Topic: The Itty Bitty Titty Committee

Forum: Breast Reconstruction — Talk with others facing decisions about whether or not to have breast reconstruction, and if so, what type and when.

Posted on: Dec 31, 2019 03:17PM

Posted on: Dec 31, 2019 03:17PM

hapa wrote:

I really should have started this thread two years ago, but I didn't, so I'm starting it today. If you are wanting to stay small-breasted or are just generally thin and want advice on reconstruction from other women in the same boat, this is the place to ask. Hopefully other small-breasted/thin women will chime in to offer their experiences and advice as well.

Personally, I was a 41 year old trail runner, BMI was a very solid 19-21, 5'3" with an A/B cup and wanted to stay about the same size. I never considered myself to be particularly thin or athletic, or even small-breasted, but I don't think my PSs had a lot of experience reconstructing women my size. I had direct to implant reconstruction plus two revisions: one because my first set of implants were horribly mis-sized by my PS, and the second more recently was fat grafting, which only yielded 30ccs of fat (which is about 2 tablespoons - not worth the down time IMO). I currently have Allergan Inspira Responsive Low-Plus profile 215cc implants. If I had to do it again, I would have gotten TEs at my BMX instead of going direct to implant, and I probably wouldn't have bothered with fat grafting.

Dx 3/20/2018, IDC, Right, 3cm, Stage IIIA, 3/18 nodes, ER+/PR+, HER2- Targeted Therapy 3/28/2018 Herceptin (trastuzumab) Targeted Therapy 3/28/2018 Perjeta (pertuzumab) Chemotherapy 3/28/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 8/22/2018 Lymph node removal; Lymph node removal (Right): Underarm/Axillary; Mastectomy; Mastectomy (Right); Prophylactic mastectomy; Prophylactic mastectomy (Left); Reconstruction (Left): Silicone implant; Reconstruction (Right): Silicone implant Radiation Therapy 10/22/2018 Whole breast: Lymph nodes, Chest wall Hormonal Therapy 12/21/2018 Arimidex (anastrozole), Zoladex (goserelin) Targeted Therapy Nerlynx
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Jan 13, 2020 02:42PM - edited Jan 20, 2020 03:21PM by hapa

I've not heard of Ideal Implants until now. They look interesting. One thing to consider: the silicone implants that are used today are cohesive, so they do not leak if they rupture. They are also "overfilled" so they have a profile much like the Ideal implant, they don't look deflated and they don't deform as much when held vertically. The Ideal marketing info appears to be comparing their implant to older silicone implants. So not that much of a difference IMO, though I haven't felt the two side by side or seen any implanted.

With the swelling down, I can now see where the fat grafting evened out the top of the breasts on both sides. The divot near my armpit was also filled on both sides, though it looks like the fat took on the prophy side but not the cancer side. The cancer breast still sits higher than the other. I am hoping it relaxes and droops a little over the next couple months. The scar tissue that was removed from my armpit does not seem to have made much difference in terms of how tight that area is or the nerve issues it was causing, though I will wait and see how that plays out as well.

Dx 3/20/2018, IDC, Right, 3cm, Stage IIIA, 3/18 nodes, ER+/PR+, HER2- Targeted Therapy 3/28/2018 Herceptin (trastuzumab) Targeted Therapy 3/28/2018 Perjeta (pertuzumab) Chemotherapy 3/28/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 8/22/2018 Lymph node removal; Lymph node removal (Right): Underarm/Axillary; Mastectomy; Mastectomy (Right); Prophylactic mastectomy; Prophylactic mastectomy (Left); Reconstruction (Left): Silicone implant; Reconstruction (Right): Silicone implant Radiation Therapy 10/22/2018 Whole breast: Lymph nodes, Chest wall Hormonal Therapy 12/21/2018 Arimidex (anastrozole), Zoladex (goserelin) Targeted Therapy Nerlynx
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Jan 13, 2020 03:13PM Cpeachymom wrote:

ali52- I have Ideal, I liked the idea of saline, prepectoral with alloderm.

39 at Dx. Fate whispers to the warrior, 'You can not withstand the storm.' The warrior whispers back, 'I am the storm.' Dx 6/21/2017, IDC, Right, 4cm, Stage IIB, Grade 1, 1/3 nodes, ER+/PR+, HER2- Surgery 7/5/2017 Lymph node removal: Sentinel; Mastectomy: Right Hormonal Therapy 9/11/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 9/18/2017 Lymph nodes, Chest wall Surgery 10/10/2018 Reconstruction (right): Tissue expander placement Surgery 3/24/2019 Reconstruction (right): Saline implant Hormonal Therapy Zoladex (goserelin)
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Jan 20, 2020 03:25PM hapa wrote:

Cpeachymom - can you tell us more about your Ideal implants? How do they look/feel? Any ripples? Did you have fat grafting with them?

