BREAST IMPLANT SIZING 101
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jade: Oh...good....I thought you were referring to a ribcage anomaly....Bony chest walls are pretty common around the recon forums.
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16 bras a year?? My jaw is hanging open. I wouldn't know what to do with myself with 16 brand new bras a year. I would change 3 times a day, just because I could!
I'm not even thinking about bras at this time. I'm trying to get through the process. I will call the Nordstroms in our area and see if they can give me any information. I guess I can always call the insurance...but man that is always an hour long conversation.
I realize that this may not work in my case but I think it is fantastic that insurance do this for women and fantastic that Nordstroms offers it.
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Tricare is one of those that does NOT cover bras. I think the wording is that they will cover bras in lieu of reconstruction. Considering everything so far was covered 100%, Ill take the cost of bras. Just FYI for any military folks.
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Suebee -- for sure! I never bothered submitting my bills for reimbursement. I didn't spend THAT much and I just, I don't know, am tired of the whole dealing with insurance thing. And, like you, my coverage has been very good with everything else.
Whippetmom -- HUGS!!!!
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I don't have insurance right now but I talked to my accountant this winter and he was able to take a few off (I think it was 3) for my taxes ... an option for those who don't have insurance. Filed it under 'medical devices' or something like that.
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Fighter33, I am 4 weeks out from exchange and today PS said my foobs are what they will be and I have been crying all day. I hate them. I wanted them to look like coconuts and they look more like a teardrop, all silcone seems to have settled to the bottom, this is what reall boobs looked like, what happened? I am 5'4 125 lbs. Bras size is smaller, how could this be? I had to go to a specialty shop where they only had a few bras to fit me. I had been looking so forward to this day since MX to finally get bras again and pretty ones, did not happen. My band size also went from a 34 to a 29/30, strange? Not sure if they will do anything, Whippetmom any ideas?
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Greyt -- did you get gummy implants? I think 4 weeks seems soon for "final"... I know that even my gummy implant was different after 3 months. But the tear drop shape...well that sounds like a gummy to me. That part doesn't really change (with gummies).
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Greyt, I know exactly how you feel!!! I had such different expectations...and felt that I was being realistic. Even before my exchange, I was smaller than I expected, my expanders were filled to 370 but I was happy with that, but then he put in implants that were 325...it's been a lil hard for me..but I am dealing with it better. Being on this thread has helped me some.
In regards to your band size...my guess is, from what I am just starting to gather (no expert) but not all bras and brands are created equal. Many of us may have shopped at VS in the past and were told we were a certain size, which may not be quite accurate. I have heard that if you go to Nordstrom you can get fitted by a MX specialist. I have not done it yet, but I am guessing, my band size will probably be different as well. I use to be a 34A.
I also, kind of agree with Lilah, based on what everyone has told me also, that it will take 3 - 6 months before they start to settle.
Also, just out of curiousity, how many cc's were filled with TE and how many cc's are your implants?
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can someone tell me how to get to the picture forum...
thanks
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fighter33 you have to be on this site for a while and then you can pm timtam, and some others to get access to the pic forum.
Why did you doctor use such a smaller implant than your expander was filled to. Did he discuss this with you before the surgery?
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Fighter33 I still think you're going to fluff out as they say in the upcoming months. Maybe not a C but I bet bigger than an A. As my PS explained to me they do base what they can do on what you were before. Your torso is only so wide. I measure a 31" torso but my old breasts where never close. Even with a push up bra I never had cleavage. You really don't want to look unnatural.
I know by the time we get to reconstruction we are so sick of waiting… this is such a process. I'm sure in a week I too will be thinking the same as you after my surgery. After having overfilled expanders for months then suddenly to go smaller is going to be a shock to the eyes although I think I'm too sexy in my expanders right now so I do want to be a little smaller.
