Category Archives: Expansions

Healing well

WARNING: NSFW / graphic content below.

Elephant on chest So far, so good. Things are looking good and healing well after my latest surgery two weeks ago when a tissue expander was placed on my right side. I am not loving the discomfort I have. Feeling no pain, but the tightness is definitely there! It is that elephant-on-your-chest feeling. Not as bad as after original mastectomy, but still very uncomfortable.

I have not been doing my stretching and range of motion exercises on a regular basis, so time to get back to those at least once per day. No lazy days! I am a fan of the Coach Casey Eischen post-mastectomy exercise program. She designed it specifically for women recovering from breast cancer related surgeries after she had her own PBM and noticed a void in this area. Check out FoobieFitness.com for exercise tips, videos, and nutritional information. Here is the video with level 1 & 2 exercises. These helped me a lot after my original surgery two years ago and each one after that.

And here’s my progress pic: two weeks after tissue expander placement on my right side (left in pic).

First expansion: March 4. Exchange surgery: July 23, 2015.

Are my breasts uneven?

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WARNING: NSFW / graphic content below.

Two months after my most recent surgery I now have the same volume in my tissue expander as I do in my implant. We added 50ccs to the expander, for a total of 450ccs. Even though they are the same, they are uneven. I am at the perfect point to show the difference between the look of expanders versus that of implants.

The tissue expanders are hard, sit high up on the chest wall, and have more projection. Implants are soft, pliable, and more natural. Women who have been through the process and had their exchange surgery often say they are disappointed with size. In a 1-to-1 volume swap, the differences between these two types of devices are to blame.

Here I am as of today: 450cc tissue expander and 450cc implant (Mentor, round, smooth, high profile, silicone). Can you tell which side is which? The one with the lighter areola is the expander. From the front, they don’t look that much different, but from the side or top you can see that the expander is narrower and sticks out further than the implant.

When I was going through the expansion process after my prophylactic mastectomy, I reached my happy point at 400ccs. Having read and heard that women are often disappointed with their size post-exchange, I gave myself a cushion and declared that I wanted 450cc implants. That’s what I ultimately got (took a while to get there, but I’m there) and I’m glad that I decided to do a little extra. I am very happy with the implant size.

My plastic surgeon overfills by 100ccs, so I have two more expansions to do. Then I wait a couple of months for my exchange surgery on September 11. This is going to be a weird summer with high temperatures, skimpy tops, and two different size boobs. Oh well. I already spent six months with a single boob, so how bad could this be, right? 😀

So what size are you?

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It’s strange how often I have heard this question. Yes, I had a prophylactic bilateral mastectomy, and yes, my boobs seem to be growing right before your eyes, but this question is not appropriate for watercooler chat. We’re not that chummy! How would you like it if I asked your wife her bra size? Kind of weird, no? Apparently not. If I had a Dollar …

The times I actually did answer this question, the only measurement I had was the volume in ccs. Unless you’re one of “us,” this don’t mean jack, so after yet another time I fielded this question, I decided to go on a quest and figure out exactly what the magic number was.

How I measured my cup size

A lot of women make an appointment for a fitting by someone who knows what they’re doing (usually Nordstrom lingerie department). I have not yet taken this step, because I’m not completely finished. Off to Google and the FaceBook groups I went. There seem to be a few different ways to do this. One of the ladies in a FB group, who is familiar with the topic, was happy to assist.

Source: Jason Lee, RealSimple.com

Without a top, I first measured the underbust, which is the lower yellow line in the graphic = 29″.

Traditional sizing says to add 4″ if even number or 5″ if odd number. Modern sizing rounds up to the next even number. We went with modern sizing, so that brought me to 30.

Then I measured at the top yellow line, which is the widest part of the bust = 36″.

The math: subtract the underbust from the bust. The difference is what determines size, with each inch representing one cup size. 1 = A, 2 = B, 3 = C, etc.

Ladies and gentlemen, we have our verdict: 30 DDD. Yes, that’s right D D D. I was shocked when we came to this conclusion. I still am. I was not expecting this at all. Having been wearing an A cup bra pre-op, triple Ds just seem ridiculous to me. I never had a number or letter in mind when thinking about reconstruction. I was of the mindset that I would keep expanding until things seemed just right. I hit that point at about 400ccs. Having read a lot of feedback of women feeling that they should’ve gone bigger, I told my plastic surgeon that the sweet spot was 450ccs. Since I’m getting round implants, we overfilled by 100 for a total of 550ccs. It’s at the overfill point that I measure a DDD, so this isn’t the final FINAL verdict. I will get a professional fitting a couple of months after my exchange, once things settle down. Stay tuned!

