BREAST IMPLANT SIZING 101
Comments
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Laura: I agree! I usually always tell women that much is riding on the integrity of their skin flaps. If you so a search with the word "integrity", you will come up with a lot of posts where I mention "skin integrity." I usually see photos of most women who come here and I can discuss this with them privately. But yes, the skin flap coverage over the TE...and as I mentioned above, sometimes excessive skin coverage - can impact how the implants appear on the chest wall.
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I have a question regarding projection. Like a lot of women, one of my breasts was larger than the other. When I came to my new PS, I had already had a mastectomy on the breast that was the larger one. So when she did all the measurements on my other breast just prior to my second mastectomy, she was basing my size on my smaller breast. I have Allergan 133 MV - 400 cc. I'm wondering if she should have gone larger. I have 320 cc and I see projection when I'm naked but as soon as I put my clothes on, I look flat. She will be using the Cohesive Gel. Am I ever going to see the size I desire? I don't want to go larger than before. My left breast was a B but my right breast was an A/B. I definitely do not want to go less than a B. Is this possible with the TE I have?
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Deborah
It seems you always have a knack for guessing the bra size of a woman after exchange. Val61 says i may be not doing my self any favors with the bras i have been buying. My rib cage is 27'' and My implants are Allergan Natrelle Silicone 20-300ccs high profile. What would you think my bras size would be? I am currently wearing a 34 B.
Thoughts?
Kristen
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Mantra: As long as your skin is doing well and you can handle it, I do not see any reason that you could not have a larger implant with your current TE. It is not uncommon at all to have one implant with larger volume than the other, in order to gain symmetry. It might require only 50 ccs to 75 ccs [or the equivalent in grams for the gummy bears] to do so and it is done all of the time. So tell your PS your concerns and let her know your DESIRES regarding size. This way, if she feels she needs to overfill you a bit, she can do so and get you where you need to be.
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Kristen: I think your band size should be 30 inches and 32 at the most, but 30 is more appropriate. It does not calculate for everyone, because some women might have some ribcage protrusion or kyphosis or lordosis or some, what I call "MECHANICAL" reason for a bra band size not fitting within the "norm" on the sizing charts. But I would think a 30 D or a 32 C would be the two sizes I would want to try. You want to be hooking that bra on the hooks at the end of the straps and it should be nice and snug. You move upward on the hooks as the bra ages and loosens. Try these sizes and let me know what works for you.
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Hi Deborah, I just sent you a PM. My exchange is June 3rd.
Karen
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Deborah
Thank you. More peeved as i really notice how my warners 34 b is floating around me. Lilly of france runs pretty small and i wonder about a 32 on the last notch? No dept stores around me sell 30s except maybe macys and online it did not list that size. so i go back to shopping and checking on a 32 possibility or i go online. the only 30s i see online are $68. ugh. how about victoria secrets--do they sell 30s i wonder?
Thanks again for your help
Kristen
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Kristen: I don't know if you have Nordstrom's in your area but they do have a selection of 32s(not sure abut 30s). They can be a bit pricey though. Victoria's Secret makes 32s also,but in my area they are not in the stores but can be ordered online. I'm sure Deborah will have other places to suggest. Good luck in your hunt!
TCK
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Ladies, Thank you so much for making this your "ministry." It is so comforting to have an advocate here! Thank you.
This is just my second post but I have been reading, reading all I could for the last few weeks but just discovered this thread. I am a YOUNG 60 yr old grandmother who still pictures herself in her mind as she was at 30! That lady in the mirror reminds me more of my mother. LOL
I had BMX in March with TE and am in the expanding phase. I didn't spend a lot of time with my PS before my surgery and was just asked what "cup size" I wanted to be. After what I have learned here that just seems so inadequate! so now I am seeking your wise counsel.
Here is my info:
Ht: 5' 5"
Wt: 135 lbs
Ribcage: 29 1/2 "
TE: Mentor CPX 3 Siltex Med Height Model 7200
Width: 12.7 cm
Height: 10.8 cm
Proj: 7.0 cm
Cap: 450 cc
I am leaning toward a silicon implant. What implant would you suggest for me?
Many thanks!
