretch BEFORE radiation!!!!
-
Kitwe: Glad you found your way here!
Whippetmom's the best!
-
MBJ: You are pretty swell yourself sweetie!
-
Ladies,
There is a thread on BCO called
WHAT IS BCO WORTH?
It was started by our KATE33..:)
This is BCO's TENTH year...
I wanted to post this for all to see... if you can give any kind of donation... BOY...this is a GOOD THING! BCO has been here for all of us..... and hopefully will be here for ladies who come after us. They have PAYPAL.... and Kate posts this in her heading.
Let BCO know... how you thank them.
Laura
-
Thank you Laura! I celebrate two years on this forum in November. We can donate a little something - even if it is $1.00! Paypal is very easy to set up. BCO provides this wonderful forum for us and I am here only because this website exists!
Thank you so much!
Deborah
-
RESULTS OF NEW STUDY OUT THIS WEEK: TIMING OF BREAST RECONSTRUCTION IF RADIATION IS REQUIRED:
"The results of one study out earlier this week finds that about half of women who need radiation therapy after having had a mastectomy with immediate reconstruction develop complications that require additional surgery."
The conclusion drawn from this study is that delayed reconstruction is preferable, if radiation treatment is anticipated as a part of cancer treatment. The principal surgeon involved in this study suggests that the sentinal node be biopsied first, in order to determine if having immediate reconstruction would be prudent. He states, "If the sentinel node is negative, there is a low probability they would get radiation,"
The complete article is linked below:
http://www.businessweek.com/lifestyle/content/healthday/643306.html
Please cross-post...
Deborah
-
Thank you Deborah! I had heard that it was 40/60% chance of failure but that was a year ago. City of Hope was going to do radiation regardless of the pathology report, so I am glad that I changed dr/hospitals.
-
The uncertainty about treatment was one of the reasons I opted to not have "immediate" (I take issue with that term) reconstruction. I did not end up having radiation, but I can say that having had one breast with delayed recon and one breast with immediate, the delayed side is doing much better. It has caused me less pain, less discomfort and less grief. (I currently have TEs and probably one more fill left.) Even if you take radiation or treatment in general out of the picture, it's a tough call because immediate recon may eliminate one surgery, but on the other hand, giving your body time to heal a bit before growing foobs might be beneficial. Delaying recon also gave me time to grieve over my loss before moving on to rebuilding, so to speak.
-
This has been the thought from the very beginning dealing with radiation. This is why a lot of doctors will not even try implant only.. after radiation.
Most all of us were told we had about a 40% shot at it working.
-
I have just viewed the video clip where Dr. Weiss relates her very personal journey with BC.
Here's the link: http://www.breastcancer.org/about_us/press_room/press_kit/video/mw_message.jsp
-
I am a newbie, this is such a great site. It has really helped me with my new journey after being diagnosed with DCIS on August 9, 2010. To make a long story short (or what feels long with surprises along the way). I am to get a mastectomy (right breast) with immediate reconstruction silicone implants, will find out date of surgery this week. I decided on PS after talking to several. Would like to know if Whippetmom could suggest what size of implants I should get. I am thinking of going with one-step surgery but at times think the two-step maybe better. Any suggestions at all would be great.
I currently wear a 34D bra. Height: 5'5", Weight: 125 lbs, Ribcage: 28.5"
Thanks for all and for such wonderful postings! Great site and people!
-
HappyGirl: Your focus will be achieving symmetry with your native breast. If you do a one-step, you will have a smaller skin envelope - after dissection and retraction - than the opposing breast. With a one step, I don't know if you are going to have the best shot at getting that much desired symmetry you want to shoot for as a unilateral. So I would want the PS who says he can do the one-step to be honest with you about the anticipated volume he would be able to achieve with that procedure.
Are you planning on having or do you need to have a lift of the opposing native breast? That is a discussion to have with the PS as well. If you have some droop currently and you are not having a lift, your PS will need to overfill and overexpand the MX side and then exchange you to a smaller volume implant, in order to match the "ptosis" or droop of the native breast. I think that if I were looking at this in terms of what works well for your frame, I would say an implant with a volume ranging from 400 ccs to 475 ccs would be appropriate. But because you are a unilateral, symmetry is what is key and essentially, the PS is going to want to match the width of your native breast and select an implant which gives the same projection [more so in the lower pole = bottom portion of the mound] as you have with the native breast.
Deborah
-
Deborah,
Thank you very much for the reply. A lift will be performed on the opposing native breast to match. PS claims an 80% success rate for one-step. Can I get good results from one-step? There was so much information given in such a short amount of time...at first I was thinking I need to get this done as soon as possible without missing much work. Now that I have been reading and had time to soften the blow of BC the two-step reconstruction maybe best. I have another appointment this week to discuss surgery with PS.
-
HappyGirl: I think my question would be: Will a one-step dictate the size of implant and is it possible that the MX side will be smaller than the native breast or will not have the same shape as the native breast? And the question: Which method would enable you to achieve better symmetry? If you have a TE, I would definitely want a low height TE - a TE which leaves the upper pole techically "alone" and expands in the lower pole where projection naturally occurs.
Deborah
-
Could you give me help in deciding on an implant size? 5'4, 135, 32 inch ribcage(my bras were always 34 or sometimes 36) ...TE's are Mentor siltex contour profile 354-2513. My rads side is filled to 600 and my non rads is 550.
On a funny note my non rads side started leaking...so I've been going in for refills so I'm not too loopsided LOL
Thanks, Deb
-
HappyGirl: I am a uni, too. Although I didn't need a lift on my natural side, I did need augmentation to match. I had my final fill and then waited 2 1/2 months to allow enough stretch so that I could achieve symmetry. The idea of a one step is very enticing, but I think that works better on someone who hasn;t lost all of their breast tissue--you need time to stretch and my total time was from 3/20 to 8/20 with the expander in. You can work while being expanded if you want--many women do. Whippetmom helped me and she is amazing--I don't know what I would have done without her!
-
I am also wondering about that "80% success rate for the one-step." Is that percentage geared towards the cosmetic aspect of success, or referable to the viability of the proceedure itself?
-
Everett:
Well, your PS used the Mentor Spectrum Expandable implant, instead of a tissue expander. So obviously if you have sprung a leak, he is not going to be able to keep you in this implant. This type of implant is used in order to avoid an exchange procedure in most cases, but perhaps your PS used it as a TE for some reason. Does your PS perform a lot of reconstruction cases or primarily augmentations?
I would want to be switched out anyway....to silicone implants. If you are happy with your current volume, such as it is with the deflation, then I would say you would be happy with around 500 ccs or 550 ccs in a high profile, smooth round silicone implant. You don't want to put too much stress on that rads implant and so I would not push it size-wise. I would stay with an implant under 14.0 cm wide - and so the sizes aforementioned would work well - preferably 550 ccs.
Deborah
-
Whippetmom, you're right. Originally the PS talked about not doing an exchange. But, I'd really like to go to silcone. I think she was looking at 500cc, I'll have to compare sizes and verify the profile on my next visit. How much different is ithe result for 50cc?
Thanks for your insight! Deb
-
Deb: 50 ccs is not going to represent much difference - which is why either would work. Typically, it requires about 100 ccs [sometimes more] additional volume in the implants to match the volume of the TEs. Your TEs are 450 cc TEs....overfilled to a greater volume, and the only thing that changes with overfilling is projection and height. So this is why I suggested 550 ccs. Your PS knows your skin tolerance factor and your skin integrity, so trust her with selecting the implant she feels would best. She could order both sizes to try in the OR at the time of the exchange.
-
I had bilateral partial mastectomies (kind of like a lift/reduction, nipple sparing) last April. They had to remove more tissue than had been expected during surgery, so I am quite a bit smaller than we had thought I would be. I am almost finishing chemotherapy and will undergo radiation approximately 1 month after I complete the chemo. Although I am really pleased with the results of my surgery, I am considering augmentation . I know that I need to speak with my plastic surgeon, radiation oncologist, etc etc etc....but I'm not really sure what to ask? Can I have radiation with implants? Any input would be helpful...thanks!
-
Whippetmom: I have an appt with PS in the morning. I have all your suggested questions to ask and will also ask him for clarification on the 80% success statement.
MBJ: Thank you for your message. It is good to hear what someone else has gone thru dealing with this issue. I think not rushing the process is better and the results will be worth the wait.
-
Janny: I would wait until after rads - perhaps at least four months - to have the "augmentation." I just posted a recent article out last week about the timing of reconstruction when radiation is anticipated. I am copying it here for you as well:
RESULTS OF NEW STUDY OUT THIS WEEK: TIMING OF BREAST RECONSTRUCTION IF RADIATION IS REQUIRED:
"The results of one study out earlier this week finds that about half of women who need radiation therapy after having had a mastectomy with immediate reconstruction develop complications that require additional surgery."
The conclusion drawn from this study is that delayed reconstruction is preferable, if radiation treatment is anticipated as a part of cancer treatment. The principal surgeon involved in this study suggests that the sentinal node be biopsied first, in order to determine if having immediate reconstruction would be prudent. He states, "If the sentinel node is negative, there is a low probability they would get radiation,"
The complete article is linked below:
http://www.businessweek.com/lifestyle/content/healthday/643306.html
You might want to inquire about the radiation device called a SAVI - it might be something to discuss with your oncologist....you might be a candidate for this device.
http://www.sciencedaily.com/releases/2010/07/100712162634.htm
Please let me know what you decide to do and if I can help you with a "sizing" plan, I will be happy to do so. It could give you something to look forward to!
Deborah
-
Deborah,
Thanks so much for the reply & link of 9/11 re my question. I only saw it today! Very interesting. Am looking for the list of questions one should ask the PS at the pre-srugery exchange appt. Can you direct me to that? Thanks, fo rall you do for all of us, you are truly a GIft from God!!
orchidgal
-
Orchidgal IS there such a list? Did you try searching for the info using the search function here?
-
I don't know of a "list" either Melissa. Are you having some concerns you want addressed?
-
I am too waiting for delayed recon after chemo ends in February, no rads recomended at this time. I am 139lbs and 5'5 inches tall my rib cage measures 33 and 1/2 inches. I was a 36 C but while breast feeding enjoyed the 38 C would like to be that size or a little bigger. What do you think? I would like some input as to how your recon went and if the infamous gummy bear is BEST and is it available in the US? Please help:) I also would like to know how to find the picture fourm on this site, not sure how to find it. The pics google searched are not that impressive and am looking for some encouragement and positive outcomes. Thanks so much, Heather
-
KC Mom - Deborah will answer most of your questions but here is some info I can help with.
Re: Picture Forum -- send a PM to Timtam on this site. Be patient. Post and be a part of this community as that is part of what it takes to be accepted into the picture forum, which is private (not connected to BCO) and guarded to protect everyone's privacy.
Re: Gummy -- I have one (I am a unilateral) which is a pretty good match to my remaining natural breast. It is a little firmer than the natural breast. It does not move. It has a nice anatomical shape and, so far, I have no rippling or divots. I like the gummy. I can't say I love it. I can't say, though, that I would love any implant
Women who get the softer, regular silicone implants say they are very soft and squishy... so if softness means the most to you, I'd say look into the smooth round silicone that many here have opted for. I chose the gummy because of being a uni and wanting the best possible match to overall shape. I am happy with the results and don't mind not having a super soft and squishy implant side (my natural side having never been all that soft and squishy anyway).I'll leave it to others to talk about the regular silicone!
-
KCmom: There is another KCMO gal on the recon forums...Estepp....you might want to contact her. She has a very good plastic surgeon, by the way. She might see your post here, but you can find her over on Exchange City.
Just off the top of my head, I would recommend implants with a volume of 600 ccs - high profile round smooth silicone - perhaps 650 ccs. The "gummy bear" implants are only available through plastic surgeons who have them in clinical trials - they are not yet FDA approved. So this size range is what you could discuss with your plastic surgeon.
-
Oh yeah I forgot to mention that gummies are in trial stage -- see this is why Whippetmom is the breastwhisperer
Her brain holds multitudes -- multitudes! -
Lilah: Oh, if you only KNEW!!! LOL! That information is part of my long-term memory, because my short-term memory left the building a long time ago.
-
LOL Deb -- well your long term memory has clearly compensated!
-
Whippetmom,
Thank you for posting the link. I did need radiation following TE placement . Hopefully I will not be part of the third who has complications.
By the way, thanks again for all your help in the past. The expansions are going well, now I am at about 570 on eacg side. I told my PS, as you advised me that I would like a final implant of 550 cc, so we are now continuing the expansion.
Donna
-
Trytostaypositive:
How are you looking at 570 ccs? How much more does the PS say he/she will overfill in order to use the 550 cc implants? And they MUST be high profile 550 ccs....not midrange plus or moderate plus...
How is your rads tissue holding up? You don't want to overfill rads tissue too much. I worry about skin integrity, implant coverage, etc. I do not know why expansion protocol differs so much throughout the Kaiser system. My own Kaiser Sand Canyon PS told me, "we rarely overfill anymore.."
Keep me posted!
Deborah
-
Whippettmom, I wanted to ask how/why the high profile are better then moderate etc? I'm just curious...I noticed many opt for them and wondered why they are better? (I'm just a curious type lol)
-
Namaste!
whippetmom: I am 5'3", 176#, rib cage 38 inches. I was a 42 C before bilateral mastectomy. My PS said he thought I would like gummy bears. My BMX was 4/29/10. Immediate first stage with TE was planned but had to be aborted because of poor circulation to the remaining skin. The BS had done a skin sparing procedure but on the cancer side there was scar tissue from a previous large excisional BX that did not have good blood supply. There was barely enough healthy skin to close. On the prophylactic side he removed all the extra skin. A couple weeks ago he said my skin was ready and he recommended bilateral Lat Dorsi flap for the best outcome but said I had a reasonable chance for a good outcome with TE/implants if my expectations were "modest". I did not want a flap. I use these muscles in canoeing, swiming and boulder scrambling when backpacking. I will be 64 this year and I need to keep as much upper body strength as possible. Yesterday he placed Allergan TE 133MX-14 600 cc. What size gummy bears would I be looking at in my future.
Thanks for your assistance.
Karla
-
Whippetom:
I am 5'4",127 lbs., ribcage measures 33". I had a bilat. mx 6/16/2010 with tissue expanders and Allograft. I have Allergan style 133mv size 12cm. My PS is over filling 2xs over what the size of the final silicone implant will be. Currently I have 390mls of saline in each TE. They will put another 40mls of saline in each TE at my next visit and that supposedly will be it for the expansions,which will bring the total vol. for each breast to 430mls. I was an A/B cup size prior to the bilat. mx. I would like to be a C cup size. Before the last expansion the PS saw me and said I was about a B. With this size tissue expander is it possible to expand more than they already have? I have left the size decision mostly up to the PS telling him that whatever size he thinks will look good on my body frame will be good but that I would like to be about a C cup size. I know that it is very difficult for the PS to deal with cup sizes but I don't know how else to decribe the size I would like to be. It is very difficult to tell from the TEs if this is the size I would like to be. He stated he does not like to over expand to much because he doesn't want the patient to be in too much discomfort. I appreciate you expert advise.
Thank you very much,
Pam
-
Hi
I too am a plus size, but am trying hard to lose weight. I have lost a few pounds and plan on losing more. Right now my PS wants to put me in an 800 cc implant. I was very large before surgery, and want to be much smaller. From what I'm reading, 800cc is probably fine if I stay the size I am now, but I am worried about being too big if I lose the weight. How long can we leave the TE's in? I am thinking if I could leave them in until I lose the weight that may be the best thing. Also, how do I get hold of Timtam. I think pictures would really help!
-
5'7", 118 lbs. I used to be a B before I nursed my 3 kids. Then went down to an AA. ribcage 30". I'd like to be a B again. The problem for me is due to a nerve problem in my back, I can't wear a bra, so they have to look natural without a bra, and not hurt my back. My PBM is scheduled for Nov 2 with immediate reconstruction, expanders, then probably silicone. My husband thinks I should go a little bigger than what I was originally because "someday your butt will get big and you'll want it to be balanced" but I'd be satisfied with what I had. Any advice?
-
When you have reconstructive surgery, the bra size goes out the window becuase implants are wider then a natural breast. I was a b and went to c and this suits my body and build now which is the most important. If you give whippetmom your specs (see above) she can help you with the sizing. I think the gals are all in Las Vegas so I don't know when she will come back on here to help, but be patient! BTW: I can't believe your DH said your butt is going to get bigger--you should spank him for that! Sounds to me like he just wants bigger breasts LOL! My DH loves them!
-
robynkk, I hope by now you got an answer to your questions, between working on our new home, SE to Arimidex, completing expansions... I have not been on much other then reading for support. I hope by now someone answered your questions... I believe I have TE's as a placeholder for an implant that will come some time after I have healed from radiation. Good luck to you.... I have just finished my first week of radiation. 4 weeks to go.
-
Dear mom3band1g -- Your message resonated with me because I too wanted to be an A! I had a prophylactic mastectomy with reconstruction in February of this year. I told my PS at every visit that I just wanted to fill my A bra...since it was empty after breastfeeding 3 babies. I had 400cc TEs that were filled to 360ccs. (not sure why since I had already told him I wanted to remain an A) At my last visit before exchange, I told my PS that these TEs at 360 were way way way to big for me and reminded him that was aiming to be an A. Well I woke up after exchange a very full C. He had used Natrelle 335cc MFs. This last Friday, I had surgery again, and my PS exchanged my 335s for 225s. I am now either a full A or smallish B - so pleased. I wish I had known to ask for a cc amount and not just a cup size. I also wish that I had looked at measurements of implants beforehand. Several of my friends who have used the same PS all have 425-450ccs and they are full Bs. Not sure why it took only 225ccs to get me to where I wanted to be. I learned through this process that a request to remain an A is quite rare! Nevertheless, with the help of wonderful Deborah and lots of analysis, I got my A/Bs. I'm glad to share measurements or pics if that would help -- haven't posted to Timtam's site yet. So grateful for you all and for everyone's input...
-
Flippy: Good luck with your radiation and I hope everything turns out well for you!
Catchturn: I am so happy your were able to get what you wanted!
-
Karla...Confirm for me there is a PS in NE who has access to gummy bears...anatomicals. I need to review the catalog when I get back from Vegas. I know the silicone rounds dimensions by heart, but not the Allergan 410s. I like the size of your TEs though...but confirm your PS is talking about the 410s...
-
Pam...I will provide more when I return Sunday, but I will tell you it will take 425 to 450 ccs to approximate what you have with your TEs. Exchanging out to that range is reasonable and "doable". Perhaps using a mod plus profile - e.g, Allergan Style 15 in 397 ccs or 416 ccs would be nice also. I prefer the higher number for you.
-
Kjbrown...More when I return, but around 400 ccs or 425 ccs is what would be appropriate for meeting your desired "cup size" and more on "cup size" phenomenon when I return.
It takes me too long to type all of this out on my phone... -
BTW...kjbrown, I read YOUR post while the plane was on the tarmack this afternoon and almost ejected the chewing gum out of my mouth when I got to the breast to butt size displacement theory...
-
Catchturn...REALLY?? I am so happy for you! You MUST send me photos!
-
Did I miss Robyn's post somehow??
MBJ...Could you explain to the new gals how to request entrance to the pic forum
? -
HI,
I found this forum really useful. I am a BRAC1 carrier have just undergone a double prophylactic mastectomy and breast reconstruction. I know how helpful it has been to read about other people's experiences so I have begun a blog about being single and trying to find love post surgery in wonderful London.
I hope my blog helps bring greater confidence to women seeking love post-surgery and I really encourage people to leave their own stories of romance as well!. http://diariesofalondongirl.blogspot.com or follow me on www.twitter.com/diarylondongirl
London Girl
-
Namaste!
whippetmom: PS talked to me about saline, regular silicone and gummy bears and of the three thought I would be happiest with the gummy bears. He talked quite a bit about the differences between gummy bears and regular silicone so I assummed they were available here. I am back for follow up on Tuesday so I can ask specifically again. Somehow I got the impression that he could use the gummy bears for reconstruction but maybe not cosmetic. I don't know where I got this impression from, his office or the support group.
Karla
-
PICTURE FORUM ACCESS: For those of you who are new, send a private message to TimTam here on BCO, she will send you a message back and tell you how to access the private picture forum. If you haven't posted much, now is the time to start familiarizing yourself with BCO--your posts will be limited per day at first, but this will also help you gain access to the picture forum faster. Good luck ladies, and I am so glad you found Whippetmom, the breast whisperer. She will get you to your heart's foob desires and she's never wrong!
-
Londongirl: There are others from the UK here and we welcome you and would love to hear of your progress!
-
Momcat....
Mentor and Allergan both refer to six months as the temporary period of usage for expansion purposes. However, many women have retained them for up to a year, due to requiring chemo, rads or other treatment which delayed the exchange to implants. I will go over sizing issues when I get back to my computer tomorrow. -
Whippetmom,
Thanks so much for responding while you are away!! I am not sure I understand what you are saying. When I see my PS in 2 weeks I will get one more fill of 40 mls. bringing me up to 430 mls. He wants to have me to be 2 fill amts over what the implant size will be. This would be 350 mls (probably about a B cup). So what you are saying is that I would need 3 more fills including my next fill, each fill has been 40 mls. This would bring the total expander volume to about 510. Is this correct? Also, how can I learn about the styles of different implants, like the the Allergan Style 15 you are talking about? Thanks so much for your time, Pam
-
Pam: The links for the implants are on the Exchange City thread. You can go through their entire cataloge and see the complete sizing information plus how much projection each size has. They correspond to your expander size.
Deborah: Hope you are all having a blast in Vegas!!!
-
Pam: With a 350 cc implant you might be a "B" cup - you might wear a "B" cup size bra, but you will look smaller than a "B" cup in clothing. It simply takes more implant volume for breast reconstruction - to give the appearance of volume on the chest wall. You have a 33 inch ribcage - you can handle an implant with a width of 13.0 cm. I think that at least 425 ccs - 450 ccs preferably - in the high profile Style 20 would be needed, or 371 ccs or 391 ccs in the midrange profile - Style 15 - in order to give you the appearance of having a "B" cup size mound on your frame.
Currently, here are your dimensions:
133MV - 300 ccs:
12.0 cm wide by 11.0 cm height by 5.2 cm projection
Allergan Style 20 high profile implant: - 425 ccs
12.0 cm wide by 5.2 cm projection
Your "overfilling" does not add to the width of the TE - it only adds to the projection and to the height of the TE. The purpose for overfilling is to get some additional stretch to the skin to allow for proper implant coverage with the skin envelope and to get some "natural droop" or "ptosis."
I personally think that 450 ccs in a high profile implant would be better, if high profile, simply because you get just a few more millimeters of width and it helps with mitigating any proclivity you might have towards rippling and also because you can use the width. If you PS is looking at something under 400 ccs, then I recommend the midrange profile Style 15 - 371 ccs at the minimum - which gives you sufficient width for your frame.
So discuss with your PS the numbers above and see what he feels he will need to do [vis a vis "overfilling"] to facilitate exchanging you out with those numbers in mind.
Deborah
-
So I had my last fill, now at 405 cc's in 400 cc TE's. I can't handle getting anymore, this last one caused muscle spasm almost immediately and I ended up having to leave work it got so bad.
I have my exchange date set, 12/20, exchange to what I have no clue. I was given a book to look thru about silicone implants. I feel huge at this point, bigger than I was before bmx.
As a reminder 5ft 5 1/2", weight 152, ribcage 33.
Anyone with similiar stats that can offer some insight would be appreciated. I do have access to the picture sight, but have no way to post pictures. Very behind in the tech field here I have to admit.
Thanks!
I think I should change my name from Stlcardsfan (boo no post season) to STLRamsFan!
-
MBJ: Wait, wait wait! whippetmom is "always right?" Oh, I don't think I want that kind of pressure! Eeeks...And if I told my husband THAT one he would be finding a way to get onto bc.org and post a few savory thoughts of his own on that topic!!!! LOL
-
Deborah: LOL!!!! Well, you are you know, just because our husbands don't appreciate how great we are, doesn't mean it isn't true!!!
-
stlcardsfan - the cardinals ... how sad. Terribly sad. I'm a STL card fan too and they just fell apart. I feel your pain! Sorry I can't help you on implants ... but you're in good hands with whippetmom! Saw your reference to the cards and had to respond!
-
STLcardsfan....You are talking to a football widow here! My eyes glaze over when the game is on so I cannot help you with your name change.
If you want to email me photos, you can do so. If you feel too huge right now, then I would say stay with implants with a volume of 400 ccs to 450 ccs - in a midrange profile style. In Allergan, this would be Style 15. In Mentor, it is called a "moderate plus profile" style of implant. The implants will be somewhat smaller than your TEs.
Deborah
-
There you go MBJ...within days I have shown you that I am often wrong. My DH just told me [picture his eyes rolling to the back of his head] that the Cardinals are a baseball team, not a football team. Shows you how much I know.
-
Ahh...see...STL...Dawne-Hope can help you...
-
whippetmom - but the Cardinals ARE a football team! It used to be the St. Louis baseball and football cardinals ... but the football cardinals moved to Arizona ... and the L.A. Rams moved to St. Louis ... so now it is the Phoenix Cardinals and the St. Louis Rams! Go impress your husband, whippetmom!
-
Deborah: I'm so not into sports! I thought the Cardinals were baseball, too and now Dawne-Hope has just showed you, that, yes it's true, you truly do know everything LOL!
-
The Los Angeles Rams are in St. Louis? How did they sneak THAT one by me?
-
But St. Louis DOES have the Cardinals baseball team, right? I just looked it up. So you were lamenting over the Phoenix Cardinals football team....Now I get it. Hey, this all goes to show you we can talk about things other than implant sizing on this thread!
-
Deborah,
Thank you so much for educating me about implants. I don't want to be a "B" cup I would like to be around a "C". So are you saying that a high profile implant with 450 mls or a midrange profile Style 15 with 371mls to 416mls would provide a "C" look? What about the TEs? Will the TEs I have in now accomadate these implants? How many mls of fluid do the TEs need to have to accomadate the implants you are recommending and will these implants have ptosis?
Thanks again, I really appreciate your imput,
Pam
-
Pam: Read this: It is extracted from what I have posted in the thread introduction above:
"WHAT CUP SIZE WILL I BE?" OR "WHAT SIZE IMPLANT DO I NEED FOR A "C" CUP?"
I CANNOT PREDICT CUP SIZE. PLASTIC SURGEONS - THE SMART ONES - ADMIT THAT THEY CANNOT PREDICT CUP SIZE WITH ACCURACY!
It is very difficult to determine cup size with breast reconstruction patients, as volume does not easily translate to a specific bra size. There are so many factors which determine how implants will look on any one individual, e.g., your ribcage circumference, whether your chest wall is bony or if you have a fair amount of adipose tissue surrounding the chest wall.... if you have any ribcage deformities or other structural issues which might impact implant placement. We can sort of "project" where you might want to be...or estimate the implant volume which you could "aim" for - so that you can sort of look at the prize ahead of you. Most of us have found though, that it is better to continue with tissue expansion until you have reached a desired volume and appearance, and then compare these dimensions with the breast implant dimensions found on the links at the top of the Exchange City thread in the Breast Reconstruction forum.
FOR MORE INFORMATION RE: IMPLANTS VS. CUP SIZE, READ WHAT THE EXPERTS HAVE TO SAY:
http://www.realself.com/question/Breast-implants-size-full-b-cup
http://www.breastsurgeondallas.com/breast_augmentation_faq.html
-
Pam: Could you measure your ribcage circumference again and verify it is 33 inches. Are you pulling the tape nice and snug, wrapping it around the ribs under the TEs?
-
Whippetmom,
I am 32 inches when I pull it snug. Why did you ask? Does this make much diffence? Will the TEs I have, filled to 430ccs the amount I will reach on my next and probably last fill, provide enough of a pocket to accomadate the 450 ccs in a high profile implant Style 20 that you recomnmend. I understand that there is no predicting but it is difficult when I don't have any pictures to look at. I did purchase one reconstruction book that was recommended but did not find it to be very helpful.
Pam
-
Pam: I just want to make sure you exchange to an implant which is appropriate for the width of your ribcage. I just know the height to weight to ribcage averages and so I had you pegged between 30 and 32 and so there you go! So my recommendation would be 450 ccs in a Style 20, if Allergan, or a Mentor high profile round silicone implant. Allergan has a "style number" and Mentor does not.
Many of us have implants which have a larger volume than did our TEs. For instance, my TEs were 133MV-13 - 400 ccs - and my implants have a volume of 550 ccs. Plastic surgeons vary widely in their method of taking a patient from expanders to implants. Some feel they need to overfill. Some do not. Mine did not. I would personally feel that implants with a volume of 450 ccs would be most appropriate for you, in the high profile style, but your PS is the one to discuss this with, as he can see how your skin is responding to expansion. I would even venture to state that 475 ccs is a nice size as well, but I think we might be pushing it at 450 ccs for your PS and his expansion methods. If it is less than 425 ccs or 450 ccs, I would recommend the Style 15 - which is the midrange profile - as you at least will have sufficient width for your frame. I think that the 397 cc or the 416 cc volume implants would be the two sizes I would recommend for you in that style.
Deborah
-
Wow, this is really cool!! I have been so overwhelmed with my diagnosis, that I just told my ps to do whatever...I let him be in total charge, just didnt want to think any more, or research! I guess I should step in now and take the wheel somehow!! I was only a size a before and figured if I'm going to have to go through all this I may as well get a normal size now.....that is if I can handle any more pain of the expansions. I think I am up to 250cc's and the last filling got really painful...skipping the filling this week!
-
tsmc4 - I think it was at 250 mine starting getting extremely painful as well. I was only expanded to 290cc's. I took a couple of weeks off in there too. Couldn't handle it. Extreme pain all the way down my left side. Take the fills slow. My last two fills were only 25cc's a piece. Not a race here, it's OK to go slow. You're almost there!
-
tsmc4 - now I think about it .. I think I was actually expanded to 310cc's and was exchanged for 325 allergan style 20 silicone implants. my brain is a little slow here! Know you're not alone, take it slow, as slow as you need to. There was a four week break between my next to last and final fill.
whippetmom -
) Yes, St. Louis has a baseball team and I think she was lamenting over the BASEBALL team because they blew the final part of the season. They totally could have won the pennant, but fell apart. My understanding was that instead of rooting for the St. Louis Cardinals, she is going to start rooting for the St. Louis Rams. -
Oh, I am so confused now. I'm sorry about the Cardinals, but I think I had better stick with implant sizing and leave the sports world entirely alone.
tsmc4: Here is an extraction from the informational part of the thread above...
If you are interested in discussing implant sizes, make sure you compile and provide us with the following information:
Height, weight, ribcage measurement [measuring the circumference of your ribcage under your tissue expander(s) or under your bra line]. Also, if you have TEs [tissue expanders] - we need to know about them. The style - Mentor or Allergan most likely - and whether they are short height, moderate height, full height if Mentor and style number if Allergan. We also need the recommended fill volume of the TEs - the number of cc's. -
Sorry - didn't mean to cause such ruckus over a Baseball team.
I was referring to St. Louis Cardinals Baseball and the meltdown that they had. I have been in the St. Louis area for 6 years now, and before that was in the Chicago area - Chicago Bulls Basketball Michael Jordan Era, now that was fun, Chicago Bears Super Bowl shuffle, Chicago Cubs - will they ever win? So, when we moved, we were kinda of in limbo, then the Cardinals won in 2006 and boy was that fun. I also work right next to the baseball stadium so that kind of adds to the excitement.... Wait this is not a Sports Blog...sorry
whippetmom - could you pm me your email address. I think I found a way to take pictures. And the reason I said I feel huge is partly because of the bra I have been wearing. I don't know why I am wearing one, it's not like these things are going to move, but anyway, have been using the Wal-mart front close sports bra and the Sports tank. After the last fill, I had to go up to a 44 just to make it comfortable. I had been using the 42 for all previous fills will no problem. Oh, and side note, when I measured my ribcage I wasn't sure how tight to pull the tape measure, so 33 maybe on the big side as it wasn't pulled super tight. Thanks so much.
-
STL: Blog on honey!!! Yes, PM'ing you my email address right now....
-
I found out today my PS uses drains for exchange surgery. I'm sooooo disappointed. Sigh.
-
Hi all: I saw my new{hopefully} PS last week, and he suggested removing the TE I received from another PS who put in one way too big for me, and replacing it with a spectrum implant which would be used as a TE in my situation, and also doing a muscle sparing latismus at the same time. I just need coverage towards the bottom of the breast where the infection had been. Is anyone familiar with the spectrum implant or had one used as an expander? And what is the difference between the latismus and muscle sparing latismus? Hope all had a great time in Vegas...Thanks in advance for your response.
-
whippetmom
pictures just sent to address provided via pm.
thanks so much
-
This is for whippetmom: What do you think of the idea of a spectrum implant, and if so, what size would be good for my frame..26 inch ribcage..5''3" 102 lbs.There is a textured and a smooth..Which one would be best. It would be used as a temporary measure instead of a regular TE.What is your opinion? Thanks again for all your information.I presently have a Natrelle style #20 475cc in the other breast.
-
tory: You know drains are merely an inconvenience....a matter of days to endure them...you can DO this!!!
-
joie...
The Mentor Spectrum expandable is used for single stage reconstruction, but we have only seen several women come through the forums in the past two years whose doctors used this implant. In your case, I think it is a novel and perhaps even ideal approach to continuing your expansion without the need to have yet a third surgery for the exchange. A number of unilateral MX gals here have the Mentor Spectrum expandable used as augmentation for the native breast, as it enables the PS to be more exacting [the Spectrum can be expanded in very small increments] and thereby gain better symmetry with the opposing breast.
Deborah
-
joie...If you want to talk with women who have this implant, their photos are on the pictures forum....Nedeza and Sandysunshine...
-
joie: Oops....did not see your other post about the Spectrum. Well, I cannot tell you what size you will need...the Spectrum is "expandable", which means it will go in deflated and the PS will gradually add saline and "inflate" the implant until it matches the opposing native augmented breast. He will select the width of the Spectrum, based on the width of your native breast. So implant "sizing" is really not required in this case. Additionally, you will have the latissimus dorsi flap to add volume to that breast, and we do not know how much of that volume will be made up with flap and how much with implant. I think that this is the best possible solution for your reconstruction dilemma....
-
whippetmom - yes, I know drains are an inconvenience and I actually believe they do good, but I still hate them. This will be my third go-round and I had just hoped to avoid it. Oh well.
Since I'm here I'll update you instead of sending a PM. My PS & I decided that she'll take 600s and 650s into the OR & see what works best. She thought I could go up to 700, but I really don't think I want to. I have some time to decide - I won't be having surgery until after the first of the year. Money (new deductible year) wins out over comfort. She also allayed my fears about symmetry and the seemingly huge gap between my TEs, so I am looking forward to the exchange, despite the drains. :-}
-
tory: It all sounds good to me.....the implant sizes. I think you tell your PS to use the volume which looks best and fits best in the pockets. Looking forward to the day when we can see the final results!!
-
Thanks for all your help, Deborah!
-
whippetmom,
Just saw my ps and was 'armed' with info from you! Thank you. We decided he will bring 325's and 350's into the OR and see which one looks/works best. He knows I truly don't want to be any bigger (smaller if possible) than I am now. He had wanted to do a small fill but when I almost started to cry (ugh) he changed his mind. I was serious about the size thing! He's really a very sweet man. His scheduler will call me with a date and we'll go from there. I cannot wait!!!!! I did ask about fat grafting and he felt it wouldn't really help me at this point. He may 'tighten' up the skin when he gets in there. I'm feeling like I just need to trust him at this point. I just wish I could have my old breasts back. I really don't want any of this. sigh
-
Whippetmom; Dr.B plans to use the spectrum only as an expander and remove it after all the fills are done, and put the same implant in as I have on the other side.He would also at that time cut the muscle and bring most of it back to it's original position in the back, leaving just the tip of it on the breast, since I just need a small amount, so at that point, the size difference would be minimal.I am excited about his knowledge and expertise and I do have a surgery date of January 10th/2011,since that is the soonest he has open since it would have to be done in a hospital, and not at his surgical center.If my HMO does not approve him, I already have a plan in place to change to a PPO insurance after November 15th where I could go to him.Thanks for all your help and lightning fast responses.
-
LADIES.... I have posted the rest of my pictures on the picture forum...... I keep this part of my life PRIVATE.. and do NOT talk about it here.... but you can look at pictures there.... it is PRIVATE
Rads girls..... my thread is a good thread for you to look through.....I am in the WELL BURNT area......
-
I see you talking about different kinds of implants and profiles. You recommended 400-425ccs for me, which I'll stick in a baggie and look at later to see if it looks right. But if I'm 42 what "profile" should I be looking for. This is what I had written 2 pages ago:
"5'7", 118 lbs. I used to be a B before I nursed my 3 kids. Then went down to an AA. ribcage 30". I'd like to be a B again. The problem for me is due to a nerve problem in my back, I can't wear a bra, so they have to look natural without a bra, and not hurt my back. My PBM is scheduled for Nov 2 with immediate reconstruction, expanders, then probably silicone. My husband thinks I should go a little bigger than what I was originally because "someday your butt will get big and you'll want it to be balanced" but I'd be satisfied with what I had. Any advice?"
-
kjbrown: I am so sorry...I thought I responded to your post...but I was in Vegas on my Blackberry and so I suppose it did not go through....
Okay, so how about if I map out your entire tissue expander to implants scenario for you? I hope your PS is receptive...I think it will be worth taking to your PS or emailing to him next week - so that there is plenty of time to discuss this prior to your surgery on 11/2.
Tissue expanders:
Short height or low height in either Mentor or Allergan:
Here are the options:
Allergan: 133 SV - 250 ccs - 12.0 cm width
Allergan: 133 SX - 350 ccs - 12.0 cm width
Mentor Contour Low-Height = 250 ccs...11.7 cm width
I believe that the 250 cc TE would probably be best...either Mentor or Allergan. I just threw the 350 in there as an option....
Exchange to:
Allergan or Mentor:
High profile [Style 20 in Allergan - just high profile in Mentor] smooth round silicone implants with a volume of 375 ccs to 425 ccs.
There are a number of great articles supporting the value of using the low/short height TEs - which I can provide for you if necessary. I have discussed this many times over the past two years.
Are you on the pictures forum? I want you to go take a look at Val61's photos. She had the Mentor 250 cc low height TEs and her implants are 425 cc - high profile Mentor smooth silicone rounds. She has nearly identical statistics to yours. Go take a look...
Let me know if you have any other questions.
Deborah
-
Thank you so much. I see the plastic surgeon on 10/22. I'll bring all the info. with me. I'm still waiting for access to the picture forum. As soon as I get it, I'll look at Val61's photos. This is SO helpful!
Kathy
-
I still have not gained access to the pic forum and I am looking for some encouragment when it comes to the matter of delayed recon. I won't have my recon until after chemo and the photos I have seen haven't been the best work. I tried to email the picture guy but it wont let me put in a name in the recipient box. Any suggestions or anyone have successful, beautiful delayed construction photos that they would share with me. I am not interested in the flap procedures just the TE and then the implant. Thanks so much:)
-
KCmomx3: Thank GOODNESS we do not have a picture GUY! Holy moly!!!! I'll try sending you the link to PM Timtam, who is a female and a member here on BCO. Did you ever contact Estepp on Exchange City? She lives in your same town and state. Check your private messages...
Deborah
-
I guess I misunderstood:) Thanks so much.
-
Whippetmom
Question - 400 cc te's. You have seen my pics. Right side slightly smaller than the left. I made an appt for one more fill on 10/18. I don't want to go much bigger, but do want to try and even myself out. How much realistically do 400 cc's te's hold? I am at 405 cc's now.
Per previous notes, I think I will be aiming for the style 15 457 implants at exchange in Dec.
Thanks!
-
STL: Oh, I have observed that they can handle significant overfilling. I recall seeing some literature - Mentor or Allergan, with mfr recommendation or admonition regarding overfilling, but it would certainly be more than the range you are in currently. And the mfr warnings are probably for liability/warranty purposes. More importantly, the rule is to not expand more than the skin will safely permit, and so that infers to me that 10 ccs or 50 ccs or 100 ccs might be too much overfill in some cases...so it is up to the PS to ensure that the patient can handle the overfill. In your case, it does not sound like a concern. So even them up!
Deborah
-
Will do - thanks!!!
-
Whippetmom-
My PS uses textured implants instead of smooth. What's your take on this? Is it a big difference? He is going to use Allergan in 600cc or 650cc high profile. I'm not sure which style. I have my tissue expander pictures on the pic forum titled TE 60cc-exchange scheduled 10/12/10 if you wish to look.
-
It was recommended on this board I get about 450cc implants for my size to make me a large C. The PS ended up putting in 636cc's and it looks like I'm a large A cup, VERY small. I am very unhappy with the outcome. I started out a DD and wanted to go smaller but not THIS small. I'm happy the cancer is gone so I can't complain but am looking forward to revision surgery. I did not have TE's.
-
buyo - I posted on the picture forum and referred you to whippetmom. You're TE's are gorgeous. Never seen any that look as good as yours.
-
buyo: I cannot ever recommend textured round implants for breast reconstruction. They promote traction rippling and they do not feel natural to women who have had them. The few women who have had textured rounds have had them replaced with smooth silicone rounds.
-
Robyn: I recall that your PS was recommending he use the same size implants you had previously - 350 ccs, and I said they would be too small and that you needed 450 ccs or 475 ccs at the minimum. I am really perplexed about your sizing issues with 636 ccs. What type of implants did you get, with a volume of 636 ccs? There are no silicone implants with that volume...
Do you want to send me photos so that I can see what is going on?
Deborah
-
Robyn: I feel for you girl! I was DD also and now with TE's about a B cup. Because of radiation I may not be able to get filled to 700cc's (am at 550 cc's now) before my exchange surgery. I can't imagine being an A! I can understand you wanting to have another surgery to fix.
-
i was a D cup with TE and am definatly a D if not a DD now and my implants were smaller. I am still a little swollen. Is the difference more to do with body size etc? I am a tiny little woman..?? seems like eveyone feels they are smaller. I think mine are the same even though exchange was to smaller CC implant
-
I'm almost finished with expander fill-ups, one more and total will be 450cc's. I am 5'5" and 142 lbs. I measure 31" around ribs. The expanders are Mentor moderate height. My ps is trying to convince me to go larger. I would rather be smaller than larger...and will be furious if I wake up and my breasts are too large!
I suppose my best hope is to find a picture of the ideal size (regardless of what size my ps thinks I should be). How do I get access to the photo forum?
-
Cookie: You will need to post a bit more - newbies need to establish a presence on these forums and threads - before gaining entrance to the private pictures forum. You can go to the "members" link above, click and in the members box, type in the name Timtam. You can send her a private message requesting entrance and she will put your name on the list.
In response to your question about sizing...are you happy with the size you are currently with your TEs? Are they too big, too small or just right?
Deborah
-
whippetmom,
My PS also says he uses the textured silicone implants for reconstruction. I am wondering why some PS do that. Have you heard of this much? Your suggestion is not to have the textured correct?
-
Whippetmom: I had my mx 3 1/2 weeks ago. left side only - nipple sparing. It was after lumpectomy and re-excision so they had to follow that scar. My TE is Allergan 133 MV with a fill volume of 300cc. 150 cc was put in during the surgery. Now I am seeing your posts on short height rather then moderate and am concerned that I don't have the best size TE for me. I am 5 ft. 1, 110 pounds and my ribcage is 28.5. My first fill is on the 21st and he said he is planning on 100 CC. Then he thinks another 100cc will be all I need to equal the natural side. We discussed the possiblity of an enhancement of that side and he said that I can decide as we expand and see if the skin will be able to go larger. (natural side is a small
And my Dr. is in the "gummybear" study, so I am planning on those. I have 2 sets of photos so far, before the Mx and 2 weeks after. I was waiting till I had the first fill photos to post them on the picture forum. What are your thoughts about the TE size and in genearl about my size needs. thanks very much. -
HappyGirl: I actually have only heard of three cases where the textured round silicone implants were used in the past two years. One of the women was unhappy, but I don't recall if she did anything....but the other two I know for certain found new plastic surgeons and switched out their textureds for smooth rounds.
-
heebie_jeebie:
Don't worry about your TE....it is fine. I had the 133MV style also. It is just that I think that the low height/short height TEs are preferable.
If you are going with anatomical gummies, the pocket must be created specifically for that implant. Your TE dimensions: 12.0 cm wide by 11.0 cm tall by 5.2 cm projection. The anatomical closest to those dimensions: 410MF - 295 gms..12.0 cm wide by 11.1 cm tall by 4.8 cm projection. It all depends on how much your PS overfills, if he does, and how much larger you want to be if you augment the native breast. You will be able to visualize all of this a little better once you get to maximum fill [300 ccs] with your TE...
Deborah
-
FYI re: gummies and TEs.... it's my understanding that the PS has to overexpand for the gummy. Since it is not quite as squishy as regular silicone, and since it is anatomical in shape and therefore it MATTERS how it is placed (as opposed to a round which has no top or bottom), the surgeon needs more space to work with inside the pocket to properly place it -- so for example in my case my PS said she needed to expand me 100 - 150 cc's bigger than the final implant.
-
Hi Whippet Mom - Bless you for doing this. I have a BMX w/TE scheduled for 10/18. Preop w/PS tomorrow. I'm 5ft 115lbs 29.5in ribcage. I currently have 325 cc HP allergan implants. My PS said I was at about 550cc total now (complete guess) when we met before. I'd like to at least a cup size larger than now. I was thinking HP TE but after reading this forum, am questioning that. Recommendations would be greatly appreciated!
-
Dear Deborah,
My PS does like to overfill. I would like to have a final implant size of 550 cc. I believe the PS will want to overfill until at least 650 cc , if not more.
From what I understand, if it is overfilled it is easier for the PS to close up.
The rads side is holding up very well. I think I am loooky to have very "flexible " skin. Never had stretch marks during the pregancy etc.
I will post pictures so you can see.
Right now Timtam has given me access to the picture forum, but when I clicked on the link, I still cannot open it.
I think I will email Timtam again.
Thank you for your help.
Donna
-
Donna - by any chance did you try more than few times to get in and fail? I think there is a firewall issue where, if you do that, it bans you. The good news: Timtam can help.
If for example you type the password wrong or forget the password you made and retype a few times that's all it takes to get locked out.
So DO send a PM or email to Timtam and I am sure she will fix it for ya
-
heebie_jeebie: As Lilah mentioned above re: overfilling TEs for exchange to gummies...ask your PS how much he overfills...don't hesitate to tell him where you want to be size-wise and let him calculate what he needs to do to get you there...
-
willid21:
Okay, clarify something for me. You currently have 325 cc implants, having been cosmetically augmented previously, correct? But what does your PS mean when he saids you are "about 550 cc total now"? Does he mean he will need to use implants with a volume of 550 ccs to match what you have with the 325s?
Referable to the TEs: I think the short height/low height would be best, but you probably need to stick with a 12 cm wide TE...which means an Allergan 133 SX - 350 ccs...which would be the largest short height TE he could use. It would be better to keep the TE at 12 cm width and use a 13.0 cm wide implant - e.g., 500 ccs or 550 ccs...if that is what the PS meant by his comment. With these short height TEs, it is pretty easy to swap out for implants with an additional 200 ccs, because the lower pole has expanded so nicely. That is just my preference. But I would definitely recommend against a full height TE.
Deborah
-
Donna: Yes, overfilling does allow for more of a skin envelope for good closure, but it also is done for ptosis - or to achieve "droop". I just would not, in your case, want to overfill too much, because of your rads hx. So you might need to convince her to depart from her views on overfilling to the degree she likes, at the slightest sign of tissue intolerance. Try Timtam again, as Lilah suggested. If you need further help, let me know...
Deborah
-
Thanks Deborah, yes I am happy with my current TE size (450cc) except they ride very high on my chest and wide under my arm and it does seem peculiar. I can only assume that when the implants are inserted they will be in a more natural position. If I like my current size, will that mean the I will get the 450cc implants?
p.s. I found another site, realself.com which has before and after photos...I will also send Timtam a message.
-
You ARE the breast whisperer! Yes, you understood what I was trying to communicate. My augment was just 10 months ago. The implant pushed my breast tissue out and in my opinion helped me discover the lump during a self breast exam. Also, yes, the 550 was to get me where I am now. I'm wide enough but don't fill out the front of the cup of a bra or the lower poles well. I was hoping for more projection without looking like torpedos
I was considering 100cc more to be total volume of 650. Is that possible with the Allergan 133SX - 350 TE? This is so encouraging and Thank You for your help. A PS, that I decided against, said not to expect great results but it would be better than not having any reconstruction. It made me so happy to hear of all the women who are not only pleased with their results but want to go and tan their new beauties You go girls! -
Cookie: Welllllll....typically it takes at least 50 ccs, but more often 100 ccs additional volume with implants, to match what you have with your TEs. If you like the look at 450 ccs, I would at least swap them out for silicone round 500s or 550s. Going to realself.com to find photos is useless. Those gals have breast tissue in addition to implants.. The size of implants THEY have will never translate for us. We need more volume than they do, to achieve the same result. You need to get on our pictures forum.
-
willlid21:
I feel that the SX with 350 ccs and perhaps a little overfill, could easily take you to 550 ccs. I think 650 ccs is pushing it, but I personally think 650 ccs would be pretty large for your frame. I am 5'4" 125 pounds, 30.5 inch ribcage and my implants are 550 ccs. I am a 34 DD. You would probably be a 32E or 32F with 350 ccs....
-
Thanks Deborah, I'm starting to understand. I will get access to the photo forum.
-
Thank you for sharing your knowledge Deborah. I know I don't want to be that large. I'm a 32d now and have a tough time finding bras. I'm much more at peace knowing this and seeing that my surgery is less than a week away, I'm especially thankful. Blessings to you.
-
mom38: Go to the Bras 101 thread....we know where you can find 32D bras in abundance! But a 32D after breast reconstruction is entirely different than a 32D with a natural or augmented breast. The recon breast will look smaller. There is no spillage over the cup - the reconstructed breast will fill up the cup because of the width of the mound, but there will be diminished projection. The recon breast will never project like a natural or augmented breast. So it does take more volume than we think, to create the look we want to achieve. I am a DD cup, but I look the same in clothing as I did in my pre MX "C" cup bras. Keep us posted and report back after your surgery. Praying all goes well for you!
Deborah
-
Hiya - I'm new to this forum. Just started my fills after BMX on 16 September. What is the 'photo forum' - I'd be interested to have a look. Do I just find it by searching on the forum 'search engine'?
Thanks, Jen
-
Whippetmom- I read your comment to me on the pic forum about lateral support. What type of bra do you recommmend for this? My dr has me wearing the surgical for 24/7 for 2 weeks. He said no underwires. I was confused because a lot of Drs do recommend underwires. What do you think?
-
Jen: Go to the Members List link in the upper right hand corner of this webpage - under your screen name, and look for Timtam. Send a private message to Timtam, with a little blurb about yourself, and she will let you into the forum. You have been posting here long enough. The pictures forum is a separate, private forum...which requires a passcode for entrance.
sweetie: As long as your surgical bra pushes the implants together, you are getting sufficient lateral support for the time being. If it is not doing that - and if it is only compressing and flattening them, just go to Kohls or a sporting goods store and find a Champion sports bra. You might need to try on several, but I am finding that this sports bra gives sufficient lateral support for the first stage bra after the exchange. You want it to push your implants inward - medially, keeping the implants out of your armpits. Go to the Bras 101 thread and look at Val's list and see if she has listed bras with lateral support.
Deborah
Edited to state: I posted some bras which would work for you on Val's Bras 101 thread...
-
-
Sweetie -- my PS said no underwires (not forever but for months, anyway, as I am still underwire free after 5 months). She said the reasons were twofold: (1) if a wire pokes through you might not feel it until it's too late and (2) concern for the wires rubbing against sutures that are under the skin. I get great support from the various wire free bras I've found.
-
Deborah-I get a lot of lateral support from the surgical bra. I don't mind wearing it but it squishes me in and it's not very attractive looking. I'm going to look for that bra you suggested.
Lilah-That makes sense. I have been looking through the Bra thread and getting ideas. Right now I don't know when to start buying since it's only a week out. I think I'll wait at least one more week before I try anything. I'm going to start at a local store and just try things on based on the guidelines posted on the bra thread. We'll see were that takes me. Right now I'm feeling like I'll be lucky to fit into a B cup.
-
sweetie: Post photos in a week and let's see how things are settling. I agree to not spend a lot of money on a bra or sports bra for at least a few weeks. But one with good lateral support [try Kohls for Champion bras] which do not compress or flatten, would be a worthy purchase at this point.
-
I don't know Sweetie - I think you will be surprised! Go to Nordstrom's when you DO go... and definitely wait another week at least!
-
Yep...I agree with Lilah Sweetie! You will be surprised...
-
Recovery: I would be very judicious and careful about using emollients after MX, simply because you do not want to run the risk of having some adverse reaction to a topically applied product. The gals who have had rads do have some methods they have used to keep the skin pliable and soft and you might want to ask this question on Exchange City - I know Laura [Estepp] will have some suggestions. Keeping the skin healthy and clean and free of bacteria and injury is important during the expansion process. Some products others have used that I am aware of: Palmer's Cocoa Butter lotion and Bio-Oil - both drugstore finds. I personally did not use any creams or lotions, because my skin is pretty thin and seemed to stretch very easily, and my PS felt that the use of creams or lotions might soften my skin, and make it more pliable and thereby stretch even further during the expansion process, perhaps causing too much droop or ptosis at the time of exchange. That was her premise and I just adhered to her suggestions.
But ask around, because I know a lot of gals did use certain products and were pleased with the results.
Deborah
-
Whippetmom,
Thank you for your reply.
I would like to ask your advice again. I am worried since today my PS said " You have such nice projection now with the TEs, but the final implants will be wider and with less projection". My PS is so unaapproacheble, I was afraid to ask what she meant.
A little background. My stats are 5' 5", 147 lbs, 32" rib circumference.
I have in Mentor Siltex model 6200 expanders, medium height countur profile, model 354-6213.
They have projection 7 cm, height 10.8 cm and width 12.7 cm.
Now I am filled to 640 cc bilaterally and it looks very good. I would like to achieve a similar look with the final implants.
What do you think of the statement of my PS and what do you recommend?
I do not know how to upload pictures, I guess they would help.
All day I was thinking that I am so fortunate to have you to ask these questions.
Thank you,
Donna
-
Whippetmom,
Forgot to mention, I had rads on the right side.
-
Donna: The projection of the TEs cannot be replicated with breast implants. The exaggerated projection of the TEs serves a dual purpose, which is to stretch that portion of the breast sufflciently for skin closure and for droop, aka "ptosis." The closest you could come would be the Allergan Natrelle Style 45 smooth silicone round implant which is an ultra full projection style implant. You would need at least 600 ccs and the dimensions would be 12.7 cm width by 6.1 cm projection. I am thinking you are going to want at least 600 ccs - even in a high profile implant - which would take you to around 14.0 cm width and 5.6 or 5.7 cm projection...depending on whether you go with Mentor or Allergan. If you go with Style 45 - it must be Allergan as Mentor's ultra full projection style implant is not available here in the US.
There is a caveat to using the Style 45 and it is that you will need a nice healthy sternal notch to imaginary nipple distance to carry it off, as it is a taller implant and sits higher on the chest wall, in addition to having more projection. I would ask you to email me photos...PM me if you would like my email address.
Glad to help Donna!!
Deborah
-
Donna: To clarify: I think you are probably going to be happier with 600 ccs volume - to approximate what you have now with your TEs.
-
Deborah,
Within 2 weeks or so, I will take pictures and e mail mail them to you.
I am not sure what you meant by "PM me". How could I do that?
-
Donna: If you want to send a private message to someone, click on their screen name and a new window pops up with their profile and a link in the upper right hand corner which allows you to "send a private message"....
Deborah
-
Deborah: It has been almost 8 weeks since my exchange and I now notice my MX side is slightly smaller and higher. If you recall, my PS used a HP Round on my MX side Natrelle 20-550 Silicone and on the Right Augmented side Natrelle 15-397. Should I be waiting another month for the full drop and fluff? Thanks in advance!!
-
MBJ: As a conservative, implant displacement exercise, you can use the palm of your hand to compress the upper pole of the breast to push the implant downward on the MX side....whenever you think about doing so. I would give it a full three months post-exchange to evaluate if any tweaking needs to be done. As you know, gaining exact symmetry in unilateral reconstruction is a difficult thing to do. In our former lives before bc, many of us had assymetrical breasts. I did, as my right breast was significantly smaller than the left. I always had to wear padded bras, to hide the discrepancy. So we have to accept some minute discrepancies in size after reconstruction.
At this stage after the exchange, it is typical to have a critical eye and begin analyzing every little defect and change. I don't know how I would have held down a full time job, for as many times as I was going into the bedroom to look at my breasts in the first few months after the exchange. The good news is that there will come a time when you will realize, with some element of glee, that you have allowed twelve hours to elapse without examining your breasts.
In photos - at least the ones you have posted thus far - everything looks about perfect to me. You would not believe how many women PM me, telling me they would be thrilled with your results!
Deborah
-
LOL Deborah re: "some element of glee" -- I totally relate!
MBJ I think your results look amazing on the site... unless your MX side has changed I can't even see the different you're talking about!
-
Donna: Keeping that rads tissue in mind, let's not push the envelope. If your PS can safely use a 600 cc implant, great. If she feels she would need to continue to expand your TEs in order to use a 600 cc implant, then stick with 550 ccs. I personally do not think you should expand any further. But you could mention the Style 45's to her and write down the dimensions of the TEs vs. the dimensions of the implants.
Deborah
-
I only look at MINE more frequently in the past two weeks, because I am so happy with the tattooing by FACECRAFTER! I'm posting photos as soon as I find my doomafloppy - the USB cord - or whatever it is called.
-
Nancy: Thanks for the heads up. I did look at the cream she is touting and I would not advise the use of this product at all, especially referable to its intended us on irradiated skin.
Ingredients:
Water, Mineral Oil, Glycerin, Glyceryl Monostearate, Polowax, Silicone Oil, Lanolin, Bronopol, Propylparaben, Methylparaben, Fragrance, FD&C No. 1 Blue, Aqua Ammonia, Carbopol, Salicylic acid.
Not a product I would ever use, especially on irradiated skin. Some of these ingredients most of us steer clear of anyway...e.g...ammonia, parabens. But to add perfume, salicylic acid and other potential acid products does not appeal to me at all.
[Contraindications for the use of salicylic acid, or who should not use this product: Peripheral Vascular Disease, Skin Infection, Skin Inflammation, Small Skin Blister, Skin Irritation, Diabetes.]
Just my two cents...
-
Deborah: LOL! I am constantly feeling myself up so it's no trouble at all to push that side down as often as possible! I had no idea that you had the same issue that I had prior to recon. I always had to wear padded bras as I was completely two different sizes before. I think that it's now more visible since my augmented side dropped & fluffed. Also, will my MX side ever hang down like a real breast? When I bend over is when it's most obviously smaller, oh and in bras: A bit of a wrinkle in the cup area though this could be lack of a nipple. I was just concerned that it would be even smaller if they make the nipple from the breast the oragami way (does anyone know what this is really called???). I will post my new pictures today so you can see if it's obvious or not. I only look at them a 100 x or more a day LOL!
-
To MBJ and all memebers of this forum:
So glad to hear that others are loooking at their breasts all the time. This is why this forum is so special. Nowhere else could we get this support.
I am going now through the expansion process, and also go check on "them" often. The radiated side is quite painful for about 2 days post inflation.
How does anyone deal with the fear of recurrence? My diagnosis was less than one year ago, December 2009, and I have days when I cannot help but think that the cancer might come back.
Sometimes I look at the threads on mets and pray that I will never post there.
I know this might not be related to the exchange, but I felt sharing it.
Donna
-
Trytostaypositive. I imagine if you were DCIS and had no nodes and Stage 0 that recurrence wouldn't be an issue as you would have a very good prognosis. I was told I have a very good prognosis due to clear margins, no nodes and being stage 2. But I do have those days when it just gets the better of me.
-
i love the term "inflation"
I try to stay on the threads that have to do with my diagnosis and choices for treatments
i do go to a counselor to help with my "obsessive thinking" - damn they have a name for everything- how can you help but obsess about cancer - and anyway - when it gets the best of me, i fill my tub and cry. I sure do feel better when I get out.
-
Whippetmom, does an alloderm sling with the TE's replace need for a lattisimus flap in irradiated tissue? Am kind of confused on this issue.
-
Donna: DCIS is not invasive breast cancer. From the Mayo Clinic:
"Surgery for DCIS typically doesn't involve removal of lymph nodes from under your arm because it's a noninvasive cancer. The chance of finding cancer in the lymph nodes is extremely small."
This is an interesting article - two years ago - which supports that women who have been diagnosed with DCIS "overestimate" their risk for recurrence of breast cancer. Why this is...I don't know. According to this article, you have a 1% risk of systemic recurrence and a 1% change of local recurrence. This is pretty darn low. But look at the women's perceptions of their risk. I would say they grossly overestimate their risk!.
http://www.medpagetoday.com/HematologyOncology/BreastCancer/8334
I know that there are some gals on the DCIS forum who could reassure you as well....
Deborah
-
Fearless_One: The Alloderm graft as a sling, will support the weight of the tissue expander [and ultimately the implant - especially if there is muscle deficit], provide implant coverage in the lower pole [the pectorals only cover the top two thirds of the implant], and it can assist in allowing better skin coverage of the tissue expander and/or implant. A latissimus dorsi flap can also address either tissue coverage or muscle deficits, but there are reasons for selecting an autologous procedure vs. an implant-based with Alloderm. The chief reason for opting for a lat flap appears to be that the patient has had radiation and a better cosmetic result can be achieved with an autologous procedure over TE-implant based reconstruction. The risk of capsular contracture is not an issue - provided an implant is not used in conjunction with the lat flap. The risk of capsular contracture is elevated in implant-based recon after irradiation. There are other reasons....I believe that a lat flap can render a more natural appearing breast mound - with greater allowance for projection - and a perfectly natural feel. The body habitus is also a key issue. A woman who is plus-size and has adipose tissue overlying the chest wall, could achieve a better result with an autologous procedure. Someone with this body type can have a tendency to sort of swallow up breast implants - and there is not always a size selection sufficient to provide the desirable volume, projection or just presence on the chest wall. Therefore, a lat flap PLUS implant could make all of the difference for some women. Also, there is the issue of the longevity of the procedure. Alloderm - far less time than a flap procedure. So there are many issues to discuss if you are wavering between the two procedures. Some of you are reading this and thinking, TMI, TMI!!! Oh....I could wax on all day about this stuff! . I honestly know very little about the lat flap procedure - the actual technique or mechanics of same - and there are many others on other forums and threads who could put me to shame talking about autologous procedures. I know enough just to be dangerous.
Deborah
-
Claire: AMEN girlfriend!!!!
-
Donna -- I deliberately do not read the forums for cancers more advanced than mine -- especially not the Stage IV forums -- because I know I would be tempted to indulge in obsessive fear and worry about recurrence. As it is, when recurrence happens to people on the forums I DO read my heart goes out to them AND I find I am more somber and worried for myself for a time after; at these times I recheck with my doctors to make sure I am doing all that I can. It reassures me. There is really nothing else we can do (other than the treatment we have already undertaken).
In your case, as Deborah pointed out, your chance of recurrence is so very low that if I were you I'd take solace from that! Furthermore, it sounds like you've had a BMX which is aggressive treatment for DCIS and you can feel reassured by that as well.
That said, if it helps, I know how you feel
Other than the above, I try to keep focused on living and enjoying life (healthfully of course) and most days I do not dwell on fear. -
I guess I'm still confused about sizing of implant and bra size vs. what it really looks like in closes, when refering to implants. Are you saying if I want to look like a full B, that with implants I'll have a bigger "bra" but the same "look"?
-
kjbrown92: Yes, that's correct. My bra size is a 34DD but I look like a full C cup.
-
kjbrow92 - My bra size is a 30DD or a 32D and I feel like I look like only a full B cup.
-
So is that because of the "projection" I'm hearing about? I'm so used to seeing nothing when I look down, that I feel like anything is going to feel huge. But if I get what I think is a B, but end up in a D bra, well... I can't since I can't wear a bra (back spasms) so I really worry that it will hurt my back or that it will look strange on me. I'm just confused. I'm going to see the plastic surgeon on Friday, and my surgery is set for Nov. 2 and I'm worrying about everything, I guess.
-
kjbrown92 - whippetmom is the guru. Implants are generally WIDER than our natural breasts, you will not get the projection from implants in a reconstructed breast that you would have in an augumented breast that has breast tissue behind it, thus projecting it further out. A lot of it depends too on your skeletal system. Do you have TE's in right now? Your implants will not have the projection that your TE's do because they are rock hard, immovable and the implants are soft.
-
Right now I just have me (32AA). PBM with TE is Nov. 2. I'll just go with Whippetmom's recommendations when I go to the plastic surgeon, even if I don't understand it.
-
Whippetmom..
I read where you mentioned that an implant would need to be 50 or 100cc bigger then your TE to achieve the same size....My PS used the mentor expandable implants as TE's (because I thought I might want to not have an exchange)
Will my 500cc look a lot smaller then the overfill of 600 I have now? Thanks!
I'm REALLY getting exciting about the exchange!
-
kjbrown: Did you get into the pictures forum yet? I wanted you to see some photos. Also, talk to your PS about the style of TE he intends to use. A number of surgeons are beginning to use the newer Mentor CPX3 tissue expanders - which have suturing tabs to keep the TEs from migrating during expansion. This would be a good choice for you and I would recommend the low height style first [in 250 ccs volume] and then the moderate height style. But talk over all of these issues with your PS. If you want to be on the smaller side, you could go with 375 ccs - high profile implants. Don't worry about bra size, because it does not equate to implant volume. You want implants which will not be too heavy [since you will not be wearing a bra] and will look nice and proportionate for your frame.
Deborah
-
Everett: That depends. Which volume of Spectrum do you have? One of the last two I presume, but let's nail it down so that we can get the correct dimensions.
http://www.justbreastimplants.com/breast_implants/mentor_1400.htm
-
I have Mentor Siltex contour profile 354-2513...rads side is 600cc..other was up to 550..
-
kjbrown: I have 550 ccs and they don't feel heavy at all. I have horrible back problems but not from my foobs. You are in good hands with Whippetmom!
-
Everett: Thanks for reminding me of your style #! Okay, so your width now is 12.7 cm. The projection is possibly 7.5 cm or more. I honestly do not know what happens to the Spectrum when it is overfilled beyond the recommended maximum fill on the chart - the max fill for your style is 540 ccs. I do not know if it continues to diminish in width and gain in height and projection. The TEs do not gain in width.
But you are not going to find a silicone round implant to match the projection you now have. The closest you could come would be with an Allergan Natrelle Style 45, in 600 ccs. The dimensions would be 12.8 cm width by 6.1 cm projection. I personally think that you would be happier with around 550 ccs or 600 ccs anyway, if you are happy with the size you are now with the Spectrums. But with your ribcage circumference, I would recommend staying in the 13.0 to 13.6 cm range. So a high profile implant with 550 ccs would be preferable to 500 ccs - if Mentor - dimensions would be 13.6 cm width by 5.5 cm projection.
Have you been to the pictures forum?
Deborah
-
Thanks Deborah! I love the picture forum! I actually think my side filled to 600 is a to big, so I'm thinking that the 500 or 550 should be perfect. I also, really want the round high profile.
I have pictures in the forum under "guster"
-
Everett: Eeek...why didn't you TELL me???? I just went and looked at your photo. Absolutely not the Style 45's! They would be too tall for you and completely wrong. Yes to high profile smooth round silicone implants - 500 ccs to 550 ccs. Sounds good to me! You are looking very good right now, by the way!!
Deborah
-
Hello all. I am new to this forum. So I'm not too sure of the protocol. Still learning how to tag my information. But I thought I would pop in for my first post.
I underwent a BM on July 31st, with immediate reconstruction. I have TE's placed and go go for my last fill on Thursday October 21st. I believe I will be expanded to just over 600 CC's. Following my BM I went home at 250CC (more than I expected) and the healing has gone relatively well. I feel for the women after reading some of the stories, and my heart goes out to them. I just have absolutely no idea of what to expect. It feels like I'm watching a movie, and haven't read the book, and the only thing I know is that my life will change.
But on Thursday, I will have the required information for you regarding my TE type and size. I am also curious about the lack of projection that the implants offer as opposed to the TE's. I am very small-framed, (4'11" and 103lbs) and would like to get as close as possible to my original sizing. Which was a 32D. My ribcage measures 29 inches. But seeing as I had a fairly un-remarkable healing process, I have found the need to become very focused on the possible outcome, as to give my mind something to do besides worry. As of now, I am most excited about feeling more feminine with softer boobs. The hardness is really getting to me. I miss the femininity of cleavage, and having my breasts in the same zip code as each other, and not in Left Armpitville and Right Armpitville. They miss each other. But most of all I wanted to just finally work up the courage to introduce myself, as it seems like this is a friendly welcoming environment.
-
I did look at the picture forum, but when the person that was my frame ended up an "E" I was terrified. But it's hard to tell what people look like in clothes, and my frame of reference is probably skewed, with my shrunken and dented boobs. I'll have to look around more on the picture forum and see what/who else is on there. Thanks!!
-
MSNOMORELUMPS - Welcome! I love it, "I miss ... having my breasts in the same zip code and not in Left Armpitville and Right Armpitville." LOL! Oh, how can we relate!
You are going to love your softies ... they're a coming! It's great that you've had an uneventfull fill process. You're in good hands with whippetmom. Do you have an exchange date yet? Again, welcome to the boards and thanks for a much needed laugh this morning! -
Thanks Deborah! I have had a pretty uneventful time expanding, even with rads.
I've been thinking about posting a picture now that I have one side leaking. The overfilled side is high and full and HARD. The leaking side is contour shape and soft. The PS fills me up whenever I ask, but it only lasts a day or too. Sometimes you just have to laugh!
-
MSNOMORELUMPS: Welcome to the board and you will find amazing support here. Don't be afraid of bra sizes since implants fit so differently in a bra then real breasts! Just be sure your PS knows where you want to get to and you should know it when the TE's (which won't fit into a bra) are at their maximum extension. Whippetmom is a goddess and she will get you out of your armpits and back into a squishee bra!
-
Everette: I had no idea your TE was leaking! Is it on your rads side?
-
MBJ: The leak is on my non-rads side. I had been fully expanded since April, so the skin is fine. I just look a little lopsided!
Everything was fine, then one day after lifting my son I noticed my size going down. Thankfully, it's only gone down about a 1/3.
-
kjbrown: Do-not-go-by-bra-size! An "E" cup in breast recon does NOT look like an "E" cup. I am sticking with my recommendations for you!!!
Everett: I would really like for you to get those TEs out and into implants as soon as possible. I am concerned there might be capsular contracture on the rads side. When is your exchange?
-
MSNOMORELUMPS:
Welcome....and I am glad you found us! I do not think it will take much to give you the volume you desire. Once I have your TE info, we can refine the numbers further, but I believe implants with a range from 300 ccs to 350 ccs in a high profile, smooth round silicone style, would be nice on your petite frame. Why don't you also join the discussions on Exchange City, and once you have an exchange date, it will be posted on that thread.
You will also want to send a private message to Timtam, so that you can gain entrance to our private pictures forum, where many of us have our reconstruction photos. You will need to post a bit more and make your presence known on the forums, which is the criteria for gaining entrance to the pic forum.
Deborah
-
Can I ask a stupid question - when you measure your ribcage, it's right under the breasts right? Do you do it on an inhale or exhale, because there can be a difference of an inch. On exhale I'm 28". And fully expanded it's 29" (5'7", 119 lbs). Before I said 30" (I think I did it over my shirts at the time - oops). I'm really worried about this, if you can't tell. Probably by focusing on size, it's taking my mind off the fact of the anesthesia, pain, etc. that I know I'm going to be getting into in 2 weeks. I just want to go in armed with as much info as possible to the PS on Friday. I'm getting my brain around 400cc at the moment. High profile.
-
HI and thank you soooo much for taking time and to share your knowledge!!! We appreciate YOU!
I am very different than all of the others who have posted here and I will speak more with my PS, but really want your input before I do speak further with my PS.
I had a BMX and a muscle sparing TRAM flap reconstruction on 9/14/10. Before the surgery, I had asked the PS if I had enough fat from the belly to become a large D. The PS said probably so. (Of course now from your post, I realize that in my mind a large D is a large D bra-size cup and the PS was thinking a surgical large D. Sigh..... who knew... So, in my mind I am not a large D and a little disappointed.
I really wasn't prepared to ask my PS about making my b@@b's larger, but she popped in one day on one of my weekly visits and I asked. The answer was sure, we can do that. I asked will you be using Tissue Expanders? The answer was no, silicone.... 1 size up from where you are now. It would be inserted between the muscle and the new belly fat/skin. At that time, I was a little stunned and decided to come back to the PS with more questions later. I was also a little surprised that the PS didn't ask "what size would you like to be"? Another fact (maybe the PS forgot) is that my right boob was radiated 12 years ago and I wasn't sure how my skin would stretch - but maybe one size it isn't an issue(??) Or, maybe she did remember and 1 size is all she feels comfortable with re: radiated boob. The Tram flap on the radiated boob at first was a bit tighter and different than my regular boob, but is softening up quite a bit. I will definitely ask her, but it sure would be appreciated if you could shed any light on this as I am a newbie on TE's and implants.....
My question: Why wouldn't she use Tissue Expanders even for one size larger than I am now, especially since one side was radiated and is definitely not as stretchable as the other one? Any other information would be great re: tram flap and implants.
Thank you so much!!!
Warm wishes and hugs,
Deb
P.S. Maybe I should be happy with the size the tram recon gave me...... just expected a larger size.
-
Deb: Sorry you are dissappointed with your procedure. I am sure someone will come in and help you with this. I know that when I thought I had to have radiation and a lat dorsi flap, my former PS said that I wouldn't need expanders, either. Just a silicone implant. BTW: I didn't know that there were two different ways of measuring a D cup--I thought that it either fits a bra cup that size or it doesn't! Never heard of that before.
-
Deb: I think we need to come to some agreement regarding how much implant volume you will need to get you to the place you want to be. You are probably going to need to send me photos [unless you have them on the pictures forum or can put them there.] I need to see how much volume - how much of a mound has been provided by the flaps. I'll PM you my contact info.
Deborah
-
Whippetmon: My exchange is 12/6 and i'm very excited! My PS wanted to do it soon, but also wanted to wait the 6 months because of the rads.
I'm hoping I dont have any contraction, my rads side is still moving freely. Anything else I can do?
-
Everett: Talk to Laura [Estepp] over on Exchange City or PM her and ask her what she would recommend for the rads side. Congrats on the exchange date! What a nice Christmas present! Keep me posted on how you are doing!
-
Deb -- so you already had the Tram flap so that means they moved the belly muscle up to your chest and formed breasts for you, right? So it sounds like your PS is going to put an implant between your pectoral and your Tram flap... so maybe the reason you don't need a TE is the same reason augmentation doesn't --- he is not going to put the implant under your pectoral muscle but on top of it... and the TE is made to stretch the pectoral muscle. He must have some reason to think he can insert an implant between Tram flap and pectoral and achieve a larger size. It may also be that he didn't ask because how much bigger will depend on what fits? It does sound unusual. I'm sure Whippetmom can help you but I suspect you also need to ask your PS more questions.