Here’s an interesting graphic related to cup size. A 30F on me is a 38C on someone with a larger ribcage/underbust. It’s all about body size and proportion.

Cup size and proportion

Done, DONE, D O N E – ninth expansion

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WARNING: NSFW / graphic content below.

I am officially finished with the expansions! YES! We added the final 25ccs to each expander, for a total of 550ccs/side. I am so ecstatic to have reached this milestone. I was really hoping to be completely done late Spring/early Summer, but my rebel nipple Dusky and his pal necrosis had other plans. Six months after my prophylactic bilateral mastectomy on January 22, 2013, I am finally done with fills! This is what I’m doing right now:

What’s next?

7/31: follow up to make sure I haven’t decided that I want to go bigger
8/19: pre-op appointment
9/03: the long-awaited exchange surgery!!!

That’s a lot of fills!

100 + 50 +75 +75 + 50 + 50 + 50 + 50 + 25 + 25 = 550ccs

Eighth expansion

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WARNING: NSFW / graphic content below.

I can almost smell it: the end of the expansion process. This was supposed to be my final expansion, however I wimped out and we only added 25ccs to each expander, for a total of 525ccs/side. The goal is 550ccs, so I have another appointment for the final FINAL expansion in one week.

Gravity The reason for halving the volume is pain. The last expansion brought on a lot of pain. Not that I thought it was going to get more pleasant, but it was pretty bad. As usual, the worst of it come early in the morning. I’ve never dreaded getting out of bed so much. As soon as I sat up, gravity would work its magic. Talk about grumpy mornings.

The pressure was intense and I was on ibuprofen for about three days after. It didn’t help that we spent that weekend camping, so I was not sleeping in my own comfy bed. I really thought if someone poked me, a foob would pop. I even had a dream that my cat sat on my chest and the thing just blew up under her. Not like a slow deflation, but a violent explosion! I woke up in a sweat and immediately groped my chest to make sure everything was still there. Whew!

Enjoy the pics. It’s getting crowded down there!

100 + 50 +75 +75 + 50 + 50 + 50 + 50 + 25 = 525ccs

Extra! Extra! Seventh expansion

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WARNING: NSFW / graphic content below.

The story I mentioned in my last post, has been published in Sunday’s edition of The Virginian-Pilot. “At-risk local women take the fight to breast cancer” features stories of the two local FORCE coordinators and mentions this very blog. Check it out.

In other news, I am definitely over the hill with the expansions. I reached the size I’d like to be after the exchange surgery with my last expansion that brought me to 450ccs and am now in the overfilling stage. My seventh expansion added 50ccs to each expander, for a total of 500ccs/side. There is one more 50cc fill left. I don’t know how that’s going to go. I feel like any minute now, these foobs are going to pop!

No surprise that this was the most painful expansion thus far. After previous fills I usually had a shitty Saturday morning, but did not really think about it by Sunday afternoon. Today is Monday and I did not have a pleasant morning. I slept fine, but I was feeling pain as soon as I sat up in bed after waking up. Gravity … I hate your face right now! I am both looking forward to and dreading the final expansion in three weeks.

100 + 50 +75 +75 + 50 + 50 + 50 + 50 = 500ccs

Sixth expansion

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WARNING: NSFW / graphic content below.

Yup, I’m done size-wise. I wasn’t 100% sure after the fifth expansion, but I’m 200% sure now. 50ccs have been added to each expander, for a total of 450ccs/side.

After the last expansion brought me to 400ccs, I was quite happy with the result and declared that this is what size I’d like to be after the exchange. However, the feedback on pre versus post-exchange size has been pretty consistent: when you think you’re done, do a little extra; implants sit different and will be a bit smaller than the expanders. So here we are, at 450ccs.

What’s next? Two more expansions are in my future. My PS overfills by 100ccs in order to overstretch the skin and muscle. This ultimately gives a more natural result post-exchange surgery.

Here they are after six expansions.

100 + 50 +75 +75 + 50 + 50 + 50 = 450ccs

Fifth expansion

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WARNING: NSFW / graphic content below.

In other news: I had my fifth expansion. 50ccs have been added to each expander, for a total of 400ccs/side. We’re getting there.

