BREAST IMPLANT SIZING 101
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I started reading the first few pages and jumped to the end. I haven't had my masectomy yet. I see the plastic surgeon tomorrow. I prefer fat grafting as it sounds like a better method and outcome. I am seeing another plastic surgeon on Wednesday who has only done fat grafting for those who have had lumpectomies...so he might not be a good option.
The iron bra feeling is scary. I don't care for large breast, a size b is good enough for me. I've been a good c but with the few lumpectomies I'm not sure what I am anymore. Is it possible a size b will hurt less or have the iron bra feeling? Will the implant feel like I am wearing a bra? Will I wake up with a breast or wait until it's filled? I know little about all this right now except I want breast. At this point I'm only having a mastectomy on the right breast. I heard that recovery time is easier and faster than having a blmx. I have had breast cancer in both breast, but the left breast according to the recent mri seems clear.
If I just do one breast will they somewhat match or age differently?
Thanks for this thread and the other reconstruction threads. This is important to me right now as I muddle my way through this dreaded surgery and reconstruction.
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Evebarry:
Sorry you have to join this group, but these women are an awesome bunch and a wealth of knowlege. I don't have implants yet, but have TE's. I had a BMX. First, from everything I have read and heard, fat grafting is not done to build a new breast mound. That is used to fill in divots, get rid of rippling and other types of revisions after you have gone thru a reconstruction surgery. There are options to use your own body tissue such as tram flap, diep flap, free tram flap, latimus dorsa flap and others, but those are the most popular of the flap surgeries. The tram flaps take muscle and fat from your tummy and uses that to build a breast mound. Diep flap uses only fat and skin from the tummy area and is a micro surgery to connect blood supply to keep the flap alive. the latimus dorsa flap take muscle and fat from your back. These are over simplifications, but there is a wealth of information in other forums for these types of recon.
Whether you choose a UMX (single) or a BMX (bilateral), you can get good results with either. The option you choose is highly personal and depends on so many factors. There are many women on this forum that have had good results from either option. It all depends on your circimstances and what you and your doctors feel will give you not only the best recon results, but will be the best option for your recovery.
TEs (tissue expanders) are not very comfortable. I haven't heard of very many women who love those! For me (and I think many here will concur), they are hard rocks the lay unevenly on my chest and they are very uncomfortable. But they have a job to do and that is to stretch your skin and muscle so it can accomodate an implant. Since I am not scheduled for exchange until January, I cannot speak yet from personal experience, but most women will tell you the the implants are much, much better. I will be getting a cohesive gel silicon implant. From everything I have heard, they are much softer (you will hear people refer to them as squishees!) and have a more natural feel. And with a UMX you have many options to get symmetry in both breast. You can have the natural breast, lifted, augmented or reduced.
My initial consult with my current PS took 2 hours. He and his staff went over all of my options in great detail. I got a chance to see pictures of women with a similar body type to mine and see what their results looked like. I think it is very important the have a PS that you are comfortable with and who has a lot of experience in the type of surgery that you end up having. I know this time can be confusing and scary, but there are a lot of women here who have been down this road before and who are more that willing to offer support. It is funny in a way, but I have share much more of the intimate details of my journey with these ladies than with my friends and family. It is just that because here you find women who get it, who understand what you are going thru because they have gone thru it too.
I wish you the best with the choices you have to make and I do know it is not easy!
Phyllis
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momoftwo526 There are a couple of PS that do create breast mounds with only fat. The technique was developed by Dr. Khouri of the Miami breast center.
http://www.miamibreastcenter.com/brava-breast-enhancement.html
BTW I have implants. Exchange was in June. I don't have an iron bra feel. I went larger. My PS says I'm about a C (full C since I went a lot fuller).
