BREAST IMPLANT SIZING 101
Comments
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MBJ - thanks. Sounds like you have been down this path before me. That 100cc over for similar projection is a good ballpark measure to have.
And to Whippetmom and the Ta-Ta Sisterhood - ENJOY Las Vegas!!! Watch the Hangover! Win Big! Laugh lots. All the best.
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whippetmom: Enjoy Vegas! Wanted you to know that the exchange went well and my symmastia was successfully repaired. He went a little smaller (650) but with moderate plus probably because my pockets were so lax, and he needed to fill the space. He assumed the laxity was from my weight loss. No matter, my mounds look great even with swelling and expected asymmetry. Nice to have cleavage again. Thank you for all your input. Here's to hoping the repair holds..
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Tinydancer: there are a number of options for sizing, each and every one depending on whether you or a uni or bilateral, your ultimate expanders width, skin integrity, pre-MX breast size, and your PS' vision for your recon. If high profile, I would say between 425 ccs to 500ccs and if midrange profile, implants in the 300 to 400 cc range. What do YOU hope to achieve from reconstruction?
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Whippetmom - Thanks for the advice. I did see my PS and asked about my TE. I have the Natrelle 133v MX - 14cm wide, 13 high. In looking that one up, it says the recommended fill is 600cc, which is in line with what you recommended for me going down a bit. But I do wonder if he has to (or can) over fill that a bit so I can get a 600cc implant since the TE needs to be filled larger than implant (unless I'm wrong about that?).
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Rene: The TE does NOT always need to be filled larger than the implant. It all depends on your skin integrity and how your skin has responded to expansion. I think it is best to keep expanding up to 600 ccs and then tell me how you feel about the size. Many of us have implants which are 100 ccs to 150 ccs greater volume than the tissue expanders.
Deborah
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jyg: Congratulations! I am so thrilled that it has been repaired. Are you instructed to wear a bra which helps to separate and encapsulate the implants separately? You want to encourage them to remain separate.
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whippetmom - right now I am wearing a compression bra 24/7 with a surgical roll keeping the implants separated. Seeing PS tomorrow to get drains out and will discuss when I can get rid of the roll and what bra he wants next. Do you have recommendations for this specific circumstance? (Sutures in one's sternum are definitely uncomfortable!)
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whippetmom - Whew! That's great to hear. I should be more of an expert on this stuff after all I went through for my right one, but that was 6 years ago and my memory is just not that good about the details. Thanks for the expert advice.
jyg - Glad to hear about a successful synmastia repair. I'm realizing that my exchange/repair may not be as easy as a simple exchange because of the sternal sutures. I hope you don't mind posting updates about your recovery time - or, I can PM you if that's preferable.
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Rene23 - I had drains removed today, after 6 days; now arm movements restricted for a couple of days to make certain I don't develop seromas. I do have more discomfort than expected because of the extra rows of sutures and additional pocket work he had not anticipated.
I am limited to very light activity for the next 2 weeks then can start walking and gradually increasing distance and speed over 8 weeks until back to vigorous activity. I can start using arms weights in 4 weeks and progress slowly. He said that no bra would prevent symmastia repair from breaking down. It depends on adherence to activity schedule to let sutures do their job and luck. Unfortunately the defect recurs at a high rate, so I will be going slowly. Those thong bras look beyond uncomfortable, but if anyone has info about their benefit, I would certainly wear one... or at least try.0 -
Well, the thong bra does what it is supposed to do. It is expensive though - so check to see if insurance will cover it. Go to the Bras 101 thread and ask about bras which encapsulate and separate the implants. There are a number of bras which fit the criteria mentioned on the header of that thread.
Well...not all THAT expensive. When you are accustomed to wearing $70.00 bras, $49.00 seems like a mere pittance!
http://designveronique.com/cgi-bin/ic/dv2/455VN.html?id=vNtv8Rr3
Video from "The Doctors" - a presentation on symmastia correction.
http://www.myfitv.com/videos/518624/the-doctors-what-symmastia-is
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Whippetmom & Rene: I would be a case where my TE's are filled to a lesser amount than my implants will be. My TE's are filled to 655 on the left and 705 on the right. The PS is proposing we use 750cc to 800cc for the implants. One reason he gave is that since I was larger to begin with and had skin sparing surgery, I have plenty of excess skin and the pocket is large enough to hold the larger implant. He will be doing some revision of the pocket and will be pinching off some of the excess skin and will lyposuction fat that has settled under my arm area. He said this occurred because when I had my breasts, they were large and they pulled that excess fat forward. Now that they are gone, there is nothing to pull it forward. He also said that the final result with the silicon implants will be about the same size as my current TE size, although the overall appearance will be much nicer.
Phyllis
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RoBo: If your PS uses high profile implants only and I presume he means Style 20 - using Allergan, by example - you would need at least 450 ccs in that style. Some plastic surgeons call the midrange or moderate plus profile "high profile" - which style would work well for you, because you can use less volume to get the width you need. I personally think that you could use around 13.0 cm in width on your ribcage. A Style 15 - again using Allergan - in around 339 ccs would be nice. You are going to need to fill to capacity though, to get the good insurance of implant coverage and to get the desired ptosis.
It might be worth your while to schedule a consult with the other PS who has gummy bears, as the anatomical shape might be ideal for your build and body type. Additonally, there are more selections which would enable the PS to achieve the appearance you are seeking from reconstruction. I would strongly consider exploring this option.
