BREAST IMPLANT SIZING 101
Comments
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Kate33: I have those linebacker arm "pooches" between the expander and my underarm, too! My PS says that maybe he will have to lipo and it won't look like that when I am finished. I had an additional non cancerous lump removed there besides my two lymph nodes and it was incredibly sore and extra poofy for weeks but as long as it's gone after exchange, that is all I can ask.
Rebecca: I am so sorry--You have been in my thoughts for days and I just want to wish you a speedy recovery!
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whippetmom- Thanks for the reassurance. I don't know why I am stressing so much about this!
MJB- The thing that worried me is when I asked my PS about it and she had this puzzled look like she didn't know what I was talking about! I have read, though, that those pooches can go away on their own. Part of it may be that I can't really put my arms straight down because my TE's are practically in my arm pits. I'm just wondering if having lipo there is covered by insurance?
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I have fatty bits under my arms also ever since my TE's were placed. One side seems worse than the other,but i wasn't sure if it just FEELS worse cus its alot more numb than the other side,and therefore just SEEMS bigger.it feels quite soft and spongey.
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I am new to this. I just had my 2nd fill on friday and in great pain and my PS suggested that he was not going to do another fill because my skin was getting too thin.He suggested to move forward with the implants in 2 wks. Is he rushing?
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Mimi: Absolutely he is rushing! Pain is subjective but TEs are uncomfortable and painful for nearly all of us. But you need to let me know a bit more to see how much further you can go. You surely need to wait two weeks for another fill. For most of us, the fills progressively get more bearable...
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Mimi...It might well be that you need to stop the fills, but wait at least 4 weeks to exchange. Longer is better.
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First of all thanks a lot for replying so soon!
I fear he is rushing as well, I am not sure how much fluid he put every time but I think is way more than 50 cc (he uses a full syringe every time and it looks like a 200 cc syringe).
I just wanted to make sure i understood well your request (quote below)
"But you need to let me know a bit more to e how much further you can go. "
Do you mean if I can bear any more pain like this?
If that is what you meant, the answer is no, I can barely sleep and move now!
For me the pain from the last fill is stronger than the first time and it feels like burning and like is going to explode anytime...
should I just go for the implants in two weeks and (hopefully) put an end of the pain or should I wait for my skin to strech more?
I will ask the PS how much fluid he already put in my TE and let you know, so you can tell me if is abnormal or if is ok...
Thanks
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I know, and i feel like i should wait ...but the PS keep insisting that i should not wait because the scar tissue from the MS would harden and lose elasticity. Is it plausible? Should i get a second opinion?
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Mimi...I Am on my way home and I will respond when I can get to the computer...
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Mimi: You can have some saline extracted from your TEs which might give you some relief. I have never heard of someone rushing to the exchange so that the scars would not harden and lose elasticity...
The standard period of abeyance between MX/TE insertion and exchange is two to three months.
When WAS your MX? What style/volume of TEs do you have? What is your height, weight ribcage circumference - measuring around under the TEs? Were you small-breasted prior to MX? Just wondering what degree of skin flaps your PS had to work with. Trying to figure out why you are having such a tough time of it after two fills. I mean, this can occur - but there must be some underlying reasons for this.
Deborah
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I had MX on march 18th .I am about 5'3, 105lbs,ribcage about 28 1/2 ,breast size btwn B and small C. Not sure about the style/volume of TE's but i know they are bigger than my original breast.
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Hi whippetmom. I have been cruising these forums since my diagnosis last october, but it's only now that I need to decide what type of implants to go with (scheduled for my exchange in July) that I find myself freaking out enough to need to post. Vanity, huh! I hate the look of my 400cc allergan TE's (filled to 660cc)-MUCH too much top boob, but my ps thinks I will be unhappy with the 410's -thinks the bottoms won't be full enough for me. I was a small-med C and requested a full C. I'm 5'6, 130 lbs. with a long torso. I'm considering having some fluid removed from my TE's because I'm afraid I'm going to have playboy boobs! It's very hard to find reconstruction photos on the web. I keep seeing references to a picture forum in these posts but I can't find one anywhere. Where would I look for it? Can anyone who has gotten the 410's tell me if they feel like a real boob? Will they take the shape of your bra, or hold their shape no matter what you put them in? Thank you all for being so open - reading posts from all of you going through the same things as me has really helped me to get through a tough 6 months.
