Exchange City
Comments
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Sam59: You definitely have some complex issues. You must also be in Canada....you have a 410 low height full projection implant. Without checking the number it looks like a 625 cc? Wow....going from over a 1000 cc's and now in the 600's. I do hope you post photos so that we can see what you are describing. In my opinion, your final option is to have an autologous donor procedure such as a latissimus dorsi flap. I have no idea what is done in this regard in Canada. To get on the pictures forum you can PM Timtam directly from this link and tell her you would like to enter and post photos:
http://community.breastcancer.org/member/11047/message
Geena: I think 300 cc's sounds just right for a B cup. But needing to be expanded to 600 cc's sounds crazy to me. Honestly, it does! Whatever for? That does not sound like modest droop to me....it sounds like implants down around the knees! You need to have a consultation with her again and ask her reasoning for expanding so much. At 300 cc's, you should be able to go braless more often than not! Is there some issue with your skin or muscle? Referable to implant choices, A Style 20 [the most popular style] would work but with the high profile it would be taller on the chest and perhaps "perkier" than you describe wanting. Does this sound right? What might be more athletically suitable would be implants narrow enough for your very small ribcage but without too much projection. So a Style15 or Style 40 might work. Can you post photos on the picture's forum? It helps so much to help you gals out for us to see your photos!
Style 15:
286 cc's 11.7 by 3.8
304 cc's 11.9 x 4.0
Style 40
280 cc's 11.4 x 3.8
300 cc's 11.7 x 3.9
Without going back to check....I think you are the one with the unfamiliar expanders....PMT 650 cc's. I need to do some research on those. I believe they are lower height expanders....which I like....but I know nothing further. I'll get back to you on dimensions.
Baxter: At 380 cc's, there is no reason you should not be able to get to a 450 cc and perhaps a 475 cc implant. You might want to look at the Style 15 though....it is wider and you will have better cleavage. You might need a bit wider implant to fit your chest wall. We can go over these numbers later. I'll get some sizes.
EDITED: Oops...just reread and see your PS uses Mentor. So he might take in a moderate plus profile in 450 cc's and a 450 cc in the HP. I would not go smaller than 450 cc's if you want a C cup.
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Julie
I knew my rib cage was different and after reading your post I did a search on pectus carinatum. I discovered that I do not have that but what I have is called flared rib cage.....mine kinda flares out and I really notice it when I am laying flat on my back and one side of my rib cage sticks up higher than the other side. I never noticed this in my younger years. I thought that the radiation I had 24 yrs ago might have caused that one side to flare out more.....so I will never be able to have 6-pack abs no matter how hard I work at it.....LOL....I am 55 yrs old so I guess it does not matter this late in the game......Thanks for your info
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Deborah
My ps is already concerned that the implant will show through my skin that I am surprised he was looking at textured. I am wondering if he realized it. We both decided that the 440 was too big but I need to make sure he isn't looking at textured, and if he is, why. I would be very surprised if he chose that. He did say that the options are limited every since Connie Chung came up with her report on the dangers of implants. It caused a lot of companies to go out of business.
I am going to call his office this week. I want to get more info on the style 20 first. I really appreciate the input.
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Dani if I remember right you said you feel your TE are too wide
when your PS does your exchange he should be able to do some pocket work to make it more narrow so you implant doesn't move to the outside.
since your rib cage is only 27 inches I would think you'd want style 45 or 20 from Natrelle or the ultra high or high profile implants from Mentor. Style 20 has about the same dim as mentors high profile. These implants don't have a real wide base and have the best projection (except for style 45 which even has better projection which is like mentors new ultra high profile implants)
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Dani something I want to share
when I was being expanded my PS said my skin was getting thin
after my 1st exchange which was a saline implant
when I layed on my back I could feel the valve from my saline implant
so when I had my 2nd exchange my PS added AlloDerm which helped with my thin skin
mention this to your PS maybe this is something your PS will want to do
at the top of the thread they have links of differant implant
click on the Allergan link and if I were you I would print out style 20 and 45 and take those with you to your appointment
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Deb could you find dim of wabiarts te which she said is:
expanders PMT 650cc 3611ES-200-2i.
I didn't have any luck when I tried looking
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Deborah and Rockwell Girl (((((((((( thank you))))))))))
I will get pics posted today Timtam's forum if I can.
I could not find th PMT expander info online either.
