BREAST IMPLANT SIZING 101
Comments
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Lago & Whippetmom...THANK YOU for the messages. I have done a little bit of massage already, with a lot of care, using whatever creamy milky lotion I have on hand. I thought I would get some kind of product to help blur the scars a bit even though they are really not too bad.......but if there IS a product out there that would diminish them a bit more, why not? I am quite happy with the PS's job, actually.
Thanks ladies and I hope you all had a great day yesterday. I ate so much I don't think I should be allowed to eat for at least 2 more days!
Smiles, Ana Maria
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TinaT: I love Dr. DeWire's website - and Dr. Pousti's also - because they are teaching websites. Both plastic surgeons do a lot of secondary revisions. Thank you for posting!
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Tina T: I LOVE THAT quote !!! I am going to copy it to my facebook wall ! I am a royal pig but I also go to the gym 3 times a week, and do not really have weight issues........after cancer, I don't care anymore what I eat. Cancer has taken 11 years of my life away from me so far, and I'll be darned if I let it take away my glazed donuts and Chinese food. Or my Margaritas.............
Smiles, Ana Maria0 -
Dear Whippetmom,
I have been reading on this thread for the past two hours. I have no idea how you've amassed so much knowledge but I am surely THANKFUL that you have!
I had a NS BMX on 11/4 with Allergan 133MV-11 250cc TEs. They are currently filled to 170ccs and scheduled for a second fill tomorrow. I am 5'7, pear-shaped 145 lbs, longer in the torso, shorter in the legs. Rib cage measures 32" and was barely an A cup before surgery. As I get expanded I am starting to worry about the outcome. I'm wondering if my TEs are too narrow? I'd like to be a solid C cup in the end as it seems like that would balance me out a bit. The expanders seem to be pointing straight out, causing my nipples to point outwards. Any advice you can give me would be so appreciated. Thanks so much for your time.0 -
Cjn: The TEs are pretty narrow for your frame. Your PS used the smallest tissue expanders he could possibly use, so it is very important that you communicate your desires to him. It is hard to believe your native breasts were only 11.0 cm in width.
Since you had a NAC-sparing, your ultimate implant size is prohibited to some extent by where your NAC ends up on the mound. But I certainly feel that you could use implants with a width of at least 13.0 cm and so two options come to mind for you: A 397 cc Style 15 in Allergan or a 500 cc in Style 20 - Allergan - both styles smooth round silicone implants. So this will mean over-expansion to some degree, since you were so small pre-BMX. You will not have the odd balance of width vs. projection as you do have with the TEs. But discuss these two sizes with your PS. The Style 15 is obviously a more reasonable leap, although not an unreasonable leap at all. Many of us have implants larger than our tissue expanders. My implants have a volume 150 ccs greater than were my TEs. If you want me to take a look, you can send me photos privately. Just PM me and I will send you my email address.Deborah
Edited to state: I am basing this primarily on your physical description, your vital statistics, and your ribcage circumference of 32 inches. Certainly, if your PS could at least use something like Allergan Style 15 in 371 ccs, this would be on the smaller end of what I would recommend, based on what you hope to achieve. All of this is your skin-integrity permitting, of course....
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Thank you Whippetmom. I have a horrible habit of trusting without question and then being sorry later... My last fill caused me to start getting concerned, which brought me to this thread. I will definitely send a picture so that you can see. I can't even stand to look at myself at the moment, nor will I let my husband see me. I feel horribly deformed. : (. I SOO appreciate you giving me this info so that I can go to my appointment tomorrow and ask the right questions. Hopefully it's not too late to get results that I can live with.
Best regards,
Cindy0 -
I just got a call from the ps that my mastectomy is Dec 27th. That's a long time. Since I was dx in October, I thought the surgery would be late October or the latest in November, especially since I was dx with idc with the herpecin +++ gene. I'm hoping that the biopsy removed most of it, 2 Cem - all cancer. The surgery is about 3 months to the biopsy. I will just be happy if it didn't spread beyond the breast. Part of me fears the surgery, and the other part just wants it to be over.
I have an oncologist appointment this Friday, and two pre-op appts next week. I'm sure there will be blood workup before surgery.
I' suppose when I talk with the surgeons, I'll know for sure if I'm doing a uni or a blmx. I'm somewhere in the middle so it won't be too hard to persuade me, I guess. I'm so reluctant to do both, but in my gut that's whats' probably going to happen.
Well, the good of all this is I can enjoy the holidays without pain, the bad of it all, is the dread of it hanging over me...and the uncertainy of it all.
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Whippetmom, question...I spoke with someone (using Dr. Gabriel) who said their scar was directly under her breast where you can't see it. He explained that mine would be a line underneith the crease and up toward the nipple. Why would I have a scar going up to the nipple with someone else having the same surgery only had a scar at the crease?
