BREAST IMPLANT SIZING 101
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Thanks for the replies, all. I see PS again Tuesday and will ask more questions. Regardless of his leanings, he's already made it clear that he'll go with whatever I choose, so I won't be shy about insisting on silicone, slowing down expansion process, and going to 300 or beyond if that's what it takes to get the size I want.
Believe it or not, I consulted with 4 plastic surgeons before choosing my young guy. Although he's new to private practice, he's got first rate residency experience (300+ surgeries with one of nation's pioneers in TE reconstruction), is a NSM expert, and has really good team chemistry with my BS. I can tell already that he's done a great job with the underlying structure of my new chest and I look way better at TE stage than I ever imagined.
My second choice surgeon had a ton more experience but lacked this guy's fresh learning, enthusiasm, and desire to build a following in the region (the upside to going with a newbie!). When I saw the Boston oncologist, she had was extremely positive about the quality of work done on me. She said she didn't think anyone on my side of the state (about 2 hours west of Boston) was doing such nice work and that my finished reconstruction was going to be gorgeous. That was very nice to hear from someone who didn't have to say so!
Where his "greenness" shows is in explaining things and helping guide me. BC has already sharpened my self-advocacy skills, though, so I'll just keep using them as needed. I also think maybe he enjoys being different from the others, but that doesn't mean that a petite woman will be happy with saline! I'll try to post 160 expander photo to photo forum soon -- I'm already nearly as big as I was, but understand that I need to get uncomfortably top heavy to get it right.
Oh, also ... he said "side boob" (which my husband says is barely anything) is because of tissue left by BS in her part of operation and can be corrected. I'll see if I can post that to forum too, for comment.
Thanks again, everyone!! Can't imagine going through this without you. -Jade
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MBJ,
I just got my bandages off 3 days ago from the new PS and I am soooo thrilled. Dr. Schooler,........where do I start. He attempted to do the implants at the same time as my MX, he worked on me past midnight THEN he blamed me for "wanting to do it all at once". He said I was really too big to start with to have done it all at once, well then he should have TOLD me that prior to the surgery. My breasts were under my arms, hard, too big and had these huge lines, like puckers in them, I wouldn't let my husband or anyone look at me and those who I did GASPED when they saw it. So when I went in for a follow up HIS nurse says, oh yes these need to be redone and Dr. Schooler agreed and said his office would call me to make an appt. Well, they never did and 6 weeks later I wrote a letter to my BS Dr. Holmes (whom I LOVE) and told him how UNhappy I was w/Dr. Schooler. THEN Dr. Schooler calls me w/a half apology telling me how famous he is and how people from all over the world come to him and I should have called HIM. He said he could give me a reference if I wanted to go to someone else. I told him I didn't need a reference I had already found another PS locally, Dr. Dev who I was very happy with.
So....not only was I unhappy with Dr. Schooler's WORK but he was rude and has no bedside manner at all.
I am glad you had a more positive experience w/him. My current PS confirmed what a mess Schooler had made and he fixed it all!
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Robyn: Wow, I am so sorry you had to go through all of that! I don't know the details of why or how but I am glad it could be fixed and that you found another PS that was a better fit. I know that Schooler is famous for his micro surgical abilities and DIEP surgeries and I also know that when I first consulted with him he didn't particularly care for implant surgery and he seemed more in line with giving a "natural" look which I did get but just not the way he envisioned it. I was lucky in that I had Whippetmom guide me through the whole thing and that Schooler was receptive and did all that I asked and I ended up getting the results I wanted. I do know that he is over worked but that is no excuse for rudeness. I never had a problem with him and I thought he was very gentle and a good listener. I cannot imagine having my MX & recon done all at the same time-my first surgery with expanders took 6 1/2 hours for only one side because of all of the pocket work Dr. Holmes had to do. The exchange was easy at just over 3 1/2 hours. Best of luck to you. Is your new PS at Norris or did you go somewhere else?
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Cindy: I have seen his name mentioned on bc.org. I think he is one of the docs using the BRAVA enhanced fat graft transfer procedure. Other than that, I do not know of anyone who has gone to him. He does far more cosmetic procedures than he does "reconstruction" procedures of the breast. Where is she in So. Cal? I do have other names. You could have her PM me...or email me...you have my email address.
