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  • Lilah
    Lilah Member Posts: 4,898
    edited October 2010

    Aw What-to-do -- your hubbie is a sweeettiiiieeee!!!!!! 

    Beesie -- well now it does make sense NOT to keep it in your wallet LOL... I just put it there the day I got it (when I was being discharged after the exchange) and haven't thought about it since.  I figured if I ever do need it, I'll probably not be home and so I am keeping it there.  It's right next to the card for my port -- which, I'm happy to say, will be coming out in a few weeks!

  • whippetmom
    whippetmom Member Posts: 6,920
    edited October 2010

    Per this Canadian PS:

    "Allergan 410 implants - or as they are more properly known, NatrelleTM Highly Cohesive Silicone-Filled Breast Implants (Style 410) - offer the highest level of cohesion and more than 140 different combinations of height, width, projection and firmness."

    http://www.plasticsurgerycan.com/article_breast_implants.php

    From a UK PS...

    postby ukplasticsurgeon » Sun Mar 08, 2009 12:48 pm

    "The 410's are available in soft touch silicone which is softer than their "27" silicone. The inspiras are available in soft touch and responsive gel, the latter being softer than soft touch silicone.

    I'm not sure about what is an what isn't FDA approved, though, as I don't work in the US, but I think I know which are the best implants available in Europe. Some UK implants aren't available in the US (ie are not FDA approved) and are very good. I think the Inspiras fall into this category as I haven't heard of any US surgeon offering them."

  • whippetmom
    whippetmom Member Posts: 6,920
    edited August 2013

    Another link describing the two degrees of cohesiveness...

    http://www.puls-norge.no/upload/Puls/BR-Brosjyrer/RP%20Brystproteser/120,058%20Rev.%20B%20Style%20410.pdf

    But what interests me even more is the reference to the 410XP range of implants, which reportedly will benefit breast reconstruction patients, especially it seems, unilateral reconstruction cases.  Very promising!!!

    EDITED:  Well, I think this was a bit misleading...perhaps they refer to the "X" extra full projection being added to the different height ranges.  I'll research this further. 

    I just found two other references elsewhere to the new XP style in the Allergan 410 line and its advantages for breast reconstruction...

  • Mantra
    Mantra Member Posts: 968
    edited August 2013

    I especially found this part interesting :

    Firmness: In addition to appearance, women can now choose how their breasts feel. Allergan 410 implants provide varying degrees of firmness with a unique range of cohesion from very soft to firm. Furthermore, the textured shells of Allergan 410 implants provide better adherence to natural breast tissue, with many patients telling me they feel just like a part of their body.

    Is he saying the cohesiveness ranges from very soft to firm? What does that even mean. And is he saying that the implant is firm but with varying degrees of firmness?

    I wish they would just spell out which ones are firm and which ones are very soft. I was not given a choice but unless they actually disclose the softness/firmness of each perhaps I have the softest or perhaps I have the firmest. Who knows . . . but they feel firm to me. Although, oddly enough, my right breast feels softer than my left breast. Still not what I would call "soft" but since I have two different 410 implants, I wonder if one of mine is infact softer.

  • Beesie
    Beesie Member Posts: 12,240
    edited October 2010

    I recall reading a couple of years ago that Allergan had introduced the "soft touch" 410s in the UK/Europe and Deborah I notice that two of your three links are from the UK. In Canada at that time the softer 410 had not been introduced. Currently, except for that one PS in Canada, I still can't find anything else, either from other PSs or from Allergan, that says that the softer 410 is available now in Canada.  The 410 product matrix on the Canadian Allergan website does not include the softer 410. And here is the brochure that is currently available on the Allergan Canada website:  http://www.natrelle.ca/landing_pdf/final/11174%20Recon%20Labeling_7308.pdf   The 410 models are listed on page 60; there is no reference to the "soft touch'" 410.

    Based on this, I would assume that anyone in Canada who has a 410 has the most cohesive model (i.e not the soft touch model), and I would also assume that anyone who is about to get a 410 in Canada will also be getting this firmer model, unless their PS specifically mentioned that they are getting the new 'soft touch' model or gives them a choice of firmness.  It would be great if the 'soft touch' were to become more readily available in Canada but that doesn't yet seem to be the case, from what I can find.

    Mantra, FYI, on page 61 there is a reference to the Device Identification Card that you should be receiving.