Deborah
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Robo I wish I could have done the gummy bears. I think they are perfect for us thinner gals. From what I hear less rippling issues although they are firmer. BTW the nurse at my PS said most women wish they went larger. I doubt you will go to large. I did get moderate profiles though.0
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Robo I think the rippling issue is less and shape is better especially if you want to stay small. Looks like there would be less step off but I don't know much about them. Since it wasn't an option with my PS I didn't research them much. I would question your PS about why s/he doesn't use moderate profile in some cases. My PS usually uses high profile but felt the moderate would be better for me. I know I'm happy. I got more fullness but the projection is just right for me. I quess more of an "athletic" look. But I did end up going bigger. I'm on the pict forum so you can check out the journey on page 1. Granted I know you've seen the real thing. Do we dare tell the Startbucks story
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Gee, I was wondering if I had missed something about Starbucks and breast reconstruction!
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Gotta say I LOVE these Chan Luu bracelets! Chan Luu [a very notable jewelry designer] partnered with BCO to create these lovely bracelets. 50% of all proceeds go to BCO!
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Nice bracelets!
Robo if you want access to the picture forum, PM me.
Lago and Robo -- lol on your special Starbucks experience
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Lilah you should have seen the guys face sitting in view of the ladies room when we both walked out.
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LOL Lago!
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I've barely skimmed this thread, but I think this is where I should've asked my questions in the first place, if I even knew what questions to ask. I had my NSM (right side only) on May 24, and had the TE exchanged on July 13. On my card it says I have a Natrelle style 10, 270cc. From the start I was complaining to the PS that I felt the implant would be too big (I'm barely a
and no way did I want to be any bigger. He said to wait until I was more healed, once the swelling would be gone, etc. Well, it's three months later and now he's agreeing with me, the implant is too big. It's also sagging through the Alloderm and I have referred pain down my arm, but that's a whole 'nother story... upshot is that I'm wondering if the moderate profile is reason I look so big. I feel like it's too wide for my torso (I'm rather narrow in my ribcage, wear a 32 bra).My consultation with the PS for the revision surgery is in two weeks. Up until now I didn't realize I had so many options. I trusted him to know what he was doing with my body. So I'd like some help now, thanks.
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I have a Starbucks restroom "experience" too, lago!! I met my walking group of ladies at Starbucks 2 weeks after my mastectomy and wanted to show them it didn't look as scary as they thought.(I had an NSM).so off we went into the restroom....all 5 of us!! We still laugh about what the other customers must have been thinking!0
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orangemat: The Style 10 is rarely, if EVER used for breast reconstruction, because projection is so difficult to achieve and this style has virtually no projection. It is very wide and flat. It is sometimes used for augmenting the native breast, but again, not often have we seen this style used - and it would be especially an odd choice for someone with a narrow ribcage. The bottoming out is a separate issue. Would you be willing to get a second opinion before going through surgery with your current PS?
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whippetmom, thank you so much!! I just called for a consultation appointment with the doctor you suggested. I'm totally beside myself about all this... why aren't patients properly informed???
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orangemat: I know who your PS is and he is a "highly rated" - e.g. - his patients like him - plastic surgeon. It is just that some plastic surgeons have specific styles which they seem to always use because they work for "most" women, and there is really not a one-size-fits-all or even "most" implant in breast reconstruction. Well, the high profile comes close to being the most utilized style in breast recon - but still - it is not an exact science. But your bottoming out is an issue worth obtaining a second opinion concerning, as you have a very small implant and to bottom out - I just think maybe a fresh perspective is needed. Please keep in touch.
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whippetmom:
Ok I finally got my tape measure and guess what color it was? Pink! I laughed. So here is my info: I am 5'8" 136 lbs, ribcage 30". I had my bilateral MX on 7/18, waited two months to start filling. I am filling at 50 cc's a week and am now at 400cc's. My expanders are allergan 133MX 500cc. Expanders were placed at surgery.
I had implants before the surgery and they were about 330'cc. I believe the doc said they removed along with my implants about 530 and 560 cc during surgery.
I don't want to be quite as big as I was. I wore a C or D depending on which bra. A small or med C would be nice. I'm almost liking the way it looks now at 400 cc's.
Just looking for some guidance. Nurse said they will fill to 500 and I will then talk to the doc. I'm not too worried cause I think he is great but still wanted your opinion. Thanks, Jenny
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Jenny: If you like the way you look at 400 ccs in a 500 cc TE, you will probably be happy with around 550 ccs in a high profile smooth round silicone implant. In Allergan, this would be Style 20. You have the "footprint" of a 500 cc TE - despite the fact you are only filled to 400 ccs. The smallest implant I would recommend would be 500 ccs in Style 20. You might be a bit smaller than you are presently - it generally takes about 100 ccs - 150 ccs to approximate the appearance you have with TEs. But your PS may take in several sizes at the time of the exchange. Sounds like you are in good hands.
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Whippetmom
Thanks! I guess I like the projection but it is still little "wide" I think. But I guess that is just the expanders. Nurse did say he would take a few different sizes in. I think I'm going to be even happier when I get the other fills. Just don't want to be too big.
I still wouldn't mind looking at some similar pics in the forum. I sent one request and she said I needed to start posting more. I'm guessing my exchange will be sometime in January.
Thanks again,Jenny
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Lago: LOL on your link!
Phyllis
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