BREAST IMPLANT SIZING 101
Comments
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Stepmic - I have absolutely no restrictions at all. I don't do any swimming this time of year but I'm back to the gym. I run on the treadmill two mornings a week and do a group class the other three. And the group class isn't for wimps! It's a total body workout that uses lots of the moves you see from 'Insanity' and 'P90X' and similar programs. I'm not totally back up to speed yet but am getting stronger and more fit every day! I wish for you a successful and pain-free reconstruction process. God bless!
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Laura -- it was her advice re: extreme itching that I was thinking of (on page 249 of this thread)... I copied and pasted it and PM'd it to you.
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Sweetandspecial....oh my word!!! To have HALF the energy that you do...Keep it moving girl!!
Stepmic~I did'nt have any restirctions either,except my J-O-B!! No lifting/pushing/pulling blah blah. (I work full time in EMS) and he is only having me wait 2 weeks after last fill for exchange (which is next Wed)! Good luck with everything!
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annemaieh......oh my word back atcha!!! Oh, to only have to wait a couple of weeks for exchange, I'm jealous!
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Thanks Lilah!
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Whippetmom
If I may ask your expertise. If you have direct to implant surgery immediately following a mastectomy, does the PS preserve your own nipples, or is this not possible? Trying to decide whether to do RT, or have a unilateral mastectomy w/reconstruction. Thanks.
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Waiting - the preservation of your nipple usually has to do with where your cancer is located in your breast. I don't believe it matters if you have TE's or direct to implant.
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JamieB86
Where in the breast would the nipple preservation not be possible? When women get elective breast implants, aren't the nipples always preserved? Thanks.
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Waiting - my cancer was located directly behind the nipple, so it had to go. If someone's cancer is located farther away, the nipple can be spared. Breast augmentation is altogether different. The implant is put behind the existing breast tissue. In a MX, the breast tissue is removed.
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Waiting... - Direct to implant vs. tissue expanders/implants vs. flap surgery, etc. are all reconstruction options to be discussed with your plastic surgeon. Nipple-sparing mastectomy is in the realm of your breast surgeon. Yes, nipple sparing surgery can be performed with direct-to-implant reconstruction.
Not all breast surgeons perform nipple-sparing mastectomy so you need to find out if yours does them. As mentioned above, if your cancer is close to the nipple (different surgeons have different comfort zones regarding the exact distance) it is usually suggested to remove the nipple. If you are deemed a good candidate (location of tumor, breast size, etc) your breast surgeon will separate the tissue just behind the nipple to send for separate preliminary examination by the pathologist during surgery. If there are cancer cells in that tissue the nipple will be removed. If it looks clear the nipple can be spared. However, if the more thorough pathology exam finds cancer cells the nipple would be removed after the fact.
There is a thread on BCO called Nipple Sparing Mastectomy with Immediate Reconstruction. There you will find posts from women who are having direct-to-implant reconstruction as well as 2-stage implant reconstruction, and perhaps flap surgeries as well.
If you are interested in NSM please be sure to ask. Don't assume that the nipples are saved. Some women still are only finding out about this option after their mastectomy surgery
I was able to have nipple-sparing surgery, but I lost part of one nipple and some adjacent tissue due to necrosis. Because the breast tissue is removed, the nerves and blood supply to the nipple are disrupted so they are somewhat in shock for a while. That's why each patient needs to be evaluated by the surgeon to determine if she is a good candidate.
Best wishes!
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jamieb86- I lost my nips because I had DCIS as well as IDC. My DCIS was very close to the nip, and since I was doing a BMX both nips were removed. Now my biggest debate now is nip recon or no nips. But I'm leaning more towards Whippetmoms advice and go without and do tattoos.Good luck with your surgery.
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Chrisrenee - Thanks for you good wishes, but I'm done!!! Yay! I'm a uni so I did have the skin graft and the tat to try and make the girls as symmetrical as possible. They're not perfect, I wish my recon nip was a little bigger, but all in all I'm happy. It can be a tough decision. I'm not sure I would have had the skin graft if I had a BMX. I hope you are happy with whatever you decide.
