BREAST IMPLANT SIZING 101

momoftwo526

I posted this also on Exchange City, so this is a cross post, but am at a loss for what is going on and thought some of the experts like Whippetmom might know.

 I have a new development.  The skin on my left "breast" (in quotes cuz it isn't really a breast anymore, is it!) has changed in color.  On Thursday, I had noticed a sharp pain for about 2 minutes and then a warming feeling.  About 2 days later (Saturday), I noticed a small area of coloration change.  By Sunday, this color change covered 1/2 of my "breast".  I called my PS's answering service on Sunday and he called back within 10 minutes.  I described to him what was going on and he said it sounded like cellulitis.  He told me to apply a warm compress, take it easy and he prescribed an antibiotic.  I saw him today, and he is perplexed. It looks like a bunch of capillaries are broken.  He said more like a bruise than cellulitis. No sign of infection, but told me to continue taking the antibiotic and to keep him posted if anything changes.  Getting ready for bed, I noticed the color was pinker and it had advanced to midway in the sternum area.  So, I took my antibiotic and did a warm compress.  After the compress, the pink went away and the discoloration is again looking more like a light bruise.  So weird!  Anyone else have anything like this?  I still have TE's in and no sign of rupture and have not done anything that would bruise them, or at least I don't think so.

Phyllis

Lilah

Phyllis -- not sure.  I've heard of something called Red Breast syndrome... but I don't think that occurs with TEs (just implants -- and, if I remember right, it's usually implants with alloderm).  I'm so sorry.  I hope it goes away soon.  As long as you've got your PS on it (and he's seeing it in person and treating it as best he can) I don't know what else can be done.

MargieC

whippitmom ---  need your advise I am trying to decide between high and extra high profile.

I am 5'3" 140lbs currently (up 6 lbs from normal weight since surgery) ribcage 30" -- prior to BMX I was a large A/small B - I have my pics on the photo site.  My hope is to end a bit bigger then I was to balance out my body.

I have the Natrelle 133 MX expander filled to 360cc - final fill will bring me to 460cc (PS wants to over fill a little).

The implant sizes PS is looking at is Allergan style 20 (high profile) or allergan style 45 (extra high profile).

~~Margie

momoftwo526

Ok, I woke up this morning and the discoloration has spread to the top of the breast and to the middle of the sternum.  I am scared that it my spread to the right breast (also has a TE).  I contacted PS and he said to call my BS to rule out IBC.  I contacted them and now have an appointment for tomorrow morning.  I now am very worried.  Nothing seems to be working.  The warm compresses are not doing any good. Can you get IBC after you have had all of your breast tissue removed?

I hate this! 

Phyllis

Anonymous

Momoftwo,



So sorry to hear about your problems. I don't know the answer to your question, but I'm sure that it is very unlikely. Good to get it checked out, but try not to think the worst now. At some point in our past we didn't think twice about those odd aches and pains, etc, and most of the time it was nothing. Its hard not to worry after what we've been through, and we all do it so well, but try to find something positive to focus on now, as that's all we can do. When do you see the breast surgeon?

Anonymous

Sorry, I re-read your post and see that you are going in tomorrow. Hang in there, our thoughts, hearts and prayers are with you, and keep us posted.

<<hugs>>

Eema

Oh mom' I hope it is nothing. I had something similar and mine was from the skin being stretched. Now it is yellow, but I, too, am on lockdown and not allowed to move. Breath, it will all be ok, no matter what it is.

Eema

And one more thing -- the bs is covering his/her @$$ by making you see the bs.

CBeam

So much great information here!  This is my first post here...I had TE placed at the end of Oct on the "bad side" (had masc. on one side only Feb 2010 and finished chemo in Sept 2011).  Today I had my second fill (100 cc's both times), and PS thinks we might only need one more.  I don't know what kind / size TE was put in - my "good side" is a small B and I would like to go bigger.  I'm almost 6' tall & weigh 180; rib cage is 35".  I think I need more fills to get larger than I currently am.

