BREAST IMPLANT SIZING 101
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My PS doesn't seem to care whether I have underwire or not for regular bras, when I graduate from my 24/7 Triumph triaction high impact sports bra! Do you think that is weird? But I am only a 34 full B or small C, so maybe it doesn't matter so much. I just went through trying on all my old bras 34C-DD and have faced the fact that I will never wear any of them again (without padding, that is!) But I am excited to buy new bras in my new size which I am really comfortable with.
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Deborah,
First I want to say thanks for providing all of us your knowlegde, I know when I was first diagnosed I did so much research and that consumed a lot of my time, I know that you have done way more research than I so I can only imagine how much time you put in to it and it appears that you have been on these posts for several years and continue to give us great advice!!!! THANKS for everything you do for us!!!!!!
I want to apolozie that I didn't provide you with all the info that you needed to answer my question, I'm bad. I just assumed I was getting Mentor b/c doc office had a brochure on the desk, silly me if I were to look farther, I would have saw the other brochures. I'm usually so involved in my treatment - I don't know what has happened, but I better kick myself in gear and get more involved. Just tired of dealing with all this.
I did go back to doc yesterday and learned that I would be getting Allergan implants, not Mentor. They took most of my stitches out, except 3 of them. I go back on July 9th and will ask the questions you need. I think that day I will also get my first fill. He did tell me that he usually fills 50 cc's in each every time, we will see if he changed his mind, since I have had some minor complications. I asked the nurse yesterday if I could sleep on my sides and she said yes that the TEs would not move. Tried that last night and boy was it painful, I will continue to sleep in recliner. She gave me some stretching exercises to do. Thank god, my arms are stiff.
lago, I noticed that you are in Chicago. That's where I go (2 hour drive from home). Is it appropriate to ask who your doc is?
Take care everyone.
Brenda
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Whippetmom-
Well, I had replied to your last sent reply from early june but who knows, dang computers!
Retried as a new PM just now.
Thanks for letting me know to resend.
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Fearlessfoot: I am not surprised that your PS permits use of underwires early on in the recovery after the exchange. In fact, many more plastic surgeons are advocating use of underwire bras right after the exchange. It all depends on the PS and also, the location of the incision on the chest wall.
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Thursday: Allergan implants are just fine - essentially the same dimensions and style offerings as Mentor. I think that 50 ccs per fill is a good number, but for you, it might be better to take it very slowly - every two weeks.
I am still here because this is my ministry. It is a blessing to help each and every one who comes through these web portals to my humble little thread!0 -
Whippetmom: Hi, I had a BMX, NS on non-cancer side, reconstructed NAC on cancer side from excess breast skin on on non-cancer side, one-step Mentor silicon cohesive anatomical implants, total sub-muscular placement (pectoral majoris, serrata anterior, fascia only of rectus abnominal). No tissue expander or Allerderm involved; I was going from 34D down to 34B and am very happy with the size! I love being more petite for once in my life! So maybe the small size is why the underwire is okay? I imagine it should be a good quality one so there is no risk of poking through and "punctures!" (omigosh!)
BS and PS moved a "pedicule" of the NAC on non-cancer side up and did a keyhole/anchor type incision. Same type of incision on cancer side but with grafted skin from excess non-cancer breast skin. All scars healing well EXCEPT the nipple on the cancer side has necrosis and must be redone in 3 months! My big question is how to influence my PS on where to source this tissue? I know you advocate tatoos but my left breast NAC survived well and I would like a matching physiology if possible on the right side! So a bit of a nipple would be nice! I'll need to get the areola tatooed anyway because it is just white breast skin colored now. But where should the tissue come from for the new nipple? I've heard stomach, inner thigh, labia, ear (especially for cartiliage for projection). Actually here are some wrinkles on my left breast that PS has talked about removing -- maybe that could be basis for nipple? Is it all like playdoh; you can just mush it around and use body tissue from wherever?
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Fearless: This is how it is typically done here in the U.S. - nipple creation via a flap created from the skin of the reconstructed breast. I know some docs probably use other methods, but I just do not know any of them. I do know gals on the forums who have had areolae created from autologous donor sites, such as those you described. But your inference that your PS was going to do something about the rippling, makes me wonder if he is thinking of a flap...it would tighten up the pocket a bit. I just do not particularly like it because I feel that you run the risk of a flattening defect in the middle of the breast mound - which is what happened to my mounds after nipple creation.
http://www.breastreconstruction.org/SecondaryProcedures/NippleAreolaReconstruction.html0 -
Deborah-do you think that I should talk to my PS about using alloderm on my non-mastectomy breast when he insert implants in there?