Yes, the gap between my desired 300cc (modest B cup?) of prospective implant and the 600cc expansion seems odd to me too - and I know nothing about how this stuff works! Only tissue issue I have is one breast had been radiated 2 years ago and already it is tighter, more sore, not healing in the way the non radiated breast is...
Deborah - the styles you mentioned - are they Mentor? I have kind of crappy health insurance and my choices are limited - she may be using Mentor because that's what is covered? I need to GET MORE INFO!!!!!
I need to get the surgical reports from both my doctors which I would hope would have more info. When I asked for it from my surgeon (a substitute for my original surgeon who had a tragedy in her family) - she said, "You don't need that, it's a bunch of gobbbledeegook". When I asked for it from my PS, who has two office sites, she originally said it was at one office, and then when I was at that other office she said it was at the OTHER office. Hmmmm.. Paranoia up. I need to get my info in my hands at this point. I'll start that Monday.
Thank you, dear women. ~Geena0 -
Good luck to you guys going in for surgery this week. Congrats and we'll be thinking of you.
6/22 - tg33 - Exchange surgery
6/25 - Bukki - New exchange
6/26 - wbuggie - Exchange surgery
6/26 - Georganne - Exchange to Style 15 allergan implants
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Geena--Just go to the hospital and sign a medical release form and list what you want. Sometimes docs are weird about their dictation. I have a binder that has EVERYTHING from the first dictation regarding my dx mammogram to the ultrasound I had on a lump about two weeks ago, all labs, op reports, chart notes, everything, the things you can't get from the hospital, you will need to get from each doctor's office--but that should only include office visits and labs they've had you do outside of the hosptial. Unless Deborah and Sandy have a different opinion, I wouldn't worry about using Mentor products. I've been happy with mine and they aren't an "off" brand, Allergan is just larger.
Elaine---The old saying is wrong, it is actually "Four times is a charm." I wish you success, and truly hope all goes well.
Laura--I LOVE the new photo!
Jan--I hope your pain resides soon. Getting back to work was OK, however, I'm in warp drive, this is my favorite time of year, high school interns arrive tomorrow, so do some hs science teachers, and I'm putting the finishing touches on our two summer camps. I came home and slept each afternoon as I only worked 4 hour/day, next week will be a full 40!
I have a thought about fills that I want to share. My PS was very conservative and aside from the normal discomfort of hard expanders, expansion was very easy for me, until the final fill, it hurt.
My PS only filled me to 125cc during surgery, we waited 2 weeks before we began fills and then it was only 50cc at a time (weekly) somewhere around 400cc we took a 2 week break, and then went on 50cc at a time to fill my 600cc TEs to 725cc. This is only my personal experience, and yes I had to deal with some loose skin for awhile, but the pace was really good for me. I know we get excited as do our PS about getting something to "show" but I think there is something to be said for slow going.
Deborah--I'm going to try and get that reconstruction book tomorrow at our library, I work at university with a medical school, I hope they have a copy available. I can't afford to buy a copy and the web is blocking much of the book for me now.
Sweet success to the ladies of the week:
6/21 - Alo123 - Exchange surgery
6/22 - tg33 - Exchange surgery
6/25- Bukki - New exchange
6/26 - wbuggie - Exchange surgery
6/26 -Georganne- Exchange to Style 15 allergan implants
Hugs--Karen (KEW)
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Hi, everyone, My surgery was last Friday, July 19. I had a bilateral mx and then TE's expanded to 425 cc. on the radiated side and about 400 on the non-radiated. I got Mentor High Profile silicone gel implants which were 375 on the radiated side (the PS said that my ribs had gotten pushed in and he needed to put a bigger implant in to allow for the concavity and make them symmetrical. The other one is 350 cc.
I was kind of afraid to look at them, but did last night and they are, I think, as close to perfect as it gets. I told him I wanted not to be rock-hard like the expanders, and he said then he would have to go a little smaller, and I said, "fine." They are soft, but still a B cup, which is exactly what I wanted. There is nice cleavage, and they are at the same level (the TE's were different heights by almost an inch). They also don't start bulging out up so high the way the TE's did. They look very natural.
I'm feeling pretty good now, with only a little discomfort and will be going back to work Tuesday. I'm so glad it's over.