My revision is settling and I'd say there is slight improvement over where I started. The scar tissue in my armpit is looser than before; a lot of the tightness I still had after surgery was just swelling. I could feel a long, hard ridge under there after surgery if I dug in, but that isn't quite so hard anymore, though it is thick. I don't know if that was a muscle or tendon or just the scar tissue. The cancer side looks a little more like the prophy side but is still smaller. It is a bit more droopy than before but still kind of hard and perky compared to the left. Maybe it's just me but I like them to look a little bit droopy without a bra as it seems more natural. Otherwise they look like barbie boobs to me. Still hoping for more improvement. I am a little over three weeks out from surgery at this point.

Dx 3/20/2018, IDC, Right, 3cm, Stage IIIA, 3/18 nodes, ER+/PR+, HER2- Targeted Therapy 3/28/2018 Herceptin (trastuzumab) Targeted Therapy 3/28/2018 Perjeta (pertuzumab) Chemotherapy 3/28/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 8/22/2018 Lymph node removal; Lymph node removal (Right): Underarm/Axillary; Mastectomy; Mastectomy (Right); Prophylactic mastectomy; Prophylactic mastectomy (Left); Reconstruction (Left): Silicone implant; Reconstruction (Right): Silicone implant Radiation Therapy 10/22/2018 Whole breast: Lymph nodes, Chest wall Hormonal Therapy 12/21/2018 Arimidex (anastrozole), Zoladex (goserelin) Targeted Therapy Nerlynx
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Jan 20, 2020 04:52PM nola70115 wrote:

My natural breasts were very large, droopy, and asymmetrical. I HATED them and had basically been ashamed of my body since I was 11 years old. I was glad to have an excuse to get rid of them, although I'd have rather not had cancer though LOL. I had to argue with the PS about wanting to go down in size. It was like they'd never heard of somebody wanting smaller breasts before. Since I had plenty of skin I went direct to implant.

What I didn't plan on was gaining weight during chemo and from tamoxifen. Before, my breasts were where I carried most of my weight, so when I gained, they just got bigger. Without breasts to absorb weight gain, it went to mid-section. My proportions are all screwed up now because my waist measurement is the same as my bust. I'm basically barrel-shaped. I don't miss having large boobs but I miss being able to buy clothes that fit. Work clothes, like suits, are just about impossible to wear anymore.

I really don't want more surgeries but I feel like I need to get a revision and lipo around my waist. The implants still feel exactly like silicone bags shoved under my muscles, even five years later. My body is just something I live with rather than feel good about. I won't let them give me huge breasts again though. I can only imagine how much that much of an implant would weigh. Even the relatively small ones I have feel cumbersome.

Age 40 at first diagnosis, 47 now. I've got an autistic teenager and a toddler to live for. See my 2014 blog at snarkforthecure.wordpress.com. Dx 4/15/2014, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 5/15/2014 Lymph node removal; Lymph node removal (Left); Mastectomy; Mastectomy (Left); Mastectomy (Right); Reconstruction (Left); Reconstruction (Right) Chemotherapy 6/20/2014 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 9/1/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 2/8/2021, IDC, Left, <1cm, Grade 2, ER+/PR+, HER2- Dx 2/22/2021, IDC, Left, Stage IV, metastasized to liver, ER+/PR+, HER2-
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Jan 20, 2020 04:54PM hapa wrote:

Nola, are you a candidate for a DIEP? It's more scars, but women who get them seem to love it. I guess it feels a lot like normal breasts, which you will never get from implants.

Dx 3/20/2018, IDC, Right, 3cm, Stage IIIA, 3/18 nodes, ER+/PR+, HER2- Targeted Therapy 3/28/2018 Herceptin (trastuzumab) Targeted Therapy 3/28/2018 Perjeta (pertuzumab) Chemotherapy 3/28/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 8/22/2018 Lymph node removal; Lymph node removal (Right): Underarm/Axillary; Mastectomy; Mastectomy (Right); Prophylactic mastectomy; Prophylactic mastectomy (Left); Reconstruction (Left): Silicone implant; Reconstruction (Right): Silicone implant Radiation Therapy 10/22/2018 Whole breast: Lymph nodes, Chest wall Hormonal Therapy 12/21/2018 Arimidex (anastrozole), Zoladex (goserelin) Targeted Therapy Nerlynx
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Jan 20, 2020 04:58PM minustwo wrote:

hapa - one thing with implants, it takes from 6 weeks up to 6 months to tell how they will look. You said you are only 3 weeks out, so although it is hard - try to step back from the mirror for awhile. You can read about the changes everyone goes through on the "exchange" thread.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Jan 20, 2020 06:10PM hapa wrote:

MinusTwo - I'm aware of that, just giving an update. I don't expect any major changes though, these are not going to "drop and fluff" like sub-pec implants do. Hopefully the fat grafting causes some of the scar tissue to remodel and the skin on the cancer side will get more elastic. It is definitely not going to get any bigger than it is now, so if it's smaller than the prophy side it will always be unless I get more work done.

