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BREAST IMPLANT SIZING 101

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whippetmom
whippetmom Member Posts: 6,028
edited November 2022 in Breast Reconstruction



DISCLAIMER! I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon.


PLEASE NOTE: New information!!

Allergan now has a very easy chart to follow to help you see how sizing works in relationship between the tissue expanders and the ultimate style and volume of implants to be selected at the time of the exchange.

https://www.natrellesurgeon.com/Content/PDF/Matchup_Guide_FNL.pdf

INFORMATION WE NEED:

1. Your height, weight, ribcage circumferece (measuring under the bra line or under the tissue expanders with a measuring tape).

2. If you DO have tissue expanders already, we need to know the exact style of TE (Mentor, Allergan, Sientra, SSP) AND the volume - the mfr's recommended volume, NOT your current fill volume. So if you have Mentor TEs, they would be LOW HEIGHT, MEDIUM HEIGHT or TALL HEIGHT. If you do not have the "height" information, you might have a style "number", i.e., 354-6311 or 354-7114...etc. If they are ALLERGAN TEs, they would be one of six styles, with letters such as "MX" or "MV" or "SX" or "SV" or "FX" or "FV". They might have the number 133-V followed by a number like "13" or "14". TO SAVE TIME (FOR MOI) YOU COULD LOOK UP THE DIMENSIONS OF YOUR TISSUE EXPANDERS....

3. Also, please advise if your PS has told you that he/she uses one brand or style of implant exclusively so that we can save time in our research.

4. Your pre-mastectomy breast size is also important, because it does have some bearing on expansion, tissue expander volume and the need for good tissue coverage over your future implant.

5. OVERFILLING OF TISSUE EXPANDERS: There is no hard and fast rule regarding overfilling of tissue expanders. Some plastic surgeons overfill, merely because they always do for every patient. Some never or rarely overfill (my plastic surgeon was in that camp.) She felt that if the right tissue expander was selected, there was no reason to fill beyond that which the manufacturer recommended. In cases where the patient's skin envelope is very tight, and a larger implant is desired, overfilling would have some benefit. In the case of a unilateral breast reconstruction, where the future implant needs to mirror a native breast which has some ptosis (droop), overfilling can help achieve that needed symmetry.

6. CUP SIZES: There is no predictable way to tell you what cup size you will be with a specific volume of implant. Maybe with breast augmentation it is done, but it is all entirely different with breast reconstruction. Plastic surgeons cannot guarantee or predict cup sizes! Cup sizing is tricky, because you might be now wearing the wrong size bra. So you might tell me you wear a 36B, and you really could instead fit better in a 34C. Also, after reconstruction, there are only sports bras and European bras that we recommend as the best option for reconstruction patients. So you might tell me you want to be a "C" and end up in a European bra, like a "Freya" or "Chantelle" (my favorites.). So you might wear a D cup! But you will LOOK like a C cup or even a B cup. It is confusing, I know but you will see what I mean when you are on the other side of this.

UNILATERAL VS BILATERAL MASTECTOMY,

NOTE: IF YOU HAVE HAD OR WILL BE HAVING A UNILATERAL MASTECTOMY- REMOVAL OF ONLY ONE BREAST - THERE ARE DIFFERENT FACTORS INVOLVED WHICH MAKES IT DIFFICULT AND SOMETIMES IMPOSSIBLE FOR ME TO ACCURATELY APPROXIMATE TISSUE EXPANDER TO IMPLANT SIZING. THE REASON IS THAT SYMMETRY IS THE KEY. NOT IMPLANT SIZE. NOT IMPLANT VOLUME..NOT IMPLANT STYLE. YOUR PS WILL SELECT THE TISSUE EXPENDER TO CREATE THE TISSUE ENVELOPE WHICH WILL MATCH (AS CLOSELY AS THE SURGEON IS ABLE) THE HEIGHT AND WIDTH OF THE NATIVE BREAST VOLUME. THIS IS HIS FOCUS, AND ONLY THE PS CAN SEE THIS, MEASURE THIS AND IMAGINE OR CALCULATE WHAT IMPLANT HE MIGHT USE AT THE TIME OF THE EXCHANGE. REMEMBER…SYMMETRY - NOT SIZE. IN MOST CASES, THE TE WILL BE LARGER THAN THE FUTURE IMPLANT. SOMETIMES SIGNIFICANTLY SO.

SILICONE IMPLANT LINE UP:

MENTOR: www.mentorwwllc.com/global-us/...

ALLERGAN:

Page 33 breastimplantadvice.com/wp-com

ALLERGAN NATRELLE INSPIRA

"The new Natrelle INSPIRA™ implant is a silicone gel, smooth round implant. The smooth round implants are the more classic implant style as compared to modern anatomically shaped implants that mimic the natural distribution of breast volume. However, the new implant differs from other round implant options with its higher fill ratio.

