BREAST IMPLANT SIZING 101
Comments
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Di: There are a number of issues you have to address, and first and foremost - the discomfort with the right breast/implant. It is not uncommon at all to have what is called "Post-Mastectomy Pain Syndrome"....there is an active thread on this topic in the Surgery forums. It might be PMPS and again, it could be something to do with the pocket itself - perhaps a slight rotation of the anatomical implant - some displacement? At some point, when the pain and discomfort is sufficient to disrupt your life...it is worth going in for a revision/replacement. Because of your pain issues, I would advise to switch out to a standard silicone round, because it will be softer and there will be no rotational risks. That would be my recommendation. That 410MX has a width of 15.5 cm, but with your issues, I would hate to recommend to much in the way of pocket revisions, which might cause more discomfort. So, in order to stay within the realm of the same width, it would probably be an Allergan Style 15, 616 ccs - which would not be too much volume for you.
Referable to the time constraints for a revision, I do not at all understand your PS' premise that you need to wait a year. I do not know what type of insurance you have, but I have never heard of that sort of moratorium on submitting a request for a revision to an insurance company. I cannot think of any one of us who have had revisions, having been told we have to wait that long and that there is an issue with insurance covering a revision from a "time" standpoint. You also can get a second opinion at any time and your insurance should cover this. There might be a few exceptions with some carriers, but it is the exception, rather than the rule.
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Laura: On some page of this thread, I supplied some links which showed that too much load or taxing of the pectorals can lead to implant displacement and/or implant distortion. The premier risk appears to be lateral displacement of the implants, with pectoral contraction continuing to push the implants laterally towards the armpits.
EDITED: Laura, we had a discussion re: pectoral exercises on Pages 36 and 37 of Foobville...
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venus: Good luck with your surgery! You are in very good hands with Deborah, the Breast Whisperer! My exchange is tomorrow and I can hardly wait!!!
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venus: Praying for you today...please check with us to let us know how you are doing once you are able to do so!
MBJ: The big day you have been waiting for for so long is finally here! You will be in my prayers tomorrow....
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Aw Di -- I was one who suggested it might be LE but I DID also say only IF you had nodes removed. Since you did not have any nodes removed, it is extremely doubtful that it is LE. Post Mastectomy Pain Syndrome could be a possibility. It could also be, as Deborah said, that it's the gummy you have -- that it may not be sitting right in the pocket (which can only be addressed through surgery and which you should NOT have to wait for).
By the way: the Allergan 410 is aka the "gummy" because it has the firmness/feel of a gummy bear. I actually have the exact same implant as you: Allergan 410 MX 685. Since I am a little heavier than you, it is not too big for me. But it is snug in how it fits in the pocket and I'm looking around for a good PT myself to help loosen things up (although to be honest my problem is mainly in my shoulder and, I suspect, is to do with having had surgery in that area and not to do with the implant itself). Any implant can feel tight; the gummy maybe especially because it has a textured surface designed to adhere (internally) to your skin and your body.
Some women, both those with gummies and those with smooth rounds, have found relief through Physical Therapy. If you have not seen a physical therapist, it is worth investigating. That may relieve your pain.
If it does not -- and you feel the size is too big -- then I think Deborah is right that you may find a smooth round more comfortable because it does NOT adhere to the body internally and does not have the issues of placement that can happen with the anatomicals shifting.
Certainly, it's worth finding out if PT can help relieve the pain short term. You may still want to replace the current implant with a smooth round, long term, but short term relief helps
Others with gummies who experienced pain or discomfort have reported relief after PT (check out the All About Gummies thread).0 -
Laura -- for what it's worth, I was told by my doctors at Sloan Kettering in NY that I should not do push-ups or other exercises designed to strengthen the pectorals. You want your pecs to remain flabby, basically, because empowered pecs could flatten out the implants or otherwise press on them. Of course, do what YOUR doctor tells you.
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MBJ- Want to wish you all the best tomorrow, your in my thoughts and prayers! Can't wait to hear about your success! Hugs
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MBJ -- WAHOOOOOOO YOUR DAY IS FINALLY HERE!!! Good wishes for an easy surgery and a fab outcome.
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And, of course, Lilah and I, sloth-like creatures that we are, have no problem being told we should keep our pectorals flabby. Eh Lilah?