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Re: insurance coverage. My Aetna covers 6 bras per year, but it goes by cost of bra. The prosthetic bras at specialty shops are pretty much entirely covered. But for those pretty Nordstrom's bras, they only pay $28 per bra. The Chantelles (probably the priciest) run $70-80, so the insurance only helped a little bit. But now that I know how to fit the bra properly with the assistance of the Nordy's bra fitter, I can look at the less expensive, but still very effective, bras they have.
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Right said Lauren LMAO!!!!
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Lago -- I don't know if you read one of my earlier post, but i think one of the things that really missed me up was my PS that kept allowing me to think I was gonna be a c cup. He asked me what size I wanted be during my pre-op (for BMX) and when I told him a c cup, he simply said ok. Even when I went for my first fill he asked me again and I said the same thing. So that's what I was kinda expecting. I was even afraid of being too big..HA! I wish my PS told me to expect to be restored to pretty much the same size. I think it would have made things much easier for me. I can tell that you will come out of the reconstruction process really well, because you are well informed, by your PS and being on this site, which is so informative and you really have a good idea as to what to expect. I wish I had that before hand. It makes such a hugh difference. Knowing is half the battle
Carrol2 -- I have no idea why my PS went so small...what happen to 350 at least? IDK. When I first saw him for my post op, I was so upset I really couldn't speak. I did not say anything to him, bc I did not want to have a big fall out with him in the office..but I will ask him next week.I kind of already have an idea of what he is going to say. From what I've heard my PS is one of the best, but in dealing with him I have discovered he had one of those god like complexes. Most of my visits were with the nurses, They did most of my fills. WHen he did come in, it was really quick..in and out, he is always rushing....
Whippetmom: do you know anything about fat grafting for enhancement at this point?
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Fighter I know that my PS said to me that all manufacturers have a different idea of what a C cup will be so it was hard for him to say. He said about a large B small C. All I know is I am going to be bigger than before (A/B cup). Also on my concent form it also states that there are no guarantees of outcoment.
I still don't really know what I will end up with but I am trusting I will look the best and most natural that he can possible make me. I still think you will end up with a B. I know it's hard because you were promised something before surgery. As a person who works with numbers you are used to talking in exact amounts. It's just not like this in cosmetic surgery. I wish someone had explained that to you up front.
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Fighter: I had my recon at USC Norris Cancer Hospital near downtown LA. It's a cancer research hospital and a teaching hospital so they did my fat grafting even though insurance didn't cover it-twice and the second time was with my nipple/areola surgery. Wait 6 months to do anything and see how you feel then. If you decide to have it re-done, I will send you to my PS at Norris--they accept ALL insurance and the dr's there are just brilliant!!! My Ps is very kind and gentle and he listened to every request I made which means he followed Whippetmom's instructions!
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greytcruise: This is what I told you when you first gave me your vital statistics and TE data:
"Okay, so I presume you have the moderate height Mentor 550 cc, which would place you at 13.5 cm. I personally think you should have at least 550 ccs in a smooth round silicone implant, preferably 600 ccs. I would stick with the high profile style. It just seems to be the style which works best for most reconstruction patients. If your TEs were smaller, say 450 ccs, I would recommend a moderate plus profile, because we need to match the width of your TEs. But your TEs are sufficient to get you to that 550 ccs or 600 ccs volume. It also depends on how big you want to be."
But then you PM'd me sometime later and said that your PS showed you a 550 cc implant and you felt it was too big. Frankly, there is no reason you should not have been able to get a 550 cc implant, unless your skin was really too thin and perilous for exchanging out to that size. Your PS is probably just done with it and telling you that is it and I am here to tell you, as are many others, that you do not have to accept this. You had 550 cc TEs.....the 450 cc implants have a narrower width than the TEs, which is ridiculous - why didn't he just use a 400 cc TE to begin with? You go too much narrower and smaller and the implants hang like a rock in a sock. So it is time for a second opinion. You might have to come to California. I'll PM you....