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Lee - Do not worry about having "playboy boobs". It "takes a lot to make a little" when it comes to breast reconstruction. You probably need high profile implants with around 550 ccs. You will have to read through this 101 thread to see all of the discussions re: 410s. The pockets need to be created for the 410s and with your PS' comments, it does not sound like he is creating pockets for the 410s. You will be happy with standard silicone rounds. What is your ribcage circumference?0
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I am so happy I found this forum!! In a nutshell, I has TE and implants mid 2009, after only 3 months my radiated side got hard and small. I am doing TE again on that side, this time he expanded me 120cc more than the 1st time. Plus, the TE he is using is more anatomically shaped with the lower pole projecting more. I am still getting the same size 425 cc implant put back in, just like my other non radiated side. I am so afraid of getting cc again and am looking for ways to prevent it. I plan on doing vigorous massaging and wearing this bra:
http://www.makemeheal.com/images/products/estore/10006/large/4510a.gif
Do you think it will help?? My exchange surgery is this Thursday coming and I've had the TE in for about 2 months.
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Whippetmom - I'm not sure if you can help me. I had my double mx on March 5th and immediate reconstruction with the lat. muscle and he put in permanent implants at the same time. I was a small B and asked only to be slightly larger.
Well, my right side feels totally different than my left and is smaller. When I had my last apt. my PS right off the bat said oh your left side is bigger. He looked at his notes and said well there was more tissue removed from the left side. I told him yes that was because after 3 biopsies on my right they took out tissue each time. Which I know we discussed in earlier meetings. He never admitted anything and I have never been given or offered any information about what type of implants I have or their size.
One of the reasons for having the double was so both sides would match. Originally I was to go in for the nipples in June but he said I needed to be sure I was happy with everything first. He said perhaps there is extra swelling..... I could buy that as there is a lot more swelling under my left arm than my right but they just feel so different. The right side feels all of one piece and feels more like a real breast. The left is a better size even though I do not fill out my old bras and was hoping at least to fill them out nicer and be a little bigger not less. The left side I can feel the implant and it sort of thunks from one side to the next when I do the massages. Also I am almost 50 so no I didn't want 20 year old breasts but these seem to sag more - could it be because along with the muscle and implant they are just heavier - is this normal?
Any thoughts or advice? I think I'm more troubled by this as I broke my nose last Sept. and now I cannot breathe and it seems to get worse every week so I'm trying to figure out what to do about that as well. I had so hoped to be done with surgery!
Thank you so much.
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Whippetmom: Thanks for your reply on the other site. I have a few questions and thought I'd post them here as well.
I wonder if Strattice is available in Canada (Ontario)? If so, it sounds like a wonderful tool to correct the previous surgeon's error. I'm really hoping that this can be fixed. If it can't, I'd be very tempted to sue my old surgeon but even if I have a case, money isn't going to fix the problem.
If Strattice is not available here, are you aware of any other options? I know Alloderm is not available here . . . only on a study basis and although I am part of the study, I am part of group B . . . the group that does not get Alloderm.
The new PS talked about an implant stabilizer from this company. http://marenagroup.com/store/entity/tabid/198/c-3-breast-support.aspx
I checked out the link you sent me for the V Panel Bra. They seem to be so different. Any idea which one is better?0 -
Hi Whippetmom, My ps said I could decide on my implant type at my preop visit. He's with MSK and they keep telling me to stop worrying...he knows what he's doing. I really hope so. My ribcage (the top - right under the TEs) measures 31 in. Thanks so much for your help.
