BREAST IMPLANT SIZING 101
Comments
-
whippetmom-Why do the TEs have a higher projection than the implants that are available? May be a silly question, but in my case the projection is way off. Does this mean that I will be smaller after my implants are placed?
0 -
Emerson -- TEs are quite hard (coconut shells and turtle shells are common nicknames) so they push harder against the muscle. That is their job actually (and how they stretch the muscle). Implants are soft and don't have the same power to push the muscle out... so they tend not to have the same amount of projection and in general appear smaller. Some doctors overfill and then put smaller implants in (mine did -- I had TE filled to 850 cc's but implant is 685 cc's); others will put a larger implant in but even if the implant is larger it probably won't project quite as much. This is a good thing, since the reason for the reduced projection is increased softness.
0 -
momoftwo526: It is very exciting that you are getting such good care and being told realistic outcome from your exchange.
I am Plus Size too even though I still can not wrap my head around that since I was thin most of my life. I have looked for Plus Size ladies on this site and rarely find any which I think is kind of odd since being over-weight is one of the risk factors. I am now thinking they, the people who figure our what the risk factors are, got it wrong because there are more thin people on this site than over-weight.
It is good that you have realistic expectations because it is different for plus size ladies, we are just not going to get that big though- I have to say I think I look almost like I did before bc except now I have no sagging. You should look amazing considering you are also getting that tummy tuck.
It sounds like you plan on loosing weight so I was just wondering has your PS told you how that is going to affect the implants? My PS just said, "everybody loves bigger breast". I will ask him today for more information on that but I am more interested in any problems with implants after loosing like 50 lbs. Has your PS said anything about that?
Vickie
0 -
My PS just said, "everybody loves bigger breast"
Your PS is male right?!
0 -
Lago: Ha-- Yes, Male- I didn't think it made any sense either but my DH was there and was just a smiling, though he has said many time he really didn't care how big I went.
I just wanted to look normal in clothes and then there was that stomach thing where I just did not want to see so much of it. I don't want to be big. I do want to loose weight- have to loose weight. I am a bit scared as to what 750cc is going to look like when I do loose weight- huge I am thinking. It's hard to know. I have some time before that is a problem so---- wish someone knows what happens when someone looses 50 lbs. as far as implants goes. Will I turn into a cartoon person at that point? Will implants be moving around in loose skin? Does skin get loose?
I really like my PS but like so many other PS he is just kind of all business so when he made what I think was a small joke, I thought- alright, not funny but alright. At this point I think I look just right not too big not too small. I actually look small with clothes on, just like my before bc self. Naked- well, I stopped looking because I am doing that change thing and it scared me. I will look today when PS takes tape off. Anyway naked I look larger than with clothes on. I really trust my PS and know that he knows that I am loosing weight and that I was more concerned about how I was going to look then rather than how I look now.
At this point I am taking pictures so that maybe this question will be answered at some point- but then everyone is different so maybe not. Ha, just like everything else in this process it is hard to know when we are all so different.
Vickie
0 -
Just to let you know I told my PS after my 4th expansion I thought I looked good. He said "You a few more." He had me do 6 more… a total of 10 expansions. He was right. I like my new size. At first I thought maybe a little to big but that was just because I had to get used to it. I was so small before.
0 -
CorrineM1,
Congrats on being on the other side of exchange, and having your bra fitting!
You and I are similar in frame, and I'm still in TE's. I see that you are a 'd' in cup size. I realize that this is mostly due to width. Could you share what size you were before mastectomy, and whether you feel you are the same, smaller, or bigger? I am trying to get an idea of how this volume works on a frame like ours, though, of course, there are many other anatomical features that may differ.
Thanks!0 -
Pink,
I was a B before. I am a very big C or small D. The fitter had me try on both, and agreed that the D was more comfortable. She did state that I might go down to a 32D in the future when the swelling goes down, but that the 34D would still be a nice fit.
I went up to 500cc in the expanders and they ordered 550s, 600s and 650s. I am glad that they chose the 550s. I am very happy with this size. Doesn't look obnoxious or cartoonish in clothes and rounds out a more hour glass shape. I have wider hips/butt area.
0 -
Called PS today to discuss sizing more in depth and had ot make appt for Friday. So all week I get to think and research and wonder about this size thing. Will let you all know what he says about the TE vs implant projection thing.
0 -
Whippetmom - I called my PS today and this is the info I got from his assistant.
Forgot to ask whether they were Allergan or Mentor - He does Natrelle implants if that helps - Medium Height, fill volume 450 cc each. He said I have 440 in left and 390 in right. No info on width either.