Diane0 -
angel: Absolutely - discuss using Alloderm. Not every surgeon feels it is necessary though. But if you are a candidate - if you have fairly thin skin - it is a pretty amazing tool for reconstruction.
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Is there anyone around that has sientra implants? I have been through 2 fatgraftings with Khouri and do not really care to continue down that path. I have seen 2 seperate PS', who both seem really excited about these new ones. I have a second consult next week. Would I measure myself the same? I know they have an online brochure, there are several new shapes etc. UGH!!! Just want this all behind me : (
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I should add my "specs", lol.
I am 5'8, 140
31" chest circumference.
I had the Mentor High Profile 550's put in initially. They were too small on my chest. Dr Khouri removed them and put in Mentor Smooth Round 325's and has grafted over them twice now, but they are way smaller than the 550's and there is absolutely no upper pole fullness, skin and bones up top...and he was thinking another 3-4 graft sessions minimum. Ummm...no thanks!
I did have rads, but skin is doing great, primarily I am sure because of Dr K's fatgrafting.0 -
geewhiz: Hi....wondered how you were doing with Dr. Khouri - had heard you were seeing him. He just should have kept the 550s and added to them with the fat grafting. I do not know about your pocket issues, now that you have a smaller implant and I am not certain about the integrity of the fat grafts, once you penetrate the pocket to reinsert another implant, which only is to state that leaping from 325 ccs to what I am going to recommend might cause a PS to balk a bit. I think that 600 ccs or 650 ccs would be appropriate for your frame. I do not know anyone here in the states who has Sientra implants yet. But I am not sure that this is your answer, because, from what I hear, they are essentially the same as Mentor or Allergan - just another cohesive gel option. I think that my best recommendation would be 600 ccs or 650 ccs in Allergan Style 45, which would give you an ample 12.8 or 13.2 cm of width respectively, and a handsome 6.1 cm or 6.2 cm of projection respectively. This would definitely give you what you want in terms of sizing.
Deborah
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Thank you as always Whippetmom!!
I struggled with Dr K removing the 550's. We argued about it at length. He says he cannot add fat to an existing implant without the fear of stabbing, rupturing etc given the method of microfatgrafting he does. The liposuction just really kicks my booty. I don't care to go through so many more procedures.
I had a consultation with Dr Philip Namnoum. He did impress me, and walked me into the room of a patient he had just put Sientras in a month earlier. She looked amazing. She let me squish her boob (ONLY another survivor could understand the excitement of this, LOL!!) and it felt very natural. She was really thrilled with her outcome. You would NEVER know she had a bmx. He works in tandem with an oncological surgeon named Dr Barber. The scars are invisible a month out, all done inframammary.
He was a trial investigator for Sientra, and seems to really like them a lot. There are more shapes, and apparently its a much more natural squishy feel than the Mentors or Allergans. I know he has some tie in with Mentor as well. I appreciate you recommendation of Allergan's. I see him again this week for a second consult, so I will be definitely having the Allergan conversation.0 -
I do not agree that the breasts dont look natural or good. My PS showed me some of her photo albums and the patients were shown before and after and then 3 mths out and I could not believe it! After only 3 mths out most of them looked completely natural. You could not tell it except for the scar and the poor quality tatoo for the areola. Everything else looked fantastic! She is doing mine in Aug with 600 cc mentor memory gel so hope they look as good as the ones she already did for other patients. I was a small B at most and I told her I wanted to get a fluffy C out of this. 5' 4" and 153 lb with very petite bones. Need desperately to lose the weight.
Good luck to you all! Did the rest of you have the natural droop after 3 mths? I like the TE high placement. If I wear a bra after,can I keep these "girls" high? My PS says they're too close to the collar bone,uh meaning? That they dont look like hers? Those lady surgeons around town are extremely thin and ought to get implants,dont they eat? LOL..
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whippetmom - Do you have a name or model number for that Chantelle bra? I couldn't wear bras with seams through the cups until recently so my options have opened up a little
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geewhiz: I have heard a lot of good things about Dr. Namnoum - so if you go with him - let him make the decision about implant mfr, style and sizing.
I have never had a very clear explanation from Sientra, nor have I read anything in the press, about the cohesiveness of Sientra's implant offerings. You see, they ARE in clinical trials with a round "gummy bear" "true cohesive gel" and I had assumed that THIS was the implant which had been approved a number of months ago. But then I heard it was just a standard silicone round and silicone anatomical [but not an anatomical to compete with Allergan 410 or Mentor CPG] which had been approved. If you could find out more about the Sientra implant, I would be so appreciative.
