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How many ccs per fill typically?

Camillia
Camillia Member Posts: 34
edited June 2014 in Breast Reconstruction


I had TE placement a few weeks ago and will be going in for my first fill this week, I am quite excited about it :-)


My PS didn't know if she would be able to put any saline in the TE on surgery day but I was quite excited to see a bump when I woke up; she was able to put 100cc.


How much more should I expect this time around, on my first official fill? Is another 100cc an unrealistic expectation? (I started all this completely flat, I had no skin sparing at my mastectomy over a year ago)

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Comments

  • specialk
    specialk Member Posts: 9,221
    edited October 2013


    How many cc's you get at each fill depends on how well your skin stretches, your pain tolerance and your plastic surgeon's philosophy. The problem with filling too quickly is that you may experience substantial discomfort - remember that your pectoral muscle and skin are being stretched in an unnatural way, and your skin may form stretch marks, much like a pregnancy. I personally believe that low and slow is preferable - you will be more comfortable and your skin will adapt better aesthetically.

  • Blessings2011
    Blessings2011 Member Posts: 1,801
    edited October 2013


    Yeah, what SpecialK said!!! :-)

  • juliaanna
    juliaanna Member Posts: 575
    edited October 2013


    I second what Special K and Blessings said. I had 50cc fills once a week, starting about three weeks after surgery. My PS said it was up to me- if that was too much we could do every other week or less ccs. I was never uncomfortable during the fill process, but I definitely felt tight later in the day- ibuprofen or Tylenol took care of it.


    Best wishes.

  • Camillia
    Camillia Member Posts: 34
    edited October 2013


    Thanks ladies. I will make sure to take some ibuprofen an hour before I see my PS :-)

  • dayzoo
    dayzoo Member Posts: 15
    edited October 2013


    I go in this week for my 6th and final fill.


    My fills have been as follows (although I'm not sure if he put any in during placement surgery). We started with the fills 2 weeks after surgery.


    Fill 1: 120 cc's


    Fill 2: 120 cc's


    Fill 3: 100 cc's


    Fill 4: 100 cc's


    Fill 5: 60 cc's


    PS is overfilling, as he said my TE was a 450cc expander.


    The first 3 weeks were easy. No pain or discomfort, only a feeling of tightness for a couple days. My 5th fill was quite uncomfortable, and took 3-4 days for the pain to subside. Tylenol and Advil worked well.


    Good luck - I love going to get fills, as it's real progession that I can see quickly! Plus, the nurses at my doc's office always tell me how great I look, and I love the ego boost, because I certainly need it... :-)

  • specialk
    specialk Member Posts: 9,221
    edited October 2013


    camellia - I would recommend taking Tylenol before, not ibuprofen. Fills are done with a large needle (it is a little crazy when you see it for the first time!) and you might increase bleeding risk with ibuprofen. I think it would be ok to take it later, but I would not take it prior to the fill.

  • Camillia
    Camillia Member Posts: 34
    edited October 2013


    Dayzoo; I have read about seeing your breast grow right there as the fill happens. I look forward to seeing that :-)


    Specialk, thanks for reminding me; my dr actually had said something about that ;-)

  • Sassa
    Sassa Member Posts: 98
    edited October 2013


    I had bilateral 800 cc TE's and implants. Each side received 300 ccs at TE placement. I had two more fills of 250 cc on each side.


    I had delayed reconstruction. I had been exercising and had regained upper body strength and muscle flexibility before I started reconstruction. I had a feeling of tightness for about 20 minutes after each fill; no pain at all.


    Go with what your plastic surgeon thinks you can handle.

  • Camillia
    Camillia Member Posts: 34
    edited October 2013


    Homosassa, I do a lot of yoga, sit ups, push ups, so I am hoping that I too will benefit from that as far as flexibility goes. My Dr was impressed to see that I still had full mobility on my surgery side a day or two after TE placement.


    I'll let you know how tomorrow goes :-)


  • Camillia
    Camillia Member Posts: 34
    edited October 2013


    75 cc's it was :-) Really no pain, just tightness. I go back in two weeks :-)

  • dayzoo
    dayzoo Member Posts: 15
    edited October 2013


    Congrats! Did you see a difference?


