BREAST IMPLANT SIZING 101
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MBJ you look amazing! I see a slight difference but it's not that noticeable. I am jealous! I wish i got to keep my nipples. and your so thin! well I am working on that.0
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Carrol: You are too kind! I lost my one nipple so what you see is the reconstructed nipple without the tattoo. I am about 10 pounds overweight for me but I am saving this for fat grafting, lol.
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wow MBJ that was a reconstructed nipple? amazing! I hope mine come out that good.0
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Carrol: I am thrilled with the results of the nipple/areola-it doesn't feel like anything but I thought my PS did an excellent job! Thank you!
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Hello whippetmom. My wife will be having nipple & skin sparing BMX after she completes chemo. So surgery in Nov or Dec. We haven't yet had any consults with plastic surgeons, so we don't know what is proposed for reconstruction. My wife is 160cm (5'3") 45kg (100 pounds) her rib-cage is 71cm (28 inches), and her natural breasts are A-cup, B on a good day. (She claims B, but it's like me claiming 5'9".) I measured her breast width, just below the nipples, as 15cm. Given her petite build, we expect that implant reconstruction will be recommended (due to a lack of donor tissue). Besides which, she is not keen to get scars anywhere else.
My wife doesn't want to go huge, but she'd like to be bigger than now and have cleavage for the first time. As she says "there has to be some benefit from having cancer". As we haven't picked a plastic surgeon, I don't know what brands or models of implants we'd be limited to. We are in Australia, so gummy bears are available I believe. Anyway, your advice would be greatly appreciated.
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merovingian: I don't know where you are in Australia but you should send a PM to Deen- her surgeon was brilliant!
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Thanks MBJ. We're in Perth. I'll PM Deen.
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merovingian: Deen lives in Washington but flew back to Australia for all of her work. Good luck to you!
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whippetmom wrote:
Erika: Heavens, what was your PS THINKING? <snip> I would suggest you get a second opinion, because I cannot even fathom that you had that degree of width with your native breasts and I don't know if I would trust this same PS to perform the revisions. <snip>
I'm not 100% sure what she was thinking... My native breasts were rather ponderous & I had a lot of "arm-pit" boob. I was a 34DD prior to my BMX. Honestly, this size does NOT look huge, but instead actually looks about right (according to my co-workers, family, & friends). The exchange PS (& the expansion PS) both said that due to the shape of my chest wall as well as the size of my native breasts, this size is the 'right' size. When she did the exchange she did a capsulorophy <sp?> to fix the capsules/pockets. She stitched my skin to my ribs both axially (4 columns of stitches) and in my IMF (3 rows of stitches) to keep the capsule the right size. However, according to her my skin is stretching, not the capsule (or IMF) messing up.
I've gone back to the doctor that did my expansions (not the one that did the exchange or the TE placement). His opinion is that I don't have that much bottoming out (different opinion than my exchange PS). He also seems to think that my muscle hasn't retracted (window-shaded as my exchange PS said) very much. He had me push my hand down on my hip. Since the implant(s) moved with the pec, he says the muscle is over the top of it. My exchange PS said the movement was due to the skin attaching to the muscle - not the muscle being over the implant. I don't know. All I know is that I hurt. The expansion PS's opinion is that I need to give my body more time to heal. Its been a little less than 5 months since my exchange. However, in the year between my BMX & the exchange I had some very horrible health experiences. Really, to put it mildly - the 2 years since my dx have been hell: 20 weeks pregnant dx with Stage 2 TN BRCA1 breast cancer, FAC chemo, vaginal delivery of an 8lb 4oz baby girl, taxane chemo shortened due to neuropathy & allergic reaction, BMX w/ expander placement, low blood counts, bilat ooph w/ bleeding (needed 4 units of blood tranfused - 3 days/4 nights hospital), emergency hyst (abcess where tube met uterus - 3 days/4 nights in hospital), exchange surgery (out-patient), now constant pain in chest wall, collar-bones, neck, etc...
whippetmom wrote: Also, I would like to backtrack with your history and find out what style and volume of TEs you had prior to the exchange....could you get that info?
"The tissue expander that was then chosen was a 3 cm x 15 cm it was now 130 MB 133MV-13S surgery 14662080" -- I quoted that directly from the operative report. I don't really know what it means though. This was performed during the same surgery as my BMX. I was expanded to 750ccs I think. I stayed fully expanded for over 8 months before I could have my exchange surgery.