184ccs (pre-op) vs. 400ccs

I am very happy with how these things are looking so far. Compared to how expanders usually look on women, mine have a pretty natural shape. A bit lop-sided, with righty higher up than lefty, because of how the internal pockets healed post-op. The right pocket closed up a little bit on the bottom, so the expander sits higher in my chest, but it’s not too bad. This will be fixed during the exchange surgery in September.

I have a few more decisions to make before September. Mainly: will I get silicone or saline implants, what shape will they be, and what am I going to do about my nipples. If you’ve been following me for a bit (or can tell from the photos), you know that I lost one of my nipples to necrosis. I need to figure out what I’m going to do about it. The options are:

Nothing
Reconstruct the lost nipple via skin graft or skate flap
Get a 3D tattoo
Remove the other nipple

I can’t decide what is best. On one hand, I went through all this trouble, so why give up now, but on the other, I just don’t think I’m going to like the aesthetic result if I do nothing or reconstruct/tattoo just one. What’s more awkward than two hard nipples? ONE! I like symmetry. I think I’m going to remove the other one and maybe reconstruct them both. Not 100% on that though. We shall see.

Here are the pics. Big difference between what 100ccs looked like after my mastectomy in January and the 400ccs I have today.

100 + 50 +75 +75 + 50 + 50 = 400ccs

Fourth expansion

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WARNING: NSFW / graphic content below.

Another fill behind me. We took it back down a notch from 75 and added 50ccs to each expander, for a total of 350ccs/side. I’m not sure that you can see much of the difference in the photo, whic is at the bottom of this post.

I must say that I feel better after this fill than I did after the previous three. Typically I wake up on Saturday and it takes me a while to get going. This morning I didn’t feel much pain at all – no ibuprofen needed. I went food shopping and cleaned the whole house. I hope I don’t regret this tomorrow! Fingers crossed that this continues for the next four fills.

To celebrate my over-the-hump expansion (four down, four to go), I present to you: t-rex. In a previous post (see: Shower time) I joked that I had t-rex arms because of my limited range of motion right after the mastectomy. I could barely scratch my head (or butt) for a few days. I got this shirt shortly after. Enjoy!

Ask me about my t-rex

100 + 50 +75 +75 + 50 = 350ccs

We’re getting there – third expansion

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WARNING: NSFW / graphic content below.

Fill number three is done. We added 75ccs to each expander, for a total of 300ccs/side (pic below). It is about the same on the pain scale as it was last time – nothing initially, but feeling pressure the next morning. I continue to slather these things with cocoa butter oil with vitamin E to keep the skin soft and prevent stretch marks. So far so good. If you missed the scoop on the first two fills, see: They’re growing and They’re back.

Since I still haven’t decided just how big I want to go, while I was in for the fill I checked in with my plastic surgeon to get his feedback (I trust that he has an eye for these things). Another 150ccs or so will be just right based on my body size and shape. Ultimately, it is up to me how many ccs will be the sweet spot, but I do agree that we’re not there yet. So we are going to continue the fills until I’m happy. What then?

Once the desired size is reached, there are two more 50cc fills done. As you see in my photos, the tissue expanders are kind of boxy and sit high up on the chest wall. The additional expansions are done to overstretch the skin and muscle, so that when the final implant is placed it has a more natural shape. When the expansions are done, we wait four to six weeks before we move on to the next step.

Exchange surgery

When we’re done will all of the fills, including the overfilling step, an exchange surgery is performed. This is an outpatient procedure during which the plastic surgeon exchanges the tissue expanders for saline or silicone implants.

I asked how far out they are booking surgeries for Dr. M and quickly realized that I need to get something on the books STAT. The first available date is September 3rd. That is over four months away!!! My (sarcastic) thanks to Dusky, my rebel left nipple. Had I not experienced necrosis (see Tissue necrosis), we would’ve started the expansion process about two months sooner. What can I do about it? Be grateful that necrosis was as bad as it got.

Current plan: three more 50cc expansions + two 50cc expansions to overfill = 550ccs. Here’s to a Dolly Parton-esque summer! Not sure if this is good or bad. Thoughts? I’ll be celebrating my last expansion with July 4th fireworks. On this day last year, I was struggling to enjoy myself while hanging out with friends at the beach. I didn’t get the call that was supposed to come on July 3rd – the results of my biopsies. I spent July 4th entertaining thoughts of tumors, cysts, breast cancer, chemo, and worse, rather than enjoying fireworks and my friends. It was a really bad day. What a difference a year makes.

Anyway, watch my boobs grow!

100 + 50 +75 +75 = 300ccs