BREAST IMPLANT SIZING 101
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Hi Whippetmom - can you help me a little bit? I am feeling a little overwhelmed reading through the reconstructive stuff. First, I KNOW how fortunate I am and I feel, I don't know, PETTY I guess because when I read about everyone else my breast just doesn't seem that important! My left breast is not in good shape - I had two stereotactic procedures, a lumpectomy in December and then another in February and then 30 rads, just finished in May. I have an appointment / consult with a well known surgeon on August 5 so I have a little bit of time to continue reading. I am 5'1" and weigh 185. I have always been a B cup and now the surgical side is definitely A cup and the other is still B cup; also so much tissue was removed that if you were standing in front of me looking at my breasts, the surgical breast's nipple points downward - like if I was cold, you would see one nipple only! Hard to describe I know (I just asked for access to the private photo forum). I am 50 years old and almost certain I want some sort of reconstruction done - thinking I probably will need something done to both so they look similar? I am so lost. If you can direct me to where I should read more or if you have any recommendations for me before I go on the consult, I would be so very appreciative.
Thank you!
Donna
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Donna: Reconstruction of lumpectomy deformities is called oncoplastic reconstruction. Typically, the two most common elements utilized currently would be fat graft transfer and flap reconstruction. There are some new flap procedures being used for lumpectomy defect correction {TDAP and LICAP are two...see link below} but you need to talk with your PS in August to see what methods he employs in this regard. Perhaps fat graft transfer plus an implant would be another option. I do not know about nipple salvaging, when it has been so drastically displaced with the lumpectomies. I would want an assurance from the PS that he will revise the nipple areola complex for better placement on the future breast mound. Keep me posted on what you learn in August.
LinkDeborah
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Deborah - THANK YOU so very much
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Hi Whippetmom,
I am new to posting on this forum, but have read through so many posts and topics. Thank you so much for this forum! I had a BMX on May 20. I am BRCA1+, and spend a lot of time on the FORCE boards also. I am 51 years old, 5'11", 170 lbs with a 36" rib cage. I was a large C or small D cup prior to surgery, and my breasts were 800g (on the biopsied DCIS side), and 900g on the prophylactic side. I had a NS MX with incisions around the bottom of the nipple and out toward the side about 2". My BS did not want to go through the IMF because she was not confident she could remove everything that way given the size of my breasts.
I would like to be smaller, hopefully a B cup. I woke up with 300 cc on each side and have had one fill of 50 cc. Everything has gone pretty well so far. My TEs are Natrelle Style 133, catalog # 133MX-13. I see the PS tomorrow for another fill. Right now I look like an A cup with some loose skin at the tops of my breasts that still need some volume. Any suggestions you could give me regarding my final implants would be greatly appreciated. Thank you so much!
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Deborah, thank you so much for the additional input!
Please forgive me for asking yet another question, but I am curious what it is you like better about the Allergan ultra dimensions over the mentor? The Allergan are wider and have less projection, which seemed like a downside to me... but all I am looking at is measurements on paper, so maybe there is something else I am not considering? I was thinking I needed to get as much projection and cc's as I could as close to the 12 cm width that I currently have with my expanders.
Thank you again, I so appreciate your knowledge on this matter!!
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FLOWERGRL: Everyone focuses on projection, which is important, but width is important also. Width helps create a more natural appearance on the chest wall, helps gain cleavage, and helps fill out a bra. Sometimes I envision a torpedo, when I look at some of the Mentor ultra dimensions. I feel you can handle a little more width on your frame. Width helps balance out your frame and does not make the upper half look so narrow and out of proportion to the lower half. Just my opinion.
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Deborah, thank you so much for that explanation!! I appreciate it! I see my doctor next week and will discuss the options with him
I am so thankful for you taking the time to answer so many questions here... it's such a relief to go into a doctor's appointment feeling knowledgeable!
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Popping in to say I just posted my journey on the picture forum. BMX in November with 350cc TE placed and had my exchange in March to Mentor 400cc smooth round HP. Now I just have fat grafting and nipples left to do. I had the "lollipop" style BMX which I haven't heard anyone else talk about here. You can find me as Nwgirl on that forum as well.