Deborah
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Thanks, all. More questions arose as I had some "swelling" near the drain site that I assumed was fluid build up and went to see PS today. He said that it's actually, well, 'side boob,' frankly. Apparently there was a bit of adipose tissue surrounding the breast tissue that was removed. As the TEs were expanded, the remaining fat pushed back to below my underarm area, leaving some unattractive lumps. He said the liposuction is a later option if it's not resolved. Great. Has anyone had this? Is it common? Did you need lipo? Does insurance cover it?
We also talked size more and he thinks I should do two more weekly fills of 60 cc and call it good at 280 cc. He said he thought 300 + would begin to look unnaturally large on my frame. He also said my implants would not be much smaller than the expanders (What? I thought expanders are typically 10 or 20% larger than final implants!) and I should be careful not to over-expand as putting in smaller implants later would lead to sag once skin had been stretched. Also I think I'm going to ask for 3 fills of 40 cc instead of 2 of 60 cc, both for comfort and control.
He recommended 4 weeks from final fill to exchange surgery and also encouraged me to consider saline implants (huh?) for safety reasons and smaller risk of capsular contracture -- said he hasn't noticed the cosmetic drawbacks other surgeons report with saline for reconstruction. REALLY? I don't know anyone using saline for reconstruction anymore and am extremely wary of that suggestion. Would love to hear from women who have chosen saline and are happy with it.
Am curious what others think: will 280 be a good fill size? (I'm hoping for full B/light C breasts.) Is there any upside to saline besides safety? Is sillicone that problematic? (Good articles/websites to research this are appreciated!) What was the size difference between your fully expanced TEs and final implants?
Thanks so much. Am a bit confused and discouraged today. My surgeon is great but young (34) and green (in practice for one year although has great reconstruction residency credentials). I like him and trust him and admire his passion and enthusiasm but I don't want to make a mistake as one of his first "solo" reconstructions, so I really appreciate feedback from women with more seasoned PS's.
Best to all, Jade
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Jade: So many things to discuss. I need more time...and I am off to a dance recital for my granddaughter. I'll respond either later tonight or tomorrow morning!
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Hello all and Whippetmom:) I am DONE with rads. YEAH!!! PS suggested after rads we do a fill or two "soon" after rads to ensure 650 implant, I am only at 625 now and seems to have been going down since not expanding weekly, any experience with fills post rads and if so elaborate:) Thanks
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Jade-I know I sent you my stats and we are pretty much the same size. I filled 250 implants to 330 swapped out for the 350/375 implants...I know it's different on everyone but you saw my pics- I am certainly not too big...I am a 34B in almost all bras. I think any smaller and I would have been quite unhappy. Whippetmom will weigh in with great advice, but honestly, if you are not totally confident with this PS find another. Better to get the right doc now than try to find someone to revise his work later and face another surgery. 'Young' and 'green' are not words that inspire confidence, and passion is great, but this is your body/your life. Get another opinion at least.
Ilene
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Jade - I had a hard time deciding what kind of implants: saline or silicone. It sounds like you're pretty thin. One of the drawbacks of saline is the rippling issue. I am small framed and have thin skin. I have ripples which, from what I've read, are only worse in people like me (thin skin, bony on top) if they get the saline implants. From my understanding, for reconstruction purpose, those who opt for saline implants are going for large (800cc or lager) implants.
I agree with Illene ... 'Young' and 'Green' are NOT words that inspire confidence. You're well within bounds to seek a second opinion.
Edited to add: While I had a lot of trouble at first deciding on what type of implants, as I read and researched silicone was my choice. They are so much safer than they used to be ... read whippetmom's bio ... that inspires confidence too! There are many threads on BCO exploring that issue. Search 'silicone vs. saline' in the search option on the right top of the page and it will take you to those threads.
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fighter33 - whippetmom will respond to your fat grafting question but from my understanding most fat grafting is for smoothing out step offs to give a natural slope. Some women get this done when they get their nips.
There are some PS's who use fat grafting for volume but not many at this point. Kate33 is someone who has had this done. It's called 'micro-fat grafting.'
