BREAST IMPLANT SIZING 101
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When I had the tissue expanders placed they put the IV in my foot.
April 13th is my exchange..thanks whippetmom for your input!0 -
Green: I do not have a clue about the tampon issue. I was 15 years post-menopausal when I was diagnosed. If you had a bilateral SNB, as marial stated, have them use the foot. I also had my IV in the foot for my BMX...
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GreenMonkey - I only had one node removed. My BS told me I didn't need to worry about blood draws, blood pressure cuffs, etc. on that arm. However, I usually mention it if it's something like an IV or if a blood pressure cuff will be on for more than one reading. Looks like you had a total of three nodes so it seems pretty safe to opt for the arm on the side that only had one node removed if you're having blood drawn. When in doubt, check with your BS. I would certainly check with my BS before directing people to poke needles in places other than my arms
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GreenMonkey - I've never heard that about tampons during surgery ... but you need to follow your PS's instructions.
I had sentinel nodes taken on both sides for my BMX and I've developed LE on both sides ... it is worse on my left (cancer) side but no one is going to protect you from LE but you. I've been amazed/apalled/frustrated at all of my doctors' ignorance and denial of LE. I've had nurses walk out of the room and slam the door when I tell them they can't take BP on either arm. They can take it from the foot/ankle ... but you'd think asking them to do that I've asked them for a million dollars.
Regarding LE ... YOU are the only one that is going to protect you. While many who 'only' get sentinel nodes taken out don't have a problem .... I've met several ladies on the LE threads who only had one node taken out and got it. You don't want it if you can prevent it. Here are some links on lymphedema that may answer some of your questions.
http://www.stepup-speakout.org/riskreduction_for_lymphedema.htm
http://www.stepup-speakout.org/what_we_need_healthcare_providers_to_know_about_lymphedema.htm
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TinaT - I hope you didn't delete your post because of me. We posted at the same time. I hadn't read your post when I wrote mine. I was in no way responding to you ... just telling my story. xo
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Actually, I did
delete it because of you. I then signed off, but decided to come back and write another comment and saw yours above. I originally wrote that I had one sentinel node removed and my BS has told me that it's OK to have blood drawn and blood pressures taken on that arm. I do mention the lymph node if a blood pressure cuff has to be on for more than one reading or if I need an IV. I came back to the thread because I wanted to thank you for enlightening me. I honestly didn't realize that LE could develop with one missing node. But....now I do! 0 -
TinaT - I saw your post and read it after I wrote mine and then I thought, "Uh-oh, it sounds like I'm coming down hard on you." And in absolutely NO WAY did I mean that ... again ... I wrote what I wrote before reading your post. I came back a few minutes later and saw you had deleted your post and my heart sank. I'm pretty passionate about LE because I so thought I couldn't get it. Not everyone will ... but some of us do even with 'only' sentinel nodes removed and some even get it with a simple MX with no node removal. At my LE therapist's office ... she showed me a map of our lymph system .... our breats themselves are full of lymph nodes. You get one breast taken out .... that is a disruption to lymph flow .... you take out two breasts .... you've essentially take out a major interstate of lymph flow.
There is so much IGNORANCE of so many doctors regarding LE. I had a great BS a great PS ... my BS assured me that with only a sentinel node I would not be at risk for LE. I specifically asked if I was at risk because I wanted my life back after BC ... weightlifting ... all of it ... and she said, 'no problem.' My PS said with reconstruction it would take me longer to get everything back but eventually it would be 'no problem.' Well ... LE has been a HUGE problem. They were great docs but completely ignorant of all things LE. I've had some massive rants on the "GRRRRR I hate LE thread" in the LE forum.
It's a problem that is hugely ignored, IMO, because they [the docs] don't want to be responsible for the after-effects. One of the best ways I've heard secondary LE described is, "The Dirty Little Secret of BC." No one wants to talk about it.
Bless you, TinaT! You're a gem on here and in no way did I want to offend you.