What should I ask her next week when I return for fill three?  How many fills is "average"?  The TE seems fairly big now, I guess, without anything to compare against.  Any advice?

Thanks in advance for any info you can all provide!

whippetmom

Phyllis: As Lilah mentioned, it could be Red Breast Syndrome - and can happen with TEs if you have Alloderm.  It is harmless and typically resolves within three to six weeks after occurrence. Tell me if the redness or discoloration is in the lower pole - where the Alloderm hammock would be located.  Just just keep monitoring for warmth and any temp changes.  If it is RBS, it will not resolve with ABX treatment - so don't stay on them unnecessarily for a protracted length of time. 

Deborah

whippetmom

Margie: I need to know the width of your TEs.  It is a MX, but what volume?  Is it a 400 cc?  You probably could go either way with implant style - no chest wall placement issues that I can see which would make one better than the other, but it depends on the width of your TEs, how large you want to go, and how large an implant your PS is willing to use. 

whippetmom

Phyllis: Just saw your latest post.....praying it is NOTHING!  Keep us posted!

whippetmom

FOR THOSE WHO NEED HELP WITH IMPLANT SIZING:

From the header above:

3.  IMPLANT SIZING INFORMATION:

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. 

whippetmom

CBeam: I am confused about whether you have a BMX or a single MX.  Did you have a prophylactic MX on the "good" side?  Do you have two tissue expanders?  Please read the post above and let me know all of the details about your TE or TEs. 

Eema

Deborah, any suggestions for an engorged booby besides not moving? I had my drains out yesterday and lefty is about half a size bigger than righty, is fairly firm, and hurts. I took some arnica but don't know what else to do. I'd rather not call the PS on duty over a long weekend if I don't have to.

christine47

Eema, I am no expert, but did see your question.  Engorgement is a term that is typically used when discussing breast feeding and swelling/filling of the mild ducts.  After our mastectomies, we no longer have these ducts.  More likely is that you are developing a hematoma or seroma.  Since your drains have been pulled, this is possibly fluid that can not go anywhere and could make the breast warm, swollen and hard.  I would call the plastic surgeon tomorrow.  just my 2 cents.

whippetmom

Yes, Christine is right...it sounds like a seroma/hematoma to me.  They never should have sent you home saying "do not move for 72 hours", because it sounds to me as though there was some suspicion that something was going on.  So please call tomorrow morning and insist on getting in so that this can be addressed.  Let us know how it goes tomorrow.  If it is a hematoma it needs to be evacuated.

CBeam

@ whippetmom - I will have to ask my PS about the TE type & size.  I had a single MX and so only have one TE.  I will get additional infomation as requested.  Thanks.

whippetmom

Cbeam: Okay, great!

momoftwo526

Thanks for all of the support.

I just posted pictures of the discolored breast on the picture forum.

On another note, my I left a message with my OB/GYN office re the lack of response on the followup results of my papsmear & cervical biopsy.  The Dr. called today and apologized as he had given them instruction to call me as soon as they got the results.  He said the results show abnormal hyperplasia, but not cancer.  He said he would redo the tests in 6 months.  I also told him about the breast skin discoloration, and he said since all of the breast tissue had been removed, he thought it would be unlikely that it was IBC, but with all of the issue I have had especially with the left breast over the years, (3 other biopsies and nipple discharge) he thought it would be a good idea to have the BS look at it and take a sample of the skin. Sooo, wish me luck today!

I will let you know as soon as I know more, but I know it will could be a week or more since this is a holiday weekend coming up.

Phyllis

MargieC

whippetmom - thanks for replying.  I am not sure of the width of the TE but I believe my PS said it was 400cc but it could be over filled if I wanted to go bigger then we originally talked.  My problem is I am just not sure how big I want to go. 

Eema

Well, I was on the border when they took the drains out, still putting out about 24 ccs a day. They told me not to move the last time they took the drains out, too.



