Topic: The Itty Bitty Titty Committee

Apr 7, 2020 03:46PM hapa wrote:

Eh, my fat grafting didn't seem to give good cosmetic results. I asked the PS why and he said to get the cancer side to match the other side he would have had to do a capsulectomy. SO WHY DIDN'T WE DO A FREAKING CAPSULECTOMY???? I don't know that I want to bother anymore. I will say that the tightness improved significantly from removing the scar tissue from my underarm and so did the numbness and tingling. So at least there's that.

Jun 16, 2020 02:36AM mikichi wrote:

Hi Ladies,

So happy to find this post, I only wish I had found you all sooner. I too ended up with implants that are bigger than I wanted.

I am 5'7' 124lbs, small frame, athletic. Before BMX I was 34AA.

When researching implant sizing on this site months ago I found so little information for 'smaller' women. I only wanted to be a B and from reading all the forums I thought I needed to get 350cc implants. Several PS websites said 250cc was a 'very small' implant.

My PS recommended direct to implant with 240cc since he estimated I had 190cc breast tissue. He never showed me sizes so I went off information I found online and I asked him to put in the biggest size possible - 300cc, which he said would be a B. Well, after the surgery I discovered my actual tissue was only 80ccs and that the 300cc moderate plus profile mentor smooth rounds looked completely ridiculous - I felt like a porn star. Even my husband cried for how completely out of proportion they looked on my body.

So I had the implants replaced. Again the surgeon wanted to go 235cc (narrower base, mentor smooth moderate profile - lower profile looks more natural PS said). I said lets do the smallest size available - 195cc, but we ended up agreeing to meet in the middle with 215cc moderate profile.

Two months post surgery and I went bra shopping. I am now a 32D. Both my husband and I think that the implants are still too big. The PS did a good job - they are symmetrical, and there is light/ moderate rippling as expected. But the foobs are bigger than I ever wanted. For many women they would be ideal, but personally they still feel huge.

It's a relief to hear that I am not the only one on this forum who feels this way, but also really frustrating. I don't want to go through another exchange and then end up with a worse result/ scarring/ contracture so I will just leave them alone for now. Maybe when they need to be replaced I can finally down size to some nice itty bitties again.

Just today I had what might be my final consult with the PS and asked about fat grafting. My chest was bony before, but now you can really see my ribs, including in between the implants, and a significant depression and line above the implant. In a bra or bathing suit my husband says you can obviously see that I have implants and the concave areas above the implant are noticeable. The PS said he could do fat grafting using fat on my thighs, but he would not recommend it. 'It will make a little improvement, but not what you are hoping for.' He told me the best option would be to gain weight. For someone who has been the same size since they were a teen and is very active, that is not a helpful suggestion.

So now I am wondering if it is worth it to do fat transfer. The experiences of ladies on the breastcancer forum, as well as recommendations on PS sites are really mixed. Is it worth it to go through another surgery? Do I want to use up my fat reserves on a procedure that might work? The big incentive to do it now is that I will lose my insurance coverage in three months so any future fat grafting will be out of pocket.

What do the other itty bitty ladies think? Was fat grafting worth it for you?

When I went in for direct to implant BMX, I naively thought it was going to be one and done. Now I see from this forum that it starts with the first one and then continues on with a lifetime of surgeries.

Advice to small women out there - make sure you have a really clear idea of what size you want to be after surgery. Ask the PS for photos of different sizes on women with similar frames. I went in with no clear idea and just trusted the PS to do what they thought was best. Ask to try sizers so you can get a feel of how new bigger implants will look and feel. The goal is to feel comfortable in your own body, not fit into the stereotype of what 'most women want.' If that means special ordering a smaller size implant than the PS usually caries, then be prepared to wait to get the right size.

Jun 18, 2020 04:44AM beach2beach wrote:

Hi,

I was always very small chested. Barely filled an A. After finding out I had BC i decided to do a bilateral mastectomy. Both boobs had taken biopsies over the years and doing a lumpectomy really would have left that sucker deflated. Because I was thin I did not have any fat to use for DIEP so the PS suggested direct to implants. My skin was tight..so couldn't say how big he could go. End result, I came out with a 140cc..more than I had before but still small but I have shape to it. Before I don't even think I had anything you would call cleavage. :) I can pass in a 32B now, not completely filling it. You can see ripples but unless they lob fat off of my butt and stuff it around it, I'm ok with it. I would not have looked right with anything big. I'm 5'10 and at the time I was 137.

