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 02:17PM

Posted on: Dec 31, 2019 02:17PM

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 21, 2020 12:50PM Cpeachymom wrote:

beeline- yes, I have prepectoral saline. I did TE surgery almost a year after finishing rads. Then exchange about 5mos later. Expansion was no picnic though, radiated skin doesn’t stretch the way normal skin does. My PS was on board from the beginning and used alloderm to secure the implant on that side. I had no complications, other than a drain pushing on a nerve bundle. I guess you have to find a good PS who has experience with radiated skin.


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 9/10/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 9/17/2017 Lymph nodes, Chest wall Surgery 10/9/2018 Reconstruction (right): Tissue expander placement Surgery 3/24/2019 Reconstruction (right): Saline implant Hormonal Therapy Zoladex (goserelin)
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Jan 21, 2020 01:20PM Cpeachymom wrote:

hapa- I did reply a while ago... no ripples, I had fat grafting on my radiated side, but my ps was only able to get very little, so a second round isn’t an option. I realized about a month ago that I can feel the port that is on the front side of the implant, that was unsettling, and prompted a call to the PS to make sure that’s what it was. My radiated side is high and tight and hard, my good side is squishy. I think it feels weird, but my hubby says he doesn’t notice...not sure if he’s just being nice.


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 9/10/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 9/17/2017 Lymph nodes, Chest wall Surgery 10/9/2018 Reconstruction (right): Tissue expander placement Surgery 3/24/2019 Reconstruction (right): Saline implant Hormonal Therapy Zoladex (goserelin)
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Jan 25, 2020 12:20AM SuBeez88 wrote:

This is a great thread! Its refreshing to hear from other itty bitty people.My doctors kept referring to me as "petite" but I know they were just saying "flat chested." LOL. I'm 5'2", 118 lbs and like a 34A. The size of my DCIS relative to size of my breast made mastectomy a good choice (along with family hx). My plan is to be maybe just be a tad bigger than what I was before (recoop the post nursing droop) and like maybe a B but nothing more.

I was so fixated on the mastectomy itself that I realize I didn't really tell him what I was envisioning w/ PS at my first visit. We talked about the process and he said we fill the expanders until you are happy, but I didn't think that it might change anything. Well I found out in post op visit, they he put in high-profile expanders. I was wondering if they were contributing to the pain I am having. I told him at my first fill vist this week that I'm not hoping to be that big and it sounds like the implants don't have to be high profile.

It sounds like with petite people they often use high profile because we're narrow diameter and they look better? Anybody have insight into this? I feel like they should have a catalog of implants besides just the pre/post boob mug shots.

For people who have already done theirs, did you get a choice of brands/type? Did you have to push your PS for options or did they offer? And did you all do a lot of research before? IF it wasn't for this forum, I wouldn't even know about all these brands and types of implants!!

Tx! Su

Dx 11/30/2019, DCIS, Left, 3cm, Stage 0, 0/1 nodes, ER+/PR+ Surgery 1/2/2020 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Jan 25, 2020 11:40AM hapa wrote:

I got direct to implant reconstruction and didn't know much about implants. My whole case was kind of a cluster b/c I decided on pre-pec with one PS, that PS abruptly "left" the clinic before my MX, and the next PS didn't do pre-pec but didn't realize that's what I wanted until a WEEK BEFORE MY SURGERY when she told me she "doesn't really do that surgery". I did ask about implant sizing and she said she'd try a couple different sizes, taking into account how much tissue was removed in my MX, and pick the ones that looked the best. Long story short, she did the pre-pec surgery anyway, the implants she put in were the lowest profile ones they had, and to get the pockets to close she wound up using moderate plus profile Mentor implants that were too narrow for my chest. They looked ridiculous. Do you remember that cone bra that Madonna wore? It looked like I was wearing one of those under my clothes all the time. Without clothes, they roughly looked like two oranges nailed to a telephone pole - completely unnatural and bolted on, and you could see the sides of my chest sticking out past the sides of my implants, ribs and everything. They also got capsular contracture after rads, so I had revision with implants that I picked out myself from the Allergan catalog. Mentor doesn't make anything lower than a moderate plus profile in their overfilled line of gummy implants, which is what is typically used for reconstruction. They special ordered the implants for my revision, but they ordered responsive implants instead of cohesives. I was worried they'd have terrible rippling once the swelling came down but they don't and I like the softer feel of the responsives.

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 25, 2020 03:27PM beesy_the_other_one wrote:

You can make me laugh every time, hapa--

"Without clothes, they roughly looked like two oranges nailed to a telephone pole - completely unnatural and bolted on . . . "

Now that's a visual.