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((Geena)) Go to the hospital where the surgery was performed, go to medical records and ask for all surgical reports and lab and pathology reports and pharmacy records. It is your legal right to have them, they may charge you up to .25 cents a page, but well worth the cost. I keep all of my reports, copies of mammograms, MRI reports under separate tabs in a PINK binder. My reasoning is that if I ever have to move or change Dr.s, I have my surgical history accessible and not have to wait days or weeks for the information should I ever need it. This is s good thing to do and not paranoid. The PS that told you that it was gobbleygook was insulting your intelligence. We may not know what all of the terms mean but we have resources to decipher what they mean and this forum is just one place. I am grateful for the Sandy's and Deborah's and the others that have shared their experiences. We are not stupid women and we have a right to know what happened to our bodies when we are unconscious. BTW, I do not like condesending doctors, so be your own advocate! Climbing off my soapbox. Jan
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Northstar, Congratulations on your happiness at returning to normal, I am so happy that you are pleased with the results. We have the gift of choosing reconstruction in this time. We are blessed, and we had good surgeons. Unfortunately some women don't get the results they were hoping for. I pray that they connect with a surgeon that can give them back what cancer took away.
I am a week out myself tomorrow, Dr. appt. in the am, I have lots of questions about the implants that came up by reading the posts here. I had to go buy an emergency bra yesterday, I didn't have one that fitat all. The velcro surgical bra was so annoying. I am going next Saturday with my sisters to go purchase a really nice bra(s) I have never owned or needed a bra, so this will be an adventure. I thought I would try Nordstroms like I think Deborah suggested. Any other ideas for bra shopping or fitting underwires, vs. no underwires, bra types? I have used every piece of advice and since I have never worn a good bra I would ask for input in this area too! Jan
Jan
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Hi Jan,
The word is no underwires, mostly because if they poke into us, we can't feel it. I have purchased a few bras since the exchange, trying to keep it to only a few until the lift in November, but I did buy some with underwires and then took them out, they fit fine. They were too cute not to have. Nordies has some really pretty and not practical lace bras (not good for under t shirts), they are almost like a sports bra but it is all lace that fits your shape, and they come in many colors, matching panties too if you are so inclined.
I have found a favorite sports bra that I've been in since week 2, the first contraption didn't work well http://www.movingcomfort.com/dyn_prod.php?p=350003&k=101635
The thing I like about this bra is that it gives great support, and you can adjust the straps in the front, it is a Velcro strap closure. Very comfortable. You can order them online, Title Nine also has them, and so does REI, but this URL offers more colors than I've seen in stores.
Have fun!
Karen
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Sandy....found it:
http://www.squabb.co.za/BreastExpanderBrochure-HQ.pdf
Geena: PMT Integra Breast Expander: Is a lower pole projection expander. The port is easilly identifiable through the skin. A low profile design for easy placement and positioning. Yours is a "2 Stage Wide Base Oval". Dimensions: 11 cm x 13 cm [it is usually width, height, but not sure if this is the case with PMT] Projection is 10.0. This is to state that the projection in the lower pole of the expander will be 10.0 at full fill level.
ALSO...I had your ribcage dimensions confused with Dani's....[Sandy's post reminded me to look again] as she is 27 inches you are 31.5. Just for reference in the future!
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Geena - We are about the same size and weight. My PS told me that 300 cc would give me about a B cup and 400 cc would give me about a C cup. I chose 400 cc and am indeed a C cup, so I think your PS is correct w/ the 300 cc. That being said, I was only filled to 400 cc w/ my TE's. 600 CC does sound like a lot, but perhaps that would create more of a natural look when it is all said and done.
Northstar - Glad you are doing well post surgery.
For this week's surgery sisters - we are there with you all!!
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Sandy,
I am printing your post to have in front of me when I call the ps. I don't have another appointment before the exchange so I will talk to his nurse that actually orders the implants.
I have a question: right now I have 450 cc te's that are only filled to 330. He said they are mentor medium projection, which from the website states are 12.6 cm x 7. I do seem to have alot of projection but probably not 7cm if I am not fully filled. I am a full C cup right now. If I go with say a style 45 or 20, what would give me a C cup and similar projection? It seems like the implants do not have the projection that the expanders do. If I tell him to go with the style 20 375 cc, will it be comparible? Also can you reduce the diameter from 12.6 to 11.7 ( don't remember if that was the diameter of the 375's in style 20).?
Thanks!