Deborah
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Just a couple of weeks til my pre-op and then exchange surgery July 21. I recently checked out the size charts for implants and noticed that Allergan's implants in the high profile style 45 have narrower widths than the Mentor High profiles for a given projection and volume. Not sure what my PS will use (hoping the Allergans). He is concerned about implant width as my chest is pretty narrow. My TEs are actually narrower than the implants will be. I wonder if I should ask him about this at pre-op or before?0
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redsky: Absolutely, the Allergan Style 45 is a very useful style in the Allergan lineup and it could be the ideal style for you. Mention it to your PS!
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Whippetmom,
First of all thankyou for all the work you do to help us on this site! I have learned so much reading all the posts.
I called the PS office today and got the specs on my TEs. They are Allergan 133 MV-13, 400ccs, but I am overfilled to 525cc. I am very please with how they look, as I mentioned before I am probably a C+ cup now and would not mind being slightly smaller. My PS told me I could achieve this. I am 5'2" and about 150lbs, hoping to drop a few extra pounds I gained with chemo, I measure 33 inches below the epanders. Your thoughts and input is greatly valued.
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Christine: Allergan Style 20 - 500 ccs - high profile smooth round silicone implant. You probably could use 550 ccs as well, but I am keeping in mind the fact that you want to be a little smaller than you are currently. As an alternative, - 421 ccs or 457 ccs in Style 15 - midrange profile smooth round silicone implant. You will probably be happier with the high profile style....
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I do have hanky pankies....I see they won the Undie Award...
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Posted on the wrong thread!!! OOOPS!
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Lago is right, the tear drops are not available in the US. My PS also told me that even if they were she would not recommend due to the possibility of rotation. Its funny too because we noticed that my TE's have rotated at least 45-60 degrees!!! Maybe that is more common with TE's because they are round. But I can just imagine what the results would look like if a Tear Drop implant that holds its shape will look like rotated. I wouldn't be a happy camper with that!
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Teardrop is available in the US if your PS is in the study. If I'm not mistaken this is phase III of the trial. I'm sure they will be available in the future. I have not heard of any stories of rotating from any of our Canadian or European cistas.0
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i swear to god...can you folks believe the things we have to think of or consider? rotating,,,capsular contraction...nipples,,,,no nipples...gummies...silicone....saline....tattoos....the list goes on and on...:) not to mention when i am really feeling odd i get worried the implant will somehow come out or fall off...GEEZ
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My expander actually moved a little on one side. I know because the port is in a different spot the last fill. Doc said the stitch may have come loose. He is not worried.
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Carrol2
My left TE rotated early on. The left port is at about 2 o'clock while the "good girl" right side is still staying put at 12 o'clock. My PS said that doesn't matter, she just wants the pocket stretched for the implant and it will be okay. Still makes me nervous! Does this sound about right in comparison to what you PS says?
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I my TE's rotated. The reason why I think this is the access ports are definitely not in the same place. PS says that happens. Seriously why do you think they have magnets to find them. If they didn't move around they wouldn't need that.
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lago is right in this case....i still crack up remembering the fills...asking "is that a stud finder?" very weird:)
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My PS will will not use anatomical shaped implants because they can also rotate. My TEs are definitely "stud finders", LOL.
Lago, are you excited for your exchange this week?? Wishing you well!
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I have a gummy and it is not going to rotate or move at all. These implants have been in WIDE use in Canada and Europe for 10 years (and are more common than the rounds); rotation is not common. Silicone rounds can migrate under the arm. Really it is a matter of the implant being properly placed and sewn down (the Allergans have tabs for that purpose if I remember what Whippetmom has written). I know my implant is sewn down on the side. If a PS is in the study he/she can offer the gummy as an alternative. The chief difference, really, aside from the shape (which I chose/preferred because I'm a uni and the shape is a better match to my remaining breast) is that the silicone is firmer -- more viscous than regular silicone. But it is still soft and squishy (especially as compared with a fully filled or overfilled TE)!
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I obsessed for a short time at the realization that I was going to end up smaller than my pre BC size. Shopping over the weekend shattered any sorrows I had. Wow, it's actually nice to shop and get shirts that fit! I'm a definite size small and a teeny dress size. If my PS stuffs these puppies with as much as I have right now, I'd be set. I know that they usually turn out a little smaller than the TEs.
Whippetmom - does the profile make any difference in the projection? Am I correct in thinking that you get upper pole fullness with the high profile but more projection with the moderate profile plus in the Mentor round silicone? Or is it the other way around? I'm confused.
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christine47 I should be excited but I have to admit I'm not looking forward to down time. I feel so good right now. Exercising regularly again. Walking everywhere till my feet hurt. I may not feel that bad but I know they want me to take it easy.
So yes I'm excited to get rid of my hard stripper boobs but not happy about the down time. Remember I had 5 weeks of down time for shingles too.
