BREAST IMPLANT SIZING 101
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Hi, I had a BMX on 9/14. I am 5'8 155lbs currently but usually ~145lbs. My rib cage circumference is 34 inches. My expanders are the smooth round Spectrum Saline 425-510 ccs, model # 1400. I am currently filled to the minimum of 425 ccs. At my last fill with my PS my left side seemed smaller and the skin looser than the right and so she just filled that side. I experienced pain when she was filling (burning sensation that went up and down my arm). She stopped filling because of the pain and guessed there was a leak. A week later my left side has gotten smaller so imagine there is a slow leak. I would like to be bigger than I am now. What I imagine to be a C cup would be ideal I was a small B before.
My PS is very matter of fact and not the best at answering my questions. I am concerned that I will be unhappy with the results and will want to go bigger. What would you recommend? If she can't fill anymore on the left side due to the leak will I still be able to go bigger if I am only at the minimum fill?
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SFNora: If there is a leak, then the Spectrum needs to be replaced. Plain and simply, the PS needs to replace the defective device. You do not just short-cut the expansion process because of this, because you will not be happy with the outcome. You need to be in the 550 cc to 650 cc range with implants and that leaking 425 or diminishing Spectrum will not get you there. So you need to communicate that this is unacceptable and you want it replaced. If there is any balking, you need to find a new PS. And if you need to find a new PS, let me know and I can help you find one. Did she use the Spectrum with the plan to leave it in as a one-step of sorts, or exchange it out? I always wonder why these docs use a Spectrum as a tissue expander....
Deborah
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SFNora,
Whippetmom is right. Your TE needs to be replaced. My left TE also leaked and had to be replaced. It slowed things down about a month but is the best thing to do. The replaced TE will be filled some during the replacement (I got 260 ccs) and I was able to get fills weekly after. I caught up in just a couple to doctor visits. The pain from the replacement was nothing like the mastectomy.
Hope this was helpful!
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jbennett: You are an
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Thank you! The plan was to replace the Spectrum's with Silicon implants on 12/6. I have an appointment with the PS tomorrow.
JBennett how long was the recovery with the change out surgery? Did you have to have a drain?
Thanks again!
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SFNora.
No, thankfully I did not have a drain. The nurse in the PS office thought I might but my PS didn't think I would have to (he should know, right!). He "loosened up" some stuff while in there and said it would depend on how much bleeding there was. So I guess, depending on what the PS does, it is possible you could have a drain.
As far as the recovery, I think about a week. I think I took pain pills for a couple of days every 6-8 hours and then after that at night for another day or two. It really wasn't that bad.
I posted to the TE Trouble thread when mine started leaking. After reading what some of our ladies go through, I was thankful my problem was just a leak. That put it all in perspective for me but it is still disappointing to have any kind of setback. Good luck with your surgery and let us know how it goes!
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Question...anyone NOT stay overnight after their mastectomy?
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I stayed 3 nights, 4 days
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stayed 2 nights and one night with my exchange surgery.
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Whippetmom, I saw the plastic surgeon today. His office is quite plush! He has a fantastic team of women working with him. He seems to be good at what he does. He uses botox to relieve pain...which is the main reason I checked him out. He isn't giving me a choice about not wanting aoderm (dead skin?) not sure I got the spelling right. He also said he spoke with the breast surgeon, I met with on Wednesday, whom he works with, and she insist of blmx and possibly only saving one nipple. I asked to save both. I wanted the nss. I am suddenly feeling out of control...like I am being pushed through all this. I know they are a good team and are the best around, but I'm not sure if I can do this. He did say because I didn't have rads, he could save the skin. For this i am glad. Just feeling overwhelmed about the upcoming surgery.
The plastic surgeon I saw before would do whatever I asked, but I did not feel comfortable with the woman in his office that I would be going to for questions or help.
Also, the plastic surgeon I saw today takes the whole person into consideration. He sends all of his reconstructive breast surgery patients to pt.
Just to add, the new breast surgeon I saw on Wednesday is aggressive...hmm.. She insist on taking out a few nodes and said if there was cancer in them she wanted to take out more. I finally conceded to 2 nodes only. I can't believe she got me to concede to that! The other bc surgeon said since my sentinel nodes were already removed from previous surgery that she wouldn't be taking any out. I went in to her office being unsure about a blmx and by the time I left she too had me conceding to removing both breast. I think I needed that push. It looks like if I go with them the surgery date will be in December.
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I think I'm getting close to my fill size, but I'm afraid to say stop. Is this normal! I'm going smaller, so I'm a little unsure of how to guage my size. 0
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Eve: knowing your prolific cancer history, this is a good team for you. I will PM you tomorrow night.
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mamalou: let me look at your numbers again....
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mammal: I cannot answer that question because I believe that you have sufficient fill now to exchange out to 533 ccs..midrange profile. Why does he keep expanding? Why is he waiting for you to tell him "when"? I am perplexed, because of your described tenuous skin. Did you discuss sizing with him?