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Mantra: Strattice is also made by LifeCell - as is Alloderm. It might be available in Canada, because it is porcine dermis/tissue, rather than human acellular tissue.
I think that anything from the Marena Group would be just fine. The premise is the same with any good implant stabilizer band.
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Lee: Excellent! A number of gals here go to MSK. Do you have Dr. Disa?
I think high profile 550 ccs would be just about perfect for your frame!
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Stanzie:
Well, by now, the post-surgical swelling should be resolved or there should be very minimal residual swelling evident. I would like to ssee what this left side looks like. Your size discrepancy was an oversight by your PS. I think he so much as admitted it, right? I will need to see photos so that I can see what is needed for you, since you have the flaps. It sounds like another exchange surgery if you are serious about symmetry. It is ALL doable. Nothing has to be done until you heal from your nasal fracture and you are feeling better. But I will PM you with my email address so that we can go over all of the possibilities.
Deborah
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whippetmom - I want to thank you for the help via pm. I now feel ready for my next fill on Wednesday and know what questions to ask my PS.
My question - Why do we need to wait a month or so after the last fill? I am just curious. I know my PS said at least a month.
Fat grafting - does it work? Is there another choice other then fat grafting? Do you get a choice where they take the graft from? Is fat grafting lipo?
Thank you!
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Hi all! I am wondering if anyone knows who the best PS for reconstruction is near Boise, Idaho. Mine is in Meridian and there are only 3 in the valley who are supposed to be "the ones" but I am curious if anyone from this area has been happy with their choice of PS. He has never discussed with me what kind of implant or size or shape. I am plus sized - especially after going thru all of the ups and downs on this road - and was a 38C or D. He told me I cannot get anywhere near that same size and I said if I don't I am going to look like a huge human pear...but he does not seem to care about that. I have had 3 reconstruction surgeries and my implants are almost under my armpits. It seems like some on this thread have gone with the bigger sized implants. I am now going to go under the knife to do the back muscle to the front as my implants now looks like "rocks in a sock" his description. Nice!! Anyhow, I would love to hear about any PS's in my area.
Thanks, Tami
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Whippetmom - Strattice is not available here in Canada and the only thing she can do is some heavy duty internal stitches.
I've read that the problem is not easily repaired and has a high failure rate. It says that if it fails, it has to be taken out, wait 6 months and start all over but with a smaller implant. I really don't want to go through this again. I'm wondering if you know if I could just leave the TE in place until such time a viable option becomes available? Are there problems with leaving TE in place for years? I'm just not prepared to deal with something that has a high failure rate. Why bother?
Mantra: Strattice is also made by LifeCell - as is Alloderm. It might be available in Canada, because it is porcine dermis/tissue, rather than human acellular tissue.
I think that anything from the Marena Group would be just fine. The premise is the same with any good implant stabilizer band.
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Tami - I don't know how limited your choices are in the Boise area, but YOU NEED TO DUMP THAT GUY! It sounds like he is lacking any sort of sensitivity!
Whippetmom - I'm curious about the TEs themselves - it looks like Mentor has a couple different models and I'd like to know how much bearing what kind of TE you have has on what kind of implant you plan to end up with. How important is the TE? Or does which TE you get just depend on how much they expect to have to fill it?
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I'll start at the beg
Stage 2 breast cancer in 2003 bilateral mx ( no reconstruction at this time)
Decided to have have breast reconstruction years later (2006 I think)
2006 went something like this:
II had expander surgery etc and had my exchange surgery and then had the nipples made
also had 1 session of tattoo to the nipples that were made. (1 more tattoo session still needs to be done)
had the best health insurance at the time!!!
Also at this time I mentioned to the surgeon that the bottom of the non cancer side breast
was sagging she told me that was extra skin and that she would have to back and fix it.