    For me, even though I had less fill as the weeks went on, I could see a much bigger size change each time.


    Had my final fill yesterday of 60cc's, and wow - a huge difference than last time. PS prodded a bit and declared me 'filled right up'.


    I'm so happy - this fill wasn't nearly as bad as last week's.


    In two weeks I go see PS and make a plan for my exchange surgery. Looking forward to having my 'natural' boob the same height and size as my new one!

  • sandra4611
    sandra4611 Member Posts: 1,750
    edited October 2013


    Camillia,


    As you read posts elsewhere on this discussion group page, you will see a huge difference in how many cc's and how long it takes - not just from "empty" to full, but also how long you wait from "full" to exchange. Some plastic surgeons have you wait 6 months after your last fill. Others have you wait half that time. Some only put in 30 cc a week. Others give 100 cc's every time. There really is no usual amount or average waiting time. Just like all of us are different, PS seem to all be different too.


    Some women report no pain from TE's, others are just the opposite and call it TE hell. I suspect some of it boils down to your individual pain tolerance, but the big difference is what a person calls pain. There is a big difference between being uncomfortable, feeling tightness, and being in pain. Some people don't deal well with what I consider discomfort, especially in one area of their body vs. another. I can't stand to get my teeth cleaned...it is painful to me and I'm miserable for about a day. My mouth is my Achilles heel. It's not uncomfortable, it's painful and I want drugs! Seems ridiculous to everybody else. On the other hand, I don't think the BMX was VERY painful. I am allergic to narcotics and opiates so all I can take is Tylenol. My pain level was never above a 5 even at the beginning.


    When someone says TE's were terribly painful, I scratch my head and say, really? I've never had a moment of pain but several hours after each fill I feel tight and achy...uncomfortable, not painful. I take Tylenol and it's gone. No problem the next day. The needle doesn't hurt (numb after the BMX) and they put a little pressure on the injection site for a few seconds so there is no bleeding or bruising after even though I am on a blood thinner. There is no pressure or pain during the fill. I truly feel absolutely nothing.


    I've had the TE since Sept. 6th and started getting fills during the third week. I've had 5 fills: 180 cc's, 240 cc's, 80 cc's, 80 cc's, and today 100 cc's. There may be one more small one next week but otherwise he says I'm ready for the exchange in late November. Bring it on! Just don't make me go to the dentist.

  • Camillia
    Camillia Member Posts: 34
    edited October 2013


    YAY, Dayzoo!!! I cant wait to be where you are at right now. Good for you! I too cant wait to see how closely we can maych my new boob with my natural one. My surgeon doe not want to go there until she sees how much we can expand on my MX side. I certainly can see how much bigger it is, I dont need padding in my bra anymore to match my natural side :-D


    OMG, Sandra! I think I could have written what you wrote! I HATE the dentist, I have some kind of phobia about them and just a cleaning feels SOOOOO uncomfortable!!!!! Worse part is the only dental work I ever needed was 2 fillings (I thank my family genes for that!). I just HATE the dentist. But much like you, my UMX was really no big deal as far as pain goes and this TE is really not bothering me. Yes I feel it insode me and there is some tightness, but to think I waited over a year to do this! I was persuaded that it would be a big deal with lots of complications. I feel so blessed that it is going so smoothly so far. I am now at 175cc's and almost as big as my natural 34b. I read about your fills and wonder how come only 175cc's total is making me look big enough allready. My PS said probably only one more fill. But hey... I'll do what I need to do. Just like you said.... bring it on, just dont tell me I have to go to the dentist, lol!!!

  • larst
    larst Member Posts: 3
    edited October 2013


    I had a N/S BMX with TE placement on October 10. The PS filled me with 200 cc's at surgery. Two weeks later I had my first post-op fill of 125 cc's. I felt some pressure at the time, but by that evening I was in pain. I don't think I have a low pain threshold because I was able to stop the IV pain meds in the hospital after one day, and only took a few Percocets after I was home. I started out very small (A cup) and now I'm a little bigger than I was before surgery with 325 cc's. The goal is for 450 cc's and he said he will overfill by 100 cc's to make sure there is enough room for the implants.



