BREAST IMPLANT SIZING 101
Comments
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Pink: I think 450 ccs might be too small for you. If I recommended 650 ccs in a HP implant, I had a reason for doing so, but I would need you to post again your height, weight, ribcage and TE style and volume....
Your PS is thinking moderate plus style so that he can use a smaller implant. Moderate plus has a wider base and less projection and HP implants have a narrower base and more projection. There are a myriad of reasons to use either style - so I am not sure what prompts your PS to choose this style over the HPs. I would certainly want us to make this assessment for you before going to surgery. You want to try to get it as right as possible and be as happy as possible the first time out of the box.0 -
joie: I see his point about using Style 45. I just honestly do not know if this will give you perfect symmetry - and with the flap going on and other chest wall issues - all he can do is try it - and I think he should try both the 460 cc and 500 cc. I think that in silicone, it is his only option. But, I would like a backup plan in the OR. The only other remedy I can think of is that he would use a Mentor Spectrum [contour profile] expandable implant on that flap side and then he could gradually add saline until you are happy with the results and then close off the port. This way you could allow for any post-op tissue swelling, etc and over a month or two, do some adjusting of the size.
Do you want to send me pictures so that I can see what is going on?
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Whippetmom:Thanks for your prompt reply..I am considering the style 45...I haven't decided yet for sure or which one, the 460 or the 500... The spectrum does not work for me. I had that in as an expander and I had a 325cc which had a diameter of 12.4 and a projection of 4.9, so it was almost as wide as what I have now in the 475cc style 20., The 475cc in the spectrum is 13.8 wide at maximum fill, That is even wider than what I have now...And I hated it..also being saline....not for me...But the style 45..I am considering...It is so hard to know what to do..I just want to be happy with my decision and be done once and for all. Thank you for your input and if you come up with more ideas, I am always willing to consider..Hugs to you...
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Have to agree with Survivor & Tina T. I did go for a second opinion based on bed side manor, but the 2nd PS said the guy I have is the best in the business so if possible I should try again to communicate. 2nd PS was at a different hospital & totally different operation. 2nd PS even said he's be my sounding board on the side & to call whenever I had questions. Wow.
I'm supposed to start masssaging the scars in 3-4 weeks once stitches & glue start to absorb or peel off. No massage of the foobs since their gummies. I'm trying not to peek too much yet.
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Deborah,
Here's me in a nutshell: 5'2", 118 lbs, 28 1/2" ribcage, Dermaspan expanders (model LPPFH14), recommended fill volume 480-575. currently at 420 on the right, non-radiated side, 470 on the left, radiated side. I am liking righty, though she needs to come up a little, he said he would fix at exchange. I was a droopy 'D' pre-BC, and a perky 'C' once upon a time, before kids. Was trying to re-capture my youthful figure (I can dream, can't I?). Anyhow, I am happy with the current size and projection of the TE's, and would like him to duplicate, especially righty, cause she's not as wide or quite as big as lefty, although I'd really be happy with either, as long as they matched.
Thank you ever-so-much!0 -
joie: I was referring to the contour profile Spectrum - which would be filled between 350 and 420 ccs - just as narrow as the Style 45...
http://www.justbreastimplants.com/breast_implants/mentor_2500.htm
But I would go ahead and try the Style 45, since you know you do not like saline....
Deborah
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Pink: Oh yes - Ms. Dermaspan! I stick with my original recommendation of 600 ccs to 650 ccs in a high profile smooth round silicone implant. 600 ccs would be the minimum. You will be be quite a bit smaller than you are currently with moderate plus 400 plus volume implants.
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Whippetmom: Thanks for the info..I like th idea of the Natrelle style 45 the best.
My surgery is not till October 24th..so I have time to research more and come to a decision..Your help is always appreciated. 0 -
Thanks, Deborah. But, bear with me, because I just cannot grasp some of these concepts...why will the implants be smaller than the TE's?
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My exchange surgery may be delayed until after the 1st of the year as I still have 1 drain in after 9 weeks post op and the drain volume is going up now instead of down. Also, waiting until after the 1st of the year will be better for me financially as I will start over with available sick days and vacation.
Olearca: I had asked my PS about downtime and for exchange surgery he said approximately 10 days, longer if your work requires lifting. There will likely be some lifting and exercise restrictions for some time after surgery, but that depends on how you are recovering, I would think.
Emersongrace: Wow, you are tiny. 800 cc is the largest implant they make in silicon. I am much larger that you (5'7'' and over 200 lbs). I am currently filled to 705 cc's on the right side and 685cc's on the left. This has me at about a C cup. PS said I will probably end up with 750 to 800 cc implants with a cup size of about a C. I would think with your frame, 800's would give you a very, very large cup size! I also asked him the affect of losing weight post op and he said that if I lost a large amount of weight, my cups size would be larger. For example, if I got down to between 170 or 180, my cup size could go from a C to a D. Losing 10 to 20 lbs will improve the projection to some degree, but not greatly. As it is, during my exchange he will do some lypo on the sides and he will pinch off any excess skin too. I had skin sparing surgery and because I was pretty large breasted to begin with, there is quite a large amount of extra skin and they may not need it all. I am anxious to see my final results because he is a very good PS and is well known for his attention to detail and to getting the best aethestics possible.