BTW I'm not doctor hopping or shopping for the heck of it. The dr who put my TEs in changed hospitals before I could get my exchange. He was also 900 miles from my home (now about 700), so he set me up w/ a more 'local' (150 miles away) PS. Then my insurance decided this new PS was not 'in-network', so I chose a more 'local' (45 miles away) dr on the premise (given to me by the 1st PS) that an exchange could be done by anyone. I'm now going back to the out-of-network dr simply b/c he does more reconstructions than the more local one who actually did my exchange. I trust him more too b/c my initial PS (who I LOVED) recommended him, went to school with him, and did his fellowship with him at MD Anderson. If I can convince him to do my surgery (if necessary) b4 the end of the year, the out-of-network aspect won't matter anyway.
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MBJ looking really good girl.
Babycakes, I had a Skin Sparing MX, I wasn't a candidate for Nipple Sparing. I am very happy with my results thus far, Deborah was able to recommend a PS for me and I decided after meeting with her recommend PS to go with her, I think she has done a great job. SO if it is something that you can have I most definitely recommend looking into it and considering it. The incisions that were made for my procedure closely resembled the T-incision used for a reduction. My photos are on the picture forum.
Meek
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merovingian: I have some reservations about gummy bears for your wife, because she probably has a very bony ribcage, and I would only be able to advocate Mentor CPGs. You might have the softer version of our Allergan 410's available, but I still think CPGs would be my preference, IF you decide on anatomicals. You have CPGs in Australia. But gummies can feel pretty rigid on a bony chest wall.
I honestly feel she would be happier with the silicone rounds - around 325 ccs - high profile - either Allergan or Mentor - but Allergan HPs preferred for her. I would recommend the Allergan 133 SX 250 cc tissue expander - which is low height and works best for someone with her body habitus.
Wish I could help you with plastic surgeons in Australia. If you get some names and run them by me, I will do some research on them for you.
Deborah
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Oh....just reading MBJ's post. Wonderful....I completely forgot that Deen had her work done in Australia!
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Erika: I PM'd you....
I am exhausted, reading about all you have gone through. It just is beyond my comprehension how much you have endured in the past two years. I feel you should ask for referral to an anesthesiologist who specializes in pain management. Also, ask for a referral to a physical therapist who deals with lymphadema, as they know how to address post-mastectomy pain syndrome. A lot of women have benefited from this type of therapy. I feel you likely have PMPS and my sister started a thread dedicated to that topic - here on bc.org. I'll bump it up for you.
Deborah
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Thanks a lot whippetmom. So when you say Allergan HP you mean Style 20? The 325cc with 11.2cm base diameter?
Since making my post, I measured the height of my wife's breasts as 12cm (in addition to the width of 15cm). I'm not sure if that's useful information, but I am guessing it might mean an 11.2cm base is bit big. Either way, you've at least given me a ballpark.
I take your point on the 410s and CPGs. Nonetheless, what size would you think is appropriate if the plastic surgeon is pushing anatomicals? (We know of someone who recently had a recon over here, with anatomicals.)
Yeah Deen had her work done in Sydney. Perth to Sydney is about the same distance as LA to NY.
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Hi
I haven't been on in a while, and wanted to update you all. My second exchange was in April. I'm a uni, so I was concerned about looking symetrical as my first PS made a mess the first time. I must say that I am pleased. My foob (600 cc silicone round) has softened and dropped a bit, and my natural breast, which was lifted and enhanced (300 cc), has healed and the swelling has gone down quite a bit. I love the shape of my natural breast although I think the placement of the nipple is a bit high. Without a bra, my breasts do look different, but I've come to accept it, and I like both for different reasons
I wear only Victoria's Secret push-up wireless bras, and I must say I look great in clothes. Bathing suits had me worried but I found that strapless with a tight band across my breasts look awesome. It took a while for me to find what worked for me. So don't give up.
Whippetmom, Lilah, and MBJ - I owe you all so much! I never thought I would like shopping again. When I think back to last July, I was a mess. You all just opened up your arms and helped me through. I think my PS was a little intimidated by my knowledge of breast reconstruction and what I wanted lol
For the person whose PS was contemplating putting the implant on top of the muscle - Both my implants are under the muscle on both my foob and natural side. I did ask the PS why. She said that it gives a clearer view for any future scans that need to be done.
Good luck to you all!
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merovingian: The Style 20 - 325 ccs - will not be too wide for a 28 inch ribcage. Trust me.