Whippetmom, if you have time could you drop by to take a look. My PS wasn't able to exchange to the 450cc you recommended, but says it's an easy exchange to do when I have the nipples done. Just wondering if it would help or if you have other ideas. I'm meeting with him later this week. Thank you!
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nwgirl: I posted a comment on your thread in the Pic Forum!
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i can't find a link to the picture forum, I got access long time ago but some how I just can't find a link to it. Can any of you give me the page? WWW.....
I want to post all my pictures in case anyone wants to have info on the NSMX.
Thanks
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Enerva - go back to your BCO Private Messages, and find where you received your access and instructions from either Lilah or nowheregirl.
That's the easiest way to get into the Picture Forum, as it contains both the site information, plus the passwords you will need to enter.
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lol thanks I never thought about going back there lol for some reason I looked up in my personal email thinking I had delete it.
I will get and post the pictures, thanks again
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Enerva-
I did the same thing...I kept looking in my personal email for the instructions and finally I noticed there was a message for me on the community board. LOL!! You can tell I am a newbie!
Thanks for posting pics...it does help others so much!
Ally0 -
Ally thanks i just finished posting my pictures, I really hope i find others who may have similar experience in my case i am waiting for a revision surgery and hopping it is the last one
)Blessing thank you for the info. I had not clue where that original msg was lol
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Darn it...I tried to post pictures and could not get them to load onto this site or the picture forum. I even read the sticky notes. I am a computer disaster so not too surprised. I will keep trying...
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Hi all-
Will try to load pics on the picture forum I did not find this site until several weeks after my first surgery. I have my exchange surgery on August 11th Yippee!! Whippetmom recommended the Allergan 20s Smooth Profile. I am 5'4", 118 lbs, short-waisted with 31.5 inches under the ribs (37 inches across the TEs). I have my pre-op appt with the PS on July 22nd. Counting down the days!!
Tank top (little lopsided with my shoulders)
I will keep you posted after the meeting with the PS!
Ally
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Ally thanks for sharing, I had a hard time posting the pictures and it was due to the size of the pictures. I then open each picture with the paint windows program and resize each picture to be 80 X 80 or 300 pixels save the new pictures and then load those. Just in case that maybe why you are having a hard time. I think your girls look great I like how your scars heal so nice. I got one side healing beautiful then the other not so great
hopping when I get the revision surgery I LL have better luck with the scars too. thanks again
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Enerva-
The size could have been the problem. I had more windows open on the computer than you could imagine. I seem to be healing pretty well. My understanding is that the PS is going back through the same incisions so I don't know whether I should put scar stips on the scars or just keep putting bio-oil and lotion on the girls. Hope your one problem child falls into line...it seems that the PSs have done some amazing work matching up the girls.
Ally
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Hi ladies. I didn't realize there was a photo forum here. Who and how can I gain access? Thank you kindly in advance. I'm 30 days to exchange!
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budrfligal13 - The picture forum is completely separate from BCO and is run independently by members nowheregirl and her sidekick Lilah. Go here
https://community.breastcancer.org/forum/44/topic/...
and read the very first post (ignore the heading that nowehergirl accidentally deleted...). If after reading the rules and conditions, you would still like to participate, then simply send a PM to nowheregirl or Lilah requesting access and after that it's all up to them.
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AZ85, I see you had surgery in Dec 2013 and then now in June. I wonder if you had different implants placed in? I am still having a lot of disconfort from my exchange surgery in Dec 2013. I wanted to as Wheepetmom or maybe Sandra or anyone here, does this pain ever stops? I mean is like nerve pain and in comes and goes, sometime sharp around the scars. I just feel so down knowing that I will start from zero again soon as I will have surgery again, but keep thinking is it ever going to get over? like no pain.? Or do bc survivor live life with this pain for ever? Forgive me if I sound nuts. It just seems as if it never ends.
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Enerva - I'm so sorry that you are still in pain. Yes, I just had revisional surgery on Monday. My first surgery (an excisional biopsy in July of last year) turned into a bigger, more invasive surgery than they'd anticipated when they found LCIS and ALH in addition to the DCIS that had been found previously with a stereotactic biopsy. They removed quite a big piece of my left breast during that one. To make a very long story short, the internal scarring from that excisional biopsy became a problem not long after my exchange in late December of 2013. I had a NSBMX in August, but once I no longer had the rigidity of the TEs to stretch that internal biopsy scar, it retracted with a vengeance and caused the left implant to twist and contort. My nipples were completely misaligned and very painful. (You can see pictures of what I'm talking about on the picture forum.) So with whippetmom's help, I found a new PS (neither of us had very much faith in the old PS at this point) with a lot of experience in reconstruction and revision work, who agreed to help me.