  • whippetmom
    whippetmom Member Posts: 6,920
    edited October 2010

    Here is a link to Allergan Academy Canada:

    "Available in twelve different anatomical shapes and two gel options, each with its own choice of projection and height, the NatrelleTM 410 was designed to provide surgeons the ability to control shape, not just volume, to help achieve the right fit in a more natural-looking, anatomical shape."

    http://allerganacademy.ca/Products410FormStable.aspx

    Even though the softer version might be available to Canadian doctors, as Beesie suggested, most of them must not order or stock this version for their practice.

  • Lilah
    Lilah Member Posts: 4,898
    edited October 2010

    Thanks Deborah -- that is GREAT info!  I suspect the version currently in the trials is the firmer type... I will ask my PS about the softer version when I see her next week (she is in NY at Sloan but was trained/education in and IS Canadian)... she no doubt knows about the softer profile.  Since the 410 (in any form) is still in trials in the US, though, I don't think it is actionable for those of us here in the US.  Might be an option, though, in 10 - 15 years when it's time to exchange out for a fresh one :)

  • Claire82
    Claire82 Member Posts: 684
    edited October 2010

    Maybe we can all go to Canada for our exchange in 10 years :)

    You think she might come with us?

  • Lilah
    Lilah Member Posts: 4,898
    edited October 2010

    LOL

    Let's hope we don't have to!

  • Mantra
    Mantra Member Posts: 968
    edited October 2010

    I wonder why surgeons aren't using the softer version if it's available.  I also wonder why they even sell a firmer version if a softer one is available. Wouldn't everyone prefer the soft one? I'd be tempted to switch (but doubt I'd actually do it). I'd also have to be completely convinced that Natrelle's idea of soft and my idea of soft are one in the same.  Lilah, your mission if you chose to accept it is to get the scoop on this!

    Is there anyone on this thread from the UK that might have some first hand knowledge?

  • Lilah
    Lilah Member Posts: 4,898
    edited October 2010

    Its not clear they are widely available yet in Canada, Mantra... and in the US they are still in trial phase (and for whatever reason are only testing the firmer ones).  Anyway that's my understanding... but am seeing PS next week for a F.U. and plan to ask her about it.  Will let you know what I find out.

  • Beesie
    Beesie Member Posts: 12,240
    edited October 2010

    Deborah, thank you for finding that!  Great info!

    Mantra, from the comments I've read about the 'soft touch' 410s, I think there may be some concern whether this is really a "true gummy" that maintains it's full cohesiveness and it's shape.  So I can see why many Canadian PSs, who are familiar with and comfortable using the original 410, might be hesitant to switch to a new softer implant that they have no history with and that might act differently.  I find it interesting in fact that while it took so long to get the 410 approved, now another variation is introduced by Allergan and it seems to not have to go through the same approval process.  I've been trying to find information about what testing has been done on the soft touch 410 and so far have found nothing (which doesn't mean that there is nothing, just that I haven't found anything yet).  I have found a few Health Canada documents about the Allergan approval and they include only information about the original 410s.  I would think that some submission must have been necessary for the soft touch 410s but so far can't find anything.

    http://www.hc-sc.gc.ca/dhp-mps/prodpharma/sbd-smd/phase1-decision/md-im/om_gl_2008_natrelleround_61865-eng.php

    http://www.hc-sc.gc.ca/dhp-mps/prodpharma/sbd-smd/phase1-decision/md-im/sbd_smd_2008_natrelle410_88573-eng.php

  • whippetmom
    whippetmom Member Posts: 6,920
    edited October 2010

    Great Beesie!  So it appears evident that Canadian docs are using only the firmer form stable Allergan 410 anatomical.   I recall that m-star from England telling me her PS said she had different degrees of firmness to offer her in an anatomical implant...so we know the UK offers the full line up of anatomical products. She just had her exchange...  I also had an email from an Australian woman almost a year ago, who said her PS discussed having degree-of-cohesiveness options...but we were talking about the Mentor CPGs as I recall... 

    Interesting.  In the U.S....we just wonder if the form-stable gummies will EVER be FDA approved.  I am personally waiting for the Sientra form-stable cohesive rounds to be approved.  That is my gummy choice! Wink

  • What-to-do48
    What-to-do48 Member Posts: 11
    edited November 2010

    When you have a mastectomy, do they remove your lymph nodes?  My surgeon says he doesn't do that, so wondering if this is his opinion or not.

