BREAST IMPLANT SIZING 101
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Thanks TinaT. I was just googling it... looks like it was fda approved as a matrix awhile ago, perhaps for other applications?
I had no trouble with the alloderm so if I need to go that route again, I am fine with it.0 -
Wow, I so agree, those pictures could have been cropped. Imagine if you were his patient and saw your pictures out there.
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Weird -- that link doesn't work for me, GreenMonkey. But I get the picture and agree it's a horrible practice.
Geewhiz I'm so sorry. I sure feel your pain and am sending you more hugs.
Tina -- cool about that new silk stuff!
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Just wanted to give you an update, whippetmom. I met with the PS at Mayo Clinic and loved her! She agreed that the 800 cc implants were too large for my frame, plus she said they were too far apart and into my armpits. She thought a Style 20 (around 600 cc) or a Style 45 (around 550 cc) would work well for me. She said she'd probably have to take some skin off the sides in order to center the implants better on my chest, then she would use Alloderm over and under the implant for support and to help prevent rippling. She suggested fat grafting to fill out the ripples, but I'm a little scared of that -- sounds painful, and it seems like people have mixed feelings over whether or not it's worth it in the end. I am tentatively scheduled to "downsize" in December, and I can't wait. Thanks so much for all your guidance.
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Hi Whippetmom
- these are my stats:133 SX - 13
5'3"
105 lbs
28" rib circumference
I had a unilateral mx and now my TE is filled to 400ccs. The TE is coming out of my sides a little and I can feel it when I lift my arms in front of me. I am now a 34C cup. I like this size but I would like less spillage on the side. My PS will bring in 425cc, 450cc and 475cc in style 20 HP. He says that the current TE is too big for me and he doesn't want to put too big of an implant in me. He said to trust him with his decision.
My question is, if he decides to put the 425cc implant, will I still be a size C? I like the projection that the TE gives me and I know I won't get that after the exchange. I don't know what to expect and I'm afraid to be disappointed.
Thanks again for all your help!
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angellunch: Why did he use a 13.0 cm wide TE? Does he plan on performing a lateral capsulorrhaphy on the MX side, since he plans on using a narrower implant? If you like what you have currently in terms of volume, you would need at least 450 ccs in Style 20, but it still would be narrower than your TE. And you will not come anywhere close to the projection of your TEs. I DO, however, think 450 ccs or 475 ccs would be a good size for your frame - but I would like to know what he plans to do about the TE to implant width differential. You plan on augmenting the native breast, correct?0
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Joanna: I like what the female plastic surgeons at the Mayo in Arizona are doing these days. I think that you should not worry about fat graft transfer in the nipple region. You will not feel it - unless you have feeling there now....??? Or are you referring to from whence the fat must come? But I have had fat graft transfer, placed everywhere over the breast mound twice - and it was not painful at all. My abdomen was a little sore, where the fat was extracted, but it did not keep me from refinishing furniture the day after surgery....
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My abdomen was a little sore, where the fat was extracted, but it did not keep me from refinishing furniture the day after surgery....
Now why does this not surprise me?
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Whippetmom - I don't know why my surgeon used 13cm and he did not say anything about adjusting my pocket but I hope he will. I don't want my implants moving around. Would less than 1cm make a big difference? I'll make sure to talk about that before the surgery and let you know what he says. He decided to go smaller than what I wanted (500ccs) because I'm stretching so much and my skin is thin (can see bumps from stitches) and I have cording between my breasts which he thinks is from the TE being at it's maximum size for my skin to handle. He's also doing fat grafting on day of exchange for my upper pole.
I know that I'll lose significant projection (that's too bad, I love this TE). TE is 6.7cm and implant is 5.2cm - 5.5cm. That's a lot!
Yes, I'll be augmenting the native breast.
It's tough not knowing how the outcome will be after talking ccs and width and projection. I'm very nervous.
Thank you for all your help again!0 -
angellunch: You will be fine! The additional projection created by the TEs is a good thing in your case, because it gives your PS extra skin to ensure good implant coverage.
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Blessings....better refinishing through chemistry!
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I'm worried about the fat transfer, because some have said it's painful, while others have been disappointed with the results. I suppose I could talk to the PS a little more about it, since my surgery isn't until December. It sounded like she was pretty confident that Alloderm over the top would help reduce the rippling that I currently have.
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Joanna: You are reading the threads about micro fat harvesting and grafting, a la the Dr. Roger Khouri method - and this is entirely different than the miniscule amount of fat which will be harvested and transferred to the nipple area at the time of your surgery. There is no comparison.
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It seems I don't understand what constitutes fat transfer. My PS said she could essentially lipo some fat out of the tummy area, then place it around the implant (mainly over the top and sides) to reduce the rippling effect. This sounds similar to what I've read on other threads here, with some saying that the lipo part was really painful. Or maybe I'm confusing two different procedures?
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Joanna: Very little fat needs to be liposuctioned in your case. In the case of the fat graft transfer procedures done with the BRAVA method, a great deal of fat is harvested. You are not building a breast - you are just filling in a few centimeters of space on the mound.
I have known many gals who have gone through FGT for rippling and none of them complained of being unduly disturbed or uncomfortable in the area where the fat was liposuctioned. It certainly was not a problem for me and I had it done twice. .0 -
Joanna: I would say if you are worried about FGT, then do not do it. There is no reason you should do something which causes you any worry or concern. Eliminate stress in your life after bc!
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Hi whippetmom,can you tell me who is good in l.a. county or orange county for plastic surgeons? I want a really good one,somebody who does lots of these reconstructions. Everybody I check out is a hand one. Some of them do faces too,but they say bc reconstruction in their profiles. Is that normal?
