BREAST IMPLANT SIZING 101
Comments
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Eve,
I decided to do a BMX since I had cancer on one side and a "benign" area on the other side that I was just certain would change later. I was scared prior to surgery but was pleasantly surprised to find that it was not nearly as bad as I had imagined. I had 4 drains (2 each side) which were my biggest PIA and had TE's filled to 300cc during surgery so I was a small B immediately after. I wore baggy shirts and do not feel anyone had a clue. I had full range of motion immediately after surgery and did not need help getting up or down from chairs. I was up and down our stairs pretty regularly (to let our dogs in & out) with no issues. I stayed overnight one night at the hospital and only used pain meds at night for the first week once home.
I understand the angst in making the decision and recommend you go with your heart on this one. I always felt the BMX was right for me as I just know I would have done this again in 5-10 years if I had not done both. After surgery when I saw the onc for the first time, he agreed.
Hope this helps and may you find peace in whatever decision you decide is right for you. Hugs!!!
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I'm probably making too much of all this. It seems it might not be as painful as perceived. The idea of losing a breast or two is hard. I have a feeling I'll be doing the blmx as this new surgeon is so insistent I do it, but emotionally I'm not sure I'm ready to lose both. But, seems from what you shared the recovery might not be as bad as I imagined.
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Eve - ask ALL of your doctors what they think you should do (re: one vs two). My oncologist, my BS and my PS all told me not to remove them both... said there was no reason to do so based on my specific situation. So I did not.
Being a uni means you still have feeling on one side. But being a uni means it's more difficult to match with the reconstruction (to achieve symmetry) -- due to the difficulty of matching natural breast tissue to artificial implants. But, with that said, you should know there CAN be symmetry issues with a BMX, too.
These are considerations if it is PURELY a cosmetic decision. If it is something more -- something to do with your pathology -- then of course the decision is about THAT.
Losing one was VERY difficult for me to face/deal with but I have to say once it was done it was not the horror I expected. I actually felt giddy afterward because I had a bit of a bump (the partially inflated TE) and because it was not hideous.
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Eve I had a bmx even though my cancer was only in one breast. Honestly i think a big part of my thinking was that i would have better symmetry this way, and the other part was the idea of ever going through this again. My mom had two separate cancers one in each breast 30 years apart. I was terrified to go into the surgery. I was afraid of what pain I would feel and how i would look. I was up and out of bed the next day after the surgery. I was very sore but nothing to terrible. I was able to walk around, go up stairs, and sleep in my own bed. I could not raise my arms right away it took me about 6 weeks to get my full range of motion back. When I woke up after the surgery I was almost catatonic with fear. I was afraid to move and even more afraid to look at what was done. Once I got out of the bed and saw i could move around ok i felt much better. I almost did not let them change the bandage in the hospital because i did not want to look. When they finally did it they said you don't have to look, but i did, and i thought . . . not so bad. I just looked deflated, nothing gory like i imagined. I was a 36DD. When i got home and looked in the mirror i could not believe how thin i looked. I tried to embrace the smaller me but i did miss my feminine curves. 2 months later i had chemo 6 months after that i had expanders placed, 7 months later i had implants exchanged, which was 3 weeks ago. I can;t say it looks great yet i still have a way to go, but it's better than it was.0
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Eve my BS initially did not recommend the BMX. He doesn't believe in removing healthy tissue but would support what ever I wanted to do. I was seriously considering since it took them so long to find this first tumor (long story). Anyway he said wait till we do an MRI. There were 4 spots but one in particular that he said I would need biopies every year so he recommended removing it. He was right. It was a small amount of LCIS. I would have had biopsies every year.
I have no regrets.
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In Eve's case, she has already had cancer in both breasts - and had lumpectomies. Cancer has returned in one breast. Am I correct in this Eve? So THIS is why the doctor is urging her to have a BMX...because of her history and proclivity for recurrence.
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Again thanks...my husband and I have been weighing out the pro's and con's. After he looked at the pro's and con's he feels a uni would be right for me. He will of course support what ever I decide.
Pro's for a blmx
1. Get breast cancer behind me once and for all. Done.
2. Semitry
3. I have December to recover...two weeks out for school.
4. No more mammograms
5. Don't have to wear a bra unless I want to.
Pro's for Uni
1. Seems like less recovery time and easier adjustment after surgery.
2. One breast has sensation, feeling.
3. Less pain.
4. I would feel half normal
Con's for blmx
1. No feeling.
2. May have problems with implants
3. Possible frozen sholders (I've had several in the past, tendancy toward frozen shoulders) hard to exercise.
4. blmx more likely to be dependent on others (my husband feels this will be difficult for me)
5. Fear of regretting losing a possible good breast (although it too was once dx with stage 1, but only grade 1 cancer).
con's for uni mastectomy
1. lack of semetry (fear that the breast will sit differently...especially before implants).
2. Two surgeries if I decide to do the other one in a year.
3. Continue annual mammograms
The b.c. surgeon doesn't know I'm wrestling with this. She feels that a blmx is the only way to go because I have had cancer in both breast. I am afraid to call her and tell her that I'm not sure.
