Not impressed. Revision? Solutions?

Cmoore615

long story short: exchange was 4/23 (I know, I know, don't look in the mirror yet).  Expanders were 540 & put in round smooth "high profile" 610.  I was constantly concerned I wouldn't end up "the same or better" & I LOST projection from TEs once expanders placed:(. I'd rather have them back (really didn't bother me too much)!

Here lies the problem: I was a healthy F prior to dx (5'6" & 145#).  When I met PS, I was 130 & a D.  He didn't really believe me that I was an F prior to treatment & said I was too petite for much larger than a D. I was "voluptuous" prior to this crap & I'm not feeling it post exchange at all.  & my DH agrees (he is VERY supportive so please don't think he is being negative or adding insult to injury)!

So, do I hope for some type of revision post RADS or am I fairly stuck in "average land" when I was larger than average before?  Anyone else get to go larger post RADS?  And anyone know the insurance ramifications of "touch ups"?

sandra4611

It's a shame you didn't know this before your exchange surgery. It's a familiar topic on a number of threads here. Those of us who have gone before you always make sure women understand that implants will be a lot smaller - could be half the size of TE's -  even when they have exactly the same number of cc's. TE's have hard backs so the saline pushes the muscle and skin out. Implants are soft and conform to the shape of your ribs so they don't push out like TE's.

The kind of implant you can get depends on the manufacturer and size of the TE's that were put in. The implant has to fit exactly into the pocket created. Most TE's can be overfilled without damaging the TE and the pocket can usually take an implant with 100 more cc's than the TE. Yours did. The plastic surgeon may be able to put in a slightly bigger one but it's probably not going to be what you want. 50-60 cc's aren't especially noticeable and the benefits won't outweigh the dangers of another surgery. You may be able to get TE's again, bigger this time, and end up with bigger implants a few months later. The surgeon could also revise the pocket to conform to a different kind of implant. I've had that happen several times. Pocket work hurts, but it goes away after about a month. Your doctor should be able to tell you what options are open to you. Most will ask you to wait a year or so before any revisions though.

Implants are misshapen at the beginning and take several months to assume their permanent shape. Each side heals at its own rate so don't expect them to look the same. Most of us report that new implants look more like hamburger buns. They are wide and pretty flat. (I thought mine looked like "man-boobs" at first. You will not be able to fill out a bra cup completely because the cone shape is no longer there. (Minimizer or stretch cup bras are more likely to fit since they are flatter.) After several months, most implants "drop and fluff" which means the pec muscles settle down and relax, allowing the implant to assume a more natural, lower position. The flatness becomes softer, smoother and rounder.

Cmoore615

thanks Sandra4611!  I'm trying to be patient & looking at your info, you are an exemplary example of patience with the process.  I've been through weeks of PT & have complete range of motion in both arms (been throwing the baseball with my son since 4 weeks post mast!) so I feel my pecs are stretched & relaxed. I see the PS tomorrow for follow up appt from surgery.  I guess there won't be a real answer until after Rads.  Just wondering how the insurance company will view  any revisions.  Thanks for your help:)

SpecialK

cmoore - radiated skin does not stretch well, can have healing issues post-surgically, and many PS will not attempt reconstruction related surgery after rads, particularly to go bigger.  You might risk surgical complications and potential loss of implant.  Also important to note that the largest silicone implant is an 800cc, so only 190cc larger than what you have now.  You might get another 1/2 inch of projection from the size difference.  Right now I have two different size implants - a 650 on the right and a 500 on the left - long story that I don't need to go into - but you can't tell the difference between them unless you look very, very closely.  So, a difference of 150cc, but virtually no difference visually.  I am petite and small boned - 5'2" and about 125 lbs., had 550cc expanders put in, filled to 600 on left, 650 on right and exchanged to same in smooth, high profile, rounds.  I visually look like a C cup, but measure a D cup in an underwire.  Insurance will pay for medically necessary revisions with reconstruction, but it might be a hard sell because you would like to be bigger.  Do give things some time - you will not really know what your implants will look like for several months more.  Good luck!

Moonflwr912

C more I am sorry you are not gappy with your permanent implants. But just so you know the biggest Saline implant is 900 cc. I have 850 cc and I fill a C cup pretty well. The simple fact is that your skin will not be strong enough to hold a much larger implant for reconstruction purposes. They have to put it behind some of the chest muscle just to hold the weight of it. They usually use an alloderm sling to help hold it in place. Your natural breast is held in place against the skin by EVERY cell near the skin in a network. That network is no longer there. There is also the fact that radiated skin is very hard to heal. They are having some success with fat grafting after rads before implants are placed. Lots of discussions about that. Feel free to check out Exchange city to get opinions from others who have had implants placed. Everyone who answered you is already on that thread. You may not get as many people finding this one as a lot just go to their favorites.

Much love.