Jan
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Kristen: TJ Maxx and Marshalls very OFTEN have 30 band size bras. In fact, I bought a slew of Chantelle bras at Marshalls six months ago for $15.00 each and they sell for $60.00 at Nordstroms and the high end boutiques. I paid $68.00 for this bra and found the same one at Marshalls for $15.00! This one:
http://www.barenecessities.com/Chantelle-C-Chic-Underwire-Bra_product_Chantelle3582_,search,.htm
At the time I purchased my Chantelles, they had many bras in the 30 and 32 band sizes.
So find your nearest TJM or Marshalls and scour the bra section to see if you can find some 30 and 32 sizes and try them on.
Deborah
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Jan: I am a young 60 year old grandmother also!!!
I would recommend a high profile silicone implant in 475 ccs or 500 ccs - either Mentor or Allergan. I think either size would look very nice on your frame. You also have the ribcage which could support an ultra full projection implant - but that only is available by Allergan - Style 45. I would say 500 ccs in that style as well, although the implants would be slightly narrower than your TEs are currently. It really depends on the look you are after. But also, some plastic surgeons are dead-set against using the Style 45 or ultra full projection implants. I think they are just fearful of the projection issue - putting tension on the delicate skin flap after MX. You could go over these two styles with your PS. See what he thinks!
Deborah
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Deborah,
I love being a grandmother! It's a little compensation for getting older!
Your quick answer is much appreciated! I thankfully have an appt with PS tomorrow. I will ask him about the implants you suggested. I have always wished I had a bigger bosom (barely a b) and am kind of enjoying how these TE's are looking. I should have been more careful of what I wished for. This isn't exactly how I would have done it!
My skin on and under my cancer breast has been red and irritated since my last expansion last week. It actually looks more like a rash but is not hot or itchy. We are four hours away so this is my first opportunity to see my PS. I'm hoping this is not suggestive of a problem with the skin flap.
Thanks again for everything you do here. I think it is a great example of using your talents to benefit others.
Jan
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Whippetmom:
It's been a while since i posted, but the last time we talked my PS was thinking about a using a 190-270 cc spectrum implants on me for exchange. I am a single MX, My ribcage is 29" i'm 4'11" and 100 lbs, Icurrently have a low profile mentor expander 265 cc on the right side only, very small framed.
Anyway, I went in to see PS again to dot all our I's and cross all our t's before surgery and now he is saying he thinks he needs to go with around a 225 cc saline implant. He is considering this size because he feels that he just can't get anything large enough on my left side to match the expander side if it is any larger, due to the small size of my intact breast. That being said, 2 weeks before surgery he decided to remove 40 cc's from my expander to allow the skin to go back before my surgery. Now, I understand my body has its limits to what it can do and still look "natural". I also understand that he will be taking sizers into surgery so he may go larger or smaller than planned once he see's what he can actually do. However, doesn't 225 cc seem kinda small, or does this sound right on target? I really like my PS personally, but I guess I need some reassurance about his decisions.
Don't get me wrong, I don't want to be unnaturally huge. Because I am such a small person, I feel acheiving a B cup would be sufficient. But can I acheive that with 225 cc? I was thinking more like 250 to 265 considering the projection will be less than what it is with this expander. What do you think? You can PM me or just respond right here, either way is fine. I've PMd you before with my stats if you need to look back at them.
Denise
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Denise: I am going to need you to email me photos. I'll PM you.
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Deborah,
I saw my PS yesterday. I asked about the Allergan implnts and he said he uses the mentor and they are comparable. I really do trust him. I am filled to 560cc and think this will be it for me. He said he doesn't necessarily need to overfill expandd if I am happy with my current size he will accomodate for the size of the TE and use a 600 or 650 implant. I have three weeks now to live with this size and see if it works for me. This will allow for the rest of the swelling to go down and then we can talk exchange dates. He is fully aware of my wants as far as projection. I left the office feeling like we are on the same page. Does this sound right to you given all the info I pM'd you?
Tracie
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Tracie: Again, it depends on how much added volume you have to the mound with your LAT flaps. I would err on the 650 cc side of the spectrum.
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Denise: I went back through your PM to me. Here is the issue: Symmetry is the key and focus when you have a unilateral MX. You have such an unusually small frame, I see your PS' dilemma about finding an implant small enough to augment the healthy breast to match the MX side. You can certainly tell him what your desires are relative to size, but ultimately, the "fitting" will all take place in the OR when you are under anesthesia. You can ask him to please try for 250 ccs, but your chest wall is probably quite thin and you want to make sure you have sufficient skin coverage over the future implant. You want the breasts to match - and so whatever your PS can do to achieve symmetry is what you should be focusing on at this point.