Deborah
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Here it is Tina: Maybe it is being discontinued.....
Keep an eye on Ebay...
http://www.ebay.com/sch/i.html?_trksid=p5197.m570.l1313&_nkw=chantelle+3586&_sacat=0
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whippetmom - Yep, dang it, looks like it's discontinued!
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I've found a couple other Chantelle bras that are soft cup:
http://www.herroom.com/chantelle,bras,soft-cup-wireless,cha001,001,58,24.html0 -
kayb: You know, I think it was more of a sensation of the temperature of her implants as compared to her own body temp. I have heard that implants maintain a temperature somewhere between our own body temp and the temp of our surroundings. Here is something I found which might explain the phenomenon...
Heat Reservoir
"Breast implants will store both hold and cold temperatures, based on your surroundings. However, unlike other body parts, the implants are slow to return to normal body temperature. For example, if you stay in a sauna for too long, your implants will heat to above body temperature. Once you leave the sauna, your body will return back to normal temperature within a few minutes, but your breasts could remain warm for up to an hour. While this may be uncomfortable, it is usually not detrimental to your health or well being."
Deborah0 -
Whippetmom- It's so nice to hear that we can still enjoy going to the sauna after reconstruction. I love saunas, hot springs and whirpools.
makes the skin glow. Thanks for the info!0 -
kayb, thanks for asking on my behalf. And whippetmom, thanks again for sharing your expertise. I had the same thing happen last summer with my old implant (had it switched for a smaller size in March, you might recall our conversations about that). It was an odd sloshy feeling, almost like the silicone was congealing and jostling about, perhaps? I did read that they retain temperature changes longer than the rest of the body, but I didn't feel it was hotter or cooler than the rest of me (I only have one). It was the change of texture that was very disturbing feeling. I do remember asking my PS about it last year, and he said not to worry. But I think I might call again today just in case. By the end of last summer and many hot miles of running, my implant had bottomed out, after all, and which was one of the reasons why I had to have the revision in March.0
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whippetmom I have a question for you. I am trying to lose weight so I ahve a few months before my hopefully last surgery to get my nips and def do some lipo on my sides. My PS and I have gone back on forth on if I need fat grafting. i don't really see any rippleing but I wanted a little more upper pole fullness. I was wondering what the risk of puncturing the implant is during fat grafting? If it's risky and it's not super necessary perhaps I should skip it?0
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Carrol I had fat transfer twice. As far as I know, no puncture. You have a good PS with plenty of experience. I bet its rare with the good ones.0
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Ditto to what Lago said above about fat grafting.
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orangemat: I wonder if it has something to do with the friction and compression of the sports bra against the implant. It might be generating more heat than just the mere absorbtion of heat from the outside temps. Very interesting. Let me know what your PS has to say.
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I just received a Sientra implant three weeks ago. It says silicone gel, but not cohesive gel. It is a very nice shape, its a tear drop shaped implant, but it's firm and when I lay on my back or lean forward, I have rippling in my cleavage area. We are waiting 6 more weeks to assess how this one is settling before deciding on the size size for my left side. There is a saline one there from previous augmentation. My PS was trying to match my "good" side, but my new implant is definitely larger, 550 hp is the measurement. I'm only 5'1" and 108 lbs, and I'm so worried I'm going to be a full D cup. I know people talk about fat grafting to eliminate the rippling, but would that make me even larger? I really don't want to have to replace the new one. Other than the size, the shape is wonderful.
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I need some advice on sizing.
I was a 34A prior to my BMX. I currently have TEs in (not sure what kind). I was almost flat after surgery and had 60cc put in during my first fill - at the most, I think I have 100cc, I'm 35" around my fullest point in and I'm already larger than my old 34A size.
I'm 5"4, 140 lbs, bony on top. Ribcage around is 31".
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Roadwarrior what size do you want to be? I was a 34A when I was your age. In my mid 40's I went up to a small 34B (not full). My ribcage is 30" but I'm 5'6" with no fat on my upper body either. I decided to go a little bigger and fuller. I'm a 34D now but mostly because of the width. I did not get high profile. (Allergen style 15, 397cc). I only had to toss out 2 really tight sweaters… and my jackets actually fit much better.
Also note that after my 4th expansion I too said I was big enough. My PS said a few more. I had a total of 10 expansions but my PS does fill slowly and likes to over expand.
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