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I have only seen the nurse practitioner for fills. I guess I better get an appointment with him. I'm wonder why they haven't suggested that?
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I woke up at 3 a.m. and my mind again is wrestling with blmx or unimx. The Plastic Surgeon did say it would be at 3 weeks recovery time and I would be taking pain meds during that time. I have two problems with the blmx. First, recovery time. Removing one breast might be less pain and recovery time. I could drive sooner if I only removed 1 breast and did the other one at a later date. Second, previous pain syndrome with RSD...and that I'm at high risk for mps (mastectomy pain syndrome). My husband and I talked and he thinks it might be best to do one at a time.
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Evebarry, I'm not in the same situation as you with RSD or mps, but I am about to have my second mx next week, after having my first one in February. I didn't have a bilateral in February because my docs didn't think it was necessary... Another family diagnosis last month made me decide to go for the other breast now.
Since I haven't had a bmx, I don't have any idea if it's more painful to have both breasts done at once. However, I WISH I had done both of them at the same time... I've already gone through the recovery stage once, and now I'm looking at having to start over from square one. Intead of having my expander exchanged Monday, I'm now looking at having another MX, having a NEW expander placed, and having to keep my current one through the expansion process of my pmx side. I thought I was ready to begin job hunting, but now I'm looking at more appointments for fills, the exchange, along with the recovery time there, etc. I am really ready to be done and move past breast cancer, but am kind of stuck until I finish this process...
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I had my bmx Aug. 31st 2010. It took a while to heal but I never took any pain meds. I'm not typical but I know of one other gal who also didn't need pain meds. I was so scared and thought I would be in so much pain. Not so bad for me… but I wouldn't want to do it again. Personally I rather go under once rather than twice. Everytime you go for surgery there is risk. One of the biggest being infection. The fewer times you can have surgery the better IMO. Also just one recovery time instead of two.
I didn't drive for a while because I felt if I couldn't put my arm up on the back seat to turn around I wasn't going to drive. I live in the city so I'm no stranger to public transportation. It was about 2 weeks or maybe 3 that I took the bus during rush hour to do some freelance work at my old job (laid off 5 weeks prior to diagnosis). I was also taking the bus to PT as well.
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Evebarry- I am not an expert like some of these other girls, but I thought I would add my opinion. I had a BMX and it wasen't as bad as I expected. Getting it done all at once was better for me. After the first week I had minimal pain at surgery site. The most discomfort I had was from the drains. I was told I could drive as soon as I was off pain meds, but it was a little uncomfortable with the drains though so I only drove short distances until they came out. I also had full range of motion immediately post op, which I know is probably not that common, so pt might not be a bad idea.
Can't read back as to who asked about staying overnight after surgery, but I stayed 2 nights with the BMX, PS wanted me home after one due to infection risk, but BS wanted me to stay 2, and outpatient for the exchange.
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I also had full range of motion post BMX. I only had one node on each side removed. I think maybe that's what makes a difference.
I agree with other about have both side done at one time. Other than recovery time and risk of infection, depending on your insurance, the costs could go up also. For me, I have had out of pocket expenses with both of my surgeries (BMX and TE replacement). Just something to think about.
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I stayed one night for MX and it was day surgery for exchange and lift/reduction.
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Hi Eve, I only had uni mx (with TE reconstruction) because the other breast had no "issues" -- so I can't speak specifically about BMX -- but even with the uni mx I had 4 surgeries in 14 months (lumpectomy, mastectomy, exchange of TE for implant, nipple recon) and I would be concerned about minimizing the number of surgeries. The anesthetic always knocks me for a loop, cognitively speaking, so do pain meds (even though I used very little after getting home), and antibiotics also do a number on me. (As I recall, oral antibiotics were only prescribed after mx, but I think there were some IV antibiotics with the exchange surgery.) Anyway, my guess is that possibly doubling the number of surgeries might be harder to go through than having BMX. Just my two cents -- sending you hugs and best wishes whatever you decide.
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My concern about getting a uni mx is that after the mx, my right breast will only be a small bump and it will look weird next to the normal breast. I would feel uncomfortable going out in public. I went into Norstrom this afternoon because I heard they sold mastectomy bra's. I thought perhaps I could buy one bra and insert a prothesis so it would match my normal breast at least until I got an implant. The sales lady politely said that I probably wouldn't be wearing a bra until the swelling went down, or about a month to six weeks. That was a surprise. I thought you would be able to wear a bra right away. She said my insurance would pay for one prothesis and 4 mastectomy bras. That's probably for those who don't get reconstruction.
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Eve:
I would echo what everyone else is saying here. I opted for the BMX for a number of reasons, one of them being I didn't want to have to go thru all of this again on the other breast. Since it turned out I had ILC and there were pre-cancerous cells in the prophylatic breast, I was glad I did. My recovery was prolonged because I had an infection and I had drains in for 9.5 weeks. I can only imagine how much longer recovery would have been if I had each one done separately. Whatever choice you do make, it has to be yours.