But I'm sure by Friday I will be happy to get my breast cancer boobie prizes.
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LOL Lago on "boobie prizes"
I think the downtime should be short for you this time around... and the benefit, well, keep your eyes on the prize!
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sweetbadger yes basically my PS tells me the TEs are just there to stretch the skin to make room for the implant. Whenever I ask abut the way it looks or will look he says we will discuss this when you pick which implants you want.0
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westieluv: The higher the profile, the more height to the implant, hence the liklihood of more upper pole fullness. It also depends on your skin flaps, the positioning of your inframammary fold. Some end up with more upper pole fullness than others. It is a body habitus thing also. The moderate plus profile have less projection but are wider and width helps with filling out a bra and cleavage.
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Hello everyone - I was wondering if I can get some help on this thread, I ave posted on another thread but I haven't heard back yet...........I am wondering if anyone here had radiation before recon and how was the outcome of the implant.......I have a great PS and I never doubt his work but mine was very hard at the beginning and now it looks much better (Had my exchange in October 2010) but my concern is about the lifted non cancer side, it looked great at the beginning and after the revision, I am a size C but now i lost some weight and the lifted sidelost pleanty of volume, if anyone can share similar stories and what they did to fix this problem it would be greatly appreciated. Thank you ladies
Patricia
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Hi Deborah,
I'm new to this board...Had a BMX on April 25, 2011, with immediate reconstruction TE. Hoping you might have some advice for me about fills and when to stop. I have always been quite small chested (less than a full A). I figured I'd take the opportunity to increase my size since I had to go through all this, anyway, right?
My nurse told me to continue to fill until I am happy with the projection...but this is difficult for me to know. After every fill, I feel giant (for me) and tight. After each fill, I think...ok, last one...but after a few days i change my mind and think...well, maybe one more,...kwim? I want to have a nice shape, not too big for my frame, but not so small that I'm unhappy. I'm thinking I'd like to be a full B/small C when finished. Following your instructions, I called my PS this am and asked all the pertinent quesitons (at least i think i did ) so here goes: TE - Mentor style CPX3 size 350cc / 1.7cm across, med height, 10 cm height, 6.6 cm projection. Silicone, round implants.
I'm 5'5" (maybe 6) not sure, weight around 120, rib circ 30" under TE (although I've always worn and not even filled out 36A bras). I'm filled to 345cc now. I only do 30 cc at each fill. Nurse said I can overfill (can go to 600, if I want - which I don't) .She said that the PS will put in an implant larger than the fill CCs. (for example, if I stopped now at 345, they would probably use a 360 implant to get a size similar to the TE size).
But I've read on the site that the implant usually looks smaller than TE!!! What do I do? Stop? Do more fills? I'm confused.
Any advice is appreciated. I really don't want to get this wrong...
Brett
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BrettW: I'm sure Deborah will chime in, but I just wanted to say HI and let you know that you're not alone! It's a really hard thing for many of us. Some know exactly what they want, some think they know what they want, but they kind of change their minds during the process ("boob greed"), and some wait for some sort of epiphany while the PS says "Say when!". It's not an easy thing to decide how you want to look for the rest of your life - it's actually a wonderful, amazing thing, but it certainly isn't easy!!!0
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Psal70: If you plan on staying at your current lower weight, you can go back for a revision - and have a small implant placed on the lifted, native side - to augment that breast to match the MX side.
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Brett: I think you need implants with a volume of 425 ccs - if, that is, you go with a Mentor high profile style implant. You also might like the moderate plus profile style - and in this style - you could size down a bit - 375 ccs would be nice. You need to sort of disregard the size of the TEs - the expansion is needed to stretch the skin sufficiently [you have some skin retraction when the TEs are removed] and especially since you are small pre BMX - the PS needs to ensure he has sufficient skin for good implant coverage.
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Tina T. - Thanks so much for your kind words...It's nice to know I'm not the only one going through this.
Deborah - Thank you so much...So, knowing that the PS will use a slightly bigger implant than the fill size, are you saying that if they plan to use a moderate plus style implant, I should fill to slightly under 375cc? And if they plan to use a high profile implant, then I should fill to just under 425 ccs? Is the style (moderate plus vs high) something I decide with the PS, or is that something the PS decides (depending on medical factors that I may not be aware of)?
Also, my PS suggests to wait 6 weeks after the final fill to schedule the exchange. Do you think 6 weeks is good or is the result better if you wait longer? I think I read that its better to wait longer in some of the above threads...
Brett
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