BREAST IMPLANT SIZING 101
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Hi sweetS, yes mind should be simple swap, i was going to have fat graft but i decided not to for now. I started some stretch exercises that have helped me a lot and hopping that the PS is able to repair the internal scars on the rad side but i think all my discomfort is due to my TE been over fill to 600cc so they ate like to iron rocks plus rad made thing worse very very tight on the Right side. I should be ok over all. I just love that you guys share with us as much as possible so i am prepared. Thanks a lot
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Ladies - many of you have wondered why whippetmom needs all those numbers from your TE cards. Like she just said, one of the numbers she is looking for is the WIDTH of your TE - usually the last number in the series, and it tells how wide - in centimeters - the hard plastic backing of your TE is.
During your surgery (MX or delayed recon) the PS Is creating a specifically-sized pocket for your tissue expanders. They already have the actual TE size in mind as they create the pocket. The variables can come with projection size and stretching, but there is really not much wiggle room in regards to width.
Here's an example: at the time of my BMX, I weighed quite a bit more than I do now. The PS chose Allergan 133MV-16 as the size of TE that he thought matched my body. That meant the TEs were 16 centimeters wide.
But after losing weight, it became apparent that I would not need such large implants. Complicating matters further was the fact that I was getting saline implants, and there are no saline implants that are 16 cm wide.
Think of a regular pocket in your pants. If you slide in a tennis ball, it will fit, and stay in position. But if you put in a Ping-pong ball (or a marble!) that smaller object is going to move around and migrate to places you don't want it to go.
In my case, whippetmom suggested a procedure to narrow the pockets at the time of exchange, so that the narrower implants would not end up under my armpits every time I'd lie on my side, nor would I have a cleavage the width of the Grand Canyon!
Thankfully, all her suggestions were spot on, and I have to say, the New Girls are perfectly placed, and staying where they're supposed to.
So this is why it's SO important to give whippetmom absolutely every bit of information she requests. If you didn't get the info from your PS (they often forget to give you the card) then yes - make that call and get it.
Hope this helps...0 -
Thanks Blessing i didnt get the card from my PS but i know the size of my TE is 13. I will try to get it this thursday but i already know more or less the implant size and style i need. It will just be a matter of getting my PS to agree, i have one of those PS that thinks she knows better and rush you, and does not explain much of what she is doing. I am ok cuz i have given her a bit of my mind and haven't let her intimidate me. I feel my PS is similar to Tessa 's she feels i should just be grateful to be alive and let her make the decisions since i am not a PS. I will always be grateful for finding this site and all of you,
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Is there any Topic regarding specifics about what goes on during surgery? i looked but didnt find any. Blessing i wonder if you or any body here can tell me about the exchange in terms of what the PS does, i mean do they open the existing pocket which was created by the TE place the implant inside and close it or do they remove the entire pocket and the your body creates a new membrane around the implant? i am asking because i wish to know exactly what goes on. I saw a video in you tube in which the PS removes a tissue like a sack and he said it was been removed cuz it was hard and causing the implant to retract to the upper chest quadrant. Anyway i will ask this to my PS but i know she wont give me specifics about my surgery, unfortunate this is the kind of patient i am i want to know all the details of what is been done. If any of you know and can tell me i will appreciate it. Thanks Ladies
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That was most likely a surgery due to capsular contraction.
Your basic exchange should just be opening up your exisiting scar line and trading implant for TE.0 -
Ladies,
I'm preparing for my TE switch to Allergan 410s. I'm at 830ccs with the TEs, and while I'm short, I was originally big busted, with a large 38" rib cage. I now am about 50 pounds overweight. I go in for my meeting with my PS next week and am wondering if you can help me a bit. I'm a bit nervous because I've been through two failed TUG flaps, one TE removal due to a MRSA infection, and now I'm so close to the switch I want to make sure I do everything right.- I have Allergan TEs and I wonder if I can switch to the softer Mentor gummies?
- I am having a LAT D with the gummies, and I wonder if they can get rid of my underarm bra line big ole flaps of skin?
- Anybody know how they do the more natural ptosis with the Lat D? Is it with an incision, or more of a tuck?
- Should I wait to have my surgery until I lose the weight? I hate to wait longer...
- Where does the lat d flap usually go...on the lower part of the projected breast?
- Does the nipple reconstruction usually only happen by tattoo or is there another incision for a round nipple shape?
I very much appreciate your knowledge and advice.0 -
Yes, Enerva....what Dulci said. There are actually two incisions. The first is through your existing external scar line, then the PS has to cut through the pectoral muscle again to access the TE and replace it with the implant. That's why my PS insists on 6 weeks of weight restrictions and no running....because the muscle has been cut again and needs that much time to heal properly.
