BREAST IMPLANT SIZING 101
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Hi girls,
just saw my general surgeon for my 3 month check, I have a suspicious lump in my cancer breast ;( I was going to be starting all over with new expanders, he said ask the PS if he would remove lump during procedure to biopsy. Has anyone ever heard of such a thing. Any advice.
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mnmbeck, I just plan to enjoy short walks until I reevaluate at 3 months post revision.
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Hi whippetmom,
I would like to get your input. Thank you so much for sharing your knowledge!
I am 5'4", 132 lbs, ribcage 31". TE 350-mL medium height Mentor contour profile CPX3, catalog number 354-7212.
BMX 2/27/14. 175cc during surgery, 3 fills since & I'm now at 325cc. AlloDerm was used. I have a copy of the operative report if any other info would be useful.
The nurse has been doing the fills; haven't seen the PS since the first one. I am to let her know when I'm at the size I like & will then meet with the PS. I think I'm about there but from reading all these post it seems like 325cc is very low. Also, I have had radiation on both breast so I'm thinking smaller is better on that account. My skin held up great with the radiation- you can't really even tell by looking at it. Here's what the operative report says about my skin: Right side: (radiation 20 years ago) "The skin flaps looked to be in very good condition." Left side: (radiation 3 years ago) "Over here, the skin flaps were thinner and more soft tissue was removed. The skin flaps appeared to be viable and there was minimal if any dermal exposure".
I really want smallish decent, respectable (what a crazy description!) size breast. I hate bras & would love to go without. My original breasts after lumpectomies on each side were maybe a B on one side; C on the other. I'm 62 (a young 62, haha) & pretty active.
My PS has a lot of experience with flaps but I'm sure hoping I don't have to go there. I don't have enough fat for diep.
Alice
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Friendship, yes I agree. I had a harder time snapping back after the exchange than with the BMX or my second surgery. I expected to feel instant relief but didn't altogether. I still got waves of "iron bra" for a couple of months.
Salina, my PS always uses a new implant. It may just be one of those things that different PS do differently.
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friendships...I honestly do not think that the "bear hug" is going to be a problem. Many of us were doing implant displacement exercises a month after the exchange. Google this term, to see videos of how this is done, if you are interested. I think Linda54 had a thread about this a year or so ago. This is only applicable if you have smooth silicone rounds! Not for textured rounds or shaped or anatomical implants.
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WOT: You have a plethora of options, which will absolutely confuse you, no doubt, but here are some possibilities:
For a high profile smooth round silicone implant:
Mentor HP - 400 ccs or 425 ccs
For a moderate plus profile smooth round silicone implant:
Mentor MPP - 350 ccs to 400 ccs
For a Sientra implant:
Smooth Round HP - 405 ccs or 435 ccs
You probably could use one of the shaped implants in the Sientra line up - from 370 ccs to the mid 400 ccs,
With your prior rads history, even though your skin integrity is good, this puts you at higher risk for developing capsular contracture. It is felt that the "gummy bear" true cohesive gel implants might lower the risk (jury is still out on whether this truly is the case), and so that would mean Sientra.
So I have a question for you: What do you think of the size you are currently? Too large? Too small? Just right?
Deborah
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Thank you, Whippetmom! I am breathing such a deep sigh of relief! You have shepherded me thru this whole process! I can not thank you enough.
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Sometimes I'm really glad my PS only used Allergan saline implants. It sure narrowed down my choices to just what size to pick.
I think having to sift through all the choices for silicone would have driven me crazy.
No, wait, I would have had WONDERWHIPPETMOM to guide me!!!
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mnmbeck - I can't remember now how long it was that my P.S. didn't want me doing any cardio exercise … 3 weeks? six weeks? I was so sick of not doing anything … I jumped ahead and did it anyway and I totally paid for it in pain. IT HURT! That implant and everything is healing internally … and so whatever the protocol your P.S. wants you to follow … do it.
