BREAST IMPLANT SIZING 101
Comments
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Janet: Typically, the TE is filled to the recommended fill capacity, or as your skin tolerates, prior to radiation treatment. After your first fill, you will get some idea, rather quickly, regarding how you can handle the amount of fill and the spacing between fills. The minimum fill might be 25 or 50 ccs, and some women can handle 100 ccs to 150 ccs. Usually, TEs are filled once a week or once every two weeks. Again, this all depends on your skin and your level of discomfort with fills. I doubt you will have much of a problem, because of your breast size prior to BMX. But let us know, okay?
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Chawkins
This makes me really nervous, as I have asked my PS office and they said everything would be fine as they code it as breast revision surgery for symmetry as a result of breast cancer/MX.
I am a uniMX and the first attempt lacks size & projection so that is what they are going back in for.
DOES anyone else have knowledge about this? I could try calling my insurance company again, but you know even if you do they always tell you "this is not a guarantee of payment". What are we to do if no one can tell you for sure. The PS office says they have not had a problem with this. Any one had a similar situation & was it paid by insurance?
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janiceg415: I am a uniMX and I had a revision and I did not have any problem with the insurance company. In my case I lost weight so my MX side ended up being bigger and therefore uneven. I had my exchange in June 2011 and had the revision in April 2012. I went from 550 ccs to 450 ccs. Your PS is correct it all depends on how they code it.
In any case it is always easier to go bigger than smaller. My PS had to reduce the pocket which was painful. It has been 8 months now and I feel completely back to normal. I saw him couple days ago and I asked him if I can I can lift weights he said: No restrictions.
Overall I ended up a little bigger than I had envisioned before the mx but I have gotten used to them now and I am glad to be DONE. My bra size is 32DD or 30E.
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whippetmom,
Thanks for the reply. I had heard stories about 50 ml every two weeks and figured this could take 6 months, really a problem when my radiologist would prefer to start in 6 weeks and not more than 12. My PS said she usually found she could put in 100-150 without much discomfort the frist time since you're starting from empty and just to tell her when I started feeling pressure or discomfort. Well, after 150 she kept asking if I was feeling anything (she had to ask the nurse for more saline) and at about 270 I felt a little pressure. I ended up with 310 and I still don't have any discomfort. I have a foob! It does feel like a rock, but at least it's a padded rock. I figure just one or two more fills and I'll be good to go, assuming I finally get rid of the last drain. I have switched back to my regular older bras (40DD) during the day since they are loose enough to be comfortable but still offer support for my droopy right boob. I just add a little fiberfill and pin on a drain bag aand I look pretty normal. Those camisoles are comfy, but boy (girl?) did I look asymmetric!
I am concerned that my PS tells me I'll have to wait 6 months after radiation for the exchange and right breast reduction since I will already have moved to New York by then (We're building our dream house near Ithaca, NY with a stunning view of Lake Cayuga). I guess I can either come back to Texas and stay with my sons or look into having it done at Sloan-Kettering in New York, where I got the second oponion that started me on this odyssey. I assume the skin has to recover from radialtion, but is this a typical amount of time? As you might guess from my history, I heal quickly and am not terribly sensitive to pain.
Janet
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Yes your skin needs 6 months after radiation to recover. I had chemo, mastectomy and then radiation. It ended up being a year before I could get reconstruction started.
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Hello Ladies-
I am new to this thread. I just had my exchange surgery yesterday and am feeling great. No pain, nausea, anything.
I know it's only one day post-op, and I'll have my post-op visit with my PS next Wednesday, but I have some questions for those who know more than I.
I am 41 yo, 5' 7.5", 115 lbs. my ribcage measures 28 3/4. Prior to BMX, I was an A cup and decided I wanted to go larger to give a little back to myself for having to endure this journey. To that end, in June I had the dual chamber Sientra tissue expanders placed and then filled to 435ccs. They looked great and even the Sientra reps were impressed apparently. At my exchange surgery yesterday, I received the Sientra classic base shaped 450cc implant (I'm pretty sure that's the one). Obviously, the projection is not nearly that of the TEs and I'm feeling a bit disappointed as far as size goes. The TEs seemed much larger. I was hoping for a comparable look/size.
Thoughts, please? I want to be prepared for my post-op next week with questions, concerns, options, etc.
Thank you!!
Tricia0 -
25weeks - I'm about your size, a bit shorter.
Two things come to mind:
1) Yes, your implants are going to be smaller than the TE's - TE's are hard, implants are soft.
2) Very few of us were happy right after our exchange. Over time (up to six months) the implants will soften, drop and fluff a little ... become less pancake and hamburger bun like.
