Exchange City
Comments
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IMPLANTS SMALLER THAN EXPANDERS:
I just bumped up the old thread with the above title, where the discussion regarding implant sizing methods originally began. Look for the thread in the Breast Reconstruction forum....
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When I had my first exchange, I asked PS about the drop and fluff. He did all of the above except to say he had never heard of it before. Your post gave me a good laugh.
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Tory - My first implants were Mentor High Profile Smooth Saline expanded to 750cc. I liked the projection, but there was a wide gap between the implants and if I lifted my arms, they sort of disappeared. The pockets stretched in the 2 1/2 months I had them and when PS was going to do the nip surgery, I insisted I needed larger implants. DH wasn't so sure, but by the day of surgery, he told the PS he thought I did need the larger implants. We went to the Mentor Moderate Profile Plus smooth saline expanded to 960cc each. I am very pleased with the size and shape. Just the vascular problems the thin skin and muscle has caused with some ripple effect on lower pole that PS is not happy with. This is why he is going to correct them with the alloderm sling. I think it is worse on my right breast due to lowering IMF. I see PS on Wed. for follow-up and will see what he thinks now that it has been almost 6 months. I wear a 40 C or D depending on bra style. Some of my older 40Ds still fit, but I am now uncomfortable in underwires.
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Reading the message board under the influence of pain meds, is a unique experience to say the least.
Glad to hear that everone's procedures went well this week.
Oddly I think I have less pain with the DIEP than I did with the BMX last year, but it might just be better pain managment.
Back to my fuzzy little world, I'll check in again soon (((hugs))))
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Hi All--
Well it looks like I'm finally going to have my revision on July 19th. My right pocket is too large and my implant gets under my arm. He is going to stitch the pocket down and excise some skin, as I have a little extra skin on that side. If I don't do it this summer, I won't be able to do it again until next summer because I'm too busy with work, school, and mom stuff.
I'm also booked for fat grafting to reduce step off and hopefully some rippling. I would really appreciate hearing from those of you who had grafting--did it work? How do they blend it in? Any problems? Really I'd like to hear anything regarding the grafting. So we don't clog up the site, you can PM me if you like. My PS doesn't seem to think it will help the rippling, but I've read that it can. I'm still kind of uncertain about the process.
Hugs--Karen
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HI BIGAPPLE, Been keeping an eye out for you. Glad to hear everything is going well. Amazing that your pain is either so well managed or so minimal! I think you are at MSKCC, right? Hope the nursing care for flap surgery was better than the "self-service" care I got on the regular floor after my BMX!! I couldn't wait to get out of there! Enjoy your haze...it must be good to have this behind you...
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I had the DIEP at NS Manhasset. Unfortunatly they will be getting a detailed letter about the deficient care on the specialty surgery unit I was on. When I was at MSK last year (both stays) I was on 10 and the care was great the nurses were wonderful, proactive and dilligent. I was literally emptying my own drains at NS. At one point my drains became so full thatthey started to pop open, and spill out (onto my newly stitched belly) and when my roommate went out the second time to get someone to come help me, we were treated to my nurse saying "what is she complaining about" It was quite the experience. The home care services that NS has arranged so far have been very good, no complaints there, but the patient care was like the self service you described.
I'm still a patient at MSK, but I went to Dr Isreali for this procedure for a number of reasons. If I could have had him do the surgery there and recovered on floor 10, it would have been great.
back to sleep again
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The mystery of predicting size after exchange is even more mysterious now ..I read some of the thread on "Implants Smaller Than Expanders". On the first page were posts from 3 different women, seemingly similar in body habitus ( couldnt compare exactly), who each had Mentor smooth round hi profile 425's and one was a B, one a C and one a D!!! Yipes. The moral of the story IS ???
(How come I can't figure this out?)
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. Breast Reconstruction wreeks havoc on your stress level, doesn't t.????How did WE end up making Plastic Surgery design dscisions??????lol
In my opinion, they moral of the story is;
1. Start with a Experienced (Portfolio?) BC Reconstruction PS
2. Inform yourself here, (consult Whippetmom with your measurements and expander types( and photos during expansion ideally)
3. Read everyones story-We all have many variables and we will all have varifying results and ideals
4. Familiarize yourself with products and options on the market, EARLY
5. Develop an open and direct line of communication with your PS (come with a couple of direct questions written down at each app - It makes GREAT use of the 5,6,7 expansions apt while we have our PS undivided attention.