I was in overnight, for my BMX, but I did not get out of recovery until 8pm and I left the hospital the next day by 11:00 am, so it seemed like I was in and out very quickly! for my reconstruction in January, I will be in overnight, but that is because I am having a tummy tuck too. If it was just exchange, it would be outpatient.
Phyllis
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Thank you all for your thoughts, experiences and patience. I am driving myself nuts with all the flipflopping on blmx or uni. There are pro's and con's both ways. Not to bother you again but for those who did the blmx was it hard to get out of a chair? Did you feel dependent on others to help you? Does it hurt to walk up and down stairs? Did you feel awkward or self concious without your normal breast? Did you feel sad? Did you notice people staring at your chest? How did you respond to people who asked about it?
For those who got a uni...or only one breast removed.. Did you have a hard time wearing clothes feeling the breast were uneven especially right after surgery? Was it easy to get up out of a chair? Was it easier to drive? Sleep? Were you glad you had one breast...sensation.
I would love to do it all at once, but worry that blmx would double the initial pain, double recovery time, and healing...Taking off two seems like twice the pain, much more of a major surgery and twice the chance of infection. I'm hoping the botox will be the deciding factor in regard to the pain issue.
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Hi Eve,
I had bmx with TE reconstruction in 1999. I only stayed in the hospital 1 night. I had full range of motion right away. I did not take any pain meds once discharged from the hospital. The worst part was the drains. I went back to work in 2 weeks before my drains were out. I recall how terrified I was the night before the surgery . . . and how relieved I was that the worst was behind me when i was discharged from the hospital. I was unfortunate enouph to have received TEs from a lot that was subsequently recalled by the manufacturer. One had to be replaced because it leaked and the other burst. Those were 2 more surgeries. Then the tissue expanders had to be replaced and the nipples were reconstruced with skin grafts from my abdomen. I found it took longer to recover with each subsequent surgery.
Only you can decide what is right for you. Based on my experience I can say that for me it would have been much harder to start over with a second mx once the TE was out and implant in.0 -
I had no difficulty getting in and out of a chair, getting up the stairs etc... My husband only took 2 days off the day of my surgery and the following day when I was discharged. I needed assistance with showering and washing my hair. I had difficulty reaching items in kitchen cupboards and the fridgebif it involved lifting my hands over my head for the first few days at home. I had at PT come to the house before surgery. She gave me some great pointers and I rearranged my kitchen cupboards a bit for easier access by putting some stuff on the counters.
I did not feel self conscious as I was not assymetrical. No one stared at my breasts though one of my neighbours said I looked like I had lost a lot of weight and asked which diet I was on. I was a 34 DD before mx and asked for a B cup. I wore a lot of loose button down shirts until TEs reached the desired size.
I do not feel thst Bmx was double the pain. As far as surgeries go it was better than the laproscopic surgery i had on a pain scale of 1 to 10 I'd say it was a 3 to 4.0 -
Eve -- I was a uni. I wore a sports bra (soft, zip front -- actually it was the Undescore from JC Penney) immediately after surgery. Actually, at first after surgery they put me into a post-surgical bra (made by Mirena). Not pretty but it did the job. I had a small bump where the breast was inmediately after surgery (I think they put in 200 cc's of fluid to start) but I was a DDD so they were definitely uneven. BUT here's what I did to solve the evening out problem: I bought a soft, fiberfilled insert that I could put into my sports bra to even things out. Since the insert was fiber filled, I could remove stuffing as the fills made my MX side larger. Eventually my MX side and my native side evened out enough that I did not need to use the insert. The insert was sold in the store at the "breast center" of my hospital -- and actually now that I think about it, they gave it to me. You should ask your doctor (or his nurse -- my PS's nurse is the one who told me) about this... I would be surprised if they did NOT have suggestions as to where you can get such a thing locally, before your surgery. You should also ask your PS what you will be wearing when you wake up from surgery (I was wearing one of these post-surgical Mirena bras, over bandages). Also FYI you will undoubtedly have drains (two per side -- so two if you have a unilateral MX and four if bilateral) for at least the first week post surgery. PM me if you have more questions.
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My PS put me in a Barely There bra after surgery. If needed one could put some "stuffing" in there. I did the BMX with expanders so I did have some. Also I was pretty tiny before so not a huge difference in size in clothes.
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Eve- I did not have trouble getting up from chairs and doing stairs. I had more trouble with my hysterectomy then my BMX. I will say getting comfortable in bed took a little while, but I would think it would be that way with a uni too.I did better in my own bed than I did at the hospital. I had TE's placed and had 200cc fill at time of surgery. There is some muscle spasm, but that didn't last long even with future fills it wasn't bad. The drains were the worst for me. I only had 2 with my BMX, one on each side. The only people who stared were the people that knew what was going on. I was very open about what I was going through so I expected to be looked at. Strangers didn't have a clue that I had be a large C/D cup.
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