BREAST IMPLANT SIZING 101
Comments
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MAPBB: I just have to state that the one "caveat" which is the consensus of many plastic surgeons who perform a one step with Alloderm, is that the patient's breasts not be droopy or "ptotic". If your PS performs the one-step on a regular basis, I presume he knows what to do in your case. Did you "vet" him? Do you know his level of experience with this procedure? He may find that he will need to use tissue expanders in order to create a better result or you. Please let us know how you are doing when you are able to do so on Friday or over the weekend.
Deborah0 -
Whippetmom, thanks for your reply...he plans to use Allergan gummie, 410's, I believe. We meet when I am done fills to talk about this. Will my choice be more limited if I don't fill to 850cc? I live in Canada so I believe all sizes are available. Thanks so much!
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I just joined the forum today. I need some advice deciding on the size of my implants. I had a bilateral mastectomy in May. I am scheduled to have an implant exchange at the end of August. I currently have 250cc's on both breasts, woke up from surgery with this volume. Even though the TEs can be inflated up to 500cc each, I did not want to expand any further. I still feel comfortable at this volume, but the TE's settled down some after surgery, and I started having some deformities at the top. Still I like the size, and do not want to become any larger or heavier.
My plastic surgeon on the other hand recommends using a larger volume on sillicone implants than TEs. He plans to use the Naternelle 410 series. He says we need a height of at least 12.5cm, and recommends MM style. Those implants would have a volume of 400'ccs each, 150cc's more than what I have now. I am afraid they would end up being too large.
I am also concerned about the damage to the natural capsule around the TE. A friend explained to me that the body forms a natural capsule around the TE, and if I go with a larger implant than the TE, I risk damaging the capsule, which can lead to complications.
Is the Naternelle 410 series a good choice? It seems they are preferred because of their safety, and because they provide a more natural drop. But are they heavier than other implants? I understand the textured implants are better because of the friction, but would a smooth implant have a more natural feel?
Thank you very much for your help in advance.
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Have a question for those of you who had your exchange to implants a while ago: does the feeling of having something foreign sitting on your chest ever go away and if so, about how long? I'd post this question on Exchange City, but I really would like to hear from ladies whose exchange wasn't fairly recent. Thanks to all!
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Oxford Rose,
I have a lot of the same questions as you. My doc wants to use the same implants your doc is recommending. I have expanded to 310 so far, and I am planning to expand to 450cc and he is planning to use a 425 cc implant which he said should make me a nice B cup again. I hate the feel of the expanders, they are tight and uncomfortable and can't wait to get them out. I noticed something else the last few days, they are warm all the time. The are not infected and I have no pain. They just seem to heat up.
I am surprised your doc is putting in an implant that is larger than your expander.
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2nd time - My exchange was 3 years ago. They do feel less foreign with time. The only time mine feel weird is I don't wear a bra. So I don't do it very often.
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2nd Time:
I am 6 months out and most of the time I don't feel any different. Exceptions: When I bump something and can't feel them. When I bike ride and they are colder to the touch afterward. When I buy bras...this size is hard NOT to notice! When I have pain where they are sutured to the chest wall. When I open or close the back hatch of my car and the pec muscles squeeze them.
Otherwise I feel quite normal. ;-)0 -
Dulcigirl--I'm 5 months out and could add alot of examples to your list. Good to know that it improves with time!
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I know most of you have had exchanges and comment about the foobs feeling colder. I have expanders right now, and they feel warmer than my body temp. They are not red, and not infected, just warmer, and they get warmer as I exercise. Did anything notice that?
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goldie - I think the cold factor has a lot to do with whether the implants are saline or silicone. The saline is going to be the same temp as your body. My implants are silicone and they are cool. I'm used to it now but it was an adjustment.
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dawn,
so you definately noticed a difference in the temperature of your expanders vs your implants? I really don't like how warm my expanders feel.
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goldie - I don't remember my TE's feeling cold. All I remember is them feeling absolutely miserable!
It is the difference between saline and silicone. Saline is going to warm to the temp or your body. 0 -
Dawn, sometimes miserable isn't a strong enough word for it. I just want it over so badly.
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Whippetmom= Do you know if the allergan 410fx are approved in the US? or can you give a runddown of which allergan silicone are?
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Katey - Madry can do all of them. Talked to him about it today. Since he was one of the original PS in the study he has access to the ones the aren't fully approved yet.
Jenn0 -
After I got out of the shower today I noticed that my right foob was really red and very warm to the touch. It doesn't hurt or bother me. Has anyone else had this happen or know what it might be? I have my pre op appt. Tuesday and I sure don't want my exchange surgery to have to be postponed.
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chinneymae~ I hate to tell you this, but you need to call your dr. now, and if they aren't available, you need to go to the ER. This could be cellulitis and is very dangerous. Please don't wait, and good luck!
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Chinneymae, yes, it happened to me twice. My PS was very concerned about it and had me come in right away. It cleared up both times with a course of antibiotics. Tamiami is right - cellulitis is dangerous and should be seen right away. Mine wasn't cellulitis but a low level infection of some sort.