Apparently he feels (I'm assuming here) that since the TE's are temporary (although I wouldn't call months & months temporary) that I didn't need this info.
So don't know if this is much help. He's supposed to be very good and maybe he is better with augmentation patients but he's never asked me what I want, what I am expecting or what I want to look like. I'm supposed to go for my last fill next Monday but still having pain in the right foob despite that one having less saline in it and it had no breast cancer. (I think it's just really pissed off). I will be having my "expectation conversation" with him then.
In looking through the sites for tissue expanders one of them said they shouldn't be left in more than 6 months but for best results should be left in 3 months after last fill which is what my PS told me. I was wondering why I had to wait 3 months. Unfortunately that brings me right to Christmas for the exchange. Like this should be the worst of my problems.
Sometimes I amaze myself at my silliness.
0 -
I know you guys will think I'm weird, but I like the cleavage and projection the TE's have given me. I am worried that I will be disappointed once my implants are exchanged. My PS believes in overfill. I am looking forward to the softer feel though. It's hard to believe I'm less than 3 weeks away from my exchange. I'm ready to get it behind me...
0 -
Emerson -- make sure you discuss this with your PS. I remember I said to mine: "bigger is better" -- and like other surgeons she had a plan to bring different sizes in and see which suited me best... but I did ask her to try to get the biggest one in (and she did). (I'm a uni so just have one implant). So you just need to tell your PS how you feel about the size and projection of the TEs and ask him to do his best to match. Have you given your details to Whippetmom? She too can give you some ideas.
0 -
chiluvr1228 - The day I was discharged after my BMX the hospital was very busy. I didn't realize until days later that I hadn't been given the medical device card for the TEs and when I called they couldn't locate it. I was able to call medical records and they faxed me a page from my surgical notes that had the stickers and info (I had to sign a release form). Took all of 10 minutes and they sent it to me. If you really want the info and can't get it from your PS office that might be worth a try...
I'm sorry you and your PS haven't discussed your hopes and expectations. Funny how they each seem to have a different approach to reconstruction, isn't it? Is he assuming you want to look the same as you did before BC? I'm glad he's at least scheduled one appointment to discuss your expectations. I hope you get all your questions answered and that he "hears" you loud and clear
.Best wishes!
0 -
Thanks Tina!
0 -
Lilah- Thanks! I have discussed it with whippetmom and my PS. He said he would take several sizes into the exchange and he knows I want to be the size I am right now. Just the waiting causes second thoughts I think. I'm ready to get this behind me, then onto nipple reconstruction. Then I will obsess about that!! Just my nature I guess...
0 -
Thanks CorrineM1. That is very helpful!
0 -
Emerson -- I will now add (because I think you sound like someone who needs to hear this now
-- after exchange there is a settling in period. I don't know if anyone told me this and I didn't hear it (or I just didn't know this) but I, irrationally I see now, expected to look finished when I woke up. I did not. It took months for swelling to go away and for the implant to settle in. If you are getting regular silicone (I have a gummy) this is especially true. The "drop and fluffl" takes a few months (at least) to happen, and before that your implants can sit higher than they will, ultimately,or look flatter. Most women, though, do end up seeing changes that result in really fabulous looking foobs. So this is all to say: try to moderate your expectations for immediate gratification and stay in touch here!0 -
Ditto to what Lilah said!
0 -
I wish I had seen this forum last year. So, DX Aug 4th 2010 with right side pagets disease of the nipple....then non invasive dcis ... whirlwind BS/PS Oct 7th surgery. Decisions.....to many too fast. was going to be lumpectomy until dcis was found, so mastectomy..,BS says " uni or BMX? Gees I'm thinking, both? Anyways, thinking that the BS or PS would give me info without me asking questions that I didn't know I needed to ask. Nope they didn't. PS gave me my options, Lat flap, (to heavy for tram). or TE's and implants. I chose the te/implants bmx due to less time on table and idea that having front and back surgery was not a good thing. He gave me high expectations, YAY! So I'm 50yrs old, 5'3" 60 pounds overweight, broad back big rib cage. He chose hi profile smooth 800cc's largest they make. Exchange day, 1/24/11. Got home DH says oh by the way PS said that it didnt go as he thought. basically my body swallowed the implants so what would have been full c's were barely a-b and really weird shaped, I was devastated. So obviously I didnt expect centerfold, but it was worse than pre puberty. I was not advised they will change . In fact the advice I got on my follow up was prosthetics to help.. um I did recon so I didn't have to deal with those, it felt like I was punched in the stomach... I have improved, except left is an inch lower and the right gets in the way of my arm constantly. now it's not under my arm but enough to annoy. I said all this to ask this. I see my PS 9/29/11 I'm not happy with how they are, Would getting the LAT with implants improve things like making them more even, I know it'll add more volume. So, my husband calls me vain,He's been awesome and is fine with me... I'm blessed and cancer free, but I hate the way I look, even in clothes I see the difference. In fact acouple people asked if my bra had slipped because they saw the uneveness So I guess I needed to vent, but any advice on what I need to ask my PS and am I being vain? Thanks sorry for the ramble .