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Hello, I hope I can get some help before I have my exchange done. I had a BLM in April and I have been going through the expansion process since. I'm now at 450cc. I was a D cup before BC and I don't want to be that big again but hope to be at least a C cup. I have had some problems with pain and spasms the last two expansions. So I have taken a break. I guess the silicone implants will be heavier than the saline. I hope to have the gummie bear implants. When I taked to one of the nurses in the office this week she said the Dr told her the implants feel like gummie bears. Not sure what brand though. I sure don't want to do this exchange twice!! But I see some people have had to do that. A friend just had her exchange done and she is not happy with the turn out. It is higher and not shaped the same as her other breast. She only had one breast reconstruction. The expanders I have in now seem really wide. Are the high profile implants better? not so wide? My PS said in the begining that I would probally go to 450cc be done with expansion by end of May first of June, but it just doen't seem like they are big enough.Said exchange could take place the end of Aug first of Sept. Not sure what to do. Thanks for any info you can share. Di
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To the ladies going through exchange, or other procedures this week, I will be thinking of you, can't wait to see your posts and experiences. I hope you all get what you need and want.
Karen, thanks for the website, that looks like a great bra, may be more than I need, I am a C+ cup, The lady measured me and put me in a bra that felt better than anything I have worn yet. It is a 34C, I feel like it is riding a little low on top, and folding under at the bottom band (it is a full coverage bra) I will go get a second fitting at Nordstroms next week end. That may give me some better choices. Thanks for the underwire thing, I forgot that little fact about potential wires poking through. Great reminder. Thanks Jan
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Di: We need some additional info. Your height, weight, and ribcage circumference. Measure around your ribcage just below your bra line. Then, obtain info re: your tissue expanders. Manufacturer, style number and # of cc's. If your PS did not give you a card with this info at the time of surgery, it will be in their files. It is a medical device....they must retain this data.
Deborah
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Ladies... here is a HUGE HUG and a BIG old fashoin cheer for your exchanges this week!!!
Wahoooooooooooooooooo
Lord, I ask for heathly healing women this week!
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Dani so if I get this all right you have a rib cage of 27"
your TE were 12.6 which you feel is too wide
You can reduce the size of your implant but your PS might have to do some pocket work
so I think you could go with style 20 375cc would be 11.7 by 4.9
Style 20 350cc are 11.4 by 4.9 (these have the same projection as the 375cc)
Or style 45 would also be a option 400cc would be 11.2 by 5.1
Style 45 360cc would be 10.8 by 5.1
Style 45 460cc would be 11.4 by 5.9 (most projection of all implants given)
All of these just depend on how much narrower you want your implants
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Deborah, I'm 5'3 tall, 160 pounds and rib cage is 34. I can't get the manufactures name today as no one is in the office. I have an appoinment with my PS on Thursday. I know I have the largest expander they make he told me that in the begining before my surgery. I'm now filled both breast to 450cc saline. I was a D cup. I was told I could go for two more expanions. But in the begining he said I would probally be good at 450cc's. They only put in 50cc at a time. I hope this is enough info. I guess I should have been more informed before now. I never knew all this stuff. I just asked a friend yesterday about her exchange and she is not happy at all with it. She only had one breast done and it is to small and to high. They are telling her that it will drop with time. She is talking about have it changed. I really do not want to go through this again any help would be appreciated. Is it true that the larger you go the more problems you can have in the future? He said after the surgery that I had a very large pectorial muscles and they were very healty. Probally from shoveling horse poo for so many years! Ha!! Sorry for rambling here. Thanks, Di
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I'm sorry about the type not sure how that happened. Di0
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Di: I think 450 cc's sounds about right for final fill level if you are aiming for a "C" cup. If he could get you up to 475 or 500 cc's with your expanders, that might even be better. I personally think probably 550 cc or 600 cc high profile or moderate plus profile implants would be nice for your frame. Nothing less than 550 cc's. Once you get your tissue expander details we can reevaluate. Your friend's implant will indeed drop, as long as the pocket is sufficient. She probably had a completely submuscular placement and they tend to sit high for quite some time until the muscles in the lower 1/3 of the chest relax and allow the implant to drop.
Deborah
Addendum: Something to consider with large pectorals....it is something to discuss with the PS further because large pectorals might have a tendency to "swallow" the implants which would require the PS to go larger than intended with the implants. I am not a plastic surgeon, nor do I play one on TV, but based on what I have read in some medical journals lately, this is something which needs to be taken into consideration with you "large, healthy pectoral" gals...
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Deborah, Thanks for the info. I'm not sure I know what you mean by "swallow the implant". I'm wondering if he has that in mind when he said in the begining that I should expand to 450cc of saline. Maybe he is considering the size of the pectorals. When I was in the hospital many nurses and people there said he was the best here in town and ranked high in the USA too. Everyone I have met that has went to him loves him. I liked him from the first because he was very frank an up front about everything. His nurse I'm afraid I can't say the same about. I was taking her flavored popcorn every week. Untill she told my husband that I need to quit feeling sorry for my self. Hubby was worried that I was doing to much too soon and causing some of the pain I was having so he called the nurse. Di
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Hi all! So... I posted to Timtam's site, pics and all. Uh..... enjoy?