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Had my final appointment with my PS yesterday. Kind of bittersweet.... he's really at the end of his expertise with me. Now it's up to my new Myofascial Massage and LE Therapist to work out the "Iron Bra" issues.
He did ask if I were still interested in getting 3D nipple/areola tattoos from Vinnie, and I said yes. He cautioned me to wait for about a year after exchange (mine was in August 2012) just in case there was any need for surgical intervention that might come up. (Wouldn't want to mess up any great artwork!)
And he made me PROMISE to come in and show him the tatts after I got them....he's been so interested ever since I sent him the link to Vinnie's photo gallery!!!
He could not believe that some of those ladies had not had nipple recon!!!0 -
I know my time with my PS is quickly coming to an end - I will be so sad to say goodbye. Hard not to get attached after playing such a big role in the last year of my life.
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What a wealth of info is here - it's overwhelming for me! Have been reading along for a couple months, time jump in. Couldn't find answers to my situation, hoping I can get help. Initial DX (on left side) in '96 at age 41 (I actually found something wrong over a year before but my doctor said it was because I was still breast-feeding my daughter so no mammogram at that time). When DX was finally made, entire tumor 7+ cm. Back then, GS did mx: took quite a bit of tissue. At that time (and after) didn't want any more surgery with a young one so prosthesis worked for me.
2nd primary DX back in August during routine mammogram. MX on right side with TE's on Halloween; tumor so small so less tissue taken. PS put in Allergan 133MX-15-T (700 cc). Initial fills not equal but now up to 570 cc both sides - not even close to symmetrical and still feel like with all that amount I'm still almost flat-chested on left side, right is looking good. I am 5'5", 160 lbs, have 35" rib cage, short waisted, 38D (not big projection, but very wide). Don't want to be as wide if possible but would like to be somewhat symmetrical. These TE's are constantly bugging me and I want to move on with the process but I also want it to look nice and more natural. My PS believes in slightly-overfilling so I should be getting close to last expansion. Does it mean that 700 cc is max or can more be added? I thinking of gummy bears for exchange but my PS doesn't want to start talking about it yet. I also have a big roll of extra tissue under my right arm pit - she's talking a 3rd surgery (ugh). Any suggestions?0 -
Chrisrenee: You look great! Glad to help!
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Thank you Tina and Jamie for answering Waitingforthenextstep. I would add that "direct to implant" recon is tricky and I think that there are far too few good candidates for this procedure, especially if you are a unilateral. I would want to know WHO is doing that one step for you....
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2ndtimearound....I think Allergan Style 20 - 750 ccs, would be just perfect for you, with the exact same width as your TEs and nice projection. Yes, those 700 cc TEs can be overfilled. I wonder about the one TE which seems to not be increasing in volume. Is there any concern that there is a problem with that TE? What does your PS say about the discrepancy?
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Thanks for the replies. I appreciate them and thank you also for your caring. Best of luck to all those out there who are in the beginning, middle or end of this particular journey. In my small town I don't know anyone who has done this so it is comforting to know I have a place I can go to learn some answers to my questions as they arise.
We are going to Hawaii in April and starting my recon in May. I think some of you can relate when I say that I am equally excited for both events!!
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Hi whippet mom,
It's about what I started with: delayed recon side had little tissue to start (very concave), on recent mx side they removed so much less tissue. Also, initial fills in surgery different (150 vs 250cc). Am envious when I read so many completed their fills with less than I have now and have so much more to go. Last fill was 160cc on both sides - talk about feeling stuffed! Will take in smaller doses from here out. So looking forward to losing metal bra!0 -
Laura: I just went back through the posts to see if I missed any and I missed yours! Well, I feel that the surgical remedy would be fat graft transfer, but barring that, I would try homeopathic remedies like Aloe Vera gel and pure/raw apple cider vinegar. Look for Braggs ACV or any high quality ACV with the "mother", - the yeast and fermentation matter produced when the cider ferments to vinegar. Shake the bottle up before using. I would try these topical solutions and I would also think of finding a good naturopath or accupuncturist and consult with them if you do not get any relief from the topicals. It is a temporary relief we are looking for at this point....as I think that rich stem cell grafts from a fat transfer would be the best bet for permanent relief down the road. It might take more than one session though.
