BREAST IMPLANT SIZING 101
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Thanks so much! It's kinda weird......I haven't been the least bit tired since I got home. Spent at least an hour on the computer and have been watching TV/reading since then (which would normally put me right to sleep even on a normal day!). I'm not doing anything physical other than typing, sitting down, getting up, peeing, etc.
DH went to work shortly after we got home this afternoon.....he just now walked through the door and is going to grill some burgers now that I suddenly realize I'm abso-f'ing-lutely starving!!!
xoxoxoxoxo
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Lisa Jayne, even though you feel great, please take it easy and don't over-do! You just had major surgery, might still be under the effects of pain meds. For today, try taking some pain meds so you're not hurting badly. And, you're amazing!
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2nd_time: I'm definitely not over-doing it. "Just because you can doesn't mean you should!", right? Still not tired and still don't need pain meds but will take ibuprofen before lights out just to be on the safe side. The drain tube sites are the biggest PITA/annoyance so far.
Nighty night all!
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Finished talking to PS earlier today. My ribcage is 30. I'm 5'8" and 140. I had a mastectomy earlier in the month and we decided against immediate reconstruction because it was mastectomy #2 on the right hand side. 1st reconstruction (DIEP) had difficulty in that the DCIS was so close to the skin that the surgeon just could not get it all despite re-excision and two lumpectomies, so off came the reconstruction. This time, thank God, the margins are clear 3mm all round. 1st mastectomy had a SLNB, and theey took a total of 5 lymph nodes after I finished reading the pathology report. They couldn't do that again 2nd time around, but the pathology report shows they took another two.
Not much muscle or tissue coverage close to the sternum. I'm looking at a lat flap reconstruction with placement of a 450cc Mentor CPX3 tissue expander (I'm not sure on the height, but he said it's 12cm wide). Current breast width on the good side is 12.5-13cm. The plan is for it to be replaced with a similar width round/smooth Mentor memory gel implant. Size will be determined by what I feel comfortable with, so not entirely sure on what profile it will be. He says the tissue expander is good to 100cc over the stated volume, but I may only need 400cc (or less).
Currently I want to get back to at least my pre-diagnosis size, which was 32C, so that may mean a small augmentation on the DIEP flap side (200?), which the PS is looking into to see if insurance will cover (United HMO, Texas). He wasn't sure,so I'll be curious to find out. He did say that fat grafting was an option on the other side, but I'm worried about necrosis showing up as calcifications, and I do NOT want to have to go through the nightmares associated with mulltiple biopsies and lumpectomies again.Originally he thought I might just need two fills, but that was if I was just going to match the other side. Time will tell. I'll keep posting.
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Has anyone on here used dr Bryan Armijo in dallas? I met with him for a consultation about bimx with tissue expanders ... The cancer nurse I've been assigned and my breast surgeon have nothing but great things to say about his reconstructive work...
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Momof2girls: That particular tissue expander sounds ideal for your frame. The volume of the future implant is going to depend on the volume and projection of your other breast...and symmetry is really more important than volume in that regard. Keep us posted!
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Whippetmom, thought of you earlier today. At my darling PS, Dr Z, she's so excited I'm healing well after mud flap revision, she takes such pride in her work! Saw the Mentor implant samples: 375 cc in M+, HP, and UH profiles. Holy cow! What a difference between the styles, all the same cc's.
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hollyboo: I am honestly pretty shocked at your plastic surgeon's edicts regarding breast reconstruction. I actually looked at some of your other recent posts and read some of the comments he made to you, and I am wondering what kind of neanderthal that man might be. I want you to get a second opinion. There have been a lot of "bodacious" gals who wear 40 or 42 band bras who have come through these bc.org portals and they have had breast reconstruction - and they have been very large busted, like you. Let me help you sort through this...I am so frosted about your PS....grrrrr....
