BREAST IMPLANT SIZING 101
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Whippetmom,
No she isn't willing to address the asymmetry issue. Her exact words were; your breasts weren't perfect when u came in the first time, why would they be now? She said I should see a counselor because my expectations aren't realistic. She said I had cancer I should focus on the fact that the cancer is gone and I have mounds on my chest that look good in clothes and appear to be normal breast. I'm dillusional if I think they are going to be perfect. She said if she took a picture of my reconstruction to one of her meetings she would get a standing ovation for the job she did.0 -
Sorry, Mommyathome....I have no other words of wisdom here. You could go to another plastic surgeon for a second opinion.
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Mommyathome... Your PS has some sort of God complex. Me personally? I couldn't run fast enough to find another.
This surgery is about you...not her. I am so sorry you have to go thru this.
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Whippetmom, do u recall if the IMF line was symmetrical in the pictures I sent u? My ps insists that it is not an issue of the implant being displaced or that there is any other problem. She insists that breasts just aren't usually symmetrical and I should not worry about it. My question to her is there a problem? Did the alloderm not hold the heavy implant (750cc) or is the pocket too big or not holding the implant the way it should etc. I'm not looking for perfection- she's right, I wasn't perfect before. But, I think if there is a problem going on we need to address it! She says there may come a time when we need to but right now isn't that time. They are fine..... Opinions?0
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Ladies,
The more I think about comments she's made it pisses me off point blank. I think I do look ok, but there is pain and some obvious things that I'd like to fix with reconstruction: specifically the flattening above the implant and divots.
I guess I'm scared to see another ps. It'd be starting all over again. I really just want to put this all behind me. I feel that I owe it to myself to see it through but getting the fat grafting but hopefully that will be it. I had trouble healing and had like 4 excisions on one side. I've had 11 surgeries/procedures in that past year and a half including BMx, exchange, total hysterectomy... I just want to feel whole again and strong and confident. I hear women talk on this site how in tune they are with their bs and ps and I feel like I got the short end of the stick. I had a 5 minute conversation with the pa about my fat grafting not because I didn't have questions, but because I felt like I couldn't ask them. I don't know where on my abdomen they are taking the fat, exactly what to expect for recovery, what I'll be wrapped in when I wake up, where they are injecting the fat, how much they are taking, etc etc. I feel like I'm going in blind! I got more feedback from you guys! I don't know, maybe I should have switched ps... I just don't know. I need to get myself to the point where I can say- without lying to myself that I know what to expect, I'm confident in my ps and I being on the same page and having the same expectations. I need to trust her. I need to be able to say that she knows how I feel and she will be able to fix what needs to be fixed. When I'm put to sleep on the table I am at peace. Right now I have no clue what to expect when I wake up!! That is unnerving!0 -
Mommyathome: When I responded and commented about your photos, did I mention anything to you about symmetry of the IMF? About one fold being lower than the other? Cannot access my old emails right now.
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Ontario...I hear your concerns. But I would still try for a second opinion, if possible. None of this is easy but don't want you to ever have regrets.
I will be thinking about you!
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Whippetmom I will check back at the emails now. You mentioned renting and ptosis. Would far grafting fix these problems? Or would it mean another revision? What type of revision?
The ironic thing is I met with the pa, bit the ps for my pre op and when she walked in she said so our we swapping out the implants? I said no! Dr w said she would only do fat grafting. It's like get it together ladies! Shouldn't the pa have known that prior to walking in the room?!? Do u think the ps and pa talked about doing a swap in the future? See, this is one of the problems I have to read between the lines because everything isn't said right up front0 -
Whippetmom,
Can I send u another pic today for your opinion on the IMF?
Let me ask you, if the IMF was not symmetrical what would have to be done?0 -
Hi mommyathome. I'm in CT too. I haven't seen your pics so I can't comment on what revision you might need. I will say that it's SO important to be able to communicate with your PS. It may be worth it to get a second opinion. I had 7 consults over 9 months before I decided which Surgeon to go with. Are you going to Yale/Smilow
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Mommyathome: If I only mentioned ptosis, that is not assymetry. You can email me photos, but if your PS will only do fat graft transfer and if you are not going to go to someone else for a second opinion, it does not matter what needs to be done for correction of any of your issues, right? It is just crazy-making for you to keep asking what could be done, when you know in your heart you are wanting to move on and accept things and also not go to any other plastic surgeon. So it is just spinning wheels. I would rather you not go there and wait another six months to do anything at all. Don't go through another general anesthesia for fat graft transfer, if it will not address your issues. It is better to see if you are still unhappy in six months and then get a second opinion. The second opinion will at least reassure you that either things can be made better or they cannot, and then you will have your answer. I cannot tell you what can be done. You have to go to a plastic surgeon for that information
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D nice,
No I have been going to a bs and ps from southbury. My mom was diagnosed 7 years ago and it was her bs. Once I was diagnosed and needed a ps my bs recommended this ps. They work closely together. I go to either hospital in Waterbury. Again this makes me wonder if it's the best choose... Neither hospital really specializes in cancer stuff but the ps and bs have hospital rights there.0 -
JJOntario - Don't mean to be doom & gloom, but radiation can totally change your skin, but also interior tissue forever. As my RO said, 'radiation, the gift that keeps on giving' - expect continuing changes for up to 2 years. You need to have a serious talk with your Radiation Oncologist about what to expect. And your PS should be able to answer some of those questions too based on experience. Every PS has different answers & parameters. If you don't want to get a 2nd PS opinion, maybe go back to your BS and discuss those issues with him/her.