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Its been a wiel since I have posted, but just wanted to tell some more of my story incase others are going threw the same thing. Last thing was my ps dropping me out of the blue, what I thought to be a pre-op apt. was her saying I can't finish the job. WoW that was a surprise I had no Idea, there was no reason given by her. I felt like I was going to be stuck with expanders in me forever. So I started getting second opinions the first ps wanted to replace my expanders and start all over. I hated the expanders from day one and didn't want to do that again. So I went to one more opinion and she said she could do the exchange, she would need to do some lowering of one side. I was so excited to be close to implants. Well exchange was on Oct. 6th and NOT all looks good, the one side keeps falling its kinda twisting my skin in the middle with it. I have no iff on one side and the other side is sitting above with alot of extra skin underneath. I was hoping to look a little more normal. My hb has been with me every visit and I just can't bring myself to show him this end result. I couln't believe this is it. Every question I asked the ps about could we fix this was, thats the way you were when you came to me. Okay threw whippetmoms advice I have meet with my first second opinion doctor and am sceduled to go in for replacement of the expanders and try this one more time. I have hope again even thought I wish I was done now. Also FYI even though I don't look good, it is much more comfortable with the implants compared to the expanders, it was like night and day the second I woke up.
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bcs2011 - I am so sorry you are having to go through numerous doctors and now additional surgeries to get an acceptable outcome.
For what it's worth, the PS who kicked you out of her practice without an explanation (and presumbly no referral) might have commited something called "patient abandoment". This is a grievous breach of medical ethics. Physicians can only terminate a doctor-patient relationship under very strict guidelines. Sounds like you are better off without her, but I hope you give feedback about this doctor's behavior to whomever referred you to her.
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Tiki: 300 ccs.
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Thanks...I wish I had the money to fly to Florida for the fat grafting. I' weigh about 132 more or less, and I'm 5'8". I am concerned with fat grafting having enough fat to graft. Is it possible to have an implant with one plastic surgeon and have another add fat grafting around it? If the plastic surgeon messes up the job will insurance pay for reconstruction after it's been done? Will the insurance consider the redo cosmetic?
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evebarry: There are plastic surgeons who perform the enhanced fat graft transfer method in other areas of the United States. Kate33 on the "Has anyone had micro-fat grafting?" thread maintains a list of those plastic surgeons. You might want to contact her.
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bcs2011: I am so glad you are going to forge ahead and do it right this time! Please let us know how you are doing....the time will go so quickly - a blip of time in your life....
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Thanks jyg, for that information! I agree that bcs should definitely file a complaint with the medical board regarding the actions of her first plastic surgeon.
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A women, friend of a friend called me asking me to check out a different plastic surgeon that she recently used for breast reconstruction. After seeing the one I had an appointment today perhaps it is a good thing.
The plastic surgeon I saw today is ok. The woman in his office who works with you was rude. She is the one who is suppose to be there for you..to answer your questions. She seemed annoyed when I begin asking questions. She was pretty much done with me after I signed all the papers for the surgery. She was about to excuse me, and I said, is it ok if I see pics of the surgeons work. I couldn't believe they weren't going to show me that.. I wasn't that impressed with his work Maybe I'm expecting too much.
When I asked the surgeon about fat grafting he said I didn't have enough fat on my body. Someone here, I think Largo said they can find fat even on thin women. BTW...those implants look huge. The plastic surgeon said rarely do women have a problem with TE' or implants. I said, I read otherwise on breast cancer threads. He said don't read threads, they are full of horror stories..that's not real life. Only read reports from plastic surgeons. After that I didn't quite believe him. Your stories are real.
So...tomorrow morning I'm going to call and see if I can see this other plastic surgeon, who does a little fat grafting along with the implant.
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evebarry: I sent you another PM!