-
MBJ: Thanks for your response. You say "former" PS. What made you change PS?
Sorry for the confusion on my statement of what sizes really are. Whippetmom said in her post above to kjbrown: Do-not-go-by-bra-size! An "E" cup in breast recon does NOT look like an "E" cup.
-
Lilah: Yes, she only takes a very small portion of the belly muscle to get a good blood supply with the fax, plus the skin.
Oh gosh, I didn't realize but certainly makes sense that the TE is to expand the pectoral muscle. Duh.... Thanks for explaining!
-
Whippetmom: Thanks. I will send you a PM....
-
DebinATL: I actually changed my BS because I so disliked him and left his office hysterically crying every time I went. I changed all of my surgical team and the hospital because I wasn't given any choices there and the one choice they gave me was extreme for my situation. I ended up with a better team of dr's and less invasive surgery.
-
MBJ - I did not know that... and you ended up with such a GREAT team indeed!
DebinATL -- you're welcome!
-
Lilah: Good thing I am outspoken and stubborn or I wouldn't even be here this far along. They wanted to remove my breast, radiate me (even though this was unnecessary--they never checked my lymph nodes!!) and make me wait a year for reconstruction. So glad I got two more opinions and so glad that I found all of you here!
-
Wow MBJ -- thank goodness YOU had the good sense to get another opinion!
-
Lilah, it just goes to show you that we are our own best advocates and we have to listen to our guts and mine was screaming NO WAY! That first BS told me that I WOULD DIE if I didn't listen to him and do what he told me. Most insensitive dr I have ever encountered. My PS told me other women had come to him experiencing the same thing. He just gives all women radiation no matter what their diagnosis!!! He should be strung up and shot! I shudder to think at all of the damage he could have done to me.
-
That is almost criminal. Did you file a complaint with your insurance company (which, I assume, is how you got to that awful doctor in the first place?) They should know he is not a good doctor.
-
Lilah: I had MediCal so therefore limited resources and choices. I do want to eventually write a letter to City of Hope regarding this dr. but I think he already left.
-
Dawn-Hope: Ok sorry I haven't responded. I checked yesterday and almost shed a tear because no one responded to my first post.....ok, ok, I can admit, I went looking in the wrong forum, that's why I didn't see it. LOLI pouted for nothing! Hahaha!
But thank you for the welcome!!! I go tomorrow, for my last fill, and I'm guessing she will then give me my exchange date. Or maybe I should say, I'm not leaving without an exchange date, the unknown kills me. But the thing that surprised me, is that I actually miss wearing a bra. I have always had to wear one since the age of 9, and that was, or so I thought, that was the biggest sigh of relief I thought I would get from all of this. Not having to wear a bra 24/7. But now these kidney bean shaped things on my chest, are rebelling against any sort of bra. (not to mention I now walk like a bulldog or a body builder) On occasion, I can manuever into a sports bra, but other than that, I miss pretty bras...go figure.
-
MBJ-Thank you as well for the welcome. Yes, I cannot wait for the squishys. I can't wait to stop feeling like I'm wearing a breast plate and ready to go into battle with whoever is willing...I do have to admit, I feel a little invincible, like I could take a bullet in these things, if need be.
-
Thank you as well for the welcome, Whippetmom.
Yes from my infrequent browsing, Yes, I am interested in seeing some of the photos. And I have also taken note that access must be allowed. So I'm trying to work out my kinks, before I request access.
Lol I have checked out the Exchange city, actually by accident, and you're right, I think I will also start posting over there as well. With my personality, I had a hard time reaching out, and took on the task of supporting everyone else through MY process, and luckily, they (my friends and family) needed it more than I did, and things turned out ok. I will have to admit, I am dealing with a little bit of what they call survivors guilt. I've known people who have had a rough time with this, and I feel guilty, like I didn't get the full experience. I'm working on that, it's an odd feeling.
But my PS seems to feel that roughly around 600 is where I was previously, (and we're going with the smooth round silicone just like you stated) and that's about where I am now, plus one more fill tomorrow. My goal was to get as close to my previous size as much as possible. As I kept this private from most people, and I have a hard time with people fussing over me. I'm usually the caretaker, I'm usually the one out partying and have a good time. I like attention....but only when I call for it. (LOL) and so for me, trying to put this behind me, and find a "new normal" was my goal. So although not many people know about it, I felt for me, it would make the transition easier.
-
MSNOMORELUMPS - The implants are nothing what you're experiencing with the TE's. I absolutely could not stand anything on them, it hurt to touch them, sometimes my clothes hurt them just laying on them. At most I wore a cami with a shelf bra. You'll find that after you get your implants you will NEED a bra. Don't give up on those pretty bras! Some PS's, and they are all over the place on this issue, require that you wear an underwire right away, mine said no underwire for three months. But, bottom line, you will have a NEED for those pretty bras!
There is a thread called "Bras 101 the great post-exchange debate" that will tell you everything you need to know about bras!
http://community.breastcancer.org/forum/44/topic/753120?page=32#idx_956
-
What IS MediCal MBJ? Is it something unique to California?
-
MSNOMORELUMPS: That is pretty funny....you READ the wrong thread and I sometimes POST on the wrong thread....
I did not wear a bra with my TEs either....well...I did find [the last month in TEs] a Warner's bra which fit but it was very uncomfortable. However, I wish I had worn something - a sports bra perhaps - to hold up the weight of my TEs..because mine dropped quite a bit and this left my resulting implant placement a little lower than I would have liked.
-
MBJ: I'm so glad you didn't stay with the first bunch and ended up with people who you can actually communicate with, as well as, not having unnecessary surgery AND they didn't even check your lymph nodes!! What the #%^&*? Stick with your intuition.... it will guide you!
Lilah: Ditto!
-
Dawn-Hope. Well that's good news. Yippe! Now I just need to start setting money aside for the bras. Thank you, it's just so hard to know what to expect. -
MBJ- I have Medi-Cal now, and I had a different experience. My BS as well as my PS advised me because of the lawsuits, they are very accommodating. They will not put up a fight as far as symmetry, or preventative care. I had cancer in one breast, but opted to have both removed. I have found this to be the case so far. Keeping my fingers crossed, I'm not symmetrical with these expanders, but PS said it's an easy fix with the implants.....uh huh we'll see....because now that I put it in writing, I might have jinxed myself. I hope everything has worked out thus far for you.
-
Whippetmom- I was hoping my TE's drop. But noooooo they are perfectly happy sitting right next to my shoulders.....the nosey buggers, Always getting in the way trying to see what's going on in the world.
-
One more question, to any who can answer. I have inverted nipples. Actually they are just flat. They rarely ever come out to play. Does anyone know if this will change when I have my implants put in? I've heard about using alloderm for projection, and I've also heard about the nipple reconstruction. But there's nothing wrong with them, they just are very shy, and I remember a friend of mine who had implants put in for cosmetic reasons, and her nipples were always poking through her blouses. I called them 'the nosey neighbor nipples...and yes, I have a name for everything lol.
-
MSNOMORE....
I don't think you will see any changes with your nipples after the exchange, other than if the PS does fat graft transfer to plump up the nipple/areola complex. If you have had a nipple sparing procedure, I cannot see the PS wanting to do too much to disrupt the nipples - wanting to keep them viable you see. It just makes it easier to wear sheer bras after the exchange....I am grateful that mine are "low-profile" nips.
-
MSNOMORELUMPS: I think we are all so used to taking care of everyone but ourselves here! For me BC was a wake up call to finally take care of me first. You have a great attitude and wonderful sense of humor and you have found yourself a great place for support. I too have had a relatively easy time of it compared to some. Still, we are all coming from the same place being that it's BC. I was told not to wear a bra during the expansion process but because I was a UNIMX, I had to do something to augment my other side until I was done. I agree with Dawnhope--nothing felt comfortable when I was fully expanded.
-
WHIPPETMOM- I guess since my son is now 19 and I will no longer be breast feeding anyone anymore, it shouldn't be an issue that my nipples don't protrude. I know it was off-topic, but I like to ask when they are fresh in my mind.
But yes, I did have a NSM. And other than some scabbing, they held up well. Actually I feel them now more than I did before.
I'm glad you're grateful for your low-profile, it's nice to be happy with an outcome that you really have no control over.
The funny thing is, is that I always had a decent amount of breasts for my size, so I never had to think too much about them, but since I'm black, and never had much booty, I was okay with it. So when they were gone, I felt like a 7 year old boy. So yes now everything is a big deal when it comes to them. Not much junk in the trunk, but I had a lot under the hood, so it's important to me that I don't get a lemon. I was never this shallow before all this, I was happy with whatever God gave me....but now....I'm a boobie freak. I see boobies everywhere! I don't know if thats normal. I feel I should just be happy the cancer is gone.
-
MBJ- Well that's good news to me. It's always great to see someone who has gone through what you have gone through. Whether it be good or bad, I just didn't want to come on here and negate everyone's experience who did have a rough time of it. That does make me feel better.
But I totally can relate! I believe everything that happens has a lesson, and I think because I was finally still long enough I got the message this BC was trying to tell me. I was doing too much for other people, and wasn't taking the time for me. So I was forced to take the time, and it worked out relatively well. Funny thing is, is that I let a lot of people go that was in my life, so I could focus on me, so I tell people that I cut the cancer literally and figuratively out of my life. My life got a biopsy.
But as far as the expansion process went, only one or 2 weeks, it was on a nerve, but other than that, it was only towards the end (now) that I'm able to get better sleep.
And thanks for recognizing my crazy....the only way I was able to make it through this ordeal was to get mad at the cancer. How dare it be in my body without it asking first. Get out!! Now I treat it like an ex-boyfriend and cracks jokes about it being foreclosed and evicted and forcibly removed from the premises! I have a restraining order too.
-
MSNOMORELUMPS:
Since you say you had large breasts prior to MX, I just want to know if you have fairly large skin envelopes - if you have a lot of excess skin. Because I want to take that into consideration as you expand. It is my impression that a lot of women undergo tissue expansion and might need very little in order to get to the implant volume appropriate for their frame. It is up to us to let the PS know that we do NOT want to replicate the drooping breasts we had prior to MX.
Oh, and if you are looking for the booty you never got, it is right behind me...
-
MSNOMORELUMPS - Re 'boobie freak' I so get it! Your comments above made me laugh. I did not appreciate my body, my breasts before all of this cr@*. I was modest, I tried to minimize my breasts under my clothes ... didn't even want reconstruction at first. Since all the surgeries I too have become a 'boobie freak.' I look at women's boobs all the time ... in restaurants, at the gym ... and I think, "Appreciate them!" I love men, but yes, I've looked at more boobs in the last six months than in the first 40 years of my life. You're not alone, sister!
And I think for what we've gone through, it's quite normal! -
MSNOMORELUMPS: For a minute there I thought that I read that you stopped breast feeding when your son turned 19 LOL!!!! I have always been built more like a boy then a girl so now I finally got something under the hood, but Deborah, I doubt that you have any junk in your trunk!! Crazy is the only way to get through all we have to do
-
WHIPPETMOM-Bwaa haa haa! Well would you mind if I borrowed your behind for an evening after my exchange? I would like to go out on the town and shake more than just my tail bone.
But yes, I did have a good amount of skin post MX. It took me a couple of visits to understand that's what they were meaning in regards to envelope/flap that sort of thing. Last fill today went well. The only information I was able to get from her as far as make/model of TE was that they are MENTORS 600. She told me in an earlier visit that she took extra care in choosing the model because I have a short torso, and needed to make sure they would fit. She also said at that time that they were 600 cc. But today she just sort of cocked her head, like "why do you ask." When I asked her about the TE's. I guess since because it is my last fill, and now I'm showing interest in them. So as far as numbers goes, I think I may have to call the receptionist and see if she can look in my file. There was a long line of patients behind me, so I didn't want to hold her up any longer. She doesn't rush me, it was just I know what's it like to wait.
And they are waiting for final approval from my insurance to get me an exchange date. She said it takes about 3 weeks.
-
DAWN-HOPE- Ok cool, there are other boobie freaks out there. I too used to minimize the attention when it came to my breasts, because I hated all the oogling and stares....who knew I was going to turn into an ooogler? LOL but I have been able to contain myself and not reach out and grab any. haha!! I love men, I love men, I love men, I love boobies...oops I mean I love men.
-
MBJ- Ha my son is a mama's boy, but not that much. Plus I'm 4'11" and he's a 6 foot fireman, Just the sight of that alone has me cracking up. I can just see me going down to the station and telling him it's dinner time!
-
MSNOMORELUMPS - You crack me up! LOL!
-
MSNOMORELUMPS: You are going to have to come up with a shorter screen name....
So your TE has a 600 cc capacity? And what are you filled to currently? Is it 600 ccs?
-
DAWN-HOPE this is tip of the iceberg sweetie.....I've been bored to tears with this BC. Quit my job right before finding the lump. Whoo hoo lucky me. You mean I get to focus and concentrate on this for 24/7? YUCK!
-
WHIPPETMOM- yes to both. 600cc's and that's where I am at as of today. Tight & shiny (the names of my TE boobs)
-
MSNOMORELUMPS - There is a period of grief we all experience and we need to go through it but I think to laugh is part of the healing process. A few weeks ago I ordered a work-out bra with underwires & it criss-crossed in the back. I live by myself and couldn't figure how to put it on. Talked to a couple of lady friends and they suggested different things I could try, so went home and I got STUCK! I had the bra over my head, with the criss-crosses somewhere between my head/shoulders/back but somehow/someway I got stuck with my arms up in the air with the bra almost covering my foobs, but not quite and I couldn't budge ... bra didn't move ... I couldn't get out ... I started crying and praying to the good Lord to help me and I finally wiggled my way out ... in a few minutes I started laughing. I've thought ever since that someone who's been through all this needs to do a stand-up routine with all the bull s*%@ that we've had to put up with and go through. And girl ... I think it may start with you. Use that time to come up with a good comedy routine! You're hilarious!
Sorry though for all you've had to go through. -
LOLOLOLOL!! ok I know you can't see me, but I am cracking up!! Who knew the actual work out part of the bra, is getting it on??
Ok I will do the comedy portion of the Breast Cancer talent show, and you can do the Harry Whodini magician portion. The Amazing Dawn-Hope, watch how she squirms and sqiggles her way out of the un-thinkable. No bra can hold her down. Lol Whippet mom can get on stage and shake her booty.
-
LOVE IT! Although I'm pretty sure I couldn't do that again if I tried! If we go to Vegas next year for the ta ta reunion ... we'll go on front and center!
-
OMG: I would be in the front row cheering you both on LOL!!!! dawnhope: I remember your tango with the bra and it just gets funnier everytime I hear it!
-
DAWN HOPE-Front and center? If i am able to go, and I still have these expanders, I'll be front....but no center....sort of off to the either side.
lol @ Bra-tango. Yeah it was a story I so needed to hear.
-
Lilah: sorry, I never replied to your question: Yes, MediCal is medical coverage by the state of California. Luckily it covers all of my medical expenses for up to five years. Don't know what I will do when I need to change out my implants..
-
Wippetmom - Wow - you were right on. Went to the plastic surgeon, forgot the index card I'd written all the info. on to remember what you'd recommended. Talked to the surgeon, he measured me, looked at a picture I had from my 20s when I'd flashed my husband, and wrote down 133SX with alloderm. Came out, called my husband, and had him read me what you'd recommended. You're a genius!!
-
I'm confused on how the fills and implants are sized.
I had a DMX and my ribcage measurements is 33
I'm 5' and weigh 124
I currently have T/E's with Alloderm but that's all I know for now.
My PS uses Natrelle implants and I am getting silicone but I have no idea how many CC's he is filling to. I was a "B" cup prior to surgery but am thinking on going to a small "C".
Any info from anyone would be appreciated!
Thanks
Jan
-
I had my first fill last week - 100 cc added to the 150 cc that was there at the installation. I have 2 questions. He is having me wait 3 weeks till the next fill. (it has been less then a week and I feel fine with the first fill). Do you think I should ask to get the next fill after 2 weeks instead? He only expects 2 fills total to equal the natural side and 3 if I go larger.
2nd question: the fill vol. of the TE is 300cc. That seems like very little........what does that really mean in terms of how much the PS will fill it?
-
Deborah - bought my first bra after exchange and I am a perfect 34 C - just what I wanted, thanks so much for your help in this decision making process!! a big hug to you, Valerie
-
kjbrown: That sounds great to me! You are off to a good start!
-
jan508: I will need your TE info - you can get it from your PS' office - it is recorded in your chart. In the meantime, what I think would look nice on your frame - with your vital statistics, are implants with a volume ranging from 475 ccs to 550 ccs - high profile most likely - which would be Style 20 in Allergan Natrelle.
Deborah
-
heebie_jeebie: I think every two weeks is reasonable for fills, if you are tolerating it nicely. Not weekly though...there is no rush to the finish line here...
In answer to question #2: The volume is based on your native breast. If your PS is aiming for symmetry, as he should, he will select the TE which will get you to the implant which will match the width and volume of your native breast. In only very few instances have I seen a unilateral recon which did not require doing something to the native breast - e.g. - a lift or a small implant or both.
Deborah
-
Valerie: So glad to help and I am so happy that you are happy!!! You might go down a band size and up a cup size in many of the Nordstroms bras....so a 32 or 34 band but likely a D cup instead of C. I will be interested to see what they come up with for you at Nordies!
Deborah
-
whippetmom:
thanks so much for your info. i'll get the t/e info tomorrow when i visit the PS
Jan
-
Valerie: Looking forward to seeing your pictures also! Post them for us!!!
-
whippetmom:
where are the pictures that I can get an idea what my finished boobs will look like?
Thanks
Jan508
-
Whippetmom - MBJ told me to also ask you about implants and sent me to these forums. I too would like to know how to get on the private site for pictures - I too would lilke to see what reconstruction may look like. I am up for my bilateral breast reconstruction surgery in December.
Thanks, Kelli
-
Ladies who want access to the picture forum: send a PM to Timtam on this site and she will advise you on how to gain access. The picture forum is a private site unrelated to this one and access is closely guarded to protect the privacy of those on it. So be patient once you write to her
-
Heebie-Jeebie-Dr. D had me going every three weeks for fills too. I only ended up needing 3 total and one of those was to even out the side where the TE had to be replaced. The 300TE sounds good for your frame. You are VERY petite. You saw how tall I was and mine was a 400TE. Don't worry he'll get you to where you want to be, just make your wishes clear to him and he will do everything he can to achieve it for you.
-
I have a quick question. My PS tells me that I can have a B cup.She wants to stop filling when I get to 360cc'c. From reading the posts that doesn't seem like enough of a fill.
Does anyone know how much saline I would need for a B cup and also if you think I need more, has anyone told their PS keep filling. If so, how did they take it??
I am in chemo now so I know I have several months before I will have the exchange.
Thanks for yout help
-
Norma: Whippetmom will first need your info: (Read above) Please provide your height, weight, under breast rib cage measurement and style of expander you have. If you don't know what expander you have, just ask-it should be in your file. Whippetmom will be on soon to help you with your sizing.
-
Sweetie -- cute picture!
-
Sweetie: thanks for the info. I spoke to Andrea at the office today and she said the next fill will probably feel much worse then the first one..........did you find that? I just moved fill #2 up to next week (one week early) cause I'm going to spend some fun time in NYC the followiing weekend and want time for the fill to settle down before then in case it hurts. The next fill should put me to 350 and I"ll be done unless I feel up to going larger.
Norma: I'm a uni and a smallish B cup. At 350cc I expect to be at the appx. size to equal my natural side.
-
Thanks MBJ and Lilah!
Yes Sweetie - adorable picture!
-
MBJ, thanks for the information.
My height is 5'1" and I weigh 112 lbs. ( I have gained weight with the chemo and steroids) My ribcage measures 28 inches.
I have bilateral Allergan Tissue Expanders Style # 133MV - 12 series. 300 cc.
I wish I would have found this site before my operation. Everything just moved so quickly and I only found the site after my surgery and the expanders were already in place.
Thanks
I go to Sloan every other week for a fill. My PS would like to stop filling at 360cc. Is that enough for a B cup which was my size before surgery? I will not be finished with my chemo until Feb 1st. I understand that I will not have the exchange until 6 - 8 weeks after the last chemo
-
Heebie-Jeebie-I had no issues at all with fills, but then again I had to wait 5 weeks for my first one because of having my TE replaced. That allowed time for everthing to heal. The only thing was with one fill I felt the needle prick for a minute, but no other issues. 350 sounds good for your frame, I was only expanded to 400 and implants were 450. Do you want to be around my size or smaller? I think with your petite frame you won't have to be expanded to much to get the size that you want.
Whippetmom and Lilah-awww thanks. I thought it was about time I put a pic up.
-
Norma: Whippetmom should be by shortly to assist you!
-
Norma: Your skin permitting, your current TEs should enable to exchange out for implants with a volume of 400 ccs. The overfilling of your 300 cc TEs just ensures a little extra expansion to stretch the skin a bit more for implant coverage. Recommended for you would be: Allergan Style 20, high profile silicone round implants or Mentor high profile silicone round implants - 400 ccs. 375 ccs would probably be just fine as well for your frame, if your PS wants to get a little ptosis going.
But come back here and let me know how you feel about the size when you are expanded at fill level - at 300 ccs. We can firm up the size much better at that time.
Deborah
-
Hello!
I had my BMX on Oct 4th with immed. recon TE w/Alloderm. I have no idea what kind of expanders I have but think they must be Mentor. My PS uses Mentor silicones and Allergen gummies. I had thought I wanted to use the gummies but have decided on the Mentor Smooth Round HP. My PS actually said recommended the same exact ones to me the other day! Was glad we are on the same page there.
I think I was a full D before. Wore anything from 34 D to 36 C and around that. Never got measured before. HATED bra shopping! So hard to find something that fit me properly. Will be nice to have perky boobs again that acutally will make bra shopping fun!
I would like to be a med/ maybe full C I think. I want to be a bit smaller then I was before but not terribly. Such a fine line there....
So, no radiation needed for me. My stats are:
My rib cage is 32 inches. I am 5'8" tall and weigh 126 lbs.
So what size? Think my PS might have said 600 cc's at one of my visits when we were talking about size. Does that sound right?
Currently I have 200 cc's in each that was placed on day of surgery. I had a good amount of skin left because I had wide margins. I shouldn't have to stretch too much. BUT, it has been delayed because of a small area of necrosis on one side. New skin was underneath and is there now and looks good but small scabbed area above it at the incision so have to wait to fill. Also, when I was there on Weds he mentioned that my "breasts" are a little harder then he'd like. They need to soften up some before fill also. Said something about fluid in there that needs to disperse. He tried to explain something about the lymphatic "highways" through the breast tissue that had been removed and needs to adjust to new pathways, etc. Anyone else have that problem?
-
Biscuit: have you gone ahead with the second surgery? and if so, are you happy this time around? I know you have chosen Mark Sultan. I consulted with him, but find him to be a bit too blunt. So I went with another PS.
I just had my exchange done today, and right now I am so depressed and unhappy with my new breasts. I had a unilateral implant and a lift on the other side (with a implant too) to make them match. They both look so big, and wider than i would have liked. I don't know it is due to the swelling or it is just the shape. I am 125lbs, and 5'6. I am a 34D before. She put in a round implant of 700cc, and put 180CC in my regular chest. I put lots of confidence in my PS and on the hindsight, may not have asked as many questions. Would the breasts really settle over the months?
Whipetmom: thank you so much for dedicating so much time to this thread. You are BEAUTIFUL and AMAZING
-
Interesting article in the current Wired magazine:
-
Hello Whippetmom,
Although I am a first time poster to the discussion board, I have been faithfully reading your discussion board for the past 5 months. It has been especially helpful to me during the long nights immediately after BMX when I was very uncomfortable and unable to sleep. Thank you so much for giving so much of your time to minister, support, and comfort all of us on our journeys.
I had skin sparing, BMX and immediate reconstruction with tissue expanders and Alloderm on July 15, 2010. No radiation was necessary. My tissue expanders are Mentor medium height Style 6200 550cc. I am 54, 5' 7 1/2", 155lbs, ribcage=32". I left the hospital with 100cc per expander, have been expanded by 50cc every 2 weeks, and am currently at 450cc. My PS says that it is up to me, but she thinks maybe one more fill, then wait 6-8 weeks for exchange. My implants will be Mentor smooth silicone. I am wanting to return to my same size, 34C, and still fit in my same clothes. Right now, I feel wide, need more projection, and a little "droop". I wish I had a more feminine look. My skin looks really great and I am pretty comfortable.
I think that's everything. What are your thoughts on where I should expand to, implant size, and style that would be best for me?
Blessings to you and thanks again for all you do!!
xoxo Deb in Kansas
-
Look at all my Picture forum girls here helping Deborah... I feel bad now... I have not been here helping.... BAD ME.....
KANSAS Deb............. Cali. Deb will be alone to help you soon.. as she gets on the PC about this time at night..:).. I just wanted to say hello to you.. and wanted to see how close you lived to Leawood, Ks... Overland Park?? I am really close to these two towns....:)
-
Tory -- yes I saw that! I wish we could see the before after! Amazing.
-
Hi Estepp,
Yep, I'm in OP. 5th generation born and raised in KS. Me, Dorothy and that little dog, Toto! Are you a native Kansan?
Deb
-
So cool!
I live in Lee's Summit... Dh grew up in OP well.... they are an entire family that went to Shawnee Mission East... ...:)
Who are your doctors..
I use Associated Plastics/ and St. Lukes at the Plaza.... AWESOME!We have a group of us here on BCO that go to Vegas... like 60 of us... NO JOKE...LOL .... So I want you to know you are in good hands with these girls.!!!!!! I hope I have the chance to get to know you.
There are a few of us on BCO from OP.. Shawnee....Springfield.. Lee's Summit... Witchita...etc...
If you need anything. PM me here on BCO.. I will help all I can!
Laura
-
Laura,
Ha ha! I was a SMNW er... a LONG time ago.
My PS is Young at Associated Plastics and my surgeon was McCroskey (2 xs). Both did a great job. I stayed out south at Menorah for my surgeries. I had never been to the hospital, but it worked out really well for me. Have you seen the Breast Center at KU Med? WOW! Very impressive.
I will have to figure out how to PM. newbie...
Deb
-
FYI Deb from Kansas..
I am 5ft... at the time I was in TE's.. I was 29 rib cage... I was expanded to 420cc so that a 450CC High Profile Implants would work and get me to a small C. Well .. I got a 500cc HP and I wear a 34 D... BUT.... as these are implants and NO tissue left ( mast) I look like a C cup. Like I wanted.
So remember... you might " wear: a D cup or a DD cup after exchange.. BUT these are implants AFTER mastectomy. You will not look like a D cup... you will look like a C. Deborah will help you pick the TE cc;s you should shoot for... I think i know.. but she is the master... and I never touch toes...LOL.... plus............ I have to sleep with her in Vegas... I DO NOT want on her bad side! LOL LOL!!!! Geeezzzzzzzzz If I get on her bad side... she will not only leave things in our hotel room like Pj's, shoes and glasses for me to send to her.. but she will leave heavy.. high dollar stuff.... LOL
-
Deb from Kansas: how to PM... click on the name of the person you want to PM and you'll get a page about them (which may or may not have a bio). On top right it will say: "send member a personal message" and you click on that and you'll get a window to write in. Write your message and click send
-
whippetmom - Hi! This is my first post on this thread but you may have read my post on the exchange thread. I am just over 2 months post-op. I had a DMX with immediate implants placed over my muscles into what my PS calls an Alloderm-bra. I'm 5'1", 115 lbs, ribcage 28", and present implants are Natrelle style 115, midrange profile, 469cc. I am presently wearing a full 34C or small 34D and I feel they are too large for me. I was a 34A before MX. I have talked to my PS and we are looking to replace my implants to 354cc (same style). I'm nervous about another surgery and whether or not I am making the right decision. My present implants look great on me, I just feel like they're not me. Maybe if I regain some feeling back in my chest I would feel different. I know you have a lot of experience in this and am curious of your thoughts. Thx!
-
Eastcoastgirl: I really like the way your PS thinks!!!! I believe 600 ccs should be just about ideal for you - 600 ccs - high profile smooth round silicone Mentor implants! Excellent plan!
-
Christina100: 700 ccs on the MX side sounds like a pretty big implant for your build, but I will comment on that a bit more below. I would think your ribcage circumference is around 30 inches? But you will see some changes over the next two weeks - this is probably the most nightmarish time for many of us - the first week after the exchange. This is the time when the implants could be at their very worst in terms of appearance. They often look wide and flat, like the bottom half of a hamburger bun. So all I can say is to be patient and give it ten days to two weeks....and you will see some very positive changes. If you feel they are too large, you can always go back and downsize. But, in defense of your PS using 700 ccs - perhaps this is the size your PS needed to use to fill the pockets. You were a "D" cup prior to MX and you likely had an excess of skin to be taken up by an implant. It is better than getting too small of an implant and having excess skin and a lot of droop. So let's watch and wait and know that you can always go back for revisions....it is not over until it is over...okay?
You can email me a photo if you like [PM me for my email address]....or post on the pictures forum. But photo journal the changes...
Keep me posted on how you are doing.
Deborah.
-
SMH:
I would not have pegged you with your build and especially your ribcage, for implants as wide as you have currently. I would have said 425 ccs in a high profile smooth round silicone implant. I would not have recommended textured round implants for you but I would not recommend textured round implants for anyone, quite frankly. But that said, it hinges also on what style and width of TEs your PS used for expansion. Perhaps it was a 13.0 cm wide TE..which is why he did not use a HP implant. But in that case, I would have preferred Allergan Style 15, 397 ccs - which is 13.1 cm in width. Do you recall the style and volume of your TEs? Your current implants are 14.0 cm in width.
Hate to throw a monkey wrench in here...I just think the style of implant has as much, if not more, to do with your feeling of the implants being too large, than does the overall volume. Do you want to email me photos? PM me if so. You say that your implants look good and I think you are trying to decide whether you want to go through another surgery. I can understand your angst about this....it is a weighty decision. I think you need to get fitted properly for a bra and see if you are happier with the size. You are not a 34 band - and so get thee to Nordstroms in Phoenix for a fitting. I have to say that I have far more women wishing they had larger implants, than smaller implants. Going from an A to a D is a bit of an adjustment. I wish you would post photos on the pictures forum and you would have a bevy of women weighing in to give you their thoughts regarding size as well.
Let me know if you have any further questions.
Deborah
-
DebinKansas:
Let's try to determine why you feel your TEs are so wide, because they are 13.0 cm which would not be too wide for your frame. Is it that they are too far apart - widely spaced? Have they migrated laterally? You are desirous of more projection, and your TEs have a maximum projection of 7.4 cm, which cannot be replicated by any implant on the market. You should see a more projection when you are fully expanded. Is your skin pretty loose in the TEs? Or is the skin very tight? If you want ptosis after the exchange, you might need to overfill the TEs to around 600 ccs, perhaps even 650 ccs. So now on to implant selection. If you have a long torso, and since you like projection, you could be a candidate for the ultra full projection Allergan Style 45 smooth round silicone implant in 600 ccs or 650 ccs. If you go with a high profile smooth round silicone implant, I would vote for 600 ccs in that style, 550 ccs at the minimum - Mentor or Allergan, does not matter. The ultra full projection only is available by Allergan - Style 45. But I do want to know about your complaints about width. It would be helpful if I could see photos also, which you could either email to me or post on the pictures forum. What Estepp said above regarding sizing - that it takes more volume than we realize to "make a mound" - is absolutely correct. But we can refine the implant selection after I see pictures or get a better idea re: what is going on with the width of your TEs.
Deborah
-
Laura: What would I do without you to keep me humble?????
I was so happy you found my sunglasses.... oh....and my shoes.... -
Deborah... I will be having a NSM BMX w/ TE's on 11/30/10. I plan on taking pictures before, during the time of "fills" and after. I plan on coming back to this thread to ask your advice!
Does seeing pics before the BMX help you determine what would be good for my frame? Should I make sure I take side shots too? I'm probably a wannabe "B" right now and am not sure if I want to go "bigger" or not. I'm thinking I probably do considering pretty much ALL of my bras are "padded" in some way or another. Should I take pics of me with my padded bras that I like on too? The waiting is so hard. I am so curious as to how this will all look afterwards! ... I've seen pics.. but even looking at the NSM BMX pics... everyone's TE pics look so different depending on what size they were prior to surgery. Just wondering what would be helpful to make sure I do BEFORE surgery. Thank you so much for your time in helping all these women! -
Whippetmom - thanks for your reply. I did not have any TEs. I had my nipple-sparring DMX and my implants put in all on the same operation. My implants are also placed in a pocket/hammick or bra made out of Alloderm; not just an Alloderm sling, which is why my PS says she always uses textured implants with this procedure. In other words, the Alloderm goes from the top of the implants to the bottom of the implants (armpit level to fold level). Because my pictorial muscles were not cut or used, the width of these muscles are not an issue. I am also under the impression that this a fairly new procedure,..I have not talked with anyone else yet who has had this done. My PS has only been doing this for 2 years now. You are right about your statement about me being worried about another surgery and I'm wondering if the size change will make me happier. I do realize that my current implants are 14.1 in diameter. If I replace with 354cc, style 115, they would be 13.0 cm in diameter. From your experience, would 1 cm in diameter make that much of a difference, not to mention the reduction in cc?
-
SMH it sort of sounds like the Alloderm one-step process (which does not use TEs either).
-
I had no idea that the muscles aren't used when you have Alloderm. It's only available as a trial here but that method sounds like it has a lot of advantages.
-
Susan: Sure...we can map out now what might work for you. It gives you something to discuss with your PS at the time of your preop - so that he uses the best style and volume of TE to get you where you want to be. You can email me photos...but I also need your height, weight, ribcage circumference. PM me for my email address. Since you are having a NAC sparing, we do have some limitations with size, because we want your NAC to end up in the right place on the mound.
Deborah
-
SMC: Yes, 100 ccs will make a significant difference as will even a 1 centimeter reduction in width.
I apologize for not thoroughly reading your initial post. I am also very perplexed about the above-the-muscle placement of the implants. Did your oncologist have an opinion about this placement? I would be concerned about the ability to detect a recurrence which might appear close to the upper chest wall, if the implants are over the muscle.
-
Mantra: There are very few instances in implant-based breast reconstruction with the use of Alloderm - even in one-step procedures, where the implants are not placed under the pectoral musculature. SMC is describing a new procedure...
-
SMH: You could talk to your PS about using Style 120 instead - still a textured round - but high profile, which would give you more projection but would be narrower on your chest wall. This would require some lateral revisions to narrow the pockets, but 400 ccs in this style would be nice on your frame.
-
Hi,
Struggling here...looking for the page on this discussion board that has instructions on how to attach photos to a private email. Help?
Deb
-
SMH - Hopefully I don't sound like a pervert, but you should consider posting pictures on the picture forum. The procedure you had sounds very interesting and I'm sure there would be others that would like to see too. How do you feel your implants look compared to those done with a more traditional method?
-
Thank you whippetmom! That is what I will plan on then.
-
SMH: I agree with Tory in that the picture site would give you perspective on how your recon looks compared to what others have gone through, which is the whole point of the picture forum: support from others who have been there. It isn't for everyone, but it so relieved my fears and concerns and gave me high expectations as to what is possible in plastic surgery. It is incredible what they can do and also what can be fixed! Best to you, whatever you decide. I started out by giving my private pictures only to whippetmom as it took me awhile to build up the courage to share.
-
Whippetmom - I'm so relieved to hear that the 1 cm reduction in width will make a difference. I'll have to revisit the hi profiles again with my PS. When I talked to her before about them she believed that the midrange would give me a more natural look. I was and am so new at this that I was more concerned about the NSM and her procedure than what size implants were going in. My PS is a female with implants herself, which gives me a lot of trust. I just need to figure out the size thing! You know, I never thought about asking my oncologist about her opinion. I see her in a couple of weeks, I'll ask her then. I know she too was very intrigued by my procedure, not to mention my gynecologist!
tory - I don't know if I could do the photo thing. I don't think its perverted, I just don't think I have the comfort level to do it. Sorry. I think they look just as good as others I have seen through photos. My skin feels a lot thicker where ever the Alloderm is. My PS does both over and under but the reason I was interested in trying this new procedure was: she and my GS/OS said the recovery time was much easier (I was washing my hair by myself 4 days after surgery); My PS thinks it looks more natural over the muscle; she showed me pictures of other patients she had performed this procedure on; and lastly, she said I could always have it redone with the implants under the muscle. So far I am very happy with everything other than the size. (I'm thrilled about keeping my own nipples also.) Hopefully I will feel the same 5 to 10 years from now since my PS only has a 2 year history with this procedure.
Tory, by the way, I was very moved by your Lynn Redgrave quote. Looks like you and I have the same diagnosis. Are you on tamoxifen also?
-
SMH - I totally understand about the pictures. I haven't posted any either, partly because I don't feel I have anything that isn't already there and partly because I'm not totally comfortable with it. My plan is to post some pictures after I have my exchange, which won't be until January. I don't like the way the TEs feel underneath the muscle, nor the way it makes me feel weird to do certain things (using a 3-hole punch at work, who'd have thought?), and my suspicion is that what you have probably looks and feels better, especially with arm movement.
I didn't notice your diagnosis, but you're right! Yes, I am on tamoxifen, since May. Have you been to the "bottle o' tamoxifen" thread?
I love that Lynn Redgrave quote. It just says what I feel so perfectly. If you have not seen the photos that her daughter took, they are moving too. http://www.nytimes.com/slideshow/2004/04/15/magazine/20040418_REDGRAVE_1.html
-
Tory - No, I didn't know about the "bottle o' tamoxifen" thread. I'll have to check it out. Thanks for the link about Lynn Redgrave. It's very moving. Thanks!
-
Thanks for sharing the photos, tory.
I look at her and say, "What a brave woman."
Wait a minute! We all went through that. What brave women we are!
-
LOL Claire -- so true!
Thanks Tory -- loved those pictures. Looks like she chose not to reconstruct, which always fascinates me. What's brave is not just that she went through it but that she had her daughter document it.
-
We ARE brave women. I agree, her particular courage was in letting her daughter document it. As a celebrity I can't imagine how hard that must be. I got the feeling that she was especially comfortable in her own skin though, and somehow that was really reassuring. She died about a month after I had my first mastectomy - without reconstruction - and I was really moved by that set of pictures and the little things she wrote with the pictures. Knowing other people go through the same things isn't quite the same as seeing it and the timing could not have been better for me. Despite the fact that she had just died, I found great strength from her.
-
Whitppetmom,
Thank you so much for your reply. Your description of the breasts being flat and wide was right on. You certainly make me feel a little better. I am trying not to look at them too much.
-
Christina....Let's see how they are looking in a week to ten days. Let me know, okay? You can email me photos if you need some affirmation regarding size...PM me if you need my email address...
-
SMH - just read your post - so your implants are on top of the muscle? I had nipple/skin sparing surgery, but no one ever mentioned putting the implants on top of the muscle. Very interesting, you really must post pictures!! Do you see any ripples since there is just thin skin there?
Whippetmom - I just got back from PS, and really he is so pleased with himself and thinks they are the "perfect" size. And again I have to say thanks to you for your help with that. I told him about this site and he thinks it is very interesting - I think I am the only one that asks so many questions when I see him. He wants to wait a few more weeks for the "after" pictures - so I don't know if I should wait and take my then to post on the forum - will they change much in a month?
-
Valerie: Post them now and then post them a month from now. This way you can journal the changes in photos.
-
I'm not sure what's happening with my implants but have posted updated photos on my thread called TE to gummies (Fore). If anyone has time to look at the photos, I'd really appreciate it your opinion. I've now put the old photos and the new photos at the end of the thread for better comparison.
It does not feel the implants themselves are moving. They seem to be exactly where they wrere on day one. But I didn't think that gummies have that drastic of a drop and fluff. And because of this, are these implants now too wide for my frame?
-
I looked Mantra. Is it possible you were standing up straighter in the first set of photos?
I am surprised if it's really a shift because gummies DON'T drop and fluff as far as I know (well mine hasn't).
-
Over the next several months, the doctor will periodically inject saline solution to gradually fill the expander. This gentle stretching of the skin creates the space in which a permanent saline implant will be placed during a subsequent operation. Some patients find the gentle stretching involves a small degree of temporary discomfort.....
-
Fred seems to be using the board to advertise Viagara for Men. He just joined today. Time to report a post.
-
Lilah, I was trying to stand straight and pushed my shoulders back just to see if the picture could look like the first one. Clearly . . . it didn't happen
The implants do not seem as if they have moved and appear to be in the same place since day one. I just didn't think that gummies drop and fluff. Now I'm wondering if they look too wide for my frame.
I will print out and take the photos with me to my appointment. It's still three weeks away but even if I sent them to her today, nothings going to happen that quickly. I'm just so shocked at how big a difference there is in such a short time frame. I'm thinking either perhaps the second pictures look more natural . . . or perhaps they look too wide for my frame. I honestly can't tell.
-
One other quick question.............
I am a runner (it is killing me that I can't run right now) and I also play Golf. Is one implant better for sports than another? I also had radiation on my right breast 15 years ago for a previous cancer.
Thanks for all you help,
Norma
-
Mantra -- I don't think it looks like a BIG difference! And I do think the implants look good on you... good size and the cleavage still looks good too. I do agree there's a difference, though I don't know why. I wonder if it's the bra you're wearing... if it IS pushing them closer somehow. Try wearing Big Bertha for a week and see if there is a change (sorry I know how you hate that one).
Norma -- I am not sure about that... perhaps Deborah can help you. In the meantime: hello and welcome to this thread
-
I just looked in the mirror, and yes, they look very similar to what they looked like in the first photo, The first photos were taken by DH. The second photos I took by using the timer on my camera. DH is going to take additional photos. It has to be the angle of the camera, I guess. So he'll take them tomorrow when he's working from home so the lighting will be similar. Now there a tough chore for the honey do list . . . honey, can you please take some more topless photos of me!!
-
Manta-I looked at your photos and they do look very slightly different,but it may be like Lilah is saying about the angle of the camera. However, that being said I think they still look fantasic on you and definately do NOT look to wide. They suit your frame perfectly and I think you have great result. In fact I like how they are close together and full, it gives you great cleavage and shape.
-
Norma57 - I play tennis competitively and did so with the TEs - so is there a reason you can't run? (Not that comfortable I know) I just had my exchange to implants (silicone) and asked PS the same questions because I didn't want to give up on tennis, gym, biking etc. and he recommended silicone - said they won't get in the way at all. He would like me to wear an underwire bra when doing any type of exercising - just another opinion...
-
Norma: you just want implants which are appropriate for your frame. You probably want to stay on the narrower side - implants which are not too large.
-
Mantra: I responded on the pictures forum....
-
Thanks. I go for a fill tomorrow. I know I have a long way to go but I'll keep in mind everything you suggested. I probably won't have my exchange until March or early April 6 weeks I finish Chemo. I guess I am just trying to get all of the information I can. So, Thanks again.
-
Hey Mantra, I know you concluded that maybe your implants are the same, just the different photo conditions, but I agree with your first impression...I think the change in upper pole fullness may have to do with post-op swelling that has resolved. But I definately think that gummies have their own way of dropping and fluffing -- well, maybe just dropping. My (bilat) gummies have DEFINATELY gone through a transformation, and my bra size has changed by 2 cup sizes( bigger) to prove it! Even tho the implant itself doesnt change form, and maybe the pocket -- if it is snug -- doesnt change much, the structures all around it -- muscle, skin, etc, that are holding them in place -- do change. I think, especially, if you tended toward ptosis before MX, that things are likely to go towards floppy, again. That has not seemed like a bad thing to me -- I think I have a more natural look as I've developed a bit more droop. Also, with more of that comes more ability to push them around with a bra -- uplift, cleavage, etc. if you want. (except that it is a weird, and not very pleasant feeling to push 'em around..). So that's my 2 cents on gummie d+f!
-
Wow Jerusha I wish my gummy would droop! If it would it would match my remaining breast better (when nude). Sigh. Glad that you are seeing improvement there.
I am able to move the breast more... was NOT able to make cleavage by pushing at first but COULD do that now... but the movement is very tiny.
-
I had DH take a photo tonight and he definitely got a different result than I did. I posted the photo on my thread (from TE to gummies (Fore).
Tomorrow is exactly 3 weeks from the date of my exchange and the date I'm supposed to start massaging the scars with cream. I want to go to the health store and pick up some cream that doesn't have parabans. My normal body cream does have paraban (I know . .. not a smart move) but the thought of massaging it into an area that isn't healed causes me to pause. I think perhaps a natural cream perhaps with vitamin E may be best.
-
mantra - I found organic cocoa butter at a local health food store and it has helped me. There is a Scar thread that has some very useful info on it. Here is the link: http://community.breastcancer.org/forum/44/topic/756050?page=5#idx_142
-
Thanks Dawn, I hadn't thought of cocoa butter. I will check out the thread too.
-
I finally got around to changing my name on the other site. Fore is no longer and it has been replaced with Mantra.
-
I liked fore. It's like - watch out! Here I come! lol
-
Mantra -- it's gratifying to know that you in fact DO look the same! Amazing how a camera angle can distort! You look terrific.
-
I agree with Lilah - Mantra, you look terrific. Bra going out to you today!
-
vmudrow - In answer to your question about ripples,..the left breast has a nice shape and the only ripples I have is when I lift my left arm over my head. Their are a few ripples by my arm pit. The Alloderm becomes part of my skin, which gives it twice the thickness. The only place were my skin feels thinner is to the side, towards my armpits. The right breast, which is the cancer breast, has some catching up to do. The size, shape and location is just a little different from the left but I believe its because of all the scar tissue. The right breast has a lot more rippling but it changes weekly (for the better).
whippetmom - I took your advice and went to Nordstrom to be fitted and I'll be dipped,..I never thought I was one of the 8 out 10 women (or what ever the figures are) who walk around wearing the wrong size bra!! Nordstrom put me in a 30DDD. I went over to Dillard's and they fitted me in a 32DD. (And I had walked in with a 34D bra on.) So, I used to wear a 34A, maybe it should of been a 32B? (I'll never know now.) Wearing the correct size bra didn't make me feel any better about my size. They still feel too big for me, even though to me I only look like a C cup with clothes on. I actually felt better in the 32 band size, the 30 was just too tight for me. It seems to me that the volumn of the cup didn't change from the different bras, just the size description because of the different band sizes. The lady at Dillard's agreed with this. What do you think?
-
I think 32 DD and 30 DDD are the same size... (effectively).
-
Yes, I agree with Lilah. The 32 DD cup might be a smidgen wider...and it is important to wear the right band size because if you are wearing an underwire bra, that side support needs to land in just the right place lateral to the implant.
-
Thanks Deborah!! I''m really looking forward to it and here's hoping it will lift my spirits as well as my implants!
Gawd, I hate being in a $@%^% mood. It's so unlike me. But between disliking my gummies (see explanation on gummy thread) and trying to decide if it's time to put down my yellow lab (white dog in my avatar) it's just been a real crappy week. And being in this mood makes me feel ungrateful and selfish knowing that many people have much more on their plate than I do, and that is only adding to my stress. Oh, and what's up with this snow.
-
Mantra: So sorry to hear about your lab. My animals are my children and they are getting old and I will be just as heartbroken with a decision like this. Hugs.
-
Thanks MBJ. Our pets bring so much joy to our lives but having to make decisions like this is extremely difficut. DH and I have done the prep work (ensuring our vet will come to our house rather than us having to bring him into her office. And making sure it's legal to bury a dog on our property). These things were very important to us. Now we wait and enjoy him as long as he's able to enjoy life.
And the snow continues . . . a light fluffy snow that makes me feel like I'm living inside a snow globe.
-
Who here has traded in their teardrop shaped implants for rounds? Was it the right decision? Do you like the look better or is it more of trading one implant for another but not really happy with the look? Did your surgeon do this willingly? How did you approach it with them? This is a big decision for me. I'm the type of person who always moves in a forward direction. Even thinking about taking a step backwards and going through this all over again is a huge issue for me. So if I'm going to do it, I really would love some input from those who have been there, done that. Thanks
-
Deborah, I've made room for the new foster bra. Big Bertha, Pinky and their other homely looking friends have been shoved to the back of the drawer in anticipation of the beautiful new arrival. Might be a bit of bra-rivalry going on, but I think it's normal . . . although, you can clearly tell that I am not!!!! Any woman who names and communicates with her bras is clearly one cup short of the perfect bra!!
-
Mantra: LOL! One of my friends suggested that I needed to name the "girls", so who's crazy??? I can't really anwer your question but I can tell you my experience. Before having surger I thought I wanted the teardrop shapes so I would have a more "natural" look, but I am so very happy with my rounds. They look very natural although larger and nicer to me and, even though I am a uni, there seems to be only the slightest bit of difference between the two. I really like that they pretty much "behave" like natural breasts and except for a small bit of ripple (which they all do) it's hard to tell them apart. Oh, and of course that there is a scar and no nipple. Even to the touch there is only a slight difference. I know that Lilah feels the same way about her teardrop shape. Maybe it really depends on how thick the skin is and anatomy which makes one a better choice then another. Are you thinking of changing yours?
-
I'm thinking about switching but I don't know if I'll actually go that route. I'm still in the research stage. I don't want to jump into silicone rounds until I have more details. The rippling scares me. But does it scare me as much as looking like I'm walking around without a bra . . . and shouldn't be? I want to have as much knowledge as possible before meeting with the PS. I'm quite sure she will try and talk me out of it but knowing it's the right decision will make her less able to do so.
-
Mantra: My dear, having seen two of your bras on the pictures forum, I would put them in the category of upper extremity birth control devices. LOL!!!! [I actually have one of those - was sent home from the exchange surgery in that attractive little number.] You are going to love the Freya - but your DH might love it more!
-
Gummies dont fit into bras; bras kind of SIT on the gummy, which SITS on your chest wall. All quite solidly! Bra selection is a challenge with most reconstructed breasts, but more so, I think, with gummies. Because they are form stable they do not conform at all to a bra cup or wire. The bra has to be exactly the shape of the gummy -- and that is not easy to accomplish. All the snazzy Freyas, and all of the other really gorgeous bras have gone right back to Nordstrom, BN, etc. Good thing they take returns. (Even without tags, I've discovered...)
-
I do know, since we are on the subject of "gummy" implants, that the premier west coast plastic surgeon who is the principal Allergan 410 trial investigator does not feel that the 410s are for everyone. He feels it is not a one-size-fits-all implant and he assesses each woman individually, to determine if the gummy would be appropriate. I feel this is the best approach.
-
whippetmom: I have been following this site since I was diagnosed. Had surgery about two months ago. How do you get into the photo forum? I sent an email to the suggested contact so requesting admittance (forgot her name) but did not get a response. I had my last fill and waiting to see the PS in a month. Very confused. I am afraid that the silicone implants will be a disappointment. I have the mentor 350 1460 filled to 500cc's. I believe it is 13.0 cm/13.4 cm. PS is talking about exchanging them with HP mentor 600cc. I would like to be a small D full C. I noticed that the Natrelle style has more projection than the mentors. My bandwidth measures 31" . Has anyone exchanged with saline? I like the firmness and do not want to be squishy. Please advise. thanks
-
bnita:
You will need to spend time around the forums, posting, responding to other members or asking questions before gaining entrance to the pictures forum. It is a very private and separate website and for the protection and privacy of its members, we require the ability to get to know a bit more about those seeking entrance and to see them getting involved in posting on the various threads and forums.
Many of us - I believe the greater majority of us - have silicone implants. There is a "SEARCH" feature on bc.org - you will find it at the top right hand corner of this web page. Click on the SEARCH link and then type in saline or saline vs silicone and you will come up with a bevy of posts with discussions regarding the topics of saline or silicone. Based on your ribcage circumference and TE data, 600 ccs sounds like a good size...but it depends on how you feel about your TEs once you are filled to 500 ccs capacity.
Let me know if I can help you further!
Deborah
-
Jerusha, you've definitely hit the nail on the head. Hadn't thought about it in those terms. That's why finding a bra that fit is an impossible task. I guess the only bras that would really work are lycra stretchy types. Not exactly the style of bra I was used to wearing before BC. Depressing
-
Mantra - I'm interested in knowing how you like the freya bra ... they are lacey and SEXY! I'm sorry your gummies aren't what you expected, but give it a little time. There are some stretchy bras out there that are pretty sexy. This whole BC and reconstruction thing has opened me up to a whole new world of lingerie that I didn't know existed.
-
Dawne-Hope, stretchy bras that are pretty? Oooh, tell me! I've come across a lot of bra-lettes that are lacy and sexy,etc, but they are all made for small breasts, and they just look goofy stretched over a big hunk of gummy foob!
-
Jerusha - I'm new to this world of fancy lingerie ... whippetmom and Val61 are the experts ... but the Freya Arabella and Eleanor are both stretchy, lacey cups. They provide firm support but they are sheer ... the Eleanor is on close-out but I've received very good deals on E-bay. I think the Arabella is still available at Nordstroms and BareNecessities and Herroom. Both are available on e-bay with greatly discounted prices. Try them out. They're gorgeous and they do the job and they may govern those stubborn gummies!
-
Mantra, in early August, about 6 weeks after my xchnge, I was up to 86 () buy and returns!! Each shipload was a different size -- I kept adjusting band -cup-band-cup and just could not find ANYTHING that fit. After each box of failed attempts I would go wailing to my husband who thought I was just nuts to be so distraught over bras. My teenage girls were, like, there she goes again! The only things I could wear were my Marena surgical compression bras (looks like Bertha, but TIGHT), and marena sleep bras and just wore them for months. I've stopped counting but I've for sure crossed the #100 line. Hope springs eternal, I guess, but Bare Necessities is probably not too fond of me. My gummies have definately changed shape and I can actually fit into some bras now, but they all feel so uncomfortable on the gummy. I did finally find a VS non underwire that is made just like an underwire. I think I mentioned it before. If you can get your gummies into it -- you will probably like the look in clothes. I may be done in for now on the bra hunt as it is just sooo unsatisfying. Before bc I was a D and had many happy years in Freyas, Chantelles, and the like, and I really thought I'd had my day and would not miss bras one little bit. In fact, I would often choose comfy bras over sexy bras. When i got home from work, the first thing I did was to remove my bra!. The only perk I anticipated with the BMX was not wearing a bra ever again. How ironic that I now spend half my waking hours in the never ending pursuit of a bra, preferably a pretty, lacy, sexy one, that actually fits and is actually comfortable!
-
Jerusha - Here are links to some of those bras. Early on after my exchange I was fitted for a Wacoal 65149 ... it is lacey and stretchy ... doesn't give a lot of lateral support, though. But do you gummy ladies need that lateral support? Here are a couple of links:
http://shop.nordstrom.com/S/2864688?origin=keywordsearch&resultback=222
http://www.barenecessities.com/Freya-Arabella-Plunge-Bra_product_FreyaAA5721_,search,.htm
Search 'freya eleanor' and then your size on ebay and you'll likely come up with some hits. I've done well buying from sellers in the UK. And some of them (I've learned after the fact) will take returns, just check first before you buy.
Good luck in the bra hunt, ladies!
-
Thanks for the links. At this point my PS says I can't wear underwire. She said no underwire for at least 3 months and only if she approves me to wear it . . . not all patients get the seal of underwire approval because she bases it on where you have feeling. I am fairly sure I will be allowed to wear underwire but 3 months is still a long way off.
At this point I'm just going to admit defeat . . . for now. Now that I am aware of the reason why bras don't fit, and that I am really limited to stretchy, non underwire, I realize finding a bra will be quite impossible . . . while I'm in Canada. I can't order on line because putting an item through customs has often cost me more than the item itself. I'll wait until I get Stateside before I begin the online journey. Of course, the first step in all of this is going to Nordstroms to get properly fitted. Again, that will have to wait until I'm south of the border.
That said, I plan to have a talk with my PS about all of this because I really don't know if PS are aware of the additional challenges that having gummies brings. Patients should be made aware of all of these practical problems in order to help them make an informed decision regarding the type of implants they want.
I've gotten to the point where I am only wearing Big Bertha (and we all know how much I hate Big Bertha) and taking advantage of the cold weather to wear layers and other unflatteringly outfits to hide the implants and bra.
As the gummy population grows, perhaps more manufacturers will design sexy gummy friendly bras.
It definitely is a huge disappointment. But unless I'm prepared to switch to silicone, I'm just going to have to suck it up and stop driving myself crazy trying to find a solution. It is what it is. The only reason I'm hesitating on switching to silicone is fear of rippling. I've decided I am not going to make that decision until I've exhausted all avenues in trying to find feminine, lacey bras that work with gummies. As much as I dread going through surgery again, at least knowing that there is another option out there makes it an easier pill to swallow.
-
The Anita Style 5490 has stretch cups....I love that bra. Incredibly comfortable. You can pull the material up and over and around the implants to get a snug fit....
The Chantelle C-Chic - the non-padded version, has stretch cups. My sister Deeds is wearing that bra - the last photo in a bra - on her thread on the pictures forum. KEW also has that bra - Val has it...and someone on Lilah's bra thread is wearing it. I think it is discontinued - but you can still find it on Ebay.
Deborah
-
Whippeemon/Deborah - thank you so much for your response. Will do- become more active than an observer on this forum. This is all so new to me. I am thrilled that there is a discussion forum available for us gals. I felt so alone until I stumbled across this site. And believe me I was on the internet researching as soon as I got the news. Doc's - although supportive could not help in that arena. I am still confused and it all happened so fast when first diagnosed. I am not sure what you meant when you said how I feel about my TE's at 500cc (btw - I am already at 500cc's) - my PS said that this should be enough. Will the 600cc's give take me to a full C with enough projection or will I look smaller since the exchange seems to make you look smaller than the TE's. You gals are so supportive of one another and each has contributed so much information - by the way - Deborah - you bring so much knowledge to the table when it comes to size - which is pretty significant. My PS said that he does not use Allergan Natrelle's and I was just wondering if they give you a better result. Anyway - I am grateful of our choices today {advanced medical technology} but most of all thankful to be alive - I am raising kids and want to be around a long time to see them grow up.. again thanks for your response!
-
Maybe I'll just have to consider stretchy bras a right of passage . . not unlike switching low rise jeans to ones that sit at your waist.
-
Mantra and Jerusha- Just want to say to both you I have the rounds and have had a heck of a time finding bras that fit me right, so rounds aren't that much easier to fit. I find ironically the "stretchy" ones fit the best. I found a really nice,sexy one at Kohls, APT 9 lace bras that came in a few colors and had matching underwear. It does have a wire, but I hear if you can't wear a wire you snip a few stitches off and take the wire out.
Jerusha-I feel your pain about buying and returning bras. I selected over 20 styles online and 1 one of them worked. I was so embarrassed returning them I didn't want to say a thing. Fortunately the girl was nice and didn't seem to care that I was returning that many bras at once.
Mantra-you may be sitting on a goldmine idea-making bras for gummies, patent that one quick!
-
bnita: What is your height and weight? That might give me a better idea so that I can tell you what to expect with 600 ccs. Typically it takes 100 ccs to 150 ccs additional volume with implants over TEs to approximate the volume of your TEs. You are going to want high profile implants. Mentor high profiles are just fine and most of us have the smooth, silicone rounds in either Mentor or Allergan.
-
whippetmom - I am 5'3" and 124 lbs. BTW I was a C cup prior to TE's. Thanks again!
-
bnita:
600 ccs in a high profile implant is plenty of volume for your frame. I think 550 ccs would be fine also. You and I are the same height and weight and our ribcage measures the same also. I have 550 cc high profile smooth round silicone implants and they are the perfect size for my frame. I think you would be very happy with either volume.
You will not be a full "C" cup though. I do not want to freak you out....but you will likely be a "DD" cup. You will not look like a DD cup in clothing though. I was a "C" cup previously, and I look the same in clothing now as I did pre-MX. With breast reconstruction, you need to end up with a larger cup size in order to achieve the appearance of fullness. Our reconstructed breasts are not maleable or "floppable", nor do we have to fold them into a bra cup any longer. So I can see that your PS knew this and he was on the right track from a sizing standpoint. You will understand this after your exchange.
-
Getting excited in Kansas. Two weeks ago (14 weeks post BMX) I posted that I was at 450cc. Now tomorrow is another fill day! I am amazed how much my new foobs have changed and shaped up in 2 short weeks. The TE's were sooo square-ish and now at 16 weeks post op, they are finally rounding out on the bottom. I'm finally starting to look feminine! When I sit back and reflect on the entire process, it really is pretty incredible.
Has anyone seen the November 2010 issue of More magazine? Page 117 "After the Big C". 4 breast cancer survivors write about what it feels like years down the road. Good perspective.
-
Hey Ladies-- just back from a long weekend and catching up.
I have one gummy and one natural breast... and have found a few great bras all wire free (I too am not allowed to wear wired bras yet). Chantelle, Anita and that Wacoal Lace bra that Dawn linked above (which I have in a wire free version). All fit very comfortably. My bras are on the picture forum... page one of my Post Your Bras thread... if you want style numbers. I do think it is more difficult to fit bras on implants of any kind but not impossible; definitely a challenge for those of us not allowed to wear wire! The selection of wire free bras is limited compared with wired bras.
-
Lilah, does your PS think you'll be able to wear underwire in the future? I know mine said I had to wait a minimum of three months . . . but no guarantee she'll approve me. I really think she will. She bases it on how much feeling you have in certain areas and I have complete feeling everywhere the underwire would touch. I'm hoping she'll be able to at least give me the thumbs up at my 6 week appointment so I can buy some nice bras over the winter while I'm away.
Deborah, did you say somewhere that the European underwire bras have the underwire on the band? Or did I just completely make that up??!!
-
I asked her: "will I have to not wear an underwire forever?" And her answer was: "no, not forever"
I have not asked when I can wear wire again but I am content with the bras I've found... and I guess I will just ask again at some point. My exchange was in May... so it's been 6 months. I just realized you are still so early, though; you need to chill a little! Be patient
Though gummies don't drop and fluff they DO relax and get a little softer, a little more pliable with time. Right now it's about letting your body heal. -
Mantra...You must have dreamed it....
-
kansasmom....Yes...it is an interesting and exciting transformation!
-
Deborah, so I made up a completely false fact about bras and pulled it out of thin air?? Geez, you'd think I was talking to the government about my tax return. "Yes sir, that's correct that in 1945, just after the second world war, ice cream became tax deductible. SERIOUSLY?? NO?? Hmmm, I guess I just thought I had heard that. Okay, so now I owe you HOW MUCH!!??
-
I will TELL you though Mantra, that there is a vast, huge difference between high end quality underwires and the less expensive underwire bras. It is a night and day difference between my VS underwires and my Chantelle, Freya and Anita underwire bras. The reason most docs are nervous about the wires, is that they envision these wires breaking free of the fabric and poking us in the lower pole where we are most likely to have no sensation. But a good underwire sits on the ribcage - does not even touch the implant....and it is strongly reinforced in the well-made bra.
-
AHA!!! Now I remember .. . you said a good underwire sits on the ribcage. That's what I must have heard/read.
-
I was googling to see where about breasts should sit on your chest . . . wondering if mine are perhaps too low. I came across this " The way to know if your breasts are in the right place is to bend your arm at the elbow and form a 90-degree angle. Then, lay your arm down across the middle. Your breasts should be sitting about half way between your shoulders and your elbow"
Does this sound right? If I'm doing it right, my implants are closer to my elbow . . .no where close to mid way between the elbow and shoulder.
-
Mantra: Read this [I posted it on Exchange City a year ago] and provide me with your measurement...
Another measurement I have found which plastic surgeons calculate is the distance between the sternal notch [the concave region under your neck] to your nipple. This is called the SN to N ratio. It is felt that a SN - N distance of >21 cm is indication for high profile implants. This is because the higher the profile, the taller the implant will sit on your chest wall. Conversely, a SN - N distance of 16 - 19 indicates a low height implant might be a better choice, and a SN-N distance of 19 - 21 cm indicates a moderate height or moderate plus implant might be a better choice. That cusp number of "19" or "21", meaning you could go either direction - one height up or one height down.
You will have to use an imaginary placement of your nipple, if there was no nipple preservation.
-
That theory of measurement is also used by a PS to determine if a patient requires a breast lift....
-
Deborah, is there supposed to be a link to an article?
I wasn't exactly sure where some of the measurements were to go in the diagram but this is what I came up with (if I measured the correct areas)
Line A & A3 = 17 cm
B= 16 cm
C = 7 cm
D =17 cm
So if I'm reading this right, I was only supposed to have low profile implants (I have one MX and one MF. My concern is, is that the implant should sit higher on the rib cage. Does this measurement tell that?
-
Your implants are not too low at all! Your implants are sitting where they should be sitting, because the placement was predestined by your inframammary fold. The IMF does not/should not change from where it was pre-MX. Mine sit lower than yours!!!
STEP AWAY FROM THE MIRROR!!!!
[Edited to add emotion!]
-
LOL Deborah
Mantra -- hugs!
-
Whipettmom - thanks so much for your response. This really makes me feel less anxious. I have been reading all of the stories out there and it can be so confusing and discouraging. Can I ask you if you also have Mentors? If so were you able to keep your upper pole with the exchange? It sounds like you are firm and not squishy ...which I prefer more firmness. My last fill was last week and I am to see my PS in one month and he will probably schedule my exchange then.
Anyway, here is to you and to all of the ladies out there..... it is so encouraging and comforting to know that you are all out there cheering everyone along!!! You are angels....and ESPECIALLY you Whippetmom - looking out for all of us gals with sizing issues!
-
Step away from the mirror?? Not gonna happen.
So really . . . they're not sitting too low? Remember I'm short. Doesn't that factor into the foob location equation??
Edited to add: I know. I know!! I have officially reached obsession status. Admitting it is the first step to recovery.
-
mantra - And then, step away from the mirror!
-
Hi -- I've been "around" the BC.org boards (mostly Arimidex) off and on for a few months now and I am SO grateful for them and all of you! I had my bilateral mastectomy in January of this year and have yet to switch from the saline to the silicone. I'm definitely planning on doing so since I'm told it will be much more comfortable, but the time has not been right and probably won't be until next spring. But I do want to make sure that the sizing is correct, and so I will be taking all the measurements you suggest and will have some specific questions for you (and my PS) soon. But before I do that, I just wanted to ask about how the silicone will feel compared to the saline. I'm well aware of the "turtle shell" feeling of the saline, and have been told the silicone will be more naturally soft. However, I kind of like one aspect of the tight saline implants and that is that they are fairly light feeling and there is no movement or jiggle -- I really don't NEED to wear a bra to keep them in place! :-) Will the silicone implants be heavier and more "mobile"? Will I actually need a bra for them? Just curious and wanting to prepare myself! Thanks for any information you can give me...
Sharon
Edited to add: I'm around a 38C...at least I WAS... ;-)
-
Sharon:
It all depends on the size of implants you will require. I have not heard of anyone going from saline to silicone who has not been very satisfied with the decision to switch. But if you require implants larger than 800 ccs, saline is the only choice currently. You could go over to Exchange City and ask this question. I know that Astorm switched not too long ago. It is my impression and the impression of many of us that bras are essential - even more so in volumes greater than 500 ccs - no matter what type of implants you have - because gravity is not our friend.
-
bnita: I just PM'd you...
-
Hi whippetmom,
I had my exchange surgery back in September and I am going to have a revision in December due to a problem with one side dropping. I have saline implants and am debating whether to switch to silicone. One question I have is regarding the relative dimensions of each. It seems like the dimensions of the silicone are generally wider and with less projection than the equivalent ccs of the saline. Am I reading this correctly? So, I'm not sure exactly how to pick the equivalent silicone implant. I've read your comments on this regarding the TEs, but I'm comparing implant to implant. Could I just get your expert opinion based on my measurements? I'm 5'5, ~114 lbs, and ribcage is 29''.
Thanks!
-
JT124: Yes, I know what you mean....the dimensions of the saline implants in the high profile ranges do have more projection and are narrower in width than their silicone HP counterparts. It may be that the saline compresses more than the silicone implants and so the additional projection is needed - when they compress, they gain in width. Honestly, I would love to compare two women of the same build who have the same volume - one silicone and one saline and investigate the projection issue. But what I need to know is, what volume you have currently, or even more importantly, what width of implants do you have currently? We want to stay with the same width so that you can avoid lateral revisions.
Another question I have, is do you want to increase in volume or are you happy with your size?
-
whippetmom: I currently have Natrelle HP68 350 implants filled to 375. I believe the width should be about 11.4 cm with that fill. I discussed possibly going up to a 400 filled to 425 with the PS, but haven't decided yet. And I also told him I would consider the silicone. Another consideration for me on the size is that I'm also having fat grafting with 50 cc. I'm assuming that will add some volume as well. I think I read you had that done too. Did it add extra volume for you?
-
JT: I think you have a couple of silicone options. Let's take Allergan implants for example: You could switch out to Allergan Style 20, high profile smooth round silicone implants with a volume of 425 ccs and your dimensions would be as follows: 12.0 cm wide by 5.2 cm projection. Or, because of your current width, you could go with 460 ccs in the ultra full projection implant, which has a width of 11.4 cm and a projection of 5.9 cm. However, I believe you need to have a nice long torso to carry off the Style 45, because the dimensions make it a taller implant - tends to sit higher on the chest wall. I think though that Style 20 in 425 ccs would be my preference for you. It would be easier to fill out a bra and it would give you a nice look. Width really is pretty essential for purposes of filling out a bra sufficiently. If you are on the pictures forum, take a look at Val61's photos....I think you would be very happy with that size...
Deborah
-
Thanks whippetmom. I see these in the catalogue. It seems like the 425 would be the best option. I don't have access to the pictures forum. Maybe I will request that.
-
Whippetmom:thanks so much - just left the photo forum..you look beautiful!! I want what you have.... LOL! I cannot tell you how this has helped me. There are so many wonderful ladies out there looking GREAT!!! So just looking at the photos - would you say that the Allergans give you a better projection, and overall look than the mentors? It is hard to say. Just wondering why my PS is adamant about using HP mentors and not Allergan.
-
Don't worry about the Mentors bnita....they will look the same. Take a look at sandysunshine's photos...she has Mentor 550 ccs. Most doctors go with one mfr or another simply because they like the rep. You will be just as happy with Mentor...
Thank you for the nice compliment....I got the When-Harry-Met-Sally reference.....LOL...
-
In reference to the saline vs. silicone debate:
-
Interesting article -- thanks for sharing Deborah!
-
Whippetmom -- Yes, I second bnita -- I want what you have too! :-) I just had a chance the other day to view your photos..... you DO look great. I had PM'd you a while back.... I'm getting ready to have a revision on Dec. 3rd and I go for my preop visit on Wed with my "new" PS. The current plan is for 600 HP on reconstructed side up from 475 and 400-ish HP on the natural side up from 213 mod profile. If you could please take a look at my photos and see if you agree or if you have other recommendations. (btw, you had recommended 600.... I can send you that PM as a reminder if you wish). Thanks! Pam
-
HI Kansasmom, I too am from Kansas! This is an awesome forum with great women!
-
Pam: Okay, so I have some additional thoughts. I feel that you could also switch out to Style 45 extra full projection style implants, because you have plenty of chest wall to fill up and these implants sit higher on the chest wall - they are taller - and you certainly are a candidate for this style. My implants sit low also, but our implants sit low because our natural breasts prior to MX were low on the chest wall. Now the key issue with these Style 45s is getting enough height and width with the native breast to match. It is not always easy to use this style of implant with a unilateral. But either the Style 20 or the Style 45 in 600 ccs would be just about perfect for your frame.
Deborah
-
Hi Anna_M,
I see you are from Wellington. I know exactly where that is cuz' my cousins grew up in Wellington! I am in Overland Park and new to the forum... read: I'm not very fast at posting and I make alot of mistakes! I typed a post today and then didn't submit. Not the first time either... slow learner.
Good to meet you sunflower sister!
Deb in KS
-
Whippetmom,
I agree with all the other posts. I looked at your photos yesterday and you have a great result and look amazing!! Seeing your photos, made me realize how much difference the nipples and tatooing can make to the overall result. You look soooo natural. When I initially began this whole journey, there were so many other things to address that nipples and tatooing were the farthest things from my mind. I didn't even want to bother with the extras. But now I want them! I don't even have any idea what technique my PS uses!! I never bothered to ask.
Anyway my question is this... if you want nipples with the c-v flap construction technique (like you have : ) ), does the PS need to plan for that in the expansion process/ implant size selection so that there is adequate tissue available to create a nipple?
Thank you,
Deb in KS
-
Deborah - I will check the pic forum for the mentors 550 photo thanks for your response. I loved that movie When Harry met Sally!!!LOL ..BTW - reading along you mentioned PS making lateral cuts or cuts along the mammory fold - is this the norm to adjust exchanges? Do they have to do some adjustments? thanks
-
I'm curious as to the amount of skin needed for nipples too. My PS doesn't do grafting ... he does one of those 'origami' techiniques. I'm worried that I don't have enough skin to pull to make a nipple because things are so tight.
-
Dawne-Hope: I have the same fear as you!
-
I recall reading a post from Deborah awhile back and if I'm remembering it corrrectly, she said she had never heard of PS leaving extra skin for nipples. I think we're all in the same boat . . . skin is tight but I know one of the co-ordinators told me the nipple is made from the scar.
Also, one of the PS who works with her and did the first part of my 2 week follow up appointment was describing to me the two different methods and told me I had time to decide which route I wanted to go and to let my PS know at my next appointment.
I looked at someone's photos yesterday, can't recall whose, and they had NSM and when I looked at the fabulous results complete with real nipples, I just can't help but be a little envious! I still wish they offered something like a nipple transplant! I keep asking DH if I can have his and he said if I wanted furry ones, he'll gladly donate them to me.
-
Mantra - LOL! Now that's a site ... furry nips!
-
Mantra: LOL! I cannot imagine a nipple transplant that is furry, too!
-
LOL Mantra
-
EEWWWW....!!!!
-
EWWWW is right!! LOL!! Too funny. Maybe DH would be willing to undergo electrolysis prior to giving me the gift.
-
Wow -- that's it just: wow
-
Mantra -- hahaha....funny....furry nipples.
Deborah -- Thanks for the update.... I'll do some quick calculations with the 45's... I see my new PS tomorrow and will discuss with him as well. Thanks again for everything. Pam
-
Mantra- Too funny... actually, I think it's pretty sweet that your DH said that he would give you his
At least the sentiment behind it is good! I really know what you mean... I was envious of the reconstruction with real nipples also.
If you remember where the post on the nipple construction is, let me know. Thx. Deb
-
LOL!!!!
-
Kansasmom: Somehow I think the offer was made because he knows it could never happen. I really should freak him out and tell him I did a lot of research and spoke to my PS and she said "Brilliant. Of course we can transplant his nipples!" And with that, I'll hand him a gift certificate to an electrolysis shop. I'll have the camera ready to capture the expression on his face.
Just noticed we had the same diagnosis.
-
Mantra you are a riot!
-
Hi Ladies, Just wanted to give a shout out (as I just did on Exchange City) to Deborah for giving us the best advice and caring concern for our implant choices. Saw my PS yesterday for pre-op as I will have exchange surgery Dec. 7. When asked by me what type, size, etc. he would use, he said Round, Smooth, High Profile Mentor, in the 375-450cc range. This is exactly what Deborah's advice was a while ago after I gave her my measurements etc. Feel so grateful and fortunate to have your expert advice Deborah and it makes me feel more confident, although I love my PS, and trust him very much.
