BREAST IMPLANT SIZING 101
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Winter...You ALSO should have been given your little credit card with your implant information also. That will have the catalog number and # of ccs. The TE has no bearing on the implants. Don't wait until you see him - call the office on Monday and have them look this up in your chart. This MUST be recorded in your chart - it is a registered medical device!
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Whippetmom,
You are an amazing resource! Thank you so much fro sharing your knowledge. I'm wondering why most PS overexpand the TEs. I thought it had to do with the eventual size of the implants. implants? I know my PS did not overexpand me and now I'm wondering why.
Winter,
I'm 8 days from exchange and I was so disappointed whn I saw my implants on the second day. Like you, I thought they looked like flattened pancakes and that the shape was pretty much like the expanders. . They are getting better each day and the nurse told me at my followup appointment yesterday that they will continue to improve as the swelling goes down. I am wondering when they will feel soft and squishy like everyone says?
Lyn
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thanks Lyn and whippetmom
That makes me feel better; swelling is still pretty bad so I'm hoping the "girls" will look more normal in a week or 2
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Hello whippetmom:
I have never posted here before but you come highly recommended !! and from reading all these posts I can see why.
So here is my story: I had Skin-sparring, nipple sparring bilateral mastectomies with immediate reconstruction on Jan 7th. I am do for my exchange surgery late May/beg. June. I have TE's for which I do not know the make or size but my PS said they could be filled from 300 to 400cc. I am 5'1" and weight, right now, 124lbs but I have always weighed about 116, gained 10lbs since dx and am really hoping to loose the weight however so far it is been quite difficult - anyway that's another matter. My ribcage measurement is 29". I was a small B cup before, never had large breast and breastfeed 2 kids but they still looked pretty good :-( I told my PS I do not want very big, I'm thinking big B would be sufficient. I am very active and do not like to look of fake breast at all - no offense to anyone, it's really a personal choice and I respect evryone's decisions. I am now filled to 400 cc and this is definitely to big for my liking, I am worried that I will find them too big after the exchange. He said he will be using :gummie bears - tear shape - mid profile and would bring a couple of different sizes into the OR.
Your advice would be greatly appreciated!
Thank you
Marie
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Lyn: With reference to "over-filling" of the TEs....
It is presumed, based on research and conversation with plastic surgeons, that over-expansion is often employed by some[fewer plastic surgeons seem to be over-filling/over-expanding these days] in order to gain additional projection. You will note that most TEs have a projection number which exceeds that of any implant on the market. The reason is that, after mastectomy, projection is very difficult to achieve, by virtue of the mastectomy defect. So additional expansion beyond the recommended fill level is sometimes followed, in order to get sufficient "natural droop" or "ptosis", which is the medical term for "droop." Another reason is to gain additional volume for the patient whose body habitus dictates a smaller volume TE. Perhaps for that patient her skin flaps are not sufficient, she has a very narrow ribcage and a smaller width of TE must be used, but for whatever reason, over-filling in this case becomes a necessity if the patient desires an implant which is substantially larger than the TE. It appears that some plastic surgeons just over-fill because they have always overfilled, and so in some circumstances, it is actually to the detriment of the cosmetic result. Sometimes the flaps are entirely sufficient on their own and over-filling is not required. My PS told me, "we [meaning the newer generation of plastic surgeons - she is relatively young] rarely overfill anymore." Techniques are ever-evolving and so it is a matter of preference for some, an unswerving rote method for some, and practiced rarely, if ever by many. There might be other reasons for over-filling, but I am not apprised of them at this writing. I am always in a learning mode though...so I might have more to share down the road.
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marie: You need to read what I have written above about gummy bears. Knowing the style and volume of TE is key, because the gummy needs to properly fit the pocket created by the TE. But in terms of range, with the parameters you have given me, I would say the 410 MM [moderate height moderate projection] in the 320 gm or 360 gm range or the 410 MF [moderate height moderate projection] in the 335 gm to 375 gm range would work for you. The final volume is predicted upon the dimensions of your TE at the time of final fill. Implants of the same volume as your TEs will be smaller - will appear smaller than the TEs. So I think you probably want to be a member of the "300 Club" [someone on Exchange City assigned this moniker to the gals with implants under 400 ccs]. But again, the implant needs to fit the pocket because this is an anatomical implant and you do not want it rotating around or too tight to the extent it might distort the pocket. It is even more important to communicate to your PS what you want...when it comes to the gummy...
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My Ps said he overfills because there is always some skin retraction and this way you don't end up with a misshapen boob.