6. Follow your PS guidlines about when you are optimally ready for exchange (fully expanded, skin ready, time set aside to heal from adjuvant therapies and emotionally ready for the next surgery. DON'T COMPROMISE BCUZ UR IN A HURRY!
7. BE CONFIDENT THAT YOU HAVE MADE THE BEST INFORMED CHOICE YOU CAN AT YOUR TIME OF SURGERY-PRAY-SPEAK POSITIVELY
AcceptALOT is OUT of your control and thats 'ok' xo 8. Remember a large percent of us require revisons or may experience complications!!! Remember Some Don't:) ,Pray again!!!!
And when in your heart off hearts you feel in your deepest of dreams "not satisfied"... try try try to recall a time whenur mind was FLOODED with apts. and unfamiliar decisions and unwelcome responsible to deal with cancer.... you remember your caregivers saying "Reconstruction" can never return you perfectly to your pre-cancer/prophylactic Tx Breasts, its a LOOONG sometimes arduous process, but the majority of women who chose it , in the END, would do it again and again.....
Some even find the journey...... a time of deep personal revelation !
Hugs to all my EC sisters that extended time, love, and patience with me. WHAAT would i have done withOUT Breastcancer.org????????????????????????????????????????????????(So glad the DAY of my diagnosis, my preventative onc of 12 years, cried with me, and said.... be careful what you read on the internet.... try BREASTCANCER.ORG!!!!!!!
4.
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A SISTER ON BCO needs some major prayers . I will not give up her story or privacy ( not my place) but she NEEDS prayer for her special intention. Girls.. we ALL know this girl here...... PLEASE lift her up in your prayers...0
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consider it done
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Thanks for letting us know, Laura.
karen
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Geneskirt: Well said!
Laura: Will do!
TCK
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whippletmom- this is my first post. I've been an avid reader on the discussion boards since my diagnosis last Fall and have been following the advise of so much shared knowledge here. Now I'm needing advise regarding my exchange.
I was dx with bilateral BC 9/09 at age 53, left breast triple neg (ductal), right breast hormone +(lobular). Yep, a double whammy. Had bilat MX w/ TEs 11/09. Was expanded every 2 wks during dose dense chemo. Was small breasted--A cup prior to Mx and wanted to be a B cup with the implants. I'm 5' 9'', 155lbs, rib cage 32". Last fill was 3/22/10 to 500ccs. Exchange surgery was 5/5/10 using Mentor moderate profile plus 500cc implants. I'm 3 1/2 wks post exchange and I think the implants used may be to wide for me. They are placed very high on my chest and protrude under my arms. They are very firm and do not 'squish' at all. The right one is bigger and higher than the left one. My PS said he had to do a lot of work on the right one(not sure what that means). It also feels like I still have those dreaded TEs in(not as painful, more like I'm wearing a tight internal bra). It's very uncomfortable when I try to lift my arms across my chest(my pecs contract hard and implants pull at my underarm ligaments). Do you think they will eventually drop down away from my underam ligaments? Will they get softer and squish at all? Also, does this internal bra feeling ever go away or do you just get used to it? Any advise ladies (you are my heros), other than to be patient for the next 3 months as they settle?
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Estepp: Done!
Geneskirt: Well said!
BigApple: My experience in hospitals is it's all about the nurse you get! My day nurse had an attitude and couldn't be bothered with anything, yet my night nurse was an absolute angel. Wishing you a speedy recovery.
DelRayBeach: Wow, I am reading your post very carefully. I am 6' tall, 156 pounds, with a 32" ribcage and I was also going to have the Mentor Mid Profile Plus 500's. I am not the expert here so I don't have an answer to your questions but I am curious: how close together in the middle are they? Also, did he do an Alloderm sling to hold them in place? Finally, maybe you had alot of scarring when they removed the expander or maybe the expander moved so they had to do more work on one side. Did you also have radiation to one side? Being it's a holiday weekend you might not get an answer to your questions right away but I am sure if you are patient you will get the help that you need! I do know that it can take 3-8 months for them to drop into the pocket--if you go back a couple of pages Whippetmom posted some detailed information on this. I don't think they should still be under your arms though--Whippetmom can also help you with this.