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Eve -- for what its worth (and I did not know you had had cancer in both breasts... sorry I guess I missed that among the posts) -- I would do the BMX if it were me and I had had cancer in both breasts. The only reason I did not is because all tests (Pet Scan, MRI, Mammograms, and Sonograms) showed NO areas of anything (not even suspicion) in the one breast that remains. Have you asked your oncologist's opinion? Maybe a second doctor's opinion would be best, since your surgeon (don't you have two -- a breast surgeon and a plastic surgeon?) advocates the BMX.
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Eve I think you are missing a few more pros… not that I'm convincing you to removed both. Another gal I went through chemo with on these boards was dealing with her 3nd breast cancer but decided on lumpectomy for the 2nd time. She's a year out from surgery and still doing fine but she wasn't HER2+ and I believe a lower grade. I would talk to a few more BS and Oncs and see what they say. The pain is not something you should consider because it goes away. Also you will not be that depended on anyone, you just can't push as hard or reach high or push a vacuum for a few weeks. I think that issue is more to do with lymph node removal than breast removal.
And don't assume you will have issue with implants. Mine are doing great. I have read about problems but not from people here, yet. If you have frozen shoulder issues be sure to get PT from the start and you will be fine even if you do the uni.
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Whippetmom,
I sent you a PM about my sizing question. You are so helpful and I truly appreciate this board.
Thank you,
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Susan: I responded!
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Weird - has anyone had problems with any threads being dropped from their "Favorite Topics"? I thought it odd that a few of my very active threads were suddenly quiet, only to discover that they have been unchecked and simply aren't popping up on my list any more!
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Whippetmom,
I am new but I've been reading this thread to gain info about the reconstruction part of things. It sounds shallow to worry about which plastic surg. to choose but I worry about ALL parts of this. Bilateral mast. without chemo or rads will be in my future.
I thought I'd just come straight out and ask, do you know of a good plastic surgeon in Minnesota? I'm in the Twin Cities. I need advice. Actually if ANY of you are from Minnesota feel free to send me your thoughts about surgeons.
You could send me a message or answer here, thank you for this. It certainly seems overwhelming!
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Tina -- this site can be buggy. I am STILL not getting any notification when someone PMs me (even though I have the box marked for that) and the moderators can only tell me "it will fix itself eventually" ::shrug::
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Minniemom: I have sent you a private message with some information.
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whippetmom, Lilah & MBJ: You ladies helped me out a lot Aug 30 - Sep 1 (pages 132-134). Many thanks for that. I just want to post a follow-up, particularly if there are other Australian patients reading my earlier posts.
After numerous consults, we've gone with the 3rd PS (the one who was most positive on Alloderm). He has been fantastic. He actually listens. I put it to him that LD flaps were the procedure of choice here more because of economics not outcomes. He didn't agree, but he did concede that Alloderm would be more widely used if it had TGA approval and insurance coverage.
Quite incredibly, he went away and researched Alloderm recons for a few weeks. He got back to us with the opinion that Alloderm was a good option for thin patients because the LD flaps would be very thin anyway. He believes that, in thin patients, Alloderm will produce cosmetic results very close, and perhaps equivalent, to LD flaps. He also says that my wife can always do LD flaps in future if she's unhappy with the results.
So anyway, we applied for Alloderm under the TGA special access scheme, and it's been approved. We have to pay for it ourselves (around $AUD7k), but that's fine. Surgery is Dec 9. My wife will be only the second Alloderm breast reconstruction in the state. The PS has spoken with the PS who did the first.
Personally, I am much more comfortable with this plan. My worst fear with the LD flaps was that the BMX pathology would find something amiss, and that my wife would then need rads. Thereby frying the LD flap.
The PS has gone for a Mentor 6200 TE (350cc, 11.7cm base width). He picked that because he was very precise about the base width - he wanted something in between the 11 and 12cm of the two Allergan models. He also ordered an equivalent 6300 (same, but tall height instead of medium), and will decide during surgery. But probably the 6200. Final implant to be decided later, but it will be anatomical, around 300grams.
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Merovingian - thanks for the update and wahoo on the plan! I hope your wife comes through the surgery easily and that recovery is swift. Please keep us posted.
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Well, I had my exchange yesterday! However, my PS gave me more than I wanted. In our consultation the day before surgery, I told him I wanted cleavage, and for my boobs to not be in my armpits. He proceeded to lift them up where the 'should' have been and told me, "this is where I put them!". In no way could this be true! I've got the photos to show it!
I ended up with 500 cc Mentor cohesive gel. I have the card somewhere and don't feel like getting up to get it:). High profile, too. He warned me that he would have to do "significant" pocket work, and I'm feeling it today.
Here's a question-- I have what looks like a large light red welt across my breasts. Is this normal bruising from the skin being stretched, or should I call the PS? I hate feeling like a PITA.0 -
Merovingian: I am very happy for you and your wife - that you found someone willing to do the research and willing to use a product which has improved the quality and integrity of so many breast reconstruction procedures here in the U.S. It is a blessing that you are financially able to pay for this - just wish it could be made more affordable. Keep us posted on how she is doing. I prefer the moderate height TE...the full height expands the pectorals too much.
