BREAST IMPLANT SIZING 101
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Sweetie: Keep me apprised of how fills and the shape of your TEs are progressing, okay? Send me photos anytime you like if you have questions.
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Kate: Some implants do not change much in size at all after the exchange. Some change quite a bit. You can post photos and I can take a look...
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Deborah~ i was watching a video on youtube yesterday,where a woman had a cap.con-but only very slightly- and she was having thr existing implant and capsule removed. It was pretty gross,but i watched it out of interest.
So judging by what i just read in your above post,when we eventually need our implants exchanging for new ones,do they KEEP the original capsule and just pop the new implant back in it?
Also something else that has been 'bothering' me......when you have nipple recon,what happens when,again,the implants need replacing? If the nips are where the scar is,and they open up the same scar,wont the nips get cut? I wouldn't want (or afford )to lose that amount of skin. Wouldn't be so bad if the nips were below the scar somewhat.
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Kay -- good question re: what happens to nips when you replace your implants... I've been wondering the same thing!
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Deborah- I get my drains out on Thursday so I will try to get some new photos posted after that. Thanks!
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Kate - can't wait to see pictures post exchange - I'm sure they look great!!
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Deborah--I should clarify--I had a great result on my augmentation as it goes, it's just that in hindsight, I liked my natural little small-B boobs better. To answer your question, I got 250 cc Mentor round smooth implants, which made me a D cup. Since I had second thoughts about size, this seemed like my 'opportunity' to 'fix' things.
As a pair I would never have considered lifting them. It's just that I can't imagine my remaining breast matching up to an implant without a lift.
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Kay: In answer to your question:
What Are The Surgical Options For Treating Capsular Contracture?
1. Open Capsulotomy
This is an open surgical procedure involving gaining access into the implant pocket and cutting or "scoring" the scar tissue in multiple areas to release its contracting forces. This is the least successful of the surgical approaches.[In the above procedure, the same capsule is retained and the implant placed back into the pocket or replaced with a new implant. I think this is a rather archaic method of addressing CC.]
2. Capsulectomy
This is the total or subtotal removal of the capsule. Capsulectomy was long felt to be the most successful treatment of capsular contracture. Unfortunately, even patients undergoing capsulectomies still have a very significant rate of recurrence. Recurrence of capsular contracture after capsulectomy leads many surgeons to advise no further surgery and/or removal of the breast implants.[The above is the current, recommended method of addressing CC, but taking this one step further, many plastic surgeons recommend also replacing the implant with another style and size of implant entirely - to do something "different" than was done originally.]
There are a few plastic surgeons who perform a third method of addressing CC - which follows:
3. The "Capsule Switch Procedure"
There is nothing particularly magical about this procedure. It is based on some factors well known to cosmetic surgeons. For a capsule to contract, resulting in a hard and/or distorted breast, the scar must be continuously circumferential around the implant. If only half of the implant is surrounded by scar, a contracture generally does not occur.We have all known, for example that breaking up the capsule by squeezing it very hard (closed capsulotomy) results in a softer breast - until the scar recurs and resumes its contracting forces. Next, e-PTFE (Expanded Polytetrafluroethylene) is an FDA approved material known to inhibit the formation of a contracting scar.
The "Capsule Switch Procedure" consists of a subtotal or total capsulectomy utilizing meticulous control of bleeding, with the placement of a very thin (0.35mm) implant of e-PTFE, which replaces strategic areas of the former scar and prevents circumferential scar formation and a resulting capsular contracture. E-PTFE is used in many fields of surgery for multiple surgical applications and has an outstanding safety profile. The 0.35mm thickness allows for inhibition of contracting scar formation while being essentially non-palpable."
The "implant" described above is called a "Pocket Protector"....
http://www.ascbs.org/pocket_protector.htm
Aren't you glad you asked?
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Wow, Deborah, everything I ever wanted to know about implants! As always, you provide a wealth of helpful information! Thank you!
Lilah, maybe they go under the implant when they change them out? I would almost prefer they do this then reopen my existing scar for the exchange. It looks almost healed now and then it's going to feel like I'm starting all over!
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Oh...forgot about part deux of Kay and Lilah's question:
A revision on a previously reconstructed breast with nipple in place: I believe there would be two preferred methods - both utilizing the previous MX scar/incision and then curving up or under the constructed nipple and then that nipple becomes part of either the lower or upper flap. The second, and probably what mine would do [especially if I required a dfferent size or style of implant which would malposition the existing nipple], is excise and discard the nipple, insert the implant and close. The nipple would need to be recreated once again. I cannot imagine that many plastic surgeons would use an inframammary approach - would create a new incision - but it is something to ask your own PS.
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Wow, I never thought that you would have to get another nipple done. Lots of maintenance, these new breasts!
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Deborah -- I'll bet cutting around the nipple and along the old MX scar line is the way they do it more often than not (similar to a lift -- where cutting around the areola and reattaching does not leave much in the way of scars long term). I will look forward to that day many years hence
MBJ -- when they do the exchange they don't reopen the entire MX scar... only just enough to put the implant in. So much of what is healed will stay healed. The rest will heal again!