I have LE too and figuring out what I could do and couldn't was hard for me … but you WILL get back into the gym and into shape. Maybe not doing what you were doing before but you can get back. Early on, what worked best for me (after six weeks) was the incumbent or recumbent bike … the one where you sit down. I would raise my arms up in the air and do fist pumps while I rode the bike. I also did some intervals on the bike (increase in speed or incline for 20, 30, 45 seconds at a time, then drop back down and repeat) and that not only helped with getting my heart rate up to help the LE but it is great for your metabolism as well. Lunges, squats are great. Took me a while to figure out what I could do with my arms … bicep curls, overhead tricep kick backs with very light weight (2 lbs). Walking always causes me to flare because of holding my arms down … but walking with my arms at 90 degrees is good and the elliptical is OK for me … but I know it causes some LE issues for some … but I can do it fine. Hold off the core for a while … while your internal healing takes place from the exchange … For me … sit-ups and core hurt for a while (I started too early). I can't do planks anymore but I've found core work using a ball to be very helpful. Don't use bands … not good for us LE ladies because we don't have any control over how much weight we're using.
I gained 20 lbs too over the course of BMX and reconstruction but I'm back down now to my pre BC weight. Be kind and gracious to yourself while you're healing … you'll get back where you were … it may take some time and some creativity on your part (I've found working out with a trainer to be invaluable…helped me think out of the box for doing core work and getting back into shape with LE) … but you'll get there. Love and hugs to you.
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Sandra 4611 great results... how did they repair the pocket? You barely look like you have any scars on u.... where did you get this done? it looks great
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Deborah, I think 325 looks good. Maybe they could be slightly larger but I wouldn't be disappointed if they weren't. I need to try them out on different clothes but need to wait until I'm not so sore. They look so much better then my originals because they set higher & I'm slightly shortwaisted. It's hard to be objective about myself. Also, I'm reading all these post where women are getting like 600-700ccs and questioning my judgement. My husband has the same opinion - they could be slightly larger but they look fine. Of course, the TE look all kinds of lopsided & crazy with indentations at the top. My PS intends to fill these with fat. She asked me to gain 5 lbs. which I have. I now have a roll around my waist. Never mind the unsightly stuff that's happening in my armpits. I digress.
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Stix, I have a magic plastic surgeon. He is the primary PS for the burn clinic at the military hospital on Ft.Sam Houston in San Antonio. He performs miraculous repairs to our young soldiers who come back with such horrible injuries. Although that is 99% of his time, he does some breast cancer reconstruction patients too. My husband has been a volunteer in the burn clinic for 6 years and knows my PS so well since he works for him. I don't get any preferential treatment...he's magic for all his patients.
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thank you, az85048!
I have been disheartened how many PS do not take insurance. I've called several VERY well known in my city only to be told no ins taken. I feel like crying to them this is not an eye lift or a face lift! I was left deformed by my recon! But onward I walk, making calls and talking to others who have been in my shoes.
Smaccyl, what is your update?
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Hi
I am new to the group and just found this site. I need to call my PS tomorrow and get the details on my TE as I never thought to ask that. I was a full D cup before my double in Feb and told my PS I wanted to be close to that with my implants. The PA at my PS just said I could be done or do one more fill but my TE are only at 280 cc. I am 5' 6" and 190lbs. I need to measure my ribcage but I wear a 38 in bra size. My PS did say he would only take me up to about 80% of what I wanted to be. I am wearing a non structured (no underwire) C cup bras with my TE and they are filled up but I just don't think I look like a C cup right now. Maybe a B cup. I never knew this would be so hard to figure out. I guess I should also say that I had incisions that were typical for a lift rather than horizontal. Meaning mine were nipples vertical down and then horizontal under breast. So right now all you can see is the vertical scar. This is stressful.
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savedbygod, I am so sorry to hear this...please keep us posted.
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WOT....Make sure your PS addresses the mudflaps, if that is what you are referring to near the armpits.
So...if you are happy with the size, I think that you want to be around 425 ccs or 450 ccs with implants. It takes about 75 ccs to 100 ccs in additional implant volume, to approximate what you have with the TEs. What might be the strong contender, is the Sientra HP smooth round at 435 ccs. I feel that you need to try to get close to 450 ccs with a HP style implant.
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KGSN: Well, 280 ccs fill sounds quite small for your frame. So please find out as much as possible about your TEs. Essentially, I need to know the WIDTH....but whatever info you can gather, please let me know.
