BREAST IMPLANT SIZING 101
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Yes, I have "extemely dense" breast tissue and my first cancer was never seen on mammogram. It was found with an MRI but not ultrasound. Now I have a "probably benign" finding on ultra sound in my "good" breast. The problem is that I can't get an MRI with a tissue expander in my other breast. I am supposed to have a reduction and lift on my good breast in June, but I feel I need the MRI first. So, I'm wondering if I need to separate my exchange and lift/reduction into two different surgeries so I can get the MRI before the lift/reduction. My breast surgeon said that she thought it would be ok to use a mammogram to detect surgical changes, then do an MRI 2-3 months after lift/reduction. Sometimes it seems like docs don't take these dense breasts seriously enough.
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Mammalou- go for the MRI, it's the one way to spot something obscured by dense breast tissue. I had extremely dense breast tissue and it was only by luck and a persistant radiologist doc who found my extremely extensive lobular carcinoma. Never showed up on the mamo and over half of my breast was either LCIS or ILC, which was determined when I had the mast. Good luck to you.
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People -- if you are looking for information about the Picture Forum, please send a PM to me, MBJ, Estepp or Nowheregirl. But before you write please know the following: the Picture Forum has nothing to do with BCO (except that a lot of us here are members there) and it is a privilege (not a right) to be invited there. If you are a lurker here on BCO, start posting and sharing of yourself; if you already have been a member here on BCO for awhile and HAVE been sharing of yourself, then by all means send one of us a PM. But please know that it is a site that is ONLY for those who are willing to share. Thanks.
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Thank you Lilah!
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I know I need an MRI, but I can't have one with a tissue expander because of the magnet in the port. I am wondering if it is ok to just have it after the lift/reduction?
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mammalou: How about an ultrasound on the native breast? I think they are going to require some diagnostic before the lift/reduction.
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Ok. Thank you. They are definitely going to require something because I just had a birads 3 ultrasound finding. I guess I will need to discuss this further with my BS. It makes me wonder if I should be mucking with the native breast surgically, BUT I can't live with lopsided breasts forever!
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You ladies inspired me to do some digging today!
I went into the deep dark basement (ok, not dark) of my hospital and sifted through my records until I found the OR report. My PS left and took my info with him so I was clueless...
I had a uni-skin sparing MX with TE placement and left side augmentation. (Later had RADS) (Is it weird he did that augmentation then and didn't wait for the exchange? Not that I haven't loved my uni-boob...)
Whip-any feedback you can give me will be great!
5'3" 115 pounds 30 ish rib cage.
My left side was augmented with: 375 cc Mentor MemoryGel, high profile, round smooth (This makes me a D cup)
My Rads right side TE is a 450cc tissue expander expanded in placement to 250 cc (no specifics tho).
Ok, over the last year I've had fills and empties and by two differenet PS, I know for sure it is filled to at least 400cc, but I'm thinking it probably closer to 450.
I know my PS said the implant can be bigger than the TE becaue he can make the pocket bigger. I don't want to be smaller. And when I wear a push up bra now (one that pushes that fluffed out auggy up higher, the two sides match and fill out the cups equally...though the TE is wider.
My question is, what are the sizes in high profile rounds starting at 450?
Any help/suggestions is much appreciated!
Tonya
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Tonya the sizes and CCs are different depending on the style and the manufacturer. You can find specs here: http://www.justbreastimplants.com/breast_implants/implant_specs.htm0
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Thanks Lago!
When I looked at the site it reminded me of him saying something about 500 cc in the right side. So I think it'll probably work.
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Tonya: Somewhere on that op report there should be a recording of the mfr, style and volume of the TE used. This must, by law, be documented in your chart, since it is a registered, implantable device. It could be a myriad of styles with various dimensions - width and projection. The implant needs to match the width of the TE - but we do not know what that is. If you have some ptosis or a little droop on the native side, your PS will need to match that ptosis in some way and this generally is done by overfilling the TE and then using a bit smaller implant - but one with the same width as the TE.
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bump for lstreett
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Thanks Whip.
I checked the entire report and all my medical records, there is nothing about the TE. Either he took it with him, or they just didn't document it. I never received a card or anything with it ....
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TonLee I would contact him. I never got a card either but I'm sure it's in my chart. I would demand my card if I were you since he is no longer treating you. Your medical records are your property not his.
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Thanks for the reminder. I got the cards at the first hospital after my BMX. Although I 'd had a fair amount of painkillers, I remember the nurse stressing that I should keep the cards and be able to refer to them down the road, if needed. The PS told me he was putting in Mentor Medium Plus 600 cc in my TE exchange operation last week but the surgery was at a different hospital and I didn't recieve the cards. I'll follow up and make sure that I have them with my other records.
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whippetmom: What do you think about choosing a size for TE and implants when one is in the process of loosing a significant amoung of weight? If I loose all the weight I am planning to loose, I do not want to end with huge implants.
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mkw1 - Good question. Your native breast structure will dictate, for the most part, the width of the TEs and future implants. There also is the consideration of the size of your breasts currently, and if you are large breasted, you would want somewhat of a "reduction" - at least an excision of more of the skin flaps which you would need if you remain on the heavier side, but will not need if you lose the weight you intend to lose. I would definitely go over your plans with your PS and ask him what he would recommend. My personal recommendation is that you do go smaller, because it is ever so much easier to exchange out for larger implants at some point, if need be, than it is to try to reduce the pockets and exchange for smaller implants. Also, having smaller implants just might be added incentive for you to continue losing weight...right? If you want to PM me and go over your current vital statistics, including ribcage circumference, and then let me know how much weight you anticipate losing, we can come up with a good range for you to discuss with your PS.
