BREAST IMPLANT SIZING 101
Comments
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bluewillowskys - I had a lot of pain immediately after my BMX, and I'm pretty sure it was from the TEs. I took pain meds for about a month and thought seriously about having the TEs removed, they hurt so much.
But once I started healing from the BMX, the pain started to diminish, and by four weeks post-op, I was able to get my first fills. Occasionally I would feel a pinch as the needle went into the port, but other than that I had no pain at all with fills or TEs - and I had them in for almost 9 months!
They were just plain stupidly uncomfortable - think turtle shells, coconut bra, rocks on your chest, boulders, baseballs, you get the picture. And the shapes!!! Sometimes (on other people) they look like perky boobs, mine looked like weird diagonal loaves of french bread. Or balloon animals, depending on where I was in the fills process.
But not to worry - TEs are temporary, and usually the pain comes from the PS or the patient wanting to fill too much, too fast. This can cause muscle spasms. In that case, the PS can remove saline. But the best motto is "Low and Slow"... smaller amounts of saline per fill, and spaced farther apart in time.
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bluewillowskys - My PS filled my TEs with 350cc on the day they were placed so I spent a few weeks feeling pretty tight. I never had any pain. Once that initial tightness subsided I really did well with the expansion process. I was dealing with necrosis so my PS took it pretty slow and once even pulled some fluid out (not because of pain, but to help with healing). Remember that there are plenty of women who have pretty uneventful reconstructions and don't feel the need to post on discussion boards. It's possible that it will be uncomfortable, but it's not a given. I wish you smooth sailing!
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bluewillow - I experienced initial pain and misery for about a month after BMX/TE placement. At four weeks out my BS realized the pain I was experiencing was nerve pain and switched my pain med. After that I had no more pain at all and just a little tightness with my fills. With me the TEs got more comfortable the fuller they got. My initial surgery was 11-5-12 and I finished expanding to 750cc in early April with exchange to implants on 8-7-13. I'm one of those who got back on the fitness horse a couple of months post BMX and the TEs did not slow me down or make it impossible to do anything at all that I wanted to do. Well, except sleep on my side or tummy. You'll probably find that to be nearly impossible for some time. Good luck and keep us posted on your journey
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thank you ladies for being frank and sharing your experience....this is such a hard decison to make and I need to know the good and the bad sides of doing implant vs a DIEP....im not sure i asked this but are you able to keep your nipple area with implants? that is something important to me and one of my considerations for which procedure to have.
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bluewillow,
Keeping your nipples/areola depends on the skill of your surgeon (make sure he/she has had lots of experience with nipple sparing) and where your cancer is located. There may be other factors too. But there are women here who have had NSM with implant reconstruction. I did not. My cancer was located slightly outside of the range that is considered "safe" but I chose not to keep them in an effort to eliminate as much breast tissue as possible. I hope some day they really perfect the art of sparing them and keeping sensation for as many women as possible.
I had my TEs for 4 months. I was tight/sore for 1-3 days after each fill. I had 150 cc's filled the day of my bmx and 50 cc's every other week til done. Daytime was fine with minimal discomfort. Nights stunk. I spent most of those 4 months sleeping in our recliner mostly upright. I'm not sure what made the difference. During the day I could forget they were there (unless I ran into something).
But my reconstruction looks better than I expected. The TE discomfort was gone about 2 weeks after my exchange. I am back to sleeping in the fetal position....heavenly!!! Each night when I curl up and get comfy I catch myself smiling. I don't think I'll ever take it for granted again! And despite the pain, etc. I would do it over if I had to. My surgeon told me at our first meeting that implants would be my only option, so I'm thankful it worked!
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thank you ladies...you are all so welcoming and helpful....so far the TEs dont sound much like something i would want to willingly do....i have sleep apnea , wear a CPAP and having to sleep on my back would not be good I dont think. Im a right side sleeper and thats my lumpectomy side. I have made BS and PS appts to discuss all my options next week. I feel so much more informed and wont feel so stupid when i go see them and need to ask questions...
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I am 35 lbs overweight and had the one step - BMX with immediate placement of permanent implants. My breasts were very large - FF? FFF? - and did nothing but droop.