I asked him about nipples and he said he uses the scar. When asked about the areola, he prefers to use other scar tissue such as a C-section scar. Since I don't have any I'm not sure what he will do. One patient of his had areolas he made by cutting the existing skin and leaving a "margin." The after photos she sent look great. I don't want anything taken from anywhere, so we'll see what he comes up with. I wish they could make a conical nipple and inject fat underneath it instead of the breast looking so round in profile, as my breasts were more of the pointed type. Am glad to have this wonderful surgery though. Best wishes to you all.
-
Good wishes OrchidGal!
-
Mantra- You are right...our DXs being the same! You had MX on one side only, right? And you have already had your exchange. I am jealous. Still waiting in KS.. probably won't be til' 2011, but I will know more on Monday.
What kind of dogs are in your pic? They look like labs. I have an 8 year old black lab and used to have a yellow lab.
Orchidgal and anyone else who is interested- have you seen the diagram that modernmade has of the modified c v flap procedure on the picture forum? It is very helpful to understanding one technique for creating nipples.
Deb
-
Deb -- Mantra had a bilateral MX.
-
orchidgal:
It is my absolute pleasure to help and I am so glad everything is working out for you. I am excited about your upcoming exchange and I look forward to seeing photos! Be well!
Deborah
-
- Deb; I had my first mastectomy in Sept/09 and a PMX in April 2010. My exchange was going to be this month but because I was going out of town for 4 months she squeezed me in and I had it done last month.
Hopefully nips in April when I return to Canada and I think she said four months later she'll do the tattoos.
Yes, two labs. Gee, if I had your black lab I'd have a full set . . . chocolate, yellow and black. The collector's edition.
-
LOL Mantra -- a collector's edition -- you crack me up woman!
-
Okay, I'm just putting this out there to see if anyone feels/felt this way.
I'm completely uncomfortable at the thought of having the PS do the nipples. I'm not afraid of the procedure nor of being awake for it. She does the C flap.
However, it just feels embarrassingly weird. I mean, what do you do while someone is handcarving nipples on you! Chat? Talk about your idea of the perfect nipple?
I just imagine being there shifting my eyes every direction just to avoid looking at her. Before I discovered laser, I used to have my bikini waxed. Nothing . . . no embarrasement at all. But this is so outside of my comfort zone that I've briefly toyed with the idea of not getting them done even though I really want to. And then to think I have to go through this again for the tattoos! It's just beyond weird and part of me is tempted to do the more extensive procedure just so I can be asleep for it. Sad but true. I have to let her know next week which procedure I want.
-
Mantra - Funny because I was always so ashamed of my body my whole life before all of this...but now after having 10 people in the room with between the nurse, surgeon, and 8 residents, man, I have no problem at all sitting there topless. Funny, isn't it?
Personally, I try not to distract them when they are doing stuff.... don't want them to be distracted on the task at hand so to speak. So, well, here's an idea, bring your ipod and close your eyes. Pam
-
Deb -- Met with my PS today.... I am so encouraged with this "new" PS..... I really think I'm on the right path. We decided on 600 HP (perhaps 650) and then the tricky part will be matching the natural side..... we are thinking either 400 HP or 425 HP (up from 213 mod). He has been great to work with and has spent perhaps 15 minutes at each visit just going over the calculations on the size.... great guy. So open to my input. So, I'm all set for a Dec. 3rd revision..... I'll keep you all posted. Oh, and he seemed to think no problem in getting rid of that ripple... I was a little surprised at his certainty as most docs wouldn't do that. Trying not to get excited because I don't want great expectations only to be let down again. Pam
-
Hmmmmm... I figure after 2 galactagrams where they are searching for the suspect duct, inserting the infant catheter into the nipple to inject dye for mammograms, the needle localization, and whatever they did in radiology to inject dye into the breast for the sentinel node biopsies... I am pretty good with fake nipples and tatoos. You can do it. It will be a piece of cake after everything you have been through. The doctors are so professional about it. I do remember that I had to do alot of Pilates back breathing to relax. : ) I was scared to death to let my chest rise or fall for fear of making the doctor miss her target!
-
Pam- just read your recent post. I totally agree. Sometimes I feel like it's not even my body anymore. It's just a science experiment!
-
Like many others have already said, Whippetmom is just the best in terms of sizing advice. I already PM'd Deborah (Whippetmom), but wanted to let everyone else know that I ended up with 450 cc Allergen style 20 (high profile round silicone) implants - exactly what Whippetmom recommended. I had my exchange surgery a week ago and am very happy with how they look so far. I'll post photos on the picture forum as soon as I figure out how to do so (I have access to the forum, but haven't posted any pictures yet). Also, I had an allergic reaction to the adhesive from the bandages, so I currently have hives on my chest and upper stomach. I think I'll wait till the hives clear before posting any pictures ;-) I've had so many complications following my surgeries (staph infections, allergic reactions, the nurse mistakenly using another patient's leftover Fentanyl in my IV), that when I told one of my friends about the hives, she joked that it's time to put me out to pasture (luckily I can laugh at comments like this at this point).
Regarding the underwire discussion, my PS told me that I can never wear underwire bras again. Right now I'm still wearing a post-surgery compression bra round the clock, but when I had my TEs, I alternated between wearing sports bras, going braless (which was kind of nice), and wearing some of my old regular bras from which I removed the underwire (they were older bras that I wore a couple years ago when I was thinner but hadn't thrown out - I'm smaller now than I was before the surgery). I liked some of the bra styles, and it wasn't that difficult to remove the underwire - you just make some snips at the seams and pull out the wire.
-
Mantra: I was so thrilled to know I would be awake for the nipple procedures, because I could pick my plastic surgeon's brain about breast recon issues. I had a ball having my nipples done! LOL!
Pam: I think 600 ccs or 650 ccs sounds good to me. And as for the native breast, it is whatever looks best. Sometimes the MPP is the right choice for the native breast...but as long as your new PS has taken all of the measurements and he can eyeball you and I cannot [
] I think you just trust he will do right by you! Sounds good to me!LG300: Glad to assist! Cannot wait to see photos after you heal! And heal quickly!
Deborah
-
Mantra -- maybe tell your PS how you feel and she/he can reassure you? I agree with the others: it's not a good reason not to do it! And it is kind of cool, I think, to be awake while they work on you. BUT, that said, you may find that when you tell your PS how you feel he/she will offer to knock you out
-
I have not been on this thread in some time because I knew... " Deborah had it covered". and I trust her 100%. Any new sister reading this.... all I can advise is this..... LISTEN to DEBORAH!
But I wanted to respond to the other girls posts here in the support of Deb.. So... I post tonight ... a great big... WOOT WOOT., for our Breast Whisperer..
XXXOOO,
Laura
-
I agree -- Deborah is AMAZING!
-
AW SHUCKS, YOU GUYS!!!! I am so blessed to come here tonight and read these sweet and loving comments! Knocked my socks off!!!
-
Well, put those socks back on lady..... you still have work to do here.....:) XXXOOO
-
Hello ladies,
I am having my fips done on Monday! I will let you know what is talked about as I am going to be awake. Deborah, I think that is fantastic that you had such a great experience while getting yours done! Give me some great incentive and thinking positive! I have canceled once before but this time I feel the timing is right so I am going forward, ready to give these girls a face if you will LOL! Hugs!
-
Anna_M - Good for you! Congratulations! I too have cancelled getting mine done. I was supposed to get them done this Tuesday, 11.23. But I post-poned it and now it is just going to be my three month (turned into 4) post-exchange follow-up. How did you know the timing is right? I'm struggling with this decision ... it shouldn't be this hard! LOL!
Here's to a really pretty face for the girls!
-
Two one-eyed faces girls.... like cyclops....
-
Hi wonderful ladies! I'm so glad to be moving onto this phase of my journey! I just had my BMX with TE's placed 11/11. I am going tomorrow for a follow up appt with my PS and to hopefully have these drains removed! Whippetmom, I will be coming to you for advice on implant sizing if you don't mind, once I have my operative report as to what kind of TE's were placed. So glad we have this forum to share our experiences!
-
in_cognito: Welcome....and I will be happy to help you when you are ready!
-
Anna- Best of luck tomorrow! ; ) Deb in KS
-
You are in my prayers tonight Anna!
-
I just want to say hi to Deb (kansasmom)...I too am in Kansas, diagnosed on Oct 1st and awaiting by BMX w/TE's on Nov 30th. I live in the Hutchinson area and this site and all the information has made this journey much less frightening.
Thanks to you and all the others for your help,
Kelly
-
I am leaving the house at 430 a.m. to head to te hospital for my stage 2 free tram. I am going to have the lift done on my natuarl side and get implants on both side. My natural side is a small c now and my TRAM side is a full c. I am getting 275 ccs put in the natural side and 200 ccs in the TRAM side. I assume that I wll end up with Ds that are hopefully pretty even when it is all said and done.
I will also have a little bit of dog ear revision. They are not too bad but one side bulges a little. I can see it in s swimsuim and I figure I may as well have him deal with it now.
I am nervous. I am worried about messing with this free tram flap by putting an implant behind it. I so do not want it to fail! I feel bad for even risking it but I really do want it to have a less square shape and I want to be bigger.
ugh- I am just rambling on now but am dreading the whole ordeal. I wish surgery day was over and I was back home resting!
-
Welcome Kelly! I had my BMX in November also....two years ago! You are just starting your journey, so please come back to update us after your surgery....
-
jc3win: My girlfriend had a free tram flap bilaterally seven years ago and, like you, did not feel she had sufficient volume. So she went back for implants as well, six months later. She is very happy with the results.
Please let us know how you do....we want to hear from you after surgery. I have you on my list now for prayers tonight...
-
Whippetmom - Can I call on your expert advice?
I had my BMX with TE's on 11/11. Here is my info so far:
Height 5'6", weight-139, ribcage measurement= 33
The TE's are Allergan catalog #133MX13. Initial fill is 300 over 500ml (not sure what that means? - I think I have 300 to start?)
Alloderm regenerative tissue matrix 6x12 cm extra thick.
I remember my PS saying something about going to at least 600 for implants. I will be getting 60 cc fills weekly starting in about 3-4 weeks.
What are your thoughts? Thanks so much!!!!!
-
Hello my friends!
Well, I am home from having the fips done. Deborah you were so right, a great experience talking and talking while he was creating on the canvas. I have more feeling in each breast than I realized and my PS was also quite taken back by the amount of sensation I have. Of course, the lidocaine takes care of it, but it took quite a bit to get me numbed. Amazing! All I could see was their big bright eyes shining from a slightly elevated position. So strange to see, another step in the journey! I will get to see them tomorrow after 24 hours, of course I love it as I remember many ladies sharing here that they seem so big at first and my PS said they will shrink over time. I so appreciate this site as it truly helps us prepare as well as ask the right questions.
Dawne-Hope you asked me how I knew the time was right, well as I said before I canceled once before in September after 4 months from exchange, it just didn't feel right then. I struggled with the decision but after seeing all the pics here in the forum I felt that the fips/nips just give them that real breast look that I have been struggling to accept in my head (not feeling or yet looking like a real breast). I am praying my results turn out good, I have lots of scars yet, but they are fading ever so slowly. Hugs and prayers for each of you and thank you so much for the thoughts and well wishes!
-
Anna_M - Thank you for your reply. I'm so excited for you and very glad that the experience was a good one. Yay for you!) I pray they turn out beautifully and you heal well!
-
kdhawk-- Hi fellow sunflower! I am in KC. I also had to wait 2 months from diagnosis to BMX (5/15-7/15). It was hard waiting, but you are almost there. It's also a lot of decisions to make. Are you having your surgery in Hutchinson?
You have come to the right place for support and encouragement!! The advice and knowledge of Whippetmom and so many others on this forum is incredible. It will be invaluable to you as you recover. I had and (still have!) so many questions. It has been helpful to learn from others who have been there and were so willing to share their experiences. You're going to do great.
Anna_M-- So glad it went well for you today. I can't wait til' that will be me getting fips/ nips. I completely agree with you that after seeing the pictures and hearing the comments of others (like yourself) who made the decision to get them, I want to finish the look if I can. To you! You did it... or should I say them : ) ( . ) ( . ) see how good they look?
I had my last fill today and scheduled my exchange surgery. January 4th. I asked the nurse about the PS's technique for fips/ nips and she called it a tri-lobe. She showed me a paper pattern ( it must have been a McCall's or Butterick design) that looked like a three leaf clover that they place over the MX scar to create the nipple. To me it sounded and looked very similar to the cv flap. Anyway, that's a ways down the road.
Deb
-
Kansasmom, you are getting closer in the journey! You are going to fill so much better with the exchange! It is amazing the immediate comfort you will feel. I always felt tense with the expanders as they were painful for me. Others here shared a more positive story! Hugs to you and to all the other ladies!
-
in_cognito: Sorry for the delay....I missed your post somehow when I scrolled through to see if there were any requests. I do agree with at least 600 ccs - high profile smooth round silicone implants. 650 ccs would be a nice size also. So I think your PS has the vision for you. When your TEs are fully expanded at 500 ccs, you will know how you feel about them and we can reassess the numbers. You can always email me photos at any time during your expansion process if you have concerns, or you can photo-journal your progress on the pictures forum.
Glad you are through the surgery - it is nice to be over that part of the journey.
Deborah
-
Anna: So glad everything went well today! Are you planning on posting pictures of your new fips? I am starting to get very curious as mine will be coming up soon. 4 months seems to early for me--thinking of waiting until February for mine. Congratulations!!!
-
Have a question about the name of a nipple procedure. I was looking at the diagram posted by modernmade of the modified C V flap procedure. I saw my PS and asked if she did the modified C V flap and she said she did.
When I got home, I looked up some other photos of this procedure and they were different than the diagrams/photos posted by modern. I did a bit more research and it seems like the procedure is called modified C V flap with areola grafting.
Did anyone have the same procedure at modernmade and if so, did you PS refer to it as modified C V flap? I'm thinking I asked about the wrong procedure and from her assistant's description to me many months ago, I really think the procedure she does does not include the areola grafting.
I'm wondering if I should consider going elsewhere for this final step although I'm not really sure which docs do this in Ontario . . . if any. For those of you who are already finished, do you think the finished product of the areola grafting is worth the effort in switching PS?
-
Mantra: Mine doesn't graft on the aereola, either. good question! Ladies???
-
Mantra- hmmm. Idk, but I am interested in the answers to your questions.
-
Mantra: Areola grafting is not as widely performed in the past decade or so, with the advent of areolar tattooing. Once tattoos were introduced, the insurance companies probably jumped for joy....the costs of this aspect of breast reconstruction were mitigated considerably. I have Kaiser insurance and Kaiser, twenty/thirty years ago exclusively grafted areolae. Not any longer. Tattoos are the only option now.
I have been researching this entire issue, since someone else just PM'd me with a similar question, although hers was more directed to the issue of losing some projection at the center of the mound, due to skin-borrowing for the c-v flap. So I came upon this article describing the use of a biocompatible injectible substance which will create a three -dimensional effect on the mound. It appears to be done in three stages, after the nipple is created via c-v or other flap procedure. Areolar tattooing is performed at some point after the last injection and patient/doctor satisfaction with projection is achieved.
http://www.eplasty.com/index.php?option=com_content&view=article&id=396&catid=15&Itemid=116
Something to discuss with your plastic surgeons....
Deborah
-
Artecoll, BTW, is a substance typically used to plump up the facial structures. I see it is pretty widely used in Canada....and not terribly expensive in Canada. So if your PS performs facial cosmetic procedures also, she might have access to it.
-
And here's a ps about Artecoll. If you're going to get it, make sure they do the scratch test.
The plastic surgeon who tried to repair my nose after it was badly broken, was going to use some Artecoll. I had 11 grafts taken from my ears to rebuild my nose but some of them failed. So to even it out, he was going to use some Artecoll to build up the side a bit. It's permanent so that's why he considered using it. Anyway, he said he had to do a scratch test first. I thought . .. what a waste of time but of course, let him do.
Felt great for about 6 hours. Then I started to itch everywhere. I had never experienced itching like this before and was going to go to the ER to get some meds for it because I was scratching so hard that I was bleeding. It finally settled down but I obviously was allergic to it and can only imagine if he had gone ahead and injected it without doing the scratch test.
-
Whoa...that is certainly worth mentioning Mantra! Thank you for sharing....
-
I'm getting very excited. I have my exchange on 12/6. My PS was very happy to hear Whippetmoms suggestions. I had rads, but my skin is looking good...but, just in case my PS has 3 sizes ready for the OR.
My PS says I will have two drains...yuck!
-
Hi Whippetmom and All - I am getting close to scheduling my exchange - I meet with my PS in December - first week - been looking through the photos and reading stories. Getting nervous. Still confused. I know my PS wants to exchange me with the Mentors high profile (600 cc to 650)but I have been reading that the Naturelle's will give you more projection. Need advice. Also is there anything that I should be aware of when he starts talking about pockets etc. And should I start thinking of nipples and losing projection on breasts - how much more does he take off from breast to make nipple? Do not like the flat look. Sorry for the flood of questions. Thanks
-
jc3 -- I am in the same boat.... going in for my revision on Friday 12/3 and am apprehensive about it. I had to fight and fight for the revision and then now that it is here, I'm worried. Worried that it will make things worse instead of better. But, I dig deep inside and I know this is the right thing to do..... it is what my body is telling me will make it right. So, how are you feeling now? Pam
-
Deborah: thank you so much for sharing this! I just sent an email to my PS asking if he will do this for me, since fat can go away over time.
Happy Belated Thanksgiving! I so very grateful to have found this thread and this site and everytime I get dressed in the morning I am so grateful for all of your help! Thank you!!!
-
bnita: The difference between Allergan and Mentor high profile silicone implants equates to mere millimeters. One or two millimeters. A negligible difference. Mentor implants are just fine. You can discuss nipples with your PS....the issues we have mentioned. Find out what technique he uses...
MBJ: Sounds interesting doesn't it? But perhaps the allergy contraindication is high, hence as Mantra suggested, the scratch skin test is required first. But I intend to ask about it also....
Deborah
-
Thought for the day (way off topic): why is it that fat from fat grafts "disappears" but not the fat in it's original place in our bodies?
-
Excellent question, Lilah! Doesn't seem fair, does it?
-
No it sure isn't Tory!
-
It's Murphy's Law, Lilah.
-
-
Lilah: Good Question! LOL!!!
Deborah: I forwarded your post to my PS and this is what he replied:
We are also about to do a similar study with a new nipple insert. Artecoll hasn't gained wide acceptance for NAC reconstruction. I just met Colleen a couple of weeks ago in San Francisco at a meeting.
We can discuss when I return.
thanks
Wes
Wesley G Schooler MDAssistant Clinical Professor, Surgery
Service Chief, Plastic Surgery LAC-USC Medical Center
Associate Program Director, Plastic Surgery ResidencyMaybe I should participate in the study???
-
Man MBJ I think it is so cool that your Doctor actually corresponds with you via email.
-
My dr's are the best! I have emails for all three plus my Onc's cell phone!
-
My gyne is the only doctor who will respond by email. I wish my other doctors would. When I lived in Toronto, my family doctor would charge an annual fee which would allow you to talk to him by phone. I would gladly pay a fee to have my PS and BS communicate with me by phone/fax/email . . . or even smoke signal. Although, I imagine smoke signal would go against the privacy act since sooooooooo many people know how to read smoke signals . I just hate getting home from an appointment, realizing I forgot to ask a question, booking an appointment for a month away (if I'm lucky), spending 4 hours doing a return trip for the appointment, when a simple phone call or email would suffice.
-
Hi everyone...
Hey, I have a friend sho had her mast/te last week.
It was a 6 hour surgery.
They cut her all the way across her chest... put TE in. Then made another incision in her armpit to remove nodes.
They told her on the profy side they did a " lift" while they did a mast on that side too.
Remember, she was a bi-lat.
I have NEVER heard of this? She did not use my doctors because they were not on her insurance.
WHY in the world did her surgery take 6 hours ( no complications) to do a bi-lat ( lift???) and put in TE? THEN make another cut ( after cutting ALL the way across her chest already.. and no... the cancer was not close the the chest wall... it was 3cm on the lower outside) to take out nodes?
THANK YOU for reading this... I hope someone can explain this.
-
Mantra -- you constantly crack me up!
Laura Estepp -- OMG that sounds barbaric! (a) exactly WHAT did they lift on her prophy side if they removed it???? (b) clear ACROSS her chest as in one single cut from right to left? Really? She must be so upset! Did you see the results or is this her reportage? She may have gotten some things wrong and she also may be exaggerating about the cut. There is absolutely NO reason to make a cut between the breasts!
I had my SNB at the same time as my second lumpectomy, so there is indeed a separate incision for that; it is 4 inches higher up than where my mastectomy scar ends so that may be why they did the second incision for the nodes. The sentinel node can be anywhere and "lights up" when dye is used... so that may not have been under their control (and, for example, in my case, I would NOT have wanted a single incision up to there -- it would have meant cutting four inches of skin that did not need cutting).
I am baffled, though, about the lift remark.
-
Hey, I am new to this thread..have TE Mentor medium height contour 12.7cm/10.8cm. I am 5ft 4" 135lbs..rib cage is 32"...keep asking ps about filling to reach full C cup he says he does not do cup sizes....didn't know if you could suggest about filling to reach desired size?? He also says he puts slightly larger implant in at exchange..dont want to have coconut like breast want a natural contour... Am filled to 350cc now. Thanks for any help....Sindy
-
Yes Lilah, all the way across... and there saw NO good reason to do another node scar..:( She had a bi-lat from the start. No Lumpectomy. I wish I would have known this was an option out there.. I had NO IDEA.... She was SO upset and taken back at what she saw when the bandages came off a week later!
-
Laura: Have you seen her personally? I wonder if she should even trust this PS to complete the job??? She has the option of going out of network if the PS IN her network is incompetent in his surgical technique. She can always email me photos. You have my email addy.
I am out of town on vacation this week, so checking in only frequently.
Stay well everyone!
Deborah
-
Well Laura that is just heartbreaking. I just am appalled that any doctor would do that. It sounds like mutilation to me.
I agree with Deborah -- if I were here I would NOT go back to that doctor.
-
That is just barbaric, Laura. What a shame. I cannot believe they allow doctors to do this to women!
-
Whippet - I just wanted to stop in and say 'thank you'. You helped me with sizing and I had my exchange yesterday. We went with the 325's and I think they will be perfect. Can't wait for my swelling to go down.
thank you!
-
mom3b1g - Yay!!! I have 325 too! I wasn't prepared for the myriad of changes, so hang in there for the ride! Congratulations!
-
Dawne -Hope = thank you! I am just crossing my fingers taht my radiated side holds up and doesn't rupture! Hoping on Friday I will get a look at them (I go back to the ps).
thanks!
-
mam3band: Congratulations on your exchange! You will feel like doing more, but take it really slow and no reaching, lifting or pulling for a couple of weeks to give yourself time to heal. Nothing heavier then a couple of pounds for awhile.
-
mom3 -- wahooo on being past this milestone!
-
mom3: So glad to have helped! Let us know how things are looking for you!
-
I love my reconstructed breasts right now. The problem is they are currently Mentor 450 TEs filled to 510cc. I don't know what size implants I will need to duplicate this result. My PS recommended 500cc HP Mentor but everything I've read here gives me the feeling this will be smaller than what I have now. I understand that the width of the larger sizes is an issue and don't want to go any wider. WhippetMom, can you please give me your opinion on how to achieve these results with silicone implants?
-
mom38: You need at least 550 ccs in a high profile implant - preferably 600 ccs - to replicate what you have now with your TEs. 500 ccs will not be sufficient and you will be disappointed. You probably have sufficient expansion for 600 ccs...but only your PS will know for certain, based on your skin integrity currently. What is your ribcage circumference? Measure under the TEs....
-
30.25 inches.is the circumference. I'm extremely healthy, bc withstanding, great circulation and have had no issues w/nonelasticity or thin skin. Thank you for your quick response and insight!
-
Mom38...550 ccs or 600 ccs high profile smooth round silicone !!!
-
You are the Best - Thank You!
-
Thank you
I have seen her. I saw her again today... two weeks out of surgery. Her swelling had gone down and things are looking better.
As she has questions that I cannot answer Deborah.. I will ask you... I told her.... I could help her get the size mounds she wants. She was a DD.... and would love to look like a C... as she gets closer to needed help with this.. I will get with you. THANK YOU!
Actually... her scars are all the way across... BUT... as the swelling ( SO MUCH MORE THAN MOST OF US) goes down.. I see the placement of the incision. She actually looks like she went in for a breast reduction... She looks a mess now... but I do believe.. she will have a good look a year from now.. Time will tell.
Thanks !!!!!
-
Laura -- I'm glad to hear that you think it will turn out alright. That is a huge relief!
-
Hey am reposting this and need help with sizing please!!! Am filled to 400 cc now with much pain this time... am 135 lbs 5ft 4" 32" rib cage with TE medium height Mentor...PS not much help with sizing says he doesn't do cup sizes.he does say he puts in slightly larger implants after filled..I am active and don't want to have too big of breasts.. was a B cup prior to BLM..thinking maybe a C cup but not sure how much too fill to get there. Also Onc suggesting 4 rounds of chemo and having harder time with decision to do that than the BLM! Any suggestions or help would be greatly appreciated...getting weary of this whole process!!
-
estepp - my nipple sparring bilat dmx w/three nodes took 7 hours. the incision went from the nipple lateral to the armpit and they were able to get the nodes from that opening. The PS removed the previous implants and all the scar tissue to have 'fresh' skin and baseline prior to inserting the TE. That was part of the explanation on why it took so long. Also, I have a hole on either side where the drain came out. As the fillings are progressing the scar is smoothing out and I think they will look great in a year. I'm so sorry to hear about your friend, perhaps hearing that other surgeries can take as long may comfort her.
-
neversaydie: I am so sorry you had to repost a question! I never saw the first one!
In answer to your question though, there are a couple of ways you could go with this. You would be a candidate for a high profile or a moderate plus profile style implant. I do not know if you are a bilateral or unilateral....if a uni...it all depends on the size of your native breast. The PS will want to match that side to gain symmetry. Also, I would need to know the volume of your TE....essentially I need to know if it is a 12.0 cm or 13.0 cm wide TE. But again, it all really boils down to whether you have two expanders or one....
ADDENDUM: I just looked at your previous [missed] post and see your TE is 12.7 cm. It is still unclear if you are a uni or BMX. If a BMX I would say 475 ccs to 500 ccs in a high proflle smooth round silicone would be nice on your frame. But if you are a uni, it depends on the size of your native breast and w/n you are going to have it augmented and/or lifted. But since you state you are athletic, you could also use a 450 cc moderate plus profile implant, which would have sufficient width but less projection and would be appropriate for your frame. Again, all depends on whether you have one or two TEs....
-
Laura: I will be happy to help your friend when she is ready!
-
Laura: So glad that your friend is doing and looking better.
-
I could use some size advice. I have an Allergan 133MV TE with a 300cc fill volume. Right now it is filled to 400cc. (I started with 150, got 2 fills of 100, and this week got 50cc) I am 5' 1" and 112 pounds and ribcage is 29. I am going to be getting a gummy bear and I'm a uni and a nipple sparing. My natural side, which is a barely B cup size is not very droopy, but I decided to get a small implant for a more similar look (and a little size boost while we're there anyway)
I thought 400 cc would be pretty big, especiall on little me, but it really does not look big - just kinda wide and round. My fills have not been very uncomfortable, but the PS is not sure if he wants to put in any more because the skin mayl be too tight. I'm seeing him in 2 weeks and I want to be prepared to discuss sizes for the exchange and whether to ask him to put in another 50cc. Sure it feels pretty hard, but how could it not with a 300 cc TE filled to 400 already.
I don't want to be very big, just a B plus or C. So should I stay with the 400 or try to add another 50cc? Thanks for any advice.
-
heebie: I think you are going to end up in the 250 to 280 gram range with the anatomical on your MX side. I do not know what your PS has planned for your native breast. It all depends on your native breast really. If a small implant gives you sufficient height on the native side, you could go with a taller height anatomical on the MX side. There are so many variations of height and projection in anatomicals - so it all hinges on how much your native breast projects and how much upper pole fullness is achieved with an implant. It is difficult for me to say whether you have expanded sufficiently for any particular anatomical. You certainly have enough volume for a smooth silicone round, but anatomicals are addressed so much differently from one PS to another. [If you were going with silicone rounds, for example, I would say 325 ccs or 350 ccs would be very nice on your frame.] Some overexpand considerably for a much smaller anatomical, and some overexpand only a little for the same volume. Ask your PS at this point what size he intends to use and what style he would use, and then come back here and we can discuss.
-
Whippet Mom: Thanks for your answer. I am confused about the difference between the Gram amount and the cc amount. Are the anatomicals usually sized in grams and the rounds in cc's?
I will speak to my PS about sizes in 2 weeks when I go back. I just don't know how to judge how big I will look with the gummy to how I look now with the TE. I know the shape will be different, but I wonder about the projection and overall perception of size.
-
Yes....anatomicals are in grams and silicone rounds are in ccs...
I agree...it is difficult to assess how you will look with the anatomical implant, because we do not know if your PS will use an Allergan 410 to fit the pocket or if he overfills and uses a smaller implant. If he expands the pocket specifically to fit the anatomical, you will be about the same. If he overfills and uses a larger pocket for a smaller implant, you would be smaller. Again, I do not know his mindset for expansion with the anatomicals. It is entirely different trying to size out anatomicals....
-
Mom and everyone... Yes, Judy was grateful to hear many of you had long surgeries like she. I forgot to tell you all that I did inform her of this. Thank you !
Deborah.. thanks! I will PM you when the time comes. You are the best... and I only come to the best ! LOL....:).
....... -
neversaydie - about your chemo anxiety - did you have an Oncotype DX test done? That has made the decision much easier for many of us & I recommend that you ask for it if you have not had it.
-
Hi Deborah a;nd All - thanks for your response on the Allergan vs Mentor. I see my PS tomorrow about the exchange and will keep you all posted. I will be sure to ask about the nipple technique he plans on using and will share with you. Have a great week!
-
Recent study regarding patient satisfaction of saline vs. silicone implants for breast reconstruction after mastectomy:
http://abcnews.go.com/Health/video/reconstructive-breast-implants-silicone-saline-12124677
-
Hi Whippetmom,
I will not have my exchange until sometime next year but was wondering what size implants you would recommend. I am currently in the middle of radiation treatments and hopefully my skin and TE will hold up. I am 5' 5" and 130 lbs. The width of my rib cage is 32". I had a unilateral mx with alloderm and my tissue expander is Allergan 133mx-14. I am currently expanded to 550cc. My native side is a small B size and I would like to be a fuller B or small C. I will be getting a small implant and a lift on the native side for symmetry. The PS gave me a Allergan Natrelle book so I am assuming that is what he wants to use on me. Any advice is greatly appreciated.
-
Hi Whippetmom. I finished my rads in early October and am pushing my PS to get these painful, awful TEs out of my body ASAP. She would be happier if I waited several more months but I cannot deal with pain every day of my life. (They were placed at my BMX surgery 3/16/10).
That said, I go in for a consult with her to see if scarring from rads has slowed or stopped in a couple of weeks. How can she tell?
I am 5'8", 185# with a ribcage measurement of 36. I have Allergan 133LV-15 TEs with a recommended fill of 400 --- I am filled to 420. I would like to go a little bigger if possible. Recommendations?
I am strongly leaning toward silicone, but my PS says 95% of what she does is saline. I am happy with her work, but unsure if I should find another PS who works more with silicone? Advice?
Thank you in advance and thank you for all the time and heart you put into helping so many women.
Jen
-
bher: You have a TE with a width of 14.0 centimeters. There are two different styles of Allergan Natrelle smooth round silicone implants which would work well for you. One would be a Style 15, which is a moderate plus profile implant. In this style, I would recommend 533 ccs or 587 ccs. In Style 20, which is a high profile implant, I would recommend at least 600 ccs and perhaps 650 ccs. If your skin is really tight with your TE currently, your PS will probably want to use the smaller of either two styles. Since the key is gaining symmetry with your native breast, it will all depend on how much droop you have with your native breast after it is augmented. Your PS may need to use the smaller implant to enable a little more ptosis or droop. So go over these styles and sizes with your PS and see what he thinks might work for you.
-
packjen:
Jen: Ask to be one of the 5% of her patients who gets silicone.
Because you have the low height TEs, you have the ability to exchange out to a substantially larger implant without much of a problem. That said, sizing is largely predicated upon the integrity of the skin on your rads side.
In a perfect world, I probably would have recommended that you have high profile round smooth silicone implants with a volume of around 700 or 750 ccs. I just do not know that your PS is going to get you there with your current TE volume. Your TEs have a width of 15.0 centimeters, and so to get that width, you might need to go to a moderate plus profile style of implant. I would say that the smallest size I would recommend would be 616 ccs in Style 15 [Allergan Natrelle], which has a width of 15.2 cm. Based on the type of TEs you have, I think it is quite feasible, skin integrity permitting, to use an implant with this volume.
Another thought I have is that since your PS has a fondness for saline, she might consider using a Mentor Spectrum expandable saline implant. This implant is unique in that it permits gradual filling over time. With this implant, the PS can add saline in small increments over a period of up to six months, which might enable her to exchange you out sooner than later, and also might permit going a bit larger than you could with silicone rounds. Once you have achieved as much fill as you desire or tolerate, the fill port is disconnected and voila! You are done. I would choose either the largest or second largest size in the smooth round Spectrum.
http://www.mentorwwllc.com/breastsurgery/augmentation/cs_ba_prod_adjust.htm
This should give you some fodder for discussion with your PS...
Deborah
-
Whippetmom,
So it looks like I will loose quite a bit of projection if I go from my TEs w/ projection of 6.3 to the 616ccs in style 15 at 4.9 projection. Even though the total ccs is 200 more than I have now I will look smaller/flatter? Is that correct?
Also, can you tell me why so many women tend toward the smooth implants vs. textured?
Thank you for the interesting option of the expandable saline, but I am thinking saline won't give me much/any jiggle or squish. I like a softer breast if at all possible. Am I asking for the moon?
Jen
-
Jen: Then you just push for silicone implants. The projection with TEs is a function of permitting the skin in the center of the breast - [where the MX defect typically is located and/or the-nipple areolar complex has been removed or disrupted if in a NAC -sparing] to stretch sufficiently for closure over the future implants. You could closely approximate that with a 700 cc implant in Style 45 - it has a 6.0 cm projection. However, with your rads skin issues, you need that extra skin for good implant coverage and so the Style 45 might be a risk for you. You could tell your PS that you would like for her to assess whether she could use a 700 cc implant in Style 20 - a high profile implant.
Textured round silicone implants are rarely used in two stage breast reconstruction, as they cause traction rippling, and we are already at heightened risk for rippling due to thin skin issues after MX.
Deborah
-
packjen:
You might want to ask your Dr. what the percentage of breast reconstruction patients she/he has. If the Dr. does 95% augmentation, that might be the reason for the high percentage use of saline. I chose to have saline. One side is fine. One side has ripples. There are plenty of cases where silicone implants have ripples. Ripples are very commom in thin woman.
-
Thanks Whippetmom for your input. I think my PS will probably want to use a smaller inplant because I've been told that I am overexpanded at 550 cc. He has told me he likes to use a smaller implant than the expanded TE size in order to match the slope of my augmented side. Do you know if more saline can be added to the TE after Rads is done? I will not see the PS again until a month after my radiation is complete. I will continue to follow this very interesting thread.
-
bher: Yes, more saline can be added to the TE at some point following rads. Keep me posted on how your skin is doing once radiation is underway. Talk to Laura [Estepp] over on Exchange City and ask for tips on taking care of your skin.
-
Whippetmom - I was hoping more expansion was possible after rads just in case I need it. I am a little more than half way through my radiation treatments. My skin is very red (no blisters) and is getting tight around the expander but the RO thinks it is looking good. It is a very uncomfortable process. I will check out the Exchange City thread. Thanks!
-
bher: What are you using on your skin? You should be slathering product on that rads skin. I think Laura used Aquaphor and perhaps something else also.
-
Whippetmom - I have been using Utterly Smooth cream (recommended by RO) since before starting Rads and then a few weeks ago added Miaderm. I am continuing putting on the lotion. I have not used Aquaphor but may try it. The TE tightness is bothering me more than the sunburn skin. I will be so glad when radiation is over.
-
Hey there everyone,
just back from my exhange surgery: Mentor smooth round high profile 375s. Everything went great. 5 hour surgery, have one drain in each side, ace bandage wrapped all around my torso. A bit sore, but have lots of meds to choose from! Wish I could see them!! Extremely happy, it was so easy. Best wishes to all, and thanks again for your support. As soon as I get these drains out, etc. I will take photos and post to Tim Tam's site.
Happy Holidays! Melissa
-
Congratulations, Orchidgal!!!
-
bher: Sounds like you are on the right track with creams. Just hang in there....it seems like forever but relief is on the way, because your exchange date will be here before you know it!
-
Melissa: Congratulations! I cannot wait to see photos!!!
-
JEN
I wish to pipe in here, from one RADS sister to another!
It is not only your skin they are looking at to get a bigger implant. IT IS YOUR MUSCLE. After rads... it just does NOT want to expand much more.... MAYBE 50cc( at exchange).You could try to get a few more fills now. and then wait 6 weeks after that for exchange... that might help you get a bigger implant.. Also........ since your rads breast WILL be harder than your other....... PLEASE ASK FOR SILICONE..... this is your body... you TELL her what you want. Deborah is right on. PLEASE get the silicone , closest to the SAME SIZE as your TE... because your Rads breast WILL be a tiny bit smaller than your non rads side... Also..... YOUR RADS BREAST WILL NOT NOT NOT......" drop and fluff" they do not settle...
My rads breast is a tiny bit smaller looking and it is perkier than my non rads implant. It is not that noticeable... so I am 100% AOK with it.... I still look really pretty ( foobs)
Your PS can take one look at your skin and know if you are ready for exchange... if they do enough rads/implant reconstruction. Mine told me at first...6-12 months until exchange. THEN I knew my skin looked great 2 months after rads... SO, I went to him... he took one look at me and said.... YES, you can have exchange at 3 months.
.. He was right.If you have any questions about rads and implants... please PM me. I do not check this thread very often.... but Deborah ( my dear friend....) will give rads/implant girls my name, if she feels I can be of help to them.
So far... I am a success story of rads and implants.... but it took much research and trusting the right people... to get me here.
Peace!
Laura.
( Hi Deborah....love you)
-
Congrats Melissa!!
-
Love you too Laura...
Jessica: Finally! An avatar....and you are so lovely!!!
-
Deborah--lol
-
Hi Deborah(- just PM'd you) and All.. PS scheduled my exchange on Jan 5th. He briefed me. In doing so he said he would prefer to make a new incisions under the breast to do the exchange rather than using the old incision - Can anyone share with me their experiences? Does it matter? I thought he would use the old incision - less scarring. Anybody have any advice to share? Also do you think that January is too soon to get exchange if I had my last fill Dec 4? Read somewhere in this forum that the longer you wait after the last fill the better. My last fill was 500cc's and wondering if I should have gone a little more - he is bringing in 550cc's - 600 cc's and 650 cc's into the surgery room to test. He mentioned pocket work. Is this the standard procedure w/exchange ? He only mentioned the work be done below my breast - guess I had some extra space to squeeze in a larger implant if he uses the 600 or 650. Not sure . I do not want his pocket work to shorten my midriff - make me appear short waisted. Any advice out there? thanks so much for being out there!
Congratulations Orchidgal!! I hope you have a speedy recovery!
-
bnita: I did not get a PM from you...it might have gone into cyberspace???
There must be something going on the the inframammary fold region....I know of very few cases where a new incision is made for the exchange. You could send me photos or post them on the pic forum, so that I can see what is going on with your IMF region that he feels he needs to made adjustments. If you have stretched sufficiently - if your skin has responded well to expansion, which only the PS can really determine, January should be fine. But I just want to know what is going on "below the breast". Pocket work is very common - not something to be concerned about - but let's see what he is talking about in the IMF region.
Deborah
-
Deborah: Odd that you did not see my PM. PS said it would be simpler to exchange via the IMF region - he commented that most augmentations are done that way.. He could add the fipples sooner because my scars would not have to reheal. I really do not care if it takes longer for fipples as I am in no hurry. He said that he could go through the original scars for exchange if I wanted - but may be slightly longer - do you think? . I can post my pics as soon a I get some privacy at home - kids running around. So there is really nothing unusual with IMF other than PS preference of entrance. He said my skin has responded well to expansion. I thought maybe because I wanted 600 cc'd he had to go via IMF. The pocket work just concerned me because I thought it was because of the larger implants though I will gladly give up the larger size as I do not want a shorter torso. When I asked the assistant if I should get another fill - she said it would not make much difference for the exchange. I am getting confused - but I do feel better now that you told me pocket work is common. So I should not worry about the torso issue with pocket work - I should have the same size torso as I have now - correct? Also, since implants life expectancy is 10 - 20 yrs - can they use the same incision for exchange? I hope these questions are helpful to others as well. I edited my original post 3hrs ago - rushing out of the house with the kids to shop and it was sloppy like the weather we are having today. thanks agian
-
bnita: I don't know why he needs to extend the incision....unless your incision is unusually short. But let's see photos. I'll PM you my email address.... or post them on the pic forum. Also, why don't you ask this question on Exchange City - about your PS going through the IMF for the exchange....
Deborah
-
Whippetmom, I finally have some information to see if I am on the right track....before my BMX I was a 36DD and a tad smaller is fine but I feel a bigger upper half balances out my wider bottom half. I am 5'7", 160# and my ribcage below my breasts is 32". My PS put in Natrelle 133MV-15 expanders and he added 300cc at the onset. I go back to see him tomorrow and he may give me my first post-mx fill. What are your thoughts on his choice of expanders for me?
Kelly
-
Kelly: I would recommend 750 ccs in a high profile, smooth round silicone implant. You would need 750 ccs in Style 20 [using Allergan since you have Allergan TEs] in order to match the width of your TEs. Your PS used TEs with this width because this was the base width of your native breasts. One important question is referable to how much skin you have overlying the TEs. If you have pretty sufficient skin flaps [due to your DD cup size pre-BMX] you might not need to expand fully and in most cases, I see patients overexpanded more than necessary, thereby imposing too much droop or "ptosis" at the time of exchange. So you might want to email me photos once you have another 100 to 150 ccs...so that we can determine how much further you need to go.
Deborah
-
Thank you Deborah, I will get some pictures to you as soon as I get a few more fills. I do have quite a bit of excess skin waiting to be filled up...it looks strange at this point to say the least but I am grateful that they use as much of what you had originally to reconstruct the new ones. I see my PS this afternoon and frankly I am excited about this process.
Thanks again for your help Deborah!
Kelly
-
Thanks so much for the well wishes. I'm a week out, and got the tape off, drains out today. Still stiff & sore from all the pocket work, but only taking anti-inflammatories. They look beautiful. They don't project as much as the TEs did, and I asked the PS why he didn't go larger, as we had discussed sizes of 375-425. He said that the 400 didn't look right, and they wouldn't be able to achieve the drop of a natural look being too large. I'm swollen on top now, have a little hamburger bun thing going, but not much. Was told to wear a bra, like a soft sports bra, 24/7, not to break a sweat or let heart rate go beyond 90 for the next three weeks, & no exercise for three weeks, then start out slowly, gently. And of course, keep sleeping on my back. I have devised a cheat by propping pillows such that the breast can hang free while I am on my side, but am good about staying mostly on my back. Don't want to messed it up, having come this far!
They look really beautiful, yet after drop and fluff & nipps/areolas will look pretty real. I love his style of making it look natural. Am in awe. Will let you know when pics are up on Tim Tam site. Best wishes and happy holidays to you all! xoxo Melissa
-
Mellissa: Congratulations and getting such natural results. Can't wait to see!!! What a great Christmas present for you.
-
This is exactly the kind of feedback and information I have been searching for and hope you will be able to give me some advice.
I am four weeks past a BMX where my 9 year old moderate profile saline implants were left in place. (I think the implants helped me find my 7mm tumor because my breast tissue was pushed against the flat surface of the implant.) I had breast augmentation 15 years ago with textured 300cc saline implants. Those implants were placed very high and looked like I was always wearing a push up bra, but I loved them anyway because I finally had some boobies. I had them redone 9 years ago by a wonderful PS who lowered my natural crease and replaced the implants with Mentor 350cc smooth saline (silicone was not available during that time). They were perfect and most people wouldn't suspect they were augmented. They fit nicely into a 34D bra without looking too Pam Anderson busty. I must have large pockets because they move freely...can be pushed up, squished together, have droop and fall to the sides when laying flat.
Now I need to attempt to put Humpty Dumpty back together again. After the BMX they look odd because they are full and round across my chest but have little projection like the often described hamburger bun. I am 5'3", 124 lbs with 28" ribcage but have really wide shoulders. I have been looking into silicone implant specs and need advice. My current implants are described as being 13.3cm diameter with 3.9 cm projection. I like the cleavage and "side boob" look of my current implants. I don't know if I should be looking at high profile or moderate plus profile. To get the same diameter with a high profile silicone implant I would need 500cc which would give me a 5.3 cm projection. Is this too big for me and is it even possible to increase this much in size without TEs? Will my current pockets need to be revised if I decide on a smaller implant?
My other question is how long after surgery do I need to wait before I can swap out implants?
-
Kelly: Update me after you meet with your PS, but please ask him about this excess skin, letting him know that you do not want excessive droop and therefore you might not require full expansion in order to get a nice snug fit in those pockets.
-
Melissa: I am thrilled that you are so happy with your results. We just cannot wait to see photos!
-
Darla: You will need to wait at least two months and preferably three, after your BMX. I think that you have a few options. You could also exchange out for moderate plus profile implants - using Allergan as a model, a Style 15 MPP, 397 ccs - 13.1 cm width by 4.2 cm projection - or 421 ccs, 13.3 cm width by 4.3 cm projection - could probably be placed without further expansion.
As far as a high profile implant goes, yes, it would take a 500 cc high profile implant to match the width you have presently. It is likely though that you would require expansion in order to exchange to this volume of implant. An option would be to have your PS use the Mentor Spectrum expandable saline implant. He could use a higher profile model and this type of implant, which is unique in that it can gradually be expanded over a six month period of time, giving your skin the ability to expand gradually. Once you are happy with the size, the tubing can be disconnected and the implants are then permanent. So you have some options.
But I certainly would not have thought a PS would reinsert nine-year old implants....whatever for? I would switch them out most certainly. Discuss this further with your PS and let me know what transpires.
Deborah
-
Thank you so much Deborah for your reply.
My PS was away on vacation during the time I was diagnosed and had surgery. It happened very fast. From discovery of lump to BMX was a matter of a couple of weeks. My BS was very pleased to be able to leave my current implants in place so that I could proceed with surgery without a PS available.
Without a consult with my PS prior to BMX I am left to imagine what is the next step until a consultation in February is scheduled. I am torn between keeping the implants I have loved for all these years and proceeding with reconstruction. I know my old salines need to be replaced but am afraid I will not like the new and improved any better. I like my current diameter but would likely need expanders to exchange to the current diameter and add projection.
Do you think 500cc Mentor high profile is too large for my frame? I wish there were more implant size options available.
-
Your questions/answers are helpful. I'm looking for as much info as I can find before my exchanges are done. I had my final fill Nov. 30th. I'm at 900cc...my PS wants to use 800cc silicone implants...but I'm not totally convinced. I think the base of my TEs are much too wide and high. I feel the edges in my armpits and just below my collar bone. I am being expanded in places that boobs should never be...lol Am concerned the exchanges will be the same size base. Am looking for some comfort....and projection! I'm slightly full figured and have read that although 800cc would be large for a petite woman...they might actually look round and nearly flat on me so have been considering saline with some overfill(if needed). Just not sure how comfortable they would feel. Anyone use saline instead of silicone? I would like as much projection as possible with a smaller base than my TEs. My next appt. with my PS is Jan. 4, 2011 and I would like to go armed with knowledge. I need visuals but do not have access to the photo site. Any help/suggestions would be appreciated. After going through the process, I would like to have a successful outcome...thanks!
Dee
-
P.S.
I had incision necrosis and had to have them revised...nearly lost them the second time, too...so the scars are large. I am expanded in the center of my incisions, but on the ends am not???? They are wrinkled skin flaps...anyone else have/had those? I asked my PS if he was going to revise them during the exchange and he said no...that he would wait and see when he did the nipples. Maybe that's procedure...I don't know....but what if I don't do nipples? Just a lot of things in this process that seem 'odd'(for lack of a better word) to me...
-
Darla: I would almost wager that your pockets are sufficient, without the need for further expansion, for smooth round silicone implants, MPP's, 397 ccs - Allergan or 400 ccs Mentor. It is only 50 ccs we are talking about here. You would have your same width and greater projection. I think they would look much better. We never see moderate projection implants in breast reconstruction patients. They are just ridiculously pancake-like on the chest wall. This would be the easiest fix. I think you might require tissue expansion in order to exchange out to implants with a volume of 500 ccs.
-
Dee: Find out the style of your TEs for me. You might have a little plastic card with this info - or the nurse will have this documented in your chart. Also, I need your height, weight, ribcage circumference, measuring below the TE or bra line.
-
I just saw the PS again Today and he said we can't fill any more cause the skin is too tigh. He said that the TE breast is a little bigger then the natural side and that he could put 100 cc round in the natural side. Hi is planning for a 450-495 gram gummy in the MX side. He is planning on a full height, X projection.
here are my stats again: I have an Allergan 133MV TE with a 300cc fill volume. Right now it is filled to 400cc. I am 5' 1" and 112 pounds and ribcage is 29. My natural side is a barely B cup size.
Does the 450-495 size sound right for me? Any other advice for this? I just filled out all the paperwork for the Gummybear study while I was there today. There are some loopy questions; especially the ones about how you feel about your breasts.
-
Namaste!
Whippetmom: I just sent you a PM this evening.
Karla
-
heebiejeebie: I had exactly this done--One on my non mx side to match the mx side, although I am quite tall (6') and thin (150) with a 30" rib cage. How long have you had your expanders in? Best results are when you wait at least 3-3 months or longer after getting expanded. Are you on the picture forum yet? Also, Whippetmom is amazing and will help you with the sizing.
-
heebie:
Well, 450 gms to 495 gms sounds large for your frame, not to mention, it is a leap from a fill volume of 300 ccs. The only issue I would take with the full height and extra full projection planned for the MX side, is that it might be taller and project more than your native breast - even with the augmentation of same. But your PS knows better than I what that native breast looks like and remember, symmetry is key. For a unilateral, it is not the size which is the focus, it is symmetry. So go over these issues with your PS. I just feel though that the size of anatomicals you mentioned would be too large for the pockets...especially if your skin is already compromised by tissue expansion.
Deborah
-
Whippetmom - - - The TE is a 300 cc capacity, but it is expanded to 400 cc now.
I thought 450-495 grams sounds big, but he said it will be about the same size as I am expanded to since my skin is really tight it can't be any bigger - just a more natural shape (teardrop) to match the natural side. And right now the TE side is only a little bigger then the natural side, it's just that weird bubble shape. He thinks he is going to get a close match in symmetry with these numbers and he does come highly recommended so I trust him. I will question him about the size when I see him next shortly before the surgery.
thanks.
-
heebie-jeebie: Sounds good to me then. Again, your PS can see you and examine you and I cannot and he knows what it will take to achieve symmetry. Keep us apprised...
-
Help me please on sizing. i have 600 cc expander sin right now. He filled me to 300 at the initial surgery and 150cc at my first fill. I am thinking another 150ccs is not going to be good enough. I am 5 ft10 in and weigh about 200 pounds with most of the weight around my middle. i told the ps that I wanted to be big on top. I figure if I have to do this, I wanted nice ones after, I was a 40 b/c before this. Is 600 going to be enough to fit my frmae???
-
Thank you whippetmom. I will get the info from the nurse. I'm nearly 5'8", weigh approx. 180lbs,(am in the proccess of losing weight...have lost 18lbs. so far).. My ribcage circumference is a little over 32''...maybe that will lessen as I lose weight? I know that my TE's were 650cc, but have been overfilled to 900cc. Will get brand/height/width at my next appt. Even at 900ccs I don't feel I'm particularly projected...just large round mounds... So I know if my PS uses the same width/height implants as my TE's, I will be even less projected with the 800cc silicone. Being large framed, I want as much projection as I can get. I will say that the more weight I lose the slightly more projected I look along with the high/wide round mound. Would also like your opinion on silicone vs. saline. I certainly would like some comfort, which I know I would get from silicone, but was wondering if saline was close to the comfort level of silicone? Thanks!
-
lovinmama: I agree....this is not going to be enough for you. I feel that you are one of those bodacious women who needs to go to saline implants with the maximum fill volume of 960 ccs, or you are just not going to be satisfied with the size. He will need to overfill you beyond the 600 ccs....but it depends on your skin flaps. Perhaps you have substantial skin flaps since you were a 40C previously, which means you might have sufficient skin for closure over the larger saline implants. You would definitely need the maximum volume if you stay with silicone implants - at least the high profile 800 cc implants - perhaps even what I recommended to nanadee below - the Style 45 800 cc implants. I believe this style would work well for you also.
nanadee: I do not know which style of TEs you have, but I would recommend the Style 45, extra full projection smooth round silicone implants in 800 ccs. This will give you the optimum amount of projection, and if your ribcage is indeed 32 inches in circumference, this would be an ideal style for you.
You gals present this discussion to your plastic surgeons and get back to me...
Deborah
-
Thanks Deborah...will definitely discuss with my PS.
Dee
-
Hi. a few women have asked me if a woman were to get a 410 implant (in the study) does she have an anatomical tear shaped tissue expander - or just a standard TE?
-
I had a standard TE and I have a 410 gummy.
-
flowerpetal: I see Lilah answered your question. There is no TE specifically made for the anatomical Allergan 410 or any other anatomical shaped implant. We all get essentially the same type, although there are TEs with different modes of expansion, made by other mfrs like PMT Corp and Silimed/Sientra.
-
Thanks for the info! I wanted to make sure that i was thinking straight!!!
-
I WANT TO WISH A VERY MERRY CHRISTMAS TO ALL OF MY BREAST FRIENDS!!!!
LOVE,
DEBORAH
-
Merry Christmas to you Deborah! You give us presents everyday with your knowledge!
-
Same to you dear Deborah!
-
Merry, merry Christmas to all and to Deborah, our breast whisperer!!!!
-
Hi friendly ladies
I've been lurking on these pages for a while and would really love some advice.
I had a bilateral mastectomy (one-side was prophylactic) in October 2009. At the end of October 2010, I had Natrelle 133FV 600 cc tissue expanders placed in both sides. I live in Canada, and I am ultimately getting anatomical gummy implants (Natrelle/Allergan?) when I exchange my expanders out. Right now I have 400 ccs in each expander. The prophylactic side is sitting alot lower than the other side. I hope they can correct this at the exchange?
I am 5'10" inches tall, 160-170 pounds (on the high side right now from Christmas snacking-hehe). My ribcage is 34-35". I am unsure whether to stop my fills now, or to have another 120cc fill done on each side before overexpanding (my PS likes to overfill expanders by 25%). I am eager to be done with the tissue expanders, but I want to be happy with the long term result. So I'm hunting for opinions: 400ccs or 520ccs? Will there be a big difference? I just want something appropriate for my frame and to give me back some cleavage!
Thanks very much,
Erin
-
Erin: I cannot access the Allergan PDF catalogue from this computer - I am out of town - and so I have to guess about the width of your TEs. I believe they might be 14.0 cm. I will check when I get home this evening. In this case, it seems that 535 gms in 410 FF or 560 gms in 410FX would work, keeping in mind that the TEs are supposed to be creating the pocket specifically for the shape of the anatomicals. I would not recommend anything less than 535 gms. You need the height of a FF or FX style anatomical. If your PS could use a 14.5 cm width implant - something in the lower 600 gm range would be good also.
-
Thanks so much
. I'll take these numbers to my PS at my next appointment!Cheers,
Erin
-
Just a quick add-on: Are gms and ccs equivalent?
-
Erin:...Grams and cubic centimeters.....the former is mass and the latter is volume. They are not equivalent, which is why we need to look at the dimensions of the anatomicals in comparison to the dimensions of the TEs. So your TEs are: 14.0 cm wide by 6.2 cm in projection. Something in the range of 14.0 cm wide with a projection of 5.6 to 6.5 would be something to work towards, although it all depends upon the integrity of your skin and your surgeon's ability to get you to the size of implants appropriate for your frame.
Deborah
-
whippetmom, I went to the PS for another fill today. I am now at 550cc's. I talked with my PS about what size I want to end up at. He is going to fill me to 700cc's and probably use 600cc implants. (silicone, HP, smooth round...is what I want and what he first suggested. He can do the gummies also but I don't want them) He mentioned today, because I am somewhat broad across the shoulders, that he may take "sizers" into the OR and see which looks best. He said possibly may use Moderate Profile since I am more broad but I don't think I want that, or do I??? Not sure I'd get the projection I want with those! I am 5'8" tall, approx 127 lbs, 31 in rib cage. I was a large C, small D before and do not want to be that large again. Will be nice to be a little smaller BUT I think my frame needs some size to look in balance and well, honestly, I am used to some size. He said at the 600 I would probably end up about a moderate C cup which I think sounds right for me.
It's funny, i look down at these TE and think they look large and why in the world would anyone want any larger then that? But then I look at my body in the mirror and to me I look odd....not shaped right, out of balance. All so confusing. Any suggestions?
-
i am aslo getting filled every 2 weeks - when i get the exchange will the breast drop a little bit i had a masectomy and the implant side is high not that high but i was wondering when they put the implant in does it feel softer
-
Nina -- without a doubt the implant will be MUCH softer than the TE.
-
EastCoastGirl: Eeek....!!! No, you most certainly do not want moderate profile implants. Please tell your PS to not even consider taking the sizers for this style into the OR. You will be happiest with HP style implants. I just think even moderate PLUS profile would be too wide for your ribcage - even in light of having broad shoulders. You will have 14.0 cm in width and that is certainly sufficient. You also need and want the height of the higher profile style. 600 ccs sounds good to me...
-
I would like to join this forum if that is ok. I had a bmx in august with no expanders. I jsut finished 4 tx of chemo and I have an appt with PS on the 4th. I met with him once a month after bmx and he had said i needed to heal. He said the scars need to be able to stretch. I think I had some cording then too. I see there are so many things to consider and ask when i see him next. He mentioned the possibiblity of not needing expanders but i think that is if i don;t go too big.
I am 5'6" and 140 pounds. I was a 34 DD. NOw i think I would like to be a large C, something more proprotionate and that clothes will fit in better. I have no idea how many CC that would be or how many fills that would take. I think my options will be limited because i have medicaid. I know my surgeon only uses round and only silicone.
Any advise on what to ask him?
also is it a good idea to exercise the pectoral muscle to make it strong before surgery?
I am really petrified about this surgery, it sounds painful. I wonder how it will compare to my bmx in which i did not have much pain.
-
Carrol2: Certainly you can join! There is really no way to equate ccs with cup size, because we all have different shapes, different ribcage dimensions, and so I make recommendations based on what would look best on your frame. I personally feel that you could use either the moderate plus profile or high profile style implants.
Has your PS explained the various options for reconstruction? Has he told you about using your own tissue - a TRAM or DIEP or latissimus dorsi flap procedure? You would probably be a good candidate for an autologous donor flap procedure and perhaps then you could be augmented with a small implant and you could forego tissue expanders. I feel that you need to hear about this from your care provider
At this point, I do not know how much of your skin was spared for future reconstruction. You say you were a "DD" cup prior to BMX, which tells me you had significant skin flaps. However, with scar tissue and retraction, whether you have enough for the size of implants which would be appropriate for your frame is unclear. I think what you need to ask your PS is if you have sufficient tissue envelopes to cover moderate plus profile implants with a volume of 375 to 400 ccs. This is a relatively low volume, but if avoiding tissue expansion is important, you might want to accept smaller implants in an effort to by-step TEs. So the question to your PS is this: With my current skin condition, what is the largest volume implant you could safely use? That would be a key answer to determine if you will be satisfied with the results from the delayed one-step. If you went through tissue expansion, I would change this to 475 or 500 ccs in a high profile style implant. Have you been to the pictures forum yet? You might want to go there and get a better idea of what to expect with tissue expansion and the results of using various styles and sizes of implants. I do recommend smooth round silicone implants for you.
Deborah
-
Deborah: I hope you are having a great New Years!
QUESTION: My breasts have shrunk quite a bit since August and although they are much nicer then what I started out with and larger, my question is: since I am a Uni, can I go bigger? Here are my current stats: 6' tall 150 pounds 31" ribcage current breast measurement 38" down one inch from 39". I loved how they looked right after surgery but now they are much smaller
. PS says fat grafting will help because the left is the smaller of the two but I am not convinced especially since he plans to also make a nipple from that side using a modified V-C Flap--Would any of these do anything, is it possible, should I be happy with what I have? EXISTING:LEFT: Allergan Naturell 20 - 550 13.5 diam 5.6 projection RIGHT: 15-397 13.1 diam 4.2 proj.
Would it make any noticeable difference to go up one size or would I have to go up two sizes or 100 cc's? This is what the choices are:
LEFT: 20-600 13.8 diam 5.7 proj RIGHT 15-421 13.3 diam 4.3 proj or
LEFT: 20-650 14.2 diam 5.9 proj RIGHT 15-457 13.7 diam 4.5 proj
Thanks for your help!
-
MBJ: Okay, my personal take on this, after talking with many women in your situation, is this: You feel comfortable physically with your implants, correct? You have had no complications and your only complaints are referable to a size preference. I just would not do it sweetie. I would go for fat graft transfer - absolutely. But you are subjecting your body to any myriad of complications, every single time you go through the type of surgery which would require opening up the incision and opening up the pocket. If you were woefully inadequately implanted or if you were one of those gals for whom 800 cc silicone implants are not adequate and the largest salines are necessary, I would say "yes" indeed. But you look great. You have a beautiful result. In ten years, switch them out for larger implants. By then, the ones you have now will be appropriately aged for replacement. Just wear bras which give you a larger appearance - like many of the Natori bras will do.
I too would like another 100 ccs - but I am not going to do it until I have to do so - because I feel so good and I have no pain or discomfort and there are far too many women who do have discomfort. Post-mastectomy pain syndrome is a complication of breast surgery - and who knows what might trigger the onset of PMPS. Too many risks for me - with what I know now. If you had been given 375 ccs - which is what your PS had originally planned for you - I would be agreeing with you on a bump to 550 ccs...do you see what I mean? But what you have really looks lovely for your frame. Over the next couple of years, augmenting the reconstructed breast with fat grafting will probably be so well-refined - that will be a truly viable and preferable option for many women hoping to just add a little volume to the mound.
That would be my heartfelt opinion....
Deborah
-
Deborah: Thank you for your reply as I truly respect your opinion in this. Do you think that fat grafting will truly compensate for the loss of volume after I get my nipple done, too? This is what really worries me--that I will have an even smaller breast and will have to not only pad my bras and wear push ups but also a prosthetic.
-
I know that a couple of gals on these forums had fat graft transfer applied under the nipple areola complex and I recall that they were happy with the results. Unfortunately, I cannot recall who had this done. Sorry. I know that fat grafting to the NAC can be done and IS done - I know for certain it is done with some regularity in male gynecomastia. When there is reduction for gynecomastia, the NAC is often left with a sunken appearance, and fat graft transfer is used to bring elevation to the NAC. I think that in breast reconstruction, the singular problem would me the MX scar. If it happens to be quite wide and running through the center of the NAC, it might be more difficult to achieve a successful FGT, because the scar tissue might have a tendency to flatten out and depress the fat graft.
But the thing I want you to remember [and this is for Dawne-Hope also] is that the volume of the implant has not changed at all. The amount of skin around the implant might be diminished a little with the nipple reconstruction, but as the skin naturally stretches with gravity, you should appreciate a return of fullness. My implants actually look fuller now - 1.5 years post exchange - because my skin is more compliant and the implants are very soft in the pockets, and I did lose skin volume with the nipple recon and I also experienced a flattening of the mound, because I had a double opposing flap. I did not know at the time - but this is the type of nipple recon which was performed. My bra size did not change at all.
-
Oh, I forgot to mention that Hilton Becker, MD,[ who devised the Spectrum expandable and Becker expandable 50/50 implants marketed by Mentor] uses fat graft transfer to elevate the NAC in his breast reconstruction cases....an excerpt from his website:
"If the nipple areolar complex has been totally removed, then the nipple areolar complex is reconstructed by tattooing the areola and then using either a local flap or a skin graft to create projection for the nipple. Fat injections may also be used to increase the projection in this area."
-
Thanks Deborah! I think my scar is too high to have the nipple made from it so I am not sure how they will get around this. I guess I just have to go on the faith that my PS did a great job to start and he will do an even better job to finish it.
-
whippetmom - Thank you for the post-nip encouragement. Mine look a little strange right now. Thank you for thinking of me and for your encouragement. There's hope!
-
MBJ - I am sorry that you're disappointed. But I want you to know that I think you have an absolutely PHENOMENAL result! You look fantastic! Be encouraged, girl!
-
MBJ: Well, from an appearance standpoint, it is nice to have the scar going through the NAC. However, technically - from a surgical standpoint, it would seem it is better to NOT have the scar going through the NAC - especially if the scar is flattened, as mine is. Look at this link and scroll to Page 461 to the section regarding common complications associated with nipple recon.....
-
That did not work, did it? I will just type it out from my own book later...
-
Deborah: The link worked just great! That was so informative--I really now have more confidence in what they plan to do and how they plan to achieve it. We should start a nipple/areola reconstruction thread so women have a place to go and know what to expect. Maybe on the picture forum?
-
Deborah, I have some additional info for you. I had a consultation with my PS about my upcoming revision surgery.(more drop on my left side and my right side is smaller than my left side-pic on photo site) He exlpained that he believes the problem is due to anatomical differences in chest wall (thinks right side is higher and more concave than the left). He is proposing changing the 425cc MPP implant for a HP implant (will bring several sizes to try) on the right side and raising the left side. Additionally he would use fat grafting to possibly help some rippling on the left side and fill divots above both breasts.
I think I have a reasonably good result now and after reading your response to MBJ I am really having some doubts about subjecting myself to more surgery and possible complications. Please give me your honest opinion of my PS plan. Thanks so much!
-
Let me go look again Jan!
-
Jan: Your PS does need to revise that left side. You risk bottoming out on that side. I think personally that just revising the fold area might be what is needed - meaning - perhaps another implant will not be necessary. So in this case, I feel it warrants going back for correction. This type of assymetry to me has a high value-added factor for just biting the bullet and getting it done right. If it were a minor size assymetry, I would tell you what I told MBJ. But a fold discrepancy is another matter. Your PS knows this needs to be done....
I am glad he is taking in another style implant just to see if it is needed.
You will be just fine.
Deborah
-
Deborah,
I am 5'8, 170 lbs, ribcage is 34", The expander is Allergan, 500cc, ref 133MC-14. He has stopped the fill at 430cc's. I still have my natural left, I was a C, guess you can still say I am. I meet the PS to decide on which type of implant I want on Jan 26.
-
Hi Deb: I responded to your PM as well. It all depends on what you are going to do or not do at all with the "natural left" breast. 430 ccs fill sseems a bit on the low side....which is why I need to see how you look at this point.
Deborah
-
Deb - I'm your size just 5 lbs lighter. My TEs are up to 530 ccs. I'm going to go over 600. It is now a bit bigger than my natural breast which is a B/C. I love how the TE fills my bra. I'm praying it stays this way.
-
Thanks Claire!
-
Hi Whippetmom. I hope the new year finds you well. You may not remember, but we discussed implants for me a few weeks ago, but things have changed and I now have more questions.
To recap: Bi-lat mx 3/16/10 (cancer only on left side); finished rads early October; current TE are Allergan 133LV-15 now overfilled to 520ccs; 5’8”, 185#, 36” below bust measurement.
I had a PS who said she did almost all saline implants upon exchange. Come to find out she is not certified to do silicone. So I changed to a different PS who will give me round, smooth, silicone implants.
My right side currently has a big dent (step-off?) at the upper pole that the PS said was due to the way that the mx was done. The previous PS said it was due to the crescent shape of the TE, but the left side looks good and does not have this issue. In order to correct this my PS says: “When you have the exchange of implants, the new implants will be smooth high profile silicone implants. This should give you more upper pole projection compared to anatomical shaped expanders you currently have in now. Hopefully the right upper pole concavity would be alleviated with this. We could try a 500ml implant on the right and a 475ml on the left.”
I think these implants will be too small in projection and in width – I like the size I am now with the TEs at 520mls and the bigger projection (6.3), though I could stand to lose a little on the width. The TEs are very close together giving me a very steep cleavage, and even so with the overfill I currently have some discomfort in my armpits from the width of the TEs. So I could lose some width, but going down to 12.6 and 13 from 15 might be too drastic. No? Also projection would drop from 6.3 to 5.5 on the 475ml and 5.2 on the 500ml – that’s a big drop in projection.
I asked if we could do another 100cc fill to bring me up to 620 and then go with 650s on both sides and fat grafting in the dent. He responded: “650 ml are fairly large implants that may pose some increased risk for you in terms of being heavier and puts increased pressure on your skin flap and incision line that may result in wound breakdown, skin necrosis and delay wound healing. Don't get to fixated on the numbers. Every patient is different and unfortunately we have to work with what is available from the manufacturers. I would recommend holding off on the fat grafting until down the road when we can reassess if it is even needed after the implant exchange.”
I have done the research and see that silicone 650s would weigh 24.375 oz ea – OK that may be a little heavy (over 7 oz heavier each than my current 520ml saline). Should I push for another fill and 600s? This is really as small as I am willing to go on width and projection. I don’t know if I can just tell him I don’t want to go smaller than that or if I need to find another PS. My scars healed beautifully, btw. So no reason to suspect poor healing.
Sorry for such a long note, but what would you suggest I do?
Thanks,
Jen
-
Hi Whippetmom. I hope the new year finds you well. You may not remember, but we discussed implants for me a few weeks ago, but things have changed and I now have more questions.
To recap: Bi-lat mx 3/16/10 (cancer only on left side); finished rads early October; current TE are Allergan 133LV-15 now overfilled to 520ccs; 5’8”, 185#, 36” below bust measurement.
I had a PS who said she did almost all saline implants upon exchange. Come to find out she is not certified to do silicone. So I changed to a different PS who will give me round, smooth, silicone implants.
My right side currently has a big dent (step-off?) at the upper pole that the PS said was due to the way that the mx was done. The previous PS said it was due to the crescent shape of the TE, but the left side looks good and does not have this issue. In order to correct this my PS says: “When you have the exchange of implants, the new implants will be smooth high profile silicone implants. This should give you more upper pole projection compared to anatomical shaped expanders you currently have in now. Hopefully the right upper pole concavity would be alleviated with this. We could try a 500ml implant on the right and a 475ml on the left.”
I think these implants will be too small in projection and in width – I like the size I am now with the TEs at 520mls and the bigger projection (6.3), though I could stand to lose a little on the width. The TEs are very close together giving me a very steep cleavage, and even so with the overfill I currently have some discomfort in my armpits from the width of the TEs. So I could lose some width, but going down to 12.6 and 13 from 15 might be too drastic. No? Also projection would drop from 6.3 to 5.5 on the 475ml and 5.2 on the 500ml – that’s a big drop in projection.
I asked if we could do another 100cc fill to bring me up to 620 and then go with 650s on both sides and fat grafting in the dent. He responded: “650 ml are fairly large implants that may pose some increased risk for you in terms of being heavier and puts increased pressure on your skin flap and incision line that may result in wound breakdown, skin necrosis and delay wound healing. Don't get to fixated on the numbers. Every patient is different and unfortunately we have to work with what is available from the manufacturers. I would recommend holding off on the fat grafting until down the road when we can reassess if it is even needed after the implant exchange.”
I have done the research and see that silicone 650s would weigh 24.375 oz ea – OK that may be a little heavy (over 7 oz heavier each than my current 520ml saline). Should I push for another fill and 600s? This is really as small as I am willing to go on width and projection. I don’t know if I can just tell him I don’t want to go smaller than that or if I need to find another PS. My scars healed beautifully, btw. So no reason to suspect poor healing.
Sorry for such a long note, but what would you suggest I do?
Thanks,
Jen
-
sorry for the spacing issues on my post above. I copied it from Preview and can't get it formatted correctly here.
Jen
-
Jen: You will be unhappy with anything less than 600 ccs. Trust me. I would prefer 650 ccs for you. The PS is going to need to perform lateral revisions to narrow the pockets from the 15.0 cm down to 14.0 cm. I am in full agreement with your position and as long as your skin integrity is good, I think it sounds entirely within reason.
Let me know if you need anything else.
Deborah
-
Thanks Deb. Do you think the divot on the upper pole will be fixed with round implants?
BTW, I have Kaiser ins. If I need fat grafting later to fix the divot, do you think they consider that cosmetic or part of my reconstruction process?
Jen
-
Whippetmom,
Thank you for your response. As always you are right there to answer our questions and offer your reassurances...its so appreciated!
Just to make sure I understand...revision on the left side is definitely needed and the benefits would outweigh the risk involved. The right side is more of a symmetry issue and surgery just to correct that would not merrit the risks. I have to be honest, since I am having surgery anyway, I would like to see the symmetry issue addressed. Do you think his solution of exchanging the right implant for a 450-475cc HP is a viable solution?
-
What do you think? when i go to the PS i am bringing pictures that I took before my bmx and i traced over them where i would like to see my new boobs. A little higher and rounder of course. I don;t know if this is a good idea or not but i figure it will give me a visual to show him what is in my mind.
-
Jen: I think you need to send me photos. I want to see what is going on. Or post them on the pictures forum. There are enough issues you have and I don't want to overlook something. I'll PM you my email address.
I have Kaiser also and yes, fat graft transfer is indeed covered. I have had it done twice. If you have any trouble up in No Cal with this issue, let me know.
Deborah
-
Carrol2: You need to go back to my 12/31 post where I responded to your questions.
-
Whippetmom,
I just posted photos on TimTam's site under the title of "Overfilled TEs - note to Whippetmom".
Thanks,
Jen
-
Hi Whippetmom,
I have been following your expertise postings the past month and think it's time to seek your advice. I had single mast (left size) on Nov 1st and here's my info. 5'2 and 120 lb. rib cage is 29 1/2. TE - Allergan 133MX -13 500cc.
As of today, I have 560cc which was suppose to be the final fill. Saw my PS today and he said I need another 30cc since I told him that I want to be close to my TE size now after the implants. I was between a 34 A and very small B before mastectomy. I had originally told him I want to be a regular B cup. I will also have a smaller implant on my right natural breast for symmetry. Because of changes in my insurance coverage, I had to move up my exchange surgery date to end of this month.
Please let me know what else I need to ask my PS. Thanks for any suggestions.
-
Hi Deborah/whippetmom...I saw my PS today...have another appt. in a month when I will be schedule for my exchange surgery. He said we would continue our implant debate at that time.(I addressed many of your implant suggestions w/him concerning sizing/projection/type...etc.) I could tell he was quite surprised. He said he almost always used Mentor but will order Allergan 45's, if that is my wish and if the diameter is correct. Speaking of the diameter...I measured my ribcage at a little over 32" right under the bra line, but had my husband re-measure yesterday and he said it was a little over 33"...perhaps I didn't have the tape as high in the back as he did...I don't know... Anyway...was wondering if you thought the allergan 45's(800cc) would still work if the over 33" is correct? My PS said he had planned on using the mentor moderate plus implants(800cc) but I don't think that would give me nearly the projection I need... I also mentioned the saline implants that can be overfilled to 960cc and he said that he wasn't opposed to saline, but that he didn't want to over-fill because he had seen it cause pretty significant rippling as the implants lost some of their volume. He asked if I knew that saline could lose up to 10% of it's volume yearly through leakage. Actually I wasn't at all aware of that and now am more confused than ever since that was the way I was leaning. Any suggestions? Thanks!