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Hi everyone,
I am new to this thread and just want to say I found all your comments, information VERY HELPFUL. I have been dealing with a lot of other serious life changing issues and have not really thought much about the surgery and now it is coming this Friday and I am feeling rather apprehensive. I am having a breast reduction & lift on one side (currently am size 36H) and the TE being switched out for implant on other side. I still have about 4 more months of herceptin infusions and have gained about 30 pounds since January. My onc says she will then put me on Arimidex which I understand people also gain weight on. They tell me the weight gain is probably due to chemo, herceptin, steroids and thyroidectomy I had in February 2011, as I have not changed my diet at all. Does anyone know what will happen if you lose if you lose weight after a breast reduction and implant? Also have people had good luck with getting symmetry and equal size when the PS tries to match the native breast with the implant? Thanks for any information.
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evebarry My PS did have trouble harvesting fat the first time around. He was harvesting it from my stomach/love handles area. This last time I sent him to my thighs. He found enough fat there. I do think you are thinner than me but that is your PS call not his assistant. I find the support staff really important. Is there another PS option for you? BTW I'm 5'6" 130 lbs with most of my weight in my lower body.
serenitywisdom I was still on Herceptin when I did my exchange and on Anastrozole (generic Arimidex). I gained about 12-14 lbs on chemo although 1/2 of it was fluid retention. I've been at my pre BMX weight for a while. It came off at a decent pace. Not everyone gains weight on Anastrozole. I went back to eating and exercising the same way as before bmx. BTW I was tossed into chemo-pause so I didn't even put on weight from that. Don't assume you will gain wait.
I would discuss you weight issue with your MD. 30lbs is a lot and where you have the thyroid issue… that could be contributing.
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Hi everyone. This thread is amazing. You ladies have been through so much, and you are all so brave!
I'm meeting with a PS in a few weeks to further discuss NSM with immediate recon. I met with him earlier in the year, and he said he could do direct to implants with no TE. I am wondering if I can get info on sizing w/out TEs? If so, I'll gladly give my measurements.
Thank you!
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Thank you so much for this wonderful information. I was just diagosed yesterday and was numb. Today, I feel everything and my head is spinning.
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So, after reading this thread, I have a question. I am having immediate recon after my bilateral mastectomy. Does this mean that I have to have tissue expanders? I won't walk out of the hospital with my breast implants??
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Andeerae, most PS will do TEs, but some will do immediate implants (one step). Call your PS's office and ask which you are getting. They are there for you.
I am so sorry to hear about your diagnosis. You just found out yesterday? Sending you hugs!
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serenitywisdom:
If you lose weight after a reduction on the native side and with an implant on the MX side, you will likely lose volume in your reduced breast, but not on the implant side. I would recommend that the MX side be overfilled in order to give you significant ptosis - which you will need to match the native breast, because even a reduction will not address the ptosis you are describing with your 36H breast. Then, a smaller implant could be used on the MX side, with the understanding that over time, your native breast will lose volume as you lose weight.
Another option is to, instead, have your PS use a Mentor Spectrum expandable implant on the MX side. This implant enables the PS to add volume and remove volume over a period of six months or so, until you are happy with the size and volume. This way, you could adjust the volume as you lose weight. Just an option to discuss with your PS. Then, when you are happy with the size, the fill port is sealed off and the implant is now permanent. Additionally, this gives you the incentive to work on your diet plan over this six to eight month period of time!
Deborah
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Andeerae: Hope you are having this done at the Mayo in Scottsdale - the only place in Az I would recommend having the one-step.....
EDITED TO STATE: The term for use of two stage reconstruction is called "immediate reconstruction", so it might be confusing. Typically, the term, "mastectomy with immediate reconstruction refers to the insertion of tissue expanders immediately following the MX.
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Crescent: Yes, give me your height, weight, ribcage circumference and tell me what you hope to achieve from a sizing standpoint. Also need to know your breast characteristics.
Deborah
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andeerae,
I thought the same thing when they kept talking about immediate recon. I know they do it in some places. My PS said he gets better results doing the TE's first. He was not happy putting in implants first. Just trust your PS and if whippetmom gives suggestions; I'm sure it's good.
I've had great results with my TE's and getting implants in January.