  • Lilah
    Lilah Member Posts: 4,898
    edited November 2010

    Wow -- you have a surgeon who doesn't do that?  Is that person a BREAST surgeon?  If not, you should talk to one. 

    Most women have what is called a Sentinel Node Biopsy (SNB) at time of MX unless there is good reason not to (like: the diagnosis is DCIS and there is no reason to think the cancer is invasive).  My first surgery, for example, was a lumpectomy because they thought I only had DCIS.  So no SNB was performed.  But the tissue removed showed that I had IDC so then at my next lumpectomy the surgeon DID perform an SNB and it was found I had 1 positive node.  I subsequently opted for a unilateral mastectomy. 

    I have never heard of a breast surgeon who DOESN'T examine lymph nodes when performing an MX; while some may determine that an SNB isn't necessary, it concerns me that he says he "doesn't do that"... so my advice is to seek a second opinion from a surgeon who specializes in breast cancer treatment.  It's possible you don't need an SNB based on your particular pathology, but you need to be seeing a doctor who understands the needs of a breast cancer patient.

  • Beesie
    Beesie Member Posts: 12,240
    edited November 2010

    What-to-do48, from reviewing your other posts, I understand that you are having prophylactic mastectomies because you are BRCA1 positive.  In this type of situation, if there is no evidence that you have breast cancer, then there is no reason for your surgeon to remove lymph nodes when you have your mastectomies. 

    This is very different than a situation where someone is having a mastectomy because of a breast cancer diagnosis, and particularly, for invasive breast cancer.  For those who are diagnosed with invasive breast cancer, lymph nodes absolutely must be checked.  I'm sure that your surgeon does remove nodes when doing a mastectomy if the patient has been diagnosed with BC.  His comment about not removing nodes was no doubt specific to your situation.  

  • Lilah
    Lilah Member Posts: 4,898
    edited November 2010

    Ah that makes complete sense Beesie -- thanks for the clarification!  So yes of course, and as I said above, if the diagnosis does not warrant removal of nodes then nodes need not be removed and prophylactic MX is exactly such a situation.  I was just concerned by the "he doesn't do that" comment... if he is a breast surgeon he DOES do it when warranted; but totally agree that in this case it is neither necessary NOR recommended.

    Once the breast tissue is removed it should be analyzed by a pathologist to be sure there was, indeed, no cancer and no need for further treatment.

  • Mantra
    Mantra Member Posts: 968
    edited November 2010

    I had 3 nodes removed when I had my lumpectomy. I remember my first surgeon asking if I wanted to have a SNB. I knew nothing of lymphedema and I remember asking her "what's the down side? Why do people choose not to have a SNB?" I really wish she had explained to me about LE. I think I would have said no to the SNB and I would have had more time to research and make a decision when it came to the mastectomy. 

    When I decided to have a prophylactic, I told my new surgeon I did not want a SNB unless there was proof that there was cancer. I had a BSGI to give me enough confidence to know that I didn't have cancer and the mastectomy was going to be prophylactic. My fear was of course having the mastectomy, finding out there was infact cancer and then having to have an AND.

    I think a lot of people have said their sugeon's don't do a SNB (referring to a prophylactic mastectomy.) My first reaction was the same as Lilah's  .. . he doesn't do what!! But leave it to Beesie to get it right!! Smile 

  • Lilah
    Lilah Member Posts: 4,898
    edited November 2010
  • gramoflexus
    gramoflexus Member Posts: 52
    edited November 2010

    Well excited , anxious  tomorrow I get my new gummie boob . I just can't wait to get this turtle shell off my chest . I pray that the gummie will always be soft . PS is very happy with my skin ( very soft) especially after radiation . He is also going to tweak the other breast . If anyone has had this exchange already any helpful hints are greatly appreciated . It is too funny my boobs right now are all magic markered in granddaoughters favorite color purple  hee hee

    Fondly Linda

  • What-to-do48
    What-to-do48 Member Posts: 11
    edited November 2010

    Sorry ladies, I should have been more specific.  My surgeon is a breast surgeon and because I'm having prophylactic mastectomies he won't remove the lymph nodes.  I just wanted to make sure that was alright.

