BREAST IMPLANT SIZING 101
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.
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:
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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!!!