Mary
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Laura....YES ... Special Prayers coming and ongoing ones for you and all of us. Please keep me in your prayers as well.
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Prayers are coming! Thanks Estepp~ Anna
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Delray Beach: My sister has the moderate plus profile in 533 ccs [Allergan's MPP version] and her ribcage is 31 inches. She is under Deeds on the pictures forum. I do not think that hers are too wide for her frame. She is taller than I am and has a more athletic upper body and so this is why the PS chose this style for her.
So frankly, I think something else is going on for you. The placement issue sounds like something which might need to be remedied. I worry about capsular contracture on the right. But I am going to need you to shoot some pictures over to me [I am PM'ing you my email address] so that I can see what is going on. You should not be feeling this degree of firmness. That said, however, I also need to ask you, based on your description of how you are "feeling", if you had a partial submuscular placement [implants under the pectorals only] or complete submuscular - implants under the pectorals, the serratus and the connective tissuse covering the abdominal muscles. In the "full" coverage status, the implants are more compressed, remain firmer and in this compressed state, could appear wider on the chest wall. Full coverage of the implant also can impact projection in the lower pole of the breast pocket. So I need you to confirm that you have NOT had complete submuscular placement. My sister has complete submuscular placement and her implants feel very tight and firm and they do compress more than I believe they would if they were partials.
We have plenty of time to come up with some solutions for you...
Deborah
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LAURA: I will be praying!
GENESKIRT: You rock!!! What a great, wise, heart-felt post.
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MBJ- thanks for your reply. We are very similar--even our diagnosis(at least on one breast for me!). I did not have rads. Not sure about an Alloderm sling. Will have to ask PS. The implants are pretty close together--probably less than 1 inch apart at the top and maybe 2 inch apart at bottom of the slopes. I'm pretty happy with the size and projection, just not with how they are feeling right now--firm and tight-- and the creep into my armpit ligaments. When is your exchange surgery?
Whippletmon- wow. how do you know all this? I don't know what kind of placement I had. Never thought to ask and PS never said. I go back to see PS on 6/7/10 so I'll have plenty of questions to ask. Thanks for your quick reply. What would we do without you? I'm going to have to circle back later on. I'm heading out the door to go see Sex & City 2 movie with 2 girlfriends and their 85 yr old mother! How awesome is she! Then it's dinner and some wine. .......check back later..
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Geneskirt - So well-said. Thx. Remember this page # and refer newbies as needed.
Laura - on their way.
Bigapple - so glad to hear from you, despite the nurse problems. A swift recovery to you!
Hope everyone's got sunshine on this glorious day. CS
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Whippetmom~ the full submuscular implants....i think that's what i have had. My PS and BS before surgery,said they would put the TE's under my pectoral muscle and the '????' muscle (i forget!) but the muscle he was on about,is at the bottom/outside of the 'breast'. He said they would have to partially detach it from my ribs. Does that sound like the full submuscular?
Will this make a difference to the size i can be stretched to?
If i had chosen to wait 6 months for my recon,the other PS i saw said i would only have to have the pectoral muscle 'lifted'and therefore could go to a bigger size. I was going to opt for this purely so i could go a bit bigger,but my current PS and BS said it really didn't make much difference,and that they skin would have healed down onto the chest wall in 6 months,making stretching more difficult.
Was a little onerwhelmed by all the info so chose the immediate recon.
Kay
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Delray, I'm sorry about all you are going thru. One side for me was firm at first (from previous scarring), PS told me to massage it. at appointment last week he said it was definitely softer. And i can't feel a difference anymore in softness between each side. So you might want to ask your PS about massage to soften implants up(actually the scar tissue), there' s a little controversy about it so make sure you get the okay!