Dx 3/20/2018, IDC, Right, 3cm, Stage IIIA, 3/18 nodes, ER+/PR+, HER2- Targeted Therapy 3/28/2018 Herceptin (trastuzumab) Targeted Therapy 3/28/2018 Perjeta (pertuzumab) Chemotherapy 3/28/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 8/22/2018 Lymph node removal; Lymph node removal (Right): Underarm/Axillary; Mastectomy; Mastectomy (Right); Prophylactic mastectomy; Prophylactic mastectomy (Left); Reconstruction (Left): Silicone implant; Reconstruction (Right): Silicone implant Radiation Therapy 10/22/2018 Whole breast: Lymph nodes, Chest wall Hormonal Therapy 12/21/2018 Arimidex (anastrozole), Zoladex (goserelin) Targeted Therapy Nerlynx
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Jan 20, 2020 08:28PM nola70115 wrote:

Hapa, a DIEP is what I am considering. I've definitely got the fat for it. I didn't get it the first time around because I didn't want the really long surgery and recovery time. The idea of having my entire torso cut up like a patchwork quilt does not appeal, and there's the risk of complications. It would be really distressing for me to have one or both sides "fail" and wind up looking worse than I do now. I chose implants because I wanted the fastest surgery and recovery, but it seems like the only way to avoid future surgeries to to skip reconstruction altogether.

Age 40 at first diagnosis, 47 now. I've got an autistic teenager and a toddler to live for. See my 2014 blog at snarkforthecure.wordpress.com. Dx 4/15/2014, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 5/15/2014 Lymph node removal; Lymph node removal (Left); Mastectomy; Mastectomy (Left); Mastectomy (Right); Reconstruction (Left); Reconstruction (Right) Chemotherapy 6/20/2014 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 9/1/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 2/8/2021, IDC, Left, <1cm, Grade 2, ER+/PR+, HER2- Dx 2/22/2021, IDC, Left, Stage IV, metastasized to liver, ER+/PR+, HER2-
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Jan 20, 2020 09:05PM - edited Jan 20, 2020 09:09PM by beeline

Cpeachy - were you able to do implant recon after rads? I am waiting for my official consult but have been told informally I'll need to use autologous tissue on the radiated side. I am also about a year out.
Like others here, I am/was a member of the itty bitty titty committee and hoping to stay that way!


Moved back to the US in July 2022. Starting Verzenio Jan 2023. American in NZ. Dx’d at 42. Had to stop Taxol after #6 due to neuropathy. Randomised to control group in MonarcheE trial 😩 Started delayed recon with FT and implants in 2020, finished July 2021. Dx 7/17/2018, IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+, HER2- Surgery 8/2/2018 Lymph node removal; Lymph node removal (Right): Sentinel, Underarm/Axillary; Mastectomy; Mastectomy (Right) Dx 8/21/2018, DCIS/IDC/Paget's, Right, 2cm, Stage IIIC, Grade 2, 10/22 nodes, ER+/PR+, HER2- Chemotherapy 9/17/2018 AC + T (Taxol) Hormonal Therapy 2/12/2019 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 2/24/2019 Whole breast: Lymph nodes, Chest wall Hormonal Therapy 1/21/2020 Arimidex (anastrozole), Femara (letrozole) Targeted Therapy 1/27/2023 Verzenio
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Jan 20, 2020 09:16PM legomaster225 wrote:

Count me in the committee. I've been small all my life. My PS was wonderful about making me look pretty much exactly the size I was before. I went immediately to implants 235cc. I'm 5'5" and have been about 110 lbs my entire adult life. Big boobs would look ridiculous on me. Maybe if I was younger I might have gone bigger but not now. I'm happy with my results.

Dx 12/3/2016, IDC, Right, 3cm, Stage IIB, Grade 2, 0/4 nodes, ER+/PR+, HER2- Chemotherapy 1/19/2017 AC + T (Taxol) Dx 6/22/2017, DCIS, Left, <1cm, Stage 0, Grade 1 Dx 6/22/2017, IDC, Left, <1cm, Stage IB, Grade 1, 0/0 nodes, ER+/PR+, HER2- Surgery 6/22/2017 Lymph node removal; Mastectomy; Mastectomy (Left); Mastectomy (Right); Reconstruction (Left): Silicone implant; Reconstruction (Right): Silicone implant Radiation Therapy 8/22/2017 Whole breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 10/17/2017 Hormonal Therapy 9/9/2018 Aromasin (exemestane)

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