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I haven't read through this whole thread but wanted to check with you ladies. I had my surgery to remove the tissue expanders and put in implants one year ago in April 2009. Tomorrow is my one year meeting with my surgeon. He came very highly regarded here in Houston and I absolutely loved him. However, I do not love my implants. I went with the 410 gummy bears. However, they are so firm. He thinks it is a fabulous result. I don't doubt that it is compared to some others. So..... maybe in my mind I had built this up?? Everyone kept saying.... well, at least at the end of this you will have some fabulous breasts. Well... after a double mastectomy maybe that wasn't really correct? I feel like they aren't high enough, too much under my armpits and not enough cleavege. However, do I really want another surgery? I have a hard time when I go in there because he acts like it is such a good result and I don't want to be ungratful because I really do like him and respect him. However, I can't get use to these breasts. Suggestions???
Thanks for listening......
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Cristl:
I think that you are the best judge of your results. It does not matter if your PS is happy with his handiwork...it DOES matter to you. What you are describing does not sound like the optimum result you could achieve after BMX. I am going to ask you to email me photos so that I can help you further. I will need to know the volume of the 410s and hopefully you will have information regarding the style he used. There are about six versions of the 410 gummy. I think you will be much happier with Mentor or Allergan Natrelle smooth silicone rounds. Also, you need a second opinion with another PS and perhaps a new perspective on your results. I will PM you my email address.
Deborah
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Hi Deborah,
I'm so hoping he doesn't fill me again on Friday. I'm at 480 and so uncomfortable. Your recommendation was 500cc's either in Allergan style 20 or ultra high projection style 45. Can you compare that to a cup size. All along I have told him I wanted to be a nice C. I was a droopy 34 B before. I do excersise a lot and I'm a runner. My only concern is them feeling really heavy when I run. I so want great boobs after all of this and talking to you has been incredibly helpful. I feel more stressed now than any other time. It feels like such a big decision and then I keep thinking it's just boobs. The thing is I have endured these stupid expanders for three months and want to be happy. Thanks for all of your input.
Melissa
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boromom: ACK....you girls know how I hate predicting "cup" size! But, based on your height, weight, ribcage and providing you do not have any ribcage issues, deformities, not too much adipose or fatty tissue on your chest wall...you should be a healthy C cup. This is providing you could get 475 ccs or 500 ccs...and I PREFER Allergan because Allergan does have the 475 cc high profile Style 20 which has nice dimensions.
I see no reason why you should need another fill for 475 ccs or 500 ccs. I probably with go with the Style 20 - not so much projection - you might be happier if you are a runner with a little more width on the chest wall...Style 20 is the most popular and most often used style - especially for those with your height, weight, ribcage parameters.
Relax, relax...just impress upon your PS what you want from all of this, but do NOT tell him what cup size you want to be, because trust me, you will wake up smaller than you want to be. So you must specify VOLUME....
Let me know how things go....
Deborah
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Deborah I had my final pre op appointment with my PS. I arrived with a ton of information and printouts. I refer to them as the "Book of Deborah."
It was so helpful because I was now knowledgeable in the subject and had a good understanding of what we were discussing.The bottom line is, she is using the cohesive gel. She brought out a beautiful wood box (thought we were going to have tea!!) but inside it was an expander, a gummy bear implant and a saline implants. She gave them to me to hold and hubby desperately looked like he wanted to play with them too!! So I tossed them over and watched him trying to figure out if he should squeeze it, admire it's shape or comment on the weight. I finally just said . . . go ahead . . . cop a feel.
I told her I was hoping for round and mentioned the non-issue if it shifts. She agreed with the shifting problem that can occur with teardrop shape but said the best shape for me is teardrop and went on to explain why. She also said she has never had one move. We talked a lot about the other doctor's error she has to fix. She said it is going to be a challenge and require a lot of skill and time to get it as close to perfect as possible. I'm very happy to finally have a surgeon who knows what she is doing.
She said after the prophylactic mastectomy on my right side, I should wake up with 200 cc in the tissue expander. The other side that needs the repair will likely not have any saline when I wake up. She can't promise how long it will take to complete the messed up side. The tissue expander is too high and too far apart. The breast fold is way too high as well. She has to build a pocket to secure it lower, stretch the correct area that she says is very tight, and in a addition to fixing the fold issue, she has to make sure the new expander doesn't shift into the old area. Sounds like it is going to be long, painful fix.
Thanks for all your help in getting me through Breast Expanders 101 and I look forward to signing up for your next course as things progress.
