BREAST IMPLANT SIZING 101
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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.
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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.
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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.
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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.
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My PS does not use tear shaped either for the same reason because they can rotate.
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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.
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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.0
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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.
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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.
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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
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indenttwins: i'm scheduled for exchange on june 21st using the natrelle 45s. i'll let you knowwhat i think!
kelly
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thanks kelly will be thinking of you
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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.
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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!
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Shannon: Suebee's answer is a good one.
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SILICONE VS. SALINE.....
http://www.wkrn.com/story/14689395/breast-implants-silicone-or-saline
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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.
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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.
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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.....
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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!!!
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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
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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?
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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.
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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?
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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?
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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!0
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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
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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?
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Rebecca: How are you doing? Better? Been thinking about you!
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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.
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