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Eema: If the red welt appearance is on both breasts, it likely is not something to worry about. But if you run a fever or if the red welting worsens or feels warm to the touch, then you need to see your PS.
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They do feel warmer than the old ones, but that is because they are silicone, I thought. It is on both breasts. I'm a worrier, so...
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Eema -- take a deep breath and try not to examine everything too closely right now (looks-wise)... there will be changes and healing. You are swollen from the recent surgery, for one thing, and it sounds like the welts (since they are on both sides) are from the surgery. Though, with that said, if you develop a temperature or if you notice they are warm (or a rash) or have any doubt at all -- DO call your PS.
How they look now is not how they will stay. While it's possible you will want a revision down the line (since it sounds like you're saying you're not happy with the size and position), it is also entirely possible that as they heal over the next weeks and months they WILL look much different (the "drop and fluff" can change how they sit and how they appear). Time will tell.
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Thanks Lilah!
I keep hearing about this "drop and fluff". What exactly does this entail? Will the ripples go away? This was the revision, so I'm unsure...0 -
Eema - When I read your post (that your PS gave you more than you asked for) I can't tell if you're happy or unhappy about what he did - you sound unhappy
. If you tend to be a worrier and you or someone else takes good photos, it might be worthwhile to find out if your PS and his/her PA are agreeable to "looking" at things via email. My surgeries were done 125 miles away and both my BS and PS were happy to communicate that way and were very responsive. They did comment that I took great closeup/macro photos so that helped them a lot.If not for this situation, it might be something to consider in the future if you have more questions. Quicker than a visit for all involved and better than you worrying about something not worth worry!
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Good Morning Ladies!
Well 24 hours ago I was flat out on the OR table getting my TEs placed.
I'm so happy! My original BMX was Sept 9th, 2010. So here I am 14 months later taking on this new journey.
14 months may seem like a long time for many but I have to say that during that time I really got to know that my breasts were just a part of me, and not who I was. I loved them and they did right by my kids, but in the end not having them did not change who I was. I really appreciate myself more and my body image is so much healthier. I didn't wear a prosthesis at all and when the TE on my right side failed and I ended up as flat as a teenaged boy, I actually felt better than when I was uneven (lost implant on left side to infection Oct 2010 ).
I'm now on the journey to getting fills and eventually my implants.(Whippetmom I had Mentor 350-1480s placed and looking to fill to 550ccs). I'm also looking to be a local advocate for breast reconstruction patients. I've given my doctor's MOA the go ahead to give out my name and number. Kinda like being a "doula" for us reconstruction gals.
I hope that everyone gets to feel the way I feel today, joyful.
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Pit Pat - I also had my TE surgery yesterday afternoon! I am 2 1/2 months post BMX . My PS filled the TE's with 100 cc so it is nice to have a bit of a chest again!
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Eema -- oh I didn't realize this was your revision. How long ago was this most recent surgery? And, assuming it was done to address ripples, what was changed/done differently this time?
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PitPat: I absolutely love your attitude and your outlook on life! Thank you for posting this and updating us on your reconstruction journey! I know you are going to be a great encouragement and support to other women going through breast reconstruction. You are an
.....Deborah
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Whippetmom,
When I last asked your advice, I had 360ccs and 370ccs in my TEs and I was wondering how much I needed to be expanded. My old bras were fitting me at the time. This was about a month ago and I think I thought at the time I was getting pretty large. Anyway, I am now expanded to 600ccs and 610ccs. I had a fill 4 days ago and am still in a lot of pain from the expansion. I was scheduled to work the last two days and have not been able to do so. I'm not on the schedule again until Thanksgiving day so hopefully should be okay by then.
Just to remind you, I have Mentor Style 7200 (550 cc, 13.5x11.7x7.4cm) TEs. I am 5'2", weigh 135 and my ribcage circumference is 34. You suggested that I get high profile implants at 600cc or maybe 650ccs and said I should continue with expansions.
This is my question...Do you think I am expanded enough now? I am scheduled for exchange on December 23 and I have one more appointment before then for another expansion. My last two have been very painful to the point that I have stayed in bed, for the most part, for 4 days and have had to take pain medication. My PS said I didn't have to do the next fill, but that he would take as much skin as I could give him. I don't want to have come all this way and not have a good result, but the thought of another expansion really is not appealing to me! But I will do it if that is what is best.
I know I won't be as large with the implants as I am now, but my clothes are not fitting well. I told my PS I didn't want to look like a stripper. He laughed and said I wouldn't have to work as hard if I was. At least he has a sense of humor!
Thanks, Whippetmom, for your help. You are truly amazing to spend your time helping all of us.
Janice
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Does eveyrbody have a TE? My surgeon left a lot of skin, and said "the plastic surgeons just love me" I am glad now, that I did not have reconstruction at the time of the mx. I suppose if I was a lot younger than 50, it would have been a big deal. But now, I dont think I will have reconstruction. Its hard to know what to do.
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