    I feel like this mutated BRCA1 has consumed my life.  Every free minute I have I think about my options and wonder if I'm doing the right thing.  Thank God, my husband is a pillar.  He's very aware of the stress I'm feeling and is very supportive.

    I sure wish my sister had known she had the BRCA1 gene before she got cancer.  She's a real trooper and remains positive all the time.

  • Lilah
    Lilah Member Posts: 4,898
    edited November 2010

    100% alright What-to-do and my apologies if anything I wrote confused you.  Sounds like you are in good hands and I am very sorry about your sister.

  • Lilah
    Lilah Member Posts: 4,898
    edited November 2010

    Gramoflexus -- good luck with your surgery! 

  • Mantra
    Mantra Member Posts: 968
    edited November 2010

    Yes, good luck with your surgery tomorrow!  My PS didn't draw on me until I was minutes away from going into surgery. She used purple too . . . guess that's their colour of choice.

  • jillyG
    jillyG Member Posts: 401
    edited November 2010

    Linda, good luck on your surgery, let us know how you like the new gummies.  I haven't had my exchange yet.....still sitting here with the turtle shells until Dec 22nd.

  • Lilah
    Lilah Member Posts: 4,898
    edited November 2010

    Yeah my PS also drew on me about 20 mins before surgery... I can't remember if she used purple or black though. 

  • Claire82
    Claire82 Member Posts: 684
    edited November 2010

    Black for me with "Do Not Remove" handwritten across my bandage :)

  • Mantra
    Mantra Member Posts: 968
    edited August 2013

    I wouldn't put myself through surgery again (although that thought may change), but I've decided I really dislike the tear drop shape of the gummies. They look fine naked. In clothes, it looks like I should be wearing a good support uplift bra. Of course, since they don't really move, a good support bra to lift them up wouldn't work regardless.

    I recall the PS saying that the tear drop shape most matched my natural breasts. I liked my natural breasts, they didn't sag, yet I always wore and loved the look in a push up bra. Now, yes I would say this shape most resembles my natural breasts . . . but only when I was braless. If I had been told that tear drop looks like your natural breast but only when you are not wearing a bra I would have tried on some tops without a bra and would have instantly known that I would not be happy with the tear drop shape.

    When I wear clothes, I just keep seeing this lower pole fullness and if I saw me on the street, my first thought would be "hmmm,there's someone who really doesn't know how to wear a bra that lifts!" I find myself wearing clothes that don't accentuate the implants and so I'm hating the clothes I'm wearing which in turn is making me miserable.

    I won't go through with nipples until I'm convinced I can live with these implants. If I can't, can I change to silicone rounds?

  • Jerusha
    Jerusha Member Posts: 406
    edited November 2010
    Mantra, if it is any consolation, I am miserable with my gummies, as well. I have had mine since mid-June. I am more focused on how un-breast like they feel, than on how un-breast like they act,(like in a bra), but I'm not particularly happy with that either. I'm seriously considering a switch to silicone rounds or to an autologous fat procedure. I've got some consults lined up in 2 weeks. Yes, you can definately go from gummies to rounds. It is round to gummies that can necessitate a lot of pocket reconfiguring. More surgery , especially the amount involved in the flap procedures is terrifying, but in some ways the idea of being over and done, FOREVER, has a lot of appeal. Don't really want to be doing this at 65, 72, 79, etc, unless they have something VERY cool by then!
  • Mantra
    Mantra Member Posts: 968
    edited November 2010

    Jerusha, Yes, agree that the feeling is definitely a negative factor too but I haven't even began to think about that yet. I don't have enough fat to have one of the other procedures but honestly, even if I did, I just can't imagine putting myself through it at this point in my life. So for me, I guess the only option would be to exchange the gummies for round silicone. 

    I dread the thought of another surgery but I really can't imagine living 10 years with implants that make me want to dress in layers to mask the shape of the gummies.

    I don't see the surgeon for another couple of weeks (my 6 week follow up appointment) so I have a bit of time before deciding the route I want to go.

    I think the surgeon did a great job but I really wish she would have involved me more in the decision making process. I orginally told her I wanted rounds but she kept saying that gummies mimicked the shape of my natural breasts and would look better on me. If I lived in a nudist colony, I'd agree. But in the real world, looking good in clothes is important to me. And this  bottom heavy, non-push up look does nothing to make me want to wear anything that doesn't include layers.

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