BTW, my ribcage measurement is 43.5". I was a D cup pre-BMX. I am actually okay with a smaller cup size because I know they won't be sagging!
Phyllis
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pinkbutterfly it was my understanding that my PS over expanded so he would have extra skin to work with for ptosis (droop) and that's why they use a smaller implant. I would also think my PS would need some extra skin to create the nipple. He's doing that fishtail procedure where they use the local tissue.0
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Thanks, lago. I don't really think I am over-expanded, though, except a litle on the radiated side. My non-rads side is a bit smaller than the implant he wants to use, but he said that side could stretch.
I also have a couple of little dog-ears at the top of my (very high) vertical incisions, and he said there was no way to fix them without extending the scar upwards. Also said there was nothing he could do about my port scar, which is a wide scar with a big divot. Really disheartened about all of this. Wish I could find a really great PS in Atlanta. If anybody knows one, please tell me!0 -
I would think divots could be fixed with fat grafting but you need to find a PS who does that. I have read that some PS over expand the radiated side because the skin is tighter once radiated and might pull back. I have didn't have dog ears.
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Yes, whippetmom did send me to one, and I have been to see him. I guess the thing that bugs me is that I feel like I give them more info (thanks to whippetmom and all you great ladies on this thread) than they give me. I really wish the conversation was more like, "here are your options, this is my recommendation, and this us why," etc. A conversation, a partnership. Just not getting that feeling from any of them, and so afraid to make a mistake, cuz I don't think I would do it agaIn, regardless.
Thanks for listening.0 -
Lago when are you doing the nipple reconstruction? Should be coming up soon right?
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I think I am as big as I want to go. I don't have all the info mentioned in the header but I tried on one of my 38D bra's from Victoria's Secret and although I don't fill it up it appears to look normal in clothes because it is lightly lined to prevent nipple show through (not that I will ever need to worry about that again). In a plain, ugly unlined, no wire bra I was in a C although there was a tad bit of room at the front for the MIA nips.
Whippetmom my height is 5"1", 145 lbs., short torso, broad shoulders but small framed everywhere else. My ribcage is 36". My TE's are allergan but that is all I know. Never discussed the size, width or received a card with mine. I need to lose another 15-20 lbs and although I don't look fat I do look zaftig, rubenesque or curvy whatever they are calling it these days. :.)
I am not sure what I should ask for. My next to last fill was yesterday but having a lot of discomfort today in the foobs. Even hurts to lift my arms and this is the first time I have felt like that. Makes me wonder if I'm "at capacity".
I wanted to go down from a D cup to a C as on my small frame I looked a little matronly.
Do you have an idea of what projection I should inquire about? My PS uses the Natrelle silicone implants. Do you have enough info to give me any suggestions? My avatar is from this past Mother's Day if that helps in seeing my pre BC self.
Denise
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Nipple recon a week from this Thursday. Hope I'm doing the right thing. I never had nipple issues unless I was braless and cold. I figure if these new nips are a problem we can snip them down, right?
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Pink: Go back and read my response to your first post here....but here is the data on your TEs....
Your tissue expanders:
14.0 cm wide and 6.0 cm to 7.3 cm projection
In either Mentor or Allergan, 450 ccs will not cut it in the moderate plus profile. Well, it comes close in Mentor, but the preferable volume would be Mentor - 500 ccs or Allergan - 492 ccs.
Mentor: 500 ccs - 14.1 cm width by 4.3 cm projection
Allergan: 492 ccs - 14.0 cm width by 4.6 cm projection
You can see that you will not even come close to the projection of your TEs...
It takes more volume in implants to approximate what you see in the TEs. The TEs are rigid and the implants are not.
I will use the Allergan Style 20 by example - since Mentor HPs are similar
600 ccs - 13.8 cm width by 5.7 cm projection
650 ccs - 14.2 cm width by 5.9 cm projection
You can see why I [and also the other PS you consulted with] recommended 650 ccs!
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chilulvr: What you need to ask for is your TE information. Cannot really help you accurately without it. When you say you are happy with the size, I have no volume by which to measure where you should be with implants. So call Monday and get that information. It MUST be recorded in your medical chart. These are implanted medical devices and have registration numbers which must be retained by the PS. You SHOULD have been given a little card - to use for air travel - if necessary. Mentor and Allergan PROVIDE the doctors and hospitals with these cards to give to their patients. Grrrrr....