1997: Phyllodes, R breast. 2018: IDC, L breast. TCHP, BMX, Radiation, Nerlynx. Dx 8/20/2018, IDC, Left, Grade 3, 0/1 nodes, ER-/PR-, HER2-
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Jan 27, 2020 11:39AM Ohthatcat wrote:

I just wanted to say I was a 34-36DDD before reconstruction and I am so happy with just having TISSUE EXPANDERS in because my overly large, saggy baggies plagued me forever. I plan on going to a large B, which my PS knows is tough because of bra sizing but he will keep me small. I’m 5’3 and had ginormous boobs since I was a teen. I’m hoping this keeps the fills to implant time shorter, too, although I think I need rads now. But I’m okay with itty bitties now

Dx 10/14/2019, IDC, Right, 6cm+, Stage IIB, Grade 2, 3/6 nodes, ER+/PR+, HER2-, Chemotherapy 10/27/2019 AC Surgery 1/12/2020 Lymph node removal: Right, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Radiation Therapy 6/14/2020 Whole breast: Breast, Lymph nodes, Chest wall, Bone Chemotherapy AC Hormonal Therapy
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Feb 3, 2020 03:51PM Magari wrote:

I too had direct to implant reconstruction. My first implants were shaped/textured and I developed adhesions and was having other issues with them, so I had them switched to smooth rounds. My body doesn't seem much happier with these, so I am considering having them removed and trying either just fat grafting or possibly DIEP reconstruction.

Although I am not super skinny, my surgeon told me at my initial consult that she didn't think I had enough tissue for a bilateral DIEP procedure. So whatever is doable without implants is going to yield very small breast mounds. I was only about a 34 B pre-surgically, and my current implants are slightly larger than I'd envisioned - probably because my rib cage is somewhat broad for my 5'4" frame. I'd be completely satisfied with an A, or even a AA cup at this point.

Diagnosed at 54; Bilateral mastectomy with DTI reconstruction 10/16/17; Revision surgery to switch implants 7/19/19; Cold capped during chemo - TCHP 11/26/17 Dx 9/1/2017, DCIS/IDC, Both breasts, <1cm, Stage IB, Grade 3, 1/3 nodes, ER+/PR+, HER2+ Hormonal Therapy 6/3/2018 Arimidex (anastrozole) Hormonal Therapy 8/16/2019 Aromasin (exemestane) Hormonal Therapy 9/16/2019 Femara (letrozole) Hormonal Therapy 1/14/2020 Arimidex (anastrozole)
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Feb 27, 2020 07:29AM - edited Feb 27, 2020 07:30AM by Sanzabar13

i'm considering having my implants removed and using fat grafting only. I'm a B-C cup 255cc but want to go much smaller. I spoke with my PS and he said he could do it in two surgeries. I was just wondering if anyone else out there has had this done?
It scares me with all the excess skin. I want to make sure that that's removed. I just want these implants out of me. I can't work out comfortably, can't do anything with out the constant reminder, I just feel uncomfortable in them.

I want to run without worries

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Feb 27, 2020 01:37PM Magari wrote:

I was completely okay with going to a smaller size.

But I currently have excellent sensation, and my surgeon said that I'd need both skin removal and nipple repositioning if she were to remove my implants and go with fat grafting only. Which she said would almost certainly result in the loss of sensation.

That's a significant loss, and a more involved surgery than I was hoping for. So I bought myself some pretty bras and am planning to keep my implants.

Diagnosed at 54; Bilateral mastectomy with DTI reconstruction 10/16/17; Revision surgery to switch implants 7/19/19; Cold capped during chemo - TCHP 11/26/17 Dx 9/1/2017, DCIS/IDC, Both breasts, <1cm, Stage IB, Grade 3, 1/3 nodes, ER+/PR+, HER2+ Hormonal Therapy 6/3/2018 Arimidex (anastrozole) Hormonal Therapy 8/16/2019 Aromasin (exemestane) Hormonal Therapy 9/16/2019 Femara (letrozole) Hormonal Therapy 1/14/2020 Arimidex (anastrozole)
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Apr 7, 2020 03:17PM DesertPup wrote:

Sorry Just now seeing This!!!! Hows things?

Dx 9/2018, ILC, Left, 6cm+, 1/8 nodes, ER+, HER2+ Surgery 1/14/2019 Radiation Therapy 2/28/2019 Whole breast: Breast, Lymph nodes

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