Dee
-
Hello Everyone;
I was hoping someone could tell me how to get to the picture forum. I will be having Bi-Lat-MX with reconstruction in Feb. and as you all know have lots to figure out before then.
Thanks!!
-
Polly,
You need to send a Private Message (PM) to member TimTam and request access to the picture forum. She will give you permission and instructions for loggin on.
Good luck and let me know if I can answer any questions. I had Bi-Lat-Mx with Tissue Expanders placed last March. Then I went through chemo and rads and am now awaiting my exchange surgery.
Jen
-
whippetmom I read your post thanks, you have been very helpful. I decided to take pictures to the surgeon of my breasts before my bmx to help me communicate with him the results i was hoping for. He thought it was a good idea. He explained to me that the implants wont have the fold in the flesh so much like a natural breast that hangs. He said they are more like mounds. Basically my 46 year old breasts before surgery were sagging and my new ones will not lol.
He measured me and we agreed a C cup is good for my frame which will require TE. I did not question further because less than C for me would seem to small since I was a DD. I always thought C would look better and easier to buy clothes for.
He put me at ease quite a bit about getting the TE. He seemed to think this surgery would be less painful in most cases than a BMX and I got through that quite well. He said 20% chance I will need drains.
He uses round smooth medium profile silicone implants for most people unless there is a special reason not to and there is not for me.
My insurance allows one night in the hospital but he said i could go home that day if i want to.
no lifting anything more than 5 pounds the first week.
limited raising of the arms for 2 weeks.
3 weeks start doing things but base normal by 6 weeks.
so now even though insurance companies have to cover recon i have to wait for the approval process to go through. So they will call me when they hear back. I expect then to make a preop appointment to be in February and I am going to try to plan the surgery for first week in April when my sister can come stay with me for a week.
He says he waits 8 weeks before he starts the fills.
I guess this will be a very long process. My whole breast cancer ordeal seems like it wont be over until maybe October 2011.
Here is how I figure my timeline
June 23rd 2010 diagnosis
Aug 9th 2010 bmx
October 5th -Dec 7th 2010 chemo
April ? 2011- Tissue expander surgery
June? 2011- fills
August ? 2011- Implant exchange
Sept ? 2011 - n@@ples
Oct ? 2011 - tatoosOh well I will at least plant o look great for xmas next year.
Anything else anyone thinks I should be asking him?
-
Hello Jen;
Thanks for the info. Now I have another question. How do I find Tim Tam to send a message, I have looked through all the forums and cant find her. Any suggestions.
Colleen
-
Hi Whippetmom,
I was directed over here with some questions about implant sizing. I am 1 month out from BMX, and have begun fills. I am now at 170 cc's, plannning on going weekly to "fast-track" if my body can handle weekly fills.
I am 5'6", 125 lbs, about 30" ribcage. I do not know my TE type, will find out next week at fill. Prior to BMX, I was a solid A cup/small B (on a good day). I am hoping to be a nice, solid B cup, or I'm thinking maybe a C? I guess my fear is looking too big for my frame, but on the other hand I don't want to go through all of this and feel "too small". I would like to enhance my cleavage and have some projection, but don't want my chest to be "all implant". I do have a medium to longer torso than most, I am a pretty lean person. I physically active and while I want the look of a nice bust, I don't want to look overdone.
Last week the nurse practioner mentioned getting to 350 cc's to get to the size I am looking for. This week my PS said get to where I like the size then go one more. well, I am not sure about what size would work for me. Any advice you have would be appreciated. Thanks in advance!!!
-
Polly,
top, right corner "search" button; search by member name; enter TimTam; a list of her entries comes up; select one, then select her name, then PM her.
Jen
-
Polly: You can PM myself, Whippetmom, Lilah, Firni or Estepp and we can help get you to the Picture Forum.
-
Terrry54: Your TEs have a width of 13.0 cm and since you are happy with the volume you have currently, I believe you will want 500 ccs at the minimum and perhaps 550 ccs in a high profile smooth round silicone implant. And then the native breast can be augmented to match.
Deborah
As an addendum though: I am 5'4 125 pounds, 31 inch ribcage and my implants are 550 ccs - high profile smooth round silicone and I am a DD cup. You will NOT have the projection you have now with the TE - the projection of the TE serves the function of stretching out the skin and getting some ptosis or natural droop and also ensuring good skin closure over the implant. I personally think that 500 ccs would be more than sufficient for your frame, but certainly 550 ccs, if you want that extra oomph. You have to consider how much implant your native A breast can tolerate also.... You are wearing the wrong bra size though - you should be a 32 band.
-
Carrol: I would not want "medium profile" implants for your frame. Moderate Plus or "midrange profile" perhaps. As to the issue of no natural fold - it depends on how much skin you have after the BMX. I have plenty of fold - my breasts droop naturally. But I had plenty of skin also. So not EVERYONE will have mounds - it depends on how much expansion is undertaken - how much skin you have to begin with - how well your skin responds to expansion - a number of factors.
Deborah
-
Megan: I do need to know the size of your TEs, when you get that info. Essentially - the volume and the width. I personally feel that a width of 12.5 to 13.0 cm would be nice for your chest wall, and high profile smooth round silicone implants - because you can use the height of the HPs. I feel that around 450 ccs or 475 ccs would be about what you are describing to me. I would not go much smaller. You could use a moderate plus profile or midrange profile style - if your PS insists on using something smaller. If so, I would recommend 397 ccs in the Style 15 [Allergan] or 400 ccs in Mentor's moderate plus profile style.
Have you been to the pictures forum?
Deborah
-
whippetmeom i think i am confused by what profile means.
I misquoted, my doctor did not say everyone gets mounds he said that that fold is hard to get sometimes. It seems to me like i have a lot of skin. I was surprised when i woke up from my bmx it's almost like an A cup of skin, so hopefully it will work well going from a DD of skin to a C.
I am so small now and I don't mind it that much but i don't feel very sexy, part of that is i have no hair though. But once my big DD breasts were gone my frame seemed so much slimmer. Like now I can see the top half of my abdomen lol. Also I can see the curve of my waist more now.
-
Deborah,
Thanks so much for all your info. I forgot to mention that my PS favors Mentor silicone implants also.
I am so confuse about the TE quantities of ccs vs. final cup sizes. I read some postings where some have their TE fill only to 400's and still able to achieve a C cup. Yet I will be fill to the max and more (590cc) and will be getting a B cup (which I will be very happy with
) PS mentioned he will bring a few different sizer into the OR before making final decision. Is this normal ?I have been wearing a 34 band for a long while and seems comfortable ( use to be able to fit into a small 34B before menopause and losing a few pounds a couple of years ago). Maybe I am measuring my rib cage incorrectly.
Terry
-
terry - most women wear the wrong band size. I wore a 34b for years until about six months before I found out I had cancer and then found out I was actually a 32c. 34 band felt comfortable to me but it wasn't giving me the support I needed. Since my new foobs, I can wear a 30 band because support is more important now than ever.
Cup size is relative because our bodies are all different, our rib cage size is all different. I have 325cc implants and that's a d or a dd on me. Don't get hung up on cup size. Even though I wear a d or dd now, my foobs do not project like my real ones did.
-
Thanks Dawn-Hope. I definitely will need to get some new proper fit bras after the exchange. Really looking forward to that also.
Whippetmom: I recall you had mentioned going to Nordstrom in one of your post. What is the normal time frame to wear regular bras afterward? Thanks again.
-
Terry: We all come in different shapes and sizes. So 400 cc implants on a 5'2 110 pounds woman with a 28 inch ribcage will look quite ample, while the same 400 cc implants on a woman 5'8" tall and 170 pounds with a 36 inch ribcage will look like jujubes on the chest wall. [If anyone does not remember what jujubees look like.] Hope this helps.....
-
Oh...I hope you are wearing a nice soft cup supportive bra right after surgery. The key is to wear a bra which will encapsulate the implants and keep them secure - keep them from migrating during the settling period. A good sports bra with cups will work also.
-
Dee: Oh yes, the Style 45's would work just fine with a 33 inch ribcage. I am so glad your PS is willing to work with you and order Allergan implants if this is your preference!
-
Jujubees! Lol!!!
-
Deborah - I really appreciate your input and think I will go for the extra fills, like you suggested. When I get my TE size I will let you know, I don't go till next Tues.
I have just begun over at the picture forum. I have not been able to post any of my own shots yet (but wish to), I am a bit behind on the whole computer-thing...I have no idea what I'm doing (yes, it's very sad! ;-) But the women whom I have commented on/viewed their pics have been extremely helpful in seeing how things progress.
It's weird how all of a sudden my mindshift went from surgery: the planning, prep & the recovery...to now - fills, cc's, implant sizing, etc. Now that the fills have begun I have so many more "new" things to think about. I did so much research on the BMX that now it's over I realize I didn't give much thought to what came next, and am scrambling to figure out what everything means. I definitley need to talk to my PS and get his take on what he prefers/uses, Mentor/Allergan & the profile suggested for me, and just his take in general. I don't want any surprises down the road! :-)
Well, thanks again and I will be back in touch...enjoy your weekend!
Megan
-
Deborah..love the colorful
jujubees ....My PS office gave me all the pre-op and post op instructions today which includes wearing the same 2 sports bra I wore after my mastectomy. They are the Veronique Sports Bra and were very comfortable and supportive. Might have to get another one to get me through the post exchange period. My surgery is set for January 26...I am already getting the jitters even tho everyone says that its not as bad as the mast.
I will be hanging on to this forum to get me thru this...
Thanks so much for all your info and great advice and will keep everyone posted.
Terry
-
Deborah: I wish to have your expert opinion on this. I like what my TE's look and will have exchange surgery on 1/20/11. My TE is Allergan 133FV-11, 300 cc. I'm 5'3", 117lb, and my rib cage circumference is 28 3/4". (When I went to the mall, they measured my size to be 32 C.) I only have 200 cc total fill. What kind of implant should I get to maintain "status quo" (maybe slightly smaller)? My PS knows what he's doing but I feel he doesn't put a lot of efforts into the planning part. He also joked that I'm making his life difficult when I mentioned maybe smaller. What did he mean? (I only had UMX so augmentation on the other side is in due order.) Thank you!
-
Love the jujubees!
-
treelilac:
Okay, well, even though you are underfilled by 100 ccs, you still have the "footprint" of a 300 cc TE inside that skin envelope. The width of that TE is 11.0 and the projection is 5.0. So, you have the width which is 11.0 cm, because the width is what it is, and you probably have around 4.6 cm projection at this point.
I would recommend a Style 20 - Allergan Natrelle - smooth round silicone implant - 325 ccs. You need to match the width you have currently with the TE and this implant is as follows: 11.2 cm width by 4.6 cm projection. I think that approximates very nicely what you have with your TE - and it does take greater volume with the implant to match what you have with the TE.
If you have access to the pictures forum, I have bumped up for you photos of DENRULZBC and DAWNE-HOPE. This will give you a good idea what this volume would look like on your frame. Dawne-Hope is active here and I will ask her to PM you and tell you her stats and implant size.
Deborah
-
Deborah: Thank you for your explanation and recommendation! But the strange thing is that I have 9 cm projection. When I came home from the MX, I only had a small mound from the 100 cc initial fill. But the second 100 cc is miracle molecules. Maybe the TE has stooped to the bottom? But I just saw my PS and he didn't comment on any abnormality. (He also measured the projection in this visit.) I hope it's not capsular contracture...
I'll write TimTam for approval.
Jo
-
Jo: Impossible! Not unless the TE has rotated? You can always shoot me a photo. PM me for my email address if once you get to the pictures forum you think it looks strangely unlike anything you see there.
-
I know! (The fill record is from the PS, although I thought the nurse in hospital told me the initial fill was 200 ml.) TE can rotate too? Why does rotation cause it to look bigger than the real size? I wonder if he has considered this in his planning for exchange. I'll send you an email once I minimize the picture byte size.
-
treelilac: You don't need to reduce the photo. Just email it. I'll PM you with my email address.
What you are describing sounds strange but there must be some logical explanation. Yes, TEs can rotate. I just received photos from another BC sister who had a malpositioned TE.
Deborah
-
Could it be the alloderm? I have no idea how much he put in there.
-
treelilac: You know, I just looked at your previous post where you stated your PS "just measured the projection" during your visit. So therein lies our answer. I was going by the dimensions listed by Allergan/Mentor - which have no bearing on the dimensions which will occur once they are inserted and filled. So yes, when the breast mound is measured in this fashion, the numbers will not match those listed by the mfr.
-
So with Allergan Style 20- 325 cc, would I still get the same contour? I guess this is what he meant, making his life difficult. I also looked at DENRULZBC and DAWNE-HOPE's pictures. I'd be extremely happy if my results look like them.
-
treelilac: You do not have 9 cm of projection. Your mound measurement might be 9 cm....
I think you would be very happy with 325 ccs....high profile, smooth round silicone....Style 20
Deborah
-
treelilac: Again, I'm about your size. I didn't know that the implants came in low - moderate- high when I had mine put in. I got moderate. If I have them replaced, they will be high profile the next time.
-
Deborah and Double or Nothing: Thank you for your suggestions. I'll bring them with me when I talk to my PS before the exchange surgery,
-
hello whippetmom (deborah?)
what an amzing wealth of knowledge & information!
i'm newly diagnosed & currently deciding between re-excision/radiation and mastectomy/te/implant, possibly w/ one on the other side for "symmetry". it's a huge decision & i'm just trying to get all the information i can so i can make the best decision for me.
you mentioned a picture site or picture forum a few x's. can you tell me what that is or how to access it? one of my goals, after getting rid of the cancer & getting back to being & staying healthy & strong (hence the name) is to be as comfortable with and in my body and whatever changes as possible. i'm struggling a little bit to find out what will best help me get there.
also, did you (or anyone else out there?) have the opportunity to "try anything out" so to speak, before having the mastectomy & implant(s)? i really have no concrete sense of how something like that will feel on my body & would like to know if anyone had an experience of being able to maybe wear a bra wear silicone implants or something like that. of course it wouldn't be the same but i can't figure any way to simulate it and need a clearer idea of the options i need to choose between.
although this forum does not exist specifically for my benefit, thank you everyone for sharing your information and support with each other/everyone else. it's an amazing resource and i'm so glad i decided to search for something today.
take care, all!
-
Gymnut: You might PM Val61 as she is an aerobics instructor and had a BiMX and has done just fine. There will be a period of adjustment no matter which one you decide to do. I didn't have an option of choice but there are some slight adjustments when you have an MX as there will be excercises you will no longer be able to do or that will need to be modified. That being said, if you have radiation now and need further surgery or an MX after the fact, there are many complications with scar tissue build up. I needed physical therapy after my MX, had an augmented reconstruction to match my MX side and I am very happy with the results. There is a longer adjustment period of time with an MX. Hope this helps and best of luck with your decision.
-
gymnut:
Welcome! I think it would be good to navigate around these forums - those dealing with radiation and reconstruction, lumpectomy vs. mastectomy, and then formulate your decision. The majority of us on the breast reconstruction forums have had a mastectomy - either one sided or bilateral. There are many members who share your diagnosis stats. So scroll through the topics on the Breast Reconstruction forums and keep posting!
http://community.breastcancer.org/forum/44
As far as finding an implant simulation is concerned, there is a kit you can purchase from Allergan Natrelle. I am not sure how helpful it will be, but it at least affords you the ability to try out the implants and see how they feel. I don't think it approximates how it would feel after MX though, because of sensory loss after MX.
http://www.natrelle.com/pre_consultation_kit.aspx
In order to get onto the pictures forum you will need to spend more time posting on the forums. The pictures forum is a private, protected space where we have our own personal photos and there is a vetting process required for entrance thereto. So post five times in a 24 hour period as you are permitted. You can send a private message to anyone if you have a specific question and this does not factor into the 5 posts/24 hour ruling.
We will keep track of your posting and I will send you information on the pictures forum accordingly....
Deborah
-
Hello Deborah,
I had a double mastectomy in November. I just had my second fill yesterday. I am so stuck on how big to go. I am not getting much guidance from the PS. I was very small before surgery. Only about 150 grams of breast tissue was removed from each breast. Obviously, the size and shape of my breasts will be very different now. I have no idea what style of tissue expanders I have. I will have to call the PS tomorrow. What do you mean by : "We also need the recommended fill volume of the TEs - the number of cc's"? My PS likes overfill each TE with 100 cc's and let them sit at that volume for a month before exchange. Thanks!
-
Madison777, I'm in your same boat (in my head at least). I had a unilateral MX a month ago today. I was an A before surgery, and lucky us small women... they don't make implants that small. So, I know I HAVE to be at least a B (and have an augment done on the other side so they match). I have the Allergen Natrelle Style 133V TE's (ask your plastic surgeon for a card. Mine gave me one at my first visit post-op). I'm going for my 3rd saline injection on Thursday. I'm at 240 cc's now which is pretty comparable to my right "real" breast. On the card he gave me, the recommended fill volume is 400 cc's. And I believe, that is the most he was going to do for me anyway. Talk to your PS, and ask him what he thinks would be a good size for you (personally, I love my PS's nurse. She's awesome. She measured me, noted my size, height, weight, etc) and said a big B or small C would be fine for me. I'm 5'9", 140 lbs (pre MX, I should say. I gained 10 lbs laying around and eating over the holidays. Haha.) and typically a size 6-8. My PS does 60 cc injections each time (so far) so I'm estimating another 3 injections, and then he has me wait a month for my exchange. Also, look online at pics. That helped me size wise a bit. Sometimes I think some pictures look great, and then I say "Woah! 600cc's. Okay, maybe not for me!". Overall, I think looking at pictures and going by your body type is key.
-
Madison:
Tissue expanders come in different sizes. For instance, here is a link to Allergan's breast implant and tissue expander matrices. Scroll down to Page 30 for all of the styles and sizes [volume ranges] for Allergan's TEs...
http://www.allergan.com/assets/pdf/natrelle_catalog.pdf
You can see that there are a lot of TE options out there. Mentor does not have as many as Allergan - Mentor only has three styles, whereas Allergan, I believe, has six.
So I need to know if you have a short height, moderate height or full height TE. I need to know the volume. If you can obtain just the catalog number, I can find it or if you can get the width and volume of the TE, I can determine which style you have. But this information should be given to the patient after the TEs are placed. They are medical devices and patients should have this data for their records.
Also, I need your height, weight, ribcage circumference.
Deborah
-
erica: Look on your card and tell me what STYLE you have. It should say, MV, MX, SV, SX, FV, FX....or - there should be a number like "12" or "13" - which tells me the width of the TE. I essentially need to know your width. And I need your ribcage circumference. Measure under the bra line...
Deborah
-
Thanks whippetmom! I PM'd you. But it's a 133MV. Under my bra line is 31"
-
Erica -- there is no rule that says your PS is required to fill your TE to capacity. I'm sure Whippetmom can help you find a good ultimate implant size... but I just wanted to throw that end (as it seemed to me from reading your post that you feel you have to 400 -- capacity for your current TE).
-
Erica: I am a Uni 6' tall and 150 give or take. I had the same expander as yourself and I was filled to 535 and changed out to a 550. It's now been almost 5 months since my exchange and although I wear a 34DD or 36D I look like a small C cup in clothes--I have shrunk alot! My PS augmented my other side to match.
-
I called my PS and got the information regarding the TE's. They are both Mentor, medium height, style 6200, 275 cc normal fill volume. I am 5 feet 1.5 inches tall and weigh 112 lbs. Thank you so much for any guidance that you can provide. My ribcage measurement is 29 inches.
-
oops. Forgot the ribcage measurement. That is 29 inches!
-
Erica: I am responding here and also via PM...
Your TEs are 13.0 cm in width. I believe you would be very happy with 500 ccs in a high profile smooth round silicone implant. Your PS might feel he needs to overfill you to get you to that point, but as long as your skin integrity is good and your skin has responded well to expansion, 500 ccs is well within reason. However, you are a unilateral, and so your PS would most likely need to overfill, in order to get a little ptosis with that implant.
Another option is the Style 15, in 421 ccs or 397 ccs. This style would work well also and might be more attainable. So talk to your PS and find out his thoughts regarding these two options.
Deborah
-
Deborah, I PM'd you back = )
MBJ: if you don't mind me asking, what size were you before your MX? I was/am just so small "before" (an A) that I'm afraid if I go to a "small C" that it will be ridiculous since I'm pretty boney up top. I just keep having visions of Pamela Anderson, and that's so not me! Haha. But then again, I don't want to go too small, and have it look bad that way. Deciding on boob size is one thing that makes me laugh! That and how "matter of fact" it has all become to me!
-
Madison: I PM'd you....
My recommendation is 325 ccs to 350 ccs, high profile smooth round silicone implants.
-
Hi, Erica and Madison, listen to whippetmom as far as size goes. I am 5'6" and weigh 120 pounds, was barely an A cup before surgery. TEs were filled to 400ccs and changed out to 450ccs (whippetmom and PS recommendations) and I wear a 32DD bra but look like a C cup. I found this site tremendously helpful!! My pictures are on the picture forum if you are interested.
-
Hi Ladies I am new to the site and wanted to introduce myself, plus I have a couple of question I was hoping to be able to get some advice on. I am newly diagnosed, scheduled to have my BLM on 2/4. I am 170 pounds, very athletic (triathlete), originally a 42DD++, very dense and fiber cystic breast. I am 38 years old. I have interviewed two plastic surgeons already in prep for the surgery, I am scheduled to interview one more. The two I have already seen gave me such a different opinion that I am extremely confused. I wanted to see if I could walk away from reconstruction with at least a size D breast. I have been reading this board for a couple of days and you ladies seem extremely knowledgeable......is a D after reconstruction even possible??? One PS says yes, one PS strongly says no, and that I will only be a B at best.
PS#1's opinion:
BLM, Immediate reconstruction, memory gel, 800cc's, TE, Possible B cub out of the deal as final results, she doesn't believe I will be anywhere close to a C
PS#2's opinion:
Skin Sparing MX, delayed reconstruction at least 3-5 weeks to give pocket tissue opportunity to heal, no TE, no Alledurm (sp), believes my skin can support implant. Believes because of my large breast that I have more than enough skin to have a fuller outlook. Stated we could special order 850cc implant. He did mention TE however unfortunately I can not remember in what way. I have scheduled a follow up to clarify.
Have appointment with final PS on Thursday of next week.
I have not found anyone on the site who has posted about 800cc implants. Any recommendations or past experiences would be greatly appreciated. I am so confused and don't know what to do. Thanks and I am so happy to have found the site.
Meekone
-
Meekone - You've come to the right place. Whippetmom WILL be able to help you. She will need your measurement below your bust line. I don't see any reason why you couldn't have a D cup, but know that a D cup with a reconstructed breast is going to look different that a natural D cup. You won't have the projection that have with your natural breasts.
Whippetmom can fill in all the details. Being an athlete ... some have had their implants put completely under the muscle ... would this be an option for her, whippetmom?
I'm sorry you're having to deal with all this. But know that you've come to the right place.
Take care,
dh
-
Thank you Dawn, I feel so much better now that I have found a forum. It was really hard trying to figure out everything by myself and not having anyone to talk to who has gone through it. I have basically come to terms with it now, just so many decisions to make it is a bit overwhelming. Somewhat hard to go from a person who didn't lead with her breast to someone who seems to be "over consumed" with the new size they are going to be. I don't quite understand it, but I wont deny it either. I just want to look & feel like the same person. I know that is asking to much and that they will never look the same but I want to b as proportioned as possible. I do think I am a little "too" top heavy now, so I am looking forward to losing a little bit........geshhh.....I sound like such a contradiction in every sentence that I write huh? LOL
-
Meekone: What is your height and please provide me with your ribcage circumference. Measure around the ribs, under the bra line. If you wear a 42 band bra you should be somewhere around 37" to 40" There are many women here who have implants with a volume of 800 ccs. There are some women who have implants with a volume of 960 ccs [saline implants], which is what I am envisioning as a possibility for you.
I am inclined to favor PS# 2's ideas towards reconstruction. Women who are large breasted pre-MX have ample skin envelopes, and if there is a great deal of skin and TEs are used, the end result is that the skin is stretched even further and then there is far too much ptosis [droop] and even the largest implants cannot fill the skin envelope. I would prefer you not delay reconstruction though, as PS#2 suggested. You might go see Deborah Bash, MD at the Mayo Scottsdale, as she does a lot of one-step recons - meaning, if you are a candidate for this procedure, you wake up with implants. I have seen some beautiful results from that plastic surgeon.
But provide me with the information....so we can see where you should be.
D
-
Deborah,
I have been following your conversation with Meekone and that is where my concern lies...stretching my skin too far. I am filled to 660 cc at this point and my PS is recommending (as you suggested) 750 cc silicone implants. I have another appt next Friday for another fill, I like the size I am now with the TE's..I look pretty impressive in clothes, so do I really need to expand anymore to accomodate a 750 cc implant. I will send you a photo this weekend to show you where I am and so you can see how they look. I feel pretty tight after the last fill..pior to that I still had extra skin to fill up. If I stopped with the fills at this point would the implants give me a comparable look as what I have with the TE's? I think I like this size.
Kelly
-
Kelly, send me photos, but with what you are describing, I would not fill any more at all and yes, 750 ccs would be attainable with what you have currently.
Deborah
-
Hi Mrs Deborah
hank you so much for the information, I measured right up under my breast and I ended up with a 35 1/2, I am 5'6. I usually wear my 42 bra's on the last hook (tightest).I recall PS saying that he did not think I would need expander's, however our meeting was before I had my appointment with the Radiologist. PS told me we may have to make some adjustments to that plan if chemo and radiation was involved and I think that is when he started talking about TE's possibly due to cosntriction of the skin with radiation.
The radiologist feels I am high risk because of my young age & because I first discovered the lump when I was 36 but they refused to give me biopsy, once again because of my age, I finally went "postal on them" and demanded biopsy in Dec, results came back invasive and aggressive BC. Primarily because one lump created the other and they appear to be connected. I have two multicentric tumors that are close to the surface but not on the skin. Because of this he believes I should get chemo and radiation. They have not done the gene or Onco (sp) testing so I don't know my score, margins, stage or lymph node involvement. They tell me all of that will be done and they will know more definitively once the breast are removed.
I am going to call tomorrow first thing to try and get on Deborah Bash's schedule for a consultation. I cant thank you enough, I am excited to try and see Deborah. Any additional info/insight from you would be greatly appreciated. You are truly a blessing!! I will keep you updated as to a possible appointment with Deborah!!
-
Erica: My MX side was always slightly larger, a B but my right side was an A. So I always had to wear padded bras and I wore a 34-36 B prior to recon. I am pretty boney in the chest area, too, but what I have now looks natural and the size Whippetmom recommends is slightly smaller then what I have and after the swelling goes down, you won't be too big at all.
-
Meekone: Come back here and let me know what you decide to do. With your ribcage [which tells me you are wearing the wrong size bra - you should be a 38 band...] you could even use the Allergan Natrelle Style 45, which is an extra full projection style implant. I think 800 ccs would be just about right. But it all depends on who you end up with - whether you will need expansion or whether you have the one-step.
Keep me posted!
-
Kelly....Just want to add something:
I think you would most likely have a similar appearance with 750 cc implants, as long as your TEs are no more than 600 ccs. I know you are filled to 660 ccs, but this might be "overfill." If you could get the style number of your TEs - we could narrow it down even further. We want to look at the dimensions of what you have now...
-
Thanks so much for the responses! Ok I finally sat down and got all my info to post for you.
My implants are: Style 20: Natrelle Silicone 700 cc's, I measured my ribcage with my phone charger cord ugggg soooo hopefully it is close lol I had 32.
I purchased the Chantelle # 3951 34DD; Wacoal 855136 and 851112 also 34DD.
I love them all if it wasn't for that rubbing from the wires! I am going to go back to Nordstrom and have them measure me again. You think they could be too big and therefore pulling the bra tighter to my chest... My breasts seem to fit nicely in the cup. I wish you all lived closer so I could drag ya with me to Nordstroms. This whole bra thing is so hard LOL
Deborah, I will try on the ones you suggested also and see if that makes a difference. I guess I didn't realize the wires should not be touching my skin. So I will look out for that also.
Thanks again you all are so helpful!!
Cheryl
-
Hi Whippetmom, I was able to schedule an appointment with Deborah Bash on this upcoming Monday for a consultation which is great, so you think I was wearing a bra that is too big huh...it figures. I will take your suggestion for Allergan Natrelle Style 45 with Extra Full projection. I will PM you with details on my conversation with Dr. Bash on Monday. Thanks again for you help. It is funny, since reading the blog I actually feel empowered and informed.....great to feel not so helpless and loss.
Meek
-
Deborah,
I have 133MV-15 Allergan tissue expanders. I know that some of the girls are filled more than their permanent implants and some are less. What is the deciding factor for this?
Kelly
-
Meek: But Deborah Bash will likely not use an Allergan Style 45 if she does her one-step. I think she is pretty set on a certain style of implant with most of her patients. So I will be very interested to hear what she tells you. You are doing it right....the way we all should be able to do it. Getting all of your information beforehand, soliciting various opinions...
Deborah
-
Kelly: The MV-15 to 750 cc high profile smooth round silicone implants sound very good to me! Nothing smaller though!
-
Me again - I have another question. Do 325 cc's in a TE have the same appearance as a 325 cc implant? Specifically, is the projection the same? Still trying to figure this all out. Thank goodness I have somewhere to ask these questions! I sure don't want to have gone through all of this and then wake up after the exchange surgery and end up with something different than I thought I would have.
-
madison777 - I cannot exactly answer your question, but have a general answer. I had 310cc's in my TE's. Loved how they looked in my clothes, hated what they looked like naked and felt like. I had 325cc's implants put in ... much better to look at, not near the projection I had with my TE's, however. Generally, an implant is going to have less projection than a TE. TE's are hard and immovable, implants are soft and pliable - thus not the projection.
If you like what you have now with the 325cc's and you're still able to get fills without any skin problems, keep getting fills. I'm not sure how many more cc's you'll need, whippetmom will know, to have the same projection you have now with your TE's.
-
Thanks so much for the reply. Whippetmom has been great. She suggested 325-350 cc's implants. I was just trying to figure out if the same amount of cc's in a TE looks the same. In the posts above whippetmom says, "I think you would most likely have a similar appearance with 750 cc implants, as long as your TEs are no more than 600 ccs.I know you are filled to 660 ccs, but this might be 'overfill'. " Does this mean that 660ccs in a TE looks like a 750 implant?
-
madison: Well, it typically takes an additional 100 ccs to 150 ccs to create the appearance of what you have with your TEs. But I am basing this on the mfr's recommended volume of the TEs. For instance, if you have TEs with a recommended fill volume of 400 ccs but your PS has overfilled to 500 ccs, I would not necessarily recommend 600 ccs - I would recommend 500 ccs to 550 ccs- skin permitting of course. Your skin integrity and response to expansion is crucial. We all respond differently to expansion. Not every PS overfills and not every case necessitates overfilling of the TEs beyond the mfr's recommended volume. Of course, you throw a short height/low height TE into the fray, and we have an entirely different scenario. With the low/short height TE, the PS is often capable of using an implant with significantly greater volume than the TE - even up to 40% greater volume.
kdhawk....this should answer your question also. I will add that what inspires a PS to overfill typically, is that he sees the need to gain more projection - to get the skin envelope to stretch more if he observes that he needs to ensure good implant coverage [so that the implant is not too tight in the pocket], to get a patient into an implant larger than he originally intended, or if he feels he needs to do so to get some ptosis or "droop". Ptosis is most often desired with unilaterals - especially women who have a healthy "maternal droop" with the natural breast, so that you can gain some symmetry accordingly.
Deborah
-
Got it - thanks for the explanation. So right now I have 250 cc's in my TE and I like the projection. So I should ask my PS for 350 cc implants(just like you suggested) to get the same appearance. Am I finally understanding this???
-
madison....
Yes, I think that 325 ccs or 350 ccs would be fine. Some of this is also just based on experience with seeing what implants of a certain volume look like on a chest wall like yours. We also are factoring in that the implant volume will also be distributed in width, as the implants will be close to one centimeter greater in width. This is fine...you will be happy with a little more width - it takes width to create cleavage and fill up a bra.
Here are your TEs:
10.7 cm width and 6.2 cm projection
Mentor 325 ccs HP: 11.4 cm width and 4.6 projection
Mentor 350 ccs HP: 11.7 cm width and 4.8 projection
You can see that the projection with the TEs serves a function which does not transfer to the implants. The projection of the TE is to expand the skin - to stretch it outward - for the purposes outlined above.
There is an Allergan implant [Style 45] which is an extra full projection implant, with dimensions as follows:
10.8 cm wide by 5.1 cm projection.
I just think this would be too narrow for your frame and there would be too much height with this style of implant and you are too diminutive for such a tall height implant. They might look like torpedos on the chest wall.
-
madison: Did you go to the pictures forum yet? I really want you to look at some photos - those I mentioned...Dawne-Hope, DENRULZbc, MapleLeaf, Linda54....
Dawne-Hope.....can you think of any other petite gals?
-
whippetmom - I can't think of names but a lot of the 'petite' women threads are bumped up right now. If I think of names, I'll let you know.
-
KristenPink is another one (300cc implants)
-
Yes, I got in and started looking around, but I have not had the time to really study the pictures to see the difference in the appearance of the TE versus the implants. I will definitely take the time to study them before I make my final decision. Although, I think I already have my answer. Even though my TE is not filled to recommended volume (275 cc's), it probably already has more projection than I am going to see even with the 350 cc implant. I will definitely post my pictures in the forum when I am done. I want to help others who are confused like me. Seeing pictures and having you to explain things really helps. There is no other way to understand how this is going to work. My PS sure didn't explain it.
-
Hi Whippetmom (Deborah),
I would love to have your opinion on what size implants I should go for....my last fill is this Thursday (supposedly). Here is my story. 9 years ago I was diagnosed with DCIS in my left breast. I had a lumpectomy and radiation. I was fine until I had my mammogram in July 2010, when they found calcifications again in the same breast and sure enough it was DCIS again. I decided to have a double mastectomy, but since I had the previous radiation my PS would not do just implant on the radiated side. I ended up having the latisimus dorsi procedure and TE on the left side and just TE on right side. Since the lat dorsi side has the extra tissue/skin, it has more to begin with and better projection. My expanders are Allegran 133MV-12 300 CC. So far I am filled to 415CC on right side and 375CC on left side, and left side still looks bigger. She plans for this Thursday's fill to be my last one and to get me evened out. Also, I imagine my implants are going to have to be different sizes to accomodate for the lat dorsi. I just want to look as even as possible, of course. Prior to surgery I was a 34C on my non-cancer side, and smaller on the lumpectomy/radiated side. I would like to stay a C cup. I am 5'2" and about 120 lbs. My ribcage is about 30". Also, I do not need any other therapies. The small amount of DCIS was removed with the biopsy, and all tissue taken from the mastectomy was benign. I would appreciate any info you could give me. Thanks, Missy (rockyroad1203)
-
Wow, so many newbies here! So glad that you have found us and you are in great hands with Whippetmom!!!
-
Whippetmom:
Can you give me any info without knowing TE model?
I'm 5' weigh 130 and currently have 350 cc's. My rib cage is 32"
Looking for a 'c' cup
I do have photos on forum (newboobs)
Thanks
Jan
-
newboobs - love the name
-
thanks
actually you can also find it under 260 cc's, that was the first post I made
Jan
-
rockyroad: Thank you for sharing your history here!!!
Okay, so what I think might be a solution would be to use a moderate plus profile implant on the flap side and a high profile implant on the prophy side. We want to stay in the 12.0 to 12.5 cm range for width, so something like the following might be considered:
MX/Flap side: Allergan Style 15
339 ccs: 12.4 cm width x 4.0 cm projection
Prophy side: Allergan Style 20
425 ccs: 12.4 cm width x 5.2 cm projection
Of course, this is entirely a hypothetical, because I have no idea what volume your flap adds to the MX side. But the premise is that your PS could consider a MPP style for the flap side and a HP for the prophy side. This would give additional projection to your prophy side and might compensate for the additional projection from the flap on the MX side.
But I feel you want at least 400 ccs to 425 ccs volume on the right and an implant of whatever volume it takes on the left to give symmetry.
This is just something to think about - a way to possibly address the projection discrepancy. Let me know what your PS has to say...
Deborah
-
Jan - Here is what I just posted on your thread on the pictures forum!!
You know, I think that you have a couple of options....
You could go with a moderate plus profile implant - using Allergan as a model:
Allergan Style 15 - 421 ccs
Or with a high profile implant
Style 20 - 450 ccs...
Problem is this: I cannot predict reliably on the HP implant, because if you have 13.0 cm wide TEs, the 450 cc HP is bordering on the narrow side but doable. If you have a 12.0 cm width TE -the 450 HP will be fine.I think you would be happy with this size range...
Deborah
-
Deborah,
Thank you for your recommendation....I appreciate it. I will have this in the back of my mind when I go in on Thursday, and let you know what we decide. My PS likes to wait three months before exchange surgery after last fill, so I have a little time.
Missy
-
Deborah:
Thanks so much for your 'expertise' and I look forward to chatting with my PS about this.
You really do know your stuff!!! You take the time to answer everyone's questions and you are appreciated.
Jan
-
Hi Deborah,
I wanted to let you know how things went with Dr. Bash today from the Mayo clinic. I loved her, she was very nice and by far the most informative doctor I have seen to date. She made sure I understood her and all that she was explaining and also took the time to understand what I was "hoping for" in results. She took the time to understand and explain to me how my lifestyle and normal day to day act ivies would be effected or limited based on what procedure selected.
When I asked her what type Implant she would use on me would be she responded Natrelle Allergan 20 High Profile 700-800cc although she thinks 800cc would be to much and too heavy for my frame (I am a little confused about that one
). I may have the option for immediate reconstruction with no TE's but she will need to speak to the surgeon first if not I will go directly into TE's. She believes TE will be better because I can tell she when to stop filling especially because I want to be smaller than what I am.Because this was my first time at Mayo I will need to see a surgeon there. That kind of sucks because I really like my surgeon at Cigna, however I like Deborah more for the PS. The Mayo Clinic was on a whole nother level though in comparison to the doctors I have been working with through Cigna, so if the surgeon at Mayo has the same bed side manner as the Deborah it will not be hard to make the switch.
What are you thoughts on the Allergan Style 20 for me? Do you think it will be a drastic difference from the Allergan Style 45? In looking at the specs it appears as though with the Sytle 20 I will lose possibly .6' in projection, but gain a little more width? Will that make a drastic change in appearance?
Only thing I hate is that they can not show you pictures of work they have done previously at Mayo because of HIPPA.
Would love to hear your thoughts.
Meek
-
Oh yeah, I am a great candiate for Skin Sparing MX
-
I honestly don't understand why Hippa prevents doctors from sharing photos of their work; I was able to see photos at Sloan Kettering in NY (for example). You're not the first to mention this rule (it's not just at the Mayo Clinic).
-
Meek: Wonderful news! I am so glad you like Dr. Bash. I felt you might be a good fit for her reconstruction techniques and outlook. Are you on the pictures forum yet? So that you can see some of her handiwork? I know two women have gone to her and are very happy with their results, although I am not certain if BOTH have posted their photos....
Deborah
-
Lilah: I agree....if we give written permission and if the photo is just of our breasts - who would ever know? I think it could be that a PS does not want to elevate a patient's expectations regarding reconstruction. They would tend to only show their BEST work....Oh sweet mystery of life...
-
Hi Deborah, yes I am in the pic forum. Do you think the 20 style will have a large difference from the style 45?
-
It could be -- but they should say that if that is the real reason. As it is, having seen my PS's best work -- and I saw a variety including many that were different than the kind of procedures I had -- I concluded that it's individual. Results vary based on body type, healing factors, etc.
Kinda like when you look at all the pics on our picture forum, come to think of it
-
Meek: Well, when you ask if there would be "much difference" it is a subjective issue. Some women would benefit by the Style 45 and for some it would not make much difference at all or could be all wrong. The Style 20 provides more base width which is very important for creating cleavage and for filling up a bra cup. I mentioned the Style 45 as a "consideration" and Dr. Bash has seen you [and I have not] and she concludes that a Style 20 would be better for you and so I agree!
Deborah
-
Deborah: Sorry to bother you: I can't find the link that you posted regarding nipples. Thought I saved it on my computer! Can you please re-post it? Thank you!
-
Here you go MBJ!
-
Thank you, Deborah!!!
-
Deborah: This doesn't look like the article you posted--this is just pictures of areolas! Do you remember the one I am talking about? It shows all of the different recon methods used?
-
I tried looking at that site... yeah, I couldn't find anything about reconstructing a nipple. But lots of nipples to look at! Haha.
-
Oops....sorry MBJ....
This one
http://www.breastreconstruction.org/SecondaryProcedures/NippleAreolaReconstruction.html
This is all I have on nipple techniques....
-
Hello ladies,
This forum is such a great source of information and support! I have read through many of the posts and still had some questions about my situation. I'm hoping someone might be able to help out.
Some background...I was diagnosed with DCIS and had a bmx with TEs on 9/27/10. I currently am expanded to 550cc a side, which is bigger than where I was before surgery (A/B cup). We are still in the process of expanding - not sure where the end point is. All my fills have been very comfortable (60-100cc every two weeks) with no discomfort or pain afterwards.
Anyway, I had a few questions for you all:
I noticed Mentor and Allergan mentioned all the time, but my TEs are Silimed (20799-470AGU), which I've never heard of. Is anyone familiar with this brand? If my PS uses Silimed TEs, will she most likely use Silimed implants as well?
I feel almost stupid saying this, but I don't even know what size my TEs are. For that matter, I don't even know how many ccs I will be expanded to. I told my PS that I would like to be bigger than I was (which isn't saying much!) and that I would like her input as to what would be proportionate to my frame. So, we're expanding and watching. I'm now at 550cc on each side, which looks like about a B cup. I'm not big, by any means. I've read many posts here about women with much less than 550cc but with a bigger cup size. How does that work?
So far, I'm actually happy with how the TEs look. My only concern is that I feel like they leave a bit of a gap between them. I don't know if that will improve as I am expanded more, but is the placement of the TEs a good indicator of where the implants will end up?
I'm also interested in getting input from Whippetmom (thank you in advance!) for what size/type of implant would be best for my frame and how far I should be filled. I'm 5'6", 190 lbs. (and losing, thankfully), and 34" around ribcage. I'm not sure if you can figure out this info for me without having more info about my TEs, and if not, I'll ask more questions next week at my appointment.
Thanks so much!
Heidi
-
Heidi: Silimed tissue expanders might be a little more expensive than Allergan or Mentor TEs - which is probably why they are not used more often. Also, plastic surgeons use vendors they have a good relationship with and yours probably has had a good relationship with the Silimed/Sientra rep. A number of women who have come here have had this TE. Your specific Silimed TEs have a volume of 185/285 ml, but they are low height or short height TEs, which generally enable the PS to use implants of a significantly greater volume at the time of exchange. Your PS will likely use Mentor or Allergan implants, as Silimed [called Sientra here in the US] implants are either not yet available or are not yet used by most plastic surgeons in the states. Perhaps your PS DOES have access to Sientra implants. This would be a good question to pose to her when you next see her, because the dimensions of Sientra implants will differ from those of Mentor or Allergan. So, your dimensions are as follows:
TEs:
14.8 cm wide by 12.7 cm height by 5.5 cm projection. However, with your degree of overfill, you have additional height and projection - to somewhere around 5.8 cm or so.
In order to match your dimensions and provide good implant coverage, the following implants could be considered:
Allergan Style 15:
575 ccs: 14.8 cm wide by 4.8 cm projection
Mentor moderate plus profile
600 ccs
15.0 cm width by 4.6 cm projection
[I generally like Allergan's dimensions better than Mentors....]
I honestly feel you would be happiest with implants with a volume of at least 600 - 650 ccs. With your build, you would be a candidate for a high profile style in either Mentor or Allergan, but you would need 650 ccs to match the width, and that might be pushing it for your PS to use 650 ccs. Despite what I think you could handle though, it is important to ensure good implant coverage with the skin envelope created by the TEs, and the volume of the TEs might not be sufficient to get you to that amount in a HP implant. Talk to your PS about these numbers.
In answer to your one question: Implants of a specific volume will look different on someone with your vital statistics, versus someone who is 5'3" tall, weighs 110 pounds and has a 29 inch ribcage. So height, weight, ribcage circumference, body habitus - all of these things come into play when determining what style and volume of implant will best fit someone's frame.
Let me know if you have any further questions!
Deborah
-
Thank you, Deborah!
-
Wow - thanks for the quick and detailed response, Deborah! I am going to print it out and bring it with me to my next PS appointment.
I have not yet accessed the picture forum (still need to figure out how to get there), but I would like to. Do people generally list what type of TEs or implants they have with their pics?
I'm still a little concerned that my TEs may be a little too far apart. I'm curious to see what other women's look like.
Thanks again!
Heidi
-
Heidi -- ask your PS about the spacing issue... it's not unusual that this happens and in most cases the implants can be brought closer together upon exchange. Limitations have to due with your body's specific build -- so it's best to ask your PS if he can bring them closer or not. TEs do tend to look funny in a thousand different ways (and differently on different people). I've seen some that look fantastic -- perfectly placed and shaped -- but more often than not they can take on funny shapes and look oddly placed but, once they are exchanged for the real implant, often all the weirdness goes away. But when it comes to spacing there is only so much that can be done based on how you are built (most of the time anyway).
-
Deborah:
Thank you thank you...
If PS goes with either 421cc's or 450cc's do the TEs have to be expanded larger than those #'s?
I'm currently at 340 and will get another 60 on Thursday bringing me to 400.
Thanks
-
Heidi: What MBJ said: Ditto....don't worry about the spacing. It will be corrected at the time of the exchange.
-
Jan: I am flying blind here without knowing your TE information, when it comes to assessing the need for future fills. I need to know the style and volume of your TEs. Find out on Thursday. It should be the very first question you ask your PS!
-
Hello Ladies, I have 510cc TE in right now and ready for my implant surgery (probably next thur). I am 5`71/2`` and weigh 132lbs. My ribs are 30inches. My PS wants to put in Allergans 400 or 430cc high profile in for exchange. Do you think the size difference will be dramatically smaller. I would like to be a c cup...
-
Thanks, Lilah - that's very reassuring to hear! Over all, I'm very happy with how the TEs look so far. My only concern is that they seem a little too far apart. I'll definitely follow up with my PS next week and find out what she has to say.
Thanks again!
Heidi
-
Sorry to ask...but can you tell us how to access the photos?
I am 5"10, 150 lbs, medium boned. I had a BMX in Dec, have TEs. I will do my switch to silicone in June, after six rounds of TCH. My PS has recommened 400-500. I was a 430 on the table. My measurement is 34.5" around. I have 225 ccs in me now and at times they seem tiny, other times huge!
Thanks!
Annie
-
Annie: I am sending you a private message with instructions how to get on the pictures forum.
I am afraid that 450 ccs or 500 ccs might be small for your frame. But I would need to know what style and volume of TEs you have. Take a look at the pictures forum and then we can talk further.
Deborah
-
Deborah, would you mind sending me instructions for how to get to the picture forum as well? I would like to see other examples besides my own!
Thanks so much,
Heidi
-
Heidi....Sure....I thought someone had already sent you the link. I'll do it right now.
-
Hi, Deborah! I went for my 4th injection on Thursday (at 370 cc's now) and it's by far the most pain I've been in. I spoke with my PS about the gummies again, and midnightstar from the pic forum (she's she's almost exactly my measurements) I told him I wanted to be a bit bigger than her. Hers were 310 grams (gummy's) and he told me he intended on using an implant that was 30 grams bigger than hers (not really sure how much that equates to volume wise) but then I talked to him about just using bigger rounds because I wanted more of a projection and he was checking back and forth between the implants, and what he wants to use vs. the round was more of a projection. He still plans on using a regular silicone on the native side... but I was just wondering your thoughts on this. You had told me I'd be happy with Allergen 500 ccs HP or 397-421 ccs MPP. (Or Mentor, the MPP 400ccs or 450 ccs). He uses Allergen though, I'm 99% sure. Thoughts? Again, I'm 5'9", 140 lbs (normally), 31" rib cage with Natrelle style 133V TE in right now (with an Alloderm sling).
-
Erica: If you want the projection, I would stick with the Allergan Natrelle Style 20 - 500 ccs. I just have this princess-and-the-pea thing going personally, where I would rather have the same type of implant on both sides - since there is a distinct difference in "feel" - firmness and shape - between the gummy and the silicone round. Just my personal take on the matter.
Deborah
-
I totally thought having two different implants was weird myself. Why do you think he would want to do this then?
-
whippetmom: Have been reading lots on this thread and am wondering about the pic forum too. I am having difficulty sending a PM to Timtam. Can you PM me with the info I need? I am hoping to ask some questions this week at my PS appt. and give you some info for some advice for me as well on fills, sizing, etc. You sure know your stuff after reading all the posts. How great all these women have such a wonderful resource. How did you become so knowledgable about all this? Thank you for all you are doing. Take Care.
-
Laurie: I have sent you a message....
-
Erica -- I agree with Deborah about it being weird to have two different sorts of implants. Especially since he is going to augment your natural breast... I can't see what the advantage would be for you of having the gummy. I did it for my uni because I was NOT having augmentation (I had a reduction) on my native breast. You should ask your PS what his thinking is on this (and then share it with us because now I'm curious
Also, for what it's worth, it seems to me you should stick with regular silicone on both sides (as I don't think a gummy for the augmentation makes sense at all).
Diagnosis: 6/2/2009, IDC, Stage IIa, Grade 3, 1/17 nodes, ER-/PR-, HER2+ -
Thanks Lilah! I agree, I would like to know her PS' reasoning for this...
-
Erica: You already know what I think, but I am see that Deborah & Lilah agree about the gummy being an odd choice as they feel so different to the touch. Does your PS just think you will get the most natural look with a gummy? Also, I am curious how the two different implants will look in a bra?
-
Hello Wippetmom! Maybe you could help me...I don't understand how to get to the picture forum that everyone is talking about. I am not really that good with computers
This site has been such a blessing to me. When I am feeling like no one understands these rock hard breasts on me I realize many are out there who do Thank you all for sharing your experiences! -
Lilah... he only wants the gummy on the MX side. As of nowww, he wants a round for my native side.
MBJ... This is always my question. He told me that they will feel different, but not THAT much. I have a good friend who goes to my breast surgeon, oncologist and PS and she had the same procedure as me (only thing different is what he ended up doing on her nipple procedure) so I have her to go by. She's shorter than I am, has a tiny waist, was a tiny bit bigger than me boob-wise to start out with but... she loves her new boobs. She says they look better than before (hah!) and that she's very happy with them (and in a bra she said they look awesome). This is where my confusion comes in, cause I have someone I know personally saying this... and then tons of you lovelies saying the opposite! I'm afraid what to do!
-
Maybe the PS has both samples in his office that you can feel for yourself?
I brought a piece of paper to the pre-op meeting about my desired size. It just so happened that day there was a trainee peesent, so our conversation was very brief. So brief that I actually didn't have a chance to present my note! Minutes before I was wheeled into OR, I finally got an answer that I'd be a full B. So when I woke up from the exchange surgery, I found out I got Natrelle 20, 230 cc. I must have trusted my PS very much! They look very natral though. Will post pic soon. Thank you ladies for all the info here. :-)) -
Erica -- I felt the difference before my surgery (holding one of each) and the gummy outside of the body feels only slightly firmer, it's true. But I think there is jiggle, for example, in a regular silicone -- is that correct ladies? And the gummy does not jiggle... certainly not the way my real breast does (but I guess my real breast jiggles more than my gummy). The gummy is firm and looks great. And while I agree with Deborah, as I said above, about having a matched set (as it were)... I also really think you just need to ask your PS what his thinking is. Clearly this is his practice and he must have a good reason. Does your friend find that they feel the same to her (the augmented regular silicone side and the gummy side?) I do think that gummies tend to have more/better projection due to the fact that they hold their shape. And that alone may be why he wants to go there (to better match the projection of your augmented side). But really we can guess all we want and it's so much simpler to just ask him
-
soccermom.....I sent you a private message!
-
Whippetmom,
I have been reading your posts now for a few months and boy do you know what you are talking about. I finally joined this wonderful online community last night and of course I screwed up my first post so please bear with me. I trust your opinion and your knowledge, lets just hope I give you the info you need from me.
I had BLM Oct. 2010, between all the biopsies and lumpectomies I was barely a 32A at this point. I was a 36B a few years ago but after a significant weight loss ended up back where I started at 32 A.
I have Allergan 133MX 400 cc Tissue Expanders in place now on both sides and I have 395cc's in both. My PS and I have not discussed implant size yet and I would like to be armed with all the info possible so that I can mke the right decision.
I have a few questions:
How much saline can be put into an expander of this type. I wonder because Dr. has not yet mentioned implants or exchange dates with me so I assume that I will have a few fills left to go. The last fill of 45cc was way too painful so I would like to go back to 30cc's. I still may be very sore anyway because I am almost filled and I have severe scoliosis which is causing me a lot of pain since my last fill due to muscle pulling/cramping only on the left side.
I am 5'4" or 5'5", I keep shrinking as I age and 130 lbs. My ribcage is 32" and I remember PS measurements of 11-1/2" for one side and 12" for the other, just not sure what these measurement are of.
Can you tell me with this info what size/type of implant you think would be appropriate. I definately want to go bigger than what I was. Aside from the recent pain, I really enjoy looking down and seeing cleveage and decent size chest for the 1st time in my life.
I want to go with silicone but as for shape/size, I have no clue. I can not see myself buying playboy or something and bringing a pic to PS to show him what size and shape I would like. So aside from that I don't know how to make an informed decision.
Please let me know if you need any other info.
Thanks so much
-
ericavw - I had my exchange on Friday and will be unwrapped tomorrow. I have an Allergan 410 MX 370 gram in the MX side and in the natural side a 120 cc round. He chose to use a round on the natural side cause he thinks that it will make the best symmetry. Making the MX side more teardrop shape and making the natural side more rounded should make them even. I will know more tomorrow morning when I see them. As far as feel, the natural side will have that natural padding on top that the MX side won't have any of, so they will feel different anyway. And gummies don't come in round in the US, so that is not an option.
-
heebie-jeebie - Thank you for responding to Erica! I sure hope you post your photos for us!!!!!
-
Marianne: Welcome! Glad you finally joined this wonderful website!
Your TEs have the following dimensions:
12.0 cm width by 6.3 cm projection
Despite the fact that your PS measured out your natural breast width as 11.5 and 12.0 inches, I still feel that increasing the width a little bit would be nicer on your frame. I hope you are waiting two weeks between fills [?] and if not....this is your call - and you can fill as little as you want, so that you can tolerate the fills and get to the point you need to be for exchange to the appropriate implant. You could easily overfill 100 ccs beyond the 400 cc capacity - or just to around 450 ccs, although I am not sure it will be necessary. You already have an extra full projection style TE, which means that you have pretty good expansion in the area most critical for good implant coverage. It is important to state that the size of implant your PS will ultimately be able to use will all depend on your skin integrity and the size of the skin envelope when expansion is complete.
It is entirely possible, under most circumstances, to switch out to an implant with 50ccs to 100 ccs greater volume than the TEs....but this is something your PS will have to determine and be willing to do. Skin integrity is imperative though....so he is the one who will make this assessment.
My recommendation would be, at the minimum:
Allergan Style 20:
450 ccs [12.4 cm width by 5.2 cm projection] or 475 ccs [12.6 cm width by 5.5 cm projection]. You can be sure that I feel the 475 cc implant would be preferable for you.
Please discuss this with your PS and then come back and let me know what he has to say.
Since you have been reading this thread for awhile, you may know that projection with the TEs serves a function for expansion that is not transferable typically to the implant selection. I say typically, because there is the Style 45 extra full projection implant which matches some TE projection numbers, but not everyone is a candidate for the Style 45 and in this case, you are not a candidate. You would need too large an implant to match the width.
Also, I want to address your scoliosis. There have been instances where a patient has required a different size implant, because one side of the chest is retracted and the other prominent [depending on which way the spine curves] - and so compensation for this must be considered. The level of the breast folds may need to be addressed as well. I don't know if it would apply in your case, but I thought I should mention it so that you can discuss it with your PS accordingly.
Let me know how you do with your next fill and just do the minimum. There is no rush to the finish line with this part of the journey.
Deborah
-
Heebie-Jeebie: I truly hope you decide to post your pics for Erica to see. I am curious as to how it looks/feels, too. We all just want to help her make the best choice possible! Thanks!
-
Heebie-Jeebie -- how interesting! So maybe this one side gummy, one side round is just another of the ways that PS's bring symmetry to the people, er the BC survivor
-
Heebie-Jeebie: Oh, please yes! I would love you forever! I always have a page of questions to ask my PS, and I always seem to forget to ask the biggest question I have... why does he want the gummy for the MX side. Just from what I gather from talking with him on other things, I BELIEVE it's for symmetry and because I'm super boney up top and don't have much skin to work with... my PS is pretty known for making woman look as natural as possible and like I said, I have a good friend who goes to him and has what he's intending to do with me. My Mom also has a handful of friends who've gone to him after having surgeries by other PS's and had to have my PS fix they're first botched job. I know I definitely trust him, I just don't understand his reasoning. And I'm information obsessed... so it's hard to let him just do what he knows is right without me understanding it, of course. Ohhh, to be a control freak. Lol.
-
ericavw - and Lilah & whippetmom MBJ ... I'm jumping in here, thinking out loud. From what I've seen (and you all have been around longer than I have) it seems with the gummies that there is a more natural slope for the boney gals up top than just the silicone rounds. erica, I second, third everyone else ... ask him and let us know his reasoning because I too am seriously intrigued. m-star had a boney chest, but after her exchange she had just a nice, natural looking slope. don't let us talk you out of getting the gummy, erica. ask, ask, ask but since you have a friend that's had it done and likes it, that means a lot right there. I may have missed it, sorry if I have, but have you been able to see her result, touch it? I was so reluctant to get reconstruction but when a friend who's been through it showed me what was possible that's what did it for me. Please keep us posted I'm so curious now along with everyone else!
-
Dawnehope -- that's right! Gummies are tear drop shaped. I am beginning to think that PS knows exactly what he's doing with Erica
-
Hello whippetmom! My te diameter is I think 11.7 cm. Can you put a implant with the diameter of 12.1 in there? What would happen? Why is the diameter so very important?
-
soccermom: Yes, absolutely you can use an implant with a diameter of 12.1. It is important to exchange out to an implant which is as wide or wider than the TE. Frankly, I looked back through your threads and see your ribcage is 30 inches and you could use implants with a width of 12.0 cm to 13.0 cm without any problem. I see you have been asking about the Allergan Style 45, which is an extra full projection style implant. It is a great style for certain women. If you have a long torso or your breast folds are lower on the chest wall and if you need a narrower implant to fit your ribcage proportions, this is a great style. You would need at least 500 ccs in that style to come close to the width you have now. I believe 500 ccs is 11.9 cm in width. The other issue though with the Style 45 is that because of the increased projection and taller height, the patient needs to have a sufficient skin envelope to cover this implant. Ample skin for implant coverage is very important.
Deborah
-
Whippetmom,
Thanks so much for your speedy post and all of the wonderful information. I have been getting weekly fills, but after this last fill I know I need a definate two week interval. I am calling to cancel my appt for Thursday and reschedule for the following week. You are right, I need to think about the skin integrity, esp after the radiation in 2000. I will keep you updated and again I thank you for sharing all of your knowledge with us.
-
I was unwrapped today!! I had a shower and a long time to stare at my "girls" in the mirror. The gummy MX side is a much more natural shape then it was with the TE. I am surprised at how soft it feels when I poke it with a finger. (I don't want to squish it too much as I am still pretty sore) The nipple points out a little bit, but not too much (I had nipple sparing).
The natural side with the round implant is more swollen and has more upper pole fullness right now that it won't be keeping as the swelling goes down (My PS says). He thinks when they settle in and all swelling is down that they will be pretty even and if not, he can fix it.
I was planning to post my pictures - I have them all through the process - but when I mentioned it to my husband, he was very against it. I am in a bit of a dilemma cause I want to share with all of you, but If he finds out I posted them on the site, I don't want to deal with it.
So, maybe I can mail some photos to someone if it would help instead of posting. If someone has done this, let me know how you did it.
-
Heebie-jeebie: Congratulations!!! Isn't it great to feel them finally sof?
Wouldn't want to start a fight with the DH, though the picture forum is very private and there aren't faces, just pictures of the recons. I take a picture, download it to my computer, open it in Paint and reduce the size by 90 % and then save it in a file. This way I can easily post it in a manageable size or email it if I need to. Erica would love to see your results. Is there much difference in feel between the Mx side and the augmented side or is it too soon to tell?
-
MBJ - It is really too soon to tell. If I poke either with my finger, they feel the same, but I can tell that the natural side can be lifted and squashed, while the gummy side is more stiff. It is only day 4, so things are bound to change. Also, even if I send photos of my current result , they are going to be changing as the swelling goes down.
-
heebie-jeebie: Yes, they are bound to change some in the next 3-4 months, although I hear the gummy doesn't drop and fluff like the regular round silicones. I see you asked Erica to PM you. Thank you for helping her!
-
Heebie-Jeebie -- the gummy side will soften over time... a little. And the native side will soften a lot!
-
Hi ladies,
I'm getting my PBM on 2/3 and had a meeting with my PS today. He agreed to do a direct to implant with me, but said he can't get much bigger than what I already am-- 32 A. I didn't want to be huge-- just a medium B. He suggested Allergan low profile either 210 or 240 cc's. Does this sound teeny to anyone? I'm 5'5", 120 lbs and have a rib cage measurement of 28". So confused about the sizing. Any advice would be so helpful. I'd love to hear from anyone else in the "itty bitty titty commitee":).
Best,
Jenn
-
HeroicSong - Whippetmom can give the advice you need. I can only give my experience. I'm 5'5" 28.5 inch ribcage, 109#. 210, or 240 will be pretty small. I have 325 silicone rounds and that almost puts me where I was before my surgery, but not quite (32C). The sizes you've mentioned seem a little small. Let's see what whippetmom has to say.
Is it possible to wait, put in the tissue expanders, stretch your skin and muscle a little and then go back and do the exchange? Or does your PS always do the one-step?
-
Jenn: That would be pretty small and, in addition, the numbers you mentioned tell me your PS is talking about a moderate profile implant which would be very flat in profile. I do not see that style used at all for breast reconstruction. I do not know anyone with implants that small [in saline or silicone rounds.] If I were doing the one-step with Alloderm, I would want my PS to follow the approach taken by plastic surgeons at the Mayo Clinic in Scottsdale, Az. They are using Alloderm to form a mesh "bra" support, which enables them to use larger implants. Read about it here....enter Page 45 after you get to the PDF file....
http://www.breastsurgeons.org/upload/ASBS_Official_Proceedings_2010.pdf
Look at Speech529's photos on the pic forum. She had this procedure - was very small pre-MX - quite a bit larger after the one-step with Allo-bra. You cannot accomplish this without the Allo-bra approach - unless you already have large breasts, e.g., sufficiently sized skin envelopes prior to BMX.
You are having this done prophylactically - so I would take the time to research and fly to Scottsdale, if necessary. This is the only one-step I would consider if I were having prophylactic bilateral mastectomies. I think because of the degree of Alloderm used, there is some sensitivity testing involved...not sure though. Your PS locally might be willing to follow the protocol and do this for you - so email him the PDF document.
Deborah
-
Hi Dawn and Deborah,
Thank you so much for your responses. It's been a tough day:). My PS usually doesn't do a one step. I really wanted to go that route. He doesn't think he'll need to use any alloderm because he thinks he can get the implant in all the way under the muscle without trouble. I'm really confused and frustrated at this point. I really love my BS and don't want to leave her. In my initial PS meeting I was told I could be a bit bigger than I am now. Anywhere in the B range is fine for me. Now, with 210's or 240's, I'm not sure. It feels too late to do anything else. So, I'm at a loss. I really appreciate you both taking the time to write me.
Best,
Jenn
-
Jenn: Then don't do the one-step. Go through the TE process! I would NOT do the one-step with a doc who does not like doing it or rarely does it. No way Jose. Where do you live? I maintain a PS referral list....maybe we can find another PS in your area who will work with your BS...
Deborah
ADDENDUM: Actually, I only know a handful who do the one-step in the US, so let me revise this by stating that your PS may be and is likely a very good plastic surgeon who finds he has greater success with a two-stage breast reconstruction. So I would go with what he feels will give the best results.
-
Jenn: It is not "too late" for getting exactly what you want out of this and feeling comfortable about your decision. This is an "elective" procedure! Don't feel pressured to go through with this without having a peace about the decision and the plan.
-
Jenn - I second everything whippetmom is saying. I had the same reaction when I read your post ... Don't do it! You have to live with the results. It's not too late! Let your PS do what he does best, or go with one of Deborah's recommended PS's ... but don't settle. !!!
-
Hi Deborah and Dawne,
As my people would say: "Oy".:) I have alot to think about. I think my PS is really excellent. He prefers the expander route and thinks I'm the best possible candidate. He told me if i feel I end up too small, I can have a larger implant put in when my skin heals. I'm in NYC and love my BS. She does 90% of her surgeries with my PS, but I'll be grateful for any other reccomendations. I know it's an "elective" surgery, but with my family history it doesn't feel like it. I just want to be on the recovery side. Thank you for caring, writing and advising. It means a great deal.
Best,
Jenn
-
Jenn - If you don't mind me asking, why do you want the one step? If you feel comfortable with both docs, and your BS likes working with your PS ... why not let him do what he normally does? Just wondering. We want what's best for you!
xoxo -
We are tenacious, aren't we Jenn?
-
and wouldn't that be "oy vey"???
-
I hope it's tenacious and not obnoxious!
-
You are so not obnoxious, ladies! Yes, technically, Oy vey is correct, but I'm a lazy speaker:). I just tried to PM you both and something went all computer-y crappola, and it wouldn't send. First, so sorry about your Mom, Dawne. I lost my Mom in 2006 and think I associate the expander process with her and her being sick-- she had a rough expansion. I also would like to avoid a second surgery if possible. Does that sound crazy? Wait, don't answer that:). I'm not really sure what I'm going to do, but am so grateful to you both for reaching out to me and caring. I'm glad I have an almost whole box of Ginger snaps waiting for me:).
xx,
Jenn
-
Jenn, I pm'd you!
-
LOL Deborah (and Jenn) re: Oy and Oy vey... what about Oy vey ismeer (sp?)
-
I am new, as you can see. I have been reading for awhile and planned on asking for help at a later date but due to a leaking tissue expander I will be having my exchange on Feb. 1st. Please help. I am 5'1, 170#, 40" rib cage 133MV-15 600cc filled to 600cc. I have decided on silicone, smooth, high profile implants. What would you suggest?
-
FYI....... and I add.... this might have been brought up on Jan 7th...2011....
I wanted to thank Deborah for adding this option to BCO a year ago Jan. 10'. I want to thank her for knowing... she is not a doctor nor a licensed educator......... but gave herself to us as a fellow breast cancer survivor, who researched her own reconstruction... and then... continued to research for others close to her back in 2008/09....... and now............ to continue... on a thread called Exchange City.... for about two years............. and then to start this thread... a year ago... January, 10'.
It has been a total of 2 1/2 years Deborah has gave of herself to help breast cancer survivors.. and over a year now that she started this 101 thread to continue to help.... new breast cancer survivors who want to become whole again... in their heart and souls... with their implant reconstruction. Along this path Deborah has lead... other ladies have jumped onboard to help... and give of their own time too..... Lilah...MBJ.... Firni.... and so many more....
Thank you Deborah for starting this 101 thread... a year ago!
I for one.... am very proud to call you my friend. Thank you " whippitmom"
-
Wow, Estepp! A year ago is when I first started researching implants! Deborah told me I was a little bit early, lol! I am so very grateful for Deborah's dedication, help and accuracy in predicting size!
Heroicsong: When I was first diagnosed, I wanted one step with Alloderm, I wanted the gummy bears, I didn't want chemo and, let's just say that what I wanted and what was best for me were two completely different things! Take a deep breath, realize that it does take time to get what you want and to get it right. Get help from Deborah, take her advice seriously and it is never too late--even after surgery is not too late, but it's better to get it right the first time. No one wants expanders, it's just the best way to get the best results! Hugs!
-
Hugs Laura you are such a sweetie!
-
You've all been so wonderful, ladies.
Lilah: I forgot, Oy vey ismeer! MBJ: I hear you. I really trust Deborah's opinion, not to mention all of you guys who've been thru much rougher than I have. Part of me feels guilty caring so much about my boobs because this is a PBM, but I'm seriously considering doing expanders. I'm going back on the picture site and look at photos of the sizes Deborah reccomended.
Back to the boobs, so they say:).
xx,
Jenn
-
Jenn -- you are removing your breasts and replacing them. It really doesn't matter if it's prophy or not... it's the same thing and we are here for you! (But what does "ismeer" mean??? I can't remember).
-
Laura....Oh my word, I am so grateful for your kind words and endorsement! Wow....and I treasure our friendship also! I am ever so grateful for all of you who have stayed here on BCO with me - helping newcomers and offering encouragement to others - well beyond the conclusion of your respective surgeries and cancer treatment. I am honored and blessed to be able to have this ministry on BCO and to share it with all of you!
Thank you, thank you!!!!!!
Deborah
-
JUNEBUG: One question first: Do you have one TE or two?
-
Lilah, Thank you for saying that. I also found out yesterday that my insurance company is fighting my claim. A crappy day all around. All of you wonderful ladies have really helped lighten my mood so much. As for the "ist meer"-- I think it means "woe is me"
xx,
Jenn
-
Jenn: You fight your insurance company right back. I hate that after all we go through they try and not pay for our procedures! That really sucks!
-
Thanks MBJ. I am fighting it. I'm super pissed, but my BS's office says they're doing everything they can. Does the insurance company think I'm doing this for fun?!
xx,
Jenn
-
Geez Jenn -- and exactly! Does the insurance company think this is cosmetic surgery??? What woman would do this who did not have to? I agree with MBJ -- fight fight fight! (Oh and thanks for the translation - of course!)
-
Hi Lilah, Oh those crafty insurance companies-- they figured out my elaborate plan to "pretend to need a BMX" just so I can get implants. and try to break into swimsuit modeling-- at 39 with a kid. So very clever they are:). I think this calls for an "Oy vey ist meer".
-
Jenn: I NEVER would have had a "boob job" so why on earth any insurance company would not only fight a woman excercising her RIGHTS to reconstruction under FEDERAL LAW is truly beyond me. I would even go to the lengths of starting to report these offenses to your local newspaper so that it is brought to the public's attention. This is an outrage! Sorry, getting off of my soapbox now!
-
I am with you MBJ -- that totally sucks! Jenn -- I hope you win (and give them a black eye too
Keep us posted. -
I have two expanders. I was so worried when my left side, not the radiated side ruptured. My PS says if it left more than 10 days it will begin to tighten up. If that happens he will replace TE and start over. I have had them since Feb. 2010. My last radiation was the week before Labor Day. Tomorrow we are going to refill so I can hold off surgery until Feb. 1st. We could not get scheduled before that date. I can only go by what has been written here but everyone has such great respect for your knowledge and willingness to help. I appreciate any help or information anyone has on similar situation. I also am questioning silicone or saline implants now. If this had been silicone I may not have known it right away.
-
Junebug,
I don't know if this will help your decision process or not but my mom got silicone implants 40 years ago and she still has them in. One of them has a very slow leak, but the silicone has not migrated. She just went for an MRI to verify this. She cannot afford to have them replaced, and at the age of 70 probably wouldn't do it even if she could afford it. Knowing all this as I do, I have still opted to get silicone over saline. I really need some squishy-factor in my bust and I don't think saline will give it to me. I had a BMX even though I "only" had cancer in one breast. I am now scheduled for my exchange on 3/4 -- almost a year after TE placement and I am "breast obsessed" now. Deborah and the ladies here and on the photo forum have been so supportive in helping me fight for what I want. They will help you too.
Jen
-
packjen,
Thank you for your response. I had made up my mind on silicone until this happened. I felt confident in my decision and now everything is happening so fast. We are close to the same dates of our treatments. I was about 1 month ahead of you with the same chemo and 28 rads.
You only have another month for your surgery. It seems like forever and then it's here. Good Luck.
-
Why don't implants have the same shape as TEs? I love how my TE looks and I would keep it forever if it didn't have a metal port.
-
Well it's saline, Claire... and most get silicone. Have you asked whether a saline implant would be the same? But do you like how your TE feels?
-
It's hard but it looks so good in a bra lol
I'm actually scared to death to have another surgery - last time i had an infection- 6 weeks of antibiotics which threw off my whole system and I'm still not feeling right. 3 months now - i'm waiting for april for the exchange- hoping i'll feel back to myself by then - only to be thrown back to recovery again.
I can put up with hard lol
but seriously i know i can't keep the TE - I'm overdue for an MRI now - can't have one with the metal in me.
just wondered why the implants looked flat and the TE has such nice projection
-
i am flipping out - i heard on the news last night that implants can cause breast cancer - ddi anyone see that? i am do for my exchange in march or april
-
Claire -- well think about it: the same thing that makes the TE hard is what gives it such good projection!
Nina -- I think what you heard is the news that it's possible implants can cause a rare form of lymphoma NOT breast cancer... but it is in RARE cases and you're more likely to get breast cancer again (not from the implants) than that rare lymphoma... so I would not worry about it.
-
Lilah...well said...a VERY low risk for a very rare cancer...
JUNEBUG: The fact that your TE ruptured has no relationship to implants, saline or silicone. Silicone implants will not just spontaneously rupture, as did your TE, unless the implant is defective and frankly, I have never heard of this occurring with an implant. This tells me that the TE is defective. So the chances of this spontaneous event ever happening with a silicone implant would be incredibly remote. Let's just get those wicked TEs out!
-
Hi Deborah, I had contacted you a couple weeks back (1/05) about my TE's. I'm 5' 6" , 125 lbs, 30 inch rib cage, and 350 cc's TE's. I inquired for more detail, but the nurse who filled me did not have it, but will on Monday (my next fill). I am at 290 cc's, planning for 410. The last time you advised you mentioned an implant of (if I recall correctly?) either 390 or 400 implants.
My question is : if I "sit" with 410 cc's as my final fill for 6-8 weeks, (exchange date is 3/21) will I be able to get 400 implants? Should I go for 460 as my last fill? It just seems sooo big... I would like to be a small C, I'd like projection, for the implants to sit up high, but not take up my whole chest area... and to be "perky", not all boob up top, but definitley cleavage and projection are important to the final product, to me :-)
I would post on the picture forum, but am unable to at this time. I could email you a pic of where I am right now, not sure if thats ok, or not...I have looked on the forum and hurleygurly looks about what I would like to be. My frame is longer than hers, but probably the closest I found to what might fit for me...do you have any suggestions of who I should check out for comparison? Thanks!
I definitley don't want to stop too early, or go too far...my PS only gave me the advice of going one fill past my desired size. What if I am happy with somewhere in between the two fills? I don't imagine I will want to be above 400 given where I am now, but I sure don't want to regret anything and come out too small after swelling goes down, etc.