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Babs: If it migrated down your arm, it was not Red Breast Syndrome. Sounds more like breast lymphadema. Did it look somewhat like this?
Have you ruled out autologous flap surgery, such as DIEP or GAP or SGAP - one of the more advanced flap procedures? Could you send me a private message and tell me who your PS is and we can discuss where to go next.
Deborah0 -
Sweets / Blessing Thank you so much this makes me feel a lot better, also thanks for the tip on the 6 weeks wait, cuz i have an appointment for PT and want to make sure i am ok for the weight resistance test. I am glad i asked you about this
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warmsmartcookie: Does your PS have access to the Mentor CPG implants? Few plastic surgeons in the US have access. Ptosis is generally created with the expansion by overfilling the TEs or by creating a skin envelope [via expansion] larger, but not wider, than the proposed implant volume. Your 830 cc overfilled TEs should create sufficient volume and ptosis. I do not know what style or recommended volume of TEs you have. You need to provide that info if you want further refinements regarding implant sizing. The flaps of skin should be able to be excised and/or liposuctioned at the time of exchange, but sometimes the PS likes to wait until two to three months after the exchange to do so. I cannot accurately define the size of implant needed when a flap is involved, because I have no idea how much volume will be created by that flap on the chest wall. I personally think that an anatomical implant is pretty risky for you though, since the pocket needs to be PRECISE for the anatomical and you might be at additional risk of rotation of the implant, which means yet another surgery to remove it and replace it with something else. If your PS has used anatomicals for many years - not just since FDA approval this year - I would feel better about using them in your case.
Blessings just posted some information about weight loss and implants above, but I will ask her to PM you to give you her thoughts on how to approach this. I advise not going too large if you are going to lose 50 pounds.
A lat flap typically looks like this..
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flat13good:
Jon Rast, MD
http://www.apskc.com/about/dr-rast.cfm
A lot of gals from bc.org have gone to him....0 -
Thanks I will contact and see Flatsy
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warmsmartcookie - just sent you a PM!0 -
MENTOR CPG IMPLANTS:
Mentor CPG implants were FDA approved in July of this year. However, only one style was submitted for approval. It is Style 321, which is a moderate height moderate projection style implant. So there are a limited number of women going through breast reconstruction who would benefit, as projection is the most difficult aspect to achieve with reconstruction and many women would find this style not to their liking. However, if your PS had Mentor CPG implants in clinical trials PRIOR to FDA approval, theywill possibly have access to other styles and profiles. Just an FYI....0 -
Thank you Blessings!0 -
To follow up with the question "how many cc's per fill"....I have seen some pretty huge numbers... 100cc or more for a fill! YIKES! I know I would not tolerate that. I have struggled with fills and had my first "two sided" fill yesterday. 30cc each side, and I am guessing he is going to stick with that amount as long as I tolerate it. I sure appreciate him not pushing it. Between his understanding and patience, and physical therapy, I might just get through this! I took muscle relaxers twice (once before just in case and once before bed) because things got soooooooooo tight. But, no pain medicine. I can't believe I am saying that considering how horrible the first 4 weeks were!
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Thanks so much for the great website and community information and support. I am undergoing the tissue expander process and trying to figure out how much expansion I need to get to a full C cup. I know that some brands of bras are different size, but would love assistance on a good estimate to get me there. I have PMT Integra tissue expanders (model # 3612-22-2). The dimension are 10X13 cm, fill capacity 500 ml and projection is 8.5 cm. I am a 5'7" and 142 pounds with a ribcage circumference under the bra line of 30 inches. I am currently at 500 ml in each breast. I'm wondering whether to stop now or perhaps go for one more fill to 600ml. I go every other week for fills at 100 ml each time. The PS said that although I have a 500 ml expander, I could do one more fill if I chose to get to 600 but doesn't recommend I go any higher based on my frame. I am tall and have a long torso, but I do want to look well-proportioned. He is overfilling me by 50-100 ml since I was a B cup prior to the bilateral mastectomy. Any recommendations as the volume implant I might need to get to a full C? Thanks.0 -
Hi, I am new to posting but have actually been following the site since initially diagnosed with DCIS left breast 6/29/12 and had 2 lumpectomies followed by RT. I have been following this thread since August 2013 when I found a lump in my right breast. I am an oncology certified nurse and take care of patients going through chemo and radiation daily. I have done this for 27years and love my job. I opted for prophylactic bilateral mastectomies and had the surgery 9/13/13. I had Natrelle style 133FX 800cc tissue expanders placed at time of mastectomies. The PS was able to place 360cc at time of surgery. I had 4 JP drains. These were the most painful part of the surgery recovery. I had 2 JP's removed 9/19 and the other 2 9/27/13. My pain went away after these were removed. My first fill was 60cc 10/7, second 60cc 10/17, third fill was 120cc on Halloween, 120cc on 11/15 and final fill was 11/22 with 60cc for a total of 780cc. I never had to take any pain medication once the drains were removed. I only had the sensation of a tight shirt during my fills. I have PM whippetmom and as you all say she was a great help. I have my preop visit Monday 12/16 to discuss implant exchange. The exchange is scheduled for 1/3/14.