0 -
Gee, I'm reading all these posts and getting nervous about my puny TE fills of 440 & 390. If this is as big as I'm going to be able to go it looks like my foobs are going to be kinda small.
After my 5th fill Friday I still have some discomfort in the foobs, mostly underneath them. It seems like most gals have their discomfort in their upper back so I'm wondering if this is normal.
My oncotype DX score was 9 so I'm hoping after my exchange all this BC will be behind me. Sometimes the more I learn the more confused I get. I'll blame it on fibro brain and not age.....
0 -
chiluvr1228, I am so glad you don't need chemo. Not sure what to tell you about the size, can't remember, but have you gone over your stats with whippetmom? Make sure you get what YOU want. My TEs where uncomfortable underneath, kind of like a bad underwire bra, that never really got better, completely went away post exchange. I found warm showers/ baths and ibuprofen helpful. You look young in your picture, certainly not old enough to blame anything on age. My excuse is chemo and always trying to multitask.
0 -
Tina T.
Thanks for the post about getting implant "card" notes from medical records. I too didn't get cards from the hospital & PS asst told me when she pulled the drains last week that they didn't have them yet - 2 weeks post surgery I won't see the PS for 8 weeks, just before my Thanksgiving cruise, so I'll definitely get in touch with medical records.
0 -
Fightslikeagirl -- get another opinion from a new PS. Not sure what is going on -- Whippetmom will be able to respond/give better and more specific advice than me -- but what I was talking about (that it takes awhile to settle) does not include if the implants are not placed properly... and to be honest if one is in the way of your arm and another is an inch lower/higher, then they are not placed properly (based on that description anyway).
And I don't think you are being vain, no. Most (if not all) plastic surgeons promise and deliver "looking good in clothes" -- in other words even if we don't look perfect naked, we all at least can expect to look good in clothes (and most of us look pretty darn good naked too). If you look uneven when WEARING a bra and clothes, this is just not right.
0 -
fightslikeagirl: Are you being vain???? Why do you think I started this thread? LOL!!! It has nothing at all to do with vanity - but a desire to have some semblance of wholeness again and that feeling that all is well and yes, I can live with these breasts. Sort of like instead of being comfortable in your skin, getting to a point where you are comfortable in your breast mounds. It might take a journey and a half to get there for some, but fightlikeagirl [
] and GET THERE! So let's fix it. You would not believe the revisions I have seen and how much something which is quite undesirable can be improved to WOWZA!Okay, so now on to the serious part of the response. Yes, for those women who have considerable adipose tissue covering the chest wall - who have large torso regions - the implants are "swallowed up" and this is the term plastic surgeons use in such cases. It is almost as if they are obscured - and they appear sometimes as raised outlines on the chest wall. A connundrum to be certain. There ARE methods which can be used, as described by Shestak in "Reoperative Plastic Surgery of the Breast" to address this concern. I will not be able to post his correction technique in its entirety, but I could fax it to you, if you want to PM me your fax number. But I will tell you that Dr. Shestak always recommends autologous methods for patients with this specific body type. Most plastic surgeons would do the same. But he does describe a technique he uses which would require replacement of a tissue expander to correct the inframammary fold assymetries and probably the lack of definition of the IMF.
Okay, so back to the issue of a flap. Wh the lat flap? Why not a DIEP? With the DIEP, you have the benefit [just one among many] of reducing abdominal girth and reduction of abdominal girth aids immensely in allowing the implants to appear larger on the chest wall. It is just something I would want you to discuss with DIEP gals on bc.org. Maybe Lago will come along and see this and provide you with one of her "linkies"...to some of the DIEP threads and NOLA threads.
I never get it right.So, I want you to consider all options before proceeding. Yes, I do believe you will have the best and most satisfying result with an autologous based procedure. But if this is ruled out for various reasons, then let's work on getting you the best results possible with implants. The other option would be saline implants - which go up to 960 ccs or custom silicone implants, which can go up to `000 ccs.