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MAPB -- since you're going back for a lift anyway, having the TE at first surgery will allow the PS to stretch your pec muscle, then the final implant can be placed when you go back for the lift (i.e. lift and exchange at same time). I did it that way. But I had a lift and a UMX (lift on native side, TE to exchange on UMX side). I'm not sure what is being lifted if you are having a BMX?
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Chinnemae, I experienced the same thing last weekend. Right (cancer/radiation) breast/implant very red and even blistering. I do have cellulitis and after a couple of days of oral antibiotics, had an IV today. I'll go back tomorrow for another IV and have a pic line installed. Cellulitis can develop into MRSA and other really nasty things. Right now, we are all trying to pump me full of antibiotics, hoping it will work and I can save my implant. If not, I'll lose the implant and the only option after that is a back flap since I already tried TRAM flaps ant they died -- a slow painful death. 8 surgeries so far!
Get to your doctor ASAP!
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Thank you all so much. I emailed a pic to my PA and she showed it to the PS and they called me and said they were going to call in an antibiotic for me. If it gets any worse then I am to go to the ER. I have never heard of Cellulitis before and I looked it up. You are so right, it ain't nothing to play with. Thanks again guys.
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Chinneymae, I'm glad you're in contact with your doctor! Isn't technology wonderful? A few years back, no one would've had the ability to send photos to their docs and get reassurance and/or a quickly scheduled office visit. I sound like my mother... "back in my day..." but sometimes its soooo true! Keep us posted!
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Good news chinneymae! Here's a suggestion though, take a black sharpie and outline the redness...if it goes past the line instead of receeding, then you need to go in. It's sometimes difficult to tell if it's covering more of the breast or not, but with the marker you will know for sure! This is what they do in the hospital.
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My mastectomy is scheduled for a few weeks from now. I have to decide on reconstruction with TE followed by implant or going flat. My concern is the cutting of the pectoral muscle to accommodate the expander. Will reconstruction reduce my upper body strength permanently? I am active and do a lot of upper body work: working on the land, hauling wood, walking big dogs, yoga, etc.
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Rhea3rdDiag: The all clear for upper body work depends on your PS so check with him/her for their recommendations. After BMX/TE placement healing was complete my PS gave me a complete all clear for upper body work. My upper body work doesn't come from home or office but at the gym. I was back to pushups, planks, bear crawls, crab walks, curls, clean & presses, chest presses, you name it. I'm not a body builder or anything like that, we just do all sorts of different stuff in the group class I take. I think they get a lot of it from the P90X and Insanity type routines you see on TV. I ask him occasionally 'Are you sure upper body workouts aren't a problem?' and he always responds that it's perfectly ok.
I just had my exchange last week so am back in recovery mode for several weeks before I get the all clear again. It looks like you've had multiple surgeries already so I don't know how that will affect your individual situation. Make sure you dicuss your concerns about upper body strength very frankly with your PS. I think in most cases having TEs and then implants doesn't need to compromise your strength in the long run.
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Rhea3rdDiag - My experience has not been that of sweetandspecial. Know that we are all different. What happens to one isn't going to happen to another.
Personally, I've had a lot of trouble with pain and I am absolutely not back where I was before. I cannot do planks, push-ups or even down dog in yoga. I was a gym rat and a weight lifter (body sculpt) before BC. I cannot do nearly what I was doing before. Again, we're all different and you have to make the choice that is best for you.
Here's a link to a thread started by an athlete to tell her tale. Again, not all or maybe even most ladies experience this but know that some do.
http://community.breastcancer.org/forum/44/topic/801359?page=6#idx_171
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Rhea3rdDiag - There is also a forum for ladies who chose not to have reconstruction. You'll find pro's and con's there of going flat.
http://community.breastcancer.org/forum/82
I was 39 when I had to make that decision. And at first I decided I was not going to do reconstructive surgery. My BS actually called me on my cell phone in the evening to discuss that decision. She told me that most women regret it, that I was young, that it could cause depression if I didn't ... on and on ... I had my BMX scheduled w/out reconstruction but after that conversation I changed my mind and opted for TE's. Shoulda woulda coulda ... I try not to go there but sometimes I wonder if I could do what I was doing before had I not opted to go the TE & implant route.
May you have wisdom as you make your decision.
Know that yes, you could lose some strength, you might not be able to do what you're doing now but on the other side, you might be able to do everything you're doing now. We're all different. We all respond differently to surgery. Just know that not everyone can get back to 100% of what they were doing before.
Wisdom to you, sister.
Edited to add: I see that you already posted that thread. Sorry to direct you to a thread on which you already posted.
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Am I the only one that didn't know that PS cut the pectoral muscle to insert the TE's??? I have never heard this before...did I just zone out?
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No, you're not alone. Not all the details of the surgery are discussed. If I would have known prior to the surgery, maybe there wouldn't have been a surgery. Besides, do I need to know how a watch works in order to use one?
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Another example of all PSs being different I guess! Mine was very clear about the procedure, gave me literature, drew a diagram, and explained that the muscle would move and contract differently with implant reconstruction. I was undecided between implants and DIEP so I had a million questions. I was involved in a clinical trial so perhaps that was part of the reason I got the extended explanation.
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