Deborah
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Tonya: Let's take a hypothetical, since we are left in the dark about your TE: If you were starting from the get-go, with your vital stats and ribcage, I would probably recommend implants with a volume of anywhere from 475 ccs to 550 ccs. If your TE is indeed a 450 cc TE, it is a Mentor TE, it could be either 14.0 cm wide, 12.7 cm or 12.3 cm in width. Let's hope it is 12.7 or 12.3. If so, you are in the right ballpark for a 500 cc/550 cc implant. If you have a 14.0 cm TE, your future implant would need to either be a 600 cc HP or around 500 ccs in a moderate plus profile implant. In any event, your PS is going to use an implant which will enable him to obtain symmetry with the augmented native breast. So these are approximates - based on the information we have on hand.
Deborah
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Thank you Whip. I appreciate it sooo much
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Thank you for your quick reply, whippetmom.
I will pm you my measurements and weight later. I am thinking that I want to be a full "C", whatever size of implant will accomplish that. That way, if I loose the weight, I would still look proportionate, and as you suggested, that will be a motivator for me to loose the weight.
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Hi Whippetmon, I am having BMX on March 1 and have appt. with BS Feb 16 for pre-opt and to answer any questions I might have. I am now a 38 D or DD depending on bra style. I would love to be a C cup size. I am 5'6" tall and weigh 150 pounds. I am 33 1/2 inches around my chest under my bra. I understand you are the go-to girl for advice on implants and I would really appreciate any help you can give me. Thanks so much. You are a great source.
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chawkins:
Just want to clarify: You are seeing your BS - the breast surgeon? It would be your PS with whom you would discuss sizing issues. When do you see your PS?
I think that if your PS could use a tissue expander with a width of 14.0 to 14.5 centimeters, this should get you where you need to be, which would be around 650 ccs - 700 ccs high profile, smooth, round silicone implants. Some possibilities would be the Allergan 133 MX 600 cc tissue expander or the Mentor moderate height TE - 14.5 cm in width. Another implant style which would be nice for you would be the moderate plus profile - and I would recommend around 575 ccs in Style 15 - Allergan - or Mentor - approximately 550 ccs.
Please discuss whether the skin envelope will be reduced, because you likely have quite a bit of skin with your described breast size and possible droop. Explain that you do not want a lot of ptosis - or droop - with your reconstruction results. This is an issue you could discuss with your BS - since she would participate in this aspect during breast dissection.
Back to TE width....essentially, the width of TEs your PS ultimately uses will depend upon your ribcage characteristics and the width of your native breasts, and so this is just an approximate which I recommend based on the vital stats and ribcage circumference. You might require a width of 15.0 cm, and if so, we can go over implant sizing when the TE style/volume is determined. This should give you some idea where you could go with sizing - and it gives you some fodder to discuss with your PS.
Let me know how I can help further!
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Thank you so much. I have copied your recommendations and will take them to my surgeon. You are right.......my appt. is with the plastic surgeon. Will let you know what he recommends. Thanks again.0
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I just wrote a new topic on constipation. Puns allowed sheila
http://community.breastcancer.org/forum/6/topic/781867?page=1#post_2830873
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Can anyone here tell me if they had the nips done at the same time as the exchange? I am told that I have to wait one year after my exchange because I had radiation.
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B123 I had to wait 3 months and I didn't have radiation. I don't know if 1 year is a long time but since your skin is compromised by rads I would think the longer you wait the better the results in terms of them surviving especially if you had your skin stretched. That's a lot of stress on your skin in one year.0
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Sheila: You are going to be a busy bee on THAT thread! I went to take a peek and I think this will be a great help for many women! AWESOME! 0
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B123: Nearly all of us waited until at least three months after the exchange for nips. I waited six months. I would not advise doing it at the same time as the exchange unless there is a deductible issue and/or some other reason for absolutely needing to get it done at the time of the exchange.
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mkw1 -
I am 5'5", 185 pounds. My chest measurement is 39". Prior to my BMX, I was a 38DDD. I told my PS that I wanted to be smaller!!!! He said that he would go no smaller than the equivalent of a C cup, as it would look strange on my frame.
My TEs are currently filled to 400 ccs. For many women, this is the max amount, but since the TE capacity is 700 ccs, that's where we're headed. I look at myself with 400 ccs and I seem really flat compared to others with the same amount, and it all has to do with what size TEs you have. The saline just goes where it wants to go.
But the other reason I seem flatter is that I have a bigger, er, gut. Having abdominal fat kind of hides any projection that TEs, and eventually implants, will have.
I asked my PS what would happen if I got the implants we discussed, and then lost weight, and he said "They'll look much bigger."
Well, bigger is NOT what I want, so I've made the decision to join an 82 week medical weight manangement program now, so that at the time of exchange I will hopefully be down to my normal (?) weight. I have a good 40 - 50 pounds to lose. The first 16 weeks are meal replacements with nutritional shakes, soups, and protein bars. Your medications are carefully monitored, there are weekly lab tests, and weekly appointments with the physician.
I think this will give me the best outcome, and the best situation for my PS to decide what is the right implant for me. (After I discuss it with whippetmom first!
) It will also help when he decides to lipo or remove excess armpit/side fat for a good cosmetic appearance.I've always failed at diets in the past, but now I just think of this weight loss as part of my breast cancer treatment. For the next year, I will be working on my body....physically, mentally, emotionally....and losing the weight will be almost like a "food detox" program for me. When the meal-replacement phase of the program is over, I will be starting my new anti-cancer eating plan.
Best of luck to you in your weight loss efforts!!!!
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http://community.breastcancer.org/forum/6/topic/781867?page=1#post_2830873
new thread on constipation, puns welcome sheila
tested works. sheila
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