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Hi ladies,
I am new here - currently awaiting exchange surgery. I had NSBMX on Aug. 2 and have Natrelle TE filled to 540cc. My PS said all along for size - "just tell me when you are happy" and we will use that. I liked when I got to 420cc and told him so. I am 5'5" and 135 ribcage 32". I was a 36B before BC and tried on a bra at 420cc and 36C fit. So now when he was selecting my implant he was looking at style 15 and style 20. I had thought all along I wanted 20 since worried about projection and the hamburger buns I have read about here! He said that at 420cc the style 15 has diameter of 13cm (which matches my TE exactly) and the style 20 425cc will be smaller diameter at 12cm. He asked if I liked the fullness on the top and I said I did so we went with style 15. Now I am second guessing that. I feel like I would rather have more projection over the fullness at top. I am wanting to look good in clothes more than anything. My DH knows they are fake so seeing me naked is secondary to how everyone else will see me! I don't want to be too big - I really was happy with the 420cc, but reading about how implants will look smaller has me worried. Anyone around my size have any advice? I plan to call my PS Monday to discuss further with him - I do trust him, he is very good. Also have an alignment issue with my nipples and he said he can fix that by moving one over? Anyone have to do this? Doesn't sound fun, but I told him I want them to look good! Thanks! Oh - and a laugh for you - after getting over-filled from 420 to 540 yesterday I was VERY sore and my DH asked if lotion would help. He is just too good to me - offering to rub these big old boobs!
I told him it hurt to even look at them! 0 -
momoftwo526- I know it sounds big, but I am currently wearing the same bras I wore prior to my BMX with TE overfilled to 750cc. I was a small D before I was diagnosed and I was very happy with my lift. Other than being much harder than my old silicone implants, the size right now is perfect. My PS says that once the implants are placed, I will actually be a little smaller than I am now. Guess I will find out in 3 weeks....
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dgee: I am a little worried about your PS thinking he needs to match the volume of your TEs with the implants.....it just will not work that way. You need at least 100 ccs greater than your TEs to approximate what you have with the TEs. So you need 500 ccs in Style 20 - which has a width of 13.0 cm and a projection to more closely match that of your TEs.
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whippetmom-Thanks for the PM. My PS was also leaning towards Style 20 instead of 45. He also said that he liked the Style 20 700's instead of 750cc because it has higher projection. He overfilled me to 750cc though. Now I'm wondering if I will have to go 800cc to get the projection and width I had with my old implants before BC. What are your thoughts? Thanks!
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Hmmm, Emerson, I see what you mean. I do like the width to projection ratio of the 700s better. You will have 1/2 centimeter difference in width. We just want to avoid any pocket discrepancies, which can occur if the implant is narrower than the pocket created for it. The implant will be inclined to migrate laterally...but perhaps the 700s will be fine. Your PS can certainly try....
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Whippetmom...I wanted to give you an update. I got my first professional bra fitting today, 3 weeks out from my exchange surgery.
Recap: 5'3", 118/120lbs, ribcage 28" and I have mentor high profile smooth rounds at 550ccs each side. Got my bra fitting today, and I am btw a 32D and a 34D. Thank you for your help on this board!
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Thank you, whippetmom, for the detailed explanation, now I understand. One last question, since PS does not want me expanded any further, based on your explanation, I would be able to get those implants with my current expansion? I think the answer is yes, because 650 would just be a better match with my TE's, but I want to make absolutely sure we're on the same page. Thank you, thank you, thank you!
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Pink: The answer is as long as your skin integrity is good, you should be fine. If the other PS felt you could handle 650 ccs, I am going by his assessment as well. Now if 600 ccs seems more palatable to your PS, then two millimeters narrower is probably going to be fine. I just want to clarify: This is not to state that you could not have a good result with moderate plus profile implants - I think that they can create a lovely result and I am not disparaging this style at all. It is just that you are personally expressing to me that you are focused on maximizing projection - comparing this to the projection of your TEs - and so I just feel you are going to be happier with HPs.
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Corinne: Congratulations! It sounds as though you are right where you wanted to be! I am very happy for you....
Deborah
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After reading some of the posts about other PS's, I feel very blessed with mine. He has awesome bedside manner as does his PA, office manager and other staff. He NEVER has discounted my feelings, even when I get down about things and he listens to my rants and fears. He has been honest about my outcome. He is a breath of fresh air compared to the first PS I talked to who could barely give me the time of day.
I will have smaller breasts than what I had before, but that is ok. When I was in my prime, I was 5'7'', weighed 125 to 140 and wore a 34B at my upper weight and 32A at the lower weight. I was active in sports, I worked out 5 days a week and ate a healthy diet. The years have added on the pounds and as I approach age 60, I have come to terms with a larger, rounder body. I continually work on my weight, but it has been such a battle as I have aged. I am not as active as I used to be and no long play any sports. Health, aging, work and family obligations have taken their toll. BC has taken me aback and I realize I need to focus more on my health and put myself first for a change. My PS offered me a tummy tuck when he does the exchange surgery at an additional fee (but much lower than it would be if I wasn't having the exchange surgery). I had decided to go forward with it. I will dip into my savings a bit, but I think this will give me the motivation I need to start eating right again and make me feel better about myself.
Thanks for listening!
Phyllis
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Thank you so much, Deborah. I am going back to see PS #2, will update after my visit.
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