I am 5.5, 112#, 28.5 ribcage and I have 325cc implants and I am happy with my bra size ... I wear a 30D. I was very disappointed at first with the projection of my implants (not enough) ... but over time I've become very happy with how they look. They look pretty fabulous in a bra
. Blessings to you.0 -
Dawne-Hope,
Thanks for your reply. I hope over time I too will be happy. I know I should give them ample time to settle before I make a final judgement, but I was hoping to wake up excited rather than a bit disappointed. I should be more happy to be rid of the turtle shells.0 -
Give yourself a break 25weeks. Everything about this process is hard. Most everything can be fixed, so try and give it some time and see how things look in a few months. I know that probably sounds like an eternity, but things really do change for the better. I'm sorry you're disappointed.
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Thank you JamieB86. I'm just worried that we used the wrong implant, but like you said, if I'm still unhappy in a few months, hopefully we can do something about it.
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hi ladies
question for those who did the TE to implant route. Did the space between the breasts (your cleavage) change or stay the same? Im concered that right now the TE's look kinda far apart...do they get closer once the implants are in? My PS says he can work on the pocket to get them closer together at exchange
thanks so much
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Just had the implants installed 12/7 I am petite 5' 1" 130 34in rib I have natrelle style 15 421cc used to be a 36 D but I like the smaller profile. I wanted a B or C still swollen so I won;t know where I landed for another few weeks. Yes there is space tween the implants, but I have been looking at a lot of pics of breasts and the psace seems about right.
Good Luck with your exchange Rozem
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rozem - I had the opposite problem: my TEs touched in the middle! That totally freaked me out, and yes, the PS said he would correct that at Exchange. He did, and now they look just fine. My cleavage now looks normal. Just be sure you keep reminding him of your wishes!
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rozem - My TE's looked so strange and yes they were way far apart. Everything was corrected at change.
25weeks - You're tall and thin and you were small breasted to begin with ... sometimes our skin determines how big we can go. My PS stretched me as far as I could go ... he squeezed the biggest implant he could get in there (I wanted to be the same size as before) and while I don't have the projection that I had with my natural breasts ... that's just part of reconstructed breasts ... I'm pleased. The implants are wider and not as much 'oomp' projection-wise as my natural breasts ... but all of that is corrected with a proper fitting bra.
Again ... remember that very, very few women are pleased with the results right away. Give it some time ... and let things settle a bit. We've been there and we know ... it's hard ... but hopefully they'll settle in beautifully. I think most of us too have an adjustment period after our exchange. I'd like to know the percentage of us who struggle with PTSD (post-traumatic stress) after our exchange. We've been through so much ... and after our exchange ... we're 'done' and supposed to get on with our lives. Sometimes it takes awhile for us to grieve what we've lost before we can embrace our lives now and move ahead. Hang in there. Love and peace to you.
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Janet: I would go back to Ft Worth for your continued care - and if you go to NY - I have some other plastic surgeons I would prefer you go to, other than MSK. If you go to MSK, I would only recommend going to Andrea Pusic, MD. Keep in touch with me regarding your move.
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25weeks: You will need to get me the specifics regarding your TEs - style and volume - and your implants - style. The shaped implants have various projection styles. We want to compare the dimensions of your TEs to the implants. I just think that if you liked the way your TEs looked, your PS should have used implants which mirrored that look. That likely would have been round implants. Let me know the numbers though and we can figure it out. But as the other gals have said, it does take time for things to settle - at least two weeks.
Deborah0 -
Whippetmom--Hello Deborah. Have written a new thread. Basically, it's a to do list storage area. The instructions are self explanatory.
http://community.breastcancer.org/forum/26/topic/797809?page=1#idx_4
As always you are treasured! Have a blessful and blissful holiday and holydays with an excellent year to follow
Your friend sheila
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Just had my pre-surgical visit with the plastic surgeon today. Scheduled for my exchange surgery Jan. 4. Prior to BC, my kids had sucked me down to an A cup and I was sad to have such small breasts. My initial overfill put me at 420 cc's. In some outfits - that size looked fine, in tighter shirts I think I felt a bit self concious that I was too big. I'm about 5'5", 120ish lbs give or take - but with slightly wide shoulders. I was hemming and hawing today at the visit so they gave me another 30 cc's to 450 just to make sure I have enough skin to work with. Now I feel huge. He said my choices for final implants would be 400 or 425. Don't know what to go with. Hubby says 425 since the implants won't jut out as much and will have a nicer "fall" to them than these darn TE rocks and I think he is right. I'm concerned that the 400s will feel too small in larger clothes and the 425s will seem too big in tighter clothes. I know I have to make the decision on my own - but any suggestions? Thanks!