    I'm going to ask him if he can decrease the amount of the next fill...maybe to 75 cc's. 125 cc's was too much for me, or maybe too soon after surgery, I don't know.


    P.S. I have no problem at the dentist...not much pain! :)

  • stellina
    stellina Member Posts: 50
    edited October 2013

    Hello, I'm entirely new to this site, but I wanted to chime in.

    I had a mastectomy and reconstruction on my right side on September 26th. The surgeon injected 30 cc during surgery and last Monday she added 20 cc. She injects very small quantities to prevent both pain and stretchmarks.  

    The total capacity of the implant is 195 cc (my breasts are in the mini category and I opted for a small size implant). So most probably I still have to go about 6 or 7 times before the implant is full. The surgeon told me to come back after 10 days, but I prefer to delay it a few days since I'll be having my nadir days from chemo and I prefer to avoid even a minimal sting in those days. Maybe I'm wrong, but I prefer to be careful.

    Have a nice evening!

  • sandra4611
    sandra4611 Member Posts: 1,750
    edited October 2013


    People just have different pain tolerances. Although I have had plenty of very VERY painful things happen (like the injections of radioisotopes around my nipples for the Sentinal Node Biopsy...AWFUL) recovery from a BMX and having a TE ranks very low on my list. It's not a walk in the park, but it's manageable. Some of it may have to do with the fact that I have always preferred to try other things before I resort to taking something for pain.


    I am allergic to narcotics of all kinds and have coded 4 times due to dilauded, stadol, tramadol, and a couple of Tylenol #2's with codeine that one doctor promised wouldn't hurt me at all. One minute I'm awake and the next I open my eyes with 20 people standing around me and broken ribs from too aggressive CPR on the way upstairs to ICU. (Broken ribs REALLY hurt!) The only thing I can take is plain old Tylenol so I save it for when I need it. With IV 100 mg Tylenol I've dealt with a hysterectomy & gall bladder removal (cut open stem to stern) a gastric bypass (ditto), and a lower body lift where I had 58" of incisions. Tylenol doesn't take the pain away...it just brings it down to a level where I can use other techniques to hopefully get it under control. Doesn't always work but it worked great for the BMX and for the second surgery due to infection and necrotic tissue & muscle that had to be removed on one side. As pain goes, this isn't bad. It's a surgery and recovery full of weird unpleasant sensations rather than unremitting pain.


    I was a migraine sufferer for years and had to learn biofeedback techniques to deal with them because neurologist after neurologist gave up trying to find something that would work but not kill me. I carried something that looked like it should have been in s Star Trek movie - a fat syringe pre-filled with drugs to slap into my thigh when a migraine was coming on. The drug was almost worse than a migraine - it dilates all the arteries in your head at once so you feel like the top of your head is about to blow off. I spent hours sitting in strange parking lots because a migraine had come on while I was driving and I had to pull over and wait it out. I KNOW pain and really, truly, this isn't so bad. (I only get a migraine one or two times a year now due to the prophylactic medication sertraline.)


    Biofeedback WORKS. Do yourself a favor and find online websites or a book from the library to teach you. The only thing it doesn't help with for me is trips to the dentist. THAT hurts! Having a baby is a piece of cake compared to dental work. See, we're all different.

  • Camillia
    Camillia Member Posts: 34
    edited November 2013


    Another 75 cc today; so I am now at 250cc total :-) I am now a tad bit bigger than my native side (34B). Some tightness but no pain :-) My next app is in 2 and a half week. I am happy, it looks like we will be able to achieve a c cup so that we can put a small implant on my native side to match the roundness of my MX side as best as possible.


    KEEB, did you go back for another fill? Wow, I am impressed at how much you were able to get on your surgery day. I hope the pain is gone by now.


    I asked about over filling today but I didn't see my surgeon, her assistant did the fill. She said that it depends on our final goal and what we decide to do in the end to have a good match. Basically, it's not the same for everyone at my PS' office. I will see my surgeon next time and I think we will be close to the last fill, so I imagine we will talk more about what we will be doing exactly.