Just want you all to know that we have to stand up for ourselves. LE is hugely ignored, undertreated and a misunderstood side effect of BC surgery and radiation.
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GreenMonkey I always have IV taken in my foot as well as BP on my ankle. Many times I have to fight for the foot IV. Most of the time it's because the tech wants to do what's easiest for them. I had 10 nodes one side and 4 SNB on the other. I have LE on the 10 node side and I fear the 4 node side is at risk (gets heavy feeling at times).
Don't let them talk you into doing it in your hand/arm. They can very easily do it in your foot. I even get my CT scans dye in my foot (although must fight for it every time). The last 2 times I threatened to walk out of my CT scan… in that case they agreed. The last time it ended up the tech didn't have the experience doing it my foot. He had to get another tech to do it.
I will admit my onc insisted they do BP on my arm during chemo (because the nurses could never get a good reading). I always insisted they use the manual BP though because it doesn't compress as much. Once I say my LE MD did it on my ankle and got an accurate reading I made everyone else do it there.
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Good Morning..i have a question for you smart ladies and Deborah- I am scheduled for a BMX in april..another friend is scheduled for one in May. Her PS is giving her permanent inflatable implants..i.e. sort of like TE, but they stay in and you don't have the exchange surgery. has anyone ever heard of these? pro-con? my PS never mentioned and i am curious. tx!
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Yes I have. They are saline. I know for some of us smaller gals saline aren't a good option because they tend to ripple more. There are other pros and cons of saline vs silicone. Will your final implants be saline or silicone?
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Hi longislandmom! I saw the permanent inflatable implant yesterday and I can see how it wouldn't be good for anyone who smaller.
Thanks everyone for giving me the courage to insist on having them not use my arms/hand for blood or iv. why take the risk.
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I have a BMX scheduled for april 23 and haven't really talked about the kind of implants yet..i didn't realize the permanent inflatables were even an option until this week. are there any downsides to them? i had been focused on saline or silicone w/ exhange. .i am currently very large breasted..i.e. 34DDD! but relatively slender..so DIEP is not an option for me (enough belly for one nice boob-- not two, according to PS). the permanent implants are interesting to me because it would avoid the exchange surgery, right?
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Yes but exchange surgery isn't a big deal really. Nothing like the BMX.
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Namaste!
TAMPONS: I am a Pre op and Recovery RN. Leaving a tampon in during a short procedure will not cause toxic shock syndrome. Leaving a tampon in during a short procedure AND then forgeting that it is in there because you are drugged, foggy, thinking about other things CAN lead to a serious infection and health issue. Sooooooooooo, at our facility and in our region for health care in order to protect the patient from a devastating potential complication it is the Standard of Care to require that tampons be removed prior to any anesthetic regardless of what the procedure is. We provide the woman/girl with disposable mesh panties and a pad. After recovery when the amnesic qualities wear off and the woman can replace the tampon herself she is allowed to use them IF there is no catheter and IF the surgical area is distant from the pelvic region.
Hope this helps everyone to understand that leaving in a tampon can potentially cause a devasting complication. Yes, it is only potential, but hey, why take the chance of dying from a left in tampon, when it is so easy to remove the risk by just taking out the tampon and using a pad. Its not like you are having to wear a pad in your prom or wedding dress.
Karla
Karla
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Bless both of you- Tina and Dawne-Hope! You are both gems!
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Karla: Thank you for clarifying that issue for us!
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oh... I apologize is this is off topic but...
I just got a call from the psychiatrists office at Sloan Kettering. My PS asked that they give me a call. He told them I was, "having difficulty dealing with my cancer."
First, I informed them that I am cancer free. Apparently the great Dr. forgot about that.
I then expressed my disappointment in having to have another surgery to have my TE repositioned because my all of a sudden, concerned, PS did such a terrible job.
Unbelievable!!!
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I decided my post was too off topic ...
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longislandmom, I have 1 silicone implant & 1 adjustable saline implant. Due to skin integrity issues, I lost the 2nd silicone implant & had it replaced with the adjustable saline. It is currently a little more than half filled.