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LOL -- you betcha!
But weirdly for some reason the past few days the top of my implant/foob has been sore (to under the arm)... am wondering if it's the bra I wore for two days in a row (none today) or what the heck? Maybe I'm just feeling more normal and doing more reaching/stretching.... not enough slothing. I did go to an Anthropoligie sale yesterday and tried on something like 30 tops! (Bought two). Yeesh! That's almost like -- exercise!
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There you go Lilah, all of that arms up action - pulling things up and over your head! And 30 times! Whoa! You da' woman!!! LOL! I LOVE Anthropologie tops and tees. I have to stay away from that store...danger, danger...
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Love Anthropology! Reminds me of all the european clothes I wore as a child. So bright and colorful!
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Whippetmom - You were kind enough to offer recommendations for my implant sizing in recent months. My expansion has been ever so slow in that I am 4 hours away from my doctors, I had one of those "mystery rashes", was on antibiotics and then discovered another lump which had to be biopsied. All is well now and I am expanded to 480cc. Exchange is scheduled for Sept 1. I am wanting to make the most of my pre-surgery appointment next week. I have some concerns but am not sure if I am expecting too much. I would so much appreciate your input as far as what issues to address with my PS. Would it be presumptious of me to ask you to take a look? I can PM you with pictures.
Ht:5'5" Wt:130 Chest: 30"
Mentor Med Ht Style 7200 TE 450cc W:12.7 Ht:10.8 Proj:7.0
Your recommendation: Mentor HP 500 cc smooth silicon. He was talking more in the 450cc range. Now that there is a 475cc, perhaps he will agree to try that.
Thanks so much!
Jan
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Jan: That sounds good to me. See if he can use the Mentor 475 cc high profile implant. If he is stuck on 450 ccs, then at least get him to commit that, skin permitting, he will not go any lower in volume. In Mentor, the 450 cc and 475 cc implants are wide enough to match the width of the TEs. Let's see what he has to say!
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Thank you, Whippetmom. You are always so willing to help and very much appreciated!
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Hello whippetmom, I'm reposting from yesterday because I don't think you saw my post
I was in touch recently as I'm gathering information for my recon after a R skin sparing Mx with TE- surgery has now been booked for late November - I PM'ed you my information a month ago, but to recap - I was/am 36C cup, height: 68.5 inches (5 foot 8.5 inches), weight: 154 pounds, rib cage: 34.6 inches.
I've now had a chat with my PS and he is suggesting I go with Mentor 322, moderate plus profile cohesive III, 330cc. I would love to have your feedback. It's 12cm wide, 11.3cm high, and 5.1cm proj.
thanks,
Lisa
oh and my TE is mentor siltex med height, contour profile expander,450cc - I think we're up to 450ml now.
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Ladies: I should be sleeping but I am too excited!
Deborah: Thank you so much for all of your help! I hope I can finally get to sleep because the morning will be here soon!
Lilah: Since you are a Uni, you probably have a good idea of how I feel. I cannot wait to have my breasts even out. I sure hope he does as good of a job as he says he can!
G'nite all!
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I'm sure he will MBJ! Can't wait to hear from you when you are done
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good luck mbj, I hope everything goes smoothly in the morning
lisa
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I had my last fill on Tues and am still so sore. It is really bad this time.
I've had to leave work early each day so that I can take pain meds... Motrin isn't cutting it.
I'm at 550cc on the right and less than that on the left (but I look symetrical because of the seroma). My exchange is scheduled for 9/13. So, the end is in sight.
He agreed to 375cc Allergan-20's. At first I wanted smaller and he wanted bigger but then we flip-flopped! LOL! Last visit, I was trying to get him to go to 400cc and he wanted 350cc. So, the compromise was 375cc.
So, that's my update!
MBJ~ Good luck today!0 -
Aw Michele I feel your pain! (Well, I DID feel it) The good news is it gets better after exchange. See if you can get a loved one to rub your back (around the shoulder blade) -- I found that gave me great relief. Also do some gentle stretching, that also helps, on top of the Motrin.
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Ya know, it's funny, because I had virtually no pain with the TE's.... didn't take pain meds at all. Now post exchange, I hurt everyday..... just doesn't seem right, does it? All the more reason I should go with revision I guess. Have to get some answers first though.