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SavedbyGod: I am sorry to hear about this finding. I gather your BS means that you still go through with the reconstruction as planned? It seems odd that he would leave it up to the PS to biopsy this at the time of the reconstruction. Why isn't he doing this BEFORE that surgical procedure?
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BCnotforme - Perhaps Whippetmom has an opinion about this, but wouldn't the fact that a PS doesn't take insurance indicate that he/she specializes in more elective types of cosmetic surgery rather than breast reconstruction? Seems that a surgeon who does breast reconstruction, especially someone willing to do a revision on a "failed" reconstruction, would accept insurance. Personally, I would be reluctant for someone who mainly does elective surgeries to handle a revision, but that's just my opinion. Has Whippetmom given you any references for your area? I know the thought of traveling for surgery is difficult, but it might be worthwhile if you can make it work.
Best wishes!
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Thank you Whippetmom. My PA and his PA are of course out of the office today. A nurse was able to tell me I had DermalMatrix. The only info about my TE she could share was height of 13 and Med. My Dr does not overfill he under fills to 80%. Does this help at all?
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KGSN: Medium height...and is 13 cm the height or the width? The height does not help me. I cannot believe that she was only able to extract this little bit from the record. Is the TE Mentor or Allergan? If you can get the brand...and ascertain that 13 cm is actually the width, I can figure it out from there.
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Whippetmom. He also used Allogen implants and was thinking teardrop textured. I am not sure after reading if I will be happy with that or should do a smooth mid profile round. The way they feel is important. I also am 39 years old.
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13 cm was height. She did not know the brand. She said Monday everyone would be back and they would know. I know he uses Allergen for implants so I am guessing that would be the TE as well. Just a guess though. I think I may have to wait till Mon. Honestly at 280 I am filling out a C cup no structure bra.
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Tina, I gave BCnotforme two referrals, but I did not know that she has been experiencing insurance issues.
BCnotforme....Please PM me with the names of plastic surgeons ON your provider list and I can help you find someone.
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whippetmom, do you know if size has any bearing on the risk of developing capsular contracture?
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WOT:
Plastic surgeons answer this question
When some of there docs mention "large implants and malposition, this can be true, which is why we recommend supportive bras. It is a no brainier.
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RE: Malposition....
When I first got my 700cc saline New Girls, I was obsessed with making them stay put. I had endured a ton of pocket work (suggested by whippetmom!) to make sure they didn't "migrate laterally" (or slop under my armpits when I lie flat on my back) so after that, I made sure I wore tight, good fitting underwire bras during the day, and tight sports bras at night. At Exchange, my PS said "They aren't going anywhere!"
But now I no longer wear bras 24/7. I don't sleep in a bra. If I am not feeling well during the day, and am staying indoors, in my jammies, and in and out of bed, then I'm not wearing a bra. But if I'm up and about, or doing any walking, then yes I am wearing one. However, I'm often back to wearing the Genie bras I grew so fond of during fills.
I'm almost two years post exchange (!!!!) and I DO notice I have more ptosis, or droop, and there is more lateral movement.
But I also know that my skin is VERY lax, especially after losing weight. Even before weight loss, it would be tight and shiny for less than 24 hours after a fill, then soft and pliable the day after. It was nice to have the breasts of an 18 year old immediately after Exchange, but now I realize that the slight ptosis I have is more fitting for a 63 year old. And the lateral movement? I think it's due to skin laxity more than loosening pockets. I just notice a slightly larger gap between implants than a sagging into my armpits.
I haven't seen my PS for a while, so I'm hoping this isn't what those docs were referring to as "malposition".....
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Malpositioning can mean a number of things, namely though, implants displacing laterally, and also, bottoming out of the implant. (Newbies can google "bottoming out of implant") which is essentially, the implant dropping below the inframammary fold. That latter complication has as much to do with dissection of the pocket as it does gravity and weight of the implant.
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thank you, TinaT! I agree with you - the one I really wanted, pat maxwell, is THE boob guy, but no ins. He does lots of cosmetic ps but is still renound as the go-to for revision. Whippetmom is helping me find one, I am so incredibly thankful for this group.
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whippetmom, thank you! Been meaning to email you and give you updated pics, as the malformed side seems to have gotten worse. I appreciate your input so much...emailing now.
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