Thank you to all the dear women here - especially Deborah, Sandy, Jan1 and MyKidsMom for specifically addressing my concerns re: a "B" cup and the potential expansion to 600cc!
Deborah - the post where you put some implant suggestions for me to know about - was that based on my 31.5" ribcage or Dani's 27" ribcage. I also feel my expanders are wide - could be because they are also under my armpits! Second - were those Mentor styles? My PS says she is using Mentor Round. No rush - wow - what you women offer!!!!! I've a while to go, but I want to be able to speak up on my own behalf....
Much respect and warmth,
Geena
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Geena: I just saw your photos!!! You are too preciously adorable girlfriend!!!
I had your ribcage dimensions confused with Dani's initially but I am on track now. Your expanders are widely displaced on your chest but they are not too wide in terms of dimensions. You want about 1.5 to 2 inches cleavage - between your breasts with your implants. Your PS is going to perform some pocket revisions - suturing up well on the outside of the pocket because your implants are going to want to migrate there.
Referable to a PS' choice of expander width: They base the expander width by the measurement of your natural breast's base width prior to surgery. So discuss with your PS whether she has in mind the Mentor HP or the Mentor Moderate Plus Profile....around 300 to 325 cc's.
Deborah
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I think the last 7 months would have been so much harder had I not stumbled onto this site. The wisdom and advice and shoulders to cry on during the tough times have been priceless. Deborah and Sandy, You are right you are not a PS, nor do you play one on TV, but your insight and knowledge has allowed me to ask questions to my Dr. and allowed me to base decisions with what you suggest. I had a great outcome I feel because you educated me on the big questions to ask to my Dr.s, and being my own advocate.
I went for my post op today and had my list of questions that I created from reading the posts here. He took my list of 8 questions and answered them all. He stated I was one of the most prepared patients and asked pertinent questions that reassured him that I was involved in my care, I give this site the credit.
((Geena)) If it helps, I am 5'6" and am just under 150 lbs. I was a big A, small B before surgery. I had a right sided mastectomy, TE filled to 500cc and now a 500cc mentor HP smooth implant there, my left side was augmented with a 275cc implant. I am a little bigger on the left side now, but that could be because I don't have a nipple on the right side and the scar makes the right breast makes the end flat. I am a full 34 C cup and that is right for me, and depending on the bra a D cup also fits! I figured out that not all bras are sized alike! Jan
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Hello Ladies,
I called my ps today and spoke with his nurse, who orders the implants. I left his office last week feeling great, but that just ended. She told me he ordered me Allergen Natrelle 354 cc's. I asked her to repeat that because, as you know, 354 cc's is odd and I don't remember seeing that on the websites. Now my stomach has sunken and I feel ill. They are indeed textured, style 115, they are also 13 cm in diameter and 4 cm in projection. I asked for smaller diameter and high profile. I guess he went with textured because the left keeps shifting but it seemed like he really was listening when I explained that the expanders were too wide. Since I have never done this before I will go forward with what he ordered but I will have a revision if I don't like it. I think what upsets me the most is that it doesn't seem like I have had much input in regard to my results. Thanks for listening!
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Dani: I would like for you to consider writing a letter and faxing it or emailing it to your PS. You will be as forthright and kind and considerate as can be, but you will express your concerns. You can state that you would really hope to share your preferences for implant selection - smooth vs. textured and less width and more projection. You can also state that you are so very desirous of doing this right the first time, and you want to try to avoid having revisions or exchanges to different implants. If you do it in this fashion, he is "put on notice" that you have some reservations about the implants selected and that he might want to consider your thoughts and desires. You can say how much you appreciate his skill and expertise and etc,....but you would like to go over this in a separate consultation prior to having the exchange surgery. .
If you need me to help you formulate that letter, I can help you tomorrow. I want this letter to go into your patient file.
You do NOT have to go into this surgery with angst and trepidation and sadness. Absolutely not! This is what we look forward to....we should not DREAD the exchange surgery!!! So many of us already have an emotional "let down" and disappointment after the exchange. I do not want you going into this expecting the worst!
Please strongly consider deferring the exchange until you have some better clarity on these issues.
Deborah
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