I now and forever shall be one in the itty bitty titty group.

Jun 18, 2020 09:52AM MinusTwo wrote:

Just for grins & giggles, I found the old thread from 2014. But even just look at the header, the picture is startling.

https://community.breastcancer.org/forum/44/topics...

Oct 27, 2020 02:29PM beeline wrote:

Hi, for those itty bitties who have implants and are satisfied with their outcome, can you tell me what size they are? I've re-read the thread and see just a couple mentioned. I am currently mid-delayed recon with a tissue expander filled to 140 and trying to get a sense of how much farther to go. I'm about 5'3" 19-20 bmi. Always been an A/B cup. I know it's different for everyone, but would still love more data points from others on the smaller side.

hapa, I see you're at 215 now. What size were your "oranges bolted to a telephone pole" implants?

Thanks!

Oct 27, 2020 09:17PM hapa wrote:

beekine, I think the oranges were 195 on one side and 220 on the other. The current ones are wider (bigger base) and lower profile

Aug 13, 2021 12:23AM ChrisJack1 wrote:

Oh my you are my peeps! I am teeny, maybe a 32 AA at best and I'm 5.9 and 122 so can't get a diep etc (too bad they can't use my cellulite laden saddle bags. My upper body is disproportionately smaller and bonier than my lower body so yeah, I'm a pear. I am getting a mastectomy w recon on September 16 instead of BS recommended lumpectomy w radiation because removal of my tumor will require losing my lower breast pole. Despite the fact that the BS admitted that I could have a significant defect from a lumpectomy w rads, she thought it "likely wouldn't look too bad". The first BS I consulted said it would "disfigure me" but still she recommended a lumpectomy w rads too. Honestly, I believe they assume it wouldn't be that big of a deal because I have such small breasts. The PS thought that most likely was the issue, and although he conceded that there could be an over hang/droop & puckering effect after rads (tumor is about a half an inch down from the nipple) he warned me that he would have to make me a large b or small C because the footprint of the smaller implants would be too small. I wanted to be a full A and at most a small B. Has anyone had this issue?? Anyone told they have to go bigger even thou they are narrow? This is a reputable PS from a prestigious hosp in a large east coast city saying this.

ALSO, I told the PS that maybe I should just consider going flat on that side because he said that implants (sub-pec he recommended) would look "pretty darn fake" on me bc I have thin skin and I'm boney. He warned me that I will have extensive rippling, be able to see the outline of the silicone implant in places, and it will sit high up. He said that may be something to consider since I don't want the fake look and I really "didn't have much breast tissue to begin with". Basically, he said, a mastectomy wouldn't be so drastic bc I'm pretty darn flat already. TO ME it feels like my concerns re loss of my breast and issues re reconstruction matter less bc I didn't have breasts (read, bigger breasts) to begin with. My own mother said going flat wouldn't be such a big deal bc I'm so small and so many women athletes are small and "didn't I watch the Olympics". Ahhhh

Anyone feel dismissed - like it didn't matter? I have always been so embarrassed about the size of my breasts and my body - not feeling feminine and no, therapy hasn't worked. Knowing recon w implants will put the left breast up high and the natural breast not too great is a bummer. Maybe I should just go flat. If I just could be smaller. Don't know what to do. I'm very lost. I am also trapped caring for my 91 yr old dad who fell at Easter and is now handicapped, incontinent, and he has dementia. No one helps. I haven't been home but 5 times in all these months. Any opinions or input is welcome!