The Benefits of Higher Fill Ratio

Higher fill ratio means that there is slightly more silicone gel filler per unit of volume. In the case of the INSPIRA™ implants, a more highly cohesive gel filler is also used. In my experience, I've noticed a slight difference in feel and lower wrinkle susceptibility in implants with a higher fill ratio. The denser volume of gel filler in the implant can result in a decreased chance of rippling and longer shell longevity.


BEFORE THE MASTECTOMY...READ AND DISCUSS WITH YOUR SURGEON!!!

http://www.forbes.com/sites/elaineschattner/2017/0...

https://www.sciencedaily.com/releases/2016/07/1607...

https://www.practicalpainmanagement.com/patient/co...



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Comments

  • Kristinka
    Kristinka Member Posts: 223
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    I would like to confirm for all you newcomers that Whippetmom really knows what she is talking about when it comes to reconstruction after mastectomy.  I so wish I had known which questions to ask my PS before my MX.  Better late than never, I guess!  Thank you for posting this, Whippetmom.  This is a great overview of the issues facing all women undergoing reconstruction with implants.

  • lexislove
    lexislove Member Posts: 277
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    This is excellent, thank you for taking the time to post this.

    Im having my exchange surgery 2 weeks from today, and to be honest the only thing I know is that I have been expanded to 400cc's, my implant will be the "gummy bear", and in the end should be a B/C cup.

    I have left it all up to my PS to make me look as normal as possible in clothes. Im not expecting a miracle, I just want to be even.

    The only thing that concerns me is how well my skin will take to the implant since I did have rads.

    The whole reconstruction thing for me, is harder to understand than chemo/rads. Ive left it up to the expert......in my case....my PS. Im so tired of decisions.

  • Estepp
    Estepp Member Posts: 2,966
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    I wanna give this Medical Knowledge geek... a traditional Laura.." Wahooooooooooooooooooo"

    Ladies... You have great knowledge here.

    Bless your ministry Deborah!

    Laura

  • Breastless
    Breastless Member Posts: 14
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    I too wish I came to this forum before going through recon.  Deborah has a wealth of knowledge regarding TE and implants.  Thanks again Deborah

  • musiclovermom
    musiclovermom Member Posts: 245
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    Thank you for this resource!

  • Estepp
    Estepp Member Posts: 2,966
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    Lexi... How is your skin "now"? How did it do during rads? Any real bad burning or skin color that changed drastically?

  • FACECRAFTER
    FACECRAFTER Member Posts: 433
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    Yes, whippetmom is a great source of knowledge and research!! 

    Remember, to go to "EXCHANGE CITY" in this forum and ask away, when you have gathered all the information, sizing, (use that measuring tape everyone).!!  We're here to help.

  • lexislove
    lexislove Member Posts: 277
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    Estepp,

    Looking at my breast now, you wouldnt know I even had rads. It has been like this for over a year. During rads I did not blister, burn or change drastic color. About 1-2 weeks after rads, the cumultive effect started to set in and I had some tenderness like you get with a sun burn. Then it past.

    I have more of a olive tone, even though Im caucasian, maybe this helped me.

  • Lilah
    Lilah Member Posts: 2,631
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    Woo hoo Deborah!  What a great thread :)  And I will echo the reminder: COME TO EXCHANGE CITY FOR FURTHER DISCUSSION!

    Cheers,
    Lilah

  • KEW
    KEW Member Posts: 450
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    Deborah--It is beautifully written, and we've all been so lucky to have your wisdom and support.  Thank you for reaching out to even more women.  Ladies, trust me, this thread has been started by a real gem.

     Hugs--Karen

  • Linda54
    Linda54 Member Posts: 509
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    boy, are all of you new ladies lucky.  I did not have Deborah's wisdom when I was being expanded.  But as it turned out I am very satisfied with the size of my implants.  It is a very confusing process and many women become anxious about this part of their reconstruction.  Deborah is a Godsend.  She can help you help your PS on sizing. 

    Thanks Deborah for being here for all of us.

    ((((hugs))))  Linda

  • wonderland
    wonderland Member Posts: 2,784
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    Wow, Whippetmom, this is so informative! I had diep reconstruction and know minimum about the "science" behind implants. I will direct future women who are considering implants to this thread. Thanks so much!

  • wabiwoman
    wabiwoman Member Posts: 151
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    Woooo Hooooo!  Power to the People!  Knowledge is Power!

    Deborah (aka "breast whisperer") - You GO! Thank you for all you are and all you do.

    For the newbies just getting started - listen up - this woman is a gift!

    Peace, Geena

  • Estepp
    Estepp Member Posts: 2,966
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    Lexi....after what you told me... and being a rads/implant girl myself.......... your skin sounds GREAT! It sounds like you should be in the ladies who's skin is fine... like me. My skin is fine. Under the skin ... is scar tissue. It is different than the non rad side. But.. as of now... just fine.

    Massage is so important for rads breast after exchange. Start it about 6-8 weeks after exchange. We are trying to prevent CC....

    If you want to chat about any of this.. PM me... :)...  I feel you are gonna do GREAT!