Thanks for any adcice you might have for me!!!
Megan
-
Hi ladies-- especially Lilah, MBJ and Deborah,
Good news-- My insurance has finally accepted and I'm getting my surgery next week! I guess they realized I wasn't doing it for s#@ts and giggles:). Thank you so much for your support. It's meant alot.
xx,
Jenn
-
fire-dancer: Look at the following photos: Sweetie, Lindy323, Speech529, Vanderlady. You do not need to keep expanding. Yes, with your 410 ccs, you should most definitely be able to exchange out to 400 ccs implants. You can email me photos. I'll PM you the info.
Deborah
-
Deborah, you told me to come back after I spoke with my PS about the malpositioned TE (I've got a photo in the photo site if you want to refresh your memory). My PS doesn't seem concerned about the higher left TE and says he'll fix it in the pockets.
I wanted to ask you though. You suggested the Mid Range Allergan 397 for me. He told me that he usually uses the mid-range ones with augmentation and the high profile with reconstruction in order to get more projection and a more natural shaped breast. He said he'd like to take in several and try them on me and then if I'd let him choose the one that looks best on my frame. He checked off the high-profile 350, 375 and 400, and in the mid- profile said he would try 339, 371 and the 397. But he knows I want to be smaller than I am now so he thinks I'd want the 339, 371 in mid or 350 or 357 in high.
So you don't have to hunt for the info, I currently have Allergan 133 MX, 500cc and my left is filled to 490, the right to 370.
Edited to add: I'm 5'1, 116 and ribcage is 31. I want to be a B cup.
Thank you!!
-
Jenn -- LOL and that is GREAT news!
-
Ann: Are you SURE you have a 31 inch ribcage circumference? Please measure again - the tapemeasure nice and snug around the ribs just under the breast mound. If you do not have a dressmaker's tape measure or whatever it is called, use a piece of ribbon or string, cut it off and then measure that and tell me. I agree wholeheartedly with your PS about high profile implants for breast reconstruction, but if your ribcage is 31 inches, 350 ccs in a high profile implant just would be too narrow, in my estimation. Additionally, your TEs would be wider than the implants and this would mean lateral pocket revisions and why even think about doing that? The width of the TE used SHOULD be chosen based on the comparable width of the intended future implant. More importantly, the width of the TE should be selected based upon the width of your breast fold prior to MX.
The midrange profile give more of an athletic appearance than do the HPs. I am in full agreement about trying out 339 ccs or 371 ccs, since, as you stated, you want to be smaller than you are with the TEs. However, your TEs are huge....500 ccs! You will NOT be as large as your TEs!
I have talked to so many women today, my head is spinning with all of these numbers! LOL!!! WHEW!!!
-
I had DH help and he got 32 in. for my ribcage.
-
Ann: You do not look like you have a 32 inch ribcage! Okay, so this is why I feel that you need the midrange profile, so that you can have sufficient width for your ribcage and so that you will not require any lateral pocket revisions. If you were getting 450 to 500 ccs in an HP style implant, that would be more in the range of meeting the width of your TEs. But your PS is going to take in various sizes which is "a good thing", as Martha Stewart would say, and I think he will come up with the style and size which looks best on your frame. Ask one of the nurses to be your advocate in the OR....
When is your exchange date?
-
Thanks, Deborah. I keep seeing ladies here post their ribcage measurements and they are smaller than me and I think to myself, "I am not as small as I thought I was." I'm small boned, petite, ... but I guess not in the ribcage area!
It is Feb 9. I'll keep you all posted. I love my PS's nurse. I will mention again that I like the small, athletic look. I will keep drilling that in.
-
That is why I wish I could drop by your house right now with my tape measure! LOL! Because you are a petite little waif!
Two and a half weeks! Wonderful!
Make sure you come back here after the exchange - when you feel up to it - and let me know how you are doing!
Deborah
-
Hi All,
I had a double mastectomy last summer and have completed chemo. I've got some international travel in Feb and will have the surgery to remove my tissue expanders and put in the implants sometime in March. I'm curious to know what to expect from this surgery. I'm 54 and in good shape. How long is the recovery from the surgery? Did you have drains? If so, for how long? How long before you were up and around and out of the house (say, driving to the grocery store by yourself and grovery shopping)? I've been taking lots of step aerobics, dance, and body-sculpting classes. How long after the surgery do you think I'll be able to resume those? What else should I know about the surgery?
Big thanks in advance for any information you can provide -- or links to places where this information is written up.
Katherine
-
Katherine -- recovery time varies depending on how much pocket work (if any) is done. As for drains, well, some PS's use them as a matter of course even at exchange (mine did) and some don't. You should ask your PS about that. I would say at least a week and probably more like two weeks for recovery -- you can't drive till you are off pain killers, for example, and there will be restrictions about how much you can or should move post-surgery due to healing and also not ripping stitches (like no sharp movements, no lifting anything more than 2 lbs, no reaching over your head... the same restrictions as after your MX). I think I tried driving a week after surgery and almost passed out... but was fine after two weeks.
-
Katherine - My PS was one who didn't use drains, but as Lilah said, it depends on how much pocket work is done during surgery.
I wasn't able to drive for 2 weeks. I moved at 4 weeks and did wayyyyy to much reaching and it really hurt.
It was at least 2 weeks before I could do any cardio at the gym, and even then it was walking on the treadwill and bike.
Don't come back too soon. I think it was after 4 weeks that my PS said let pain be my guide. If it hurts, don't do it.
-
Adding to what Lilah and Dawne-Hope shared above....WEAR A GOOD QUALITY, SUPPORTIVE SPORTS BRA! Visit the Bras 101 thread for information...
-
LOL Deborah! SO TRUE! Well I wore a bra 24/7 for 8 weeks post exchange.
BTW... I went to Nordstrom's finally... and got 4 fab new bras! 38D (two of them) and 38DD for two others - all four of them Wacoal... so weird that the cup size varied and boy did it ever... the ones I got in D were baggy in DD.
-
whippetmom
I have decided to stay with my original decision to use silicone. I haven't been back on since I needed to work as much as I could before exchange. I did have saline added to the ruptured TE on Thurs. and so far it is holding up pretty well. I was just wondering if you had the time to look at my previous post on sizing and have any suggestions. I can't wait to have TE's out on Tuesday but would like to have best outcome as possible.
-
Katherine: I am 53 and also work-out alot. I am one week post exchange (it was Friday the 21st). The first 2-3 days I was in enough pain to take the narcotics. I drove for the first time on Tuesday cause I was off painkillers,- just a quick carpool turnaround. I rested alot all week, no drains, and my Dr. said no restrictions except lifting, pushing, pulling. He wants me to wear the bra 24/7 for only 2 weeks. I had to run a few errands yesterday and definitly felt my enegery was low. I am plannining to go to the gym on Monday and do a spin class, although I'm going to take it very easy. No weights for at least 4-6 weeks (PS said I could lift as long as I don't use my Pecs for anything, but I don't want to risk it. It's hard to avoid that area except for lower body weight lifting. Summary of my exchange:I had a little pocket work done cause the MX side was too low and an augmentation on the natural side.
Hope that helps.
-
JUNEBUG: Oops...I was so focused on your leaking TE I forgot about sizing. I just extracted your info from that previous post:
"5'1, 170#, 40" rib cage 133MV-15 600cc filled to 600cc. I have decided on silicone, smooth, high profile implants."
If you prefer high profile implants, you will need at least 750 ccs in Style 20 to approximate what you have now with your TEs. You can easily handle this volume....and I agree that you will be happier with high profile implants. Your PS may want to overfill the TEs a bit more, which should not be a problem, skin integrity permitting.
Deborah
-
I would be so, so careful about working out with upper body weights - especially in the first few months after the exchange. It is too easy to displace these implants and why run the risk? The best choice in a sports bra is one with nearly iron-clad lateral support.
-
Thanks, everyone, for this very useful information about what to expect from the exchange surgery. It's very helpful to hear about your experiences! I'd welcome hearing from others.
Katherine
-
Whippetmom - My PS is not giving me many restrictons, but I don't want to mess anything up. Anything else I should be careful of? (I love that I can't touch a snow shovel or the snow blower)
All my old sports bras are the over the head stretchy type that support by squashing them - I was thinking I should stay away from that type - do you agree?
Thanks.
-
Heebie-Jeebie: I just posted a couple of options on the Bras 101 thread. Look at the Moving Comfort "Grace" sports bra. The "Fiona" sports bra would be fine also. Don't put on anything that needs to go over your head - step into any no-hook bras.
-
Hi Deborah,
My fill took me to 475 on non-LD side and 425 on LD side. I thought this would be my last fill, but my PS wanted me to come back in two weeks and think about if I wanted anymore. I "think" I am big enough, but I still am not sure. I want to be a full "C". You previously suggested 425cc on the non-LD side. What can you tell me about how the size of the implant cc compares to the expander size cc. Do the real implants appear larger or small than TE's generally? Thanks, Missy
-
Missy: I still believe you will want implants - high profile implants - at least 425 ccs, and 450 ccs would be preferable. Please read the header to this thread at the top of the screen, where I discuss "cup size"....
I think your PS is taking you in the right direction - in order that she can utilize implants with a larger volume than your TEs. The implants need to be 100 ccs to 150 ccs larger [sometimes even more], in order to approximate the same dimensions as the TEs. Your TEs are 300 ccs. It does not matter that they are overfilled, we are looking at the base width and projection of the TEs at their recommended fill level.
Deborah
-
Deborah,
Okay, I am getting it now....sorry I was being a little slow
I didn't understand the part about the size of the TE's, until I looked up the dimensions of my particular TE and see the base width of 12, and projection of 5.2. So, my 300cc filled to 475 seems about right. If I fill it more, maybe it won't project anymore, but spread in other directions. Is that the limitation of the 300cc expander with 5.2 projection? The decision I need to make by this Thursday...do I want to fill anymore. I will have exchange in three months approximately. I would even consider going 475 with the Style 20 HP implant on the right side for a little additional projection (width 12.6, projection 5.5). I wanted to just make sure that I didn't need to go bigger in the implant cc to get to about the same size as the TE's. From reading other posts, etc. it seemed as though people were saying that implant cc size was smaller looking than TE cc size (at say the filled size of my 475 side). Sorry for all the questions...I just feel like I have to make the right decision, and I am at the end now. I am only doing this once, I hope Thanks again for your input. Missy -
Missy: You do need implants larger than your 300 cc TEs. The overfilling only adds to the projection and height of the TE. The width remains the same. So 425 ccs or 450 ccs is what you want. If you want 475 ccs, your PS might feel it is pushing the envelope a bit much, but may be willing to do it. So you know the ballpark you need to be in - just find out what your PS needs to do to get you there.
Deborah
-
Haven't posted for a long while as I have been feeling conflicted (and really bummed) over the results of my exchange surgery. Saw the PS at 6 wks, and he said I need a revision, as one side still has muscle response, jumping, and when I lean forward have lots of ripples. PS said he wanted to replace my 375, high profiles with the next size up, redo the pockets, and do a lift, and attempt again the neurectomy on the right side. They are bigger on top, and the lower pole is miniscule, plus, they are drooping, and don't resemble breasts except from certain angles, like straight on, at least to me. I haven't felt good about this, and wasn't sure what to do. Saw my dermatologist today, who sees everyone on the red carpet, etc. He told me that larger implants would cause more capsulization, and more surgeries, that a larger size was the wrong way to go. He also said that a larger size was too big for my petite frame, and could push in my ribs. He referred me to a PS he doesn't know, but who did a revision on a patient of his who had a similar problem as I do. Saw this PS's name on another BC board as highly recommended. So I'll see this other PS Thursday. He is a breast reconstruction revision specailist, so maybe it's going to be a good move, if I choose him for that. It's hard to know how much we can reasonably expect, huh? Feeling so confused and a bit dejected, but sllightly hopeful....
-
Orchidgal: So sorry to hear you had dissappointing results, but please know that it can be fixed, no matter what the problem. I am glad you are going to another PS for a second opinion. If you would like a third opinion andan artist of a PS, mine is Dr. Schooler at USC Norris Cancer Hospital in Los Angeles. He does beautiful work. Hang in there. Gentle hugs.
-
MBJ, thanks for the words of encouragement (& hugs!.) I'll take note of your PS and keep it if I need it. Will keep you posted on what the 2nd opinion PS has to recommend.
-
Whippetmom ... I need your help! I have been doing so much reading and research on so many things! Anyhow, thanks for being here for all of us ... your assistance is invaluable. Here is my situation .. BMX Nov 30 ... no implants but TEs as tumor was too large for skin sparing surg ... Height 5'3" - Rib Cage 32" - 10 or 11 cm under each breast - my hips are 34" - TEs CPX-3 medium high contour profile expander - 50cc was placed in each side during surgery. Dec 16 - 50cc added to each; Jan 20 - 100cc added L and 75 cc added R (all that it would take, the cancerous side). I was not happy with these huge new breasts of mine ... Jan 27 had 25cc removed from L and both are at 175cc. Looked at lots of gummy bears in the office, and decided on a low profile at about 150cc or 175 cc for implants ... dont really know what to do here???? PS wants to make me about 400cc or so ... my original were only 150cc ... I just want something there, nothing bigger than what I had ... Please advise .... If you need more info, just let me know. Thanking you in advance .... PM me if you need to.
-
Orchidgal -- so sorry you've had a disappointing result but I agree with MBJ... a new PS is a great idea and revisions CAN happen (dreams can come true?
Hang in there. -
Orchidgal - I'm sorry to hear you're unhappy with your outcome too. The neurectomy was very intriguing to me and I was hoping you'd get good results. Good luck with your 2nd opinion - I think you're on the right track, even though it's a pain in the patootie to have to shop around.
-
heebie jeebie - My PS said to be really careful for 6 weeks, no heavy lifting etc. Even after that he doesn't want me to ever to push ups, bench press, or flies - kind of hard since I go to the gym alot. He thinks it is not good to build up the pec muscle - all other exercises are fine. He has found that building up the pec muscle can cause the implants to move outwards - my choice he said, but that has been his experience. I am so pleased with mine that I don't want to do anything to risk them moving. He also has me taking Vit. E every day - thinks it keeps them soft - it's been almost four months and it still feels weird to do some exercises when the pec muscle moves - he says it won't hurt anything and might always feel weird. Just my two cents.
-
Melissa! I had wondered what happened to you....I am so glad you came back to share what you are going through. I am so sorry. I do not agree with the dermatologist's view of larger implants causing more problems - certainly 25 to 50 ccs would be fine - and I cannot see that rib compression would be something to be concerned about. I mean, I have seen this done hundreds of times - read about it in various medical treatises. But that aside, I definitely agree that a second consultation is in order. I am very perplexed about the shape of your implants - with your descriptions of loss of volume in the lower pole. However, this is someone characteristic of low profile implants which do not expand in the pectoral region. It would not be uncommon for implants to be high-riding for a period of time. However, I think that this period of time would be more like three to six weeks and I know you are much further out than that. Do you want to PM me the name of the recommended PS? You could also send me photos privately, if you do not want to post them on the pic forum.
I am so sorry you are going through this....
Deborah
-
Jainey: I am gathering that you want to be on the smaller side and I feel that gummies in the 400 cc range might be a bit large for you. They just size out so much differently than smooth silicone rounds, which is why it is important for the PS to expand the pocket specifically for the anatomical implant - style and volume - he intends to use. I believe you would be happier with anatomicals in the 300 gram range. And referable to profile, I just think the low profile might be too flat in the upper pole for you. Upper pole fullness - just even the semblance of a swell - is something which difficult to achieve after mastectomy. So I think a moderate height might look more natural - give you a natural slope to the mound. In order to refine the numbers a little better, I would need to know the actual volume - Mentor's recommended volume for the CPX-3 - or at least know the width of the TEs...[you say 10 or 11 under each breast and I am not sure how you obtained these numbers?]
Deborah
-
Thank you for this thread ... I feel much more informed and ready to have important conversations with my PS!
-
Fuzzy...You are welcome!
-
Deborah, My PS measured me in the office and he said 10 or 11 cm as he measured under ... the implant is a Mentor that he wants to use .. not sure of the number .. but it fit into my bra (I have sports bras that have five hooks in the front (32 a or b depending on the maker). The expanders are in ... my boobs used to fit in my hand .. now with these only half fit in???? He said the exchange will be the same size but will sit differently as they are softer. I hate when I move my arm forward and it rubs on the expander ... will this happen when I get the exchange??? I have a couple of months ... so I want to try to get this right. Thanks girl .. I need help .. lol
-
Whippetmom ... PS (post script lol) Is 300gm the same as 300cc?
-
Jainey: Your PS must be using Mentor CPG's, which we rarely see here in the states - but are used pretty widely in Canada. Grams vs. cubic centimeters - well, one is mass and one is volume. So it is difficult to compare the two. If you were getting silicone rounds, I would peg you for around 425 ccs. I personally think that Mentor has some better style and size options than Allergan, but I am not as familiar with sizes off the top of my head, so tomorrow I will take a look at the CPG chart and perhaps it is that your PS is on the mark in the 400 gm range. Let me get back to you tomorrow.
Deborah
-
vmudrow: thanks for your input. I surely don't want to risk messing up my implants. It is hard to know what to do with conflicting information. Just thinking about my augmented side; it is just like a regular "boob job" (but a very small one), and I think people who get those don't have any restrictions after enough time has passed.
-
I am going to correct here, for the record, that Mentor CPG implants are calculated in cubic centimeters, not grams, as are Allergan 410s.
-
Hi Deborah,
I met with my PS yesterday, and I decided not to expand anymore. I am at 475 on right and 425 on left (lat side). I go back in 6 weeks for another consultation where she will firm up which implants to order, then another month or so until exchange surgery. She is preliminarily considering the Style 20 475cc on my right side and either the Style 40 421cc or Style 15. I hope I did the right thing by not getting another fill yesterday. I hope I get to my old size of a "C" with these size implants. Thanks for your input.
Missy
-
Missy: Okay, but why a different style on the left side? I don't like the sound of that for a bilateral. Just use high profile on both sides - a 425 cc on the left and a 475 cc on the right. I am afraid that one style will make one implant much wider than the other and the other style will give less projection than the other. I have honestly never heard of this done for a bilateral - unless there is some ribcage anomaly or other structural reason for this. For instance, in a case where there is a significant degree of scoliosis and one side of the ribcage protrudes more than the other, I can see where using a different style implant would be very useful. Maybe you need to email me photos.
Deborah
-
Missy: Okay, disregard the above. I just went through your older posts and see you have a LD flap on the right. So there you go. Just as long as the width is close enough bilaterally, that plan sounds fine. I cannot help you with sizing on the LD side, because I do not know how much volume you have with the flap.
Deborah
-
Hi Deborah,
My PS tells me that 50cc is about what she feels makes up the lat difference. It seems to me like the flap protrudes out a little too much, and she said she can adjust that a little in exchange surgery. I'm wondering then if it would be better to do high profiles on both sides, just different sizes. Appearance wise I don't know how much flatter the Midrange/Moderate ones look. I will take some pictures when I can and post them.
Missy
-
Deborah, my Mom was over this weekend and I had her bring her tape measure along. She measured my rib cage to be 29.5 inches, but she squeezed pretty tight so 30 in may be more accurate. Anyway, smaller than I had measured.
My exchange surgery is tomorrow. I'm nervous!
-
Ann: We are still in the ballpark with your measurements. 29 or 30 inches is on the small end of the ribcage spectrum. I think your PS is taking in a bevy of sizes to make sure he gets it right. I am excited for you. Saying a prayer for you tonight....please let me know how you do!
Deborah
-
Ann: Good luck tomorrow! We will all be thinking of you.
-
Hi whippetmom, I am 5'9" and weight 165. My ribcage measures 33. My PS used a textured Mentor, moderate height, 550ccs. I am hoping to be a small c cup with projectile and no droop. I was an E cup or DD and had always hated them. How do you think my results my work for me? Thank you.. Annielynn
-
Annielynn:
Are you a unilateral or bilateral? And in either case, I also want to know if you have a fairly substantial skin envelope, OR, did your PS reduce the skin at the time of MX? If you have a lot of loose skin, we have to come up with a plan to make sure you do not have excessive droop once you have implants. There is only skin to hold up the implants and if the skin is lax, the implants will drop like a stone. I don't know why someone did not consider you for a one-step - since you wanted to be so much smaller anyway....
Deborah
-
Hi Deborah, I am bilateral. I expressed concern to PS because of excessive skin left. He said they could trim that up. I am very determined to see this through to get the look I want. I have 120ccs in so far but it feels like under my arms are what is ballooning up. I am clear with him to be smaller with no droop and more conical than round. Thank you for your help.
-
annielynn: I want to know what he means by "trim that up". We are not talking about a haircut here. You might need to email me photos so I can see what is going on. I am of the mindset that you might not need further expansion or much more filling at all. The reason it is ballooning up under your arms is that the width is expanding first and then the projection and height. And your redundant skin is probably not helping matters. I am going to PM you my email address.
I feel that you want implants in the 600 cc to 650 cc range - high profile - and it is going to require very little to get you there.
Deborah
-
whippetmom - You have and continue to be so helpful ... How many Grams is 175ccs??? This will help me visualize and have an idea of what the size of my new breast are compared to the numbers that are being talked about ... Thanks.
-
Thank you so much whippetmom. I am overwhelmed by how much the Lord loves me with the wonderful people he brings in my life.
-
Jainey: Aren't you getting Mentor CPG's? If so, they are measured in cubic centimeters, not grams.
-
Thank you whippetmom..I will see if I can have a girlfriend take pictures Monday. I wasn't aware I had not clarified with PS what trim up means until you asked me to explain. I don't know what he meant. I see him Friday for another fill and will ask. I believe he is the best PS in Montana and have been comforted by his compassion and know he wants to get me where I want to go.
-
annielynn: He does love us, doesn't He?
-
The Beauli Method of Fat Graft Transfer: For augmentation, breast reconstruction and apparently to treat intractable capsular contracture...
http://www.beauli.de/en/beauli/about_beauli
A Canadian doctor using this method....
http://delorenzi.ca/contact-us/
From PubMed...
http://www.ncbi.nlm.nih.gov/pubmed/21161858
Still researching....
-
Hi ladies, I recently was given access to the photo forum but have not been able to spend much time on the site. I was hoping to find some picture of women my size but have not so far. I am 5'8" normally weigh between 110-115 and have a 27" rib cage. Any help would be greatly appreciated
-
Dani did you post this request on the picture forum? There are a lot of gals around your size there.
-
Lilah - I did not post this on the picture forum but Whippetmom sent me a PM and advised me where to look. I have not been able to go through all the threads yet but it is nice to be able to see other peoples results.
-
Cool Dani!
-
My PS has not told me anything yet about what I will be getting for my TE. I can't even get an appointment until the nurse talks to him on the 1st. I ma getting very anxious. He has a huge waiting list that i have been on for months. (one of the only PS that take medicaid he only comes to the learning hospital one day month for surgery). so i am trying to be proactive and ask some questions here about advise on size. I am 5'6' i weigh 147 lbs (going to lose at least 7 pounds b4 surgery). My rib cage (just under where my boobs were b4 my bmx) measures 32 inches. I was a 34-36 DD prior and I would like to be a C now. Any advice on what kind of TE or implant or how many ccs? My docotr has told me he only uses round silicone and suggest moderate or medium profile for me. How does that sound?
-
Carrol - I sent you a private message....
-
Hi Deborah, I thought I could get a picture to you by now but my husband would prefer me not. I saw my PS today and asked about the bulging skin under my arm and he called it dog ear. He said the BS took as much as she could within the sterile area. To get to this skin, they would have been in the unsterile area and they don't like to do that. He said during the exchange he can take some fat and skin off and hope that fixes the problem. I was an E cup before and would like to be a small C. When he explains it I understand, however I can't get a visual for the fix. Faith and trust! I understand when you explained the width would fill first so I'm watching that. I just got another 60ccs so am at 180. He is going to fill again next week. It's exciting and daunting.
-
annielynn: Yes, dog ears can be addressed at the time of the exchange and any residual can be dealt with three to six months down the road. But make sure your ride herd upon your PS about it and don't let him forget about doing this for you! Sometimes they resolve quite a bit - flatten out - with expansion of the TE.
-
This is what you said back in October for me:
"Allergan or Mentor:
High profile [Style 20 in Allergan - just high profile in Mentor] smooth round silicone implants with a volume of 375 ccs to 425 ccs."
Right now I have the expanders in (they were the ones you recommended) and I'm at 385ccs (this was overfill today, the size I liked - yesterday - was 345ccs. The 385ccs feel enormous. My surgery is set for April 4 for exchange. He uses the Allergan. And he said it would be high profile smooth round. And he's thinking 325ccs but said he's bringing 325, 350,375, and 400cc into the OR with him. You were recommending bigger. The expansion process has been extremely hard on my back (every time I'm expanded, I'm on muscle relaxers for 4-6 days because of the back pain) so I'm ready for it to be over with. He said I could change my mind and go in for another fill before the surgery if I decide that I like this size (385ccs) better than the 345cc. What do you think? I'm 5'7". 118 llbs and I have 28" chest circumference. I like the way the 345ccs looked in my clothes. I keep hitting them on things. It's weird. So what do you think? Thanks for holding my hand during this process!
-
kj: So your PS used Mentor CPX 250's or 350's? Which volume?
-
350s I'm pretty sure. It was the same one you had recommended in the first place. I'll go back and find it.
-
133SX was what he put in me for expanders. is that what you mean?
-
Yes...short height...but I just wondered if they were 250 or 350 ccs. If 350, they have a width of 12.0 cm and in that case, the implant of choice would be 400 ccs or 425 ccs. But I think you have sufficient fill to exchange out without further overfilling. The low height TE in nearly all circumstances where I have seen it used, enables the PS to exchange the patient out to implants with at least 100 ccs greater volume than the TEs.
The only concern I have with overfilling is that the purpose of the short height TEs would seemingly be defeated. The reason for using short height TEs is to avoid expanding the pectorals and upper pole and overfilling might do just that.
-
It was recommended that I jump over to this thread with my question. After reading the intro and multiple posts here, I am a bit chagrined that I did not do more research prior to my mx.
I had a mx 8 days ago, with the intention of having a TE placed and later exchange, after chemo and rads. My PS indicated that I could be a candidate for an 'expandable breast implant'. Well, despite my certainty that it would not be the case, during surgery, my PS determined that I was a 'perfect candidate.' So, I don't know much about this implant I am now wearing.
Did anyone else get an expandable breast implant? I understand it could be permanent, eliminating the need for exchange, if it doesn't respond poorly to the rads. He also mentioned that it would only require ~ 2 fills. In fact, with a bra on, my breasts are quite close to even in size (~c cup). They may have to remove some prior to rads to increase aim effectiveness.
whippetmom, you were mentioned as the expert, and I can see why. Thoughts?
many thanks.
M
-
Maxine: Yes, there have been a few gals whose surgeons used the Mentor Spectrum or Becker expandable inplants in place of TEs. I think it is a perfectly fine method of expansion. However, in nearly every circumstance where I see it used, the patient ultimately elects to exchange out to a silicone implant, rather than close off the port and keep the expandable. Silicone is a much preferred medium on these forums. So I think that the test will be to see how the expandable holds up and fares during and after rads. I would not recommend decreasing any volume prior to rads. It would be better to have that side a bit larger than the native breast, because volume will almost certainly be lost with radiation. You have the option of switching out to silicone implants if you prefer, after radiation [wait about three months though], or keeping the expandable, if you are happy with the appearance and symmetry.
Keep me posted on how you are doing with rads. You might want to go to Exchange City and talk with some of the gals there who have gone before you, so that you learn how to take care of your skin during the rads process.
Deborah
-
Whippetmom, I know I should not be impatient but have any other gals skipped the TE fills and gone straight to implants (after BMX with TE's)? Have they had successful results?
I guess I want to get back to work and back to normal and since I previously had implants maybe my muscles are already stretched enough to support implants. Of course, now there are incisions and an open wound that I have to consider. I want to ask my PS, but I don't want any undue risks and I don't want to appear too antsy. Thanks!
-
slinky: You need to wait at least two to three months after BMX....so you might as well have one or two more fills in the interim. It all depends on the volume of implants you hope to exchange to after expansion. Your history of having had submuscular placed breast implants prior to BC probably is of significant benefit in your case. Why don't you tell your PS you would like to schedule the exchange and ask him when he feels he could safely do this?
-
Deborah, we've talked through email and I wanted to tell you that I just had my consult, history and physical this past Friday for my upcoming exchange surgery(March 4th). I found out that I do indeed have medium height TE, Style 7200, Mentor. My PS has ordered 600 and 650 HP Silicone implants.
The measurements of TE is:
550 cc's
13.5cm width
11.7cm heigth
7.4cm projection600 HP are:
14 cm wide
5.6 cm projection650 HP are:
14.4 cm wide
5.7cm projectionWill the PS have to widen my pockets to accomodate this size because of width? (13.5 for TE going to 14 or 14.4 cm implants)
Not much difference between the two in projection....will I notice much of a size difference between these two, do you think, if it's really only width?My TE's are overfilled to 600. Wow, I'm going to lose alot of projection aren't I? 7.4 to 5.6 or 5.7?
I'm thinking of just going for the 600's since the two sizes seem so similiar unless I'm not looking at that correct...and I really can't imagine being much wider than these TE I already have at 13.5 cm.
Thanks!!
-
EastCoastGrl: No, your PS will not need to modify the current pockets in order to use either the 600 cc HP or the 650 cc HP.
Did you ask him about using the 650 cc Allergan Natrelle Style 45? The dimensions would be:
13.2 cm width and 6.2 cm projection.
It is an option for you to consider....
Deborah
-
No I didn't...I haven't really had an appt with him again since our talks thru email. My appt on Friday was with one of his nurses who does the physicals and coordinates the surgery for him. She is who told me what he had ordered for me. Maybe I could call and speak with her to see if he would order in those as well? Do most PS use only one or the other? I think the Allergan looks to be closer to what I am with the TE right now.
-
Well, just remember that the exaggerated projection of the TEs serves a specific purpose, which is to stretch out the area of skin which typically has been the area of the mastectomy defect. With the advent of nipple sparing and IMF incisions, this might not be so applicable, but essentially, the reason is to ensure that there is sufficient skin envelope coverage over the implant. It is nearly impossible to replicate the projection of the "X" extra full projection of the TEs.
If your PS uses Mentor, he is not going to be too receptive about ordering Allergan. So just stick with what he has planned. You will be happy with the high profile Mentors. The width of either size will be just fine for your frame. Just enlist the opinion of the nurses who will be in the OR and have them weigh in on what looks best!
Deborah
-
Ok thanks Deborah! I think he prefers the Mentor in the Silcone Gels (my husband reminded me that we had a discussion about it at one of the first appointments) but he does use Allergan Gummies (which I had originally planned to get but changed my mind after reading some about them) After talking with him early on, my PS agreed that I'd probably be happiest with the silicone gels over the gummies as well.
Thanks!
-
Thanks, Whippetmom. I will meet with the PS next week and see what he says. I think he was worried that if he did straight implants that there might be complications (which there is with my skin) and the size I choose is the size I would be stuck with. I am glad he made this decision for me, because it has allowed me to research the sizes, brands, etc. I will take your advice and get a few fills, since I am only 3 weeks post BMX. Thanks for your help!
-
Deborah, Yes I am getting the Mentors ... I saw my PS last week ... he said he could go 150cc with the TEs ... hmmm, I asked if he thought maybe the 175s would be better and he said yes, but it was up to me. Now ... that was nice that he was listening:-) So ... we had a discussion (and I know he is good and knows his stuff and told him so) and we both decided that if I preferred smaller (as I always have been) then he could have the 175cc look just fine. But listen to this - Quote Unquote from PS: "In my entire career this is by far the smallest implant that I have every used" ... It made me think a bit ... but, I just want to be like I was ... then all my clothes will fit etc. Exchange Date: it will be forever as I was given permission to start doing fitness classes on Feb 11th (after one week, I am right back to my normal abilities! Wow!) and now I am training for Centergy Teaching and it will happen on March 11, 12 & 13 and then I have to submit a video of my teaching a class (that will take a month or two of practicing) and he wants to wait until after I finish that as I will not be able to do anything for 6 weeks again. So, I will be in my TEs for the video ... a bit lopsided but I dont think they will notice. Really nice to be back at the gym ... cant believe how supportive everyone is and they are so excited that I am taking the training.
It was funny at Step class a few days ago .. we had the cardio portion and I looked around the class ... everyone's boobs were bouncing, except for mine ... hmmm, guess, I was the ony one with TEs. I thought that was so funny!
-
When he just measured me on Friday, he said it was 11.9cm which they made an Allergan for. Right now I have 385ccs in each one. But since he has 4 different sizes he's bringing in the OR with him and he's the one deciding, I guess I'm wondering how he'll figure it out. Is it just with my body type/size and what looks best? I told him I just wanted to look like I did before (though of course my husband thinks I should go bigger like what I have now for the overfill) which he said was a B+.
-
Hello all! I have a question about sizing.
I'm 5'4", 110 lbs, 28 inch rib cage (measured under my breasts), 350 expander to 370 cc allergan textured implant and nipple sparing mastectomy to 370 cc implant on other side. Anyone have an idea about what size I will be?
Thanks!
-
Deborah!
All I can say is....I am so grateful that I have found you and this forum. Bless the Lord!
I was diagnosed with bc in 10/2010...had a bmx with tissue expanders placed.
My expanders are Allergan 133MV-14, 500cc.
I am 5' 7.5"....weight 198lbs...rib 38.5".
My PS has filled the expanders with 660cc on L...720cc on R.
I really like my PS....he said that he felt I was ready for exchange...all the nurses in the office have said that they think I am ready as well. It's just that I don't feel like it is ready...I don't want to be greedy! I tried on bras this weekend and I was a full B cup. I called the PS office this am and they told me that I was fine...that all bras are different. In the end I would like t have a nice C cup...I'm a big girl. I want to get this right the first time...I want to be happy with the outcome. My hubby...godly man...who has treated me with such love and kindness through all of this...also seems to think that they are not big enough...he's not pushing me for anything...he's just trying to help me work through this. This is such an odd place to be in...my perspective seems off and I am not for sure what to do.
When the exchange does take place I will have the silicone "gummy" implants.
I am a puddle about this...I have had nightmares about it this past weekend. I am so grateful to the Lord for leading me to you! Your counsel would be GREATLY appreciated! If you have the same response as the PS office then I think that I can proceed with a sense of peace. I have tried to ask girlfriends but they don't know what to think. Again...my perspective just seems off.
Thank you! Thank you! Thank you!
Be very, very BLESSED!
Cathy
-
Jainey: I don't doubt that you would be his first patient with implants that small! That IS small! I would go with 175's!
-
kjbrown: 400 ccs or 425 ccs - high profile smooth round silicone. The former is 11.9 cm wide and the latter is 12.0 cm wide.
-
shredbetty: If I was a betting woman, I would say a 30 D or 32 C. But you should be professionally fitted.....
-
....and that is a fun little "guesstimate", because I have not seen you!! You could post your pics on the pictures forum and a number of us could probably nail it down for you!! Also, go to the Bras 101 thread for further discussion.
-
Cathy: Lord love you!! But WHAATTTT??? Your perspective is NOT off! We all have either been there and done that or, along with other newbies to breast recon, will be asking these same questions and caring very much what the outcome will be - as it has so much to do with our recovery process! This is important and you indeed want to get it right the first time if at all possible.
Now when you say your PS will use "gummy" implants, is he one of the clinical trial plastic surgeons who has access to the Allergan Style 410 or Mentor CPGs? Let's clarify, because sizing is entirely different with gummies vs. the standard silicone round implants.
Deborah
-
Thanks whippetmom! Do you know anything about rippling/dimpling after a nipple sparing mastecomy? I can't tell if what I'm seeing is from the drain tube, or if the lumpiness is from some sort of rippling from the implant. I asked my PS the day after my surgery and he said it will go away and that it's just swelling...I hope so!
-
Oh yeah...how do I access/post on the pictures forum?
-
shredbetty ~ my two cents
....I had an NSM and you could definitely SEE the raised outlines of my draintubes through my skin! Looked SO much better after those came out! ... not sure if this is the same situation for you.. but I would wait until those are out and after you get some more fill in you.
-
Deborah, Yes, I am leaning towards the 175cc implants .. guess, I am just getting used to them ... plus there is some fatty clumps of skin on the edges near my arm pits .. will he adjust that or do I have to ask him?? I hate to assume anything at this point. I did mention to him that my left TE dimples when I contract my pecs and it takes away my beautiful cleavage .. so, he made a note of that and said he could 'relax' the muscle when he does the exchange. NOW, that is nice to know ... I really like my cleavage:-) I can see you laughing .. as I am laughing too! But, this is truly what I want ... just seems funny that no one else seems to be in 100% agreement. It is all good. Thanks for your input.
-
Deborah,
Thank you! I will find out for sure from PS office in the morning the type of implants that will be used. I so appreciate your encouragement and help!
Blessings,
Cathy
-
Jainey: With those itty bitty boobies, I can only HOPE you have cleavage. LOL! I cannot imagine. How many ccs do you have now in your TEs?
-
Deborah, I am at a whopping 175cc and they feel huge! They dont even fit into my bra ... The cleavage is very nice ... no bouncing going on here!
Thanks girl .. I will keep you posted.
-
Deborah,
I hope that this finds you having a great day!
I found out from my PS that he will be using a standard silicone round implant by Allergan. I had overheard one of the nurses say they were gummy...sorry for the confusion!
Now, I am ready for you to work your magic and tell me what you think!
Again, your counsel is so greatly appreciated!
Blessings,
Cathy
-
Cathy:
Okay, honestly, I feel you need at least 700 ccs in a smooth round silicone implant - high profile. It is quite doable, as long as your skin is responding well to expansion. So tell me about your bust size pre BMX. Because I am gathering you might have been larger busted and if so, you likely have sufficient skin flaps to go larger. I just want to get a handle on why your PS used that size and volume TE [which seems on the small side] and whether you have the skin to go larger than he might have planned. You can send me photos privately - just send me a private message if you want me to do so and I will send you my email address.
If you have a long torso, you could be a candidate for an ultra full projection implant - Allergan Style 45. It is a taller implant - sits a little higher on the chest wall typically - so you need to be a candidate for this style. But this style could be helpful if we are limited in volume due to any skin expansion issues.
Deborah
-
Hi Ladies,
Just wanted to let you know I (finally!) posted my current pics on Timtam's site. Am scheduled to have a revision surgery March 16. The PS will switch my Mentor silicone, soft/round 375 cc implants for a size or two larger to try to improve the ripple effect, do another capsulectomy, although they are still soft, and also try to find those nerve branches that did not get severed on my left side during the BMX/recon surgery in July. Had a second opinion who told me my PS had the right idea and to go back to him to have him do it/fix it. Have had several positive comments at Timtam from our members who think I look pretty good as is, and am wondering, especially from Deborah's point of view, (Hi, Deborah!) after viewing the pics, if I should go ahead with the revision or not. The PS especially wants to do it so that the scars are on the same level so when he does the nipples they will look good. Didn't want to go larger, but am very active and live in So-Cal, so wear clothing that is more revealing due to our great weather, and work out a lot. If I lived in the northern regions of Scandinavia or Ireland, maybe I'd leave things be... Let me know what you think after viewing them! Am I overreacting? Being too vain, perhaps? Hope not...Thanks so much - wishing you all the best! Melissa/Orchidgal
-
Debroah,
I have a quick question. Is it common to have two different sizes of implants? I have 500 ccs on the left and 550 ccs on the right. I am about one month out from surgery and I am starting to notice a difference.
Thanks, Lori
-
Deborah,
You suggested 400-425 cc implant for me if the doc was willing. I seen my PS on Tuesday for another fill (up to 370 now) he said 400 was completly possible and that in his opinion bigger usually looks better and more real. When I asked about what he thinks of that size on my body frame he said it may look playboyish. Just wondering what size you think 400 cc's would put me at as I know implants look smaller. With the 370 cc TE I have now I measure to be a "C' cup. My PS also said he does prefer to use HP implants.
Also do you know do you need to use the same "brand" implants as expanders I have Allergan TE and see a lot of women getting Mentor implants.
Thank you,
Danielle
5'8" hight, 105 weight 27" rib cage
133mv-12 300cc allergan TE
-
Lori: It is not "uncommon" to have two different sizes of implants. It all has to do with our chest wall and ribcage characteristics. When you say you are starting "to notice a difference", is this a positive difference, or is there some size assymetry going on?
-
Dani: Well, let's put it this way: With 400 ccs you will not look any larger than you do now with the TEs. Certainly you will have less projection. I do believe that you would look great with 350 ccs or 375 ccs also. So let's just say 350 ccs to 400 ccs...but I would say no more fills, if so. Did you look at Val61's photos?
The TEs and implants are all interchangeable. Quite a number of us have Allergan implants. I happen to prefer Allergan. I just like the dimensions better, they offer a 475 cc HP which is a useful size, and they have an ultra full projection style which Mentor does not have available here in the U.S.
Deborah
-
Deborah, I believe it could be an asymmetry issue. The left side does not have the same projection and size as the right side. Maybe I am still in the healing process and things will equal out -hopefully. If that is not the case, I'm not sure what my options are. Thanks, Lori
-
Lori: You should know at the three month mark. You have the option of going back in for a revision - to replace that small implant with one larger. By law, insurance plans must cover revisional surgery for symmetry issues.
Minnesota Statute:
"(c) Reconstructive surgery benefits include all stages of reconstruction of the breast on which the mastectomy has been performed, surgery and reconstruction of the other breast to produce a symmetrical appearance, and prosthesis and physical complications at all stages of a mastectomy, including lymphedemas, in a manner determined in consultation with the attending physician and patient."
You will just want to get it done within the same calendar year, if you have a yearly deductible.
-
Deborah: Right now I have the last step (nips) scheduled on 04/01. Do you think that is something I should wait on doing if I feel replacement is necessary?
Thank you for your earlier help on the implants. You were spot on and for the most part I am very happy with the end results.
Blessings, Lori
-
I would wait Lori. Most definitely.
-
Ok thank you.
-
Whippetmom - I do like the size I am now so think I will go with the 400cc implant, you said no more fills but my PS likes to overfill and said if I go with 400 then he wants to fill to 500cc
I did find the pics of Val61, wow what great results. She had 425cc's and that made her a 32D or 30DD. I currenly measure at a 34C. Would the extra 25cc's made that big of a difference or is it the style that would?
Sorry for all the questions, I'm starting to think rocket science is easlier then this.
I know in the end everything will look great it's just hard for me to decide not knowing exactly what the end result will look like. -
Dani...I don't grasp why you need to be overfilled to 500 ccs to exchange out to 400 ccs, but if this is what your PS requires, then I guess that is what you need to do.
-
I was over filled to 850 cc's and exchanged out to 685... I wish I could say that resulted in a lot of ptosis but it did not!
-
It is not the ptosis issue for Dani - it is that at 320 ccs she was "tight, shiny and red" and my concern is her skin integrity. She had pretty small skin flaps...and a previous history of rads...
-
Lilah do you have droop on your natural side? I have a bit but then none on my implant side.
I saw the PS today and he said that my implant side may still drop a bit - I have more upper pole fullness on the implant side than I do on the natural side even with the lift.
I'm wondering what will happen if I lose some weight? I'm about 15lbs overweight right now (it's mostly around my middle) and now that I'm finished with tx and no future surgeries scheduled I was hoping to make a serious effort to lose some.
Will my natural side get smaller? Has anyone experienced this?
-
My PS did say he like to overfill to give the natural droop. I think my skin is doing ok I was very shinny and red after my 3rd fill at 90cc but we dropped my fills down to 50cc's and that seemed to help. I just noticed I have a little bit of discolour on the right side but the left looks fine.
I will take some pictures and see if I can post them on the photo forum, if not I can PM them to you Whippetmom.
-
Dani - did you have radiation?
I did and my skin has a reddish colour to it just below the incision line (my PS has used my MX incision for both the TE and exchange surgeries).
It's not itchy, sensitive or burning - it's just there.
If you go to the pic site you can see that I posted a photo of it.
The PS said it's just radiated skin acting up and that it will fade with time as the tissue settles down from surgery.
I've been given the go ahead to use Vaseline Intensive Care and Lubriderm Lotion and rub it on my implant and incision scar.
So just like the Silence of the Lambs "It rubs the lotion on its skin, or else it gets the hose again" I'm going to be rubbing it in and hopefully the redness will go away!
-
Hey Deborah, just checking in. My exchange is this Friday and then Monday is an MRI to check a suspicious node in my neck. I have been going to the gym 5 days per week for the past 6 weeks and have lost 12 pounds. For the first time today I got dressed and looked in the mirror and my boobs looked bigger -- because the rest of me looked smaller. So I guess even if I don't get the 650s I am pushing for I can continue to lose weight and have bigger looking boobs. That's one way to go about it. My goal is to lose 50 pounds by the time I turn 50 (18 months from now).
I can't wait to have these rocks replaced with squishy boobies. I will post pics on the forum when I have something to show.
"Bodacious Jen"
-
Deborah - thanks (I should keep my mouth shut sometimes
Marie -- my natural breast has some natural droop and my implant side has almost none (a slight bit I suppose). I don't like it/wish they both drooped the same -- but in a bra it doesn't matter (in a bra they look the same, especially an underwire which I only started wearing recently). Re: weight loss -- yes if you lose weight your natural breast will get smaller. It's real body tissue! If you gain it will get bigger
Your implant side will not change. I also have a slight difference at top of upper pole (implant a tad fuller) that goes away when I wear a bra (the bra pushes up the natural side and then they look the same). Edited to add: in the first few months the slight difference at the upper pole seemed more pronounced and now it is barely visible... I guess that is the bit of drop one gets with a gummy
So I think you will see some changes in the coming months. -
MarieK - I did not have rads for my BC I did have it 16 years ago for Hodgkin's, that's the previous history Whippetmom is referring to.
I was not able to put pictures on the photo forum last night (can find the cord for my camera
) but I will go to my parents place and do it tonight.The discoulour is very slight I didn't notice until I actually took at look at my skin. My right side was slower to heal as that is my BS side and nodes were taken so more work was done. So perhaps it has always been there and I just never noticed.
-
Lilah: No....you were 100% correct! The main reason for overfilling is to achieve ptosis and for women who have very tight breast folds, this seems to be of considerable benefit. Especially if one is a unilateral - as it is important to try to get as much natural droop as possible to give symmetry. Even though the PS might perform a lift on the native breast, it will always have some natural ptosis. But I feel that for some, it is better to have a tight breast fold than compromise the skin integrity....
-
Jen: Praying for you...keep us posted about your exchange and your MRI results...
Congratulations on your weight loss and your fitness regimen!
-
WOW! Jen congrats on your weight loss and your goal to lose 50 by 50! I love this idea.
I hope your exchange goes smoothly and your MRI shows nothing abnormal!
-
Thanks for the info Lilah. I hope that I have some more drop on my implant side and I will give it time as you've advised (never thought I'd hope for less fullness and some droop!).
-
Jen -- I agree: great goal! I wish I had thought of that before I turned 50 this year LOL
Marie -- I think it's tough for us uni's whose native breasts were larger (and reduced). Those who start smaller and augment their native breast to match an implant have better results with matching. That said, at least we still have one breast left (I guess that is good anyway
It is what it is... and, for me anyway, as time passes I care less about matching perfectly and more about just living my life. I haven't gotten a nipple yet and I have to say that the more time passes, the less I even care about that (the thought of more surgery -- ugh -- I have to weigh whether it's really worth the aggravation). I am surprised at how much I just don't care anymore. The fact that I look good in clothes and feel comfortable out of them is enough for me. -
Lilah: I hear ya about not wanting to do anymore surgery. Part of me just wants to cancel having the nipple done. What if it looks worse after they are done???? Yikes!
-
I know that feeling -- but I say go for it! I probably will as well when push comes to shove
-
WOW!!!!!! What great info!!!!! I only wish I would of found this sooner.My exchange surgery is set for March 7th, so it's just around the corner.
I will pass this on to others, that I hope to help in their steps to recovery!
Thank-you
-
mtks: PM Whippetmom for any last minute questions before your surgery! Better to be well informed then have to have a second or third surgery. Hugs!
-
Hi, just checking in. Saw the PS today regarding my upcoming revision surgery on March 16. He said he will reduce the skin, elevate the scars, and replace the implants (now Mentor, smooth Hp, 375cc) with either 425s or 450s, just as Deborah had suggested to me over at Tim Tam's site. He'll also search for the pec nerve that didn't get cut last time. He said, in response to Deborah's suggestion regarding doing fat grafting on my right side "step," that he can't do fat grafting in this surgery as the skin must be healed first in order for it to take. He said he would put in a lot, like 30cc, on that side when he makes the nipples/areolas in the next surgery. Also, now that it's been almost three months since exchange surgery, the implants have finally dropped & fluffed - just in time to get replaced! Gotta laugh, and keep a sense of humor here . . . just glad to see they actually do drop & fluff, as it seemed mine never would get there.
Thanks & Hugs to all of you!
-
Thanks everyone for all the information you have provided on this thread. I haven't posted much, but I've gathered all sorts of information that has been helpful in my appointments with my PS. My exchange surgery is tomorrow morning, and I'm excited to change out my coconut shells for something softer and more pliable!
Deborah - you were right on in your estimation of what size my implants should be. My PS chose Allergan 650cc implants, although she said during surgery she may switch if she doesn't like the looks of them.
I asked about moving the implants closer together than what the TEs are. She said that she will do her best, but that she may be limited by where my pecs attach to the sternum. She said that varies from woman to woman (which makes sense). Has anyone heard this from a PS before?
Thanks and good luck to all of you.
Heidi
-
Yes Heidi, that does make sense, and this would also have pertained to where your natural breasts, before MX, were positioned on the chest wall. I do know that my own implants share the same placement characteristics of my native breasts, pre-BMX. So it all sounds good to me - what your PS has planned for you. I'll be praying for you tonight! Let us know how you are doing when you feel up to posting!
-
Melissa: Good to know what your PS feels about FGT at the time of the exchange, since there are some gals who have had it done at the same time. I thought it was perhaps good because it would be that old proverbial killing two birds with one stone, but if it is of little benefit unless the tissues are healed, then why do it? The ONLY time then I still feel it would be warranted during the exchange would be for addressing the radiated breast tissue - when it is not simply for filling a step-off or ripples - but changing the integrity of previously irradiated tissue. Then I think that it is definitely worth the attempt.
-
I just got my preop and surgery date for getting my TEs for March 29th. I am so nervous but i keep telling myself this is a good thing, and that it won't be as bad as my bmx which by the way wasn't as bad as I expected. I always make myself crazy with anxiety. I am trying not to be so freaked. I really want this but I am a bit frightened.
-
Carrol: Congratulations~! You have been waiting for a date! You are going to be just fine! I am just glad you finally secured a date for surgery.
-
Hello ladies,
Just an update after having my exchange surgery yesterday. Everything went very well. My PS used the Allergan 650cc implants as planned and said my new foobs look great. She had to put a couple stitches in on the left side to prevent the implant from slipping under my arm when I lie down. I haven't unwrapped the ace bandage yet, so I have yet to see the foobs in their full glory. When I peak down there, the cleavage looks good. I've poked them in a few spots, and it's so nice to have squishy boobs again! :0)
The pain has been minimal. I took drugs last night thinking they would help me sleep better, since I don't normally sleep on my back. I slept just fine and haven't taken anything at all today. My only real discomfort is the area above the foobs (sort of under my arms in front of my armpit) where she did some lipo.
Thankfully I have no drains (I hated those things!). I'm scheduled to go in next Friday to have my stitches out. My PS said I can unwrap and shower today and then wear a sports bra until my next appointment.
I haven't had a chance to post to the picture forum, but I had my sister take a picture of me yesterday with the TEs in place. I'll have her do the same with the implants in to see a before and after.
The PS also alerted me to the drop and fluff process. Does it really make a big difference, or is it more subtle?
Good luck to all of you with upcoming surgeries!
Heidi
-
Hi everyone - I just wanted to update...I have an exchange date of 3/21. I am really excited and full of anticipation, feeling a little nervous about what the "final product" will look like. My 350 cc TE's are filled to 450 cc (I'm 5'6", 125 lbs, 30 inch rib cage), and am hoping for about 400 or 425 implant, I will leave the final decision up to my PS and what he thinks when he gets in there. My PS will do a little pocket work on one side that has seemed to shift to my armpit a bit, but other than that I think it's pretty straightforward...no mention of fat grafting or any other procedures. I of course wonder how everything will pan out, but have faith in my PS all will turn out great.
Deborah, I truly appreciate ALL of your input and responses to my emails. I feel confident that the size you recommended will be a good fit for my frame. You are a real gift to all of us going through this and full of great insight...thank you!
-
Heidi: Wonderful! Be very careful with those lateral sutures. No lifting, no pushing, no pulling. Look forward to photos!
Fire-Dancer: Hopefully, he can use 425 ccs. As I recall, you did not want to be too large, right? So glad you have your exchange date!
-
Heidi: Congratulations!!!
Carrol & Firedancer: You are almost yippee squishy!!!! So much nicer then the TE's!!
-
Deborah - quick question: as we have discussed, I would like to look like a small C, I will absolutely be mentioning the 425's...but when I went on to the Mentor site, I am not seeing the 425's, only 450. (I am filled to 450 in my 350 TE's now and feel a bit cumbersome). If this is the case and I have to choose 400 or 450, what would you recommend? I am comfortable with the idea of being bigger than a regular B, but worried about waking up a full C.;-) Where you would suggest I go as far as implant size if there is no 425? I think my PS is leaning towards moderate profile...I just don't want to be huge in diameter, but I'd like some nice projection...thanks again!!!
...hope you have a lovely weekend!!!
-
Heading for my exchange on Friday 3/11.
My PS is going planning on 450 cc's HP but he's also bringing in 425 and 400. I am currently on pic forum and filled to 450 cc's.
I also have alloderm.
Actually, whippetmom also recommended 450 HP. (Thanks!) I hope I get that size.
Jan
-
firedancer, sorry to butt in on your conversation, but I wondered why you or your PS would want to use moderate profile. Moderate Plus would give you more projection, and most people get the high profile for the most projection. The mod plus and high profile both come in 425 ccs.
-
you know, cameron, I might have misunderstood him (PS), our conversation was about a month ago, and I may have forgotten the details as I did hear 425's, but might have mistaken the projection size...thanks, I think sometimes I get so caught up in numbers and details I might cross my info ;-)
I'll check out the mentor site again - thanks!
-
Megan...so interested in these same questions. Most of all, I do not want WIDE breasts!
-
A little update - I unwrapped the ace bandage for the first time last night and got a full view of my new breasts. I'm very pleased. I actually was happy with the size of the TEs, but they were just a little too far apart. Now they are closer together, so things look really good.
The only concern I have is that they are more full looking in the upper part of the breast. Is that what typically changes with the drop and fluff? My PS said that things will change quite a bit from what they look like now, but I didn't think to ask her exactly what.
Thanks!
Heidi
-
thanks MBJ, I am sooo full of anticipation - two weeks from Monday I will be TE-free!!!
Heidi - so glad you are pleased with your results! It's sooo nice to hear :-)
Annie - YES, I am so afraid of big, wide boobies! ;-) When I think about the exchange, I am so excited, but just so anxious at the same time about being all-boob! I could handle being a smaller-size, as long as I've got projection ;-)
-
I had my exchange yesterday. I am the same way! Wanted to be a bit smaller then I was prior to BMX. I told my PS that also. I would be happy with less wide but more projection. I ended up with 650cc HP Mentor which are wide... to me anyway. I am hoping that it is swelling around the diam and will go down some with that and with the drop and fluff. So far i don't mind the less projection that I got. Look fine with size there, its just the wideness I'm not sure of. I haven't taken a "real" look yet though. I feel so tight and sore still so I havent noticed too much difference from TE, except when I poke them gently with my finger....then they are sooooo soft. Love that!!!!
So, someone with 650 HP Mentors, tell me the wideness is not an issue and they will drop and fluff nicely! I was sooo anxious about this going in that I was unable to be too excited about the exchange. But I am glad to be TE free.
-
Heidi -- yes as time goes by and the pec relaxes (and gravity does its work on the silicone) they should "drop" and "fluff"
EastCoastGirl -- I would say give it time to see how things settle...
-
Heidi: I agree with Lilah, they will drop some and not look so high up top and there is also swelling. They change alot in the next few months.
EastCoastGirl: Congratulations on your exchange. Mine looked so much bigger after my exchange (see my before and afters on the picture forum) and they look so much smaller now. Lilah is right-give them time to settle-mine took 4 months!
-
Anniemomofthree: The implants are wider then natural breasts, however, my PS followed the line of my natural breasts and they only feel slightly wider now that I have had my exchange and the swelling has gone down.
-
firedancer....Cameron is right! I did not catch that. You most definitely want to clarify the style and you do not want moderate profile. Midrange profile [Allergan] or Moderate Plus profile [Mentor] would be okay. Forget 425 ccs then - Mentor does not have this size. Just stick with 400 ccs in Mentor. If you want projection, you want high profile implants.
For everyone: After the exchange, the implants often sit quite high on the chest wall, and/or exhibit quite a bit of upper pole fullness. This will resolve with time and gravity. Give it two weeks or more.
-
whippetmom, I went to the Mentor website and read they do have 425 cc's in high profile?
It was listed in the "Smooth Round Gel High Profile Sizing Chart".
The catalog number was 350-4254 BC (425 cc, 12.5 cm diameter, 5.0 cm projection).Also on their website, in the "Smooth Round Gel Moderate Plus Profile Sizing Chart":
catalog number 350-4251 BC (425 cc, 13.4 cm diameter, 4.1 cm projection).Are these not available to women in the US?
-
Cameron....Oops....I had the 425 cc confused with the 475 cc implant. Allergan has 475s and Mentor does not. So disregard. But I still think Firedancer should stick with 400 ccs.
-
I feel so lucky to have you ladies helping to look out for me! Thank you for the clarifications - I really feel like I am getting such great support here with such a difficult choice & my concerns of making a 'mistake' in sizing - but I feel more in control with great info, so THANK YOU!!! :-)
-
Deborah: I haven't thanked you lately and I am coming up a year April 20th for my MX. I still don't know what I would have done without you. Thank you!!!!
-
Firedancer and MBJ: You are both so very welcome! Thank YOU for allowing me to help you!!!
It is a blessing to me! -
Yes THANK YOU Deborah for all your information and support!
I'm still not 100% sure I've got the right implant in - and being a UNI I think that I will never be matched - but I'm willing to wait it out before making a final decision regarding a revision. I've had a look at the charts and without going smaller again on my natural side I don't think I have much choice.
I've got some weight to lose around my middle so maybe by the end of the summer I will have better symmetry and/or be used to my "look".
I'm almost 5 weeks post-exchange now and although my implant side has dropped quite a bit I still have a lot of upper pole fullness. My PS told me at my last visit (1 week ago) that it will continue to drop and not be as noticeable with time.
-
Whippetmom,
I am 5'3" and weigh 117. I just had my last expansion today with Allergan expanders, and with today's expansion I have been filled 320cc. I was a AA before my unilateral mastectomy, and my exchange will be in 8 weeks. I measure 29 inches around my ribcage under the breasts. My PS will augment the other side with an implant as well, and while I'm not as concerned with cup size, I definitely wanted to be bigger than a AA, which my PS said is doable. They will be using an Allergan Natrelle implant, not sure of anything else except that my original expander was 300cc capacity, and she wouldn't fill beyond 320 which is what I am now. Your words of wisdom would be great!
-
MBJ- I had my BMX on April 20th of last year as well! I can't believe it's almost a year. It seems like one big dream. I'm also grateful for Debra and all of you ladies on here. You are all such an inspiration to me, brave,strong, funny, kind, compassionate and caring. I feel so blessed to have found this website!
-
Dawn84: A high profile smooth round silicone implant with a volume of 325 ccs or 350 ccs would be just where you want to be. I do not know how tight your skin is, nor do I know the style of TE your PS has used. I cannot recommend an implant any larger, because you were very small prior to MX and you need some inframammary fold definition called "ptosis", aka, "droop", but because you are so small, you are not trying to match the droop of a native breast, right? So I think 350 ccs would be nice...and then your PS could then use an implant with less volume on the native side to gain symmetry. Discuss these volumes with your PS and see what he has to say. The reason I mention knowing the "style" of the TE, is that the low height or short height TE most often really requires implants with significantly more volume - in order to match the width of that style and it expands in such a way as to permit a larger volume implant.
Deborah
-
Hi Whippetmom,
I posted a few months ago during my radiation txs regarding my upcoming exchange. For review, I am 5'5", 130 lbs, ribcage -32", TE - Allergen 133mx -14, single mx, currently expanded at 550ccs. You had recommended to me either style 15 with 533ccs or 587ccs, or style 20 with 600 ccs or 650 ccs.
I have an appointment tomorrow to discuss the specifics of my upcoming exchange surgery and I think my PS is only going to go as high to a 400 cc implant unless I get more TE fills because he likes the TE to be 150 cc to 200 cc more than the implant because of my radiation status in order to achieve enough droop to match my native side. Before the mx I was a small B but would like to be a little bigger, maybe a full B to a small C. I will be getting an implant also on my native side. He also mentioned doing some fat grafting. Do you think a 400 cc implant is going to look right on me? I do not know which profile he has in mind or the size of implant for the native side but I am pretty sure he is going to use Allergan. It is important to me to be as symmetrical as possible. I am not sure if I can tolerate any more fills, maybe 50 ccs at the most.
Any thoughts or advise is greatly appreciated. Thanks!
-
Sweetie: I had no idea that we had our surgeries on the same day! How are yours healing up?
-
Hi Deborah,
Thank you so much for your response! My PS didn't really take the time to explain the specifics, we didn't know that this would be my last fill, but they did give me literature on the Natrelle implants and there was so much information to process! My expander ID says style 133MX, but now that I look at it it says it holds 400cc and she said yesterday it was a 300cc expander. Either way she said that anymore expansion would only make it wider and not project outward. The reference # is 133MX-12, the SN is 1513951 if that helps with more insight! Thank you again
-
I've posted my exchange photos on the picture site. Look for "A Tale of Two Titties".
Jen
-
How do you get to the picture forum?
-
bher: I wonder why he used a 14.0 cm TE if he wants to use a 400 cc implant? So then my preference would be at least 421 ccs in Allergan Style 15, which would be 13.3 cm. 450 ccs would be better, at 13.7 cm. How is your skin doing? Any stretch marks? Is it tight and shiny?
-
jen: THAT is hilarious! A great name for a breast recon blog!
Dawn...I am sending you a PM...
-
Here is an article regarding the use of extra full projection anatomical silicone breast implants. The implant referred to is the Allergan 410 "MX" - which this plastic surgeon prefers for women who have considerable ptosis [e.g., droopy breasts] prior to bc.
-
I have the MX... the extra full projection definitely helps with matching my remaining breast. The M stands for medium height and, if I recall, the X series comes also in FX and LX (full heigh and low height).
BTW -- when I clicked that link it did not work Deborah.
-
I found another link Lilah. Hope it works....
-
Deborah,
I'm glad SOMEBODY got it!
BJ
-
packjen: Brilliant, lol!!!
-
Dawn84,
I think you have to do a few more postings and then contact member TimTam (send her a PM) and she can get you access. It is a different site, unrelated to Breastcancer.org.
Jen
-
Whippetmom - My PS originally wanted to use a bigger implant but then as it turned out I needed radiation and there was some urgency in getting me filled so I only got to 550cc. As I recalled, he wanted to get me to 600ccs but I was not tolerating the fills well and they wanted to get me going on the radiation. I am thinking of getting another fill at my appointment to get me to 600cc. The skin is looking good considering it has been through rads. I do not have any redness left, just a slight tan. The TE is still tight but not near as bad as when I was going through rads. Thanks.
-
If you get to 600 ccs, your PS might be willing to use a 492 cc implant in Style 15. You will have to see what he is willing to do...
-
Carrol: I understand the anxiety and it is normal to feel some before a surgery. This one will be shorter and easier, though, and you'll do fine! It's wonderful that you are at this juncture where you get to exchange the TEs for implants. I know you'll enjoy them right away as they are so much softer and pliable than the TEs.
Heidi: So happy that you are pleased with the work your PS has done. Yes, most definitely they drop and fluff. Mine took a lot longer than most I've read about here on the forum. I didn't see or feel much change until at least two and a half months, and in the past several weeks even more so. They have gotten more natural looking and feeling, so yes, it does happen, and it will happen for you, too!
Megan: I feel confident that you will have the right size. I'm a bit confused as to the bra sizes mentioned. I was naturally a small C, 32-C, and now with my Mentor Smooth Round High Profile 375cc implants my 32-C bras fit tightly, and I fully fit a 32-D bra I bought before DX that fit on the loose side before MX. It is now fully filled. I will have these implants exchanged 3/16 in a revision for the same Mentor in 425cc, so not sure what bra size that will be. Perhaps Deborah can weigh in here? In any case, you'll be so glad to get the soft squishies in! Your surgery date is five days after my revision, so we can compare notes! It will be over so soon, and it's such an easy surgery after the MX.
Eastcoastgirl: Congrats on being TE-free! They do drop and fluff, so I'm sure you will feel better in a few months about the size. My natural breasts were 32-C and wide, so the wideness doesn't bother me. Hang in there. Time is your friend ;-)
-
Melissa: Well, it seems that a 100 ccs increase often represents a cup size. It also depends on what type of bra you are wearing now in a 32 D. In that same bra though, you would likely move up to a 32 DD.
-
orchidgal I am not getting an exchange I am getting my TEs put in march 29th. They did not put them in during my bmx, my hospital does not do any immediate reconstruction.
-
Carrol:
Excuse me for not understanding where you are at with your surgery. It seems rare these days that reconstruction isn't done at the same time. We who have already started and/or finished reconstruction are testament that you can go through with it and it will be completed at some time in the future, and you can move on with your life. We're here for you, so feel free to express anything that might be on your mind so we can share it together. You'll do fine!
-
Whippet dogs - YES! [And there I am in the mirror...in plaid shorts...
]
-
Cindy: I think you would be happy with either the Style 20 - high profile - or Style 15 - midrange profile smooth, round silicone implants. The most popular style is Style 20, which I think you would be happy with around 475 ccs. I think 500 ccs would be nice, but it all depends on your PS' theories regarding TE to implant volume exchange. In the midrange profile, which has less projection [and I am including this if your PS is one who refuses to use a much larger implant] I would recommend at least 397 ccs. It all depends on how tight the skin envelope really is on that left side. Your PS needs to have sufficient coverage over the implant. If you want to send me photos privately, you can PM me and I'll send you my email address.
Deborah
-
Deborah: Thank you for sharing your lovely dogs on their couch!
-
Deborah: Your dogs are surely photogenic. Very nice picture.
Terri
-
thanks orchidgal
-
whippetmom - Your dogs are beautiful! Look at those faces! Gorgeous! I've had labs all my life but currently just a cat person but I miss a dog. May I take them for a walk?
-
Pretty dogs whippetmom!
I have a Golden and 2 Ragdoll cats. Love my Golden, she is like another of my children. -
Thank you, thank you....
Yep, I will have a dog in my house until my dying day. My husband fears that if he goes before me, I will become a dog hoarder.
-
EastCoastgrl...How are you doing? Tomorrow is photo day!
-
I'm doing ok. Trying not to think too much about them. They are easy to obsess over.
Yes tomorrow is photo day!
I honestly think if the left one looked like the right one I'd be pretty happy right now. That left one is just goofed up. Things look somewhat better, some swelling has gone down but still goofy. And that (too) low outer portion of the IMF on the left breast, it feels as if the implant it sorta falling into that. Bugs me.A weird thing, about the pec muscles that are overtop of them. The left breast (which is the one that looks smaller and is lower on the chest wall)....well, when I flex those muscles, without hardly any effort at all, the left implant squishes and distorts terribly towards my side. The right one barely changes shape or moves at all and the little, tiny bit it does is upward, not toward my side. ??????? Very strange...and VERY strange looking.
Is something wrong with the placement of these muscles in relation to the implant to cause two totally different reactions from my breasts? I really don't get this? I have an appt with my BS and PS on the same day next week. I plan to ask both but am interested to hear what my BS has to say about that.
Also, after looking at my breasts....it looks to me as if the left "smaller" implant doesn't have a large enough pocket and that may be why it is lower and why the shape is not similar to the right one (sticks out more projection-wise) and looks smaller.
-
hillck we have such similar stats, I'm 5'5", 140#, 32" ribcage.
Do you have access to the photosite? I started a thread last week called "My dramatic transformation". I am right now at 330 cc's.
My TE's are Mentor medium height 275 cc's. My PS obviously likes to overfill, and when I reach the size I like, I'll get one additional fill. He says the TE's can expand far beyond their capacity, but he did know from the start I wanted full B/small C cup, Mentor.
Last week I tried on a beautiful Wacoal bra, size 32 C. It was a perfect fit at 285 cc's!
So I may end up larger than I intended, foobs are just so ROUND you know, but I think a few more fills and I'll be done. I am limited with my skin, too, BS told me it's thin on left side due to tumors that stretched it out.
Sadly I LOVE the projection I have now, and I know I won't have it with my final implants. It's mathematically impossible!
-
cameron I am 5'6" 140 with a 32 in rib cage. I would love to see your pics but it's not coming up on the pic forum. Is your screen name the same there? I had bmx with delayed reconstruction and I am getting my TEs March 29th. I hope also to be a C maybe a large C small D.
-
Okay girls....My TE surgery is coming up next Wednesday. I am a little nervous, like Carrol I am having delayed reconstruction as my BMX was last August. I am having rads immediately after fills, I am scheduled to have my rads in about 6-8 weeks after surgery and rapid fills. I am having 500 or 550 TE's can't remember which anyway I want to end up with at least a 600 and possibly a 650 implant. So, with the rapid fill...which means FASTER than FAST....how many cc will I be waking up with and how many each week? If I get expanded to only 500 will a 650 implant fit? Can I get more expanded after rads at all? Has anyone else had any experience with fast fills and if so how painful was it? Was it sucessful with rads?
-
KCMomx3, I got filled 100 cc's every week once we started filling (started with 200cc's at BMX). Honestly, it was a bit much with not much of a recovery time in between. It was very hard on me. The last two were 50 each to reach 600cc's....and my PS originally was going to overexpand but stopped because I was having such pain with it...and the tight skin of course.
My PS put 650's in me and only expanded to 600. That's not as much of a difference as what you are stating though.
-
Hi Whippetmom- I had an exchange surgery 4 weeks ago and I'm trying to get some idea what size I would be. I tried going into various website you had suggested to find out my size but I think I need some help. (I mean I know how to figure out the math part but it didn't make sense..)
My height is 5'6 tall and weigh 122 lbs with actual ribcage 28 1/2 inches(circumference right under the breasts). I currently have an Allergan 410 FF teardrop. My PS had expanded me to 310cc maximum because he said since I'm small framed that is the fullest he can expand me.
When I just measured my left implant(across the fullest part) the circumrference came to 7 inches which came to a B cup. My left breast is slighty fuller than the right one. I struggled to get the accurate measurement as I was trying to measure across the fullest part of the implants.
The ID card for the implants says "290g" under "410FF". So I'm assuming that my implant is a 290cc size? What do you think my size would be?
-
wasin: Did you go to the Bras 101 thread for the measurement link? I would take a wild guess for a 32 B. You might even be able to wear a 30 C in Freya, Chantelle - the European brands. It is difficult to make a close prediction with the anatomicals - which is what you have. Do you have a Nordstroms near you? That is the place to go - the cream de la cream of fitters work there...
-
Eastcoastgrl: What you are seeing is "implant animation". It is a delightful post-MX finding, isn't it? Try scooping frozen ice cream out of a carton. It will put you off ice cream, let me tell you. All kidding aside, some docs are now performing pectoral neurectomies in order to prevent this from occurring. It is still a novel procedure though and very few are doing it. Let's look at photos tomorrow and see what comes next.
Deborah
-
KCmom....You might end up with 200 ccs to 300 ccs or close to it, if your skin envelopes are still pretty ample after MX. There is some skin retraction to be expected with delayed recon, but it depends on your doc's fill protocol during surgery. Ask Laura [Estepp] as she might know. You are going to be just fine!
-
whippetmom, Yes we have Nordstrom here so I guess I should go check it out after 6 wks are over.
I did go into the bras thread 101 and checked the links provided for bras sizing. My situation is that the measurement of my ribcage is larger than the measurement of the fullest part of the implants. I think I will just have to go to Nordstrom and just try on alot of bras. Thank you.
-
KCMOM good luck with your surgery.
Met with a second plastic surgeon, that I think wont take medicaid but he is checking. Gave me some more info on what to expect in my surgery. He said i should not have any issues I have lots of skin and get this, "good cleavage". Pretty funny thing to hear after a bmx. I got to feel and touch the expanders and all the different implants. I would love for him to do the surgery but I already scheduled with the other doc and my sister bought a plane ticket. I am home now for some lunch and too watch cash cab. Then I go to the oncology hospital to get my port flushed for the last time. They will take it out when i get my TEs. His name is Dr, Dillow in Leawood. He looks like Neil patrick Harris lol.
-
wasin: You do not need to wait six weeks to go to Nordstroms! As long as you do not have any complications and you are feeling up to it, you can go in for a fitting and pick up one good starter bra. Wait at least two weeks, giving time for some settling to take place.
-
Cindy: You saw your PS today regarding the area of disruption with the incision. What did she have to say?
-
whippetmom....Yes, it's very disturbing looking! I tried looking pectoral neurectomies up but didn't come up with much. What is it exactly that they do? My PS mentioned at my last fill visit about cutting the muscle just above the implant to make room. And he was speaking of my side that I'm having the issues with. Not sure if he did it or not...but maybe that is what you are speaking of?
Oh, and I just sent you my photos for today.
-
KC... Dr. R. will not fill your TE much at all. Maybe 50-100.cc. He feels there is too much risk. BUT... he will fill you up fast if you can do it ( if I can do it. YOU CAN TOO!)..... he will wait a week to fill you.
I received 50cc -75cc twice a week.
I did not have any muscle spasms... but some pain. I took Demerol for 5 weeks... three times a day. ( he will give you the pain pills needed to fill FAST...... just ask him.
Try to fill to 600 PRE RADS sweety.... because after talking with you. I feel.. you are going to want 650 + for sure.
I am 500cc.......and am a small/med C cup.
-
Ok. now that I see Deb posting.... I know you are OK IN CALI !
This tsunami..... earthquake........ etc............. so so terrible....
(( DEB))
-
Our beaches were fine today. Long Beach is a south-facing beach - the ocean was pretty calm all day, despite the earlier warnings.
EastCoastgrl: I am going to ask Melissa [orchidgal] to come here and explain this technique....I know too little about it...
-
Deborah -- I think I forgot to say: your dogs are GORGEOUS!
-
whippetmom, My PS told me to wear this surgical bra for 6 weeks 24/7. My breasts are looking a little better than before. I have sutures on the bottom of the breast on each side. My nurse told me that I can wear a soft bra after 6 weeks, otherwise it may aggravate the sutures.
-
wasin: The recommendation from your PS sounds fine to me....
-
WOW....Laura.....twice a week:) I am so excited but so scared ! Just three more sleeps until surgery, I HATE surgery but this is moving past BC and I am all for that. Thank you and Deb so much...I love you both:) I believe I will be starting rads on the 25th of April....that is 5 and 1/2 weeks from surgery. Do you think I can fill to 600 by then? Do you have stretch marks from the fast fills? Did I say how excited I am?
