BREAST IMPLANT SIZING 101
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I agree, its horrible, but we have to wait a good few months to see how they are going to look in the long run. Im two months out and can see a difference. I have touch up surgery in another 2 months, and will see how they look by then. Any ps worth their salt will know what else they can do later to make adjustments so you are happier. They should care enough also about their work to want to make adjustments to make them nicer for you.
I was filled in te to different sizes and have different size implants, as there was more room left on one side than other after bmx and tissue removal. I think its common.
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Whippettmom,
At the time of my BMx I had 500cc placed in left side- cancer side. Ps could only do 300cc on right side because when she put more in the skin was not looking healthy enough to take that much. The plan is to only do 50cc on right side to catch up to the left. At that point we will decide if we should go higher than 600 cc. Right now my left is 600 and the right is 450.
If we expand too much, does this create more pocket work etc? I am debating stopping at 600 but worry that when the implants are placed and settle I will have small breasts. Should I be concerned? I'm not sure how to post pictures on the forum. Right now all my pictures are on a cell phone....
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I am new to this board and am just starting the reconstruction process and am learning so much looking through all your posts! I was diagnosed last February during pregnancy so they wanted to limit my time in surgery. As a result I did not have reconstruction or expanders placed at the time of my mastectomy. I did receive radiation but my plastic surgeon said my skin feels soft and looks in good shape so he is willing to try expander reconstruction as I would like to avoid lat flap if possible. Any thoughts on the success rate of this actually working without needing a flap? My plastic surgeon is recommending the gummy bear style implant so I need to start looking through these boards for more information on that topic. I am 5'5'' and 124 lbs, rib cage is 31 inches. Would like to be in the C range. Any additional advice would be appreciated!
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Well, I have my exchange surgery in about 12 hours. I am filled to 550. PS says he'll need to put at least 600cc in....maybe 650 or so, to get the same look I have now. Whippetmom suggested at least 650, so we're close. To be honest, I feel pretty huge right now, or at least I look that way in clothes. I have gained almost 20 pounds in the last 5 months (no exercise and too many casseroles), so I'm not sure I am judging these TE's correctly. Their size could be drowned out by the 'size' of the rest of me! In which case, I'll have 'stripper boobs' when I get my weight back down!!
I am nervous.....I hate surgery. And, of course, like everyone...nervous about the results. Right now, I am more nervous about recovery, as I feel like I have NO IDEA what to expect! Everyone seems to have a different experience. My husband doesn't know if he should schedule himself to go to work or not, how much help (if any) I'll need, etc. I also have lymphedema in my arm that has chosen the last week to really get unpleasant. Not a good way to go into surgery. Hoping that doesn't get worse.
Infection is my fear, too......UGH! SO many fears! Did anybody here do Hibiclens showers before surgery? I was not give any instruction to do it, but I plan to :-) I do want to say THANK YOU to all of you. Although I feel completely clueless, I know SO much more than most people do going into this, thanks to all of the wonderful women here sharing their stories. THANK YOU!!!!
Time to get my big girl panties on and get on with my life!!!!! Off to surgery!
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Mnmbeck,
Good luck tomorrow!!!! Post back when u can to fill ( nonpun intended) us in on the process. I have possibly 3-5 more fills to go and then the wait for exchange. How long after your last fill did u wait until the exchange? I have heard anywhere between 5-12 weeks....
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whippetmom, I met with the PS today, he said he typically uses allergan TE. He uses allergan, mentor and seintra implants. I am still not sure if I want silicone or gummies. Any advice would be welcomed.
He also said he was part of a study for the air expanders but was not sure if it would be ready by the time of my surgery. What do you know about these?
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mnmbeck - Love and hugs. My LE has been acting up too. I'm thinking it is the change in the seasons … thankful that it is finally getting warmer … but the season change always means trouble for my LE.
Again, love and hugs to you. Prayers that your LE behaves, that you will have no infection and that you come out of this surgery ultimately satisfied. xoxoxo
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I think it is about 5 weeks since my last fill. My PS requires 4 weeks, but I thought I would be SO smart and wait until after I had a period....I didn't want to deal with that AND surgery. I actually rescheduled last week's original date. Well.....I was wrong, and the two should coincide nicely. Go figure!
Thank you all for the kind words....I'll post as soon as can!!!
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mnmbeck - "I'll have 'stripper boobs' when I get my weight back down!!"
It's almost time! Wishing you the very BEST of outcomes tomorrow and an easy and complication free recovery! We'll all be waiting to hear how it went, but I already know you're going to be FABULOUS! (Or is that FABOOLOUS?) Either way, you go girl! 0 -
Mommyathome: Overfilling really has no bearing on anything but ensuring that you have good implant skin coverage and some ptosis - or droop. I cannot fathom why you need to fill beyond 600 ccs.