    Stellina, I have hear other woman say that their PS prefers a slow approach. It is interesting to see how different this whole process can be for each and everyone of us. I hope you are doing well :-)


    Sandra, it sounds as if you have had more than your fair share of procedures and complications. I am so sorry that you had to go through all of this. You are a strong woman, thank you for sharing your story; it is quite an inspirational one!



  • Camillia
    Camillia Member Posts: 34
    edited November 2013


    OMG! My skin is itching me like crazy! From the stretching.


    I had pain yesterday... some this morning. Nothing awful, but more than with the other time. The "rock feeling" that everybody talks about is happening to me too now.


    Maybe one small last fill next time?

  • sandra4611
    sandra4611 Member Posts: 1,750
    edited November 2013


    Ack! Camilla, I know you are miserable with all that itching. I bought some Bio-Oil at Target after reading so many good comments about it on this forum and it really helped, especially on those areas that were resisting the stretch. Good luck and hope you find some relief.

  • Camillia
    Camillia Member Posts: 34
    edited November 2013


    Thanks Sandra, I did read good things about it. I need to buy some. The itching is not there anymore, but I sure could use some help with the stretching Winking

  • nostrilb
    nostrilb Member Posts: 2
    edited November 2013


    When you guys say "tightness", do you mean pain? I am in pain, and I only have a total of 30cc in there. It's worse then it was done Friday (today is Monday). I'm wondering what to expect, and if this will happen with every fill, or if my body will get used to it.

  • dayzoo
    dayzoo Member Posts: 15
    edited November 2013


    Out of all my fills, my 5th one was the worst. I had pain on the second night, didn't sleep well at all. The pain extended right under my arm, and to my back (I had a lat flap surgery, hence the wrap-around pain) but it did eventually go away by the 5th day. My 6th (and final) fill was the same volume, but didn't hurt nearly as much.


    With each passing day, your body gets used to the expander, and suddenly you don't realize it's there anymore...

  • sandra4611
    sandra4611 Member Posts: 1,750
    edited November 2013


    Tightness is different than discomfort or pain. (Although it can get so tight that it becomes painful or it presses on something else that responds with pain, like a nerve being compressed.) Tightness can mean feeling like your breasts are swollen or it can mean what happens when you reach for something and your arm seems to have shrunk 3 inches. (Tyrannous Rex syndrome...kind of useless and "short" arms right after surgery.) Some people say they feel like they have a tight ace bandage wrapped around their chest or have on an iron bra.


    If you hurt yourself and the area swells, it feels tight. If it is badly swollen, it feels painful and the swelling makes the pain of the injury itself hurt even more.


    Also understand that pain means different things to different people. What one describes as painful, the other might just shrug off as just uncomfortable. We all know people who call pain anything that doesn't feel good and are quick to self medicate until they feel perfect again. Then there are the people who aren't "pill takers" and would rather let their arm fall off before they would even call a doctor. I think most of us fall somewhere in between. There is no judgment here...it's just the way it is with different people. Some of us tolerate this reconstruction journey better than others.

  • aviva5675
    aviva5675 Member Posts: 836
    edited November 2013


    Im at 400/500 cc now, overfilled by 100 on each side. Now I wait 8 weeks for exchange. The tes have been generally no problem. Got 100 during surgery, first fill on one side 50cc at 4 weeks. Have done 50 a week till now Im done. However, since last week the right side is pressing on a nerve and Ive had back and neck pain. Feels like you slept wrong, but it doesnt really go away. Ill probably call ps later in week if it doesnt subside, Ive read of others getting muscle relaxers, so that might help. Thought Id get thru it painless (yes some little tweak pain, stretched skin), so this is a disappointment. And painful !


    I highly recommend smaller, slow filling.

  • sandra4611
    sandra4611 Member Posts: 1,750
    edited November 2013


    It is odd how a few cc's can make a difference, isn't it? I had discomfort and tightness for a few hours but no pain at all through all the fills. (1st @ 3 wks post op 180 cc's, then 240 cc, 100 cc, 80 cc's twice = 680 cc's.) The final 60 cc's to get me to 740 cc's put me over the edge though and I felt pain for the first time. It only lasted 2 days, but it surely did hurt. Felt like it was pressing into my chest and irritating a nerve. My TE is an 800 cc, but I told the PS that 740 cc's would have to be good enough 'cause I wasn't going through that again...or he was going to have to give me a couple weeks to get used to it before he tried for more. Fortunately he agreed to stop where we are at 740 cc's. My exchange is week after next.