-
KCMOM: I think you probably have pretty ample skin envelopes and it seems quite likely that you can be filled where you need to be filled prior to rads. Your reconstruction journey begins this week! Keep a photo journal...
-
I have already began posting in the well burnt section....I think I am one of few that have had delayed reconstruction. I hope this helps someone that has had to travel this road vs immediate reconstruction:) Thanks again so much!!!!
-
I'm having the same issue as EastCoastGrl, with my implant 'jumping' up and to the side every time I barely flex my pec's.
The strange thing is that this started happening 6 months after my exchange. For the first six months, it was very comfortable and much better looking aesthetically. It also had a higher profile which looked closer to my natural breast. Now it is flatter, more wrinkly, ripply and I have a tingling sensation near the armpit.
My PS didn't notice the difference, said that it looks normal to him and that it's very normal for the implant to move like that. I'm wondering what happened to cause the change. It went from feeling natural to feeling uncomfortable all the time. I have a follow-up with my PS this week and am hoping to be armed with more information when I talk to him.
I'll be very interested to hear more on this thread from Whippetmom and EastCoastGrl. Also, how can get access to the photosite? I think that could be helpful as well.
Thanks for the information!
Mel
-
So excited, my exchange wasn't supposed to be until the middle of May but Thursday the Dr. office called and asked if I would be interested in having it done in 2 weeks! I said YES! I really want this journey to be over with, but on the downside, I won't be seeing my surgeon until the day before surgery at the preop appointment. I had a list of questions, and hopefully they can be answered then, but still so excited!
-
Whippetmom: Sorry it's been a while, life got kinda crazy. In our last discussion you were concerned about me getting more fills because of my skin. I had an appointment with my PS last Wednesday and we discussed my skin, he had a look and thought it would be ok to continue with fills so I got another 50. He would like to do one more fill of 50 if my skin looks ok at my next appointment then exchange for a 350 - 370 implant.
Also you wanted me to confirm my ribcage it turns out it is actually 271/2"
-
Preop appt? I'm feeling like I got rushed through a bit.
I saw my PS on the day of my last fill (didn't know it would be my last fill at that time) and he said ok, we are done filling...see you in two months for surgery. I thought it was odd that we wouldn't meet once more before surgery. Am I the only one who didn't have a final pre-op appt? I saw him for like 30 seconds right before surgery where he marked me up. That's it. And now with my issue on the left side implant I'm not real happy. There's things there that I feel should of been addressed at time of exchange. Is it also typical to just want to get the implants in with minimal work on the first go to minimize infection? Then come back for revisions. That's basically the feeling I got on surgery day. But correct me if I'm wrong....is there really any difference in having to go back in and "revise" things...you are opening things up again. Makes no sense to me...but I'm not a dr. Would love input from others experiences on this. Mel22, I had BMX so both of mine are implants but only the left side does this. Well, the right side does somewhat but it looks different, better. The left side distorts terribly. But it is also my "problem" side.
The right side is coming along nicely...wish the left looked like my right. Oh, and yes, my left one also feels funky to me..maybe it's those muscles??.....the right one feels more natural. -
EastCoastGirl ~ That is odd that he wouldn't meet you before surgery? My PS has scheduled me for a pre-op one week prior to surgery so he can take measurements to order the implants. He won't even talk about the specific implant size until he does the final measurements at that time. Then he will do the "markings" the day before surgery. Though I trust my PS...I still am pretty nervous about the whole thing...it sure does seem like a pretty high percentage of us need to have revision surgeries.
-
Thank goodness for this thread! I had to fight with my PS to get to where I wanted to go--What he had in mind and what I wanted were completely different. If I had just let my PS do his thing, I would be scheduling another surgery, not having my nipples done.
-
EastCoastGirl: It seems that many of us have thin skin or not enough tissue or issues on one side or both sides that need to be addressed with an additional surgery. It isn't always because of our PS (Day is one that comes to mind). If your are still having issues 3 months or more they can always be fixed. Know that reconstruction is a work in progress and some of us need more work then others. Have you posted your pictures on the picture forum?
-
Eastcoastgirl-I didn't have a pre-op per say either. I had seen him like two weeks before surgery to go over sizing and then he said he really didn't need to see me again before surgery. I often times felt rushed at appointments. I think sometimes it's just the way it is at a Dr visit and you have to really push to get all you can out of the appointment. I understand how you feel about having an issue and him not really taking care of it. I think you are right that they seem to want to do what is minimally invasive. My friend put it this way she feels the Dr thinks we have been through so much with dealing with BC that they don't want to make the exchange surgery more difficult. I do agree though it doesn't make sense to me to do less at the first surgery only to have to go in again to revise things. I felt same as you exactly. Maybe there's just a lot more to it than we understand and things are a lot more complicated than we think. I did ask the nurse and she said about half of the patients come back for some type of revision. So I guess it is common like MBJ says a work in progress. Now the revision becomes elective and it's hard to know if we should or shouldn't do it. I'm dealing with this issue right now and I go back and forth on what I should do.
-
SusansGarden, MBJ and Sweetie...I think my PS had pre-decided he was going to use 600-650 in me. So nothing to measure or go over really except would of been nice to talk some things through about it all. What to expect, etc. I really do think I need work on my left one. Don't think at this point this will be something that will work itself out. Too many issues with it, IMO. Funny if they think we've been through too much to make the exchange surgery difficult. Ha, I would've rather had that because it's such an emotional thing anyway...and to come out of it fairly easily, nice, yes, but with issues is not a good thing. I don't know about anyone else, but I'd MUCH rather have more pain and longer recovery and had it all done in that surgery. Feel like it just gets drug out and then you don't want added risk of infection or making things worse by further messing.
-
Whippetmom has been a tremendous help to me through this though. Thankful for her help.
-
oh and no, MBJ, I have not posted pics yet. I have pics of my expanders also. Was planning to post them all to help others once I got my exchange. But I was just so upset that I haven't yet.
-
Everybody, if you can, please post your pics! Even if you aren't done yet.
I started a thread of my own, as soon as I got my first fill. I update it every Tuesday with my new pics, because Tuesday is fill day!
It helps others to see the process, and even better, you gets tons of feedback. It helps you learn what to ask your PS, and you can ask about certain aspects of PS and others share their insight. So please do post your pics!
-
Hate to be a cynic, but consider the financial incentive to the surgeon to do two (or more) procedures instead of one.
-
Eastcoastgirl-I agree I would have rather have had a little more pain and discomfort with the first surgery than to have to do this all over again. Just doesn't make sense to me. My friend's Dr did a lot of stitching and pocket work on her to get things perfect and she was in a lot of pain post exchange, but at least she doesn't have to go back for a revision. By the way it's been four months for her and she is still in pain.
Jerusha-good point, hate to think it could be true.
-
question from you ladies post exchange:
I saw my PS yesterday, we were discussing final size. He suggested that I will need to be over expanded slightly to maintain about size with TEs, because he will completely resect my masectomy scars to start with fresh scars, souns great since these scars are wide because of stretch. Is this usually done?
-
Jerusha, Yes, I have had that thought cross my mind unfortunately....hate to think like that but you never know!
sweetie, 4 months...wow, well, you know what, I'd still take it. Just wanted to be done with surgeries....
christine, my PS typically over fills but I was having such a hard time with the fills (pain) and my skin was getting too tight so he stopped mine at 600cc. I ended up with 650cc implants and my skin is much nicer, less stretched looking then with the TE. I did not get new scars. My BMX scars are about 3-4 inches across my breast and PS cut approx 2 inches right in the middle of each same scar to do exchange.
-
wow, I'm wondering about my brain lately.... I did have a pre-op of sorts I suppose (read someone elses post over on exchange and it jogged my memory!!). 2 weeks prior I went in for "history & physical" but that was not a visit to see my PS. I would of liked to of gone over things with him prior to surgery. Still, I had forgotten about that visit because nothing about the exchange was really gone over...just basic surgery stuff. Gosh, I think I'm losing it! Lol...
-
Jerusha, it frosts me too much to think it much less say it...but I fear it does occur.
Eastcoastgrl...you wonder about your brain NOW. Wait until you go through menopause!
-
Hello girls....surgery in the am....Prayers going up plz. I hate surgery!
-
KCMOmx3 sending out positive vibes for a great surgery and easy recovery. 2 more weeks for me.
-
KCMom: Good luck today!
-
Cindy: Kip is going to be running with the pack this coming Saturday. You do not know how much I appreciate all of your help in this regard. I probably have 90% less stress about it now...
Your PS' plan sounds good to me. Fortunately, in the 400 cc series, there are 25 cc increments, so it helps with really fine-tuning symmetry issues when using different size implants after a BMX. Keep me posted..
-
KCMOM: I PM'd you earlier. Please report in when you are feeling well enough to do so and give us all of the details on the sx...
-
Hey girls....I had theTE surgery today. He filled 300 cc. WOW...I am in some pain. I had no pain at all after my bmx, didn't even take a Tylenol. So, this is a huge difference. I am on Valium for muscle spams and hydrocodone for pain. I HAVE to take it, and I never take anything. Hopefully tomorrow is better. I get my next fill and follow up next week sometime. Hugs to all.
-
KCmom: I take it they are filling you fast because they are doing rads? I constantly massaged mine during the process and it really helped. Hang in there and I hope everything eventually relaxes so you can breath a little.
-
KCMOM....Good to hear! I am so glad you got a good jump start on the fills. Yes, hang in there....we have all been there - and it can only get better, right? Thank you honey for reporting in for us!
-
KCMom pain huh? yikes! I hope those meds work. I am petrified for my surgery. Hope everything works out well. let us know who they are looking. Keep us posted.
-
KCMom, I started with 200cc so I know how you feel!
I had alot of pain with my fills but not all people do. Even though I had a rough time it was not too awful ...just something to get through and sorta better that you are going to get it done and over with, without it being drug out. So that's a good thing! -
Carrol2, don't worry! Everything will be fine.
-
Had my BMX 6 weeks ago today. My PS put in 500cc's in each breast at time of surgery. Have not yet had a fill. Still waiting for one of my incisions to heal up ... had to go back into surgery 2 weeks post-BMX to reduce right TE by 50cc's and re-suture the incision (had necrosis).
I have been photo-documenting my own progress but would like to see how others have fared. How do I gain access to the pictures forum? Thanks so much!
-
Rennasus - I have sent you a private message!
-
whippetmom: I received it and will follow your instruction. Thank you! ;-)
-
Deborah, I love the photo of you doggies! Now we have proof that you are indeed a Whippetmom! Very sweet, would make a nice still life painting!
I had my revision surgery yesterday, and the pain was so intense in post op they almost put me in the hospital overnight, but in my delirium I said I wanted to go home, but should have stayed. Anyway, I'm much better today after a tough night and early morning. Have three drains, and I hope it was all worth it as I'm bandaged up corset style, and won't see the doc until next Wednesday. Since it is most painful on the right side, and two of the three drains are there as well, me thinks he worked hard to get the neurectomy done this time, and also fix the divot I had on the lower, outer side.
I was at the Natural Products Expo this past weekend in Anaheim and connected with a woman who confided to me that she had a preventative oophorectomy and BMX last June. She's 45. She had the BS who is the "gold standard" around here, the guy who came up with the SNB technique, and her PS was the guy I went to for my 2nd Opinion. Her recon is a mess! One side has a different size implant than the other, and her scars are long across her breasts. I feel for her, and hope she finds the best doctor to do a revision. Although it was sad to hear her story and see her botched job, it made me appreciate my PS even more, and have more trust in him. So will take photos and put them up when I am out of these bandages - still hurts, but almost tolerable now, this second day. Don't know what size he put in, but imagine they are 425cc. Take care everyone!
-
Really Melissa? Wow...how disappointing to hear this about that women you met and her recon results. It sounds like you got hit by a Mack truck! I cannot wait for the unveiling!!!
Stay well and rest! -
Had my exchange yesterday- all went well so far. I cannot sleep and have a headache which i think is from the vicodin. argh..hurts mostly in the middle of my chest where PS did some work for more cleavage...TEs were 450 and he put in Mentor HP smooth 550s...can't really tell much beyond they are bigger and encased in black racerback bra from PS. Saw him today in office and go back on Tuesday= have to take it easy until then- that is the hardest part for me. Posted just one quick pic I took when I was putting some cream on stitches- not very good as I didn't want to hold my arms up but wanted one of the day after...does not look like much at this point:)
-
Deborah, my meeting with the woman who had the unfortunate recon with some of the supposed top doctors in this field makes me think it is often like a craps shoot when you put a team of BS & PS together!
I'm feeling much better, having gotten my meds under control. Will let you know after my first pre-op what size he put in, and post pics as soon as they are unwrapped. It may be just the swollen tissue, but it looks like my "shelf" on the right is is gone!
Annettek, hang in there, Lady! And keep taking your pills, they are so helpful at times like these just after surgery. I can't handle Vicodin, as it puts me in a "Freddy Kruger's Nightmare" state of mind, but keep a record and schedule the type of med, the doses, and times you take them and keep to a schedule, and you'll feel much better soon. I keep a notepad on my bedside table and even set alarms so I don't forget what to take, and when.
KCmomx3: We had our surgeries on the same day! I find it hard to believe, although of course, I believe you, that you had no pain after your BMX. It looks like you didn't have immediate recon, so that's probably why - because it was a more simple procedure. What good fortune! The pain meds are a blessing, and I think of the people who have been injured in Haiti and Japan who might not have had the benefit of our pain killers, and feel so blessed.
-
Ladies: I had the big reveal today and I am thrilled with my new nipple/areola!!! He did the origami method for the nipple and he also used a skin graft from the side of my bikini area for the areola and then he finished the nipple off with some fat underneath to give it some projection. Along with the fat grafting for the step off and my "dog bite" on the side, my breast is now looking very real and natural. I have never been so happy!!!!!MBJ-Unilateral MX with Fat Grafting + Implant on natural side to match
Diagnosis: 9/16/2009, ILC, 3cm, Stage IIb, Grade 3, 0/2 nodes, ER-/PR-, HER2- -
MBJ- Congrats on the pretty new nip!
-
Thank you Adey! I am just thrilled! I feel like a real girl now!
-
MBJ so glad to hear you got the results you wanted especially with my journey jsut beginning with my TE surgery in 8 days.
-
Carrol: Thank you and I have to say, if it wasn't for all of these amazing women here and the picture forum I would have never known to ask for what I wanted. And I had to ask often because for each surgery I had to not only find dr's who agreed with what I wanted, but I also had to convince them that how I wanted it done was better for me. Yep, I am a control freak. Now that it's done though, I really appreciate this side of myself, lol. 8 days--you are almost there. The expansion process is very strange and not fun but once you change out for the implants it is so much better. Today is the first day I have felt whole in a very long time.
-
I too am thankful for these boards. It has given me comfort as well as information. For example i read about chemo ports and how some get them put in during the bmx surgery so i had that done and now i will have it removed when i get my TEs. So two less procedures really and one less scar. I have my preop appointment on wednesday and i have a list of questions for my doctor. From what I have been told I am a good candidate for this because i was a DD and they left me nice cleavage and lots of skin. I hope to be a large C. I am so looking forward to that whole feeling again even though my the journey ahead seems daunting.
-
Carrol: The funny thing about a reconstructed breast is that when you aim for a large C you will probably still fit into a double d bra, though you may not fit into the same DD bras. Right after my exchange I was a 34DD but now I am a 34D or 36C-D depending on the bra fit, however, I look like just a regular C. Go figure! You will have an easier time of it because you have lots of skin. So much easier then myself, though being older helps, too, less "tight" skin, lol!
-
MBJ: Yay!! So happy you have finally reached a wondrous state of completion, and thrilled that you are so pleased with the results. You are an inspiration for us all, and you give me hope that I will also arrive at the place where are now, nips and areolas, and fat grafting, all looking lovely, and most of all, feel like an intact and natural looking woman again!! If you'd like to send me a PM, as we both live here in LA, maybe we can meet for tea sometime.
Carrol: Yes, we are all blessed to have the support and incredible amount of resources through these boards, and also to be able to support and cheer on our fellow sisters throughout our procedures, and feel a part of this unique community. As MJB mentioned, the TE process is rather strange and can be awkward sometimes, but there is a light at the end of that when you get them exchanged for implants. Keep repeating to yourself, "mind over matter!" It won't be so long, and you will have, as already you have had, lots of info and support going through expansion. Since you have your skin flaps intact, that will be even better!
-
Orchidgal: I would love to meet up! I just sent you a PM. My PS rocks my world!!!
-
Hello,
After bilat mastec, i will finish Chemo next month and will have expanders replaced early June. So before I meet with my PS I want to be informed and this forum is so full of the info I'm looking for! Thank you.
Whippetmom: would you please advise me and share your recommendation? Here is the info you requested:
I am 5'2", 114, small frame, wear size 2 clothing, 28" ribcage.
TE are Allergan 133FV-13. They are filled to 500.
I would like to be a C cup (was a and want them to look most natural.
Thank you for your advice as I start done the path of replacement. Will be so happy to have expanders out. :-) -
MBJ...so happy to hear you are thrilled with your results!!! congrats!!!!!!!!
-
MBJ-congrats on your great results! I'm so happy for you!!
-
After hearing about MBJ's fat grafting to give some oomph to the areola, it sure makes me wish I could have some breast work done at the same time I have my ovaries removed. But I doubt that is going to happen. And if I asked, they might want to commit me to the psych ward.....
-
Thank you ladies--I am very, very happy. Just hope it lasts! I don't know Deborah--I asked if he would put some of the excess fat in my face and I didn't care if he thought I was crazy but I am glad he put it in my boobie!!! When are you have your surgery?
-
I am hoping to have the surgery the first of June....
I'm thrilled for you MBJ!
-
I have been lurking for a couple of days to see if this is the right place for my questions. A brief background, I had a skin and nipple sparring bilat mx in 12/09 (sounds like a long time ago). Finished chemo at the end of April 2010. Had Hyster/oomph in June 2010 (BRCA1+). I was tired of surgery/treatments and was training for 3-Day so I took the summer off. Life gets busy (son is a senior so college apps in the fall) and I finally found the time for recon. I had my expanders surgery last Wednesday, March 16th. It went well but I slept most of the first 2 days. I too found myself annoyed but many insignificant issue but that seems to be better now that I am off the heavy meds (never had to take the hard stuff when I had my Mastectomy).
My PS put in Natrelle (style 133V) 500cc on both sides. I have no idea how much they filled me. I was a full D before mastectomy and am surprised at how much my skin "shrunk" during the past 15 months. I am still very much smaller (projection) than I was before and yet the skin looks pretty tight right now. I go in on Thursday for my post-op and fill (I assume). They said I would be filled over the next 4 weeks and then the exchange would be 3-6 months later (depending on how everything looks).
My big question right now is about the "pockets" I have on my sides (under my arms) basically where the bra would be. My BS nurse told me that I would have them after my MX as it seems gravity seems to make stuff settle there. She said the PS would take care of it. I am not a skinny person but I don't think would call me fat. Anyway, these "pockets" are larger, I assume it is swelling. I am wondering how much of my current size is swelling. There has to be some swelling with all the work they did to put in the expanders. I am going to talk to my PS on Thursday but I am having some anxiety about how I am going to look in the end.
I would also love to see some pictures. Can I get access to your pics? I would be happy to post my progress.
Lorrie
-
Deborah: I am only an hour away so please, if there is anything I can do to help I would be happy to. Even if it just means bringing you food or taking you to a dr's appointment. Please don't hesitate to ask!!!
-
whippetmom - I'm sorry about the ovaries ... are you doing it precautionary or is something going on? I'm sorry if I missed it ... praying for you! xo
-
issymom I have my TE surgery in a week. I had a bmx in August and finished chemo in december. I am getting nervous for the surgery. My PS thinks this is less pain than the bmx but my bmx had very little pain. After that surgery i was so afraid i would feel pain i kept pushing the little button for pain medication every time i saw the light go out, I did not even wait to see if i felt pain. So you took a lot of pain medication with this surgery? It's been 5 days how are you feeling now? Are you able to get around and do things for yourself? Have you been told not to reach for things or lift things? I know i had really bad constipation after all the pain meds i took last time. Do you have anyone helping you at home? My surgery is on a tuesday and my sister is coming to stay with me until she flies back saturday. My husband will be working. I hope I will be able to take care of myself after that.
-
Whippetmom: Thank you so much for your advice. I've tried to read through the many posts to try and answer some of my own questions. Any thoughts from you and others are much appreciated on the final implants. I know that I want silicone. Do you have thoughts on the teardrop shaped implants vs. round?
My specifics: 42 years old, 1/26/2011 preventative (no further treatments necessary) bilateral nipple and skin sparing mastectomy, 400 cc Allergen 133MX TEs placed at time of mastectomy and filled to 325ccs per side, 2/28/2011 first and only post op fill to 400 ccs, I'm 5'3", 120 lbs. (up 5 pounds from my preferred pre-surgery weight), generally wear size 6 clothing, measure 27" directly beneath the TEs.
Thanks so much for any feedback.
Kelly
-
Carroll: best of luck to you next week!
Kelly
-
Whippetmom - HI! I am back from exchange (yesterday) and you were right on the money!!! My PS used Mentor 450's high profile...So far in the surgical bra they look really nice. I am happy with the size, the PS told my husband that he thought the exchange looked like an A+ on me, grade-wise, that is!!!
- I guess if he thinks that he did his job to his best abilities, then I should be pretty happy, too! MyPS wasn't crazy for going 400 cc's, thinking I might wind up with unnecessary divots. Thanks again for all the input, I felt much more confident about the sizing with your support!
Recovery is a bit more painful than I imagined, he did a bit more pocketwork on one side to bring the implants in nicely. I am taking it easy and will see him again next week!
-
Carrol2 - I really did not have much pain with my BMX except for the drains. I think part of it was they gave me some really powerful drugs post-op. I was very high for the first 2 days so all I took was hydrocodone at night and then prescription strength motrin during the day. I am lucky and have gained a fair amount of my feeling (still have it after TE surgery - YAY!)
As for TE surgery, it was pretty easy and I felt OK going home (within 30 minutes of end of surgery). I went to bed as it was the most comfortable place (propped up with many pillows). I basically stayed in bed for a day and half. I was so tired but had trouble sleeping. The pain wasn't horrible but I definately felt it. It is most uncomfortable standing up after laying down (lots of pressure). Today is day 6 and I am doing pretty well except for sleeping at night. I so want to be able to sleep on my side. I am not a back sleeper so I am waking up all the time trying to get comfortable. I was told I have to sleep on my back for 2 weeks.
It is great that your sister will be with you for 5 days. Those are the worst days. I drove yesterday and it was OK. I was lucky and my PS was able to put the TE above the muscle as I had extra tissue. I think that really helped my recovery.
Good luck. It is like childbirth, even after a few days it is hard to remember the pain.
Lorrie
-
Firedancer: Congratulations on your exchange!!! We are so lucky to have Whippetmom to help us on this journey. I had alot of pocket work done, too, so no sudden reaching or picking up even a water pitcher for a couple of weeks until you heal up some. Gentle hugs!
-
MBJ - thanks for that reminder...I did reach for something a little too fast and I flashed back to the BMX, ouch! ...back to thinking before I reach or lift! I am determined to baby my new "babies" for a while, I refuse to do anything to interefere with the healing and settling they need to do - here's to hoping that it helps!
It sounds like your fat grafting was a success!!! good for you - I love hearing the exciting news when things go well!!!
-
firedancer-congrats on your exchange! 450 sounds perfect. That is the size I have right now. Get lots of rest. It's definately good to to baby your new babies right now.
-
Well, Whippetmom... I didn't end up going with the exact implant you suggested. You said 500 ccs HP or 397 - 421 ccs MPP for Allergan. I ended up with one gummy at 495 grams, high profile, and my native side I wrote down, but my Mom has the notebook. I know it was mid profile somewhere in to 260 cc range? I really forget exactly. I can't really get in there to peek just yet, but I'm so pumped to take these bandages off. Do you or anyone else recomment a certain bra afterwards? In two days, I'm allowed to take my daisy duke corset (that's what I call it!) and the bandages and he told me to wear a sports bra that is comfortable and supportive, but does bother my incisions. My incisions are under my boobs, so I was sure what would be good for me. I did order the Hanes Bandini cause it seems a bit longer than regular sports bras, so hopefully it won't bug me. Thanks for all of everyone's help!!
-
I had my follow up visit yesterday and everything is looking great he said, and then he stuck me with 25 more cc's. LOL! I was so surprised to wake up with 300 after surgery so I thought I may get a week off. He said to begin massaging 3 times a day for 15 minutes and get ready to get filled up FAST due to my pending rads. I am still hydrocodoned and valliumed up, but moving about. I am so happy to have a shape, I am having a hard time loading my photos this time on the other site and having issues with this site reviewing all of thread instead of only new posts. It sucks! When will it be fixed?
-
Not fixed soon enough if you ask me KCMom (the thread thing on BCO) -- I hate it!
-
EricaV: Congratulations on your exchange! Can't wait to see your pictures. Yay for you--I hope you are very happy with the results! Gentle hugs.
-
Deborah: It seems the area that they did the fat grafting (in my step off area) it is very lumpy now. My PS said to just rub it into the muscle and it should flatten out. You are the only other person that I recall that has had this procedure. Did you experience this? Thanks, Mary
-
CONGRATS FIREDANCE AND ERICAV!!! Isn't it great?! I am babying my new babies as well..more so than after the BMX in fact. Maybe it is because this is perceived by me as apositive thing...back then I was shell shocked and scared out of my mind. I thought the quicker I got up and did stuff the further I could get away from BC....oh man, hard to believe it was only four months ago...
Whippetmom- you are so sweet and helpful to us all.. I have missed *seeing* ya on here the past few days.I am sorry you are having any health problems at all:(
I landed up with the Mentor Smooth 550HP in both and am loving them more every day. I get to drive today!!!! I go back for my one week check up this afternoon. I will post one week out pics on the forum tonight.
You all ROCK
-
Congrats Erica and Firedance! You too Annette! Wahooo!
-
annettek - I can relate to your reaction after BMX...I just figured I'd get up and try to get back to "normal" as much as possible in that uncomfortable, annoying and ever-changing, temporary state! I just wanted to fly as fast as I could thru that time...3 1/2 months, crazy, it feels like such a blur of time!...My PS also told me that after a month of TE's to "go ahead", there's no real damage I could do to the TE's at that point....buuuut, when it comes time for the implants - settle down and go easy. He said no matter how "good" I feel post-exchange (which I am still waiting for the 'feel good' part ;-) no major arm action/pushing/pulling...this is our time to get these babies locked into position! (hopefully!!!)
I am so glad to hear you are loving your implants more & more! It's so encouraging to hear - so far I like mine, just judging on symmetry and roundabout size...they still have that pancake-effect, though, does anyone know if there an average time frame till that kinda goes away? I'm excited to see these high profiles do their thing!
-
Had my pre op appointment with my PS tuesday I get my TEs. I started with my list of questions for him. He showed me the expander. He is going to use 550 cc moderate profile and he usually starts by filing it to 50 or 100 in surgery. I will need anywhere from 4 ot 6 fills 2 weeks apart starting 2-4 weeks after surgery. He will be using alloderm. One night in the hospital. They will be taking my port out in this surgery. I am 5"6" 140 lbs 32 inch rib cage aiming for a C cup. I am going to have a compression garment and now he says 70% chance of drains. he has had started doing the drains more now. They will be in for a week. There is no lifting over 5 lbs the 1st week and no lifting over 10 lbs the second week. And no lifting arms above head for 2 weeks. so looks like this wont all be done until xmas when we added it up but it's hard to say now. It's gonna be a long summer.
-
Hi all
I had my pre-op today with my PS. My exchange is April 14th. She is planning on putting in a 550 natrelle round silicone high profile on my right side. Then she will lift my left side and put in a saline round under the muscle . She isn't sure of the size because she will make it match the right side. Presently my right breast was expanded to 600. I'm 5'8 and weigh 155. Does this sound right?
-
Claire -- I've been thinking about you!!! How exciting that the day is coming. I think you will be glad to do the augment on the natural side... it seems to me that unis who do that have the best results symmetry-wise.
-
Thanks Annette and Lilah!!! Megan... I totally feel like mine look like pancakes right now (as far as i can see... which isn't all that far cause of these stupid bandages.
Does that pancake look go away??
-
Issymom: You are describing "dog ears" and that fat pad which some get and some do not - but is a lovely gift from the mastectomy defect, isn't it? Yes, it is taken care of at the time of the exchange, and tell your PS you will be haunting him in his dreams if he does not clean that up for you! I am PM'ing you info about the pictures forum...
Deborah
-
Erica I'm sure it's just from the bandages -- and the pecs being a little freaked. Your body will relax and the shape will come!
-
Holy mackerel...what happened to me? I feel like I was caught up in the Legend of Sleepy Hollow and slept for ten years or something. I came here tonight and found all of these posts! For some reason, they did not come up in my email alerts. Sorry you guys. I spent FIVE hours at the hair salon today getting a serious color correction and went from a blonde to a redhead in one day. I kid you not! My hair is darker than Estepps!
Maybe not as dark as MBJ's though....Not what I planned, but whatever. Okay....
Erica: We NEVER talked about gummy bear implants! They are entirely different animals - not apples to oranges at all! That is fine though and the size should be right on the mark. So give it time....ten days at least...
Claire: 550 ccs sounds fine - 600 ccs would be nice also - you could ask her to bring 600 ccs into the OR....It is only a matter of 50 ccs.....
But if she is going to lift AND augment the left side, this means you should end up larger than you were pre-MX, right? MBJ: You are such a sweetie...but I PLAN on being up and at 'em the next day. It is a simple surgery...just sucking out those shriveled, shrunken ovaries out - vaginally I presume....
Dawn-Hope: My onc wants me to do it because of the relationship between ovarian cancer and breast cancer...and because of my familial BC considerations. I personally think my onc goes to the extreme of extremes, but I'll humor her. The surgical oncologist also favors this for me...so there you go. I just wish I could have a dueling surgery and have a little fat grafting to the breast while I am under. We veterans of general anesthesia dream up ways we can kill two birds with one stone.
-
I might add that my husband is wild about my new haircolor and he has been following me around like a lovesick puppy all evening....
-
Carrol2: I like the TEs your PS plans to use and his plans about surgery and drains - all of it is as it should be. So you are on your way!
-
Kelly in Maryland: Well, if you are talking about gummy bear anatomicals, you do need to have a PS who has access to this type of implant through clinical trials. Otherwise the silicone option would be the standard silicone rounds. I think that the size of TE used is just right for your frame, but it does dictate somewhat the size of implant, because we want to approximate the width you have currently. This would infer the need for at least a 400 cc high profile implant [Style 20 in Allergan as a model] or 304 vs 339 ccs in a Style 15 - Allergan also. The Style 20 has more projection than the Style 15. Do you like the volume you have presently? Too small, too large, just right? That might help me also determine where YOU would like to be in terms of size.
Deborah
-
howard: Here is what you wrote:
Whippetmom: would you please advise me and share your recommendation? Here is the info you requested: I am 5'2", 114, small frame, wear size 2 clothing, 28" ribcage.
TE are Allergan 133FV-13. They are filled to 500.
I would like to be a C cup (was a and want them to look most natural. Your PS used pretty large TEs for your frame. I think you could use implants with a volume in the 325 cc to 350 cc range. However, your PS has you at a 13.0 cm width, so I think that what he might intend to use would be a midrange profile implant. This would translate to a 371 cc midrange profile implant in Style 15 - Allergan. This would be a pretty natural appearing implant. I think it has more of an "athletic" appeal than does the higher profile option. A question I would ask you as I did Kelly above, would be how you feel with the appearance of your TEs currently. They are full height and have considerable projection.
You want to ask your PS what he has planned for you. I personally feel that every PS should plan for the end result - should know WHICH implant, style and volume, he hopes to use at the end of the reconstruction journey. This should guide his or her choice of tissue expander. You want to ask if he plans on using an implant with as close to the same width as the TE as possible, or if he plans to narrow the pockets and use a narrower implant. That seems like defeating the purpose to me, but some do it. Let me know though how you are feeling about your size and appearance currently.
Deborah
-
Did I miss anyone?
-
fire-dancer and annettk: Found your posts with information about your exchanges! Wahoooooo....I am so happy for you both! Congratulations you kiddos...I know you are going to be very happy with your respective results. Just give it plenty of time, remember that they can look like hamburger buns [the bottom half of the bun, not the top] for days and it takes ten days to two weeks to really see how they are going to shape up, settle, drop, fluff and WHATEVER it is they do! Cannot wait to see photos girls!!!
Deborah
-
Hi Deborah. Thanks very much for your thoughts. Before surgery I had quite a bit of sag- per the PS, my skin fold was about a D cup and my remaining breast tissue was about a B cup- so I had lots of skin to work with. I do like the projection of the TEs and I do worry about the so called 'pancake effect' that some experience with the implants. As to width, the TEs feel a bit too wide on the armpit side, though I am getting used to it. What I like least about the way the TEs look is something that may be unavoidable- I feel as if my pec muscle is really pronounced. This may be because I now have breasts high up on my chest where they haven't been in many, many years! My PS is not part of the gummy bear study to my knowledge so I guess rounds it is. I guess I had assumed that the implants come in varying shapes. Thanks again and hoping that you are happy with your hair today....have been all shades of red, brown and blonde myself!
Kelly
-
Deborah - ...now, that must be one great haircolor you got there! ...love the comment about your hub being a lovesick puppy - too cute!
-
Thanks whippetmom for steering me towards the picture forum. I had my exchange on February 18th. I posted some pics under the thread "Worried about my nipple...please look" on page two of the "Under Construction" link. My nipple has been taking awhile to heal, but I've been told it can take awhile because my skin was radiated. Anyway, if anyone wants to look at my pictures my user name is MLM7 on the picture forum.
Have a great day everyone!!!
-
Deborah: I can just picture your DH chasing you all over the house!
-
Whippetmom - Thanks for giving a name to the extra tissue on my sides. I had my one week postop appointment. He removed my stitches. I amazed at how good the incision looks (very thin). Goes from the side of the breast to the nipple and then around the top of the nipple. I also asked how "full" they made me during the surgery. I had 500cc TE and came out completely full. Didn't expect that (don't think he did either). Makes me feel better as I felt that my skin was stretched already. He is having me come back in 3 weeks and we will see how things look (swelling gone). I asked if there would be any other fills and he said maybe 1 or 2 but we will see. He said we have entered the "Art" phase of the reconstruction process and we have many months to work through it to get the best result. I am definaely wider than before but the projection is less (I know that is what TE do). Another week or two of laying low and then I can go back to a normal life for a while. YAY.
-
shredbetty: I'll go take a look in a few minutes....
-
KellyinMD - I then feel you would be happier with anywhere from 400 ccs to 450 ccs in a high profile smooth round silicone implant. You are not going to have a flat pancake look. Oh - you might initially for the first ten days, as this is the ugly ducking phase of the exchange, but with a high profile implant you will have sufficient projection. The implants of the same width do not feel or appear as wide as do the TEs. Keep me posted on your progress and if you have any questions, please let me know. You can always email me photos if you have any concerns.
Deborah
-
Thank you so much, Deborah!
Kelly
-
I don't know if this is the right place to post this - but I have a question...my daughter was having a "tantrum" and I was helping her up the stairs, and I am 3 days out from exchange. I see some blood, or something dark under the steri-strip now. I don't know if I did something, but I did feel a "pull" when I was struggling with her. It's on the side I had pocket work done on.
I am so upset - not because it hurts alot, but because I'm worried something could be wrong. The surrounding skin is normal looking, and blood is not leaking out from the steri-strips.
Am I over reacting? I am now laying low and hoping that will help. What would you do?
-
firedancer: I would call your PS just to be absolutely sure. You might have just yanked out a stitch or two. Shouldn't be lifting a toddler right now for at least 2 weeks. Can you get help?
-
thanks, MBJ, it was completely spontaneous - a bad call on my part to try and help her - no one was here to help, but I won't be doing that again!
I'll call the office now if I can get someone after-hours, thanks! It's upsetting because I have been trying so hard to treat myself carefully! ....so frustrating!!!!
-
Megan: I agree with MBJ - you might have disrupted a suture also, but this does not necessarily mean that you have damaged anything. Just call your PS and see what he wants you to do.
-
Hi Deborah,
Thank you so much for your advice. Good suggestions to discuss with PS. You asked how I feel about current size? The TEs look big and round to me. Like two big balls on my chest. The expanders feel too wide under my arms. My PS can do the gummy bear implants. Do you think those would be best for me? I like some projection and want a cleavage, but do not want breasts that look too big for my small frame. A natural looking "C" cup is what I'd like. Certainly do not want my breasts to be the first thing noticed. :-) Would you tell me what you mean by the "athletic look"? I hear the gummy bears are harder...more firm.. Are they too hard?
It would be so helpful to see pictures. Would you please let me know how I can access those? Thanks so much. Your info is valuable! You're a huge help to so many! -
just a quick update from my post yesterday - Nothing is dislodged stich-wise, to my knowledge. I think I aggravated the stiching, but the skin around the incision is perfectly normal-looking and I am in no more pain than usual. I checked in and was told to take it easy for the wknd and I'll be seeing the PS for post-op on Tue morning. I don't think I damaged any of the stitches in the pocket, I think I would have felt sigificant pain after, right?
Well, I have restricted myself a bit more till my next PS visit Tues, so that if I accidentally did do something, it has extra time to perhaps catch up and heal. It's amazing how easily it can happen...all I did was stretch my arm out in an awkward direction, I've learned my lesson!!!
...now, back to vegging on the couch - my "big" project of the day: trying desperatley to catch up on all the TV I never watch!
-
Megan, so glad to hear that all seems okay. I thought of you today actually when I was trying to get my defiant 2 year old dressed- she caused quite a ruckus and I had to heft her into her crib to keep her contained! Made a mental note that I'd better come up with a better solution soon!
Kelly
-
Kelly - it's amazing how fast it can happen - be careful! I just turned my body a certain way and wham!!! I was caught up in the moment with my stubborn 5 yr old and it got the best of me...
...my main concern is screwing up the pocket stitching...I don't want to give these girls any more room to "wander"...staying "put" is where I want them - it did give me quite a fright though!
definitley gotta think ahead before we jump into "mommy mode" now!
-
Megan: Good to hear you are okay. I did a sudden reach shortly after my exchange, too, and I don't even have children. TV works!!
-
Thanks Deborah,
Yes, I will be bigger than pre mx. Is it a normal procedure to augment the natural breast under the muscle? She said that she does this to make a clear view of the breast tissue in scans. Also she is planning on using saline in the natural breast.
Thanks for all your help!
-
howard: I'll PM you the pic forum info...
With reference to gummies, now I see what is going on with the width. Your PS has intended to use gummy bears all along, I imagine. So you have several options and I like the ones which are on the lower volume end of the scale. For instance:
Allergan 410
Low height extra full projection: 365 grams
Moderate height full projection: 375 grams
Full height moderate projection: 395 grams.
I would talk to your PS about this....just to make sure you both are on the same page regarding type of implants he plans to use. I know he used a full height TE, but I just want to make sure that the implants are not too tall on the chest wall.
Deborah
-
howard: One more thing...your PS could possibly use an anatomical gummy which is 12.5 cm...which means he could a number of other styles in the mid 300 gram range. It just depends on your pockets. The key about using anatomicals is the the PS needs to plan the expansion - and select the TE - with the end result in mind. He should know what style and volume of Allergan 410 he hopes to use at the end of the day.
-
Claire: ABSOLUTELY under the pectorals!!! For the very reason your PS stated!!!
-
Hi ladies -
I was so overwhelmed at dx that reconstruction just was not on my radar. After a BMX and final staging - I just did round 2 of a 6 round TAC. I will then have rads. Then, I am considering reconstruction. I live in Vegas and am wondering what my best options are. Any suggestions on type of reconstruction and can you give me a brief lesson on implants. Is the surgery painful? Do they implant above muscle - since I had a BMX? Will I look somewhat normal again? Oh just can't see myself going through anything major, but want to look more like old self. I am 55, single, 3 grown kids, 2 grandbabies. Thanks for any advice, recommendations. xo
-
Thundershowers: There are so many answers to these questions. The best next step is to meet with a good plastic surgeon and inquire about your options. The issue which will impact recon the most will be radiation. Someone asked me about breast reconstruction and radiated breasts the other day and this is what I told her, and the same holds true for you....
Well, previously irradiated breasts do pose elevated risks of capsular contracture, seroma development, and also can impact the cosmetic aspects of reconstruction. However, I know quite a few gals who have had rads and have implants and are doing just fine. It is just that your risks are higher and if you are willing to accept the risks and you opt for implant based reconstruction, then it is still a viable option. If you have sufficient body fat for a flap reconstruction, and this can be fat and tissue from your hips, buttocks, belly, upper back, then the success ratio is much improved. I do have, on my thread, Breast Implant Sizing 101, a section about radiation and implant-based reconstruction, [Check the highlighted information above on the thread header] and the use of fat graft transfer to improve the integrity of the radiated breast and thereby improve the cosmetic outcome and reduce the risks of capsular contracture. You would need to find a PS who holds fat graft transfer in high esteem.
That said, you have the same opportunity for a very successful and rewarding reconstruction result as any of us here have had, and you have every reason to pursue it with vigor!
I'll let some others chime in about their surgery perceptions. Frankly, mine was two years ago and I cannot remember much about my BMX. Pain requiring Vicodin for five days or so - but I entertained visitors and read books and watched TV and just relaxed. The pain was well-controlled. I was 58 years old at the time. Certainly you can look normal and you might even look better than normal. You might look fabulous! I'll PM you some information...
Deborah
-
Thundershowers: Kittycat is in Vegas and interviewed several PS's before finding "the one". You might want to PM her and see who she recommends. She is now having to have radiation a year after the fact.
-
Thanks MBJ....I just sent kittycat a PM to get the name of her PS....
-
Whippetmom: Great!!!
-
Hi Deborah. I met with my PS today to schedule xchange surgery and talk about implants. If you'll recall I currently have 400cc TEs. He's recommending slightly narrower implants, 425 ccs, Allergen Natrelle Style 45 (smooth, full profile). He chose these in particular because I like the size and projection of my TEs and he felt I'd be happiest with these. Are you familiar with this style? Thanks for any thoughts you may have.
Kelly
-
Kelly: I think you would like the Style 45s. Very nice projection and since you like the appearance of your TEs, that would be the right choice. But I think you would need 460 ccs to approximate what you have now. There is not a 425 cc implant in that style, by the way, so verify all of this with your PS.
Deborah
-
Hey ladies,
I am in the midst of chemo, had BMX with TEs in Dec. Today I had lunch with a new BC friend who underwent her exchange surgery about 3 weeks ago. She had delayed reconstruction and several infections and hematoma, along the way. Although her surgery went well she is somewhat disappointed that she needs to wear forms to fill out a bra. I left lunch very discouraged to say the least. I almost fully expanded (one more following chemo, need to wait because TE was begining to displace port). I am very happy with my current size, although I can not stand a bra, TEs are very uncomfortable, eventually will consider full to high projection implants per PS. I will get details at next visit. Please tell me most people are able to wear normal bras post exchange??
-
christine47 - I tried wearing some of my old bras with my TE's and they were so uncomfortable! My TE's were fairly wide on my chest wall (practically under my armpits) and when I wore a bra, they pushed the TE's in medially and ouch! We all know how moveable and soft those TE's are! HA!
Yes, I am able to wear normal bras post-exchange. The implants vs. TE's are like comparing apples and oranges. Yes, to normal bras!
-
Christine -- yes definitely wearing regular bras post-exchange (and very nice ones too). Your size will very likely change and there may be some styles you won't fill out the same as you used to... but you should NOT need to wear forms to fill out a bra. I think most with implants find this to be the case.
If you want to get cheered up, go to the thread Bras 101 thread... where Val61 has posted a slew of info about fitting bras post-exchange. Maybe your friend needs to get a good bra fitting to find bras that are the right size. Was she larger pre-MX? Is she wearing her old bras instead of getting new ones?
-
where's the picture forum
-
Thanks Deborah. I'll double check on the fill amount. I so appreciate your input!
Kelly
-
christine47: Have your new BC friend come here and talk to me. I would like to understand why her reconstruction results require her to use a form to fill out her bra. She has every right to go back in for a revision - to see someone else - and obtain better results. I fill out a bra just fine. So do many of the gals who post on these threads. For your friend, it might be something as simple as finding the right bra....
-
sheilajoe: I have sent you a private message.
-
I just came from my 1st post-op visit with the PS. The nurse who saw me 1st said I looked like a augmentation.... all must be healing ok :-)
The PS came and took pics, etc. and felt that everything was looking great. I just need to remember my restrictions re: lifting and arm movements for another 6 weeks, I do not go back to see him for 3 months! (unless there is a problem, of course) I asked all of my questions and he was open and honest...these implants could last 4 years or 40 ;-) ...for now everything is good, healing well...he sees no need for grafting, etc.
The only thing I notice that I guess kinda "bothers" me is that there is not alot of "uppper pole" (is that what we call the top of the implant?!? :-) Will this fill in as I drop & fluff? My PS explained that going with HP's can attribute to this. I do not have a shelf or divots, it's just not round and full up there...It's only been 9 days, so I do know I have to give it time.
It's amazing to think that this part is pretty much done as far as Dr's go, now it is just up to me to heal well and take my time getting back into "real life". Next week is my 1st post-op visit to the BS and then I probably won't see her for 6 months, wow - things seem to be winding down, it's pretty surreal-feeling...
-
Firedancer-it's great to hear your doing well. You have 450's correct? I have the same and they are HP. I don't have a lot of upper pole either. I find that a push up or demi bra helps a lot. They do look natural though. You definately need to give it a lot more time though because they will fluff out and change. I think overall you will find they look great. They are new and different from the TE so you and your body just need to get used them and you will. Wish you the best.
-
Hey Whippetmom,
I have been eagerly awaiting the chance to ask you about exchange and what option you think I should go for. I had a NS BMX with TEs on 1/31. My exchange won't be till probably the first of August due to chemo, but I think I'm gettting close on the fills.
After today, I'm at 480 cc's in Allergan Natrelle TE, model number 133mv12. He overfills before exchange.
I am 5'6, 135 lbs, rib cage under my bra is 30". Before BC I was a small B/large A. I'd like to be a small C. I'd like to do the gummies or silicone vs. saline.
My PS also does fat grafting at the time of exchange to help with the upper pole so that there's not a shelf from the implants.
What are your thoughts?
-
Hi Sweetie, thanks for the support! I do have 450's and I am sure things will change and "fluff", but I think for now I am grateful that I am happy so far, it's so nervwracking leading up to exchange that I was afraid of getting my hopes up, but so far, so good! ...and I do agree, once I put on a bra, the cleavage looks good by me :-) I hope all is going well with you!!!
-
ladies,
Thanks for all your positive comments about wearing bras post exchange. My friend had multiple surgeries and complications prior to exchange. I am not sure that her PS is doing that many breast reconstruction procedures, he told her he did the best with what he had. I think she is just going to move on. She went to a good shop for bras ( they fitted me for my camisoles and some bras to use during the fill process), so I am not sure that is an issue. I did not know her well prior to BC, but think she may have been larger. Her PS is in a small town, and I am not sure about his skill set in the reconstructive surgery procedures. My PS is at a large teaching hospital and I feel quite confident with his skills. Just so disheartening to hear someone go thru recon. process and still need to wear prosthesis. When I get closer to exchange I will post my stats for review, can not wait to get rid of these TEs!! -
So sorry for your friend... too many women get stuck with plastic surgeons who really ought not to be doing reconstruction (who are really augmentation surgeons, which is an entirely different thing). That she had complications and difficulties on top of everything else is just a shame because, no doubt, that discourages her from getting another opinion at this point.
-
Home from my TE surgery yesterday. I have pain but it's manageable. I had some trouble peeing in the hospital and my blood pressure went too low. But everything turned around today and I was able to come home.
-
Carrol welcome home and glad you've rallied:)
-
Yes Carrol....and glad to hear this stage of the journey is over for you. Now on to fills!!
-
Firedancer: So happy to hear that you had great results! Wonderful news!
Carrol: Congratulations! Your fills should go quickly and you will be able to exchange them out in now time. Rest up!
-
supersally: So sorry! I missed your post somehow. But I am so glad you sent me a private message also!!! Let me know if you need anything further!
-
firedancer...Ditto to what sweetie said.....
-
Third night home since the TE surgery. Sleeping ok but do still have pain. When I wake up during the night I take more pain meds. Trying to stay on top of it as they say. Took a shower yesterday. I hate having those drains hanging there while showering. But it does feel better to be clean. I also got an xtra compression bra that the doctor gave me to use when I wash the first one that they put on me. This one is different and more comfy not as tight around my stomach area. This may be TMI but where else could i even think of discussing this but i had my first bowel movement after 5 days and ouch! Guess i should have taken the stool softener. You can bet I took it now. just took all my meds no food feeling queezy so better go rest. Just stuffed a banana and a hot choclate down.
-
OK I've been a lurker since, well this fall on this thread. I had 3 weekly expansions prior to chemo and 6 more weekly after chemo with one more to go (total 10 expansions). Sounds like I'm trying to replace D cups but actually I was a small (large A/small B cup). I told my PS that I didn't want to be any bigger than a B. He does like to overfill so he has "room to work with" as well as expand slowly… but right now I feel like I have stripper foobs!
I didn't ask for the exact amount of CCs but my nurse said I was getting a little over a shot glass with each expansion. Anyone else get this inebriated? I think I've had too many tequilas.
Still have to talk implants but I know for sure he's using mentor smooth round cohesives and does fat grafting. I asked about that at my first meeting.
-
Hi Iago! Welcome
I've seen you posting on other threads that I post on... my PS also overexpanded to have room. And don't worry. Even if they put implants in exactly the size of the TEs (cc-wise) they would still be smaller. You should find out how many CCs you have and how many he plans to put in... knowledge is power! -
Hi Lago: Welcome to the thread. The expanders do look like "stripper" boobs,lol. I was given the same size as my expanders and they are no where neer the projection as the TE's. Also, implants are wider then a natural breast, so you might end up a C cup but look like a B cup in clothes. I was an small B and I am now a C./D depending on the bra and they look very natural like they were made this way (thanks to Whippetmom). Most of my clothes still fit and the ones that don't, fit borderline anyway. Find out what size expander you have, give Whippetmom your height, weight and measurements and then she can get you to where you want to be. Many PS's overexpand to get a natural "droop" or ptsosis to the breast.
-
Yes he told me that at my first meeting that he over expands for ptsosis. I really do feel very good about my PS's expertise.
Another question. TE's of course don't move at all. My old breast were always sticking out a little on the sides even though I was small (no cleavage even with a bra). My old natural breast would "move out of the way" when needed. Will the implants be "stuck in place" like the TE's? Is it just because the TE's are so hard that they don't move?
-
My implant is a gummy and it only moves a little... I'm not sure what the deal is with the Mentor cohesives. But the gummy is textured and adheres to the skin, which probably accounts for the limited movement. I think with the smooth rounds there IS much more movement since they are able to turn in the cavity. It also depends on how much stitching your PS does internally. I've seen some women complain that their implants totally slide to the side when they lie down... and I'm not sure that is desirable either.
-
lago: I have the smooth rounds and I can pretty much manipulate them like a natural breast--nothing like a TE, but of course they are a bit fuller then my natural breasts! I never had cleavage before, and without a push up bra I don't have any now. But put me in a VS Angels push up bra, and yes, why I do have a bit of cleavage, lol!
My PS used the type of expanders that were sewed down (I asked for them because I am so active I thought they would move) and he stiched down the side after exchange so it's going nowhere near my armpit. I did have to wear a bra 24/7 to ensure this didn't happen, though, just in case.
-
Thanks for the info. I still doubt I will have cleavage. It's just not the way my body works. Based on the placement of my TE's it seems like my PS is really respecting what my body was before. Granted the TE's seem to sit higher but that's only because the are not anatomically shaped like real breasts. Lilah are yours the anatomically shaped true gummies?
-
Iago -- yes that's what I have (the Allergan 410s). The Mentor cohesive smooth rounds are, I understand, softer and more malleable. I think it's good that your PS is following what your body does naturally (because, um, it's what your body is gonna do anyway
-
Liah that is my understanding as well. I'm not looking for a change or a to replace my current wardrobe so I too am happy he is respecting my shape.
-
lago: It sounds like you are getting all of the answers you need here. Let me know when sizing help is needed!
-
Hi Whippetmom,
My exchange is schedule for the end of April and I am getting nervous about the upcoming surgery.
I finished my radiation treatments in January and had been filled to 550ccs before radiation but the PS took out 50ccs towards the end of my rads because I was in so much pain. Since rads has been over, I have gradually been getting fills the past few months. I am currently at 625 ccs and will get another 25 ccs this week(my last fill). The TE is looking way to big and I am hating it. My PS wants to overfill 150 cc to 200 ccs more than the permanent implant size because of the radiation. I am also having fat grafting and nipple reconstruction at the same time from what I understand.
I had a unilateral mx and the PS is going to do a small implant/lift on my natural side to achieve symmetry. He is planning on bringing into surgery 440 cc and 500 cc texture HP Allergan implants.
I am 5'5" and about 130lbs. My ribcage is 32". I was a small B before surgery and would like to be a larger B or small C. My TE is style 133mx-14.
Any thoughts or recommendations are greatly appreciated.
-
bher: You will not like textured implants. I would get your PS off of textured implants ASAP. They do NOT have that much more benefit for rads patients overall. Plenty of studies out there to support that the benefit of textured implants does not outweigh the negatives. He will tell you it is b/c you have had rads, but a textured implant will just grab that rads breast and you will have traction rippling. I would rather he use fat graft transfer to soften the skin of that irradiated breast. I think that you will be happy with 500 ccs in a smooth round silicone implant.
Deborah
-
bher: Wait a minute though....
I just looked at your original post and you have a 14.0 cm wide TE. That Style 20 500 cc is only 13.0 cm in width. After reviewing your TE info, I don't think that will be enough, which is why I recommended the Style 15 - midrange profile - instead - especially if you stay in the 500 cc range. So this would be 492 ccs in Style 15/Allergan or 533 ccs in Style 15 Allergan. [492 ccs is preferred, in light of your rads issues and your PS' inclination to aggressively overfill.] He could also use 500 ccs in Mentor's moderate plus profile.
It all depends on how much that rads breast retracts or retains the expansion at the time of the exchange. I mean, I suppose it is possible on an irradiated skin envelope to use a narrower width implant - much more probable than with a non-rads envelope. So perhaps he could use a high profile implant in 500 ccs. I just feel that your fills need to cease. I worry about skin integrity and this is more important than implant sizing. Talk to him about this.
Deborah
-
whippetmom I am 6 days since my TEs were placed. When I came to my doctor said he had to put in a wider expander than he originally thought. I guess because the tissue left from my bmx was wide. I was a very wide DD. Most people did not realize how big my boobs were unless i was wearing something very tight or revealing. Most of the time I felt like the made me look fat. He said they were allergan and that he put in 150cc to start. Tomorrow is my follow up what else should I ask him? I think he said i will have 5 fills 4-6 weeks after surgery. Right now I still have quite a bit of pain and trouble with my tummy from the meds. I stopped the pain pills to make sure i get in the antibiotic because i have read on here how so many women get infections and have to take the TE out. NOw I might have thrush in my throat not sure, could just be sore from the anesthesia. My tongue looks a little white but it's been that way for months since chemo. Overall I would say that this surgery has been more painful than my bmx was and the recovery is so far slower. The journey ahead seems pretty daunting right now. I can't imagine the fills no less the exchange surgery. But i overcame the bmx and the chemo. My hair is slowly growing back. SO as Scarlet said tomorrow is another day!
-
Carrol this might be tougher because they are putting something foreign in your body. It should get better. I hear the exchange is much, much eaiser… at least I can hope. So now you know why I wasn't doing Zumba in the gym 1 month after surgery like you
I was on antibiotics for 10 days. I ended up getting a yeast infection on the last day. I was expecting that and handled it holistically.
-
lago yeah i can't even imagine driving in a car right now no less going to the gym. Also everything was completely dry last time this time i had some oozing, they said that might happen. what antibiotic were you on? I have cephalexon. I think i recall this one making me sick as a child but i don't recall.
-
Carrol: Did you get a little card at the hospital which will tell us the style and volume of TE used? If not, this is the question you want to ask. You need the exact style and volume of the TEs. Essentially, I do need to know the width - and so if you get anything - get the width. I think because of your width, and also because you do not want to be too large, the midrange or moderate plus style implants would be best for you. But let's see what we can find out about the TEs.
-
Carrol I was on Clindamycin
-
Hey girls...been off line for a while haven't had the opportunity to post photos or update them. I had surgery filled to 300...got 25 cc next week, last week got 100 cc and have two more weeks of expansion before rads. I have 500 cc expanders and am at 425...I want to be 650...not sure if we will make it he said we will be close and depends on rads. I'm hoping for another 100 although painful to get where I want to exchange to. Any input?
-
KCmom...I talked to someone else today who was filled prior to rads and then went through additional fills after rads as well and she is tolerating it very well. So it all depends on how you are doing with fills prior to rads and it sounds as if you will be at a full 500 ccs at the very least before rads starts. So the protocol will be just to take care of your skin, make sure you are getting good nutrition, eat all of the "skin" food you can, e.g., avocados, mangos, almonds, cottage cheese, wheat germ, and just get through radiation treatment and then we can assess further. Keep us apprised of how you are doing. You can email me photos anytime...
Deborah
-
Hi Whippetmom,
Thanks for all your help, back in October. Finally had the exchange surgery on March 17th. My PS likes to overfill. The right was filled to 440mls and the left was filled to 390mls. The left started to blanch during the last fill so th PA removed the saline and left the left breast with 390ml. I ended up with 400mls high profiles, silicone. They are fine but look like hamburger buns, will they "drop and fluff"? When does that happen. My scar is raised, I just started using Scarfade, recommended by the PC. What do you think. Thanks for your input.
-
pamcycle: Congratulations on your exchange! They all tend to look like h
"hamburger buns" and over the next 2-4 months they will change considerably. Take a deep breath, stay away from the mirror and if you would like to actually see the changes, take a picutre once a week and you will notice they do get better! Gentle hugs!!
-
MBJ,
Thanks so much for the advise. I needed both the support and advice. I can wait as long as I know they eventually look better. Thanks again.
Pam
-
Hey girls....update...I am up to 475...again 300 st surgery, 25 first week 100 second week and 50 last week. This coming tuesday wanting another 100 to put me at 575. I am rushing to get the rads done but he said we could fill a little rite after rads before skin got too hard. I am hoping for 600 to 650 implant.
-
whippetmom- when you get a chance can you take a look on pic forum under BMX to 550 HP at my latest pics 3 weeks out from exchange- I am liking them but god help me- I want to know what YOU think:) I landed up with mentor HP 550 on both sides. You have been such an inspiration to so many of us:)
-
KCMom: Glad you are getting there quickly and hoping for the best possible outcome for you!
-
pamcycle: If the scar is "raised", you might want to get your hands on some Kelocote, which is formulated more for keloid type scars.
annettek: Going there right now!!!!
-
annettek I could not find your pics on the fourm under BMX to 550HP what am i doing wrong?
-
My scar was raised from my port surgery. I just put vitamin E oil (from Trader Joes) on it twice a day. It took a good month or so but it flattened out. Also remember I was doing chemo so that's why it might have taken so long. That was back in October. Now it's starting to disappear.
-
Carroll -- she means the picture forum, which is separate from (and unrelated) to this forum.
-
Lilah i understand that but when i search there i am not finding it
-
Somewhere on the forum there is a page with a search option (near the bottom of the page). You should be able to type in the member's name/ID to pull up all the threads/posts for that person.
-
Carrol -- Last time I looked it was on page 1 in "Under Construction" -- I'll go bump it now if it isn't.
-
got it thanks!
-
Who has had or knows of anyone that has received the Style 45 silicone implants? My PS is wanting to go with these in 800cc for me and I am curious if others that have gotten this style have an opinion one way or the other.
Kelly
-
Kelly- I haven't had my exchange yet but my PS is also recommending the 45s because I like the projection of my TEs. I think he said 500 ccs for me. He told me that his practice has been recommending the 45s again because of the projection issue. Best of luck to you.
Kelly
-
Yesterday I did my usual lotion & Bio-Oil applications, (constant...if my hands aren't full of lotion they're typing here or grooming a dog.) I changed ONE thing in my normal routine (like rubbing your boobs this much is normal, heh heh): I ate an avocado for dinner. I mixed it with salsa, grabbed some chips, and wow it was good... Today, my red incision scars. Look. AWESOME. Never have little red lines disappeared so completely so fast, my incision look less red, my skin around the incisions looks SO healthy.
So thanks for that tidbit, Whippetmom! You are so helpful; that you help me, without even TRYING to help me. How awesome are you!
Have you seen my pics lately on the forum, I think I'm as big as I dare (510 ccs) so I am trying to prepare for loss of projection so I won't be disappointed.
-
Cameron: Oohhh....I don't know if it would happen that fast....
but, whatever works... And go to Costco and get those wonderfull Marcona almonds! YUMMMM....another great "skin" food. kdhawk: A number of gals on the pictures forum have the Style 45's. Go post this question on Exchange City also. If your PS wants to use 800 ccs, I applaud the use of the Style 45's - it gives you the most projection in a narrower footprint.
-
Cameron....I'll go check out your photos....
-
Just wanted to post a new clinical trial....
THE EFFECTS OF RADIATION THERAPY ON THE RECONSTRUCTED BREAST
http://clinicaltrials.gov/ct2/show/NCT01292772
I will be watching for updates on this very interesting and much-needed trial!
-
Oh sweety.... I tried to decipher that read..... and I just am not.... um... smart enough to understand it.... ((( LOL)))
I am just going to trust..... that you will call me if any AMAZING thing is learned about rads and implants...............XXXOOO
I am going to TRY to keep up with your learning on this issue. As you 110% KNOW..... I do NOT want to have to have a flap surgery... down the road.... EVER..... soooooo..... I am trusting you will call little old me if I need to know something to pass on to my RADs sisters or know for my own past reconstruction........:)
In respect, ALWAYS.
Little old me..... ~wink~
-
Oh I have an idea!
Who's up for an experiment? It's impossible to get LESS scientific, but it'll be fun. For me.
If you are reading this, and have incisions you are TRYING to heal, will you please look at your scars closely, eat an entire avocado, and see if they improve?
Not only am I curious, but I fancy myself a researcher.
You do not even have to qualify for this study, and NONE of you will be forced to take the placebo! (The placebo is a zucchini, just FYI).
If you are up to this challenge, just go buy an avocado. And p.s. I am not employed by the avocado industry, I just have too much time on my hands. Avocados are cheap people, just do it!
-
I'm new here, have only posted a few times but had my exchange surgery a few weeks ago and I'm wondering how I can access the picture forum? I'm curious to know if I look "normal". Thanks
-
JuJuBe: Hello and welcome to the thread. The most important thing is to establish yourself here on BCO as the picture forum is a separate and private site. Just start joining in and posting here so that we can all get to know you. Once you have done that I or one of the other gatekeepers will be more then happy to help you get there. At what point are you in the process?
-
Cameron...............I like your style sister.......... BAHHHHHHHHHHHHHHHHHHHHHH!!!!! good one! LOVE IT !
-
MBJ, I posted my story on the Exchange City thread, but to summarize I was diagnosed late last summer with DCIS (extensive), had BMX with TE's in Sept. Two weeks ago I had my exchange surgery (Mentor HP 550). I didn't have chemo or radiation. Needless to say, this was quite an ordeal but reading the stories of other women who have had to endure much more complex treatments puts things into perspective. I purposefully stayed away from reading too much on the internet, worried I would fall into a deep dark rabbit hole and only within the last two weeks have I been exploring this site. Part of me wishes I would've come aboard earlier as I have found many women here to be quite inspiring as well as informative. I'm happy to be nearing the end of this chapter of my life but, is it really ever over? Now, my focus is to find ways to improve my daily life, diet, exercise regime, etc. I'm looking forward to what's ahead!
-
JuJuBe: I knew I recognized your name. Sometimes I come on here late at night and I'm not quite awake! Everyone's new foobs look a little bit weird in the beginning-kind of like hamburger buns--after a few weeks (or for me almost 4 months) the muscle relaxes and they settle into a more nautral shape, but it does take patience. Whippetmom was a great help and I shared my pictures with her in the beginning before I shared on the picture forum. Her help and advice were truly priceless.
-
Cameron: I do eat a lot of avocados and my scars look pretty good.....hmm
-
JuJube: Welcome and keep posting....you will be on the pictures forum before you know it!
-
Cameron - I eat 1/2 avocado a day and am now jussssst waiting for my steri-strips to fall of and see my scars reduced to nothing!
...btw, how long did everyones steri strips stay on? Mine still feel firmly glued in place from exchange, it's been 3 weeks now. After BMX my surgeon removed them, but I don't go back till June to see him, I'd kinda like to get these off before then! ;-)
-
Megan -- Mine stayed on a long while (probably 3 - 4 weeks if memory serves)... and I think I eventually kinda helped them when they were half stuck on and half off (probably not a great plan but I, like you, got tired of waiting).
-
fire-dancer I was told after my biopsy not to touch the steri strips for 2 weeks then they should fall off by themselves. Yeah right. I ended up encouraging them BUT
Call your doctor's office and ask. Just because you don't see him till June doesn't mean you can't call. I'm sure the nurse can answer you question.
-
thanks Lilah - that's what my PS did after BMX, he just peeled off the strip that was still attached...I am getting antsy to see how everything is healing under there, but these things aren't budging right now, I definitley don't remember my bmx steri's being so adhesive at this point...oh well, I'll wait a bit more and see :-)
-
Lago - that's what I'm thinking - I was gonna call the office and see what the nurses say by the end of the week - that'll be getting close to a month. I have "picked" at the end of the strips in hope I might "loosen things up" ;-) but no dice!
-
firedancer: It took a few weeks before mine came off. I imagine you want them to continue doing their job of holding you together. I am still healing from my nipple surgery--there is still a stubborn area that hasn't healed and I don't have a steri strip to hold it in place! I coaxed mine off when they started to come off and not before.
-
thanks, MBJ - I am being a bit impatient, ;-) It just seems a lot longer than last time, but in all reality you are right, the strips are doing a pretty important job right now, and I should let them be without interfering...good thing I am in a sports bra 24/7 and my inner 'impatient child' doesn't have access to be fidgiting with the strips!
-
Megan....Are you happy with your size now?
-
I posted an updated pic of my hair chart on the hair thread i am at 19 weeks and I posted pics of my expanders on the pic forum called Delayed Tissue Expander Surgery if anyone wants to see. My screen name is the same as here.
-
I now am 6 weeks out from BPMX, skin sparring, not nipple sparring. I am currently filled to 750 with TE's, will 800cc implants look the same?
-
Carroll- did you ever find the forum? If not,let me kow and I will pm you..I am going to check yours out rightnow:)
How come I did not get steri strips? I had two stitches on each breast with glue in between- I am going to eat more avocadoes...that sound syummy- I am using the silicone strips and they seem to be helping quite a bit...
-
annetek i did not find your pics on the pic forum where are they? I have been having rouble finding things on there a lot.
-
RNjules: It all depends on the actual recommended volume of your TEs. If your TEs have a recommended volume of 750 ccs, implants with a volume of 800 ccs will be smaller than your TEs. If your TEs have a recommended volume of less than 750 ccs, say 650 ccs or 700 ccs, and you are overfilled by 50 or 100 ccs, then 800 ccs should give you approximately the same appearance as you have with your TEs currently. Verify for me the style and recommended volume of your TEs...
-
Carrol: annettek's photos are two or three threads directly under yours on the pictures forum! Look for her name!
-
thanks finally found it.
-
Anyone get stretch marks from the expanders? did you use anything?
-
Lago: I didn't get stretch marks, but I did use BioOil on it throught the expansion process. You can find it at most drug stores like RiteAide and Target also carrys it. $10 for a bottle that lasts forever.
-
My expansions are done. The stretch marks aren't bad though.
-
Lago: The bio oil is made for stretch marks so you might want to try it. I gave my leftover bottle to my friend who just had a baby. It has a nice smell, too.
-
I am expanded now to 550 hoping for a 650 implant but have had A LOT of pain this go round on my non cancer side. It is higher and seems to be pressing on a nerve. I need another 75 or so doc says but I am just now getting around without pain meds and the last fill was last tuesday. I am to return this tuesday for last one, I am getting my rads simulation on Wednesday and starting the following monday. ,If I am at 550 can I exchange to 600 or 650 after rads? He did say if I come back immediately after rads and get a few fills that works too. What to do?
-
KCmom: If your skin holds up well with rads, and you can tolerate an extra fill after rads, it is entirely reasonable to exchange out to 650 ccs.
-
MBJ and hillck thanks
-
Annette-- some doctors use glue instead of steristrips... not to worry
-
Thanks so much Whippetmom. I am TRYING to load my pics onto the picture forum, I sent Fumi a msg this morning. I hope to have some updates on:)
-
DO SCAR REMEDIES REALLY WORK???
[From the Los Angeles Times - Sunday April 17, 2011]
The summary first: "Products abound, but doctors say the key is keeping a wound moist and covered."
1. To prevent scars from widening, use steri-strips to reduce the pulling of the skin.
2. Exercise that gets the heart pounding can speed healing, but be sure not to strain the wound for two weeks.
3. Skin exposure can darken or redden the new skin permanently. [This is a generalized article - not just for MX patients - so not so much of an issue for us. But bathing suit tops MAY permit some solar penetration....so wearing steri strips with swimwear would be advisable.]
4. Massaging along the length of the scar several times a day may soften it and reduce its volume.
"Silicone gel sheeting"
Several articles reviewing 30 years of research suggest that this can speed healing and lead to thinner, softer, less red and less painful scars. It's not clear what silicone itself does, but the sheets do a better job of keeping the scar covered and that prevents water from evaporating from the skin."
-
Oh gosh, I am panicked about TE's now. I am having my BMX surgery on May 10th. I heard about a quicker Breast to Implant procedure which skips TE's. Has anyone heard of this? How long before I can go back to work with TE's?
-
maripili - i don't know about the straight to implant procedure. whippetmom will know. it probably depends on how big you were prior to the DMX.
As far as recovery time, we're all different. If you're talking about the BMX with TE placement ... that's a pretty big surgery. I took four weeks off and then went back to work. I probably should have taken a couple of more weeks. It depends on the type of job you do too. If it is a desk job, you'll be back sooner than if it is a more manual labor job. You will have lifting, reaching, weight limits after that surgery. They're cutting the pec muscle and ANYTHING that requires the use of those pecs is going to hurt. Hope this helps a little. Bless you on your surgery! xo
-
Maripili please don't panic it is not that bad. As you can see most of us are online within days of the surgery so how bad off could it be. There is some pain i won't kid you but it is very manageable. I think Most people will tell you to expect a month off but I think I could have done it in three weeks if I had not gotten a sinus infection and a cough a week after i got home. I don't know anything about immediate implant surgery except that is done using alloderm but you have to have enough skin for it after the bmx and even then you probably won't be able to get that big. But if you don't mid being smaller you should defintely discuss it with your plastic surgeon and you should talk to other surgeons as well and get lots of doctor input, it will put your mind at ease that you made the right decision.
-
Hi Whippetmom - yes!!! I do like my implants - I mean, they aren't my "real" boobs, but they're pretty great, anyway! ;-)
I think the size is perfect for me,any bigger or smaller would have been a mistake I think, especially when I think I will pretty much always be wearing a bra in public, when these babies are pushed up, they look much bigger than I ever was, but in a good way! I think I'm measuring somewhere in the C range...you were so right with the size/projection...the HP's sit nicely on my frame, I have 'some' rippling, but in reality, I'm not usually hanging around, hanging practically upside down naked checking myself out for ripples,
(I've checked these girls out from every angle - never expected to be doing THAT a year ago!!!) so if they look good in a bra, then I'm ok with it...from what I understand I kind of couldn't avoid rippling, I am thin-framed & HP's come with the consequence of rippling? Am I right? ...not 100%, but I thought this was the case...I try to remember my real ones were never perfect either and so far, I can take the minor imperfections of the foobs andbe ok...thanks for asking :-)Lago - I had stretch marks during expansion and have none now after exchange. The nurse practioner said that my skin was only temporarily being stretched to that size and because of that, stetch marks would more than likely go away, which, thankfully they did. I used lots of lotions and oils to help the skin, too...
I liked the article on scarring - my steri strips just fell off (with a teeny bit of help ;-) the other day, I was stunned ny how good my scars look, even smaller than after my BMX. I think my PS must have done some work around the incision, it's remarkable - they are really like just a pencil-line in the IMF now...I haven't applied any lotions/oils - when did you all start treating the incisions? Interesting about exercise, too - I have just started riding the bike at the gym and am so aware of staying away from any upper-body movenment, I didn't stop to think about the heart-pumping benefits for the scars - good to know!
-
Maripili: It has been 2.5 years since my BMX - and I can hardly remember how I felt or how much pain there was with that surgery. I was online posting away [like Carrol2] , the day after my surgery. I was driving ten days later and I would have been driving sooner, but I had to get over my mortal fear of the seatbelt! A fluffy pillow solved that problem eventually.
The procedure you refer to is the one-step with Alloderm. You would honestly need to be seeing a PS who performs this procedure with a good degree of success - which means he/she does it with some regularity. You have to be a good candidate for this procedure - the tumor can only be so large and must be in the proper location and you need to either have sufficient skin flaps pre BMX or be willing to be possibly quite small. It is one certainly that anyone opting for a prophy BMX should consider as an option to TE placement. I presume your PS would have already discussed this with you if he is familiar with the procedure and felt you were a good candidate.
You can do this....you will get through it and be on the other side of it before you know it!
-
Well I can report my findings: after using silicone scar treatment for one week, my scars are flatter, softer, noticeably smoother, and generally less angry looking. I am seriously impressed! I used the generic scar tape from CVS, it was $23.99 for a box of 28. For the amount of use you get out of them, and the results: I'd even pay double. I love the results and it's been a week!
I know it takes longer for true results, but I see major improvement where my drains were, already. Each drain was showing two distinct scars, one large red indented area, and a smaller minor scar where the drain was sutured to my skin. Well, the minor scar is gone, and the indented dark red scar is now flat and light pink!!! I thought that scar was here to stay!
My BMX scars are much flatter and just...more even. I have been using Bio-Oil for my scars too, and actually I rub that on, let it soak in completely, then apply the silicone tape.
edited for corrected info, thx tampa!
-
fire-dancer I don't remember when I started using Vitamin E oil (trader joes). My PS didn't tell me to use it my PT did so it was at least 4 weeks after my surgery. I wish I had started sooner but I didn't know.
-
You really should wait to use oil on wounds/scars until they have healed. There is a risk of infection prior to that (even if from bacteria on your hand as you rub it in). So, Iago, in your case, waiting four weeks was probably wise
-
Cameron, the CVS silicone scar sheets are on sale at cvs.com for $14.99 right now. The online box says it has 28 per box and is regularly $24.99 and on sale for $14.99.
-
Thanks Lilah and Whppetmom...
Hey I got a whistle today! Just about fainted hahahaha
-
LOL Annette -- wahoo!