Deborah
0 -
fightslikeagirl: Are you being vain???? Why do you think I started this thread? LOL!!! It has nothing at all to do with vanity - but a desire to have some semblance of wholeness again and that feeling that all is well and yes, I can live with these breasts. Sort of like instead of being comfortable in your skin, getting to a point where you are comfortable in your breast mounds. It might take a journey and a half to get there for some, but fightlikeagirl [
] and GET THERE! So let's fix it. You would not believe the revisions I have seen and how much something which is quite undesirable can be improved to WOWZA!Okay, so now on to the serious part of the response. Yes, for those women who have considerable adipose tissue covering the chest wall - who have large torso regions - the implants are "swallowed up" and this is the term plastic surgeons use in such cases. It is almost as if they are obscured - and they appear sometimes as raised outlines on the chest wall. A connundrum to be certain. There ARE methods which can be used, as described by *Shestak in "Reoperative Plastic Surgery of the Breast" to address this concern. I will not be able to post his correction technique in its entirety, but I could fax it to you, if you want to PM me your fax number. But I will tell you that Dr. Shestak always recommends autologous methods for patients with this specific body type. Most plastic surgeons would do the same. But he does describe a technique he uses which would require replacement of a tissue expander to correct the inframammary fold assymetries and the lack of definition of the IMF which is typically a concern as well.
Okay, so back to the issue of a flap. Why the lat flap? Why not a DIEP? With the DIEP, you have the benefit [just one among many] of reducing abdominal girth and reduction of abdominal girth aids immensely in allowing the implants to appear larger on the chest wall. It is just something I would want you to discuss with the DIEP and/or NOLA gals on bc.org. There is much information to be gleaned from these gals.
So, I want you to consider all options before proceeding. Yes, I do believe you will have the best and most satisfying result with an autologous based procedure. But if this is ruled out for various reasons, then let's work on getting you the best results possible with implants. The other option would be saline implants - which go up to 960 ccs or custom silicone implants, which can go up to 1000 ccs.
Deborah
"My references to Dr. Shestak are merely because I personally have his book. But I also know many plastic surgeons have cut their teeth on this book, and I also research and read commentaries by his contemporaries, such as Scott Spear, MD, who might echo the very same sentiments about this issue.
0 -
chiluvr I think it really depends on your frame/size and type of implant. I have a small frame. I quite happy with my moderate profile style 15 naturelle 397cc. Are you getting a higher profile? If you are your project will be different than what I have.0
-
chiluvr - I never had pain in my back and shoulders after a fill ... mine hurt underneath too and all along my side. You're quite normal! 0
-
Vickie:
I did talk to my PS about what would happen if I were to lose weight -- would I become so big that my foobs would enter the room before the rest of me? Would I be grotesque? He said that losing 20 to 30 lbs would improve the projection and would give me a much better result, but mught not change the cup size a whole lot. Losing more, say 50 to 60 would most likely increase the cup size and could make some revisions necessary, but nothing as drastic as have to replace the implants. Since 800's are the largest they currently make in silicon and with that I will be smaller than what I was, he felt that losing weight would not only give me a nicer result in the long run, but would also be much better for me health wise (of course!).
Also, what he said is crucial to the final outcome is how he builds the pocket. When he does the exchange, he has the opportunity to revise the pocket and reposition the muscles to give the patient the best result possible. At least that was my understanding.
As far as plus size women -- I do think there are many plus size woman out there going thru this. I see many of us when I go to my appointments. I don't know why you don't see more plus sized ladies posting on the boards, but I know I was very hesitant at first because I felt shame over letting myself get so overweight and at first, I was afraid to even talk about my size. Fortunately, I have found nothing put supportive, gracious and courageous women through these boards and I am glad that I let go of my fears and came here for support!
Good Luck!
Phyllis
0 -
Phyllis: Ahem, I prefer to call you gals bodacious, rather than plus- size!!! There are many gals like you here who have these same concerns. But I will add that you will see a change in cup size with a 40 or 50 Lb weight loss. If you lose weight in your abdomen and back- in your latissimus dorsi region/thoracic region- you will go down in your band size. So if you wear a 38 band, you could go down to a 36 band with the weight loss you are describing. When you decrease the band size you increase the cup size. (the saying is: "go down in the band, go up in the cup") So let's say you are a 38 B... If you lose 40/50 lbs, you could be a 36C. Make sense?
0 -
But Phyllis, I am ever so glad you opened up and shared all of this, because there will be other women feeling the very thing you were feeling and they will read your posts and realize that there is a safe haven here. Bless you!
0
