Exchange City

Sweetie, I know that women vary a lot in terms of how much pec muscles they have, how big the sternum is, where implants are placed in terms of low or high...things like that. If you think about it or check out how pec muscles attach anatomically (Google images), the top part covers more and also since a 1/3 of our implants are not under the muscle (the bottom 1/3 is not), I would think the lower the placement, the more the implant is more visable. This is all me guessing here...I originally thought that ALL of the implant when under the muscles but in reality most "under the muscle" placements are only 2/3 under the muscles. Some docs do 100% muscle coverage but it isn't common. My ps got my implants super close because of how my sternum is but I was a bit afraid of developing a uniboob (which I seriously hope never happens!!!). I couldn't go any bigger than 400 or at least my ps was afraid to. I know they don't want too tight of a pocket nor too loose! My ps said that each chest is so different which makes it so hard for us to choose sizes etc. when we are comparing sizes against others that have similar specs. I think you look great though! I am curious too how time is going to change the look of them.

JenC, the fat grafting topic will probably give you some different answers. My ps won't even do fat grafting...she said it causes too many hard lumps which isn't psychologically good for bc patients. There are a lot of women here who have had it though who have had good results and a willing ps! I think Deborah had some fat grafting if my memory serves me correct!

Debbys17, I am 2 weeks today since my exchange and I am also in a sports bra 24/7. I go this Monday to see my ps and I am going to ask her what the schedule is in terms of what bra to wear and for how long. I am going to guess she will say a month for the sports bra. Will report what she says though when I see her! 

sweetie - I had the same issue with rippling ... it was fine as long as I stood up straight, shoulders back but if I slouched my shoulders or bent over there was some rippling.  I think mine is better but I honestly think I don't notice it as much anymore.  Hopefully yours will resolve with time.  And too, I think if your skin is thin, like mine and maybe yours, there IS going to be SOME rippling.  I do hope yours gets better, although it isn't bad now!    Remember, you're still wayyyyyy early!

Sweetie: I think all of the above but certainly, #1) pecs -- there are anatomical limits to how much they can be stretched, #2) skin (ditto) and in your case #3) the nipples... since you had NSM. 

lg300, Thanks for your response.  I'm sorry to hear you have been through so much.  I think you will be so relieved to get the expanders out and the permanent implants in.  I wish you all the best with your exchange.

Kitwe -- go to the thread entitled Breast Implant Sizing 101 and read the header there to find out what info Whippetmom needs from you (so she can advise)...

Sweetie - larger implants helped with my ripples (also went from saline to silicone which holds its shape better). I think I'm your size (5'7" 130#)... was a 32C before and 32D now (the implants ar just wider than natural breasts). Replaced 450 saline with 600 silicone. I still have rippling but its not as bad. Mostly I have that step-off that is so common. May be doing some fat grafting down the road... not sure since I have a lump now I don't want to go through this again for fat necrosis if there is any chance fat grafting will cause suspicious lumps.

Hi ladies, Yes.  Fat grafting is covered by your insurance.  Some PSs I think, are conservative in how much they're willing to stretch the muscle and skin.  My first PS said 460 expansion with the TEs was as far as he could go and he put in 400cc implants.  Second PS put in 550 cc implants.  So, I did have enough muscle and enough stretch in my skin without making my skin too thin.  I am having some bottoming out issues with my 550s now tho.  

I am planning to have my IMF raised and some fat grafting done to the right upper sternum area where the BS took more than he did from the left side.  It's a rather large area for grafting, but PS3 is willing to do it to help fill the hole in my chest that has developed.  You can see it really well on the Post your bras thread on the pic forum.  I'm not having it done until Jan.  So I can't really answer many questions about it yet.  He just said it won't be the same as the left side because it's such a large deep space, but he can make it better.  PS2 wouldn't do any fat grafting because of the lumps that can develop from the fat.  But my hole is so large that my clothes pull to one side and my bras shift.  So, I'm taking my chances. 

So saw PS yesterday and he said no underwires for 6 weeks, but wants me in a bra that holds foobs in place, but not a sports bra - thinks that some of them tend to squish the foobs and pushes them outward.  Since it has only been a week I am going to stick with this surgical bra for another week.  I guess I better read up on the Bra forum, so much information there.

PS also said that the implants are suppossed to move in the pocket (a little), wants me to cup them and push them five times and then gently press them down once.  To do this everytime I go to the bathroom - so I remember.  He says this keeps them from adhereing to the pocket.  Sounds like the massaging some of you have been told to do. 

He was happy with his work and said some breast augmentations don't look as good (I'll post picctures next week). 

debbys17 - I wonder why some use drains at exchange and some don't.  He had to remove scar tissue, move them a little closer together, but I don't have much swelling and hardly no pain.

sweetie and hurleygirly - LOOKING GOOD GIRLS!!  Don't you love how squeezeably soft they are?

Gail -- definitely do check with your Onco as well!  It can't hurt

Sweetie,  I don't know if the larger implant made them fall.  Other women have larger implants than mine and haven't fallen.  It might be that the bras that are the most comfortable don't offer as much support as some that aren't as comfortable.  The 550s really aren't heavy at all.  I don't notice the weight.  Just the volume.  I posted my pre-surgery pic, so you understand why the volume of the implants is so noticeable to me.  I like it tho.  I think the 550s are the perfect size for me.  

Astorm, an inflamed lymph node usually does mean some kind of infection.  Shaving your armpits can make the axillary nodes swell.  Also there there is some evidence linking swollen nodes to Rheumatoid Arthritis.   I'd go to the onc and see what he says.  Did you say you had a US done?  Go get the report and photos of that and take it with you to the onc.

 Astorm

Well, I guess sometimes our bodies just do weird stuff.  I'm glad it's nothing to worry about.

Okay, with Gail's recent findings, I just had to research this issue of lymph nodeds within the breast.  I did not find any scholarly articles, but I did find a breast cancer "informative" website which stated as follows:

"Yes, there are lymph nodes in the breast. The area directly under the nipple-areola complex and throughout the rest of the breast has many lymphatic vessels. These tiny channels carry a pale fluid that cleans tissue and then passes through lymph nodes, and eventually into the blood stream. All lymphatic channels lead to lymph nodes. They are small rounded masses of tissue. The lymph nodes filter the lymphatic fluid to keep foreign objects such as bacteria and cancer cells from gaining access to the rest of the body. 

 In about 10% of women, lymph nodes are found in the breast and they are 100% OK.  Since lymph nodes contain a central area of fat, they are usually easily distinguished on mammography and ultrasound. The central area of fat surrounded by the lymphatic tissue gives them certain diagnostic features."

So the only thing I would question is why these lymph nodes within the breast are not removed with connective tissue, fat and glands, at the time of MX....

But very interesting..... 

Finally had my exchange today.  I was so flipped out about it, my PS was laughing, he said the lat flap surgery with TE's was an 8 on a scale of 10 & I wasn't worried at all, but the exchange which he says is a 2, I was flipped out.  Guess I'm just odd,

Anyway, I have read all your posts about how great it is to get rid of the hard TE's & how great the gummies are, but you never really know until you've done it.  I can't believe the difference, I've been out of surgery for less than 12 hours & am so thrilled.  They are warm & squishy & feel like they are a part of me instead of some weird foreign objects on my chest.

All this to say, thank you to all of you who have posted here & on the picture forum, & helped me make a very difficult decision to do reconstruction.  I'm so glad I did it.

Thank you, cheers,

Dee

Lilah:  It's great to be back!   It was a great time and I will post pictures on foobville as soon as I get pictures downloaded and resized!

Dee:  Congrats on being done and squishee!!!