-
Whippetmom,
Need help, obsessing over getting "foobs" perfected. I am 5"4, 127lbs, 34" ribcage, have TE's at 485cc's. TE's are so comfortable and loving the size, PS did an excellent job of placement. Exchange surgery is May 2011. Thinking of 475cc high profile Mentor silicone gel. TE's are mentor 550cc max., Moderate or tall - I guess, PS recommends high profile implants. I do not want nipples, but want the "round" look of TE's and they have a nice width I feel them on the sides a little which I like, will I have the same projection, should I switch to Mentor moderate profile? I like the way I look in camies and t-shirts in my TE's now. Do not want to be disappointed as happy with TE's. Should I be happy with 475cc gel silcone implants? Thank you and to everyone here.
-
greytcruise, whippetmom's gonna ask you for your TE specifics: what volume are they and are they low height, medium height, or tall height?
-
Thank you Cameron,
Mentor max fill 550, do not know the height, PS never mentioned it. II would guess medium or tall as PS recommended High Profile implants?. I am learning so much, this is just not as easy of a process as I thought it would be.
Thank you!
-
greytcruise - Did you get a card after your TE placement? All your TE info is on that card. I hear you on the ease of the process. I had no idea either ... but you're on your way! You can do this!
-
annettek: I was giggling about your "whistle". When I first saw this, I thought, "oh, does she have a dog that is whistle trained?" Because I just bought a special whistle from England to use with my dog. But you were referring to a different kind of whistle and a different kind of dog.....LOL...
But anyway, congratulations on the whistle!
-
Hello whippetmom and DawnHope, Do not have a card still have TE's, recommended by PS to get 475cc mentor smooth round high profile. Mentor contour TE's are what I have, currently filled to 485cc's.
Trying to know if I will be about the same size as TE's with the 475cc high proflie smooth mentors or if I should do moderate high profile. See post above for what trying to achieve. I like the look and size of TE's now. How are you doing?
-
Hello girls...finally made it over 600 I am at 625 before rads start on Monday and he said we may do another fill or two RIGHT after rads. I am so pleased though...who thought after a delayed reconstruction and loss of all of that skin that I could stretch that much. I also posted a few pics on the well burnt site and will continue to update. God Bless.
-
OK back from my first fill. I barely felt a thing. It was nothing at all. I have 650cc expanders that were filled with 150cc in the surgery 3 weeks ago. Today I got 80cc. I did not feel the needle at all, i did not feel the saline. The only sensation was the extra weight on my chest. so i hope that puts some of you that are as nervous as I was at ease. He was going to use 550cc expanders but decided i needed bigger ones in the surgery. So he plans to get me to 750cc in the end. I'll post new pics on the forum asap. I could not believe it when I looked down.
-
OK new pics of my TEs at 230 on the same thread as before Delayed Tissue Expander Surgery
-
Whipptmom and ladies,
I finally got the PS to tell me what type of expanders that I have: They are Allergan 133MX, 15-15cm diameter, 14 high, 7.6 projection, extra projection, 700cc. I am filled to 750ml now. I like the size, just hate the heaviness, I fell that they weigh 50 pounds, and it is no fun working with patients with them in the way
So, does this mean that to get this look, a D size now, a DD before, that I have to have an 800cc implant? I see the PS next Friday for final fill? How much can you fill these things before they pop? -
Carrol: It's kind of like going through puberty but in five minutes, while you watch. I was comepletely fascinated by the whole process.
Rnjules: Most PS's overstretch and they shouldn't pop. Mostly I just hated that it was hard and weird to the touch. They do get the job done. Mine was stretched to 535 and they put in a 550, so they usually go in with a few and whatever looks best, so yes, you could end up with an 800 implant.
KCMom: So glad they were able to get you there so quickly. Congratulations!
-
MBJ : It is very encouraging to see them get bigger. But if you look at my pics on the forum they are not that much bigger yet. When I first looked down I thought they were but in the pics they only seem slightly bigger. I only got 80cc this time he said next time he would do 100cc.
-
Don't worry Carrol, you will get big. I know you're used to big ones.
-
Well I am used to my curves but I have been flat now since August so looking forward to getting them back.
-
Amen sister.....you can DO IT!!!!!
-
Carol: They will be big before you know it!
-
RNJules: An overfill of 50 ccs is not much at all...not a problem.
-
Btw...Dr meausred on Tuesday and I am a DD..not sure I was prepared for that
But okay! -
KCMomx3 what size are you aiming to be?
-
Glad to make you giggle Whippetmom- you do so darn much for all of us, nice to be able to give you a smile:)
MBJ- that is the best line about going throug puberty all at once@ So true
My EBAY nips came in the mail today- posted them on the pic forum-silly things but actually gave me a hint of what is coming...so I like em-well worth the 10 bucks... I see PS tomorrow for 5 week check up for what is next...
-
KCMOM: A double D is a high class problem.
-
Hello Whippetmom...
I had my exchange yesterday and was hoping you can impart some advice. I am petite...110 lbs and 5 foot1, I was a very small 34A cup to start. I was in 250 TEs expanded to 330cc. Dr. exchanged for Natrelle 20..350 on one side, 375 on the other side that had multiple biopsies). Incisions made under the fold. I peeked under the surgical bra and gauze today and was shocked to see that I look like I am way smaller than I anticipated. I was hoping for a full B. I am hoping things fill out---is it possible for 350cc's to be less than a B cup!?
Any thoughts appreciated!
Ilene
-
takeadeepbreath: Whippetmom will need your measurement under your ribcage in order to help you. Also, do you know the make and model of your new implant? It can take 1-4 months before your new breasts settle in and fill out to the size they are actually going to be so give them time! Most of us look like we have hamberger buns to start but they will change alot.
-
takeadeepbreath - I can offer my experience ... I'm your weight but about 4 inches taller and my ribcage is 28.5 inches and I was exchanged with 325cc silicone high profile implants. I'm a 'D' cup. But I don't have the projection of a 'D' ... just the width. One day out is no predictor of what you're going to look like. So ... do what you're avatar says! ... take a deep breath and wait it out. MBJ is right ... they will change A LOT over the next few months.
-
Thanks ladies...maybe I should change my avatar/ name to "Neurotic in NYC". Despite reading these boards for months, I was convinced I would peek under the bra to find Jennifer Aniston's boobs not hamburger buns!
-
LOL TakeaDeepBreath (on the possible new user name
-
takeadeepbreath: I think Jennifer Aniston might get mad if you woke up with her breasts, lol! Give it time, they will soften and expand some.
-
Deep breath,just wanted to let you know that mine look like hamburger buns one day out as well! I did hear it takes a bit to really know the size. In fact, I think my PS said to not even bother going bra shopping and getting fitted for 4 months!
I'm sure they will become Jennifer Aniston boobs in no time! -
Don't tell her but I am trying to get Angelina Joilie's boobs . . you think Brad would mind?
-
OMG what am I doing here? I think I'll head back over to the "Implant Exchange (oYo) ~ Anyone go/stay SMALL?? (B cup)" thread.
-
takeadeepbreath- what everyone is saying is true...they change everyday...there is gravity & LOTS of healing taking place over the next months to come...
-
Carrol: LOL!
-
what do you mean when you say that implants are subject to gravity, my PS says no.
-
Rnrules: The only ones that don't do this are the gummy bear implants. It's how the implants finally fall into their proper place and the muscle finally relaxing!
-
ditto what MBJ said- gravity has to work or we would all be walking around with oranges/grapefruits/etc on our chests...
-
thanks girls,
I am really paranoid right about now because I was a former 38DD, and the TE's are 700cc capacity, currently filled to 750cc. I see the PS next week for the final discussion about impant size. I really like the size of the TE's, but of course, hate the TE's! I am reading so many posts where girls feel that their final implant size is to small. Does anyone know how much TE's can safely be overfilled?
-
Rnjules, my 275's are filled to nearly double capacity but I think it gave whippetmom a heart attack so don't try this at home. Pics on the forum, awaiting E-day May 23rd. Anxiously!
Have you shared pics, what have others said about the size? Sometimes you can't actually "see" your own foobs, you know. It's commonly referred to as foob blindness and it must be stopped. Full disclosure: I made that last part up.
-
Rnjules: Give Whippetmom your height, weight, rib cage measures and she will get you to where you want to be!
Cameron: Lol, I have some serious foob blindness!!
-
hiya RNJ- my TEs were filled to max- 450- the PS took in three sizes of implants and I landed up with 550s- exactly what I wanted and what fit my body.- And Cameron is so right baout foob blindness- I think it takes weeks, possibly months to actually see them - I saw mine clearly yesterday and blinked! I am loving them more and more and more each day- had a cute summer dress lounger thing on last night and hubby cocked his eyebrow and said- you know something? You look really great. What was really cool is that it was one of the moments in everyday when I was not asking him if "they" looked good hahaha
How cool is that?
-
Annettek - Its so good to see you again!! It seems like moments since you were filling those TE's and I was dealing with MX. Your pix on the forum looked great and Im so happythat DH is sitting up and taking notice!!! I got one of those when DH touched my leg and said "wow, your workouts are really starting to show!"....its nice to get an unsolicited compliment!
I really want to ask Whippetmom about my exchange but I need to find out the specs on my TE. I know its a Mentor 350cc but thats all I got. I upgraded what I want to be from 'full B/small C' to just a C. We were looking at first for a 350 implant but PS said I can go as long as I want with fills....to be as big as I want. Im at 335 now and....well, Im getting boob greed. I want more. LOL. I dont see PS for 2 more weeks due to a vacation falling on my fill week...grrrr. But I get 80ccs each time so I am really close to done now.
-
RNrules: I had 600 cc TEs filled to 850 cc. I ended up with 685 cc implants and WAS a 38 DDD and ended up a 38 D (sometimes a 38DD, depending on the bra). What size you end up depends on the measurements that MBJ told you to send to Whippetmom (who will help you)...
-
whippetmom I am 5' 6" 140 pounds with a 32 in rib cage. You have seen my pics on the forum. I ahve 650cc moderate profile expanders. My PS is planning on filling to 750cc to get me to a large C small D. Does this sound right to you?
-
Suebee- it does go by fast in retrospect! I am totally thrilled with the size and once I get to working out again, want the rest of the body to match:) Just have to see if I *still got it*
-
Annetek: I just started working out again and I so know what you mean! I used to be in such good shape and the foobs are inspiring me to get the rest of me looking good!!! It's not easy but I am very motivated.
-
takeadeepbreath: You have had all of the good answers I might provide. The size of implants you have will be just fine - the size I would have recommended. You will be larger than a "B" cup. Give it two weeks, as the implants often look squashed, misshapen and like the bottom half of a hamburger bun right after the exchange. We have all been there! I would advise getting into a good bra which encapsulates the implants - so go to the Bras 101 thread to get in on the discussion there and someone can help you with sizing issues. Dawne-Hope can help you by sharing what has worked for her. But MBJ mentioned your ribcage circumference. With your height and weight, I think you would more likely be wearing a 32 band bra.....
Deborah
-
Carrol: I responded on your thread on the pic forum...and here is what I wrote:
Carrol: 650 ccs filled to 750 ccs sounds too huge for you. You only want a C
cup and you have a lot of skin. This is just going to create more ptosis -
droop. Frankly, I think 500 ccs would be more than enough to get you where you
want to be. Make sure you let him know you REALLY want to only be a C cup and
that you do NOT want droopy breasts. But that said, you look very good at this
point in time. Let's see your photos after your first in-office fill. -
Suebeebc: What is your height, weight and ribcage? I can give you some idea...
-
whipetmom I did see your comment on the pic forum but at the time i was unsure of the size and I double checked at my first fill. Don't you think that my doctor knows no one wants droopy breasts? I can't even imagine saying that to him. I suppose I could express some concern. What make you think that them being large would make them droop more? I was more worried about the width. I don't want to feel too wide. I suppose they have to work with what is there and if I am wide he needs to use a wide expander. Since I was so big before DD and they were on the wide side.
-
Whippetmom - thanks!
I'm 5'5" and 118 pounds. My ribcage is 29.5. My TE is a Mentor 350 but thats all I have on that. I had a single and plan to augment the other side. I was a very small A before and was thinking (hoping) I could carry off a C cup. My first PS thought a full B would be better but my current PS thinks I should fill until Im happy with my size.
Im currently filled at 335 and can wear a 36B sports bra (with foam cups - so I can fluff my other side to match). Its really hard to tell with only one TE where this whole thing will take me.
Maybe I should post some pix on the photo forum?
-
Sue: I would recommend 425 ccs in a high profile smooth round silicone implant. It takes that much volume to approximate what you have with the TEs, and, after doing this for two years, I can tell you this is what would look nice on your frame and give you the results to hope to achieve.
-
Carrol: 700 ccs is a lot of volume for your frame. You have sufficient skin flaps and so I just don't think you need to expand out any further than around 550 ccs, quite frankly. You just do not know what is in the mind of some of these plastic surgeons. Some find it a challenge to make women look like they did pre-MX. If you do not make it abundantly clear what you WANT, you will have no control over the outcome.
-
whippetmom, I do not have all my details but wonder if you could give me an opinion prior to my next PS visit. I know my TEs are Allergan, not sure size, but I know I am near capacity and I have had fills to 425, we talked about adding another 50cc on next visit. I like what I see now as far as size. I am 5'2" and 150 (gained weight with chemo, hope to lose 10 once I finish, but never going to be real thin). I measure 34 inches at ribcage under TEs. I think now I am a small C, I was a D prior to surgery and prefer to stay a C. Is this enough info to give thought on implant size? My PS already suggested a high profile implant.
-
whippetmom good point. I should make sure he knows what i am thinking afterall he is not a mind reader. I do think he is trying to get me to look like I did. But I did tell him I did not expect to be as big or a droopy. He had tole d em that sometimes it's hard to get a good skin fold, seems like not true in my case.
-
whippetmom - thanks so much for your advice!!! I appreciate your expertise and all of the time you spend on these boards very much.
-
Handing Whippetmom a big chocolate bunny for all of her help to all of us!
MBJ- i was working out my legs and waist in the pool yesterday-hubby showed me some cool excercises that don't touch my pecs (pesky damn pecs-only thing on me that is tight!)...i feel so much better after just a little bit. Of course I blew it all out eating a feast of really good chinese food-but worth it:)
I am preaching to the choir here but it is so important for all leading up toyour exchanges to really talk to your PS and let them know what you are looking for. You are a team. Sounds simple but it is not. My shirts, tops, dresses...all are just that much snugger than before- and I always wore lightly padded underwires to offset what age and babies did to my poor breasts...It is so fun and exhilarating to really be happy as the process goes on...taking care of the rest of me follows as I want to look as good as these new boobs are turning out...before BC i has considered and then discarded the idea of implants-not wanting to risk needless surgery and making peace with my droopy boobs through vigorous chest excercises and really good bras! It is so cool now- that through this whole horrible BC crap to watch these new boobs grow and come to life-to be a part of me...I don't mourn the old ones at all, they did their job- these new ones are for me:) My PS knows how whacked I am and we have a lot of fun discussing them. You don't have to be friends with your PS but certainly in a place where you feel free to talk and question. PS, I think by nature of their profession, are a bit, um, shall we say, egotistical...so it is fun for me to just drop the statement to mine that "I want great boobs, is that what I am getting? Are these good ones? Are they the best you have ever done? Will they be?" I say something to that effect during every visit and he stops completely, wrinkles his forehead and looks at me over his glasses. I might well be asking if his mom is a hooker. He knows that while it is true that I realize reconstruction is much different than a "boob job"- I want him using every skill he has to make it look right. So, sure, I praise him every step of the way-people need that, but he knows where I am coming from. A good PS can be a good sounding board for the whole BC journey as of course they see so many of us with so many various DXs, etc.
Have a great day-
-
Whippetmom- I am asking this kind of late, but would love your opinion. I am 5' 6 1/2", 117 and my rib cage is 28 1/2. Before my BMX I was probably a large A. I do not know what size my TE's are, but I am filled to 360 cc's and am having my exchange on 5/2. The PS has ordered 260 and 280 Allergan style 20. I am hoping the can use the 280's. What is your opinion? Thank you....Eula
-
annetek you are right they should know what you want.
I did tell my PS that after my bmx with no recon I was happy that i looked thinner so i did not want to be as big as i was. I don't think he could get me to a DD if he wanted to. I call him Michelangelo and that I am his next masterpiece. I also refer to myself as a work in progress. I don't know how the TEs will compare to the final exchange. I keep hearing people surprised that they are so much smaller. So I guess you can't really judge what is happening by the TEs. Mine says the final will be very different. He says that there are things he will fix in the exchange. I was surprised though that he used a 650cc expander instead of a 550cc. He said the 550 cc did not look right on me.
I do think I will review with him my concerns to make sure he knows what my expectations are. I know he is concerned that my expectations may be too high. He may be right. But even the TEs only filled to 230cc now, look better than I did after bmx with no recon. We do have to remember that this is not augmentation but reconstructing a breast and it is much more difficult. I imagine that there are some things about the way this ends up looking that even the PS can not predict.
-
I was very clear with my PS that I did not want to match what I had-it would remind me too much of what I had just been through. I asked him to give me something better (i.e. bigger) so that I was happy with my breasts not looking at them and comparing it constantly to my natural side. I am so glad that I did this! Although it isn't the same as an augmentation, they do look much nicer then what I had before. This result only happened with Wippetmom's help and many, many conversations with the PS. It wasn't until I was going into surgery for my exchange that my PS finally agreed to try and make mine the same size as the expander. I told him bigger was better and he delivered.
-
My old boobs look so small now that I have these giant expanders (reference photos). My PS is making me a full B. I was a large A/small B before. I hope I don't go too small but I know right now I feel ginormus.
-
lago: My expander felt humongous!!! Because I only had one side done it looked so strange and weird, too. Know that the implants, though a bit wider then a natural breast, feel so much better and also look better! The main reason I went bigger was because I didn't want to look at my breasts and feel like something had been taken away-I wanted to see something new and different. I am also very tall (6') and in order for clothes to fit I always had to wear a padded bra which I hated. Now I only wear a padded push up if I want to look voluptuous, otherwise it isn't very obvious that I did anything. Even though I am now a D-DD cup, I look like a C and even sometimes only a B! It just depends on what I am wearing. I decided to use BC to get the breasts I never had before and the bonus is they look like the size I should have been born with- Now my top matches my bottom.
-
hmm i worry about being too big or too small. I don't want to be as big as I was DD. But I also don;t want to be too small for my frame, or lose that curvy feeling i had. I figure a C is good because then I can get clothes that fit me better. I am concerned. I guess I better make sure I express this to my PS. I don;t want to be wider.
-
Carrol your frame is smaller than mine isn't it? I'm 5'6" and wore a 34 band size. If I remember you're a 32 band size. I'm also wider in the hips then you. I doubt a C will be too small.
-
Ladies, always remember that the bra size you will wear after exchange will not be the same as how you look! the wider implants may make you a D, but I look nothing close to my friend who wears the same size bra-she is a 34DD and truly is "hooteriffic" where I still look small in comparison. What she has is in projection and what I have is in width. They still look great
. Carol: I would follow Whippetmom's advice if you want to be a C. My measurement around my new breasts matches my hip circumfrence which is a perfect balance. How she did this based on height and ribcage will always be a mystery to me.
-
Ditto what MBJ said about the numerology of reconstructive breast/bra sizes. Go for how it looks (not cup size).
MBJ -- I remember you used to call your TE "frankenboob" didn't you?
-
Lilah: I think I was so afraid of ending up with a frankenboob, LOL! A bunch of scars and a couple of bolts!
-
Lago when you look at a 4x6 of your old boobs, of course they look smaller!!! Yuk, yuk, yuk. Kidding.
Annettek - I agree...I need to stop telling my PS "I dont know, Ill keep filling until I say stop". I know I want to be bigger than my expander is now. But I just want to fill out some clothes and look good in them!
I have no intention of shooting for DD's....my BFF is teenie petite but has DD's and HATES them. She would have my head if I even thought of going there! LOL.
-
whippetmom and mbj
Well i guess i could mention to my PS that i am afraid of being too big. But i am also afraid of being too small. I am saying a C because i want to be able to fit into clothes and DD was hard to find. whippet mom is saying 500 he is saying to got to 750 but not sure what size implant he has in mind. But I don't want to look too small either. I want to look curvy, I have small hips and a flat white girl butt. My DDs always made me look more feminine. After my bmx I kept looking in the mirror at zumba and thinking how boyish i looked. Maybe I could tell him when the expanders get to a size i like so he has a better idea. Then again it's hard to tell in my expanders because they are crooked and look different. I think i have these expectations of having playboy boobs and I better think more realistic.
-
Carol my thought about the C's is the same as yours. I understand that clothing manufacturers tend to make tops based on C being average. Its always why before my shoulders would fit, the length would fit, but the front would hang like a billboard unless I went with a smaller size. I want to be able to look 'good' in clothes...not be a porn star or get a job at hooters. I am also boyish shaped now that I lost a chunk of weight but I do have 'back' (just a little bubble)...I think how the boobs look will depend a lot on the clothes we pick.
-
So that's why I had trouble even filling out some size 4 jackets Granted all my blazers fit well in the boob area now.
-
Suebee so true we will have to really rethink what looks good on the new body. I would not mine looking a little porn star when appropriate myself. I always had great cleavage and looks like so far i still will. I always had trouble with dresses, jackets, blouses fitting way too tight around the bust. I would have to either go with the tight look or the really baggy. I almost never buttoned a jacket. Forget about buying anything that is a 2 piece outfit my top would be a 14 and my bottom was an 8. So would really like to balance things out a bit.
-
I just want to chime in here about cup size ... don't focus on cup size because as MBJ and others have stated ... silicone rounds are waayyyy different than your TE's.
I was a 32C (small C) before my surgery and now I wear a 30D but my dress shirts ... I look smaller, way smaller projection than I had before ... I wear a 30D but I look like a B cup. Please, please, please don't focus on cup size because it will deceive you. My PS likes to overfill and when I reached the size I liked in my TE's ... I talked to my PS and we decided on one more fill and I still don't have the projection that my TE's had ... remember that your TE's are hard, rock solid and that gives you more projection ... when those are out ... they're putting soft silicone in there with absolutely no breast tissue behind it ... you're not going to have the projection you have with your TE's. I forgot what whippetmom said but I think you have to go up 50cc's (??) in the implant, depending on your ribcage and other measurements, to get the same projection that you have with the TE.
-
Lago its the curse of the 'petite' woman! LOL I just went suit shopping for the first time in about 14 years. I think the clothing companies are playing games with me....I ended up with a 4P. When I was in the workforce, I was a 6 regular...now I know I lost weight but come on! I shrunk too?? And the good news is that the jacket is definitely not HANGING on me like they used to!
Carrol yes 'porn star' has only one good application that I can think of. I hardly think my kids would like me to dress like that when I pick them up or volunteer at their school!!! OMG Moooooooomm!!!!!
-
SuebeeBC O M G !! I don't have kids but i know what you mean. lol At 46 there are not that many occaisions to dress this way. But when I go out with my husband I Like to ramp up the sexy as much as i can tastefully get away with. I may be 46 but I still feel like I want to be desired by others. Right before my diagnosis I lost 23 pounds and got a personal trainer, my body was looking better than it had in a long time. I want to get back to that as soon as I can. I have always worried about being frumpy. The past few months the focus was to not look like I am or was sick. So still a work in progress is I how I rationalize it now.
-
Dawn-Hope is so right about this! My PS asked me if I wanted to be the same size as the Expander and I said yes but I have no where near the same projection even though i received 25 cc's more. Maybe with a padded push up bra.
Suebee: Your BF may have double d's and hate them but you would look like a C cup even if you fit into a double D bra because it's mostly width, not projection.
-
Carrol - Absolutely agreed.
MBJ - EEEK at the thought of fitting into a DD!!! LOL - I just wanna look good....trying not to get hung up on numbers and letters, really.
-
I have a huge draw full of 34 and 36 DD bras I could not bring myself to get rid of after my bmx. I put them away and if I need them I have them. But I am hoping that I will need a smaller bar after all this.
-
BTW: Even though I am somewhere between a 34D and a 36D, clothes fit great now! I am tall, so I can wear anything from a small to a large depending on the manufacturer, however across the board, I am pretty much a size 8.
-
MBJ I would like to be able to wear a size 8 dress when this is over. When I was a DD I had to wear a 12 or 14 to fit around my boobs and then the rest of the dress was a tent. Needless to say I was more into skirts.
-
Sue: I just read your post again and caught that you are a unilateral. So you know, I might revise my recommendation and place you at 375 ccs. Just so you have a little room there for some ptosis and also so that your PS will not have to overfill that TE.
Deborah
-
Christine47: What I really need to know is the width of your TEs. So essentially this is why I ask for the style and volume of the TEs. But that aside, I feel you probably would want to have around 500 ccs to 550 ccs in a smooth round high profile silicone implant. At least 13.0 to 14.0 cm in width. When you say you like what you see now with your TEs, it means we really want to nail down the style and volume, so that I can firm up my recommendation for you.
Deborah
-
Eula:
This is what you wrote:
I do not know what size my TE's are, but I am filled to 360 cc's and am having my exchange on 5/2. The PS has ordered 260 and 280 Allergan style 20. I am hoping the can use the 280's.
This might be too small for you - certainly at 260 ccs. You need to call your PS tomorrow and tell them you want to revisit the sizing issue. It is most certainly not too late. I would prefer 300 ccs, but certainly 280 ccs would be the bare minimum. I really would like to know the style and volume of your TEs though - not what you are filled to - but the recommended volume. So call the office tomorrow and get this info for me....
Deborah
-
whippetmom,
I see my PS in about 3 weeks and will get the exact specs on my TEs. My PS is young, but wants me to be happy, and has told me to let him know when I am happy with what I see, he will have no problem with me asking questions. I so appriciate all the work you put into helping us all! What you give back is truly amazing.
Christine
-
Whippetmom - you would still go with the High Profile Smooth Round as well? Does the HP give better projection? WIth my going for augmentation before DX and then having 2 different PS's since DX, I know that 350-375 was thrown out at some point. Im getting so lost in the numbers now as I have heard everything from 325-450 on the MX side. I am going to have to bring your recommendation to my appt next time and really hammer down where we are going. At 335 now and while I like it, I dont feel quite big enough yet. I know there is no comparison between TE and implant so that makes it harder to know where I am headed. Sorry that was a little ramble. Thanks again.
-
Thanks Deborah....I will call tomorrow. Do you think the 280's will be too small? (I know you need the other info) At my last appointment 3 weeks ago, if I wanted another fill, then I would have put off surgery. I guess I should have come here first. I am also have a revision to my margin at the same time so I would have to be reschedualing 2 different surgeons.
-
Eula....Absolutely NO smaller than 280 ccs. I would prefer 300 ccs. You can call your PS' office and tell them you would prefer they order 300 ccs HPs as well.
-
Suebeebc: Well....if you are happy where you are, and if your PS is willing to go for it, I would say shoot for 450 ccs in a smooth round silicone HP implant on the MX side, and then whatever size is needed for symmetry on the native side. If your TEs are 350 ccs and you do not feel you are big enough, you are going to want at least 425 ccs and optimally, 450 ccs to match what you will have at maximum fill with your TEs.
Edited to add: Yes, HPs for you - not anything but HPs. You have a narrow ribcage. If you were going smaller than 350 ccs, I would say moderate plus profile implants would be an option - but as long as you are hoping to be in the "400 Club", HPs will be the style for you.
-
Sue - I didn't realize our measurements were so close - I'm 29 in rib cage, 5'6", 120 lbs and I got the 450's HP. I really don't think I look monstrously big, like a nice C maybe...Whippetmom pointed me in the right direction with her advice and that helped me push for the HP's with my PS. He doesn't normally go for them (HP's) but he even said after surgery they were a perfect fit for my frame...just my experience... but wanted to share with ya - I agonized over 400 or 450, and I have no regrets. I was so nervous because the TE's felt huge and it was hard to imagine how the implants would "fit"...but like everyone here says, implants are nothing like the TE's, and I'm glad I took the plunge and went 450...
-
Thank you for chiming in Megan!
-
Thanks to both of you!!! Deborah, thanks for explaining why the HPs are the right thing to do. Meagan I still wish I could see pix at some point - you need to find a private computer!!! ;-) I think Deborah has pointed a llot of people in the right direction...its why I finally wandered over here!
-
whippetmom- Hi! Well it's finally time for me to harass you. (c: I have Mentor TEs expanded to the max of 450cc. My rib cage is 31", weight 150 lbs, and height 5'3". Any help appreciated. Thanks much!
-
Hi whippetmom - This is my first time posting. I have been a lurker on this site since November and found that you have a wealth of knowledge. It's time for me to discuss implant size. I'm not sure what type expanders I have but they are 400 cc and I will be getting the Allergan 410 gummy. I'm 5'2", 127 lbs. and my rib cage is 30. I am currently expanded to 340 and will be going up to 400 ccs next Friday as my final fill. My surgery is scheduled in June. I was a small 36B before BC, and I would like to be a full B. My PS has suggested 350cc. It sounds small to me after reading all of your recommendations. Let me know what you think. Thanks!
-
Posting some pics on my thread tonight of me now at 625 before rads in a swim suit....I will try to take more my camera is on the flip;( I am very happy now just hoping rads doesn't impact results:)
-
Nolo -- the nice thing about the Allergan 410 gummies is they have better projection than regular silicone, so should have more shape than a regular silicone implant of the same size... but I'll let Whippetmom weigh in officially!
-
Thanks Lilah! All this sizing is so confusing. I was just going to let the PS figure things out until I came upon this thread.
-
Information is power, Nolo
Always of course talk with your PS... but having info will help you to have good talks with the doc! -
Adey: If your TEs are filled to max, meaning they are 450 cc volume TEs - and you are happy with your size, you will need 550 ccs in a high profile smooth round silicone implant. It would be a good size for your frame.
-
nolo: Well, the style is important when you are opting for the anatomicals - the 410's - as the pocket is expanded with the end result - the size of the future anatomical - in mind. So I would need to know if you have a 12.0 cm wide TE or a 13.0 cm wide TE. But you probably would be in the 350 gram to 375 gram size range. The sizing is quite different for the anatomicals..] Find out more about your TEs and we can nail it down a bit better for you. But Lilah is right about the projection and enhanced dimensions of the anatomicals.....
-
whippetmom I am in need of some advise, I have mentor 650 TE's that are now at 525cc's. My ribcage under breasts measures 31" and I weigh 135lb's and I am 5'4". I was a DD before but only want to be a C cup afterwards. When do I need to stop the fills in order to be that size? My PS says when I'm happy with the size he'll do 1 more fill then wait 6 weeks to swap to silicone implants. Thank you for your help.
-
Thank you whippetmom. I will have to get the size of the expander. It's amazing what information they do not give to you unless you ask for it. For the implant, he did mention 350 full height and full projection. He said full height because I have a divet above my left "breast" from the mastectomy and he said that using the full height would fill the divet in. He said that fat injections do not work well for that. I'm concerned because I am petite and I don't want my foobs starting under my chin with a full height! I almost feel like asking him to bring a moderate height implant for the surgery to see what looks better. Should I look into the extra full projection? So I gather that the gummies go by grams and all other implants go by cc's? Thanks again!
-
Thanks Whippetmom! Yep 450cc filled to max and a good size but I'm thinking maybe a bit bigger...? I had pretty much decided on silicone but am wondering if there is a benefit to saline. Not much to be heard about saline these days. Thanks again. (c:
-
brca1953: I feel that you would be happy with 550 ccs or 600 ccs in a smooth, round silicone implant. I personally feel you could swap to that size right now, especially if you have sufficient skin flaps vis a vis the size of your native breasts. But tell me, are you liking the size you are at your current volume? I can also state that you need to not focus on cup size, because you might still be a "DD" [due to the width of implants on a reconstructed breast] but you will LOOK like a C cup. You will never have the same appearance as you did with natural DD breasts. Your clothes will fit better than they ever did, pre BMX. So don't worry about bra size right now - let's focus on what would look good on your frame. I am 5'4", 130 pounds, 30.5 inch ribcage - nearly identical to you in terms of vital statistics, and I have 550 ccs.
Deborah
-
Adey: If your PS will consider using 600 ccs - this would be a very good size for you as well. It all depends, again, on your skin integrity - how your skin is handling expansion. If you had sufficient breast skin prior to BMX, this would have considerable impact on the final volume. You could use 650 ccs - which is 200 ccs over and above the volume of the TEs if you have ample flaps. It can be done and HAS been done, e.g., my implants are 150 ccs over and above the volume of my former TEs. So this is all hinging on how your PS feels about sizing issues. The most important factor is skin integrity and gaining good closure over the implant. You need to get inside your PS' head about all of this.
Deborah
-
Adey....Saline or silicone - it is all up to you. You might have more rippling with saline over silicone - this is a known complication of saline implants. If your PS finds he has more success with saline with breast reconstruction patients, then I might trust his ability to do it right for you. But most breast recon surgeons use silicone these days. The majority of us here on bc.org have silicone implants. There are some pros and cons of both - plenty of silicone vs. saline threads on bc.org to help guide you. You can search for them with the search feature upper right hand corner of the webpage.
Deborah
-
nolo: You can email me your photos. I would need to see where your TEs are placed on your chest wall. I do think that the anatomical implant in the full height or extra full height can possible resolve an otherwise intractable step-off deformity - which really cannot be addressed by silicone rounds. There is a FX and MX and perhaps the MX would be more appropriate. I just do not know, without seeing how the TEs are placed currently. However, I beg to differ about fat graft transfer. Fat graft transfer can most certainly help. It helped me and countless others on these forums. Does it eradicate it entirely? - No,, not in every case. But it can ameliorate and soften the step-off [divot] considerably. PM me if you want my email address.
Deborah
-
Thank you whippitmom, I do feel like I would like to be a tad bit bigger
than I am right now. I think I'll see if th PS can add another 75cc's
next week and call it good. My TE's seem wide, are the implants
shaped differently than th TE's? My foobs seem too flat although
they have started to be less so with the last fill.
Thanks, Jo -
THANK YOU!!!
-
whippetmom i guess it depends on how big you want to look. I am a similar size to you and brca1953 except i am 2 inches taller and my rib cage measures 32 in. my weight is 140-145. so I think I can go bigger. I am now at 230cc in a 650cc mentor expander. I still look pretty flat in clothes. My doctor had said to fill until 750cc i think to go with a 650cc implant. I suppose i should jsut tell him as he fills when i am happy with the size. My next fill is May 3rd I think he will add 100cc this time. I think i would rather be too big than too small, i look very boyish without my breasts, i have small hips and a flat butt.
-
It first depends on your skin integrity Carrol - but if all planets align - and a choice can be made, it indeed does depend on how large or small you want to be. Hopefully this is all communicated to the PS before the tissue expanders are selected and "installed." Because thereafter, the TEs do dictate to a great degree how small or large you will be at the end of the rainbow.
-
brca: If you feel you would like to be larger than you are right now, then I would recommend implants with a volume of 650 ccs - high profile implants. The TEs might be widely spaced right now - as they tend to migrate laterally towards the armpits, unfortunately. Wish more PS' would use the new suture tab TEs to avoid this TE migration/displacement problem. So the implants will be more appropriately placed on the chest wall at the time of the exchange.
-
HEY KC.......keep the faith sister......AQUAPHOR!!!! HEY DEBORAH......I SUPPOSE THIS IS THE BEST PLACE TO FIND YOU DEAR FRIEND AND SAY........HELLO THERE.....:) and....You have yourself a great spring/summer.......love and hugs.....
-
I love you Laura! You have a wonderful spring and summer also! I will see you in September!
-
Carrol I had 10 expansions. My PS fills 60cc at a time. I'm looking for a B… I always purchased a 34A or B bra but I just measured myself and it appears I'm about a 31+ . I too am 5'6" and 137lbs. We must be twins.
-
So Lago that would put you at 600cc and you are smaller now? Guess it depends on how big your frame is to how big the cup ends up actually being. My surgeon had guessed that I would need 5 expansions but he said not to quote him. I had 80 last time. I think he will do 100 next time. Right now at 230cc I look like a B cup to me. But it looks way smaller in clothes.
-
I don't know how much he put in at surgery though so I'm probably larger than 600cc. I'm not smaller now. I have never changed size in the upper torso except when I was all swollen after BMX. I'm all skin and bones up there. Seems like those 34A/B bras were the the wrong size. I should have been wearing a 36.
-
Lago~ wow, you are expanded to over 600cc's ?!? And you are going for a B? Me thinky you may have to change that letter! Lol!
-
SusansG I just read on my PS's website that they expand 60cc per expansion and I had 10 expansions. The nurse said they were putting a little more about a shot glass in eah time. A shot glass is about 60cc. I told my PS I thought I looked pretty good after the 4th expansion. He just smiled and said I think we need to do a little more. He said he likes to have some to "work with." I know he will be creating my nipple by using the tissue that's already there.
The last time I spoke with him we confirmed I wanted a full B. Then took pictures of me in my fully expanded foobs. (He's at a teaching hospital). As I have mentioned before I do feel like a stripper. Many of my shirts I can't wear because they are too small across the foobs. I never thought I would have that problem.
But I do trust him. He spends time and listens. The nurse said to me that in her experience, if anything, the patient wished they had gone a little larger not smaller.
-
Lago~ do you know what size implants he will be putting in? You are getting the anatomical gummies, right? I wonder if those don't have the problem of measuring so much different than what they "look" like?
Either way, it sounds like you are confident and happy with your PS so sounds like you will love your results! -
I'm not getting the anatomical gummies… I'm getting cohesive gel (mentor). If I end up too big It won't be a total loss. My husband will be happy.
I don't know the size. He told me he'll be bringing in a few different sizes.
-
Well, at least you are relaxed about it! Most of us obsess about every detail! Good to be "zen" about the whole thing, I suppose.
-
Its funny Susan but I wasn't obsessed about the hair thing either. I'm just really happy to be alive, cancer free and soon to be pain free once these damn shingles go away. I'm happy to still be me.
-
This has been so helpful to me. I am undergoing BMX with recon. on June 21'st and the more I read here, the more confused I become. I have had great conversations (thank you Sandy!) with others who have recently been through this and will be sure to look at the exchange site.
Here's my basic question: I have a "wide back" 36". I have always been a small cup A-B depending on my weight. Try finding a 36 A bra-even at Victoria's secret, so I've pretty much always worn a 36B, but I swear, a 38 may be more comfortable for me.. But I don't want to go to a C cup. I'm fairly small framed and now at 5'5" and 130 lbs weigh 15 more lbs than I did a year ago-for a variety of reasons. This is the most I've weighed since I was pregnant and I don't think I'll stay at this weight-who know's Maybe I will -menopause? But I can't decide what size I should go for and I would like it to be my decision. I'm planning, at this point, on silicone, tear drop shape...any thoughts? THANKS. Pat
-
Amen, lago!
-
Lago I love, love LOVE your attitude. I wish there was a 'like' button on this site so I could 'like' people's posts.
-
I'm having trouble finding the "exchange site" mentioned in this thread. Can anyone help me? Again, I would like as much info as possible before my final appt. with my Bs and PS before the surgery. Thank you. Pat
-
Rehm - it's called Exchange City -- but really THIS is the thread where you'll get the most help. Whippetmom knows an astounding amount about implants... post your stats (see the header for what info is needed) and Whippetmom will help you.
-
Ladies for the Picture Forum PMs go to Whippetmom, me, MBJ, Firni or Estepp... we are helping Timtam so that she is not swamped with requests. Thanks!
-
thank you.
-
rehm: I am confused. Do you have tissue expanders at this point? If so, I need the style and volume and need to know if you are a unilateral or bilateral. Does your PS have access to anatomical gummy bear implants - Allergan 410s? When you say "teardrop" shaped implants - where did you get this information? The standard silicone implants are round in shape. So clear up these questions for me and I can help you further. Also, your ribcage circumference - measure UNDER the bra line, around the ribcage.
Deborah
-
Lilah: Is that you with your puppy dog? I agree...we need a "LIKE" button...
-
Whippetmom, I PM'd you.
-
6 days out from exchange and glad to report after the initial 'great hamburger bun freak out' (thanks to all here for talking me off the ledge!)....the B-boobs have emerged! They are looking good!...found great inexpensive soft cup/ lightly padded Warners bras at TJMaxx. Wore a tight v-neck t-shirt to dinner last night and you would never know there was a BMX under there. Up to doc today to get stitches out (I don't use streristrips as adhesive gives me rashes, so my doc used real stitches).
Whippetmom-question...was wondering why PSs sometimes use different size implants on each side.I am 350 left/375 right---won''t that ultimately look uneven? After NSM I would think you are working with the same situation on both sides, so just wondering reasons docs would have to use different size implants.
Thanks all,
Ilene
-
Just wanted to say "congrats" Ilene!!! I was right there with ya! Love the "great hamburger bun freak out"! LOL! I have a visit with my PS today and will have to tell him that one! I'm loving my B-boobs too! I feel like ME again!
-
Susansgarden: Glad to hear you are loving your new Foobs and feeling like yourself again! Such a long journey!!
Takeadeepbreath: It is common to get two different sized implants! Sometimes they have to do more pocketwork on one side or one breast was always larger then the other (that would be me) so the PS tries to aim for the best symmetry and sometimes that means two different sizes.
-
Whippetmom -- yes that's me and my dog (who totally manipulates me every chance she gets)! A few years ago just prior to BC and chemo, so that's my original hair. Sigh. I don't think I'll ever get it that long again!
-
Lilah: Beautiful....both of you! Your hair will get that long again....
-
Ilene: It happens occasionally - even with NSM gals. Our chest walls are unique - we might have more projection of the chest wall on one side more so than another, which might require a different volume. Any little spinal issue, like lordosis or kyphosis, no matter how minor, can throw off the chest wall projection just enough to require a modification in volume. With our own natural breasts, prior to BC, many of us had one breast smaller than the other. My right was always nearly a cup size smaller. So one of the benefits of cosmetic repair is that doctors can make up for that differential. For the first time in 58 years, my breasts are symmetrical!
-
I am in an usual situation in that I had rads BEFORE my mastectomy and TE's (orig had lumpectomy/rads). Would this make my implant more likely or less likely to fail on rads side?
And I never got that card! I need to ask my doc....have NO idea what size they put in....
-
Fearless_One: It is a hard question to answer. I personally think it is likely that the longer the period of time after rads - the more the skin has had to heal - might be beneficial from the standpoint of viability - skin integrity. There are two schools of thought regarding the timing of radiation and breast reconstruction and neither seems to outweigh the other, from what I have read thus far. But certainly, having skin which has not recently been traumatized places you in a good place in my estimation. Let me know once you find out about your TEs and I can help you with sizing issues!
-
Whippetmom & rehm- I too will have "tear drop" shape implants. My PS is with a research program & I'm scheduled for Allergan Inamed 410s. I'll be monitored regularly for 10 years. They are gummy, but I've played with them and they definitely are tear drop shape.
-
I am only 1 month out of surgery and one fill under my belt. But I was not told the size of my expander and when I mentioned the size I want to be the PA said you will know by how the TE's look. Does that not sound right?
-
I am only 1 month out of surgery and one fill under my belt. But I was not told the size of my expander and when I mentioned the size I want to be the PA said you will know by how the TE's look. Does that not sound right?
-
kerry32 - That doesn't sound quite right ... how are 'normal' people that aren't physcians or people who work with implants everyday going to know 'just by looking'? That sounds weird to me.
Whippetmom can tell us for sure ... but I think in the U.S. they're supposed to give a card with all the TE's specs. on it after your surgery. I received one and I think it is the law they're supposed to give it to you. Not sure about Canada and other places ... but ask your PS. You have that thing in your body ... you have every right to know anything about it you want to know.
xo
-
Kerry -- just call your PS's office and ask them to tell you the make and model of your TE. Most get a card but I didn't (just got the info from my PS). I did get a card for the final implant. Knowing the make and model of your TE will tell us the width and the capacity. I think what the PA meant was that they will ask you to tell them when you are happy with the size of the TE as a guide for how big to make your implant. That said, implants of the same size as a TE will have less projection... so presumably they would use your expressed wishes about the size of the TE's suitability as a guideline. You should not have to guess though. So call the office and ask for that info; then measure your rib cage as per instructions in the header of this thread and Whippetmom can give you advice that you can bring to your PS to discuss.
-
I never got a card for my TE. I know it's mentor. If I wanted to know though I'm sure he would tell me.
-
I re-read the posts ... and Lilah is right ... probably what your PA meant was the size you want to be. Let them know when you like how your TE's look and then your PS can determine how many more CC's to fill you to get the same volume with the implant.
-
Yes Lilah - that is what they meant - let us know when you feel that is the size you want to be - thanks for phrasing it right for me. I guess they are planning on doing the calculations to get the Implants to that size...but I will ask for the TE make, model. I am just at the beginning so I do feel a little overwhelmed and nervous that I won't get this right!
-
Kerry -- that's not a bad way to do it. I think in some way that's how all PS's do the sizing (really). I know that's what I did... I waited till I was comfortable with the size and then my PS filled the TE more because she likes to overfill (not all PS's do it that way though -- some will put a larger implant in where the TE was). Still, information is power
I did find out what my TE was so that I could see what the implant options were in the kind of implant (gummy in my case) that I was to get; this made conversations with my PS about what I wanted easier. -
I told my PS that I though I looked good after 4 expansions. He smiled and said I think a few more. (He only expands 60cc at a time). I had 6 more! As I mentioned I'm ginormous. Good thing I trust him and I know his philosophy is to enhance the body's natural form not redefine it otherwise I would be a little concerned.
-
LOL Iago -- well he is probably compensating for what he knows is the reduced projection / mass of an implant vs a TE
-
Whippetmom,
I'm wondering if you could answer a question based on the information I have. I know very little about my tissue expanders, but know that they are maxed out (a little over I think). I am expanded to 475cc and am planning on getting 500cc Allergan (or Natrelle) round, smooth, high profile silicone implants. I am happy with my size now--don't really want to be smaller.
From what I've read on here, it sounds like if I want to look like I do now after the exchange, I would need to go with much larger implants. Is that accurate?
I'm 5'll", 140 lbs, and I just measured between 29" and 30" around my chest right under my breasts. Just based on this, do you have an idea of how much larger of an implant I would need in order to look like I do now?
Thanks.
-
in my case my TEs were 450 and were filled to the flipping brim- PS brought in three sizes of implants in OR and went with mentor HP 550 -got me exactly where I wanted.. so far...I tried on a 36 C soft cup bra and it fits perfect..actually better than before BC- I was always kind of shoving them around in there hahaha
-
Annettek,
Reading another post made me think that going about 100cc bigger is the thing to do too. I can't imagine doing that. Actually, I had been filled to 500cc a while back and after 3 weeks of not being able to sleep through the night because of the pain (even on prescription muscle relaxors), I had him remove fluid. He removed 75cc (which I thought was a lot). I felt SO small! I had him add 50 back, putting me at the 475cc. I have no pain--not even discomfort. Can even sleep on my tummy. When I had the pain with the 500cc, it was only at night, so I thought it was a weight issue rather than a stretching issue. But now since I'm in no discomfort and only 25cc less, I think maybe I could handle a higher volume. I just don't know.
I'm scared to go up a full hundred ccs and then be in extreme pain. But I don't want to have smaller breasts than I want because I'm afraid of that for no reason.
-
Lillian - Near the end of my fills, I could only stand 25cc's at a time. There's no reason you have to have 100cc's every time your filled ... knock it down to 60, 50, or less. 100cc's at a time is a lot ... especially as you near the end.
-
Dawne-Hope,
Did you get larger implants than your expanders? If so, were they painful? Since every little bit hurts at the end, I'm scared to put in implants that are a lot larger because I'm scared they would be unbearably painful.
-
TEs are saline and hard; silicone implants are much softer and also designed differently. A 500 cc TE will take up more room than a 500 cc silicone implant (literally). TEs are designed to stretch and that is another reason we sometimes call them "turtle shells"; the final implant is not. So I don't think you would have unbearable pain, Lillian.
-
Lillian - I was filled with 310cc's and was exchanged with 325cc's silicone rounds. My PS liked to overfill ... so I thought I wasn't going to make the 300club. I was really surprised that he got 325cc's in there. The implants were not painful and the 325cc implants were not as large as the 310cc TE's.
A lot depends on your PS's philosophy. Do they like to overfill or not?
And a lot also depends on the style of your TE. Val61 had tiny TE's but exchanged for a lot bigger implants. So ... there are many variables at play here ...
Find out if you don't know, what is your PS's philosophy regarding overfilling? Some do, some don't.
Know that TE vs. implants is like comparing apples and oranges. The pain with the TE's is nothing like how the implants are going to feel.
Hope this makes some sense. Much love to you. Know that the last weeks of the TE are the worst part. Hang in there! xo
-
Lillian- I was SO SCARED before the exchange as I was so uncomfortable with the final fill-I truly felt like I would burst- totally different sensation after exchange- sure there was pain but i believe now the pain was from the work done inside during the exchange- I think i would have been unhappy with anything other than what I landed up with. As everyone has said- the TEs are a different beast-they have to expand our bodies to accommodate our new boobs;) Every single day that goes by they feel more like a part of me and I am just 6 weeks out from exchange.
-
Minus Two: Yes, the Allergan 410s are the only anatomical [[e.g., "teardrop"] shaped implants in silicone. The standard silicone implants are only available in "rounds."
-
Lillian: Are you 5'1" or 5'11"?
-
But Dawne-Hope, your TEs were 250 ccs, right? So your implants are 75 ccs greater than the original volume of your TEs. The overfill is just icing on the cake - it is done so that there is good insurance of skin coverage and in hopes that the PS will get a little ptosis.
-
whippetmom - Yes, my TE's were 250cc. Thanks. I didn't understand it at the time ... but the light just clicked on in my brain! I get it. Thanks!
-
Whippetmom, I'm five foot, eleven inches.
-
Lillian -- you should chat with MBJ. She too is tall (I believe taller than you at 6 feet). She is a uni who augmented her native side to match her reconstructed MX side.
-
Wow, Lillian, can you spare a couple of your inches in height to me, I am a short squirt of 5' 1/2"- and I think that half inch is me stretching. Although I htink I was supposed to be much taller as I have a ribcage of a sumo wrestler and feet that could easily serve as canoes:)
-
Hi Lillian! Wow, I am 6' and 155, so I have a bit more padding then you (wide shoulders and some extra padding in the tummy/butt), but I am 30" underneath my breasts and my PS filled my 400 TE's to 535 and put in 550 on my MX side. I don't know what size you were before, but I look like a full B or C in clothes but I am actually a 34D-DD or 36C-D.
-
MBJ, when you went from the 535 in your TE to your 550 implant, did you seem a lot smaller, or were you still about the same size?
-
Lillian: If your TEs are also by Allergan, then they are likely 400 cc TEs, which are overfilled to 475 ccs. Does that sound right? If so, 500 ccs should be just fine. Read what I wrote above in my comment to Dawne-Hope - that second paragraph was actually in response to your comment. I forgot to insert your screen name there. So 500 ccs or 550 ccs would be very nice on your frame and get you where you need to be. If you have been to the pictures forum, you need to look at MBJ's photos. She has a similar build - same height as you.
Deborah
-
Oops....I scrolled down to see that MBJ had already responded to your post!
-
annette: I agree! If I could just add another measely three inches, I would not have to lose the ten pounds I need to lose before summer.
-
Deborah- we can snatch some from MBJ and Lillian- they'll never notice! Man, I finally measured my rib cage...it is HUGE 32 inches-the only good thing is when I lose MY 10 pounds it really shows I have lost weight. As I posted on picture forum, I am, alas, a MOOSE. A petite moose, but a moose just the same:)
-
annettek - SHUT UP girl! You're not a moose! 32 inches is not huge! You look great! I think all of us feel huge after our surgeries and everything we've been through ... we've sat on our rears recovering! Relax, sistah! You look great!
-
dawne- but if one feels a little mooselike, for the moment, one is:) hahaha I love you guys:)
-
You guys make me laugh wanting some of our height. I always wanted to be several inches shorter. I've learned with a bit of age and life experience to be happy with my height, with everything about me (almost everything anyway)--even my great big feet.
Whippetmom, so do you think that I won't notice that much decrease in size if I get 500 implants?
-
Annetek: I've seen your pictures-NOT A MOOSE!!!!
Lillian: My PS was trying to get me to the size of my TE--Because it isn't hard like a TE so I don't think the projection is the same, however, I do think it is pretty close. I wished I could have gotten to 600's (they looked this big until the swelling went down) but not enough to get a revision. My clothes fit perfect now, so any larger I think I would have had some issues.
I edited this to add: If I wear a padded, push up bra I have the same projection as my TE's.
-
MBJ, I'm hoping to be able to view your pictures soon. I think that will really help me. I'm so glad to have found someone with a build similar to mine going through this!
-
Does anyone already have the tear drop Allergan 410 implants? Any feedback would be appreciated. Sounds like each hospital in the research study gets a limitted supply each quarter. I've been reading the lit & one of the drawbacks is they could migrate so the shape could be upside down. Then more surgery required to remove, and ?? My PS says no 'sling', & don't worry, & this is the same PS that says no bra, so I'm a little concerned.
Since I'm new to the boards, will someone please let me know if there might be an earlier discussion I can find.
-
MinusTwo -- I have a gummy (I'm a uni) and it is great. It's firm -- firmer than my natural breast -- but certainly soft (and squeezable) compared with a TE; it has a lovely shape and has not (and will not) move. I can manipulate it slightly (say to push together with my other breast to make a bigger cleavage) but it pretty much wants to stay where it is. I don't know the percentages but I think migration is not that common. The Allergan 410 has a textured surface so it adheres to the inner cavity (as I understand it) and once you've healed from surgery it stays put. There's a thread here on BCO called All About Gummies where a lot of us have discussed the pros and cons of the Allergan 410. If I were not a uni I would probably not wear a bra... but since I am I need one for the other side.
-
Lilah":
Thanks for the input. I'll go review the Gummie site too.
-
I am at week 5 just had my second fill today. I feel fine just a little tight.
I have 650cc expanders that were filled to 150cc in surgery, first fill was 80cc, second fill was 70CC bringing me to 300cc now on my way to 750cc.
I was told I can now exercise as much as I want, I don't have to wear a bra if i don't want to, and i have to massage them a few times a day.
posted on pic forum under Delayed Tissue Expander Surgery
-
Carrol2 - Did they tell you why you should massage them?
I am having pain in one particular area on the right side and I wondered if massaging would help. Glad things are going so well for you on the fills. Keep it going!
-
When I had my TEs, the PS said there wasn't much point in massaging them, but with the final implants that I should massage them after they heal a bit.
-
westieluv well it's not really "massaging" per say it's kind of squishing them around to help free them from the scars so you don't get capsular contracture. Mine are not really that big yet but i asked him about this because i heard from other women doing it. You kind of squeeze them together, push down on the top and pinch the bottom, a few times a day.
-
Carrol2, I love it that you always ask the questions that I didn't. Love my PS, but never get this much info.
does anyone hear their TEs make squishy/squeaky noises when the are active, bend down, etc?? I know this sounds crazy, but I am completely serious.
-
christine i go into every visit with my PS with a list of questions from what i have read here. He doesn't really say much not very chatty. I try to joke around with him but he is kind of dry toast. But he takes medicaid and I believe he is doing a great job. I just keep reading all the posts and then ask him if any of the issues apply to me.
-
"dry toast" I love that description. My next visit with my PS is next week, for my last fill, post chemo. I hope to schedule port removal and my exchange surgery, so I will have alot of questions. I need to get the specs on my TEs for sizing, etc. I am sure he will be excited when he sees my list, LOL. Fortunately he does a decent job of explaining things, usually before I ask.
-
christine47 - Yes I have sloshing in my TEs. Particularly on the side that had the 8cm tumor & mostly when I bend over to dry my hair. In have 650 TEs and I am filled to 400 so far. I'm glad to know I'm not the only one.
-
Hoping for some input...I am new the the site and need some advice. I was dx 1 year ago, double mastectomy, chemo, radiation -- cancer free and healing nicely.
My PS put in tissue expanders at time of my double mastectomy and I have expanded to 400 cc. I am 5'2, 118 lbs, small build and hoping to have reconstruction in October, 2011. I am really struggling with silicone vs. saline. PS is heavily recommending saline with a tear drop shape. I did some research and tear drop shape is for a "more mature breast"...I am only 38 years old!!! Also, he says he would not go any larger than 400 cc. I don't really even feel like this was the same size as I previous was. At times I feel like he looks at me and thinks...."you should be happy you are alive." Believe me I am blessed and thankful to be alive but I want to make the best decision possible for me.
I've heard from so many NOT to do saline, but silicone instead because of rippling, less natural, etc. Should I get a second opinion?
Any suggestions would be so greatly appreciated.
-
faithorfear- if that is how you feel your PS regards you- you might just need a second opinion for it is BS...you do not owe anyone an explanation or apologize or think yourself ungrateful for wanting the best possible end result. One has nothing to do with the other. That is HIS job-to please you asthetically. The BS takes care of the cancer- the PS is supposed to make it look as good as possible. I opted for silicone-my PS does not do saliine as he feels the results are better with today's silicone implants. I have highprofile 550 round mentors (my TEs were 450s) and thanks to the surgeon's skill- a nice natural shape is emerging with a nice natural fold underneath (thanks to alloderm) yet not droopy in the least. I am 54 and I certinaly did not walk in and ask for old lady boobs! My old ones were a 36 long! These are a 36 full C.
Hell, after all that we have gone through I like having some perkiness going on. They don't look fake at all in the greater scheme of things- which is incredible when you think about it. So ask your questions and if he will not consider your requests- you have the right to change PS and you have plenty of time.God spare us from doctors who feel the need to scold us for actually being excited about our bodies after the travesty visited upon us.
Have a geat Sunday!
-
faithorfearmom: Welcome! You know, 400 ccs to 450 ccs is what I would feel comfortable recommending for someone with your build. So this is not an issue. What is your ribcage circumference? [Measure around the ribcage, under the tissue expanders] Another factor though in sizing is certainly your pre-BMX breast size. If you were large-breasted previously, you might have sufficient skin envelopes - to the extent that 400 ccs might not be large enough. So give me the history as well in this regard. Silicone vs. saline. I cannot debate this here. Plenty of threads on this on bc.org. My preference is silicone for women who are thin and have thin skin or bony chest walls, as ripples are not so problematic as they are with saline. Also, if an anatomical/tear drop shape, the implant will be textured - further presenting a risk for traction rippling. One other gal here is slated to get tear-drop salines - I cannot remember who though. Nearly all of us around the reconstruction threads have silicone implants. If your PS is not interested in hearing what you WANT or what you think, a second opinion is in order.
Deborah
-
Annette.....Whoa....you go girl!
-
Thank you Deborah so much! Approx 3 years ago (after my 3rd and final baby), I had silicone implants...which my OB believes saved my life - and pushed my tumor to the surface (God always has a plan, huh?)...they were Mentor SM Round Mod Plus Profile Saline 275 CC filled to 290 cc.....but I also had breast tissue at that point, well at least a little bit. I would say that I was a full B, maybe a C.
After the double mastectomy as you know, there is nothing there. The PS has indicated that he will need to lift the inner skin, filet it if you will, to allow the breast pocket to be sewn up a bit on the sides and give me some cleavage. Right now, it looks like I have two small grapefruits under my skin....lovely. I am already experiencing some rippling with the expander, my skin is in good condition, but there isn't any tissue to cushion it between!
My chest measurement underneath current expanders is approx 32 1/2." I just want to look as close as possible to my previous body...I am not expecting perfection, but pretty darn close.
Thank you, thank you for your ministry to people like me who are at a loss for what to do!
-
Annette - you rock! You have reminded me that this is my body, my life and my insurance money.
-
faithorfearmom - TE's look strange on almost everyone! I felt like I had oranges on my chest. When I first heard them described as 'tortoise shells' I laughed out loud! So true. Don't be discouraged with how the TE's look compared to the implants. You're in good hands with whippetmom! I too had rippling with the TE's and struggled with the decision for saline or silicone. So many choices! After reading some of the discussions on here, talking with my PS and lots of prayer I decided on silicone. Prayers for you that you'll have wisdom! xo
-
faithorfearmom: You are indeed in great hands with Whippetmom! Without her and the wonderful help of all of the women on these boards I never would have had the strength or the knowledge to fire my first BS and get three opinions. I ended up with one of the finest pair of surgeons available and they just did beautiful work. They listened to what I wanted and it wasn't a fight to get there. Best of luck in getting to where you want to go!
-
Thanks faithorfear- I had a lot of help on here getting that way...Whippetmom is like the best boob coach on the planet...hatching all of us out to fly!
Whippetmom- when I get started....hahahahahQ! lookout:)
-
Saw the PS today & I think we're communicating better. Thanks to annettek & LmFlynn for your PM encouragement. Currently have 650 expanders going for Allergan 410 teadrop implants in September.
Whippetmom - you are amazing. One of your predictions of 410LX - 515 grams was right on since I convinced him to go a little smaller on the width. Currently overfilling to 550 but only 50cc at a time.
I learn something new every time everytime I read any thread on the BCO site and collect more questions for my PS. Thanks to all of your for sharing your journeys and allowing me to join in.
-
minustwo: is that a typo? 650 expanders won't be overfilled at 550.
-
Nope - not a typo but maybe not clear. We didn't agree about sizes before he put in the 650expanders at BMX, but I think he finally believes I want "willowy & athletic", maybe even boyish. He'll fill to 550 and then back off to size 515 implants. He says he'll stitch up the pockets if they are too big.
-
Whippetmom,
I'm a bit discouraged tonight because I though I would be closer to being filled than I guess the PS thinks I am. I am at 575cc now (650 mentor) and am happy with the size. He thinks I need another 150cc's but only wants to add 50cc at a time. 50cc's does not even bother me at all. Is there any reason why I can't have more at 1 time? And do I really need to be overfilled 150cc's? I just want to be a C cup when it's all over. I'm 5'4", weigh 135 and am 32" around ribcage under breasts and 36" above breasts and under armpits. I don't want to be second guessing him but after all this was started the company decided to relocate me and I'd like to have the exchange before I move instead of having to come back for the exchange. At this size is it going to cause problems with the incisions to have 75cc's added at a time? And how much overfill does a person really need?
Thanks, Jo
-
JuJuBe, you sound just like me! I have the same thing, and i am scheduled for a BMX on May 26th. Trying to stay calm and make sense of all the options. Hoping to learn what to ask my PS as I browse through these forums- so glad I found them! You are all very encouraging to those of us waiting our turn....
-
Dear Whippetmom, I just saw my PS to discuss exchange. He's Recommending 410 "Gummies" bc after bilat Mx the silicone could ripple more since skin is thin.
I am 5'2", 114, small frame, wear size 2 clothing, 28" ribcage. Expanders are Allergan 133FV-13. They are filled to 510.
He said he would take into surgery: 410 FX 495, and FF 475, and MF 470. What do you think about this size with the pockets already made with current expander? Thanks so much for your advice! -
All of you gals who are waiting for answers - HANG TIGHT! I have been working on this mammoth design project which I need to finish by tomorrow! I will have some time tomorrow to work from my iPhone to answer questions....
Thank you for your patience. For implant questions, remember, I need to know the style and recommended volume of your TEs - height, weight, ribcage circumference. -
faithorfearmom: If your ribcage is indeed 32" a midrange style @ 400 ccs might be more appropriate. It depends on the style of your TEs.
-
Brca1953: I think 75 ccs - which places you at 650 ccs should be quite sufficient to exchange you out to implants with a volume of 550 ccs. You need to inform your PS of the time constraints. If you are handling 50 ccs fill, you should be fine with 75 ccs. Make your desires known and verbalize th to your PS. Make sure you are both on the same page re: implant size. Ask him his plans for size and see if they mesh with yours.
-
Howard: Look at the top of the screen next to Favorite Topics and click on Private Messages. I sent you one last night.
-
Whippetmom ~ This is totally backwards but value your opinion and looking for piece on mind. I had 350 expanders filled to 360 on the left (Feb 2011 mast) and 390 on th rt as it was a 6 yr old mast and the exp slid a bit under the arm - muscle just didn't want to stretch normally. I'm 5'7" 133 lbs and have a 30" ribcage and wanted to be a full A to a small B. I received 300cc Mentor Siltex Round High Profile Gel Cohesive I (textured) on both sides. Can you please provide your opinion and also do these type expander drop and fluff? I'm pretty new to this so not sure I'm explaining everything properly. Thanks much.
-
ditan3: I suppose the better question is, are you happy with the size of your implants? Based on what you were hoping to achieve, I am not sure that 300 ccs in a HP style is what I would have recommended - nor would I have recommended textured implants. Since you wanted to be small, I would have preferred moderate plus profile style implants, so that you could have the width you need on your frame. But without seeing your photos, I really cannot comment whether they are appropriate for you. You can email me photos if you like. Just PM me if you want my email address!
-
Cindy: Always glad to help! I will be excited to see the end result!
-
I saw my PS for my last fill on friday ( I am now slightly larger than what I would like post exchange). My TEs look great, symetrical and nice and high. My PS will see my again in 3-4 weeks, he suggests at this time he will take photos, and many measurements and choose an implant according to current sure of TEs and his calcualtions. He did many measurements and markings prior to mastectomy as well. Is this usually how an implant size is calculated? He did tell me he would recommend silicone over saline, but my choice, and high profile to better fill out a bra. Also explained he typically brings several sizes to surgery to be sure and will even sit me up during procedure to make sure things looked good in up right position. He seems very thorough and detail oriented. Anything else I should be looking for??
-
Thank you whippetmom! I have decided to obtain a second opinion from a PS on the issue of saline shaped or silicone round. My TE is Style 133V TE matrix by Allergan. I have no idea what that information might mean. Do you have anything that might be helpful for me to know? Again, thank you so much!
-
Glad I found this post, great information and answers some of my questions. Currenly have 400 cc's TE's overfilling to 600cc's, I asked if I was going to pop, they promised me that I will not? Currently have 410, they are using 90cc's each fill up, killing me but I want to get this over with!! Have a deadline to get this done! Haven't really talked about implants yet, Saline or Silicone. What about that Silicone leak they reported some years back, whats to say this will not happen again? Just concerned. I started reconstruction same time I had my BMX which was April 1st, hope to have my implants next month, so I'm confused that others have to wait so long?? These are killing me and I can't wait to get them out!!! I'm 5' 8" 180 lbs ribcage: 33", just thought I would throw in that I got my diagnosis for my 50th birthday present. That is why it was so fitting to have them taken out on April Fools day. OK my concern, they tell me I am going to be rounded, or did I hear flat?! I don't know if I going to be happy with that? Not sure what size I will be, possibly a "C"? Love you girls, don't even know you, but were all bosom buddies!!
-
Okeefe7544
I am right there with you girl! I am about 500 cc's into my ever so annoying TE's. In the home stretch so to speak haha! To answer your question about silicone. It's different then it used to be. It's a gel. You could cut it and it is like jello. Doesn't bleed anymore silicone away! -
I am out of town and back tomorrow. My iPhone is acting up, making it difficult for me to read these requests! I will answer them all tomorrow,,,
... -
okeefe: Cindy is voicing what most of us have experienced in terms of time between the last fill and the exchange. It is not necessarily a good thing to move so quickly. Especially when you need the retention of the expansion. Quicker is not always better. Unless, that is, you had large breasts pre-BMX and you have sufficient skin flaps to fill the implants you will require to satisfy your desires to have the appearance of a "C" cup. I think you need at least 600 ccs - midrange profile or high profile implant. Most of us on the reconstruction forums have silicone implants. There is a search thread in the upper right hand corner of this webpage and you can search for threads where there have been discussions of saline vs. silicone.
-
faithorfearmom: You have the 133V Allergan TEs, but what you need to obtain is the style and volume. So it might be 133V-13 or 133V-12, or it might be written as 133V-MX500 - something like that. Your PS will have it recorded in your chart or you might have been given a little card with this info after the surgery.
-
christine47: Everything your PS is doing - measurements - silicone - high profile - taking in several sizes - it all sounds good to me. If you want to confirm sizing issues, I would need your implant style and volume, your height, weight, ribcage circumference, yadda, yadda, yadda!
-
Hillck, Great news, I know that you are excited!! I can't wait for the day
!!! Please let us know how you feel after and how long for recovery. I'll be praying for you!!Whippetmom, Thank you so much for the information, something to think about!!
-
Well third fill went very well, no pain at all. Got another 100cc on my way to 750cc. I posted pics on the forum on my existing thread called Delayed Reconstruction.
-
You are looking good Carrol! Very nice progress!!
-
I am 2 months post TE. He filled me to 500cc during surgery (had a skin sparring MX 16 months ago). My TE are a half moon shape. He says this will give me a more natural shape. I had one fill about 4 weeks ago. I think is will be happy where I am.
My question is that one my TE appears to moving. When I woke up this morning it felt like it sideways (long side was going up on down). When I stood up everything shifted back into place. I also think that the TE has flipped so that the metal plate where they fill is now on the bottom of my breast not near my nipple. I got out a magnet today to see if I was right. I think I am. Has anyone had this problem. I didn't think they should move this much. Didn't have time to call the doc today but will tomorrow. Just wanted to see if any of you experts had any thoughts.
I am also wondering if all TE are a crescent shaped. I am not a petit person and am filled to 550cc and would fit into a 38C type bra I would imagine. When I read about smaller women being filled to 600-700cc, I imagine them being quite large. I am sure we are not using the same comparison.
thanks.
-
thanks whippetmom i'll keep posting.
fyi started getting a little sore last night and this morning. nothing terrible but enough to keep from the gym today.
-
Isseymom: The crescent-shaped TEs your PS used are probably the short-height or low-height Allergan or Mentor tissue expanders - and are termed "crescentric tissue expanders." are used often - perhaps not as much as the moderate height style of TE - but I think that if I had my druthers, the low height TEs would be used more often. They have the benefit of expanding the lower pole, where projection naturally occurs, and limiting or avoiding expansion of the delicate tissues in the upper pole. Rotation, malposition - possibly a greater risk with the low-height TEs....but certainly it can happen with any tissue expander. If it is distorting the pocket - expanding inappropriately, it should be removed and replaced. Your PS will keep an eye on it. The recent advent of the suture tabs [Mentor TEs] helps prevent rotation and malposition, but very few surgeons seem to be using them - probably using up their current stock before reordering the newer CPX models. When you present for your next fill, confirm all of this with the PS.
-
Deborah - my TE photos are now out on the picture forum. Im at 415 now and look to get my last fill on Tuesday and I can update you then. PS thinks the skin quality is great. Ill be getting a 350 in the natural side - Tuesday will determine the final numbers....I will probably ask to try on some samples again just to make sure Ill like it.
-
whippetmom: I sent you a PM with my stats and my photos are on the picture forum. I don't remember if I included this in my message. My PS used 600cc expanders and filled to 350cc at surgery. I've been a little nervous thinking that he planned to fill to 600cc as I came out of surgery feeling like I was only slightly smaller than my natural breasts. However, at my last appointment he mentioned that the amount of fill I have now IS pretty comparable to the calculated volume of the removed breast tissue. I expressed pre-surgery that I wanted to be about the same size, maybe a little fuller so I guess that why he used 600cc TEs (to give me size options). His method is to continue to fill until I like what I see, then expand once more. From what you've heard from others, it is unusual to use that much larger of a tissue expander? I wonder if that partly explains why I am so much fuller at the bottom, I don't seem to have that flattened hamburger-bun look with my TEs.
Any thoughts or observations or suggested questions for my visit next week? I was supposed to go today, but my dang wound took a little backstep in healing again so will wait until next week.
-
TinaT - Sorry you're having such a time of it! Praying for complete healing! xo
-
Dawne-Hope: Thanks, just a minor setback, nothing serious. Last week that healing area was looking filled in and just about done. I travel 3 hours each way to my PS and have made about 10 trips in the past 3 months. We discussed and he thought it would be OK to put a little of the saline back in the expander at my recheck last week and I said "go for it!" However, it was enough to separate the edges of the wound a bit. After I emailed pictures he decided we should hold off. Oh well......
-
TinaT - I hear you on the travels ... mine wasn't quite that far .. but close at about 2 hours and 45 minutes. Lots of mileage on the car! Glad he's being careful! We have to keep reminding ourselves ... the fill process isn't a race ... as badly as we want them gone! Hang in there! xo
-
Dawne-Hope: Thanks for the good thoughts. Yes, my car knows the way right to the parking garage at the clinic! It doesn't always take 3 hours, but the traffic is so unpredictable that we allow that plus a little extra and sometimes make it just on time.
Have a lovely day!
-
Tina: You look superfabuloso! But I never received a PM from you! There was a snafu/glitch with our inboxes on Tuesday/Wednesday and it might have been lost during that downtime. So could you resend your vital statistics, including your ribcage circumference. Also, could you find out which style of TEs you have - low height, moderate height, full height? I doubt you have full height, based on your description of your TEs....but I want to get your dimensions. Dimensions vary based on the style of TE.
Deborah
-
whippetmom: Thanks! I got a PM from you the other day saying that you were on the road, but something weird did happen with the messages about that time. I've added my info to the picture forum, but I'll also PM you again.
-
Isseymom-I did not have cresent shaped TE, but one of one also moved. It turned upside down so the magnet was on the bottom instead of the top. My PS manuallly turned it back into it's postion and it stayed that way for the duration of my fills. I am six months post exchange and having them move like that didn't affect anything in the long term.
-
How do I go to the picture forum?
-
okeefe7544: It's a separate site. You have to post here for a while before you can gain access. Then contact timtam, whippetmom, or MBJ to get access. I think there are a number of other moderators/gatekeepers as well. By the way - THANKS to all of you who keep the photo forum going!!!
-
Tina: Oh, now I do remember that exchange we had, but then your PM entirely disappeared, so out of sight, out of mind I guess. I am glad you mentioned it again. I don't want anyone to be left hanging, waiting for an answer!
-
Whippetmom- Thanks for your thoughts and insight. It does not appear to be causing any issue with shape. When I stand up it looks normal. I will see what my PS thinks.
Sweetie2040 - It is great to know that I am not alone. It definately feels like it is upside down but that I could rotate it back into place. Of course I would not do that myself.
Love this site and all the insight you all provide.
-
Hey ladies--just posted my "work in progress" from pre-surgery thru exchange on picture site, hopefully that "drop and fluff" thing helps even things out a bit!
-
Hello everyone, I have posted my te's pics on the photo forum and I am concentrating on sizing right now. Currently filled to 300/350 ccs and have 275 medium ht. te's. I am aiming for a 400/450 high profile implant - hoping to get a proportional implant for my body frame and look like a small c in clothing post e-surgery. Opinions are welcome!
-
Wahoo Cindy and Cameron!!!
-
Deborah, no I don't have TE's yet. My BMX is scheduled for June 14'th and I will be seeing the PS one more time before then so am compiling a list of questions. The tear dropped shape silicone are not approved by the FDA yet (as you said, only the round ones are) but my PS is involved in a study that will work to get them approved, so they are an option for me.I will PM you with the other information you asked about (ribcage size etc). I'm in Boston for my daughter's graduation from BU today and tomorrow, so will send that to you when I get home (don't have a tape measure in the hotel!)
Thanks again. Pat
-
Pat -- ok the tear drop shaped silicone implants that are not yet approved by the FDA ARE indeed the Allergen 410 gummies. I have one (I'm a uni) and I'm very happy with my results. The shape is nice. You should know, though, that gummies are firmer than regular silicone (in case that matters to you). Also I recommend that you check out the All About Gummies thread... a lot of women have been posting there the past few years about this particular implant. And though it is not approved yet in the US the Allergan 410 gummy has been in wide use in Canada and in Europe for over 10 years.
-
you go cindy and cameron- we will all be in there watching- no mean feat rushing between ORs:)
-
redskyatnight: Whippetmom will need your weight, height and under bust measurement to help you get you to where you want to be.