Deborah, When I was first measured by PS, he took measurement across front of chest, I'm pretty sure from sternum to side, just wondering if that would give you additional info along with complete circumference in helping everyone with sizing.
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Kay: You will want to ask your PS about your specific placement, but it certainly sounds like you might have complete submusculars. There are differing views on this type of placement referable to sizing out implants. I recall one PS said he always uses implants larger than the TEs, in order to get as much appearance of volume and projection as he can. Who this was, I cannot recall. So actually, for YOU, if you do have complete submusculars, the gummy bears would be my implant of choice, simply because they are firmer, more rigid and would not compress as much as would the standard silicone rounds.
Here is some information on "placement" of implants...
http://www.justbreastimplants.com/placement/complete_unders.htm
Katey: Yes, there are a lot of different measurements plastics use, some of which I have listed on Page 99 of this thread. Some plastics just "eyeball" the patient - having done so many reconstruction procedures, they feel they just instinctively know which TE to use on a patient. Mine measured, my sister's did not. So it does not appear to be an exact science, which is why a layperson like MOI can figure this stuff out to some degree.
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Laura I will send many prayers.....
GeneSkirt thanks for the thoughtful and very useful post...it should help many
DelrayBeach, my implants are 4.5 weeks from exchange and they still feel very firm to me
![:\](https://community.breastcancer.org/resources/emoji/confused.png ":\")
My implants are Mentor 600 Moderate Plus...my TEs were filled to 620. I will see my ps again next week and will ask him about the continued firmness. I think it may be because there is so little difference between the size of my implants and the size of my TEs. I too still have the bra feeling and still become breathless easily...like someone is sitting on my chest =( I am hoping that the chest muscle will relax over time and the implants will become softer as this happens.Maybe some of the ladies on this list who have had implants that are similar in size to their TEs or some who have had implants that were bigger than their TEs could talk about this.
I do feel changes, especially in this last week (week 4) I felt very little change before that.
Hope you find some answers
BigApple...good to hear that your coming along
Enjoy your weekend!
Strength and healing,
Laura2
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EQUATING IMPLANT VOLUME TO CUP SIZE:
What some of the experts have to say about this:
http://www.realself.com/question/Breast-implants-size-full-b-cup
http://www.breastsurgeondallas.com/breast_augmentation_faq.html
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Delray and Jizogarden - While my implants didn't feel hard after my exchange, I had LOTS of tightness and even pain for at least a month after my exchange. My TEs were underfilled and my implants were more than twice the ccs that my TEs were. My pecs were really sore for a long time. Now I'm three months out and I feel much better though at times I have some spasms and tightness. I usually don't have that tight bra feeling anymore, which is such a relief. Good luck to you both. And yes, keep on stretching several times every day - that is crucial!
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Has anyone had a CC after implant surgery and what was your symptoms?
I am 3 months post- op, feeling tightness, and the right side is not moving around when i displace it like it used to.
Am I doing something wrong-not stretching enough?
Wore a bathing suit for the first time in front of people this weekend. I didnt expect to feel sorry for myself when i did. Thought most of those days were over. I envied all the girls and there soft, natural breasts...so carefree. Remember carefree.............
Kristen
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Y'all make my head spin, you move so fast. I posted last Thursday asking for experiences to help me decide about keeping my TEs or going for the exchange. I haven't been on for a few days & I'm so behind. Thank you to all of you that shared your thoughts & experiences! I should have been clearer about what I have -- I do have the Mentor Spectrum one step TEs (of course, Deborah nailed that one!) that can serve as the implants. This is what has me baffled. It seems to me if they're intended to be left in, they'd be more comfortable. I can't imagine going for decades with these things rubbing along my ribs or not being able to sleep on my side. Or does this get better as my body adapts? Anyone else had these? Unfortunately, I can't stretch the decision making out. I'm now on a "cadillac" insurance plan, but that will change before too long. Any knowledge of this one step option? Please pass it on. Thanks!
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Wow! Tomorrow is the Last Day of May!!!!
HERE COMES JUNE, GIRLS! Happy New Month to all the June Exchanges, Nips and
Revsions!It's like reaching the month of your unborn babies due date, isn't it? lol , but expecitng 'TWINS'
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