Deborah
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whippetmom:
Yes, I understand exactly what you are saying. I just sent you some pics to your e-mail.
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Denise, I am taller and heavier than you- 5'3" and weigh about 120. I am filled to 250 since my surgery and I am in a 34DD bra.
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Waldo....Just want to make sure everyone knows you are talking about wearing a bra with your TEs. If you had implants with the same volume, your bra size would be much smaller...
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Whippetmom - Can I just ask you to clarify your comment above. If I wore a B cup prior to my mastectomy and I try on my old bra and it fits, do you mean that I should continue to have fills until the old bra is too small in order to end up with a B cup after my exchange?
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Mantra: It is just that the tissue expanders are rigid, shell-like devices which are immovable and implants are not going to respond the same as the TEs. Implants will be compressed by the pectorals and are movable and pliable. Fitting a bra to the TE is not a reliable measure or guide for what size you will be after the exchange. The TEs sit on the chest wall differently than do implants. You want to look at the dimensions of your TE [when you are happy with the size] and see how the implant size compares to same.
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Whippetmom: You are in your 60's??!! I thought you were 35! You look good!
I just sent you a note via the exchange thread: I can send you an updated picture of my first expansion since my surgery, but I am concerned that maybe the PS didn't give me the right expander side. He says he can fix the bulk under my arm and the crease cutting into my side by the expander with fat grating and during the exchange. I would love your input on this:)
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MBJ: Send the photos...you still have my email, right?
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Hi guys, I am one week out from exchange from my te's.
Based on whippetmom's recommendation, I got the mentor 550 cc high profile. I am 5'8, 28" ribcage and weigh about 135-140 depending on how dedicated I am to diet and exercise in the previous weeks
I was really worried that my implants would look huge!! But on my frame, 550 is a very, very natural look. I really like the projection, and its not overwhelming. I am also surprised with how natural they feel coming out of the te's -hallelujah!!! My ps did some pocket revision - my te's had been so wide apart you could drive a truck through them. So its nice to feel like I have a bit of cleavage going on again. I have a nice little peek of upper pole fullness that makes me smile
but again looks very natural. Anything smaller would have been disappointing for me. I am still with tape across the incision lines, but will figure out how to post pics soon. What a simple process the surgery was! I was walking that night around the neighborhood, and driving the next day --nothing like the bmx at all. So ladies still staring down your exchange surgery - dont worry!!
A heartfelt thanks guys! There are always angels amongst us arent there? Thanks Deborah, and Laura and all who post their great support. You have been beacons of light in the dark.
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What a wonderful thing for you to come back here and tell our other girls that they are going to be ok geewhiz! That is so helpful to them, to read something like that from you !! Thank you right back!!!! ((((((hug))))))0
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Geewhiz: I agree with Laura. Thank you for blessing us with your kind words and for encouraging others taking this journey. It is a message of hope!
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Whipptmom, with your history of malpractice investigation, can you tell me what is supposed to happen with a 'failed' tissue expander when it is replaced with a new one?. I had one that had a tear; my 8 weeks of saline injections went for naught. I returned each week as flat as a board and no one noticed, not nurse nor doctor. (injections were done by nurses) I started complaining about the swelling in my axilla on week 3 or 4, evidently the leaking saline created it but no one wants to say so. They merely sent me to physical therapy. I now suffer from moderate lymphadema requiring manual lymph drainage by a professional, twice a week. And compression bras 24-7. It shouldn't have happened. I had reduction surgery on the other side with minimal swelling. I was told the compromised expander should have gone back to the manufacturer, Mentor, for investigation and a report should go to the surgeon. I have my records, no report in them. I have the serial number, etc. I want to contact Mentor myself. This isn't fair and someone should at least freaking apologize for either their defective product and/or lack of proper monitoring. Would like to know your ideas on this. Also, due to a bad staph infection after the second bag went in I could not get the proper size placed for the final silicone implant. So I'm lopsided with some contarcture on the side of the implant. Thanks for your time.