Cameron & Cindy: Wahooo for you! Yippee squishees are on their way!!!
-
Thank you Whippetmom, got 450ml (not cc's ml is on card) high profile round mentor silicone implants. Still have bandages on and feeling itchy. Have 2 drain tubes that come out tomorrow. Did a little lypo in stomach. Anxious to see how they come out. I appreciate your help very much and to those who provided photos, made me feel much better going in to surgery. PS tried 475 and said everyone in surgery room said no. My chest does feel lighter and the bandages I notice have some give to them unlike the concrete barriers I was carrying. Good Luck to everyone!
-
Lilah, Thank you for the input-I would've NEVER known. I will look into it more. My last appt. before surgery, with the PS is this Thursday, so I need to go with all my questions and concerns. I will check out the thread.
Pat
-
Cameron and Cindy: Praying that everything went smoothly for you today....and that you will come here to give us all the details!
-
yo hoo cameron and cindy....waitingo n the news (been resting since flying back and forth between the two of you....very tiring but it looked lke your surgeons did well!)
-
Hi Whippetmom...my late response on the type of TE I have...the card in my wallet indicates 133MV...does this help?
Thank you!
-
faithorfearmom: I sent you a private message!
-
I had TE put in Feb. now he's been "filling" them, ouch and they're really big. I want to end up about a B cup I think, not a DD like before BC. This is a new PS, my old one, Dr. Schooler at USC butchered me so I'm not hoping for perfection just something acceptable. My exchange surgery is scheduled for June 7th and my last fill tomorrow. I'm going to ask him about what type and size of implants he has in mind and I'll post here to see what you think. thank you everyone for your help!
-
Hi Gals,I am cross-posting this...I am back from my fill and got 50ccs in one side to even it up. Now 350ccs on both-sides and I am done with my fills! Yeah!! My ps is doing 400-450cc high profile silicone rounds. We both agreed that having that size is a good match for my body. Any wider and they'd stick out and bump my arms."My "e-day" is July 21 as I had told you guys before. So, just have a pre-op appointment next month and we are there. Also, he gave me a set of "fipples" to wear and check out to see where to eventually place my nips. Very cool...I'll post some updated pics on the photo forum- give me day to resize the pics as it might take some time.Whippetmom, We pm'd eachother and I so appreciate your input. You were on target according to my ps. He is going to stop my fills here and give me larger implants located closer to my sternum and fuller in the upper pole. I am so thrilled! Thanks!
-
Hello all...
I've browsed this site and feel a relief in seeing all the helpful, knowledgable information given. Who better to 'know' really how I feel....then all of you!.
My story in short...diagnosed with High grade DCIS in January. In March I had right simple mastectomy with insertion of Mentor CPX tall height Contour Profile Tissue Expander. I've had my last 'fill' -now at 450 cc's. I'm schedule for the replacement in a couple weeks...also a lift and small implant on the left to help even things out. .Now I have concerns as to which size implant is right for me...etc.
I'm 5 foot 2 inches tall......111 pounds and my rib cage in just a tad under 29 inches. 48 years old. Now my TE seems so high to me. (I can feel it start just 2 finger widths below my collar bone.) Maybe it seems high because I'm so use to my breasts being so low....effects of gravity, childbirth...age...
MY PS said TE 'highness' is a common concern ... but that the position is OK. Its still a concern of mine -seems so abnormal. I don't want my implants starting so high...with such a big circumfrence. Yet....I'd love a little cleavage. I'm confused. I'm short waisted....so wondering if this comes into play.
Anyway...my PS says a 350 cc or 400 cc implant would be the range for me. Mentor Memory silicone ones have high profile, moderate plus and moderate. If I have a choice which should I choose??? I like the way the High profile implants look on the mentor website...it says 'narrow base and high projection.(Projection...that means how far they will stick out...right?) Do you think thats a good choice for me? Also should I get 350 or 400 cc's?
Thank you in advance for your input. Love, Sara
I normally fluctuate between a B or C- . (I'm looking for a "c" like look from this)
PS Can I see the photo section please?
-
Sara - mine are high too but PS says its in the right place. If you send a private message to Whippetmom, Lilah or Timtam they can direct you to the photo page. I am actually a similar size and have my photos out on the forum so you can compare. I am at 495ccs on my TE side looking for a 450 implant.
Whippetmom - Have you seen my photos? I am overfilled to 495ccs and MAN I have decided I am plenty big enough today. This fill is killing me! We talked about a 350 on my good side and a 450 on my MX side. When I was at 415 I felt close but not quite what I wanted. Even my husband said today "I dont think you want to be any bigger!!!" I either have a week or 2 months to make my final decision as my PS is moving (story on my photo thread). Anyway, Id apprecate any feedback. I hope to put some pictures in a bra or clothes out there tomorrow.
-
Sara-if you get to the picture site I have TE and implant photos up, I am about your size too...5'1, 110 30" rib cage, was a very small A cup (age 52 with 2 kids). I had 250 TEs filled to 330 and exchanged for 350 and 375 implants (PS had to use a different size on left and right)...I am a solid B.
-
Sara: You will need the high profile style implants - as described by takeadeepbreath. I think that your PS is spot on about sizing.
I am perplexed about the high rise positioning of your TEs, since they are the CPX with suture tab style. The tabs are supposed to keep the TEs in place. You can always email me photos.
Deborah
-
Had my last fill yesterday!!! So thankful that is over!! Now it is just the waiting game to schedule my implant surgery. I am at 540cc.
-
Question: I am getting concerned about the way my TE look. I am wondering how my final implants will look by comparison. It's been 7 weeks since the TE surgery 650cc expanders now filled to 400cc on my way to 750cc. Right now my cancer side is a bit higher than the other side. Not so high that you notice right away but you can def tell. Also that side seems to stick out on the side less. My PS said he can even them out but I am getting worried that I might not be happy with the end result.
-
Carrol, I bet whippetmom can advise you on the pic forum and I'd discuss your concerns and worries with your PS for more peace of mind. Keep us posted!
-
Carroll2 - Don't worry ... but TE's were lopsided too ... and were way too far over ... kind of under my armpits. They looked so weird!! My PS fixed everything at the exchange. The TE's job is to stretch ... do tell the PS your fears ... I definitely told mine .... I wouldn't worry ... just voice your concerns.
-
robynkk: Hi! I am so glad you found a PS that you are happy with, but I am shocked! I had Dr. Schooler and he did an amazing and natural looking recon on me so I was surprised to hear that he had "butchered" you! Do you mind sharing what happened? He did such an amazing job on myself and he actually rescued me from being "butchered" by a BS at City of Hope!
-
How does one access the photo forum ?
-
Shannon you have to be out here a little longer. Once youre ready, send a private message to Whippetmom, Lilah or Timtam and request access - they will make sure youre legitimate. This is important beause the women who put their photos on that forum trust that the women who are looking at them are who they say they are and are going through the same things...they are photos NOT for the general population.
-
I am trying to decide on implants. I think I've decided against the gummies for fear of rotation & also, I'm starting to like the big look of my TE's. I have mentor 6300 tall height contour 750cc now overfilled to 840cc's. I am 5'6" 130lbs 32" under breast/rib cage. I am thinking smooth round 800cc's inamed style 20 or style 45 or Mentors high profile smooth rounds. I've read everything here and that helped me narrow it down to these. Whippetmom seems to know a lot and I would welcome her's, as long as anyone elses advice.
-
Hi Whippetmom,
I had emailed you last year because my original implants were too small and too far apart. I had been expanded to 600cc and thought I was getting mentor 500cc high profile, but woke up with 450cc moderate high profile. 6 months later, I has a revision and again told him I wanted high profile 500cc mentor (round). This time I woke up with 500cc moderate high profile, but they are closer together. As the new implants settled they became obviously different size and shapes. The right one (The cancer side) is smaller flatter and higher than the left. Two weeks after the revision the PS committed suicide, so now I have a new PS. I saw him today and asked about another revision. I was told if I wanted the high profile, I would need to have expanders again. Does this sound correct? I don't want to be huge, a c would be good, I don't like these mismatched hamburger buns.
I am 4'10 with a 30 1/2 inch ribcage and from the side view look kind of flat. I was thinking a high profile implant in the 500cc would not require more expansion since the moderate ones take up a lot
of space on my chest. The new PS was not too hopeful that my insurance (BCBS of Florida) would cover another revision, however, he will try to get auth. He seemed to think insurance was obligated
to pay for the reconstruction, and it would not matter what they looked like. Do you know if there
are certain cpt codes that would be more likely to be reimbursed?
Thank you so much for your advice.
Nancy -
Thankyou SuebeeBC, never dreamed it would be comforting to see other women's breasts. It is so helpful with my reconstruction anxiety to read these posts and see others having the same fears/concerns I do.
-
Shannon it took me a while to get comfortable with looking....but since my diagnosis, it has definitely been a great help to me. Have you had your surgery yet? What stage of things are you at?
-
nln- you poor thing- you have been through the wringer...I am sure your new PS will tell you upfront if your insurance will pay- they are good at that kind of thing...good luck with it all:)
-
SuebeeBC
I had a lumpectomy in February only to find out that I had DCIS in several quadrants too. So I had a BMX on 4/7/11 with TEs. I have had 4 fills which have been pretty uneventful except for some discoloration which my PS said is the stretching. I have 500cc expanders in and am hoping to be a C cup (which is a little smaller than my presurgery size). My PS talks in terms of cc's and B, C or D cup so I am confused about what I am looking for. Not to mention that the shape (seems square) of these TEs really throws me off.
-
Right they are strange. I had a uni and will go bigger than before and hope to end up with a 450. The longer youre out here, the more you'll see how the size of the TE and the size of YOU will make a difference in cup size from person to person. a 450 implant on me will bring me to a C hopefully but someone else it may be a B or a DD!!! Its also impossible for them to guarantee cup size so they dont like to speak in those terms. I dont care what I measure....Id like to LOOK like a C cup. And ACTUALLY, when I tried on some implants on my good side, the PS had me turn sideways because he like the hood to match the trunk....so my butt size came into play. LOL I thought that was pretty funny.
But looking at the TE, its higher, sticks out more and is shaped completely differently from a natural looking breast so I dont know however the PS can tell what the final result will be so in that instance I have to trust his expertise!!!
-
SuebeeBC
And I thought I had trouble finding clothes to camoflage ! I bet having one expanded and one natural is really difficult. Few of my old clothes work, anything fitted shows the side foob and ripples and many others items hang. Anything low cut at all shows the top of the TE. I am starting to figure this whole implant choice out. After the surgery I was so drained that the aesthetics of the end result was the last thing I cared about. Mostly cared about drains and pain. Now that I am better and have more energy I feel really interested....maybe even excited about the implants. I love your PS making the hood match the trunk !
-
nlm: Oh dear, how sad for everyone involved! Obviously, your PS wasn't fully focused on his work. So sorry you're still not where you want to be...
-
Shannon my implant choice was very vague until this last fill. I was going to be a Full B...then a Full B small C...then I actually tried on implants on the natural side and liked the 350 and PS agreed...and thats how I settled on the right side. But my skin is doing well...my PS said that I would have to stop if my skin wasnt responding so well. I guess there are more factors than our desire to look HOT!!!
-
Whippetmom I wanted to let you know that I ended up smack dab in the middle of your recommendations, you told me "at least 475 ccs and from there, 500 ccs or 550 ccs."
I was given 500ccs high profile, pics are on the forum! Oh trust me I TRIED for 550 but alas...it was not to be.
The good news is my TE's remained in tact until E-day came, I know you were worried!
The other good news: (at least for me) this unusual approach of 275 TE's, overexpanded to 555 seems to have left me with nearly ALL my projection. I posted pics today to compare. I am really hoping I am not swollen, I don't seem to be but we'll see. I was in denial at first and depressed after exchange but I got my head sorted out and so far, so good.
Let me know what you think, I know I have a ways to go and exchange was only Monday; but so far so good...I'm loving the upper pole and enjoying a MAJOR lack of ptosis; who needs it? I'll give up mine to someone more deserving!
-
I had my last pre-op visit with my PS yesterday. He is estimating 500 cc's for implants. He will do about 200 cc's in the OR after my BMX and then begin to fill after removing the drains-which he estimates to be about 2 weeks. He thinks exchange could be as soon as October.
I still haven't decided on tear drop or round shape. I think (I'm a B cup all my life and have never had cleavage) that tear drop will be more natural looking. He said his "turn" rate is about 1%-one of the things I've been told to consider with tear drop shapes (thank you Sandy!) but I'm not convinced I want round. He said I can wait to make that final decision until after the surgery-that was a blessing.
I'm finally beginnig to put the pieces of the puzzle together-thanks to all of you. Pat
-
Pat- I was trying to decide between round & gummie & I'm going with round because I think my TE may have shifted a bit....it sits higher & the fill ports are in completly different places on each side breast.
-
Thanks Tara... I am sooooooo undecided at this point. I'm fairly small breasted-a small B at best and so I am tear dropped shape naturally, so thought that's what I would go with, but after talking with women here, I'm not so sure. I don't "need" or want cleavage-never had it-and I think it would be awkward for me..that being said, I don't want the gummie's to move...
My PS said I have the next few months to decide.. The exhchage will likely be In Oct. so I'm really hoping to hear from others what they decided and why.
Pat
-
Regarding the teardrop shape - I'm trying to recall the conversation I had with my PS at my consult visit with him. I think I remember him saying that he would use them if that's what I had my heart set on, but he wasn't recommending them. In addition to the possibility of them turning (small chance, but apparently does happen) he had another issue with them. He said they look natural if you're upright, but if you're in any other position (like lying on your side) they just don't drape naturally. Then he picked up a round implant and held it at the top edge. Gravity causes the silicone to naturally "pool" at the lowest point. He believes the round implants more naturally mimic real breast tissue in all positions, not just upright.
One thing I've learned from being on this discussion board is that no two PS seem to be alike. Mine doesn't care for teardrops, others might think they're great. Argh, it's confusing!
-
Yes, I've read what Tina said about the round silicone looking more natural with movement & that it does take a teardrop shape when upright. I would really like to hear more on this issue from people who have either. When I first met with my plastic surgeon I was set on getting the teardrop gummies....and now I want silicone rounds. Another reason I changed my mind was that I heard that you can never push them up or put them in a bra to change the shape with each outfit. I know when I had my natural breasts I had many different bras to push my boobs however they would look their best in each particular outfit.....I could push up & pad those babies to give me vava voom, or play them down.
-
rehm046: My PS prefers teardrops. I went for a 2nd opinion with another PS who does only cosmetic surgery. His opinion is they are wonderful and he can hardly wait until they are approved for use other than BC reconstruction. That said, I hear they are more firm than the rounds. My exchange isn't until September so I will post before your surgery.
Of course that's assuming I don't pull my hair out with the darn hard, tight, painful TEs before the summer's over.
TinaT: I going to ask the questions about gravity. Thanks for the tip. I'm looking forward to maybe, possibly sleeping on my side again some day. That would be a true Christmas present!
-
here is an experience I had yesterday while at the houston med center with my son....talking with nurse came out about my bmx, etc and she totally freaked out and said "No way, you look so good, I just figured you really just had a great figure"....what I landed up from my Mentor smooth HP 550s is a nice 36 full C that while filled out with good height and projection that does not scream boob job. I can make even more cleavage with a pushup bra if I want them looking more boobalicious or I can wear a tshirt and tshirt bra like I had on yesterday that just looks like an old chick with a decent "rack". I am not trying to be crass but it is the best way to explain it without being all technical ( I don't talk like this normally but then again, I do a lot of things now that I never did pre-BC)
-
annetek that is awesome you rock those new boobs. I hope I can impress people with my new "rack" too when this is all done!!!!
-
I thought that I wanted gummies but I am glad I got the rounds as I have one augmented and one side MX, they both can be pushed up and in or however I want to manipulate them and I am not sure I could have had that with the gummy tear drop. I do like the look of the gummies upright but mine are a pretty close match regardless.
-
Annette you rock - "Old Chick with a decent rack!" I love it. You look awesome and nothing like some old chick with a rack for sure. Yesterday at the store I saw one of those dolly parton wanna be's with OBVIOUSLY fake boobs and I thought "Oh Honey, NO....time to change THAT habit"....I cant wait until NO ONE notices that they are fake! I keep telling my PS that. You've done really well!!!
-
SueBee: You know, unless I wear a push up bra or a top that is particularly flattering, no one can tell I had an MX or implants. Even my nurse told me mine were the most natural looking she had ever seen. I think really natural with benenfits was the look I was going for since my natural ones were mismatched and lacking to begin with. Who would have thought I would be somewhat better off after having BC?
Annette: I agree, you are certainly no Old Chick, lol! Always making me smile!
-
Annettek- That is exactly the kind of straight talk we pre-exchange undecided women need to hear before we make our final decision. And that's how I used to manipulate my natural breasts for each outfit & occasion.
MBJ- I too like the look of the gummies and it's nice to hear you have a round that matches the augmented natural side.... Wait, is augmented natural breast an oxymoron?:).....whatever you call it, you know what I mean. So glad to hear they can look natural or be pushed up & that you like them. My old ones almost always had to have a bra on for me to like them. -
Tara: I think either the Style 45 or Style 20 would be fine. The Style 45 would be the best for your ribcage [it is narrower than the Style 20], although you need to have a sufficient torso - and what is called "sternal notch to nipple" ratio. It would be your imaginary nipple in this case, but on Page 99 of Exchange City, I have a diagram which might help with the measurement. The Style 45 implant has greater projection and is a taller implant.
Deborah
-
Nancy: Part Two of the Florida statute referable to insurance coverage for mastectomy after breast cancer, states as follows:
2010 Florida Code
TITLE XXXVII INSURANCE
Chapter 627 INSURANCE RATES AND CONTRACTS
PART XXI HEALTH INSURANCE POLICIES(ss. 627.601-627.6499)
627.6417 Coverage for surgical procedures and devices incident to mastectomy(2) As used in this section, the term "mastectomy" means the removal of all or part of the breast for medically necessary reasons as determined by a licensed physician, and the term "breast reconstructive surgery" means surgery to reestablish symmetry between the two breasts.
You have assymetry currently and as per this statute, you would be a candidate for another revision. I agree that there seems to be no reason you should require tissue expansion again. It does not make sense to me either. Seek consultation with another PS. Since you have this projection and height assymetry, it might well be that a midrange profile will be required on one side and a high profile on the other. Are you happy with the appearance of one side or are both troublesome?
-
Cameron: Hooray! I cannot wait to go see them!!!
Annette: I too am an "old chick with a decent rack." Love it!!!
-
Thanks whippetmom. I'm going to check page 99. I think I'm wide....big broad back & wide broad shoulders....my rib cage is about an inch wider then right under my breasts. The struggle choosing is that I like my TE's upper pole projection, & width....I even like the way they hit my arm(side boob). But there is no silicone implants that come with that much projection & width. I'm afraid I've gotten, what they call, boob greed....800cc's is the largest they come....though my PS did say they could special order a custom size if I really wanted.
-
Tara: I think 800 ccs is more than sufficient for your frame!
-
I know!!! They should be big enough. i had a skin sparing mx, so I didn't have to stretch my skin. I had 480cc's at my TE placement surgery. I think I just have gotten used to these TE's. I'm finally back from page 99 & after all that figuring out my SN to N is 21" which puts me right on the cusp. Oh well, but I did read there that Mentor has an ULTRA high profile...so I'll have to check that out...I don't know if I have the specs for that one. I tried to look at the link you posted but it didn't work, well it did, but it was something in German. I'll make sure to ask my PS. The Mentor 800cc silicone round I have the specs on is 15.5 with 6.0 projection. It seems to me like the projections don't go up that much more with more cc's like I would think they would. Am I wrong? I think I saw somewhere someone with less cc's still had 6.0 cm projection? I also think I'm afraid of what the women on here call the hamburger bun. Will 15.5 diameter with 6.0 projection give me the hamburger bun look?
-
Mentor's extra full projection implant style is not available in the US and I also do not like the torpedo-like dimensions of that implant,
-
Torpedo breasts, oh my!!!
-
Ooooh - secret weapons (torpedos)!
-
Torpedo breasts, oh my!!!
-
I heard that expression too & I don't want that either. Just normal looking, like they used to be...oh well, I guess they will never be that & I have to get over it. I hear the style 45 recommended the most, which has the most projection with much less width. Does that give the torpedo look?
-
Tara-Allergan's Style 45 is a very useful style. However, we have to get our focus off of believing that projection is perfection. Width is just as important..it takes sufficient width to fill out a bra and to enhance cleavage.
-
I know, that's why I'm having such a hard time deciding....I too think width is just as important as projection, therefore, I want both. They really should make a lot more different size combination implants for reconstruction, we are more then just few shapes....or would that make it even harder to decide?
-
yes, Tara, I think it would make it harder to decide. When I am faced with too many options it is as bad as too little. Kind of like chasing the holy grail so to speak. This sounds very weird but here goes...yesterday I dug out one of my hubby's playboys out in the garage and thought I would take a look at the pics and SKIP the articles
Despite obvious airbrushing, to me the most attractive women in there had full breasts that didn't neccessarily push out from the chest. I mean they did in the bras, but not the full on nude shots. I took the magazine over to husband who braced for whatever was going to come out of my mouth and I said "Hey, which of these women do you find the most attractive?" hahaha yeah like he was going to answer, but I told him I was curious as in my mind the "best" boobs in a guy's mind would be way out front and center and he shook his head and said un uh (still scared to say anything" ) So i pushed him to pick one and he flipped through (extremely uncomfortable, waiting for me to clobber him at any minute) and pointed to the same one I had thought looked the "best". I said "Her?" he said yep, her chest reminds me of yours. OH MY GOD! hahahahaha I snatched the magazine back and said "Yeah, well she has nipples dammit and is 21 - you perv. " Ha, he knew that was coming. Anyway, my point is, I think we get so turned around after BC (rightfully so) that it is hard to know what we look like what we expect, etc. My old boobs did their job well for many years, fed two kids and kept my husband interested for 30 odd years before they turned on me. After the horror of diagnosis and the decisions made, once I was down the rabbit hole it gets easy to get confused and wanting. Wanting one damn good thing out of this mess that cuts through lives like a tornado. Not only good but friggin perfect, when I know in my heart, nothing is perfect. I could not do anything about having BC but it is like I thought there was some kind of deal to be made, like "OK I got BC but I better have perfect boobs now"....it is like it gave me something to focus on that was positive instead of freaking me out. Until I started freaking out about getting perfect boobs. I see a ripple and go shrieking into the mirror- horrified. The scar tape gives me a reaction and I am convinced I am marred for life ignoring the fact that I do indeed have two vertical scars (and some little ones from the drains) from which my breast tissue was removed. Am I really that vain? Nah, I like to look good and try to take care of myself, but I think the boobs just became a focal point of it all, I mean they are actually. So, while I won't settle for obvious mistakes or poor workmanship, I am training myself to calm down a bit. If I need a revision for something serious, I will do it. But when I look in the mirror and really remember what that poor chest looked like right after my BMX...it truly is a miracle of sorts. A skilled team of surgeons (BS and PS), lots of research, great advice on here from whippetmom, lilah and others and doing exactly what the doc told me to do in regards to healing- all resulted in an outcome that would not have been possible a relatively short time ago for any woman going through this. Their options were limited to say the least. Ahhh, sorry for going on and on but it hit me tonight what long strange journey this is. I actually looked at the heels of my feet today and thought, man, I gotta take care of those nasty things....PROGRESS...not thinking of my boobs for five minutes is a start:)))))
I hope everyone has a great week....I have my first since DX mammo ultrasound at the BS office this Thursday and am a little nervous (ok, a LOT nervous)... will let ya know how it goes and say a lil prayer if ya get a chance.
-
Annettek: Love you like a sister I never had. You pretty much summed it up there. Thank you!
-
I am new to this site, so i am still "feeling" it all out. I am 29 and I have IDC stage 2 grade 3. I had both my breast removed on 04/25. I do have expanders in. They were very painful. I am just over a month and few days since my surgery. I feel alot better now but the expanders still arem bother some and I cant sleep on my sides. I was a 36 C before i had them removed. I would like to be the same size by the time i am done with my fills. I have only had one fill so far. I was really sacred to get one after surger so i waitied almost a month to get one. They wanted me to have atleast one before i started chemo. I start chemo on June 1. SOOOOO scared. I did come out of surgery with 200 cc of saline in my right breast and 250 cc in my left. I was so flat when i came out of surgery... Thanks goodness my doc talked me into having reconstruction done. I would like to be back to a C cup but i have no idea how many CC's that would be...
-
My simplest, easiest advice for newbies with TE's who are worried about size:
Just keep filling them up until you think they're too big. Then fill once more for the hell of it. Then exchange for high profile silicone. Voila! Boobs.
-
LOL ANNETTE!!! My DH and I were on the website "love your look"....where you can view augmentations on different size women and we were doing the same thing - like catalog shopping. DH would say "oh she looks like you" or "DONT go THAT big!!!" etc. It was quite possibly the strangest hour in our marriage. But at least it was helpful before I found the picture forum. And it was really good to see my husband's realiztic expectations about where I needed to go. He would say it was most important for ME to be comfortable and look good, but he he also loved me when I was small. These conversations, though they can be uncomfortable are important!!
-
Annette, thank you so much for your perspective ! So helpful and you are so right about the way I was totally happy with my extremely saggy 34c boobs and am getting a little obsessive about how to get the perfect foobs.
-
annettetek you are so right about clinging to the hope for something positive at the end of all this. I keep looking at my expanders and worrying about all the details of the final outcome. I told myself the same thing perhaps now i can have the boobs of a 25 year old. But we all know reconstructed boobs are not really quite the same as those you see in playboy. Funny you mention that because i told my PS that I would not mind if he could make me look playboy. I also said i am not sure what that means and he thought that means very full breasts.
My husband, well, he doesn't say much about it. I know he liked my boobs before BC . . . a lot. But I can tell you I know he likes curvy women not too thin and not flat chested. So i think the "C" cup I am planning on will be ok with him. He is most happy when i dress up in lingerie so perhaps my C cups will have more options than my DDs did, nothing he wanted me to wear ever fit right.
I have had three fills so far i think i have about 4 more to go. Last night i had a dream that I went in for my next fill and my PS said nope time for the exchange and he drugged me and I was afraid and not ready for my exchange. I guess as long as we are works in progress it is easier to deal with this. I think once the final exchange is done it is going to be hard to accept that this is it, this is all we can do really.
I am so afraid that I will not be happy with the final. Will I mourn my nipples so much that there is nothing that can make up for it? I am trying not to get my expectations to high but now I am jsut very afraid of what i will have to settle for.
-
Sue -- your DH sounds like a dear indeed!
Annette -- great advice re: TEs and fills.
Tanya -- I am sorry when any of us has to join this club but especially sorry for you at such a young age. I am sending you hugs and strength. Chemo -- I was SO scared the days before it started, not knowing what to expect, with all sorts of remembered horror stories in the back of my mind. My mom and dad came with me (I asked and they obliged)! I drank a ton of water and was very anxious but it turned out to be ok. And while I did have occasional SEs it was not anywhere near as bad as I feared. Even losing my hair was not the nightmare I thought it would be. Yes I cried when it fell out but then I enjoyed my wig and it grew back. You are lucky they caught it early and I wish you a quick recovery and GREAT new foobs
-
annette....I was laughing and getting tearful all at the same time, reading your MISSIVE! You summed it all up for us.
-
Tanya: Give me the following info: Your height, weight, ribcage circumference [measuring under the TEs] and call your doctor's office and find out which style and mfr [Allergan or Mentor] and volume of TEs you have. I am looking for the style - low, moderate, tall height and essentially the width of the TEs. A catalogue number would help. You might have been given a card with this info at the time of the BMX.
Glad to help you honey!!!
-
PICTURES FORUM ADMITTANCE:
If you are interested in gaining access to the pictures forum and meet the requirements for same [at least ten or so posts and some of them in the reconstruction forums and two weeks to a month on bc.org], PLEASE PM EITHER MBJ, LILAH OR FIRNI. My wireless is out until the end of the week and I cannot send out the admittance data and link from my cellphone, which I am using to connect to you here. Thank you!!!
-
Deborah,
I'm meeting with PS tomorrow to review sizing options for exchange surgery (gummies). Can I email you a pic tonight with my size info. to see what you would recommend? I do not have the expander size right now but I am calling the PS office to see if I can get it. Thanks! Sandy
-
Sandy: Yes, send the pic to me!
-
Whippetmom,
Thanks! Can you PM me your email?
Sandy
-
Lilah - I think he is too. He is a good man.
So I have an exchange surgery date! Its June 13th! After all that has happened, my PS's military move was postponed until August....so looks like by the time he leaves, I should be well on my way to healing!!! Yeah!
-
Tanya: I notice that you are triple negative-we have a great couple of TN threads if you are interested. Calling all TN's is one and the other is TN Ten Pounds Take-Off. I was terrified of Chemo and though the first one was rough (due mostly to horrible constipation and forgetting to take my anti-nausea drugs) the last 5 were like getting the flu for a few days every three weeks. You are young, they caught it early and TN's do really well with chemo. You will find so much help and support here and on the other threads I mentioned. Hugs!
-
Sue -- wahoooo!!!!!! That is SOON!
-
Congratulations Sue!!!!
-
Thanks ladies!!! I finally feel like Im getting somewhere!
-
annettek - that was quite perfect at explaining so much of what I feel. Thank you for putting it down in words. My exchange was just a few days after yours and I feel like I am going through alot of those feelings about now...5 minutes of not fixating on my boobs is kind of a "big deal" around this house!!! ;-) ...I'm starting to return to "normal" conversation" ...although I caught myself the other day with a friend who asked how everything was going and I started in on "well, I've got a little divot up here..." and then I stopped myself and re-framed my thinking, I look pretty damn good and need to put away the magnifying glass sometimes! ...thanks again Annette, very well said!!!
-
Ditto, annetteK: that was a great write-up about our boob/foob obsession post-BC! I'm thankful I have these reconstruction issues to focus on or my mind would be going THERE. (The longer I am occupied in the moment by other things, the more distance I can put between me and BC and the less strong the pull on "going there" becomes.)
-
aw, hillck- we are just a bunch of brazen huzzies now! flashing our boobs all over the place:)))))
SUEBEEC YEAH YEAH YEAH YEAH YEAH...so darn happy for you-i am smiling ear to ear-how wonderful is that? To care so much about someone you have never met in person....I love it!
nolo and tanya- you're in great hands with whippet mom...:))
k..i gotta go get some work done...ugh
-
Awww, Annette!!! I can feel the love!!! I can hardly believe how much love and support I have gotten from my friends on this site. Its truely remarkable!!!! Thanks, my friend!!
Cindy - um yeah, about that. I was the most modest person before too. I lived in Japan and couldnt BEAR the thought of going to an onsen (public bath) with my Japanese friends even after all of their pleading and explaining that its what people do together and it was normal. Um, nope. So I hear ya....today I was standing in my PS's office in my bra and jeans thinking "oh dear, I have never stood in front of any man besides my husband like this EVER!!!" Such a bizarre thing!!
-
annettek: Hi, I sent you a second PM with my email address for the guidelines. Please let me know if you didn't get it and I'll send it again...
-
Annettek, Thank you for summing it up. This has been the only time I have really let DH look at boobs on tv, magazines.. trying to figure out what I might look like. I had become foob obsessed, which had never happened before bc. I think DH got tired of being asked to look for so many months. I was mourning losing my TE's so I decided not to take a photo as I must move forward and not look back on what I knew I could not keep. I do have more projection than I expected and am quite happy so far, I look good in a sports bra. PS did move them up, told DH if I wanted them up anymore I would have to push them up in a bra-they look fine. I am looking forward to the day I can really start exercising again, pain under arms. SueBee congrats on your surgery date, I am excited for you! Hillick, hope you did ok with injection and glad you got to show them off. Cameron, so glad to have you back with us, are you ok with the projection?
-
Annettk- First, thank you for sharing- Loved the personal, funny Playboy story.....and you & your DH could pick out the worst boobs from any Playboy & I'll happily take them....but I too want the nipples!
Before MX, when I first met with my PS I brought pics of natural unaugmented breasts- teardrop, with slope & ptosis to show him what I liked. So I was set on getting the teardrop gummies. Then I read on here too many ladies unhappy with their gummies.....even unhappy enough to have them changed out. Then I met a gummie girl in person & she told me all the bad things about them- actually had nothing good to say about them & wishes she got something else.
A little back story....I had a really hard, painful MX where the IV pain meds (morphine) did not work at all....after screaming & crying for over 24 hours...family & friends, even nurses trying to
get BS(over the phone) that night to give me something different for the pain....when he finally showed up in person, the next afternoon & with me still screaming & crying & begging for him to
"help me" switched me to dilaudid and it was instant relief. I developed a hematoma & had to have
that surgically, as well as more lymph nodes removed(by a different doctor!) with my TE's put in
then. Difficult, painful recovery...LE...PT. Anyway, sorry to get off topic, but I felt you should know
why I really don't want to get a revision.
You are so right on about wanting one good thing out of this nightmare...better breasts.
Before my MX I was so positive- focusing on the only positive I could.....trading in my old, breastfeeding, big saggy, cancer ridden boobs for what I thought would be better ones. -
Tara40yrs - There is a gummy thread. Go check it out and read the stories there. It's good to informed on the good and the bad. Praying you make the decision that is best for you. You've had a long haul. The morphine not working - what a complete nightmare!!!!!! So, so sorry that happened to you! I think the gummy thread is called "All About Gummies" but I'm not sure .... Lilah and the others will know. Check it out! Blessings to you! xo
-
Carrol2- I guess we have to face our reconstructed boobs will never be playboy.....but can't we get close?.....at least with bras, bathing suits, clothes on?!!
I too am sooo afraid I will not be happy with the final outcome. I have even delayed my exchange due to this fear. And these TE's are uncomfortable at all times & sometimes painful. But I so want to get the exchange right the first time....but I get so confused...my PS says I can have my exchange 6 weeks after final fill, but then I read on here it's better to wait longer for best results...to avoid the dreaded hamburger bun, to really let the muscles stretch or they may never. As much as I so desperately want these things out...just to sleep comfortably for one night....I can hardly sleep. I too have nightmares of surgeries. And I don't think I'd go through another one for a revision. I just hate surgery, BC.... the whole nightmare. Stupid cancer. -
Thank you Whipplet mom! Got it and responded.
-
Oh Dawne-Hope....how fitting you replied.....your name. I had a sister that died named Dawn. Thank you.
-
Tara40yrs - The fear thing is really hard to turn off, isn't it? We're all terrified when we're diagnosed ... it's like we're on a '10' on the fear scale and it's hard to come off that ... and then in every step of the process ... fear bombards us. The women on here are so knowlegeable ... learn from them! Knowledge can dispel fear. Stupid cancer is right.
I waited only six weeks between my last fill and my exchange. Not matter what ... the hamburger is part of the process ... but it is only PART of the process. It doesn't have to be the final result. What you see the first few days after the exchange is not what you're going to look like 3-6 months after the exchange. Let these women guide and help you and get as informed as you can ... it will help with the fear. In this respect, knowledge is power.
-
Dawne-Hope- Yes, you could definitely say I'm bombarded with fear, even paralyzed by it. I am so grateful I found this site. You are right, the women on here are knowledgeable & I've learned so much. I've been a lurker since dx in Nov.2010.
-
Funny Cameron, Thats what my PS said about fills & sizing....only I started liking the one more!
-
Dawn-Hope yes absolutely right huge amount of fear. I had my bmx with no reconstruction back in August and was so afraid when i woke up I could barely move. I did not want to feel pain and did not want to look at what was done to me. It was of course not as painful and not as bad looking as I imagined. 7 months later I had the TEs placed and was in a much better place emotionally. But the pain was actually worse that time and I got a bad cough after the surgery which made things way worse in recovery. I have now had three fills and at first my biggest fear was that i might have pain or the wound might open up. The first two went with out any pain pretty much the last one I was sore for a day or so and tight for a few days after that. So now I am nervous for the next fill again in a week. I also am worried about the hamburger look, one side is higher than the other, and the higher side does not project to the side as much. So they look a bit asymmetrical. I hope my PS can fix that in the end. I was calling him Michaelangelo but now I feel like he is more Picasso. I am going to ask him about all this next week perhaps he can put my fears to rest.
-
My fills got slightly worse each time. I was able to take 80 each time but I think at the 4th one I was starting to feel pain that night....then for longer stretches. Yesterday I got 50 and it was not bad at all but MAN was I afraid to sneeze yesterday.. Talk about supressing!!!! I 1/2 sneezed about 5 times before I finally let it rip. LOL...the things we go through!
But anyway, the pain of the TE is definitely managable. Especially knowing there is a finish line in sight.
-
Tara -- yes the thread about gummies is called All About Gummies. A lot of us are very happy with them. But I can understand your not wanting to take the chance. If you are interested check out that thread. I do think many PS's achieve Ptosis with regular silicone, which is definitely softer/squishier than the gummy.
-
Carrol- I too have one side higher then the other-with a weird shape to it due to the huge hematoma that formed after MX.... The bottom left outside never really rounded out- even overfilled at 840cc's. It has more upper pole projection then lower....My PS assured me it can be fixed at exchange.
-
Thanks Lilah- I've read that thread....I think that's where I first found out they were not the same viscosity/squishiness as the regular round I felt in my PS office. And that they can't be shaped into a push up bra. Pretty much everything I learned about them is from this site. My PS never told me any of this plain talk/living with them stuff. He's great, but just more focused on the final look I want to achieve. My PS isn't going to just chat about the different implants....I have to know the right questions to ask(the more the better) & I get them all from bc.org. discussion boards. I would read this, the gummie, chemo, & many other threads with a notepad, writing questions to go armed with to all my different docs.
-
Carrol2: You're right - we keep hearing that our plastic surgeons are artists and that we are works in progress. I certainly don't want to end up as a Picasso!
-
Thanks Tara and Cindy it's good to hear there is hope for some of these issues.
Tina I know i am afraid to tell him that he s being a little too abstract for me right now lol.
I have very good ptsosis though i am most concerned about the upper pole now.
-
Cindy- I'm not a member on the other private picture forum....but I really want to see pictures before I decide on an implant for exchange. Is there a picture thread on this site? What exact implant did you get? So glad to hear your happy with slope, ptosis & no hamburger bun just 9 days post exchange!
-
Tara: I would be more then happy to get you to the picture forum. Just PM myself, Lilah, Whippetmom, Estepp or Firni.
-
Tara -- sounds like you've done your research then
I absolutely think the gummy is not for everyone and it sounds like you might be someone who will be happier with regular silicone rounds! -
Thank you Lilah and MBJ for helping me out with the pic forum details. My router arrived today and I am up and running on the computer. Typing out responses on my iPhone was T-E-D-I-O-U-S!!!
-
LOL Whippetmom -- poor YOU! That IS indeed a drag. And no problem -- happy to do whatever you need.
-
My BF keeps telling me not to touch my boobs in public. Can't seem to help it though, they feel both weird and good...
-
Joandavies
I can relate to that - I'm always touching these hard foreign things on my chest but glad there is something there too! -
JoanDavies -- LOL!
-
Annettek
Humor and ATTITUDE will get us through and I LOVE yours! Thank you-
My last fill -as I squinted to look, or not look, The doctor walked in and asked with a smile "So how big do you want to be"?" Wow..I thought I have a choice....I can be any size I want! Somehow that felt impowering...considering the power LESSness I've felt the past 3 months with the Big C.
So I think I've decided I DO want to be a little bigger then I was....I once thought my expander was way too huge....now I'm thinkin' its just right.
SARA
-
Sara: It is empowering and there is some shred of excitement and hope which arises out of the ashes, after the diagnosis of cancer. Glad you are joining in and sharing the journey with all of us!
-
Hi ladies,
I am 1 month out from exchange and I am super happy with how these new girls are looking. I am so happy with the size that my PS was able to get for me because I am exactly where I wanted to be...36DD, just like before.
I have the style 45, 800 cc implants and they were just what the Dr. ordered...literally and figuratively...; ). They have great projection and not too wide...I love them.
Through all of this I was most afraid of not looking like I did before and while these are firmer and higher than my originals, if you didn't know I had a BMX you would not be able to tell anything was different by looking at me.
Just wanted to say that I am one satisfied customer!
Kelly
-
congrats Kelly,it's so encouraging to hear you ladies. I am still in the process. These TEs are beginning to take on more of a "torture device" feel than breasts. I know it is to be expected but it still sucks. My left TE has rotated to about 2 O'clock.
Ready to be done!
love, christine
-
Kelly I am really happy for you! Thats great that youre happy with the results! Great News!
I cant believe I am within a week of exchange!!! While I completely feel big enough (and actually now I feel TOO BIG because I am overfilled to 550), it was really wise to consult with whippetmom (thanks Deborah) and PS for their expertise, and my BFF and DH for esthetics. We are going with a 350 on the natural side and then matching the MX side with the appropriate HP sililcone implant....probably a 450. As my PS said, which I LOVED, he likes to make sure that the projection in the front, matches the projection in the back!!! I have a little booty even though I am thin otherwise, so hearing that all angles were being taken into consideration REALLY helped!!!
Ladies, this site has been so helpful. The photo forum has been a Godsend. I wish you all the best as you go through this journey!!!
-
congrats Kelly,it's so encouraging to hear you ladies. I am still in the process. These TEs are beginning to take on more of a "torture device" feel than breasts. I know it is to be expected but it still sucks. My left TE has rotated to about 2 O'clock. My PS said that it will be fine. Does anyone here have any experience with rotated TEs?
Ready to be done!
love, Christine
-
Torture device is a good way to describe the feeling that I have with my TE's. They have been in since February and won't come out until August...ugh. I am very uncomfortable, but have had some issues with tissue viability so things are moving very slow. I'm ready to stop the fills and just be content with what I have...not sure of the cc's but I fill out a B cup bra..just barely.
-
joect - slow and steady wins the race!!! It will all look great in the end and your patience will pay off!!!
-
Thank you Whippetmom for the Florida statue info. The ps has submitted to insurance for auth for a redo. I am hoping for a bilateral redo, but if it is not approved, if he will match the right to the left Foobs, I can live with it.
Nancy -
Had my 4th fill today I posted pics on the forum my name is the same and the thread is called Delayed Reconstruction Tissue Expanders. All comments and advice appreciated.
-
Carrol2, I have not gone on the picture forum yet (need to use different computer), but noticed your picture on the hair thread, looks like you are a very good size already?? How many more fills to you have? I go June 17 for my pre-surgery measurements. I was a droopy D, now hoping for a perky small C. BTW, your hair looks great!
-
Hey thanks Christine. I don't know how many fills I have left. My doctor thinks maybe one more but he wasn't sure. He initially said five fills but he also wanted to get me to 750cc and I am only 500 now. I was a pretty nice only slightly droopy 36DD before. Not trying to get that big. he had said a large C small D. Trying to embrace the hair but i sure miss my long blonde locks.
-
That is so cool Kelly- isn't nice to be happy about something out of this whole BC crapola?
I gotta say- I love my 36 Ds that I landed up with...will love em even more now that the PS has postponed nipples for tomorrow and I head in July 7- he is going to do fat grafting throughout for any ripples and more cush (although each day more cushy)- get rid of the ugly fat pads on each side of arm.breast where they meet and then do the nipples. He was raving over the bra I wore and called in the other office workers to show them how I filled the whole bra out hahaha...it was weird and wonderful at the same time...posted the pics on the pic forum...hope all have a goo dnight
-
whippetmom I would love if you could check out my pics on the forum and let me know what you think. I am thinking I may want a high profile implant but i am not filled yet so not sure. I ahve one or two more fills to go I think.
-
Kelly- I am getting 800cc's & trying to decide on implants & the 45's are in the running....I just don't know if they are wide enough. Do you know how wide you are under your breasts? And if you wouldn't mind, your height & weight. You said people would not be able to tell you were any different then before. I thought the 45's would look less real because of the high projection. Do you feel like they look natural?
I am so glad to hear you are happy with your implants! -
Annette your PS is the bomb! I love that! And I am so happy you are loving your D's, Thats awesome GF!!! Everytime I feel like Im big enough, I see my BFF and feel inadequate....but I have to accept that my skin is only going to stretch so far, and if I get any bigger then Ill struggle with the opposite problem of finding clothes to fit. Its not too late to change my mind....im just resigned to settling in...
-
Whippetmom: You are so very welcome
. Glad to be of some help. Typing on such a small device is pure torture!Glad to hear about the happy exchanges!!!
-
Going there now Carrol....
-
Nim--I am glad you beat the insurance jungle!
-
Has anyone had low profile mentor cohesive gel implants recommended for them?
-
Lago- no can help but I am sure someone on here can...
Suebee...i like em but am glad they are not flashy Ds if that makes any sense at all? There are moments I think OH NO I WANT BIGGER ONES but then I really don't...I just like em-which is a good thing. I think it is kind of common to get boob confusion hahaha I have it...and don't ya know there are some peaches I know that have actually said WHY DID YOU GET NORMAL BOOBS? what on earth do you say to someone like that.......
-
lago: I can see in certain instances and probably very few instances though, where a low profile anatomical implant could be useful.[If you are indeed referring to gummy implants??] That application would be in the case of a unilateral recon - where the native breast has a higher grade of ptosis and the droop needs to be matched on the MX side, or where the patient desires very little if any upper pole fullness - or where the IMF is quite high on the chest wall and a lower profile implant is desired. So why do you ask?????
-
If you mean cohesive gel - the standard silicone rounds - the low profile would be a moderate profile implant. I rarely see a moderate profile implant used in breast recon. The moderate plus profile is fine and very useful - popularly used as a close second to the high profile style.
-
whippetmom he specifically said low profile and I saw the number 15 in the catalog. Yes I mean cohesive gel. I see they are listed here. I do have a "short" body even though I am 5'6". It is possible based on the size I was and had little upper pole fullness. I used to be a large A/small B but now we are looking for more of a Large B/small C. When he said low profile I asked if I they were going to look like hamburger buns. He said no but now I'm concerned.
This could be very well what I am looking for but it's so hard to understand. He knows I don't what that "coconut/stripper boobs" look.
So why wouldn't they use a low or moderate profile in breast recon?
BTW I am now up on the picture forum
-
Annette I totally understand....and who WOULD say that??? Jeesh! If I judge my decision on my neighbors recent augmentation or my BFFs large DD's then I feel like I need to go bigger. If I judge it on how I cant sleep at night with this TE anymore, or the look on my DH's face when I wear a tank top...I know I am big enough. I think Ill go with how I look and feel and not with comparing myself to people who havent had BC.
-
Just called PS office and they are using a mid profile but he usually uses a high profile (ordered range 371-379 style 15 mentor cohesive gel). Not sure why the switch. I think I'm going to make another appointment to get this explained to me.
-
Lago ~ that is odd that he switched the size from what you had discussed? I'm thinking sometimes the PS's don't realize how much some of us research/know about all the little details (from sites like this) so they dont' "bother" us with all the specifics.. and just say.. "you will look good".
-
He didn't switch he just told me low profile but ment moderate profile. What I meant by switch is if he usually uses high profile why low on me. At least that's what the nurse told me but…
just spoke with the scheduler who orders these and she said he usually uses mid profile with reconstruction. I'm having a chat with the doctor tomorrow after noon. I wish he didn't say low profile yesterday. That's what got me thinking too much about this. The nurse might have been wrong about him using high profile most of the time.
I'm wondering if my PS is mixing up what I want to look like with what I want to fit into. I want to look like a full B/small C but not necessarily fit into a B/C bra.
-
The hard part is...The "look" of a small C to one person could be the "look" of a B or even D to another person. It is too bad they don't have you try on implants in a bra (like they do with augmentation patients) when you are still flat from the mastectomy. That way you could say... I like the look of THIS size implant on me. I wonder why they don't do that?
-
Thats an EXCELLENT point Susan!!!! When we were filling, PS just would keep asking if this was 'big enough'....or if I asked how much longer I had to go, he would just say until I felt happy with my size. But then he would tell me that the TE is a horrible way to tell what the end result would be. (Then how am I supposed to KNOW?????). So one day I went to my appointment saying "Before my MX, I was going to have a BA and we had decided on a 325." That completely changed him....so I went in with a sports bra and tried on 325's and 350's on the good side and he did his best to place it so it would look the most like it would after surgery....and we decided on the 350 on the left.
I think it should be standard practice, that unless you want to be the same size, that they SHOULD try on implants and talk about size more BEFORE....now granted there have been cases of 'boob greed' after the fact! Wah ha ha
-
lago: That is just fine for you. He will be using midrange profile, Style 15 - Allergan though, not Mentor. The Style 15 is a very nice style of implant and with what you describe as NOT wanting, the Style 15 is ideal for you. My sister has the Style 15. I will go look at your photos....
-
Suebee ~ so interesting that you mentioning the BA made him think differently! Again...why the heck don't they have us try 'em on while we are flat? I'm going to suggest this to my PS at next visit!
-
Saw the pics Lago. Your PS nailed it with the style!
-
Thanks whippetmom for checking. I am pretty sure he only uses Mentor but I'll find out tomorrow when I talk to him. I just wish he didn't make the verbal mistake yesterday of saying "low" profile. I feel I wasted a lot of energy on this. I never had any doubt with him in the past. You did make me feel much better.
-
Lago my PS usually uses moderate profile impalnts on most people. I think he may use high profile on me but i am guessing. I think they might be better for a good upper pole projection whch seems like i need because i am looking very hamburger bun now i could be wrong what do you think whippetmom?
-
Carrol - You have that appearance with the TEs because you have quite a bit of excess skin. Your pre-BMX size dictates that you have the skin flap to fill up and so yes, for you, HP is the best style. I personally do not feel that you need to be fully expanded in those TEs....Make sure you tell your PS you do not want excessive droop...that you want only a teensy bit of ptosis....droop....
-
Carrol although our frames are similar in size our breast sizes where at oposite ends of the scale. Sounds like high profile would make sense for you.
-
Susan - yes PS totally forgot that I was a candidate for a BA before diagnosis. It made it much easier that I had been through 'sizing' before. I had a general idea of what I was looking for...
-
Tara....
To answer your question, I am 5'7" and 160 lbs. I am 32" under my breasts. When I put on one of my old bras I fill it out completely, the only difference is these new boobs are already compacted and I don't have to squish them into the bra like my old boobs...if you can understand what I mean by that. They project wonderfully and I really don't look any different in clothing...I am a little shocked actually because I didn't expect to look like me. I think they look really natural...I am wearing a shirt today that is somewhat low cut and I have really nice cleavage and honestly there could not have been a better implant to give me the look I wanted. The width is also excellent and I never had the pronounced hamburger bun look, even right after surgery.
Kelly
-
kdhawk: So happy for you!!!
-
whippetmom ok thanks for the advice i have been telling him i like the side that is higher better but i will tell him again for sure next time so he knows that i don;t want to droop . . you would think he knows that though lol.
-
I just posted some updates to the picture forum...
-
I had a unilateral MX on May 13th. Prior to surgery I was about a 40DD and still am. My PS asked if I wanted to stay the same, get bigger or go smaller. I told him I wanted to a reduction and lift on the good side and try to match as much as I could on the other. Gravity and childbirth have not been kind to my non-cancer side. My PS was glad, said that was what he was thinking.
I have a Natrelle TE style 133MV-15, 600cc. He put in about 100cc during surgery, 60 @ my first fill, and 100cc at my fill on Thursday.
I'm 5'4, about 160. Measuring my ribcage is about 34 to 35. I would like to get a C or small D. I'm just wondering if we are on the right track with a 600cc TE.
How does one get access to the picture forum? I don't even see a picture forum.
-
Whippetmom, Hi I have been sent from disappointed in my exchange and exchange city. I would like a PM and your the expert. I had my exchange April 13th. I have had a 2nd opinion and she said the muscle was flattening the implant and she always put her imlants over the muscle. I always thought under was standard of care. I have a 3rd opinion soon. My PS wanted to wait 6mo. now reading all the posts I guess that was the right thing to do. I had a 650cc expander filled 760cc and a 650 implant. I feel very tight and flat.I am 5'6 190lbs rib 38inches measured just below breast.If you need more info You can email or I will come back here to look Ferrarioriginalbeads@yahoo.com
-
Beads: At the top righthand side of this page, you can do a member search and again to the right there is an option to send Whippetmom a private message.
-
Emaline: Please PM either myself, Lilah, Firni, Estepp Or Whippetmom re the Picture Forum as it isn't on BCO.
-
Emaline and Beads: Sorry.....could not get on bc.org yesterday....
Emaline: Your TEs are quite sufficient to get you where you need to be. I think between 650 ccs and 800 ccs - high profile implant, but it all depends on the amount of reduction achieved on the native breast.
Beads: Your implants are too small for your frame. You need 800 ccs - and I recommend using a Style 45 in Allergan - extra full projection style implant - smooth silicone round. I know the doc you consulted with in northern cal - I have mixed feelings about her "over-the-muscle" placement. Talk to your oncologist about this before going this route.
-
Kelly- thanks for the reply....it helps as we are about the same width & I was worried the 45's would not be wide enough. They are a bit less in width then my TE's. Do they give a nice slope, without a big drop off ?
I noticed the Allergan style 20 700cc's has more projection then their 800cc's ones....the 700cc style 20 seems to be closer to the style 45 in 800cc's. It's all very confusing. Does anyone know if going too wide without as much projection may be the problem to getting that hamburger bun look? My TE's are 750cc's now overfilled to 840cc's & was planning on exchanging to 800cc's but now thinking 700 may be better if I go with style 20. -
And does anyone know when they overfill what specs on the TE's change....width, height, projection, or all equally? And by how much? Then that throws off figuring out the exchange equals.
-
I got a little angry with my PS because he said something similar to what I'm hearing other PSes say... that the implant will look like the TE, so just fill until you're happy with the size. My TEs were humongous! But that's because they were hard and solidly fixed in place. The implants are fine, but look completely different than the TEs. You can't use them to determine the exact final outcome of the exchange...
-
JoanDavies my PS said to let him know when the projection of the TE's looked right to me. He did state that the TE's would not look like the implants. TE's are much higher, harder and not the same shape.
-
My TE's didn't get their projection until they were full because they were so wide & also tall height. It took a lot of cc's just to fill them up before they would fill out.
-
I have capsular contraction on one of my TEs so that side is high and i like how it looks and the other side is too low.
-
Thank-you Whippitmom I will take this info with me when I go for 3rd opinion.
-
Thank you so much whippitmom! I appreciate your help
It is good to know we are on the right track.What are your thoughts (or anyones thoughts) on tear shaped implants? I interviewed with one PS who did not recommend them, another who said it depended on differing factors. I stated that I thought they looked more natural then the round ones, and he stated that if done right, the round ones do the same thing. The PS who I ended up going with states that we need to wait and see, and we will discuss all those options as we get closer to exchange date.
-
Emaline: Geez, it still amazes me how much difference there is between PSs. Mine doesn't use the teardrops, says there's too much chance of rotation. If the round ones rotate, not an issue. He also thinks that round maintains a more natural drape in different body positions.
-
LOL Tina, I know. It is crazy. I see things people post here and I go "Well that is odd, my BS or my PS or whatever said that you need to do blah blah blah" and here someone elses surgeon is telling them "Yaddah yaddah". It certainly does make you scratch your head.
-
Another idea...Get a copy of your op. report. This will include an exact amount of breast tissue removed during surgery (usually in grams). This will make it easy to know exactly how much breast tissue you had before surgery and how much you need to add or subtract if you want to change your breast size (bigger or larger) or if you want to be the original size as before surgery, you can put back in the same amount they removed at surgery. Hope that helps.
-
My PS does not use tear shaped either for the same reason because they can rotate.
-
The tear shaped gummy is not approved in the US but some PS can offer it because they are part of a trial. There was one gal who posted on bc.org that had a choice. She felt the tear drop gummy was too firm and when with the cohesive round gels. It is uses in Canada and Europe. I'm sure there are several women on bc.org who can give you their first hand experience and tell you more about the benefits.
Carrol, WTF capsular contraction with your TEs! Well at least you know your PS will go back in there and fix that. As long as you are not in pain I'm sure your PS can work around that. I know my PS told me about this complication (most common BTW) and what he would do to remedy it if it happened at my very first visit with him.
-
Lago yeah well he wasn't 100% sure that was it, he just said looks like there might be a little capsular contraction. No pain from it. Just the usual uncomfy TE feeling. Guess it's more of an issue if it happens with the permanent implants. It's hard to tell what it is that is causing that side to be high he originally said it was because there was more tissue removed there cause that was the cancer side. It looked lopsided from day one but gets more noticeable as i get filled. I have more tightness on that side after my fills so i think that is why he thinks cc. I am able to loosen it up after a few days, pyhiscal therapy really helps.
-
I have a gummy implant and it is NOT going to move (or rotate) any time soon. They have been in wide use in Europe and Canada for over 10 years. Maybe its a matter of experience with implanting them. My PS, who is Canadian, had worked with them for years in Canada before coming here. It is in trial here so not all doctors have access to them... but many do. Sometimes I think the rules different PS's use has to do with what they are comfortable doing.
-
I received Gummies with exchange last Friday. Get drains out and bandages off tomorrow. So I'll have to let you know later what I think. so far...good! Just havent really seen them yet. I talked to others who have Gummies and they love them bc they look so natural. My PS does them a lot. True, that not all PS have approval to do them since they are still in clinical study. He has had no problem with rotation. Likes them for reconstruction bc they don't ripple. He also uses allerderm and fat grafting.
-
Has anyone gotten natrelle style 45 implants? if so what do you think of them. I am having my exchange surgery 8/9/2011 and am getting these implants silicone with 600 cc
-
indenttwins: i'm scheduled for exchange on june 21st using the natrelle 45s. i'll let you knowwhat i think!
kelly
-
thanks kelly will be thinking of you
-
I had my last fill and he called it an overfill. I am still trying to figure out what is the purpose of the overfill, I really do not like being this large. Trying to decide if I should call and complain.
-
Shannon I understand the overfill stretches the skin larger than the PS will need for the exchange...and for a little more natural look later. My PS ended up putting in a larger implant than I was expecting...so the overfill was good news. Also, he explained to my husband today that the expander is stretching the SKIN in a slow and easy fashion...that the muscle it goes under doesnt need that (just think of women who get the implant under the muscle in a Augmentation dont need an expander before surgery)...remember that bit of skin has been through a lot!
-
Shannon: Suebee's answer is a good one.
-
SILICONE VS. SALINE.....
http://www.wkrn.com/story/14689395/breast-implants-silicone-or-saline
-
I am new to this board, I had a BMX in Nov 2010 with immediate tissue expanders. Of course after 10 days I developed an infection on the left side (same side as cancer). No fluid was available to drain so I had to remove the TE and I never found out about the infection again. All was well. About 6 weeks later, I went back in to try and replace the expander. Two days later bam..fever, huge swollen breast with fluid. PS did a culture and I had Pseudomonas. WtH??? He said I probably had it since the BMX but since i had no fluid to culture he did not know the exact infection. Oh and Im also allergic to Levaquin which would have killed the gram negative bacteria. Once again I had the TE removed and now I wait. PS said I had to wait at least 3 months to make sure the infection is completely gone. I went on to IV antibiotics and here I am 2 weeks before my surgery and I am scared. I know everyone said, I should wait if I feel uncomfortable but I am 34 years old and a newly wed and all I want is 2 boobs. I dont even care if they are expanders only. I am so tired of wearing the foob. It falls out during yoga and I cant stand it. Ahh...I just needed to vent. I hope everyone is well.
-
sanbar: From a study of a pseudomonas aeruginosa infection in a breast cancer patient with breast implants......[NOTE that implant removal was NOT curative. Treatment with the right antiobiotic WAS curative!]
...."On hospital day 3, chest wound cultures grew P. aeruginosa sensitive to cefepime, meropenem, and amikacin and resistant to gentamicin, ceftriaxone, imipenem, and ciprofloxacin. She was started on meropenem 1 gIV every 8 hours, and the infection rapidly resolved on meropenem. She completed 7 days of meropenem therapy."
Different types of implants have varied infection patterns. Saline implants and breast expanders usually have acute onset of symptoms, whereas silicone implant infections are often seen later postoperatively. Silicone implants are more vulnerable to seeding from distant locations and may be infected.
Symptoms of breast implant infection include fever, redness, tenderness, and, sometimes, discharge at the surgical site. Imaging should be done to identify an abscess or fluid collection near implants. Drainage/implant removal is usually required to ensure bacterial eradication. When possible, reimplantation should be postponed until the infection has been eradicated. In this case, implant removal was not curative. Therapy with meropenem was curative.
-
Oh....and what the article also mentions, is that this particular patient had allergic reactions to the first two ABX treatment attempted - cefazolin, linezolid. But this is IV ABX.....not oral ABX.....
-
sanbar8771: Aack! What a tough course you've had so far. Seems we all hit snags along the way; too bad yours has been a big snag. Looks like you've been at this for over a year now, you have every right to vent! So, your upcoming surgery is a third try at placing an expander? Hopefully, third time's a charm
!Those of us in various stages of reconstruction or stalled due to problems find it extra-challenging to make it through these hot summer months without the camoflage of clothing layers. It sure isn't fun with padding, uneven chests, etc.
Hang in there and congratulations on your marriage!!!
-
Identtwins: I have the Natrelle 45 800's and I absolutely love them. They are the perfect fit for me and I have a lot of projection. I feel the 20's would have been too wide for me considering these take up my whole chest and rub against my arms...I definitely have an hourglass figure with them. I have no complaints as you can probably tell!
Kelly
-
Hi Wmom....I hear you are the "Go To Gal" for all things reconstruction! My PS said he used "Dermastan"?? TEs....He said they're similiar to Allergans. Any word on those?
-
Yes, they are called Dermaspan - by SSP Inc - designed by Dr. Dennis Hammond - a Michigan PS. Find out what style and volume you will be getting - make sure he leaves this info with you after the surgery and then we can look up the dimensions for you.
A few gals on these forums have had them. Perfectly fine TEs....probably are too cost-prohibitive for most docs to use them though, which is why they are used so infrequently.
-
Whippetmom--My exchange is coming up 7/7 so I am trying to get my ducks in a row here.
Here is the information I have so far:
I am 5'4", 140 lbs. rib cage: 33inches.
I have mentor implants and will have mentor silicone hi-projectile permanent ones.
My PS isn't going to overfill because she says I have enough skin. I have had 4 fills. I thought she said they were 50cc each time, which seems small, but I think I am plenty big. My right side fills out an old bra--36B Bali Barely There. The left is a little lop sided--non cancer side--kinda flat towards my arm. She says she will use different sizes to make them even.
I asked her about size and she said she usually takes in about six different ones. I had the lat dorsi flap surgery on my right side. PS also said she thought I would probably be a "C" when all is said and done. Does this sound right?
-
Whippetmom--My exchange is coming up 7/7 so I am trying to get my ducks in a row here.
Here is the information I have so far:
I am 5'4", 140 lbs. rib cage: 33inches.
I have mentor implants and will have mentor silicone hi-projectile permanent ones.
My PS isn't going to overfill because she says I have enough skin. I have had 4 fills. I thought she said they were 50cc each time, which seems small, but I think I am plenty big. My right side fills out an old bra--36B Bali Barely There. The left is a little lop sided--non cancer side--kinda flat towards my arm. She says she will use different sizes to make them even.
I asked her about size and she said she usually takes in about six different ones. I had the lat dorsi flap surgery on my right side. PS also said she thought I would probably be a "C" when all is said and done. Does this sound right?
-
rowan: So you have around 200 ccs - but I do not know the style or recommended volume of your TEs. If I were predicting what implant size you might want to consider [sans this TE info], I would place you in the 450 cc to 500 cc range. Perhaps even moderate plus profile - in order to get sufficient width. Additionally, your PS may find she needs to use different profiles, in light of a unilateral flap. Perhaps a high profile and a moderate plus profile. I just do not know, without seeing how much volume or projection is provided by the flap or knowing the current width of your TEs. Keep us posted though and let us all know how it turns out!
-
identwins I also have the style 45 800cc as kdhawk does and I absolutely love them. I have pics on the forum but will try to post updated since now I have my nips and have not updated pics in forever. I love how natural mine are.
Best of luck to you.
Rebecca
-
Whippetmom--thanks. I know she is planning on using different sizes. I got distravcted in my last visit with other questions so I didn't find out the exact TEs she used. I'll ask for a card when I go this Wednesday. I know she did say she would use high profile because I have no breast tissue.
Is there any relationship between amount of total fill(s) and the final cc implant size?
That's where I get confused...200ccs and implants 450-500cc? are we talking apples and oranges?
-
Rebecca: How are you doing? Better? Been thinking about you!
-
rowan: You probably had ample skin flaps after BMX. Some relationship between the amount of fills and the implants - but the TE dimensions factor in as well. You might have a 400 cc TE and it is only filled to 200 ccs, but the footprint of the 400 cc TE is still there. You still have the width of that TE to take into consideration with the future implant selection, and any projection which is gleaned by that degree of fill. You might not require 400 + ccs on the flap side - your flap provides volume and so it would be a flap plus a small implant and then an implant on the prophy side - presumably greater volume.
-
MBJ I am doing great. I really don't post too much but I do read up and check on everyone. Thank you for asking.
Deborah did you send me a PM I got one but cannot get it to open?
Rebecca -
Whippetmom--Wow, that makes a lot more sense. Now I'm starting to get it. That's probably why it hurt so much in the beginning in the middle of my foobs, over the breastbone. Very tender. As they started to get fuller the edges weren't so pronounced and the pain decreased in that area. Thanks.
-
rowan....yes....they are like a deflated football.....and those rough edges are smoothed out as air goes into the football!
-
Rebecca....Was not me. They are making some changes to private messaging....
I did not get back to the desert....obviously....
I will let you know if I make it out in July..... -
Thanks for getting back to me Deborah. I will plan to sneak up to Vegas in case you don't come in July. It is 107 here today so maybe better you didn't come.LOL
When is the Vegas trip?
Rebecca -
Hello everyone. I am totally new this site and this is my absolute first post. I just got my implants on june 1st. Its a mentor high profile 325cc's. I am very disappointed with this size, much smaller than I expected.
About me, 5'4'' , 127lbs, ribcage 28". Now before BMX i was a 34A. But when I first met with my PS he ask what size I wanted to be and I said a C cup and he said okay. He never mentioned that this may not be possible, so I went like 5 mos. thinking I was gonna now be a c cup. at my last fill in may, he told me there was no way i would be a c cup...(I also told him at my first fill i wanted a c cup and he said okay)...nevertheless I had a natrelle style 133mv 250ccs and he filled them to 370ccs...this was like a small b on me. I was happy with that. I knew he was bringing a few sizes to the switch including 375 and 400...i was hoping for 400 but would have settled with 375...i couldn't beleive he put in 325...also, when filled to 370 my skin was not tight at all.
So, yes, now I am an A cup, as I was, but they now look like flat hamburger buns, very little projection..and now i can't even wear VS push up bras like I use too...so it's almost like being smaller than I was
I just wanted to get some input as to whether I should just settle for what I have or is there something I could possibly do...
also can someone explain to me further what fat grafting is all about...i only have a slight idea...i was wondering could I do fat grafting at this point to enhance projection?
thanks for any input...
-
fighter33 - Hello! Welcome to the site!
I'm no expert ... whippetmom will come along soon. I just want to encourage you. I'm an inch taller, weigh a little less, but we have the same ribcage circumference. I had my exchange surgery to 325cc implants last July. I think we had the same exact expander. I was overfilled to 310cc's. I doubt very seriously you're an A cup. I wear a 30D or a 32C. It's still very early out from your exchange. Like you, I don't have the projection that I expected or wanted. BUT it does get better with time. Your pec muscle right now is very tight and over the next 3-6 months that muscle will relax and you will get more projection than you have right now. Relax a little (I know it's hard) and wait. Time is your friend ... a little patience!
If after six months you're still not happy and you want to go bigger, go in for a revision. But let time be your friend right now.
Peace to you! [[[hugs]]]
-
fighter: I think that it also depends on which style of implant your PS used. Do you have that information? A high profile, moderate profile, moderate plus? I would personally have recommended 400 ccs for your frame - which would not be at all unreasonable for you to aspire to with your TEs. You have plenty of time to plan your next "move", if revisions are in your future. So, as Dawne-Hope suggests, give it a little time. But let's go over your implant details.....
-
Hey guys..thanks so much for your input...my implants are mentor smooth round high profile gel.
Dawne-Hope..you seem to be a lil bit smaller than me? I never had a 30 band size bra..but i don't know, I just did online bra calculations...so I am not sure...but I have to say, just hearing from you guys has put a smile on my face
and added hopeI will give it a lil time as you guys suggested....
-
fighter33 - Good! Hope is a good thing!
There are women on here who have had fat grafting that can respond to that question.
With a 28 inch rib circumference, a 34 band is too big! It's strange and a little sad, really, that I didn't get properly fitted for a bra until after my lumpectomy. It really hurt where I had the surgery so I went for a fitting and I'd been wearing a 34B but was sized a 32C. I've learned since then that a majority women are wearing too big of a band size and too small of a cup size. Some of those bra calculators do NOT work for reconstructed breasts. On one of them I measured a -A cup! LOL! Crazy! There is a whole bra thread that is called "Bras 101: The Great Post-Exchange Debate" that provides a lot of helpful information and I think in the header there is a link to a bra calculator that works for some women who have had reconstructed breasts, although it didn't work for me. (I think I'm an anomoly!)
Blessings to you, fighter! You're in great hands with whippetmom!
-
Fighter -- there are definitely a lot of changes your implants will go through in the next 3 - 6 months so hang in there. Also re: bras -- check out a thread on this site called Bras 101: The Great Post Exchange Debate. Val who started it has a formula for figuring out bra sizes for us gals with implants that will help you to do the right calculations. The width of implants usually means a larger cup size than you might think. Finally -- over time as you heal you should find that the implants soften (and your body around them) and you very likely will be able to wear push up bras again. Anyway -- glad you're feeling better! For what its worth, a lot of women feel worse/more depressed after the exchange (the switch, as you called it) than after the MX for a variety of reasons... but longer term most come to like their implants (and those who don't get revisions
-
Lilah--its funny you mention that some feel worse after the exchange than after the MX, b/c that is definitely me. I had a very positive outlook and was in high spirits (most of the time) after BMX surgery and 6 rounds of chemo...my last treat was 4/21 and i have been having a lot of emotional ups and downs since then...i look worse now that i did two months ago, lost all my eyebrows, eyelashes and now have hugh really dark circles...from what i have just recently read, i now understand this is normal...
I will check out the Bras 101 thread
Dawne--I am thinking I should go to nordys to get a proper bra fitting, i heard they were good. Do you have any suggestions.
thanks so much guys!!
-
Welcome fighter33! I'm waiting for my exchange in July. I just wanted to say that I am glad you find us and hope for the best for you.
-
Hi Fighter: I agree, so glad you found us! You will change so much in the next few months! It took my MX side almost 4 months to take it's "real" shape, up until then it looked small and smooshed. I also had 6 round of chemo (TC) and then surgery. What hospital did you get treatment at?
Categories
- All Categories
- 679 Advocacy and Fund-Raising
- 289 Advocacy
- 68 I've Donated to Breastcancer.org in honor of....
- Test
- 322 Walks, Runs and Fundraising Events for Breastcancer.org
- 5.6K Community Connections
- 282 Middle Age 40-60(ish) Years Old With Breast Cancer
- 53 Australians and New Zealanders Affected by Breast Cancer
- 208 Black Women or Men With Breast Cancer
- 684 Canadians Affected by Breast Cancer
- 1.5K Caring for Someone with Breast cancer
- 455 Caring for Someone with Stage IV or Mets
- 260 High Risk of Recurrence or Second Breast Cancer
- 22 International, Non-English Speakers With Breast Cancer
- 16 Latinas/Hispanics With Breast Cancer
- 189 LGBTQA+ With Breast Cancer
- 152 May Their Memory Live On
- 85 Member Matchup & Virtual Support Meetups
- 375 Members by Location
- 291 Older Than 60 Years Old With Breast Cancer
- 177 Singles With Breast Cancer
- 869 Young With Breast Cancer
- 50.4K Connecting With Others Who Have a Similar Diagnosis
- 204 Breast Cancer with Another Diagnosis or Comorbidity
- 4K DCIS (Ductal Carcinoma In Situ)
- 79 DCIS plus HER2-positive Microinvasion
- 529 Genetic Testing
- 2.2K HER2+ (Positive) Breast Cancer
- 1.5K IBC (Inflammatory Breast Cancer)
- 3.4K IDC (Invasive Ductal Carcinoma)
- 1.5K ILC (Invasive Lobular Carcinoma)
- 999 Just Diagnosed With a Recurrence or Metastasis
- 652 LCIS (Lobular Carcinoma In Situ)
- 193 Less Common Types of Breast Cancer
- 252 Male Breast Cancer
- 86 Mixed Type Breast Cancer
- 3.1K Not Diagnosed With a Recurrence or Metastases but Concerned
- 189 Palliative Therapy/Hospice Care
- 488 Second or Third Breast Cancer
- 1.2K Stage I Breast Cancer
- 313 Stage II Breast Cancer
- 3.8K Stage III Breast Cancer
- 2.5K Triple-Negative Breast Cancer
- 13.1K Day-to-Day Matters
- 132 All things COVID-19 or coronavirus
- 87 BCO Free-Cycle: Give or Trade Items Related to Breast Cancer
- 5.9K Clinical Trials, Research News, Podcasts, and Study Results
- 86 Coping with Holidays, Special Days and Anniversaries
- 828 Employment, Insurance, and Other Financial Issues
- 101 Family and Family Planning Matters
- Family Issues for Those Who Have Breast Cancer
- 26 Furry friends
- 1.8K Humor and Games
- 1.6K Mental Health: Because Cancer Doesn't Just Affect Your Breasts
- 706 Recipe Swap for Healthy Living
- 704 Recommend Your Resources
- 171 Sex & Relationship Matters
- 9 The Political Corner
- 874 Working on Your Fitness
- 4.5K Moving On & Finding Inspiration After Breast Cancer
- 394 Bonded by Breast Cancer
- 3.1K Life After Breast Cancer
- 806 Prayers and Spiritual Support
- 285 Who or What Inspires You?
- 28.7K Not Diagnosed But Concerned
- 1K Benign Breast Conditions
- 2.3K High Risk for Breast Cancer
- 18K Not Diagnosed But Worried
- 7.4K Waiting for Test Results
- 603 Site News and Announcements
- 560 Comments, Suggestions, Feature Requests
- 39 Mod Announcements, Breastcancer.org News, Blog Entries, Podcasts
- 4 Survey, Interview and Participant Requests: Need your Help!
- 61.9K Tests, Treatments & Side Effects
- 586 Alternative Medicine
- 255 Bone Health and Bone Loss
- 11.4K Breast Reconstruction
- 7.9K Chemotherapy - Before, During, and After
- 2.7K Complementary and Holistic Medicine and Treatment
- 775 Diagnosed and Waiting for Test Results
- 7.8K Hormonal Therapy - Before, During, and After
- 50 Immunotherapy - Before, During, and After
- 7.4K Just Diagnosed
- 1.4K Living Without Reconstruction After a Mastectomy
- 5.2K Lymphedema
- 3.6K Managing Side Effects of Breast Cancer and Its Treatment
- 591 Pain
- 3.9K Radiation Therapy - Before, During, and After
- 8.4K Surgery - Before, During, and After
- 109 Welcome to Breastcancer.org
- 98 Acknowledging and honoring our Community
- 11 Info & Resources for New Patients & Members From the Team