Avoiding exchange surgery was the reason my PS wanted to use the adjustable saline; there's a fill port that needs to be removed at the end of the process, but that can be done in the office.
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Dawne-Hope - I wasn't offended in the least. I posted with information that I thought to be true because of my experience and what I've been told. I'm a year out from BMX and haven't had any arm or swelling problems whatsoever so LE hasn't been an issue for me. I removed my post because, after reading yours, I realized I could be passing along misinformation and I don't want to do that. I am grateful for the enlightenment and even more grateful that I haven't had to deal with LE.0
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thanks for the information!
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Whippetmom -
Just wanted to thank you again for all your support and wealth of information!
Where would we be without your knowledge?
I saw my PS last Friday, and instead of my last fills, we had a consultation. He agreed that I was filled enough at 620ccs.
I whipped out my Allergan catalog, and asked him to tell me his plans. I'd marked off the size and dimensions of my TEs (INAMED/Natrelle133MV-16) (700ccs, 16 cm wide, 15 cm high, 6.6 cm projection).
I then asked which of the Allergan High Profile Smooth Saline implants he intended to use, and sure enough, he showed me the ones that whippetmom suggested:
1) Natrelle 68HP-750 (Fill capacity 750 - 800ccs) (Minimum volume: 14.6 cm diameter, 6.5 cm projection) (Maximum volume: 14.4 cm diameter, 7.2 cm projection)
OR
2) Natrelle 68HP-800 (Fill capacity 800-850ccs) (Minimum volume: 15.0 cm diameter, 6.7 cm projection) (Maximum volume: 14.7 cm diameter, 7.2 cm projection)
Where on earth would I be without this information? I feel like I am part of the decision-making process here.
The only problem is that as I lose weight, my TEs appear much bigger, and harder, if that's possible. Now I can't sleep on my sides any more, which I've been doing for months!
My exchange will be delayed until late Summer/early Fall, when I've reached my normal weight, and have returned to regular meals.
Thank you again, whippetmom!
(p.s. Will continue to post pics on the pic forum....just for comparison!!!
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Blessings: It sounds as though you are on the right track. Your PS is going to be doing some pocket work and it is likely that you will need the narrower implants, based on the weight you are going to be losing. Congratulations on your weight loss goals and kudos to you for showing your PS the numbers and nailing him down on sizing issues! 0
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Hi whippetmom
My name is Janet & am new to these boards, although i have been reading them for some time. I was diagnosed Dec 22 2011 and am undergoing surgery this coming Tues April 3 in Toronto. I was offered immediate reconstruction and am part of a study at Princess Margaret Hospital comparing the effectiveness of the 'gold standard' TE vs 1 Step reconstruction using Alloderm.
I am of small frame...5'2, 117 lb. After feeding 3 boys ( 9, 6 & 4) each for a year my A cups are more like A-!! At any rate...all that milk coursing through my ducts did little to stave off BC & here I am! I'm short waisted with 29-30 " rib circumference. Apparenly my PS uses Allergen tear drop implants & I was hoping that you could help me in my discussion with my nurse prior to Tues surgery some greater detail about which exact 1s would work for me! PS said he could only bring in about 3 sizes & would see which 1 works best. I feel out of control of this outcome & am hoping you can help me to get some control back?! I was hoping for a good B+. They've been Cs in the past...full of milk, so am hoping they, with the help of the Alloderm, can be close to that again.
I am a Registered Massage Therapist here in Canada for !8 yrs now, and entered the study in hopes of getting back to life quicker with the 1 Step Recon. 3 very busy boys also makes the TE route more difficult. So, I was guardedly optimistic that I pulled the 1 Step procedure, but am now worried of the loss of my 'wishes' for the outcome?!