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Hi Deborah,
Thanks for your response to my last message. I had my pre-op with the PS and he said he would use Siltex Low Height Style 7100 TEs that hold 350cc. How much of a variation in ccs is there between TEs & implants is there usually, or at all? I asked what type of implants he would use and he said he didn't know yet, that is is a work in progress. He insists that the pectoralneurectomy wo't affect my upper body strength, and gave me the number of a patient of his who is an aerialist who had a single MX w/ Immed. recon using implants. I spoke to her at length today and she had a good experience, yet said something about how he told her he didn't do a procedure on her that he usually does on most people. So I'll call his office tomorrow to get clear on this. Very frustrating as I just want to let it go as I have two weeks to prepare for surgery, not hash out how many nerves I'll feel okay about letting him cut. The result is a smooth non-ripply, non- spasming chest, but I work out with weights 3x a week and don't want to not be able to do a push up anymore! Any ideas? Comments?
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Man Deb.. I mean.. Deborah...
I love reading here just due to the fact... you are LOADED in info!
TY for that Deborah!!!
xxxooo
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Man Deb.. I mean.. Deborah...
I love reading here just due to the fact... you are LOADED in info!
TY for that Deborah!!!
xxxooo
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Hello ladies,
I also love reading here just because you have so much information. I stumbled across these discussion boards only a few days ago, but now I find myself reading them daily.
Also I found a quote thatt I hope you will like:
"When the Japanese mend broken objects, they aggrandize the damage by filling the cracks with gold. They believe that when something's suffered damage and has a history, it becomes more beautiful". Barbara Bloom
Good luck to all of you.
Donna
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Hi pretty Kate, whom I am SO GLAD is feeling well again!
It all depends on your skin, your muscles, etc. Everyone is different as to how their body takes to the surgery or if there needed to be more pocket work done, etc.
There's no way to tell this early on. Wait at least 6 months before you buy any expensive bras, as you will be different sizes, or at least this was my experience. I'll leave this to the floor to help you further.
....ladies?....
xoxox
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Donna, I am going to print that out and paste it to my bathroom mirror so I can see it every single day.
Thank you, it's beautiful!!! I feel the same way about laugh lines.
xoxo
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Here's one that I've wondered about also....when we "swap" out our exchanges in 10 years or so, what happens to the nipples?
How do they do this?
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I'm glad I popped in here today, cause I think I can answer some questions. I had original mx and implant in 90 (one side only) with nipple done in 91, exchanged the original implant in 2000, and again this past year after cc (and new dx in other breast) . Original (fake) 19 year old nipple is still in the correct spot!! With third implant! And my new 3 week old nipple on the recently dx'd side matches!!
The incision doesn't have to be opened up the full length as the mx one to exchange the implant. No new incisions are necessary. This past time I had cc, the ps had to remove much scar tissue and started over again on old dx side (along with new side) with te's. And the nip is still in the right spot!! And each implant has been totally different than the previous, double chamber, shaped and textured and round! You'll all be okay!!
Kate, so glad you seem to be feeling better.
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Katey - thanks for that info!
Kate -- if you have gummy implants (sorry I don't recall what you had) I would say it's safe to buy bras now as I don't think there is much drop and fluff for gummies. If you did not, then buy one or two comfy/stretchy type bras now (you NEED to wear a bra) and wait til the final drop and fluff to go wild
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Katey: Thank you for sharing your own experience with this very subject!
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Donna- Love the quote as well. Thanks so much for sharing with us! I like Annie's idea of pasting it to the bathroom mirror.
Anniealso and Lilah- Sad that the consensus is hold off on the expensive bras for now, but glad you probably saved me all that money! LOL!
Katey- Yes, am feeling much better. I think it helped that my recovery has gone so well and was able to get off the pain meds within a few days. Thanks!
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Kate -- oh I meant to add: see what your PS wants you to do as well... some require wireless... others (like mine) forbid wireless! My PS wanted me in a "soft supportive" bra for the first several weeks... and approved a sports bra for me.
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Lilah: I PM'd you....
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Dear Deborah--I found the card for the implant I have--it is Mentor smooth round mod (moderate?) 350-7250BC. As far as I know it was 250cc, although I realize you can't tell that from the ID card. What are you thinking about changing it--it sounds like you think it's not a matter of the volume, but maybe something else.
I've been disappointed with how my clothes fit--I still have things in my closet from pre-aug. I think it makes me look fat and matronly--not the look I was going for! (Although I feel about a million years old right now.)
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Katey - thank you for chiming in. It's nice to hear from someone who's made it farther down the line, though I'm sorry you're back again. Sometimes I feel like I get so wrapped up in the now I forget there's a future.
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Orchid: The 350 cc low height TE style sounds good to me. A very popular style of TE. You are pioneering territory heretofore not discussed on these boards, with the pectoral neurectomy technique your PS will be using. You are going to be our resident expert on this, when the time comes....
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Joan: A moderate profile implant is a pretty low profile implant. I know, for augmentation, the moderate plus and high profile are the most commonly used styles, and uniquely, they work best for reconstruction as well - as far as the smooth silicone rounds go, that is. I just think that 250 ccs does not seem like a lot of volume for an augmentation and it could very well be the profile or "style" of implant which is giving you the unwanted appearance. I sort of liken a moderate profile implant as being like a frisbee in shape. And you used our dreaded word here on the recon forums - "matronly"! Horrors!! But I must say, when I see a moderate profile implant, the word "matronly" does come to mind....
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Deborah -- just got your PM! Sorry I took a break from the keyboard today -- figures.
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