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D nice,
I also find it interesting that you have a HER "diagnosis also because my bs said with DCIS there's no point in finding that out... Also I see you had a BMx, and you still took tamoxifen? My bs also said that because I did BMx there's no benefit to taking tamoxifen, the risks/cons outweigh the benefits ...0 -
Thanks for your advice Whippetmom0
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Mommyathome, my signature should also list IDC in addition to the DCIS. That may be the difference in my needing tamoxifen .I guess I signed on here before I read through my final pathology report. I will change that. It's so hard to give advice to others because everyone's situation is different. But I would offer that you have nothing to lose by getting a second opinion. Sometimes taking a step back and reassessing the situation is the best option. You have been through so much and certainly want this behind you. I chose to be treated at Dana Farber in Boston but we have Smilow Cancer center at Yale right here in CT. It is a world class facility. I'm not sure how far that is from where you live but you deserve the best care available. Now is not the time to settle for anything substandard in terms of surgeon/procedure/or hospital facility. You will put this behind you. And there is such peace in knowing that you did the best you could for yourself. I am happy to get a dr name for you or go with you if you feel like you need support from a fellow survivor! This is not easy!
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Mommy--With regard to Tamoxifen, my understanding is that it blocks the actions of estrogen and is given to pre-menopausal women as a treatment for certain types of breast cancer. My oncologist advised that since my pathology showed ER+/PR+ (responds to both estrogen and progesterone) and I was pre-menopausal, Tamoxifen would be appropriate even though I had a BMX. Unfortunately, breast cancer can metastasize to other parts of the body even though the breast tissue has been removed and since my breast cancer "needed" estrogen to grow faster, Tamoxifen would be helpful. Once I had a hysterectomy (recommended by my oncologist since my pathology results indicated that not only was I ER+/PR+, I was HIGHLY (95%) ER+/PR+), I was taken off Tamoxifen and put on Femara (Letrozole) which prevents estrogen production
The Tamoxifen and Femara were prescribed by my medical oncologist. I hope you are seeing a medical oncologist in addition to your breast surgeon and plastic surgeon. If not, I believe you should consider consulting with one.
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thanks everyone...I'm so discouraged. Please tell me if I'm unrealistic in wanting to be the same size as I am now. I feel so shallow for wanting to keep what I have. My BS (who is very small chested) was not helpful. She was the one who advised against implants and thought I would be a good candidate for DIEP ...what she didn't say was only if I wanted to be an A cup.
My breast augmentation last year took so much thought and I good chunk of money ...I have never spent that much on myself and I waited patiently for my last DD to go off to university before going ahead. Having BC is like a slap in the face to my body image. I could finally wear a unpadded bathing suit or bra...and now I'm worried that I will end up back to my A cups. I go for my rad set up today. The RO is worried about capsular contraction and skin damage as I have a large implant with very little of my own tissue over top.
In Canada OHIP pays for reconstruction and I felt like second class citizen in the PS office. I'm just so friggen tired of having to feel grateful for everything (and on a deeper level I am...)... But what the Dr's don't understand is the emotional part of all this. When I look in the mirror...I don't want to constantly be reminded if what I lost...
I'm wondering if I do rads ...how will they fix it if it shrinks ...will I still have to smaller? Fat grafting?
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Whippetmom, I would love your advise on sizing. I had BMX on Jan 26th and TE's placed on Feb 3rd.
I am 5'1'', 120 lbs, 31" ribcage. I have Allergen 133MX-13 TE's. They do feel like they push into my armpits a little. I really hope my implants don't feel that way. I had fairly large breasts for my size before, 34 DD. I would like to be about a C. I know you can't predict cup size, but wanted to give you all the info.
Thank you, Ang7604
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Whippetmom, I forgot to mention that I had nipple/ skin sparring BMX. And that the TEs go to 500cc.
Thanks.