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1Sunshinegirl - I hope you don't mind if I jump in here. The whole "hand surgery" thing sort of bothered me when I was researching plastic surgeons. But, it is not unusual for some plastic surgeons who do vascular microsurgery (DIEP and other free flap reconstruction) to also do complex and delicate hand surgeries as well. My PS does mostly breast reconstruction, but he also does hand surgery and I'm very pleased with my reconstruction results. You might ask what percentage of his/her practice is breast reconstruction.
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TinaT,i'm happy you jumped in with your information.I haven't been able to figure this out,the whole hand,breast thing.I thought only one kind of surgeon could do this but I see lots of hand and bc reconstruction doctors popping up. I guess I should ask how many they do,you're right.I had one surgeon say they want to keep their hand status or certification but still do the bc surgeries.I don't know why,maybe hand is more complicated so being a hand surgeon has more prestige.Thank you,I feel better now.
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sunshine just an fyi my PS speciallizes in facial reconstruction and he did a fantastic job on my reconstruction. I ahve no complaints.
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1Sunshinegirl: In Orange County, Andrew Smith, MD. I have met him and I have personally seen his work. He is also a very compassionate and kind doctor....
Deborah
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Carrol2,that's interesting to know.I learned a lot today about surgeons. Whippetmom,i'll look at that website now.I have insurance but I might pay out of pocket and skip insurance if I find a good plastic surgeon outside of my plan.I don't want insurance to stop me from getting a really good one. I got approved for kaiser a few months before the cancer but I don't know about them.I never hear of great names for kaiser,is that because there aren't any?Thank you all.
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1Sunshinegirl - I have Kaiser, and I ADORED my medical team!
From the diagnosis to surgery to treatment, all my physicians have been under the same roof, and all my records are on a central database available to all of them.
My plastic surgeon has an excellent reputation for breast reconstruction, but we're nowhere close to you. (We're in the Central Valley.)
Personally, though, my PS does not do silicone implants. Other Kaiser docs, as I understand it, do. (Perhaps Whippetmom knows some names.)
That was o.k. with me. I'll get my permanent squishies this Wednesday.
The total cost of my breast cancer treatment has been just $15 per office visit to see the doctors. I paid nothing for any of my diagnostic tests (seven total), nor did I pay anything for the surgery (BMX w/TEs). My drugs were either $5, $10, or $15.
I think the reason that you don't hear names of great surgeons at Kaiser is that they're not out advertising the way private practice docs are. And women who go through Kaiser may feel that because not everyone can use their doctor, they don't promote them to others.
Guess I'm just a satisfied, long-time Kaiser member. However, having said that, we do have secondary insurance through my husband, and if I had felt at any time that I was not getting excellent care through Kaiser, I would have gone with the other insurance.
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Oh how funny! You have Kaiser? I have Kaiser and of course, I have a great plastic surgeon for you! Her name is Gail Mattson-Gates, MD, a Yale med school grad and she is in Irvine at the Alton/Sand Canyon hospital. You will want Lilian Estrada-Linder, MD as your breast surgeon. I have had Kaiser for 40 years and I do not ever plan to switch...
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Blessings,that's encouraging to hear.I heard good things about kaiser before from friends so i'm leaning towards using them.And yes you are far away from me.Whippetmom,I looked up those two plastic surgeons you named.I'm wondering who you think is the better one and why?It's hard to know which one to choose,how many bc reconstructions have they both done?I'm having implants and I don't know how either one is at doing that.No invasive surgery for me,just implants.I looked up implants and alloderm and I noticed some doctors don't use it and some really like it.And if I need fat injections done to fill stuff in whose better at that?Thank you for your help,I can't find these answers anywhere else.By the way who did your reconstruction surgeries?One of these 2 doctors or someone else?
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Thanks, whippetmom. Honestly, the reconstruction part has been way more stressful for me than the actual cancer part! Since everything went wrong during the first exchange, I want to make sure I do everything right this time around. I think I'll talk to the PS again about the fat grafting to learn a little more about the procedure, recovery time, expected pain level, etc. Thanks again!
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1Sunshinegirl - Also on the hand surgery issue - I don't believe they necessarily focus on orthopedic types of hand/wrist surgery. Because there is a microvascular surgery connection I believe the plastic/hand surgeons do more nerve and vascular damage surgery, replantations (like reattaching severed digits), etc. Not all plastic surgeons do vascular microsurgery. As I mentioned, I was curious at first like you were, but the more I thought about it I decided that this type of surgeon must be patient and meticulous and detail-oriented. And since mine does more breast reconstruction (implants as well as flaps) than other surgeries I felt comfortable with that.
Edited to add: I assumed that the PSs that are also certified in hand surgery are usually vascular microsurgeons, but that could be an assumption on my part. Mine is and other ones that I have read about are, but it's possible that a PS who does hand surgery is not trained in vascular microsurgery.
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1Sunshinegirl: Yes, I understood you are doing implant-based reconstruction. Drs Estrada-Linder and Mattson-Gates were MY physicians and performed my bilateral mastectomies (Dr. Estrada-Linder) and immediate reconstruction with tissue expanders (Dr. Mattson-Gates) and then the exchange to implants. One is a breast surgeon and one is a plastic surgeon and so you will need both of them. They have performed many, many breast reconstruction procedures. But I recommend that you make an appointment with them.
I am perplexed though. Who have you seen thus far at Kaiser? Who has diagnosed your breast cancer? Just not clear where you are in the process.0 -
Interesting on the hand specialists ... My PS specialized in hands and I never got the connection. Thanks, Tina!
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