So on Monday (after months of thought and soul searching), I had a bilateral implant exchange. The internal scar was reworked, my painful nipples were removed, and because one implant had always appeared noticeably larger than the other, two different sizes were used this time. My original left implant had dropped below the IMF and that along with the internal scarring, had become very painful. My right implant had never dropped into the pocket and there was what looked to be extra skin and rippling on both. So I decided to try one last time to get a result I could live with. The new PS went with larger implants and also did some fat grafting at the same time. He went in through my old mastectomy scars as the biopsy scarring was under that scar. Go to the picture forum and post any questions you might have for me there. I won;t see the results of what was done until tomorrow. But even though I haven't seen anything, I can already tell that the pain from the scarring and the pain from the IMF is gone. The only pain I have right now is the soreness and the burn from the fat grafting - but that will go away with time.
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AZ85, thank you I will search In pick forum for you I think this pain is like yours and it's not normal. Thanks I really appreciate your info.
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Ally - Just a thought - you might want to remove your pictures after a little while. These forums aren't private so anyone, anywhere on the web can see the picts. Members in the picture forum are screened & usually have to have been posting on BCO for awhile to be qualified, so the photos are more secure.
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Ally I signed backbone the picture forum to read a few tread and saw the tread where I ask about the picture back a few months ago. I just read that another reason why I had trouble posting my pictures there before was due to we must open our own tread and then in that tread you are allow to upload. I thought I may come and let you know cuz it could also be why you were having a hard time.
did you open your own tread? anyway I also posted a few of my pictures here for a few days then removed them. Try to go back and post the picture there when you have a chance.Thanks again
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Ally: I am glad you posted photos! I thought you were only filling to 450 ccs, which would have been only 50 ccs greater than your TEs. You have filled yet another 100 ccs over that amount. If you are feeling good about the size of your TEs, you would need at least 475 ccs or 500 ccs, Allergan Style 20, in order to come close to the volume you have with the TEs. I do not want you to end up with pockets too large for the implants. I think that 425 ccs or 450 ccs would be a lot smaller than you are now with your TEs and you might be unhappy. You will NOT have the upper pole fullness....that is exaggerated only by the style of your TEs. Talk to your PS about 475 ccs or 500 ccs.
Deborah
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Enerva: You have post-mastectomy pain syndrome - which is a common occurrence after breast surgery. Most studies find it occurs in around 50% of women undergoing breast surgery. It can last for a very long time, and the key is to find ways to manage the pain and discomfort. However, it is possible that you will NOT start from "zero" with a revision, and that you might actually feel better, certainly no worse, afterwards. But demand adequate pain control during the surgery. Tell your PS you KNOW you have PMPS and you have read about it and you want to discuss how it might be addressed or ameliorated or eradicated during the upcoming revisionary surgery. It is widely speculated that the surgery itself, and pain control administered during the surgery, has much to do with the development of PMPS. Go to the PMPS thread here on bc.org.
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Whippetmom-
Sorry to confuse you. I messed up when I posted the pictures. I am only filled to 450 ccs. I reversed the numbers...hope my PS doesn't do that LOL!! I like this size if they could be a bit more narrow. The TEs tend to overflow into my armpit on each side. Your suggestion was 450cc or possibly 475cc in the Allergan Style 20. After seeing the photos, do you think the 475 might be better? Just curious as I don't know whether that extra 25 cc is more in the width or in the projection or if it differs for every person.
Ally
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MinusTwo- You are so right...I think I was able to move the pics to the Picture Forum. If I wasn't so computer-challenged, I could have done it correctly the first time. Even so, I accidentally put the pics on two threads in the pic forum...sigh.
Ally
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Wheeptmom I love you, thank you so much I will look into it I do hope it gets better after revision surgery. I try yoga and other stretch exercise but I still have not improve much so I am glad I ask you.
it makes sense now.0