Good luck to you!
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Whippetmom, thank you for walking me through this difficult time. I appreciate this thread a lot, and for the personal advice. It really helps. I am leaning now toward a blmx. It seems like the most rational decision, hard though, really hard.
I made an appointment with another plastic surgeon that is on Whippetmom's referrel list. Just happened a friend of a friend called me yesterday and said I had to go to this plastic surgeon. He does botox around the mx. Any of you heard of botox injections? It sounds a little dangerous to me. I guess he knows what he is doing. In getting a new plastic surgeon, I am changing hospital, and this means breast cancer surgeon. It also means going a little further to Vancouver, Washington. My appointments with this new team is next Wednesday. Waiting again
This friend also said her recovery time was only one week. I could do a week.
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I've never heard of botox around the MX! But doesn't that mean you have to get Botox shots for the rest of your life (or something)? Because I thought Botox does not last... that people get it redone over time. I've never had Botox so I don't really know... just surprised to hear this!
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evebarry: Yes, absolutely - very well-published approach using Botox at the time of tissue expander insertion. Studies have shown that this reduces post-mastectomy pain and reduces the discomfort and pain during tissue expansion. A number of plastic surgeons are using this now and it is perfectly reasonable to do so.
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More on botox.....
The botox benefit is only going to last for about three to six months - about the length of time we have our tissue expanders. There probably is no need for repeat injections. The only reason women keep going back for Botox for cosmetic purposes, is because the benefits wane and wear off after three to six months. Botox was first manufactured by Allergan to treat medical disorders such as blepharospasm and strabismus [think of Allergan and their ocular products] and then found to benefit other medical disorders as well. In the 1990's, a California dermatologist started experimenting with botox and eventually it was approved for cosmetic use. So we can see that botox really started out as a therapeutic agent, but this has been grossly overshadowed by the cult following for cosmetic purposes.
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Here is the abstract regarding the use of botox in breast reconstruction:
http://www.medscape.com/viewarticle/727235
and another....
http://www.kgw.com/news/local/Botox-for-Breast-Cancer-Patients-106294708.html
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I am so fortunate to have Dr. Gabriel as my to be plastic surgeon. After reading the threads her on TE pain problems and women removing them, I feared tissue expanders and implants. Now...there's hope that it might work for me.
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Whippetmom:
I just saw your post re the Mentor Spectrum expandable implants. My PS is using those as tissue expanders. Mine are very hard and uncomfortable, but I know that they are used as permanent implants as well. Do they do something else to them to make them softer? Mine are the 354-2515 550cc to 660cc. They are filled to 655 on one side and 705 on the other. I posted the complete specs on the picture forum.
I know you must have a hard time keeping all of us straight, with all of these questions and you are an amazing resource. I appreciate all that you do to help all of us.
Phyllis
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I have been reading your posts and have decided to post my question here. I am a full figured 43 year woman contemplating lumpectomy or mastectomy. I am overweight, and yes would i love to be thinner, yes of course and have battled my weight for years. So body image has always been a concern of mine. When i was told I had bc, i have been struggling with the type of breast surgery I should have.
I have seen two plastic surgeons and feel they have given me a lot to think about. However I still do not know what to do. The first ps told me about ALL the options and how they would look and what he could do for me in either surgery option. He was honest and said he does not do the DIEP but knew of a Dr. who did. That is who I went to next. I want to hear all the options. The second opinion shocked me. Not only was it embarrassing how he kept grabbing and jiggling the fat around my waist (I wasn't expecting that. I could have mentally prepared). I was told implants would look ridiculous on me and I should only consider the TRAM or DIEP. I was even told that the ps was shocked that another ps would even offer me the option of implants. I am a 42 DD and confused as to what to do.
It has been difficult enough dealing with being dx with bc. I have a family history of bc and other cancers. I am considering bmx, but now with this new information I feel as if I back at square one. Any advice would be greatly appreciated.
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