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Lisa: I am so sorry I missed your post yesterday!
I just looked at your numbers and I just feel that the Mentor 322 in 330 gms is small for your frame,and the width is less than the TEs. However, you are a unilateral and the PS is hopefully going to use a cohesive gel implant which will match your native breast. THAT is the conversation you should be having with your PS. Is he focusing on symmetry? It also depends on whether you are going to lift or lift/augment the native breast. I have a hard time believing that your native breast has a width of only 12.0 cm....and that is my concern. Ask your PS "what is the width of my healthy breast?"
Actually, the Mentor 322 in 375 grams matches the width better - 12.5 cm width. I would prefer that size over the 330.
But again, symmetry is the key here and you need to go with the style/volume of implant which will achieve the best match.
Deborah
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has anyone ever heard of a leak in the tissue expander? i am not sure, but i think mine might be getting smaller on one side.
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Webstermom - I had a leaky expander. I noticed it a few days after one of my fills. I looked down and it looked like one side was smaller than the other which wasn't like that the day before. When I went in to the PS he said it definitely was leaking and that it happens sometimes. He might have nicked the expander when he did the fill. He said the body absorbs the saline and not to worry. I had to go get refilled more often until the time of my exchange. I even asked him maybe it should be replaced and he said it wasn't necessary. I went back every two weeks until my exchange. I would call your PS and tell him what you think and see what he says. He might say something totally different than what mine did. Each individual's PS does things their own way so I would definitely call to make sure that all is OK.
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Webstermom: It depends on where you are in the expansion process I assume. The breast reconstruction journals and the TE manufacturers suggest that the TEs should be replaced if they deflate - especially early on in the process - such as during placement at the time of surgery, or with the initial filling post-surgery. Of course, it all depends also on how much expansion is required. It is a tough call, because typically you would need to wait at least two months to go in and replace the TE after it deflates, which delays everything, and repeat surgery carries its own risks. But if NOT replacing it means I must accept a smaller implant - significantly smaller than planned - I would have the TE replaced. That is just my personal opinion on the matter.
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I saw my PS yesterday,and he said he put in a Mentor MX13. I had asked for a 12 since my ribcage is only 26.He said he cannot get the Natrelle, he has to use what the hospital offers. But, on the day of surgery, he said I got the same thing we talked about size wise, but yesterday, he said it was a 13. That is why it is intruding over the middle line.But, he said that as we expand, it will pull in as it lifts, but we will watch it. If it is too much over the middle, can we go on with the expansion, and make the adjustment at the exchange? Or will I have to stop the expansions and get a smaller one put in? ...
What is your opinion.?? 0 -
joie: I am a little confused, as the MX-13 IS Allergan - not Mentor. "Natrelle" is just the collection name for Allergan. The Mentor "13" is actually a 550 cc TE with a width of 13.5 cm. Could you clarify which mfr and style of TE you have?
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joie: I do not quite understand the doctor's inability to obtain an Allergan implant for you at the time of exchange. You should be able to request a match - manufacturer, volume and dimensions - for your opposing reconstructed breast. You are in SoCal and Allergan is right down the road. I would just make a point of lobbying for this issue....
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I just had my pre-mastectomy appt with my PS and I'm feeling kinda disapointed. At the first visit he was all gung ho on how I could go bigger if I wanted and all went well and being a barely B, I had decided I liked that idea. (btw, I am a uni and have a planned ss/ns mast, and I'm getting a gummy) Now he was saying that if we can save the nipple (never a sure thing) we could maybe go a bit bigger, but if we don't, we will be lucky to even make it to the same size as now and probably a bit smaller!! Also I would have less skin, cause they have to excise the scar below my nipple that was from the 2 lumpecotmys cause the skin would not survive) I was crushed since so many things can go wrong with the nipple sparing - could have cancer found during the mast, in the pathology later, or necrosis. Here I was thinking that at least I could have a nice pair of perky bigger ones as a prize at the end of this nightmare. (I was thinking to upgrade the "good" size to match)
Has anyone else faced this? I know it is early yet and the nipple may pull through, but my bubble is burst and I'm feeling down.
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