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ramols- If it was me I would say go with the bigger size. I wish I had decided to go with more fills I like my size but would rather be just a bit bigger.
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Ramols, what type of implants are you planning on? i'm about you'r size 118 lbs and 5 4", just had my exchange Nov 9th, I have the silicone teardrop implants which look allot more natural than the TE's I had. I got 400cc, I'm actually sorry I didn't go a bit bigger now, they're ok, but I still feel I could wear a padded bra for more of the look I want, previously I was a 34 A and wanted a full B. Definitely not the same projection of the TE's. Good luck!!
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Sheila: Thank you! I am going to see how that will work for storing some information I need to refer back to for newbies....
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ramols: Do not worry about such a small difference in size. 25 ccs represents less than two tablespoons of fluid!
This is not how the calculations are made though. It all depends on the width of your TEs. If your TEs are 400 ccs, overfilled, you will be substantially smaller than you are with your TEs - even with 425 ccs. So please read #3 in the thread header and find out which style/volume TEs we are working with.Deborah
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Deborah it should work fine. I suggest storing the link pages with a short description , just as you have in the header. You made me think I can store the same type of links. Yesterday I had to spend time "findin" something. Somethings we use over and over Good! L&H&P's sheila
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Thanks all for the responses. I didn't think to write down the name of the brand and have no idea what brand is in there now. I do know I picked the wider implant rather than the one that juts out more. Thinking i'll go for the 425 and keep my fingers crossed that I like the results. So many decisions in this BC business!
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rozem, I definitely have more cleavage now. I was such a small little B before. I talked with my PS because with the TE one was almost crossing the center line. I told her it looks like I was spinning around when I got the TE and they landed a little off center. She said my concerns on that could be solved with the exchange. She did a great job and they turned out great. Then one dropped and the other still has not since Aug 31. The other one has capsular contracture.
Once I had 2 secret squishies,that lived near the heart of me.
But now my hearts an open door
And my squishy isn't squishy anymore.
(to be sung to the tune of "Secret Love" by Doris Day,released 1953) just see your mom's record collection in the attic.
Happy Holidays to all my Cyber sisters on here!!:)))
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Layla2525,
When is your PS going to address your capsular contracture? Sorry you will have to have another surgery...
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Hello and Merry Christmas to all you beautiful ladies who have become part os this thread! I've been gone from here for about a month and a half dealing with some pretty ugly family issues on my DH's side. I've really had no time at all to think about my exchange that is next Thursday, 12/27. It may sound weird, but I love my TEs. I have really come to like the way they look and the firmness doesn't bother me one bit. No discomfort at all. I'm actually looking forward to exchange as it will be a vacation compared to what we've been dealing with family-wise. Whippetmom got me through a brief difficult time after BC surgery, BTW, Deborah, that issue completely resolved itself with that weird nipple situation. I feel blessed this Christmas that things have been pretty easy for me these past two months. I had my pre-op last Friday and am leaving everything completely up to my PS with regard to implant size and style. We did have to have a "come to Jesus" conversation right after my BC surgery as we did have a communication problem early on. He since has bent over backwards to communicate and meet my every expectation. I really have come to trust him completely. Right now just trying to prepare myself for what is to come with the implants and how they will look until they settle in. There are a couple of you who are a liitle ahead of schedule of me and I will be interested to hear about your progression with new implants. I hope we will all be thrilled by the time summer rolls around next year. My PS told me from the get-go that fat grafting is almost always needed to some extent. But, that's a discussion for another day down the road! Happy Holidays dear Sisters!
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whippetmom,
I am leaning towards coming back to Fort Worth for the exchange - but I think I'll wait until October and avoid the Texas summer
. I like my PS and she says I'd only need to stay a few days before flying back even with the reduction on the right side to match. Right now I just wish my remaining drain would slow down. It's been putting out 50-55 ml for the last week, and she won't take it out until it's been below 30 for two days (this is coming up on four weeks now).My DH and sons have been great, but it has really slowed me down for the holiday season and they've been doing all the driving and most of the cooking and cleaning. We've just put up the minimum of Christmas decorations and I even told them they could pass on wrapping Christmas gifts
, which they all usually grouse about and do very badly.Janet
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vik: I hope all of the issues with your DH's family will soon resolve. Remember though, that when other people close to us choose a hellish life, we should not let that destroy the heaven in our own. We can love them and pray them through it all, but don't let darkness invade the light...and avoid the stress some people want you to share right along with their own. After breast cancer, we want to live differently, sanely, joyfully.
Deborah0 -
Janet: Ft. Worth in October sounds lovely. That would be my choice for you also....
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