He also said that the bs said I couldn't keep my right nipple. That's the breast with the now infected cancer. Both breast has been dx with idc...the recent new cancer aggressive.
BTW...I just bought a aw bra as seen on T.V, that is very comfortable. I bought a size medium. I thought it might be a good mastectomy bra. Anyone heard of it?
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Cindy: Yes, I would like to see your photos. You should not be "deformed." Granted, the tissue expanders do look strange and can migrate hither and yon during expansion, but they should not be "deformed." I'll PM you my email address right now.
Deborah
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Exchange Date: December 16th! YAY!!!!!!!!
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evebarry: Your friend had a nipple sparing, right? That incision going up to the nipple for you - is so that he can remove the nipple-areola complex. That does seem like quite a "wait" for your surgery. Hopefully your oncologist will be able to reassure you about this. Let them know you are open for short notice on cancellations. Keep us posted about this, okay?
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Evebarry,
In my experience, things could always be moved up if you persist enough. Make some phone calls and let them know that you are concerned about having to wait so long and you are not comfortable with it. A few kind words to the nurse and she/he can sometimes find room on the schedule-they really do want to help-if that is your wish to have it done before the holidays. But make sure you know what you want and that you aren't rushed into anything.
Best wishes.0 -
Hi Girls,
I am 5 days post PBMX with Alloderm and 445cc implants. 5'5" and 160lb.
I was a full C before and now looking at my chest (not allowed to open bra until first post op) , I seem to be barely an A. Could the bra be constricting things and hey will look bigger down the road? I tried to fin info on "drop and fluff" process but have no luck. Very upset being this small. Anyone else in the same situation?
Is it possible to have revisions post "one-step" BMX?
Also, just wanted to thank Wmom for starting this thread and providing so much information that I would never be able to find anywhere else.0 -
Thistooshallpass: You have fairly small implants for your frame. Without researching, your 445 cc implants do not sound like a style much used if used at all in my experience with breast reconstruction. I would suspect your PS used a moderate profile implant in order to achieve the width he needed for your frame. I would say that since you were a "C" cup prior to PBMX, you probably have sufficient skin flaps for a somewhat larger implant. I would have recommended at least 550 ccs for your frame, but it is likely that your PS was not willing to go that large with a one-step. Very few plastic surgeons master the one-step to larger implants and this is one of the inherent risks in the procedure for patients opting for same. What is your ribcage circumference? Also - find out exactly which style, mfr and volume of implants your PS used and we can go from there. Can you go larger? Yes, if your skin is nice and healthy, at least another 100 ccs is entirely within reason. You can email me photos - PM me if you want to do so and I will send you my email address.
Deborah
Edited to add: You would need to wait at least three months for revisions....so you have plenty of time to investigate your options...
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Whippetmom,
In taking the photo and Looking at myself from a different perspective, I don't feel so deformed. : )
It's not as bad as I think, right?0 -
Cjn: As I said, you are looking good!
Not to worry. Just be patient and go slowly with the fills. You saw my email response, right?
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Hi Deborah,
I just wanted to thank you again for being a wealth of information for everyone here. It's so so helpful.
My ribcage is 31' . I most likely had sufficient skin flap for bigger implant but my ps seems to have done a quite aggresive breast lift and cut away most of it. I have notseen my breast fully in the mirror yet as I was instructed not to open my bra until my first post op this Friday. I will take pictures then. I will also get my implant info then. I will pm you. Again, thank you so so much.
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Another "shout out" to Whippetmom. I had my first post-op visit yesterday since exchange on 11-18. My PS says that I am still very swollen and that I have extremely thin skin and might need to have more Alloderm placed. I think that was his way of telling me that I am going to have rippling. I can already see it. I hope there is not too much swelling because I am very happy with my size and symmetry (thank you Deborah!!). He injected a lot of fat on my radiated side with the expectation that half of it will be resorbed, so one side is fuller on the upper pole than the other. In addition, the radiated side sits about half an inch higher. Overall, though, I feel that I look great in clothes, and hopefully will look acceptable out of clothes because it will take a lot to get me to go back in. I was shocked at how cold my new boobs (that is what they feel like to me, and I am embracing them as my own) felt, until I had the realization that my old boobs were also always colder to the touch than the rest of me. This made me realize that, no, my new boobs aren't perfect, but neither were my old ones. I go back to see my PS in 3 more weeks. He said after 6 weeks I can wear anything I want. Just in time to hit the VS semi-annual sale!
Thanks, Deborah, and all of my exchange sisters for being a great source of support for me through this whole process.0 -
Thistooshallpass: Sounds good! But when you get the implant info, remind me of your height/weight/ribcage again...because I have not yet scheduled my trip to Oz to get my brain.