A year later our insurance changed at work (bad coverage and very high max of out of pocket) I could not afford to have the last tattoo done. have not been back since
fast forward to 2010 and it seems as though the left breast is sagging more is is a little & is more flat that the right side towards the cleavage.
I am not sure if this is all related to the sagging issue or not. or ?? or if it ruptured
If the silicone implants ruptured how would I know. I did fall on them once but they seemed intact at that time.
These are silicone.
Question if this needs to be fixed and or replaced will insurance cover this?
also if my cancer was ever to come back distantly would insurance pay for anthing related to my implants etc
Our insurance is better but I will be switching plans come Jan & our max out of pocket right now is almost $5,000 cannot swing that at this time.
The new plan coming Jan is that we pay 100% up to $2500 and then everything is covered at 100%
so my plan is this:
Go in and have her take a look at this before the new year since the co pay I have now is $45.00 rather than paying 100% for a office call. her office calls are $500+
Then after the 1st when the new insurance kicks in do what is suggested since we have to pay 100% up to max out of ($2500)and no deductable .
Any help or suggestion would be more than appreciated
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Hope: You need to wait at least a month [frankly, I feel two or three months is even better] to give the skin time to expand and to retain the expansion. Otherwise, the skin will just retract when the TE is removed and all will be for naught.
Mantra: It is not really advisable to leave the TEs in for more than a year. Really, I think six months is what the manufacturer states in the literature, yet some women do have the TEs for up to a year or perhaps even longer, in order to complete rads/chemo or other treatment in the interim. I have done a lot of research on symmastia and I want to go over it with you, but I will PM you with this information later this afternoon.
Weezy: I think your PS has rocks in his head! Nothing like kicking you when you are down. Let me do some research for you....I'll get back to you later today.
Tory: It does matter what type of TE is inserted. The PS needs to determine the width which is appropriate for your frame and the volume which is deemed appropriate for the amount of skin flap remaining after MX. Based on my research and from personal experience, I happen to believe that the least amount of expansion in the upper pole - in the pectoral region - is better. You want to avoid damaging the pectoral musculature and also, I think it helps reduce the risk of step-off deformities, especially in thin patients or patients with a relatively bony ribcage. So this would mean the short height to moderate height TEs seem to be preferable.
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Whippetmom- Thanks so much for all of your help. You're an angel! Yes, I have Dr. Disa...I hope that's a good thing?
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Lee: It's a good thing. You are in good company. Seems like everyone I run into lately from NY has Dr. Disa.
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anderson: Sorry....I missed your post somehow yesterday. I was looking for something just now and found it. I am going to ask you to email me photos so that I can see what is going on.
I think that with a silicone rupture [with a silicone implant of the generation you have] - if there is any deflation, it would be very gradual and probably minimally at that. So what you might be seeing is a bottoming out of the implant.
Will insurance cover it? I want to say "yes", but I suppose this might depend on the state in which you reside and the insurance you have currently, since the implantation occurred under a different carrier policy. The problem with going in NOW for consultation is fine, as long as you do not have to prequalify for the new insurance carrier you are switching to in January. I am not sure if the new "no preexisting conditions" edicts for insurance companies will stick without a fight, and so you want to be sure you do not need to divulge to the new insurance company in January that you have a "condition" for which you have not been treated and will require treatment with your new carrier. Sounds confusing, I know.
With that said, it might be that if indeed there is implant failure/rupture, you could be covered under Mentor or Allergan's lifetime limited warranty plan, which could also cover a portion of hospital/surgeon/anesthesiology costs for replacement. You would need an MRI to confirm a rupture, unless the implant is just so obviously deflated, ruling out the need for same. Warranty information link:
http://www.justbreastimplants.com/breast_implants/implant_warranties.htm
But send me photos and I can probably tell you right away what might be going on and we can plan out your revision to help you towards getting the results you hope for next year. I'll PM you with my email address.
Deborah
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Tami: Why don't you obtain a consultation with this PS in Boise....
http://breastimplantcenterofidaho.com/breastreconstruction.html
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