The anatomical implants are trickier - because the volume and the style will be predicated upon the choice of the tissue expander. The TE is chosen with the future implants in mind. There are other parameters involved - the torso length - the sternal notch to nipple distance - whether the inframammary fold sits low or high on the chest wall. With Allergan, it might be that a 133MX implant - 300 ccs - would be better - overfilled [it is almost the standard to overfill the Allergan TE in prep for the anatomical] and then think of perhaps a 255 gram or 290 gram 410-MX style implant. As far as Mentor CPG's are concerned, there is a specific, recommended formula....here is the link...and it will be something similar to the Allergan numbers....
http://www.mentorwwllc.com/pdfs-global/breast/EN/literature/CPG-CPX-sizing.pdf.
Deborah
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merovingian - [Raising my hand]
I am a witness that 325cc style 20 implants are not too wide ... I have a 28 inch ribcage and that's exactly what I have. Look very natural ... not too big at all, nor too wide. 0 -
Hey Claire: I wondered what happened to you! Kept looking for updated photos!!! I am so happy that we were able to help you, and your words just reminded me why I have hung around so long. It just blesses the socks off of me to know that you came out of a very traumatic time and you are now happy. I know it will mean a lot to Lilah and MBJ also - we are all a cheerleading team here!
BTW...I love bandeau-style bathing suits also!!!
Don't be such a stranger and come back and say hello every now and then!
Hugs,
Deborah
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claire82 - Thanks for checking in! I'm so glad you're happy and things have worked out for you! After the nightmare you've been through ... it's great to be on the other side. Happy 4u!! xoxo 0
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Thanks a lot for the information whippetmom & Dawn-Hope. I really appreciate it. I feel like we have a good baseline from which to interpret the recommendations of the PSs.
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Hi ladies,
Well I had my implant exchange on thursday (surgery was so easy). Today I took off the dressings and am not sure what to think, I have nice projection but not definition between breasts or around them, I am somewhat swollen, so I hope this improves. I got 600cc High profile Allegan silicone implants. Whippetmom, I believe you had suggested 500-550cc in the high profile style. Plastic surgeon told my husband the last thing I said was "error bigger".
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Christine....Do you want to email me photos? I am perplexed about not having definition in the cleavage area. Describe further.
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Claire! So good to hear from you! I've been thinking of you and wondering how you are doing. Have you had nipple surgery on your implant side? Just wondered because of your comment about the nipple being too high (which I think you meant on the native side, but perhaps not?) I haven't done nipple yet on implant side... hope to schedule it in late fall or early winter.
I think absolutely naked symmetry is very difficult for the uni; its the challenge of matching a natural breast with a silicone breast. Mine are not perfectly identical either when naked (and the native breast has more ptosis) but look very good in a bra as well. Anyway I am glad to know you are happy and have found such great bras at VS!
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whippetmom, I would like to if you don't mind sharing your email address. I will look for it in my private message box. Hopefully I can figure out how to send the pictures, my teenage son is away today and he is my technical help
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Hi. I have been following this and other forums for a while, but am new to posting. I am scheduled for Skin sparing BMX and will have tissue expanders placed a few months after. It seems like most people have had them placed at the time of surgery. Is there any difference in aesthetic results - other than taking longer to get there?0 -
bobeena: Are you having TEs placed at a later time because you are having radiation? What is the reason for the delay?
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no plans for radiation, chose BMX instead. I have sent you a PM as well
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Bobeena- my PS also wanted to wait at least 4 weeks to place my tissue expanders. The reason he told me was he could put more fill in after my mx incisions were healed. My PS went in under the breasts, the inframmary fold, for the TE surgery, not thru my mx scar (-)(-). He said we would get me to my final amount of cc's faster if I could go with nothing for that month & he did. I believe I got 420 or 460 cc's during my TE placement surgery, which from reading in here is a lot for the initial placement. Also, he said he could have not put that much in if I got the TE's during my MX & it would take much more then a month to even get me there (to the 460). I had skin sparing as well....but that amount was still not enough to fill out all of my skin....but got me to a B cup. Then after a few weeks he filled 60cc's weekly & I did get to my old size quickly.
I do read on here where they were happy to wake up from the MX with something, so you really have to be prepared for the mental part of having nothing for that time....other then a bunch of skin. I was in such bad pain afterwards I spent almost a week in the hospital & then in bed, other then doctors appointments so it didn't bother me too much0 -
tlc40 - Thank you for sharing this!
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tlc40 - I have been trying to prepare mentally for this, and your story helps more than you know. Thank you so very much!!
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