I sooo look forward to your thoughts on my story and inquiries. I hope to talk to my nurse in these coming days...especially if you need more info on the Allergen makes/models?!! Please, if possible, your quick reply would be so appreciated! Everything...with resprct to the recon has seemed to happen so quickly. Especially since, I don"t have much direct contact with my PS, especially due to everyone's dissappearance over our March Break!! Thanks & I hope to talk to you soon!
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Janet: I am familiar with this one-step trial led by Dr. Toni Zhong. It seems that she is using the Allergan 410 - which has not been used [at least not anyone I have heard of yet] for the one-step here in the U.S. The Allergan 410 is still awaiting FDA approval and is only available to a select number of plastic surgeons here in the U.S. So taking that into consideration, there are really only a few options. Since you are short-waisted, petite and small-boned, implants with a low height moderate height would be selected. Implants with a width of around 11.5 cm to 12.5 cm. Something in the 210 gram to 280 gram range I imagine. It depends on the degree of skin flaps you have remaining after BMX - and with some maternal droop, you have some additional skin to fill up with Alloderm and implant. Here is the list of all of the Allergan implants.
http://www.justbreastimplants.com/breast_implants/allergan_specs.htm
The Allergan 410 styles and sizes are at the bottom of the list. You can scroll through the LM, LF, MF, MM styles and get some idea of what might be available. LX might work also, depending on the availability of skin for coverage. It will be trickier to get coverage with higher projection implants on a one step. Your PS will take saline "sizers" into the OR to try out different styles and volume implants to see which works best.
Deborah
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I exchange the TE for the implant last week. I ask for a size B and what I got is larger than my other breast which is a B+ or small C. It is also up pretty high and still has a boxy look. Does not look right. I feel as if it is too tight. It needs to drop. How long does it take to soften up and drop? I have a good plastic surgeon, who seems to do a good job on others. I am probably prematurely over reacting. My last appointment is Monday morning as I had the drain out today. After that I'm done. He won't do more unless I remove the other breast. After feeling the one I just got done, I' don't want to do it again. I hate the way the implant feels (heavy and hard). I'm considering getting it removed and going to someone who will do fat grafting and get my two breast to somewhat match. For now, I just need to heal.
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I exchange the TE for the implant last week. I ask for a size B and what I got is larger than my other breast which is a B+ or small C. It is also up pretty high and still has a boxy look. Does not look right. I feel as if it is too tight. It needs to drop. How long does it take to soften up and drop? I have a good plastic surgeon, who seems to do a good job on others. I am probably prematurely over reacting. My last appointment is Monday morning as I had the drain out today. After that I'm done. He won't do more unless I remove the other breast. After feeling the one I just got done, I' don't want to do it again. I hate the way the implant feels (heavy and hard). I'm considering getting it removed and going to someone who will do fat grafting and get my two breast to somewhat match. For now, I just need to heal.
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Eve: Do you want to send me a photo? PM me for my email address if so....
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Eve - Few of us were happy one week out.
It took mine six months to soften and drop a little.0 -
Whippetmom - Can you recommend implants for me? I had BMX on 8/31/11 with Mentor medium height contour profile TEs which have been filled to 520 cc. My implant date is set for 5/2/12 if my blood levels all return to normal. I'm 5'2-1/2", currently 155 lbs with a rib cage of 33". I don't know if it makes a difference or not but I've gained 25 lbs since I've been on the steroids (I've been off for four weeks since yesterday but have not yet lost any weight) and I had gained about 15-20 the year before that when my father and niece passed. I'm still hoping to lose all that weight and get back to normal. I've gone from a size 4 to a size 12 in less than two years but had been a size 4 for a very long time before all this happened. Before the weight gain, I was barely an A. After the first weight gain, I went to barely a B. I hope to be a full C if that doesn't look too large for me.
Also, one more question, I was very set on saline but since talking to my PS again and reading posts on BCO, I'm leaning more toward silicone. I am worried about the possible leaking of the silicone....what are your thoughts on that? (I'm sorry if you've already addressed this - I'm sure I missed it somewhere!!)
THANK YOU for your help!!!!
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