Aug 13, 2021 12:20PM hapa wrote:

ChrisJack - most PSs have no idea what to do with thin small breasted women. Doctors have a bad habit of trying to either minimize or blame the patient for problems that they don't understand or can't fix. Unfortunately you are likely to get a poor outcome if you do a BMX with reconstruction. Have you asked about getting a lumpectomy and having the remaining tissue rearranged to make a small, somewhat normal looking breast? Will the dent be small enough for them to fill it via a few rounds of fat grafting? You might have to get creative and shop through a lot of plastic surgeons to find someone who is confident about working on someone your size.

The other option is to get low profile implants. You will have to get them from Allergan, as I don't think Mentor makes anything less than a "moderate plus" profile implant. You can find their table of implant sizes online -- print it out and take it to your PS and ask them which implants they are recommending. IIRC mine are low-plus profile responsive implants from Allergan. The responsives sag a little more than the cohesives, which IMO makes them look and feel a little more natural. The downside of that is that they supposedly have more rippling, but the rippling on mine isn't bad and it's less than I had with the higher profile cohesive implants. I wish there were more science involved in implant sizing but most surgeons just wing it and you have no idea what you're getting until you wake up.

I'm seeing a PS at MD Anderson about a capsulectomy and they definitely don't make me feel like my problems don't matter. The original PS I had did, and everyone at that cancer center would always tell me how great my recon looked when I looked like a cartoon. I felt like they were all trying to gaslight me into just accepting the shitty job they did the first time around so they wouldn't have to fix it. When I mentioned that the implant was painful all the way around the edges on one side but not the other they were like "well that's just how it's going to be". Okay, thanks! I say keep shopping plastic surgeons until you find one that has put in low profile implants. A lot only want to do high or very high profile implants, I don't understand why.

Jan 8, 2022 11:41AM PandaPoo wrote:

Hi everyone, I'm new to all these. Got my biopsy result on Tue. I'm very flat (like cup AAA flat) and I'm hoping for mastectomy with reconstruction so that I can finally have boobs. From the initial reading, DIEP sounds fabulous if done right (tummy tuck as a bonus after giving birth to twins). But it looks like most you gals chose to have silicone implants instead of flap. I'm very curious as of why. Sorry if this is a very dumb question. I'm still reading and there's just so much to read...

Jan 8, 2022 12:20PM - edited Jan 8, 2022 02:38PM by ParakeetsRule

PandaPoo, thin, small women often don't have enough spare flesh for a flap reconstruction. I ended up going flat because I didn't want to deal with an implant and that was my only option for reconstruction. I didn't have enough extra fat to create a boob. (and still don't)

I'm 5'2" and 112-118 pounds. I don't know my cup size because I don't wear regular bras, but I'd guess it's some variety of A cup. I kept my healthy right breast and now wear a small knitted knocker prosthetic on the flat left side. I requested their smallest size and still had to pull out half the stuffing so it would match my other boob. 😆

Jan 9, 2022 02:49AM Rah2464 wrote:

Yes, same here. Nothing to work with. 5'8" and 120 lbs. I had always had tiny boobies, now I have moderately sized implants that are way bigger than my natural ones were.

Jan 13, 2022 04:08PM NayaBean wrote:

I hope this is the right place to post my concerns and questions about my recent reconstruction surgery. If not -- if I should do a separate post in the Breast Reconstruction parent forum, for example -- please let me know!

The problem that prompts me to post here is that my implant, which was put in two weeks ago today, looks much bigger than I thought it would. I had a total of 300 cc of silicone injected into the tissue expander, but the implant size is 770 cc. Does this mean that my implant is more than twice as large as I thought it would be? Or is it possible, somehow, that a 770 cc implant is similar in size to a tissue expander that had only 300 cc of silicone injected, because of some correlation metric that I don't understand? And that my perception of the size, now that I have lived with it for two weeks, is somehow off?

Details: I had a mastectomy in the left breast only, with a tissue expander. Pre-cancer, both breasts were way too big, in my opinion, for my 5'0" height. The one silver lining of the whole cancer journey for me was looking forward to having two normal-sized breasts, with an implant on the left and a reduction on the right. During the expansion process, I said that I wanted only 300 cc. My plastic surgeon thought I should have one more fill of 100 cc, for a total of 400 cc. But I knew I wanted only 300 cc, so that's what we did. (Three fills, 100 cc each.)