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Thank you so much Deborah for your answer about the 410. I found someone in this site who has them for 2 weeks... I'm so happy to be able to "talk" with someone that has already the implants.
This site and everybody in it is a blessing...
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Mantra: Great to hear my dear! I am glad you feel reassured about the entire process. It sounds as though you are in good hands and I cannot wait to hear about your journey as it progresses! Please keep me updated on how you are doing after the first surgery!
Sandy: So glad you found someone to share thoughts with re: the 410s! Let me know if I can help you further...
Deborah
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Deborah,
I had my exchange surgery onApril 7th.He put in 325CC's each side.I was wrapped in an ace bandage until yesterday the 12th.Had a drain on each side.Went yesterday and got the drains out and unwrapped.I am now in a surgical bra.I am not so sure I am happy with the results yet.Not sure what they should look like at this point.Can you help me along in the healing process?Right now I have extra skin at the bottom and sides of each.also the left is flatter than the right.My PS said when they settle in if the skin don't fill out he will gladly remove it for me.BUT what doe's that entail?another surgery?I am hoping it all settles in and looks ok after the swelling goe's down.Is the flattened area on one normal? will it settle out?325CC's is going to be fine in sixe for me but I was not expecting the extra skin. He said he didn't see it during my exchange surgery or he would have removed it then.If it don't fill out I may have him fix it when he doe's my nipples.How long doe's it take the gel implants to settle in?I was overstretched to 400CC's int he expanders.Any help you can offer is appreciated.Also anyone else have extra skin? and if so do the implants settle in to it?
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DFC: I am PM'ing you my email address so that you can send me photos. I need to see what needs to be done for you. I have a hard time fathoming that your PS did not see that extra skin....huh??? Of course it can be removed...either excised or perhaps the pocket needs to be revised...which is why I need to see photos. It might be true that when the implants settle, changes will be made which will minimize the need for correction. But I will be able to discern that when I see your photos.
Deborah
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Hi gals, just checking in on you all...
Hey Deborah, you are SO wonderful and SO helpful...I would love to see you write a book on this. I would personally buy 100 copies of it and leave it at every surgeons' office, every rads office, every oncs and PS's office....get the info out there to all women in need of your skills.
Please think about it. You help us all so much!!
I wish I'd had you during my recon. It turned out well, thankfully, but think my PS does everything that you suggest as he is a perfectionist in his work. I was very lucky.
Laura, Laura, I see you!
xoxo
annie
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Oh good grief, I really need to change that avatar...too weird. My poor hubby and the cat has such a crush on him.
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Oh Annie, you are too funny! Thank you so much. I wish I had time to write that book...maybe next year!!!
And yes, that is a rather bizarre avatar...perhaps on a feline forum? Feline fetish forum? Where is YOUR avatar?
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Deborah,
I just emailed you pictures. Let me know what you think after you look at them.
Thanks so much,
Dee
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Deborah,
I just emailed you pictures. Let me know what you think after you look at them.
Thanks so much,
Dee
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Annie LOL -- I thought maybe you were a mannish looking woman
(Note: the pictures I see are VERY small)0 -
Lilah....Oh my goodness...YOU ARE RIGHT! Annie...you had better change your avatar ASAP!
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KristinPink, hi. I'm new to this post as i am about ready to consider the exchange. I noticed you are from syracuse and I live quite close to you. Would you tell me who did your surgery and who your plastic surgeon is? Thanks!
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cleo....Are you posting on the right thread? KristinPink is over on Exchange City.
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I have pictures up from my recent exchange surgery if anyone would like to see the improvements made going from anatomical saline to round silicone. I had extensive pocket work done to incorporate somewhat of a lift on the good breast and clevage work to fix some mild symmastasia (sp?). Although not perfect, it is a LOT better & a little something for me to celebrate on my 2 year cancerversary! Looking forward to the rest of the year with no surgeries!!!!
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Thanks for the suggestion, Whippetmom! I resent my request on the appropriate thread!
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cleo: Dani42 on Exchange City also has a Syracuse plastic surgeon....a female...she might respond as well. But I like the way your PS thinks...you are not considering a move elsewhere, right? You will find a lot of NY gals over on EC...0
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Oh whippetmom, I LOVE my plastic surgeon. This area of medicine is just so "new" to me and I had not heard of this person until my breast surgeon recommended him. I am ever so happy and confident of his expertise. Thanks for the heads-up on NY gals!
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Hood...I am going there right now to see your photos!
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