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mnmbeck: I am praying for you tonight! Please let us know how you are doing as soon as you are able to do so.
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Asb: Yes, I do know about the AeroForm tissue expanders. There is a thread I posted about them a year or so ago. Some women who have had them posted on that thread as well.
Here..
And here is some additional information from the company website:
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grahaad1: I think I would recommend Sientra for you. Not necessarily Sientra TEs (I think Allergan or Mentor TEs are perfectly fine), but Sientra implants, because they are true cohesive gel "gummy bear" implants and might have some protective benefit post-radiation. Additionally, unlike the Allergan anatomicals, you do not have the risk of rotation and why add yet another risk to the mix which might mean another surgery, after you have had radiation. So Sientra, with a volume ranging from 425 ccs to 500 ccs, depending on the style, would be something to consider. I think that the Sientra smooth silicone rounds would be a good choice, as would a number of the shaped styles in the Sientra line up. The Sientra catalogue is here:
Deborah
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Good luck mnmbeck! Thoughts are with you. I am also also paranoid about infections and feet about surgery and GA. Never heard about Hibiens showers - what are they.
I am only going to be less than 4 weeks from expansion now my exchange is scheduled for 9th May. Still haven't finished fills with only 290ml and another (?last) expansion scheduled for 9th April. No idea what size I am even having!!!
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Whippettmom,
Thanks for your response. One more question, my ps said when I have exchange they will try out an implant 50cc more and 50 cc less and the same cc as te. If I stop at 600cc for my fills, will a 650 implant be enough w my body type? I just don't want to go through this whole process and not have breast or projection that resembles close to my original size of 38c/d
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Smaccyl: That is very interesting. I wish I could pick his brain about the shaped implants and his negative findings with them. I personally like the Sientra rounds also - they are designed to provide upper pole fulness.
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Mommyathome: Here is what I said to you when I first answered your question about sizing....I have not changed my opinion....
"Mommyathome: I think you could use Allergan Style 20 - 700 ccs, minimally, and so whatever the PS needs to do to get you there. Honestly though, your short height TEs were designed to allow you to exchange out to a considerably larger implant, because of the exaggerated projection. So I would think it is up to your PS to determine if you need expanding beyond 550 ccs in order to exchange out to that size implant. I think that anywhere from 700 ccs to 800 ccs will be the implant volume to discuss with your PS. How he gets you there, is up to him. "
I guess another question is, what do you think of the size now? Is it sufficient to give you the volume you hope to achieve? The short height TEs are difficult to assess, because they have a shelf-like appearance, since they do not expand the upper pole of the breast (which is a good thing IMHO). So in general though, how do you feel about the size?
Edited again to state: If 650 ccs is the largest implant your PS will use, then it should BE a 650 cc implant and nothing smaller.
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mnmbeck - I didn't need a Hibiclens shower prior to Exchange, but I did have these huge honkin' sterile wipes that I had to rub all over my body the night before,then change into a clean nightgown and fresh sheets. Then the next morning, had to use another set of wipes to go over my whole body again, and put on clean clothes before heading to the hospital. Of course, when I arrived there, I was supposed to use a dirty pen to fill out forms, sit in a greasy chair, and have people assist me who I was certain had not sanitized their hands properly. I was a nut case. I made it clear that I had done MY part to stay sterile, and I expected all of them to do the same! I'm sure they were glad to see me go....
Hopefully by now you are done with your Exchange and are home and resting comfortably! Sending you gentle hugs....
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Hi Blessings...I had the same instructions, but they also said not to bathe or shower the next morning. The instructions didn't say anything about using the wipes in the morning, only the night before surgery. Does that really mean I can't clean my personal area? I did get permission to brush my teeth and to wear no makeup. I am not going to the hospital looking like a bald eagle without any eyebrows drawn on and my wig. I do plan on wearing my wig during surgery, however. I work in a hospital and will probably be seeing lots of coworkers who know my face and I don't want to be seen looking "sick". Sorry if I am sounding vain.
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Whippettmom,
I am fairly comfortable w the size of the te now, at 600. I was just concerned that the implant will look smaller because it is squishy and different from the te. I know that my ps is planning to catch me up on the right side (I'm 600 on left, 450 on right) and I will ask her if we can keep fills at 600 and do a 700 or so implant. I will see what she thinks about the allergan style 20 700....
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Just a few thoughts about implant sizing and the limits to what whippetmom can do... and why occasionally we end up with something different after Exchange than what we were expecting.
Unless she can examine us in person, and take specific notes of any structural or skeletal anomalies, the best she can do is go by the measurements (and sometimes pics) that we send her. She will make her best (and usually incredibly perfect) recommendations based on that.