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pink: Congratulations! You should see some settling and softening of that rads side over the next six months. I am very excited. You can deal with the rippling - trust me! If you are happy with the size and you are happy with how you look in a bra and in clothing, just, as you say, embrace the new breasts and enjoy being surgery-free for awhile. I don't think I would consider opening up those flaps for more Alloderm anyway - as I would rather see fat grafting used for rippling, but perhaps a year down the road if you must do it. I am very thrilled for you!
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OK 6 weeks post exchange. I am still not thrilled. I suppose it's better than how it looked after my bmx. I really hope this will look better in time. I posted pics on the forum. Please take a look and tell me what you all think.
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Carrol: Go check your thread on the pic forum!
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ok all you breast recon experts, I realize this is off topic, but hope you all will share your thoughts. I had my nipples reconstructed in Sept (CV flaps), they at 1st looked huge and about one week ago were perfect. My concern is they are continuing to shrink (now about 1.5-2mm in height). I am scheduled for tattooing next friday, should I wait a few months and see if they need to be redone? Once I get tattoos I assume my options will be limited?? I have decent skin and no radiation, your thoughts are appriciated.
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christine47 - My PS wanted me to wait at least three months from my nip surgery to tats. IFor you, I think I would wait a little longer, to at least the three month mark. My nips continued to shrink for at least six months. My left side is flat, my right side is a little small, but at least there is a little 'bump.'
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dear Whippetmom: I'm 5'10" 138lbs with a 32" in. ribcage. Even though I'm tall, I have a small bone structure. I have had NO FILLS in my TE's as I want to remain small......a small B is perfect for my frame. My PS is using Mentor implants........and will do some fat grafting. He used Allergen TE's with just a little saline in them. I just want them high, tight and like a 13 year old!
I would like to remain a small B.....any suggestions?
My surgery is Monday, December 5th.
Michele
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Michele:
I need to know which style of TEs you have. Essentially, I need to know the width of your TEs. Now I look at your height and weight and see you indeed have a slight frame, however, your ribcage tells me your torso is more athletic? So with a 32 inch circumference, I think you are going to need a moderate plus profile implant. I would say around 400 ccs - perhaps 450 ccs. Is your PS exclusively a "Mentor" man or will he use Allergan as well?
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Hi Whippetmom! I am a huge fan of yours like everyone else on this thread and want to thank you from the bottom of my heart for all the time, counsel and caring you give to so many women.
I write to elicit your opinion regarding my TEs and what my options are likely to be going forward. I had NSS BMX on November 21st. I was in a hurry to get the surgery done, because I really wanted to get the cancer that was in my right breast out, particularly as the tumor was only 1.3 cm from the nipple. In retrospect I did not focus enough on the details of the recon process or ask enough questions of my PS.
Here is my situation. I am 5 ft 6 inches tall, 118 lbs, with a rib cage of 29 inches. I was a B (on small side) before NSS BMX. I may want to go larger - but probably no larger than a C cup.
I am surprised to see that my TEs are Natrelle Style 133MX-11-T 300 cc. My PS filled the TEs with 175 ccs at the time of the operation. My first fill is scheduled for next week - we will do 50 ccs at a time, per week.
I am concerned that the size of my TEs may really limit my options in terms of how large I can go. I was thinking of implants of 400 - 450 ccs. Do you think this is possible given the size of the TEs I have now? What realistically would be the largest I could go now do you think? Could it be that my PS used such small TEs because I had NSS and therefore am limited as to size? My breasts were not particularly saggy - which is why, in part, I was a candidate for NSS. I guess I did not think that NSS would affect how large I could be. (I did realize that I could probably not go any larger if I opted for the immediate one step recon process, and this was one reason I decided on TEs.)
I regret not taking the time to better inform myself in advance. Your thoughts/advice would be greatly appreciated. Thanks very much. amsk
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amsk: Your TEs are just fine for your frame. Most of us have implants which are larger in volume than were our TEs. Your PS will likely need to overfill your TEs a bit - perhaps to 400 ccs. I would recommend a 400 cc HP or 425 cc HP - Style 20 in Allergan. [Using Allergan as an example b/c you have Allergan TEs.] You can space out your fills to every two weeks at some point also, as there is no rush to the finish line. As long as your skin integrity remains good, there should be no reason your PS could not use an implant in the low 400 cc range.
Deborah
Just want to add that your NSS status comes into play here as well, because we want the NAC to end up in a nice place on the mound, right? So sizing will hinge mightily on NAC placement. Let's see how you look at 300 ccs fill. You can always send me photos. Or post photos on the pictures forum.
Deborah
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Thank you Deborah - your advice really puts my mind to rest!!I am going to start posting on the picture forum shortly. I have the "before", the "right after surgery", and the "now" (post drains)... and I plan to keep photographing through the fill and exchange process and posting on the picture forum as that site, as well as this one, have been extremely helpful to me. I will "see" you there! best - amsk0