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Dear Whippetmom, I have been reading your amazing posts with great interest and gratitude for your expertise and generosity in sharing it. Guidance is certainly lacking in this area, and yours is quite a gift! Thank you, in advance. My story briefly is that in November 09 I had a 6 month f/u to yearly mammo from spring previous when I'd noted the presence of normal looking lymph nodes , upper inner quadrant, but never visible previously. I am a physician ( has not helped much in understanding this implant sizing stuff) so I always review my films with the radiologist. I was assured that the nodes were normal, just newly visible bc they were using digital film for the first time. I pushed for 6 mo f/u and saw the nodes, unchanged again. Pushed harder and had an MRI. The nodes were indeed normal nodes, but a 9mm lesion lit up in the OTHER breast. Bx confirmed IDC with small area DCIS and LCIS. Had lumpectomy, clean margins, ER/PR+, SNB neg, oncotype 16, BRACA neg. Started Arimidex and was all tatooed up to start rad, but could not shake loose the idea that I needed bilat mx. I am 57, mammographically dense breasts and my mom had breast CA in her late 30's and died at 41. I felt so strongly that I had been lucky in dodging a bullet and might not be so lucky again. A feeling deep within had pushed me to keep nudging my caregivers this time and I just felt deeply, again, that this was not going to be the end of my breast ca story. I consulted with oncologists, radiologists, surgeons, plastic surgeons. TEN times I was told that bilat mx was extreme and radical, did not prolong survival, etc,etc. But TEN times, when I asked the doctors what they would do if they were me (the women doctors) or what they would want for their wives (the men), the chart was set down, the glasses came off, they leaned across the desk, looked me in the eye and said, "ME?? No question, absolutely, positively, without a second thought.. bilateral mastectomy...." Quite a remarkable difference in what they would have me do vs. what they would do for themselves!! And so I did! Mar.8 had surgery at MSKCC. I have expanders, have been quite miserable with persistent feeling of a barbed wire bra-band around my middle, and cannot wait for my exchange surgery in mid June. The path showed ADH and multifocal LCIS on the lumpectomy side, focal ADH and apocrine cysts with atypia on the "good" side and fibrocystic changes with microcalcifications bilat. Hmm
Here are my stats: I am 5'3+1/2 inches tall, weigh 142#. Circumference of my chest, under breasts is 34". Prior to surgery I wore a 36 D bra, with ptotic typical 57 yo-ish breasts (on path 780 g and 848g), nursed 3 babes, 5y each, tho two were simultaneous! As a skinny 20 yo, 30 lbs lighter I'd been less than a B. PS, at first meeting said, not going to be a D again, you'll be a big B/little C. I don't understand how he knew that, or why he had that as upper limit (??), but it is ok with me.
At surgery they placed Allergan style:133MV TE, 400cc (ref #133MV-13). Base diam 13cm.
The TE was filled with 300cc's and alloderm (4x16cm in size and 1.04 -2.28 mm thickness) was placed.
I had a lot of drainage, perhaps secondary to the alloderm and had drains for 3 weeks. Have been expanded 3x to a total of 570cc each side. Had been told the goal was between 500-600cc.
I went to MSKCC, partly because I trained there many years ago, and my surgeons had great reps, and I thought I would get top care, and also so I could get the gummy bear implants. I had thought that they were the latest and the greatest. SInce then, have read posts from many dissatisfied recipients. (In fact, I have been so miserable with the TE's that I am really wishing I'd had the autologous fat surgery. Though my tummy has always seemed quite abundant to me, the PS says he could maybe eke out a "B-minus" for bilat. I was so absorbed in the decision whether or not to have the mxs that I just went with what seemed to be the "simpler" reconstruction option. Now doesnt seem so simple...)
Anyhow, the PS' plan is to use the Gummy Bear 410, in either 410g or 445g mod ht, extra full projection (MX), or the 450 full height - tho he thought this would prob be too high.
So, what do you think about these possibilities, and what "size" can I expect that I will be with these? Do you find that women are more comfortable, physically, with smaller implants than larger? I am so uncomfortable with the expanders that I want to do whatever is possible to have the implants be comfy and feel natural.
Just one more question, is it true that I will not need to ever wear a bra, and would that be the case after DIEP reconstruction as well. Is the implant "perkier" than natural tissue, or, since the DIEP would be for such small breasts, would they be perky and not require a bra, either?
Sorry to have gone on and on. Probably most of my story is extraneous to the questions regarding implant sizing! Thank you, again. I am looking forward to your reply.
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Ladies:
Whippitmom is out of town until tonight.
She will catch up on this thread when she gets back.
She did not want you to think she forgot about all you darling women!
Hang in there... she'll be back soon!
Laura
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