Please PM me and tell me where you live. I DO believe that a number of bodacious gals should consider becoming "less" bodacious, if only for reducing, if not eradicating, so many risks inherent with weight and advancing age. From a cosmetic standpoint, the benefit of weight loss is that the implants look better as the bra band size goes down, which means that the ribcage is getting smaller. If the ribcage is decreasing in size, so is belly girth, and these two factors permit the implants to have more projection and prominence on the chest wall. But I digress. Please PM me so that we can work on this for you. I believe that you can indeed have results you will be happy with someday. So let's work on it together!
ADDENDUM: Oh.....and I am 63 years old, and I would be very offended if some PS brushed me off about having reconstruction because of my age!!
Deborah0 -
Maddy....Really? So glad the mud flap revision was successful!
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Peachygirl: I do not believe that Dr. Armijo is board certified. I would not consider going to a plastic surgoen for breast reconstruction if he is not board certified. I am happy to help you if you PM me privately.
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Whippetmom, hoping you can help me make a decision. I am 5'4 150 lbs with a 32 ribcage. I have Allergen expanders 133fv-13 500 cc. But am filled to 550cc. I feel like I'm a little large right now esp by armpit area because of the overfill. PS said its the expanders sitting high and implant wont be as wide. He's suggesting a 550cc silicon implant vs a 500cc and says implant won't be as wide as expanders. Don't know anything bout the style other than it will likely be Natrelle since i got the book . I use to be very large and dont want to be that large again but would like to be proportioned well. I just don't want that fat that hangs out of my sleeveless/tank tops right now at 550cc but it didnt when I was only filled to 500cc. What are your recommendations?
By the way, I am in so cal kaiser and attended one of those image reborn classes. Great program! Are you part of that?0 -
Vik11: I PM'd you with some of my insurance info.
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Deborah~ Had my exchange 5/7/13 and my body is not handling the implants well...they have both slid out from under the muscle and are hanging very low. I had alloderm slings at BMX and pocket work with more alloderm at exchange, and a lift to remove most of the extra skin. Today I saw PS because one of the implants looked odd. Turns out that it flipped! The back of the implant if facing forward. PS says she has never seen this happen...have you heard of it? She has told me since my first post-op appt. that she is not happy with the implants for me, and is planning to remove them. I am considering an transferring tissue from by butt or thighs, as I'm not a candidate for DIEP. My only other option is going flat, and I don;t think I'm ready for that. Just curious if you have hear of this happening!
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@Tamiami - from what I have read, flipping of smooth round implants is fairly common and not generally cause for significant concern, though I'm sure it cannot be a pleasant experience. I'm suprised your PS has not seen this happen. It is more common with implants that have higher profiles and are more spherical in shape, and can also be an issue with teardrop implants. It sounds like the pocket may be a little large, but given time and support things should settle down. There is more information here. http://community.breastcancer.org/forum/44/topic/780800
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Peachygirl, I live in the Dallas area too, and I haven't come across his name in my search for a surgeon. Have you had your mx yet, or are you doing it all at one time?
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Mely: Are your TEs a little widely spaced? Because implants with a volume of 13.0 cm should be just fine for your frame. I recommend Allergan Natrelle Style 20, 500 ccs or 550 ccs - just as your PS suggested. Also, your TEs are full height and so there is a lot of exaggerated fullness in the upper pole which you will not have with the implants. It all sounds good to me.
No....the Image Reborn program must have started after my recon....I am almost five years out now. What Kaiser do you go to? I go to Alton Sand Canyon in Irvine....0 -
Tamiami: You did have pretty ample skin flaps....so this might have some bearing. I have not had anyone with smooth round silicone implants come to me with that problem previously. You are the first. I have seen quite a few rotated anatomical implants, but not "flipped" silicone rounds. So with your autologous flap options....are you sure you don't want to go to NOLA?
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Thanks for the info Momof2girls~ I will read this ASAP. I have Mentor smooth round moderate plus implants, and with flipping the backside is flat and has a round disc, so my breast is very misshaped. There is no safety concern at this point, but the possibility of a leak where the twist is and the damage it may cause to my already thin skin is very relevant.