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Jade I know I didn't consider saline because I read some where that rippling is more common especially with small thin women. I have no fat on my upper body and considered small frame. The one thing that I did like about the saline is they take the temperature of your body just like the TE's. I haven't had my exchange yet but I hear the silicone can get a little cold in cold temperatures.0
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Jade if you are not happy there is nothing wrong with seeking another opinion or two or three!
I considered a few before making decision. I knew I didn't like one because he said the only thing that would work for me would be saline implants, said I didn't have enough fat to consider DIEP or even TRAM and no one uses silicone. The one I settled on showed me all sorts of pictures, was honest about what we faced. He said I could have any procedure that I wanted, went over the pros and cons. He likes DIEP...for a variety of reasons, I opted for implants. Then the big silicone versus saline. My husband and I found one study, I think Sloan Kettering did that showed that women who went with silicone implants were significantly more happy with their outcome then women who went with saline.
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Based on being around here and listening to women talk about their implants, I think the chief (perhaps only) reason for getting saline is if you need/desire very large implants (like 1000 ccs or more) because saline can go that large but silicone tends to stop at around 800 ccs.
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jade: To be so thin and have these mud flaps - "side boobs" - strange.....Yes, they can be liposuctioned...but that you even have them is bizarre.
No to saline for you. You want to fill to 300 ccs. I don't care if they look too large - this is NOT how the implants will look. Besides, how much larger are you going to look with another 20 ccs? It is a negligible difference. It just ensures getting enough stretch to the skin to RETAIN the expansion and cover the implants. I would wait two months for the exchange. For you - with your thin build. You can direct your reconstruction journey here.
Regarding implant size: You need implants with a volume of around 350 ccs - high profile, smooth round silicone. 325 ccs AT THE MINIMUM. So make sure you tell him what you want to achieve and tell him you need him to do what it takes to get you there. I am just a little alarmed about going through recon with a doc who has only been doing this for one year. I mean, I know they have to start somewhere, but please dear Lord, don't let them start with me!
You have a lot of great advice from the other gals here and I know you can sort through this. You are in MA - where there are a lot of great plastic surgeons, and so I just wondered how you ended up with such a newbie?
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Jade: I am getting the impression he is thinking of putting in very small implants [in the 200 cc range] and you would be very unhappy - so you need to have this discussion with him ASAP.....
Edited to add: Also, I know you have 275 cc TEs, but find out which STYLE. We want the dimensions of those TEs......
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whippetmom,
I am scheduled for implant exchange on July 14th. I have Allegan TEs, and I quess I will need to call on Monday for the style number. I am overexpanded to 525cc and the TEs look great, although it would be ok with me if I was slightly smaller with final outcome, the position is ideal and more symetrical than I was before surgery . My PS told me yesterday he would use smooth round silicone Allegan implants at about the same size, he thought midprofile, I mentioned high profile and he did not have the chart to order with him, and said he would look. He measured me and suggested he would shoot for implant of same width as TE and implant height to match where I am now. I am only 5'2", and 150lbs, thanks to chemo I have an extra 12lbs. I measure 33inchs under implants and a C+ cup now. He said I should expect to be a solid C post implant. I totally trust this PS, he does alot of reconstructive work, large medical center. I do have one more visit right before my surgery. Does this all sound reasonable, I hope I am giving you enough info?
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christine - Yes, I need the style - or at least the width of your TEs. If I were throwing out some numbers, it would be at least 500 ccs for your frame. But I need to know if your PS has overfilled 400 cc implants or 500 cc implants. And so are they 13.0 cm wide or 14.0 cm wide? It might be that you will need midrange profile implants - Style 15 - if he needs to keep you in the high 400 cc range he will need the width of the midrange style. If you want high profile implants, for example, and your TEs are 14.0 cm, you will need at least 600 ccs in HP style implants. If your TEs are 500 cc volume, you should be fine with 600 cc HP implants. But to nail it all down soundly, let's get all the data.
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