    Others have asked how it's possible to go through this with a big TE and no pain. I don't know. It just didn't hurt...until those last piddly 60 cc's. If it had lasted more than 2 days, I would have asked him to remove some saline.

  • Camillia
    Camillia Member Posts: 34
    edited November 2013


    I have felt both tightness and uncomfortable. The first fill, I felt tight. The second fill was uncomfortable. It took 4-5 days for things to get back to "just tight". But I was overzealous ;-) My PS' assistant was going to put 50 cc's and I said I was feeling ok and ready for more so she put in a total of 75 cc's. Now I know, haha!



    Today I saw my PS and she put another 40cc's in, so I am now at a total of 290cc's. She said one more fill and we are good... I will get the 34C that I so wanted! YAY! I will get a small implant on my native side and a lift. She said that she will also do some fat grafting around the TE side to smooth out the edges. I will wake up with all of that done in one shot.


    My! My skin is shiny! But I trust my surgeon :-)


    Sandra, your surgery is coming up! How exciting!! On time for Thanksgiving or a few days later? Cant wait to hear all about it!

  • mnmbeck
    mnmbeck Member Posts: 156
    edited November 2013


    God Bless my PS.....I have only had 1 fill....only 30cc on one side. (started with 360/300). Filled only ONE side the first time....30cc to make it 360/330. I was miserable, and concerned because I know how small that amount is! Today was the next fill (It's been about 10 days). He could see I was in distress, so suggested we only add 25cc to one side, and see each other again in 2 weeks. YAY!!! I am not in agony, just tight. If it stays this way, and I don't have another fill for 2 weeks, AND I am starting physical therapy tomorrow....I might just be OK! It's the first time I've felt really hopeful since surgery!!! (other than pathology report) YAY!!!

  • cjc1961
    cjc1961 Member Posts: 54
    edited November 2013


    SpecialK ~ in looking back over the posts, I saw where you said fills are done with a large needle? I'm pretty sure you had the same PS as me and the syringe was huge, but the needle is just a tiny butterfly type. I would have died if she used a big needle.


    As far as fills ladies, a few of us are obviously the exception as to how much we had put in at placement and how many cc at each fill. I was a full 38C and had 800 removed from each breast with NS BMX. I had 380 inserted at surgery, 60 cc one week postop, 100 week two, 100 week three, 120 week four. I was VERY tight for a couple days and uncomfortable, but not really in pain. Then came that last fill of 120!!! I was in HORRIBLE pain for a good 3 days. Had to go back on narcotics to function. Funny thing, the pain was only in my right side. It took about a week to completely calm down and now it's not that noticeable, but I am still taking the Skelaxin twice daily. My exchange is Jan 16 and I CANNOT wait!!!! I have healed up nicely and am pleased that I went with NS.

  • sandra4611
    sandra4611 Member Posts: 1,750
    edited November 2013


    Mnmbeck, good for you! You've found a way that's going to get you to your goal without pain. Yay!


    Cjc, I don't think it matters which size needle they use since you can't feel it anyway, but it is a little disconcerting the first time you see the PS with that big needle coming at you. (It LOOKS like it should hurt and that big syringe doesn't help!) The PS places the needle in the port and tests the capillary refill response while his nurse pushes the saline. Her hands were shaking when she put in the last of the 240 cc's on fill #2. I asked him about it and he said the needle is actually small so it takes a lot of steady pressure to put in a big fill. I asked why he didn't use a bigger needle and he said, "Because you will spring a leak!"


    Those butterfly needles are pretty tiny so maybe they are better suited to small fills. Just guessing.

  • specialk
    specialk Member Posts: 9,221
    edited November 2013


    cjc - my PS is male, so don't think it is the same one. I did not have a small butterfly needle, I had a large syringe with a very long needle. There was no tubing, the needle went directly into the TE port.