The skin had stretched so much over the years it must have been thin but the PS said I should have no problems since I had not had rads. (He says 50% of all implants after rads fail because the skin is so fragile.) So not every PS out there is following the advice given by the website AZ quoted. (Nothing new there, hehe, they all seem to march to their own drummers and we ALL get conflicting advice about even the tiniest of things.) I had 800 cc implants put in with no complaints by the muscles or skin. Two weeks later when I had one implant removed because of an infection caught in the hospital (
) I had a TE put in. I had muscle spasms for two days on that side! So for me, the TE was much, much harder for my body to deal with than an implant, even right after the BMX. During the next three months I got to see first hand the difference since I had a very nice happy original implant on one side and a growing TE on the other.I had no pain during fills and got up to 680 cc easily. The next 60 cc's were too much, however, and I had a lot of pain for a couple of days, so much that I refused the final 60 cc's to get to 800. I stopped at 740 cc and at the exchange, had 740 cc anatomicals put in. No problem with muscle spasms at all, just from the revised pocketwork. The original implant put in at the time of the BMX was still doing great. Never had one minute of problem, but it was changed to a different kind of implant, much taller to cover some divots on my chest.
If you can find a PS like mine who is experienced in one-step, BMX to permanent implants, go for it. "One and Done" beats months of TE hell that most people complain about. Most people who go for this kind of reconstruction don't have complications.
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On the other hand, bluewillows, not everyone has unmanageable TE pain. The ones that don't just aren't here looking for help dealing with it. I had my TEs for 9 months before exchange. The first month was hard but after that I really had no complaints aside from the inconvenience of having upside down cereal bowls on my chest. I never really even considered the DIEP or TRAM or any flap surgery that would compromise my ab or back muscles because I'm very active. When I asked my PS how they would affect my strength he said if that was a concern for me then that type of surgery was not for me so phhhht! off the plate those options went. Gather all the information you can, document the pros and cons you're reading about here and make sure you know all the flap type options available to you. It sounds like you're doing your best already to be prepared for your next appointment. Keep us posted.
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BlueWillow - I too like Sweet & Special, was unwilling to compromise back muscles or shoulder muscles, etc. As for nipples - my BS said she would try to save them but it was unlikely due to the location of the tumor. Nipple sensation was extremely important to me, but I settled for clear margins w/no cancerous cells instead. Sigh. Maybe some day I'll get the 3-D tattoos from Vinnie.
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Littlecalic,
Take into consideration that the health care industry is changing. If something may develop in the non reconstructed side lets say 10 or 20 years (atypical) from now it is a possibility that insurance my possibly not pay for this unless you have the brca gene. I am not saying this will happened but insurance will change in the future.
Also, think and answer the question: Would I ever want to go through this again?
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littlecalic, Can you do nipple sparing? If not I would not have a regular PS office do this. I would go to Arlene or Vinnie..
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The 410 gummy anatomical that I have is not squishy. It's softer than a TE but not as soft as a smooth round which, in my limited "squeezing" experience (in situ, as it were, thanks to some very nice ladies who allowed me to compare with mine), feels a LOT more like a natural breast than the gummy. My two cents.
The gummy is firm and somewhat squeezable. The firmness of the gummy is what makes for less rippling (in most cases) as well as much greater projection (which as a uni was a concern for me). I have always and will continue to say that, especially for unis, the choice between smooth rounds and gummies is a hobson's choice (neither is better, they are just different, so no real choice at all).
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Hi Sweetstand/ Dulcigirl/ Aviva I just can remember who gave the suggestion for the wacoal bra? I just wanted to say thanks. I received one yesterday and i ordered a 38c since i used to be a 38dd and i am now way small, anyway it feels very good it covers my entire breast and even has a little room not a lot so its ok i am happy you gave this info. I will wear it this week and if it works i ll try to get more. Thanks again
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I agree with Stix, regarding coverage issues for a prophy down the road.....
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Enerva! So glad it worked for you! I love mine. Be sure that the wire fits just right around your implant and doesn't pinch it at all. You may have to adjust your band/cup size til it's just right.
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Thanks Dulci i order the one with no wire its good
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Hello there I'm a newbie on this site and went directly to this thread due to my current situation. I am 5 weeks out from my DMX (dec 2, 2013). I was a 32 DD previously and would like to be at least a D. I'm 5'5" 128 pounds thin boned but after having 3 kids my hips have a little meat on them. My ribcage measures 29 inches. My expanders are Sientra- rf-20789-470acx -volume max is 470cc. Currently I am 527cc on my right (not cancer breast) and 514cc on my left (cancer breast with node removal).
When trying on bras I'm measuring a C cup right now. I skipped a fill last week due to a seroma and a neuroma. Went back to jogging and my seroma has gone away! Yeah me!
Thanks for your help!!!
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Love that one, Enerva!
Welcome, Shario...Whippetmom is the Implant Angel. Hope ALL of your "oma's" go away quickly! Ouch!
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Sharlo:
Welcome!