  • my560sel
    my560sel Member Posts: 399
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    Great job Deborah! You are our RESIDENT EXPERT indeed ! Thank you so much for all your time and effort....

    Terri

  • lexislove
    lexislove Member Posts: 277
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    Thanks Estepp! Ill be Pming you post surgery.

    I appreciate you advice and knowledge, Im getting a little nervous as my date nears. Trying to look at all this as a good thing. Ill be even...lol.

    I cant believe Ive had my tissue expanders in for almost 2 years!!!! Surprised

  • Estepp
    Estepp Member Posts: 2,966
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    Sweet Lexi.. this is why Deb sent me over here... to talk to gals like you and I..:)

  • MooreTennis
    MooreTennis Member Posts: 90
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    Deborah,  I would like to thank you for the support, knowledge and time you gave to me during my expansion and exchange. You were always there. You are such a gift to all the women considering reconstruction with implants. Again, many, many, many thanks for all you do.

  • rubytuesday
    rubytuesday Member Posts: 19
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    Great job Deborah (AKA Breast Whisperer....ROFL...too funny).  Can they make this  a 'sticky' so it is always toward the  top????  Just a thought.  Best wishes

  • whippetmom
    whippetmom Member Posts: 6,028
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    rubytuesday:  I hope YOU save this thread to your favorites and come help answer questions.  Everyone - RT is three years out from her exchange and she sticks around to help and share her knowledge on other threads and forums.  She is very savvy as well about implant sizing. 

    Someone else mentioned seeing if the mods would make this a sticky and I will see what I can do.  I might need to add some legal disclaimers....

  • Mykidsmom
    Mykidsmom Member Posts: 448
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    Bumping to move it up

  • Emma8
    Emma8 Member Posts: 1
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    Dear Deborah,

    How kind of you to offer so much help to others.  Breast reconstruction is truly very confusing and many of us are women who are used to having a lot of control in our lives but become overwhelmed by this process.  Personally, I'm a doctor (a psychiatrist) with a sister who is a mammographer and bro-in-law who does breast recon, but still I couldn't get the info I needed to help me get control over my reconstruction till it was too late. I was encouraged to just let my PS "do his thing".  But now, as you know, as you have kindly offered to help me on the picture site, I am having problems and will need a second revision. I really think that if I had known about this site, and had the knowledge that you are encouraging in this thread, I would probably be in a better position right now. Ladies, pay attention to this one- it can save you a lot of hardship.  It is really important, even if you use a PS with a wonderful reputation, to be knowledgable and assertive.

  • typhoon55
    typhoon55 Member Posts: 48
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    Deborah,

    Thanks for all your help with the implant decision as well as with everything else. You are one smart woman.

    Janet

  • AStorm
    AStorm Member Posts: 1,393
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    My exchange is scheduled for 1/20 and I'll be discussing implants with my PS this week. I'm excited about the next step but a bit apprehensive... The TE's were not placed well (by another PS)... one is higher than the other and they are both under my armpits. And of course there isn't much projection. I'm a bit smaller on the left as more tisue was removed (cancer side) but PS says he can even them out a bit with different size implants. PS says I will likely need a procedure for revisions later.

    Any advice on selecting implants would be appreciated! I'm thinking cohesive gel (Allegan 410?). The TEs are Allergan 133V 400cc filled to 480cc. I'm 5'7" and 145# with smallish upper body 30" band and used to wear a 34C. I'm measuring 36" with the TEs but much of that is under the arms and I'd prefer not having it there.

    I'm getting drains again :(  Is this typical?  

  • deekaay
    deekaay Member Posts: 254
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    Deborah, a million thank you's!!!!!!!  To have an internal coach to help with questions for the docs is just fantastic! deekaay

  • jessicav
    jessicav Member Posts: 59
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    Hi Ladies-

    I really could use some help. I had a bilateral mascetomy with breast reconstruction in 2003 and am going to have 530 cc saline implants exchanged for smaller silicone. The implants hurt..they are just too big and I feel like I literally have cantelopes on my chest.  The PS chose the size as I thought he would know best. Ha! The current implants are teardrop shaped and I am concerned about filling out upper pole with round saline. Does anyone have implants that hurt or feel tooo heavy? MRI says the implants are less than 1/3 under pec muscles!

  • FACECRAFTER
    FACECRAFTER Member Posts: 433
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    Jessica- Go over to Exchange City on this forum. You'll need your sizing (see the top of this page). They can assist you.  JUDY

  • AL1841
    AL1841 Member Posts: 17
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    So, if I was a C cup, but want to be smaller is there anyway to tell how many cc's I would need?

  • FACECRAFTER
    FACECRAFTER Member Posts: 433
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    There is more than cc's involved.  The size of your ribcage, for example, and the type of implant all play a role..the same cc's on one person can be a 'B' on another a 'D'.  Please gather the info listed on the top of this thread and go to Exchange City where we'll help you as much as we can..Deborah, expecially, is the best.  JUDY

  • whippetmom
    whippetmom Member Posts: 6,028
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    Bump