So sorry that you are still in such discomfort sweetie!!
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2ndtimearound - I'm always curious about new surgeries, techniques, etc. so I hope you don't mind a question. You mention that they took much less tissue with your recent MX compared to your previous MX on the other side. Are you saying that they didn't remove all the breast tissue, like a very aggressive lumpectomy? Or, that they removed all the breast tissue but left more skin than on the other side?
Best wishes!
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Hi Tina, my 1st surgery done mid-90's by GS and the tumor large so more was taken. This time, I got smarter & saw a surgeon/PS specializing in breast cancer, they left more tissue/skin (I can feel the difference of what's over the TEs). It will be interesting to see what final results are but it is already much better than the prostheses I had for years!
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My PS said I am done my fills. I had 350cc Mentor TEs (# 354-7112) He filled to 475cc. When I look at TEs I want to end up looking bigger with my implants. Do I have enough fill? I want to be at least a full D and look like that in a shirt. Looking at the way I look with the TEs I feel I am to small.
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Well good, so you don't think it is a leaking implant? Good! It just costs me too much to do the fat grafting.....GRRRRRRRRRRRRRRRRRRRRR... DEBORAH.. can you send me any NEW info on Fat Grafting WORKING? My PS is not a huge fan ( as of two years ago).. saying it does not work long term... But he is willing to do it for me... ( again, this was two years ago)........ if research is better... He should know, but if you have any amo I could take to him....LOL...
Anyway... I might just have to deal with it... until I get some type of HMO here.... but my Insurance broker said no one will even " touch" me yet.... as I am not 5 years cancer free.
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Whippetmom - I'm looking for advice on the type of breast implants to get (I asked before - a long time ago - but may have missed the response, and things have changed since then)
I have Mentor TEs, style LPP-FH12. (have had the right in for a while, the left one just went 3 weeks ago). Both are now filled to 300cc. My PS said we need to get to about 450cc for a C-cup.
I am 5"4, 145 lbs. My ribcage measurement is 31"".
I'm hoping for a C-cup size and projection is important - don't want to wind up with hamburger looking foobs
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omg!! Road, are you getting ready?? Awsome!!! yay!!
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Annemarieh - yes almost there! I'm guessing 3 more fills at the most cant wait!!
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Whippetmom,
Thanks for being the go to gal for sizing. You have given so much advise and so much of your time.
I have been following this forum since my BMX October 17th but this is my first post. Now ready for my exchange in 10 days. Met with my PS last week. I am looking to be close to my original size of 36 B. I am 5 10 146pounds with chest size of 35 inches. He filled my TE's to 450 ml. they were very stiff and uncomfortable but he just took out 75 ml and they feel better but still too big for a size B bra.
He wants to order 330's and 397's (for the 13 cm diameter he says he needs).Allergen gel. Is it crazy to want the smaller ones? will it look rediculous as I am a tall girl with a wide chest?
thanks so much and thanks to the rest of you gals for sharing.
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Still reading through all previous post, but wanted to give my stats in case anyone had input. 5'2" 125pds 29"-30" ribcage (inhale vs exhale not sure which to use) skin nipple sparing bmx Nov. 2012 My information on expanders is minimal. 1ppl2370cc no brand I got the information from the nurse. Thank you if you can sort through that. They are filled to 350 with one more 50 cc fill scheduled. They seem very far apart, 4 of my fingers. He says he can place the implants closer. I was A before bmx and wanted to look like a C. He said he can put in implants larger than the expanders. Thank you to everyone for helping, it seems overwhelming.
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