So as I said, the reconstruction surgery involved an implant on the left and a reduction on the right. After the surgery, I was disappointed to see that the implant on the left, to my eye, was noticeably bigger than the reduction on the right. (I am very happy with the size and look of the reduction.) So I checked the Device Identification Card that I was given after the reconstruction surgery, and I see that the implant size is 770 cc.

Clearly, there was a failure of communication between my plastic surgeon and myself. Or else, I just don't understand how this all works. I had assumed that the implant size would be 300 cc or thereabouts -- not 770 cc. But maybe I am totally confused about how the tissue expander fill correlates with the implant size.

I will talk to my plastic surgeon about this when I see him for the post-op appointment this coming Tuesday. But in the meantime, I am wondering if anyone here can tell me if I am right in thinking that my 770 cc implant is way too large, given that it was clear that I wanted (and got) only 300 cc of silicone during the fill process.

Note: According to the Device Identification Card that I was given after the surgery, I have an Allergan Natrelle Inspira Cohesive Breast Implant, Style SCF, 770cc.

___________________________

P.S. I also failed to confirm with my plastic surgeon what shape my implant would be. We just never talked about that -- he never brought it up, and I never asked (that part is clearly my bad). I assumed it would be teardrop-shaped, to match the shape of the right side. (After the reduction, the right side is definitely teardrop shape, which I like because it looks natural.) But the implant I got is the kind that is very rounded on top. So that's another assumption that I should have confirmed, and another way the two sides don't match. Sigh!!!

Jan 13, 2022 04:55PM NayaBean wrote:

Thanks, hapa.

I didn't actually know that few surgeons use teardrop implants. But as you say, you would think my plastic surgeon would have made all of this clear to me. I will definitely talk to him about all this when we meet on Tuesday. It might make sense to have a revision, although I don't know if insurance would cover it.

For whatever it's worth, I realize that my post makes it sound as if my plastic surgeon messed up. But he was recommended by my breast surgeon, who was recommended by my primary care physician, whom I think is awesome. I had a very good impression of him when we first met, and just in general -- he is very kind, for one thing. But also: once I had met with him the first time, it occurred to me to do a search on him in these breastcancer.org forums. He comes up several times, and everyone here who mentions him talks about him very highly. Which makes me wonder if all this is mostly my fault? Like maybe he *did* discuss all this with me, and in some brain fog it didn't sink in? But having said that, I can't really imagine that I would have missed the kind of discussion that I now wish we had had!

P.S. I am not having radiation, so that's not an issue.

Jan 14, 2022 08:54AM NayaBean wrote:

Hi, Rah2462.

It's hard to convey the difference in size that I am seeing, without photos! But it's not freaky -- for example, I doubt that a stranger would necessarily notice it if I were out in public, walking down the street wearing a bra and a shirt. In fact, when I first saw my adult daughter after the surgery, I was wearing my compression bra and a polo shirt, and she said I looked great. But then when I pointed out the specific concern I have -- I can best describe it as a fairly large mound on the top half of my left implant side, which is not mirrored at all on the right reduction side -- she definitely noticed it, and even said if it were she, she would request a revision surgery.

That is a good question, about whether there is any pre-fill in the TE. I seem to recall reading somewhere online that a TE can start with something like 60cc before being put in. But I don't really know if that's true in general, and I definitely don't know if that was the case with my TE. So I will add that to the list of questions to ask my surgeon on Tuesday!

I'll also ask about what you brought up regarding what I can expect as time goes on and any swelling is reduced.

Thank you!

Jan 15, 2022 07:17AM - edited Jan 15, 2022 07:18AM by Ava55

Hi all,

I am getting a bilateral mastectomy and a reconstruction using Mesh ADM (accelular dermal matrix) implants on my right breast with a sentinel node biopsy.

I have DCIS 8cm intermediate and worried about whether they will find evidence of it being invasive or worse in the nodes.

Has anyone been through this with similar journey?

Also concerned that the implant will be larger than my natural breast and that it will feel strange and not symmetrical (I didn't have enough fat for DIEP).

Any advice on things to talk to the surgeon about or what to expect?

Thanks

Ava