Really Need Help with Choosing Final Size and Placement of Implants After Reconstruction, Help?

Doctors,I had a Bilateral(skin and nipple-sparing) mastectomy 11/2011. I'm 5'7", 130-5 lbs. My bra size pre-surgery was a full 36B to 36C. My expanders (Natrelle 300cc)have been filled to 380cc as of 1/20/12. The nurse said I will probably only have another 120ccs maximum, and I'm concerned. Expanders are very far from my sternum extending under my arms. My best attempts to fit bras make me a B cup. I'd like a FULL C with more centered/natural placement. This is stressful. Thanks for any help!

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implant size placement

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4 Doctor Answers | Asked by A New Me

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Mastectomy Reconstruction with expanders, serial expansion, and change for implants

Thank you for your question. I understand your concern. First, let me say that there is ample opportunity for adjustment of the pocket at the next surgery. Usually the implant pockets can be brought closer together at that time. Also, bear in mind that the expanders are narrow and harsh around the edges. That is why they are so uncomfortable. Their job is to expand and stretch your tissue, giving you projection and space for future implants. Because of this, they usually look... more

Implants for breast reconstruction

The way the bresat look after expanders is different than with implants. Usually the pocket is adjusted after the expander is removed so that the implant sits appropriately in the pcoket. If the expanders look a bit lateral, then the pocket can be closed down on the side as the implant is placed.

Steven Wallach, MD

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Manhattan Plastic Surgeon

Implants after expanders

You need to talk with your plastic surgeon. He/she should be able to understand your concerns and explain how they can be addressed. What you describe is not uncommon and much of that can be markedly improved with the implant placement, so don't let this bother you too much.

Implant Reconstruction

It is important that you communicate your concerns to your plastic surgeon. During the 2nd stage procedure of implant-based reconstruction (the "implant exchange procedure"), your surgeon will do his/her best to medialize your implants and fine tune your result. Your surgeon will review what is possible and should also highlight any limitations of what can be achieved. Best of luck.