Your TEs have the following dimensions: 12.9 cm width and 7.0 cm. projection. The closest Sientra shaped implant with the highest projection is the Sientra Textured Shaped Oval Base High Projection - 480 ccs, with the dimensions: 13.5 and 5.7. I don't think any of the Sientra rounds will make you happy. I feel you would be better off with smooth round silicone implants - such as Allergan or Mentor high profile - 500 ccs, minimally. I do not see why you need to expand any further for HP implants around 500 ccs. You could use 600 ccs as well, but then you are gaining more width, which you do not necessarily need and might not like. A third option would be Allergan Style 45 with a volume of 600 ccs. The dimensions: 12.8 cm width and 6.1 cm projection. You can see this most closely approximates that which you have with the TEs. I feel personally that you will only get the volume you seek with Mentor or Allergan smooth silicone rounds.
Deborah
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Thanks for the comments Whippetmom. A couple of weeks ago, you recommended the Allergan 20 HP in 500-550 for me to get a C cup (which I know you can't really guarantee but can approximate). Now you mention the Allergan Style 45 in 650 ccs. Is the 45 style the high profile as well? With my 600 TEs at this point and not filling any longer, I guess I could still take a final implant of that's more than 600 in the Allergan 45s? It's interesting. It seems that some style of implants can be larger ccs, meaning that just because I have a TE filled to 600, I could take a 550 in one style implant and a 600 or 650 in another. Is that right? Thanks for your expertise.
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pinklotus: It is because the Style 45 has more projection than the Style 20, but it has a narrower base than the Style 20. So the Style 45, at 600 ccs, is 12.8 cm in width, and the Style 20 at 500 ccs is 13.0 cm in width. So this is a way to gain more projection and more volume, when it is needed, while still maintaining a narrow base width, when it is needed.
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Ok, here's the latest. Just had two drains pulled out (bringing me from 4 to 2) and another 80cc's put in. This puts me at 380cc's and the ps is only looking to go to 500! How do I convince him to go bigger?
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Tessa,
Looking good! How are you feeling?
Have you asked him WHY he is only planning on 500 when you obviously want to go larger? Is there a medical reason? Start by finding out WHY and then if there is no health reason you can make a game plan. Hugs to you!
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You know that's so simple but I've never thought to ask WHY? I do know his nurse said it depends on how my skin does as well as other factors I can't remember because I was in a semi-fog. Only 120 cc's more definitely will not make me happy,
I'm really sore. If I take the valium, vicodin, citalopram, and femera I'm totally knocked out. So, I wait til I can't stand it anymore before I take meds. I just don't want to sleep my life away.
I'll know in ten days whether or not I'll still need chemo.
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Wowie! That's a load of meds!! But most people on here will tell you to stay ahead of the pain. It's had to get it back under control once you let it go too long. I had to cut vicodin in half cuz it made me feel like I was going to die. I found that Prescription strength motrin did not space me out so badly. But there is a time early on when your body NEEDS to sleep a lot. Remember that! And if you overdo physically you will hurt more and it will takevlonger to heal.
Next time you see your PS do ask him why....and if it is not for health and safety just tell him exactly what you wrote. "120 ccs more definitely will not make me happy." Then go from there. It is HARD, but we have to be very strong and clear about what we want...and then listen carefully to what our doctors say about why we can or can't.
Do you have a kind but firm friend you can take along? It helps a lot to have another set of ears. It's hard as a patient to listen, process, remember,....especially while your shirt is off and there's a giant needle inflating your boob.
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Absolutely ask why. I know that there might be skin issues on one side if I wanted to go more than a B or C size.
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I have a question that will sound stupid probably....after BMX with implants do you still have yearly mammograms? If not, how do they monitor for recurrence? or it there NO chance of BC after a MX?
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Blue there ate not silly questions, I was told no Mamos but i need to monitor my on skin that been said , they may do a ct scan once a year or every two, or only if i get some symptoms that suggest something is wrong. I was told i need to check my breast skin and arm pits and if i feel anything like a lump or anything strange then call my onco. Other than that she will see me every 6 months, then once a year. That is all i know, they say if a lump is found then they may do an US.
You must ask your Doctor but thats what is happening to me.
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Enerva: thanks for answering:)
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Hi, bluewillowskys - nope, no more mammograms after a BMX. However, if you have silicone implants, some docs will recommend regular MRIs to make sure they are not leaking or damaged. (Not an issue with saline; if they leak, you know it right away.)
Sadly, having a BMX does NOT take away the chance that BC will recur either locally, or in a distant place (local recurrence, new primary, or metastasis). However, your diagnosis has a lot to do with your risk, and this is not something you need to be anxious about. You just need to be aware. My MO wants me to become very familiar with the feel of my implants, as well as my entire chest area, so I can tell if anything is different. Luckily, I am in a clinical trial, so I will see my MO every three months for the next four years, and she does a physical exam.
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