Deborah~ My PS trained with Dr. Allen 8 years ago, and would like me to travel with her to NYC to have my surgery. She likes to work with another PS when using a flap from the thighs, and needs a second PS when doing a flap from the butt. My CT scan shows viable tissue in either place, and she is sending films to Dr. Allen for review so we can be sure to get adequate tissue for my size. NOLA is a great choice for flap surgery, and it seems like NYC is as well. If you have any inside info, please let me know either here or by PM. BTW, I think you are absolutely right about my skin flaps and pocket being too large...I'm sad because I really wanted implants.
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Thank you whippetmom,
I trust my ps and have good relationship with him but I think I needed that reassurance of how my new boobs will look like for my own peace of mind.
I'm in the Fontana kaiser. The image reborn was the "show and tell" of breast reconstructions. Got a chance to see TRAM and implanted breasts in person. I got a much better sense of how it will look like after and it helped with my decision of which type of recon to do.0 -
Mely....I used to live in Redlands and so I went to Kaiser Fontana. I was planning to have a prophylactic BMX there 25 years ago..but changed my mind. I felt I could wait and "hold off" a little while longer. Also, a doctor told my sister [who told her doctor about this] that we were "so young" and "a cure was right around the corner."
Deborah0 -
Tamiami: Would you be willing to consult with another plastic surgeon in Michigan before you undergo this next procedure?
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That's probably a good idea Deborah. Do you have a list of Michigan names...good and bad? I have insurance that is pretty limited in PS choices, and don't want to end up with a questionable PS. I did have 2 other recommendations, but they don't participate with my insurance. Thanks for your continued help!
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Help! Hi everyone, thanks for any help you can give me. I'm scheduled for BMX on Friday morning due to a seriously bad family history and testing positive for the gene. No cancer and healthy as a horse, so it has been an excruciating decision but it's made. When I went to see the PS the first time, I had not yet made my decision and he listened and said that he would suggest a one step NS surgery with reconstruction and then another surgery 7 weeks later for the lift that I wanted. Then, after I made my decision and went back to see the nurse for surgery "training", she said that I would be getting the TEs and I could choose my implant at the end. I am scheduled to see the PS again on Wednesday so I still have time to delay the surgery or get all of my questions answered. Here's my question: is there a reason to do the TEs if I have adequate size and skin to get the size I want in the end? A one step procedure for the implant sounds so much easier than the the TEs. And then I can go back later for the lift. Any experience anyone?
I'm 56, 5'4", 164 pds and wear a 38C and they are droopy now but not too bad. Thanks
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MAPBB - TE are more to stretch your pec muscles than your skin. Implants after a BMX are placed under the pec muscle, and they need time to stretch and relax before a full size implant is put into place.
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Congrats sweetand special glad to hear that your feeling good hope you are having a great weekend and got some rest
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thank you BayouBabe. I clearly do not know enough and may reschedule my surgery to give me enough time to get up to speed.
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Hi,
My TE (Allergan MX -16) has a fill capacity of 850cc. Up until the fill before the one I had on Thursday I have had no issues or pain except for my back. As my PS was going on vacation I moved my fills up to one week apart. I had a fill on Aug 1st of 120cc with no issues but then my fill one week later on Aug 8th of 60cc has made me really feel sore and stretched. I am booked to have my last fill this Thursday but am not sure if I should hold off until PS returns in mid-September. I am at 770cc, so only 80cc to go to max.I am wondering two things... will waiting another month for fill be best and if I don't do the last fill and stop at 770cc, will it really affect my implant sizing choices?
Thanks.
Karen0 -
Mapbb I had a bmx back in November and now getting implants on the 16Th of this month . My PS is doing a one step we did talk about the Te's he said he thought i would not need them but he would have them thre in case so talk to him again and take a friend if you want i know i had a lot of questions and so did my daughter and he was good at answering them What part of Illinois do you live in?
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Thx Deborah, I have my own issues of who is "too young" as I'm sure many of the other young people here but that's topic for another thread. Overall, I've been very happy with the care from Fontana. Too bad riverside doesn't have plastic surgery. That's where I had my mastectomy.
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stepmic: Depends on which implants your PS intends to use. If they are smooth silicone rounds, you can stop now, as the largest implants are 800 ccs and you have sufficient expansion for that volume currently.
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