But in the OR, it is general practice that the PS bring in a selection of implant sizes to see what looks the most natural once the implant is inside the breast pocket.
There may have been excessive tissue removed during BMX; there may be skin thinning in certain areas, or thickening from rads; or muscles that just plain weren't where they were supposed to be. (Not unusual...)
Ribs are rarely symmetrical. Chest cavities can vary greatly. Our internal structures play a great part in how an implant can look on the outside. And unfortunately, a lot of this cannot be seen outside the OR.
So usually what happens is that when we are in the OR, ready for Exchange, the PS will reopen the incision wherever he or she usually does, and deflate and remove the saline-filled TE. The pocket (created by the original surgery - shaping of the pectoral muscles, and occasionally Alloderm) will be rinsed and any scar tissue removed, and the PS then inserts several sizes of implants to see what will look best.
You are raised up to a sitting position to see what the implant will look like (instead of lying flat on your back) and once each side's size has been determined - they can be different - your permanent implant will be placed, and the incision closed.
Yes - some surgeons have definite ideas about what you should look like, and what you get isn't necessarily what the two of you discussed prior to your procedure. But usually, what gets placed is very close to (if not exactly the same as) what whippetmom has recommended for you.
Breast implants are a combination of art and science. If our bodies were perfect to start with, the sizing issue would be MUCH easier!
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Blessings 2011,
How do they drain the te???
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Nice summary Blessings. I agree a lot of this is art coupled with science (as well as the experience and skill of the surgeon). In my case, my PS has a couple of nurses in the room who also weigh in on which implant they believe looks best, so it's somewhat of a group consensus.
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Hi all! well, I made it! I had my exchange surgery at 7:30 this morning, and I was HOME by 11:30! I can't believe how fast they can do this stuff!
Pain.....yes. Deep aching across my chest....especially in the center, just like after my BMX. I was sure last time that I was having a heart attack. But, this is exactly the same feeling, only less severe. I don't know if it is because of the pulling they do, just a normal place to feel discomfort, or my extreme reflux (probably the culprit). I also feel very raw where they did liposuction. I am actually NOT looking forward to having this huge wrap/dressing taken off tomorrow. I am trying to imagine what it will look like....even just scars/bruising. I can't tell anything about size or symmetry with this on. Tomorrow morning, I will have it taken off and replaced with an underwire bra. I don't know what size implant he put in, yet. I had TE's filled to 550 and he was planning on Mentor high profile rounds. I don't know if that is what he ended up doing or not. I will find out tomorrow and let you know. He did say that he would definitely be putting in something bigger than 550.
I have been sleeping most of the day. I am taking 1 oxycodone every 4 hours, and took some Tylenol with it as well. When I get comfy in my recliner, I am fine. Moving hurts, of course. I am also on antibiotics.
So...that's the update from here!
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Rest my dear and I'm so happy for you. Hoping all goes well
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Mnmbeck,
Glad to hear the surgery went well. Wow, 4 hours for surgery, recovery room etc? That's great!!! Is the bandage like an ace bandage that goes around you?
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Yes....it seems like they padded me pretty well with gauze, and then wrapped ace bandage around several times. ...the dressing looks like it's about 10" from top to bottom....kind of like a tank top :-)
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mnmbeck - Welcome to the squishie side of life!
So glad you're home and doing well. You'll feel better tomorrow and better still the day after that. I came home from exchange with a sheet of gauze taped to my chest and an Ace bandage around that. I was in pain, but realized the next day that the majority of the pain was from the tape that was holding the gauze in place. Man, they had that stuff on tight! 
As soon as I managed to 'loosen' the tape, I was so much more comfortable. Hoping your recovery gets easier with each passing day! 0 -
I was told by my ps that when I have my exchange( not until probably July) that the use the same incision they did for the BMx. My incision is vertical and they said they only re-open it about 2/3 of the way. Can they really get the te out w that small of an incision? Also, how do they sit u up when u r put to sleep to try out the different size implants?? How do u not fall over, how does your head keep from flopping etc?
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Mommyathome - they drain the TEs the same way they fill them - through the port. A needle with syringe is inserted and saline is removed until the TE is deflated. Disclaimer: For me, this was essential, as I had saline implants. My TEs were deflated, and removed through a small incision through my original BMX incision. My permanent saline implants were also deflated at the time of insertion, and filled with saline once in place. This allowed me to have a much smaller incision than if I had silicone implants.
As far as raising you up to check placement, etc, most operating tables are quite sophisticated in that different parts can be moved into any position. Patients are generally secured well (often strapped across the forehead with the head in a nice cushion) and the back of the table gradually raises you up to a sitting position.
mnmbeck - Congratulations on crossing over to the Squishy Side!!! Now rest and relax....
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