I'm still bigger on the left than the right, visually so when you look @ my bra. I have cleavage on one side but not the other. Blah. I just want this to be over.



I will call the PS, just to be sure. Maybe the visiting nurse is a better idea?

AnaM

Hi ladies.......I have been AWOL for a long time, very busy. I am going for genetic testing next week and am very anxious about that....not the blood draw even though I HATE needles, but just the whole thing of waiting for results and what they might say. I also am scheduled for my second colonoscopy the week after...being in the high-risk group (ovca twice then brca) I have to get it done every 5 years instead of 10.

 I havea question for you: I had exchange surgery the first days of October so I am approaching the 2-month mark. EVERYTHING has gone well except that I am finding the implants are NOT squishy, soft or even drooped ! I am very satisfied with my PS, and last visit he said he does not need to see me until 6 months from now.....and to give my new foobs more time to settle, that everyone is different, and that YES they will get soft and droop somewhat. I LOVE going bra-less and have decided I don;t want nipples. But I sure would like to be soft, geez !!! Any opinions out there?

I am wishing everyone here a WONDERFUL Thanksgiving.

Smiles, Ana Maria

lago

Ana I always thought my implants were softer than my old dense tissue originals so I might not be a good person to answer this but your PS is correct. My PS even said to me not to spend too much money on bras in the next 6 months (after excahnge) because they will continue to change. I had a revision done to lefty about 7 weeks ago and it still hasn't dropped completely.

I did see my PS before 6 months because I did my nipples 3-4 months later.

whippetmom

Ana: The implants will soften over time.  It depends on how tight those pockets are - it just takes longer for some.  You are probably at a point where you could start implant massage exercises.  This is what works for most of us.  Get some BioOil at the drugstore and start massaging!

momoftwo526

I just got my Turkey in the oven, so am taking a few minutes to update you all on my Dr. appt. yesterday with the BS. He said it was definitely NOT IBC, so that is a good thing.  He said it appears to be blood flow related or an allergic reaction. However, I haven't changed anything other than I am eating less, but not eating anything new and no new medications no changes in laundry detergent or anything like that.  He also said it was not any type of necrosis and the TE
is intact. He told me to finish the antibiotics prescribed by the PS, however, it does not appear to be an infection. I am to call him or the PS if it worsens or spreads further.  Otherwise, I will go back to see him right before Christmas. What is weird, it improves with a warm shower or a warm
compress.  Then, when I get up in the morning, it is right back to how it looks in the pictures.  Oh and it is not red breast syndrone either -- I don't have Alloderm.  Also, he said the TE's have been in so long, that he doubted very much that it was a reaction to them.

I also finally got a call back from my OB/GYN.  He had been out of town and he had told his staff to call me immediately with the results as soon as they were in. I have called the office 3 times and each time they told me that the results had not yet been read. He was upset that his staff had not, so he called me at home yesterday evening. The pap results still showed non-specific abnormal hyperplasia, but no cancer. He said that it could resolve itself, but he wants
to repeat the tests in 6 months to make sure it doesn't turn into cancer. So I guess for now, just have to go thru testing every 6 months. 

So, at least it isn't cancer, but I wish I knew what was going on.  Praying that it
resolves itself and doesn't get any worse.  I don't want anything to delay my exchange any further! 

Everyone here have a good
Thanksgiving!

Phyllis 

whippetmom

Phyllis:  What great news to be thankful for today! 

whippetmom

Happy Thanksgiving!!!  I am so thankful for all of you!

Anonymous

Momoftwo, that iS great news!



Happy Thanksgiving to all!

TinaT

I just found something interesting on a PS website.  It addresses cleavage determinants for augmentation patients, but it seems it would apply to reconstruction as well.  Helps to explain why chest/ribcage/sternum configuration dictates the amount of cleavage we might end up with after surgery. 

http://www.advanced-art.com/Breast-Aug-Cleavage.htm

(I am posting this on a few of my threads so forgive the repeat...)