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mommyathome - definitely go to another PS for an opinion. Your expectation are not too high until at least three other PS's tell you this is the best that can be done. Do not settle now. You should have asked the doctor if she had BC and went through what you did would her answer be the same. That response just infuriates me. They really should teach bedside manner in med school. I know the thought of looking for another PS now is overwhelming and frightening becasue I have those same feelings too but if you refuse to settle like I do then you'll find the courage to take that step. Check out realself.com. There's lost of PS's on there that answer questions and some even give free consultations if you say it's through realself. Keep us posted!!!!0 -
Thanks mjh10
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Ang: What are you filled to presently? If you are filled to around 400 ccs, what is your impression of the size for your frame.
More important are these issues: Do you seem to have a lot of skin overlying the tissue expanders? Where do your nipples appear on the mound? These are issues to consider when looking at the size and projection of the implants to be used at the time of exchange. You want your nipples to appear in the right place on the mound. I think that with your vital statistics, Allergan smooth round implants would be good in the 500 cc to 550 cc range, high profile. Perhaps even ultra full projection Style 45, 650 ccs. If there is some indication that you will have too much droop (because of your pre-BMX breast size) , your PS might consider using Sientra HP textured round implants in the 500 to 600 cc range.
Again, let's see what you think of the size when you reach 400 - 500 cc fill. You do not need to overfill at all for any implants I have recommended. You can always private message me and attach photos.
Deborah
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JJOntario: I am so sorry that you are experiencing this type of care delivery after breast cancer. There is not one of us on these reconstruction threads who feels any differently than you about wanting to feel that our breasts have been "restored" as much as possible. It is NOT vanity! The term "reconstruction" means to build back to and reconstruct what came before, and so if your caregivers are not equipped to do this, well, they should have chosen a different medical specialty. Like perhaps podiatry.
So please find another plastic surgeon for a second opinion. I have a couple of names in Ontario. Private message me if you also want to attach photos.
Deborah
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to all my tata sisters who posted me a PM, thank you. As I'm a newbie to these forums, I quickly learned you are only allowed so many PM's in a day. So I will respond to you each personally when allowed.
whippetmom - I think you are a godsend. Although I have the Mentor Memoryshape that are supposed to ripple "less", I have read that that Allergan 410 ripple "even less". Is this true?? I know any implant ripple rate ultimately depends on how thin/thick your skin is, but I'm just wondering. I know every PS also has their preferred brand. I love my left boobie now with the anatomical implant and it looks perfect. For some reason it's sister on the right ain't liking it's home too much. I feel like I have two children on my chest that just can't get along - lol.
P.S. I just read about the new Ideal implants that were just FDA approved. Do you have any thoughs on those??
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JJ Ontario. I agree with Whippetmom that you need a second opinion and really good communication with your PS. A clear well thought out plan and someone who understands this on an emotional level. Some patients need a connection to their surgeon. I am like that. Radiation can complicate reconstruction. I think it's important for your PS to explain all of this to you so you are better prepared for the process. You will get beyond this. There was another woman on here that is from Canada. Enerva? Maybe you could try sending her a PM? Best to you.. Keep us posted.
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Whippetmom, I have only had two fills so far. I'm at 250cc. Started out with 150 and we are doing 50cc at a time. I do still have extra skin and the nipples are somewhat in the right position. I will keep your information and just wait until I am closer to the 400-500 cc range. I haven't been brave enough to take any pictures. I have pre teen kids. I can just imagine them getting into my phone and seeing moms Frankenboobs. Thank you so much for your help.
Ang
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hi Whippetmom
I wanted to drop in and say thanks. You probably don't remember - I posted here months and months ago (before I realized I would need chemo so it's been a long haul with the TEs...) and asked for your thoughts on implant sizing. You suggested 450-475ccs in a high profile smooth round on my 5'5", 130lb frame. My exchange was a few weeks ago and you were spot on! We went with 475cc style 20 allergan, and with a little far grafting my new foobs look terrific - like me only a little smaller and perkier, hooray!
Thank you!! It was great to have your guidance in the conversations I had w my PS prior to exchange
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JJ, I was a 32G beforehand and now have TES in. I don't want them as big but frankly these TEs r so wide they fit my previous bra but I wasn't as full. I just want Cs at the end.
I'm supposed to have rads and I have to wait at leAst 6 months before surgery again. Rads will also shrink the skin and size of whatever breast is affected
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Rain my July chemo sister, so glad you are happy.
Ladies - what happens with the port when you do the exchange and fat grafting? As my expanders are getting fuller, I see a 'divot' maybe, between the expander and my upper chest on one side, but the port sticking out on the other. Is it better to wait and get the exchange after the port is removed? I don't have radiation planned, so am not in a hurry, except because I hate my TEs.
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