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mnmbeck (and others), if I would have known then what I know now - small fills are the way to go! I did the 150/160 cc's (at a time) - yowza! Now I know why I had so much pain. It was difficult to tell at the time how much was too much, it hit me several hours later. Have learned that they can also remove a bit of saline if it's too much but never did that. Again, it's not a race, for me, the point was to minimize pain.
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Elsiecow - welcome! I lurked for a while too before I started posting. Sounds like your BMX and fill process has gone quite smoothly, that's wonderful!0 -
I had already had an implant for two weeks when it was removed and replaced with a TE. All that empty skin was ready to be expanded so that's why I could get such big fills with no pain. First week was 180 cc's, second was 240 cc's. No problem with the rest either until I got the last 60 cc's to 740 total. First pain of the entire fill experience! So not only are we all different, it depends on what they are filling. My skin was already loose.
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I had 350cc instilled in both sides at time of surgery and I was pretty tight and uncomfortable for a few weeks. It was not unbearable, however. My PS lets the patient call the shots regarding fills. He or the PA did 50cc/fill and I could schedule the appointments whenever I wanted as long as I waited at least a week between fills. They also always offered the option of pulling saline out if I was too uncomfortable. Due to complications unrelated to the TE process my fills were quite spread out. I don't know if that's why I had a pretty easy time with the TEs.
As many others have written....slow and steady wins the race!
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pinklotus: What type of implants is your PS intending to use? I think you would be a good candidate for either an Allergan Style 45 implant, 550 ccs or 600 ccs, or Allergan Style 20, 500 ccs/550 ccs with your specific TE dimensions. My question to you is, what do you think of the size you are currently?0 -
I am at the PS, waiting to see her, hoping she agrees with me on the size and style of implants, will let you guys know as soon as i am out.
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Ok i just saw her, she gave me this lame excuse telling me the softer the implant there is more chance for rippling ,but i stood firm and she ordered the style i want. Also agree not to order the 540cc, she ordered N-SSF630 and N-SSX610. i told her i know that the implant will lose projection so i want nothing smaller than 600cc. So i am happy
all thanks to all of you for advising me. 0 -
Thanks Enerva, I got my new nipple reconstruction yesterday. I love them and want them to stay this way but afraid they might shrink. Did everyone on this forum get their implants?
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You are a Godsend, whippetmom. I will get all the info from the PS and repost for your advice. You are so helpful. I also received a helpful email from Blessings. All your insight makes me feel so much better about the big surgery coming up.0 -
Layla,
Yes, I have implants. I am 6 days out from my exchange. Actually my situation is a little different. I had a BMX with direct to implants (800 cc saline rounds) 3 months ago. I got an infection and lost one of the implants two weeks later. A TE was placed. Last week's surgery was to replace the tissue expander with an anatomical shaped silicone implant. The new implant is taller so it solved the problem of a divot in my chest that was going to have to have a fat graft. Now it doesn't. The "good side" saline implant was changed out for an anatomical silicone implant to achieve symmetry and to cover another divot on that side. So far I don't see or feel any difference between the silicone and saline implants. I have Allergan 410 style FF now. Looks like about a small D cup...I don't wear a bra anymore, so I can't say for sure. I used to have huge pendulous FFF's, so anything looks small now. I LOVE this size. It's perfect.
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Layla, my exchange is January 3rd.
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My PS has told me that when I am happy with how I look, how my clothes fit, etc, I should let him know and we will be done. I was thinking about trying on my old bras. (I haven't done that, yet). I know these square TE's won't be the same, but I thought it might give me a good idea of "cup size" (more or less) compared to the way I was before, just based on how full the bra is. It's strange....it's only been about 7 weeks and I can't remember exactly what I was like before. My 12 year old says I was much bigger, squishier and snuggly when she hugged me before the surgery....so I know I'm not there, yet :-) LOL
Has anybody tried this before their exchange surgery (with their TE's) and if so, have you found it to be comparable to the way you "filled things out" after your exchange surgery? Just wondering if I should use this as a guide or not!
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