BREAST IMPLANT SIZING 101
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Hi Deborah (whippetmom) -- I have been following this thread since before my BMX on 11/14 and am so happy to finally be at the point in time where I can ask you about me! You are so kind to help so many of us in this journey.
I had BMX on 11/14 with TEs filled to 120cc at that time. I have had 2 fills since and am at 240cc now. My TEs are 133 FV 300 McGhan textured McGhan style. I am 5'10", weight 137 lbs, and am 30" around under my TEs. I was a C cup before my 2 children, deflated down to a B cup. I would like to be a C or B+ again, but the PS says it's probably likely I'll be a B. At my last fill he said I may only be able to do one more fill (seems tight to him already), which means I will look a lot like what I do now after the exchange surgery. I wish I were a little bigger and that they were not so far apart. I will most likely go with the gummies, but I have not fully explored my options yet. My breasts were dense before, so that's why I think gummies might be best?
Any thoughts are so very much appreciated. I could send a pic if that helps too.
Lauren
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Eve: Did we ever discuss sizing? Your height, weight ribcage info please [as found in the header above] and your current bra size....
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Lauren: The choice between silicone rounds or gummies has no bearing on breast density. I don't know if I would agree with anatomical gummy bears - because your TEs are pretty narrow for your frame and you really need to stay as closely as possible to the width with anatomicals. So this would put you in a 280 gm 410FX - with a width of 11.0, height of 11.5 and projection of 5.3 cm. P[Your TEs are 11.0 cm wide and 5.0 cm in projection.] But you could probably get into a 339 cc or 371 cc Allergan Style 15 - smooth silicone round - and gain the width you need and some extra volume. It is completely doable. You don't want the implants to look like two jujubes stuck onto your chest wall. So width is very important. I would rather sacrifice projection in order to gain width, especially when the TEs are on the small side.
Your PS is also filling too fast, IMHO - and if he took more time - the skin would have time to expand. Every two weeks - 50 ccs at a time - seems to work best for the majority - unless you have ample skin flaps. There is no rush to the finish line here.
Deborah
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Hi Deborah,
I am ok with the way it looks now...frankly being a bit smaller would be a benefit. Does the wideness go away when the implant is put in? I'll be sure to ask the PS on Thursday how much he thinks he pre-filled. But as I mentioned in my previous post it looks like when the stitches were taken out the left one is a bit bigger.
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Claudia: When you say "wideness", are you referring to the fact that the TEs are widely spaced on your chest wall? Because if so, yes, this should be corrected at the time of the exchange. If you have an excessive amount of width with the mound itself, it is likely because it is not filled to capacity. The width remains the same, but the height and projection will increase as the device is filled. I think with what you have described, 600 ccs or 650 ccs in a smooth round high profile silicone implant will be nice.
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Lauren: My natural breasts were dense, fibrocystic. After the BX, my skin was very tight after each fill (they are stretching it). From my experience, your skin will relax if you give it sufficient time between fills.
Whippetmom: My Allergan 133-MV-12 TEs are now filled to 450cc. I think, perhaps, the density issue with the Gummies is less off-putting for those of us who didn't start off with soft, squishy breasts. Is the width issue (I have a 29" ribcage) the main reason you recommended silicone rounds for me?
Theresa
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Theresa: Unless someone tells me right off the bat that their PS has access to Allergan 410s, I just always use Allergan or Mentor silicone rounds as a reference. But now that I know you have both options, I would have to say it is a matter of preference. You have a bony chest wall and typically, women who are thin and bony, might be inclined to have more of a "Princess-and-the-Pea" syndrome with the anatomicals. But this is always a subjective issue. Some women are more sensitive to this than others. But in my opinion, certainly you could go either way. The implant choice is more precise for anatomicals, as the implant needs to match the dimensions of the TEs as closely as possible. So discuss with your PS the pros and cons of both - for your specific chest wall characteristics.
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Is there more than one type of adjustable saline implant that can be used as a TE that can also be left in permanently? I recently had to have 1 of my implants removed due to skin integrity issues. The plan is to wait 6-8 weeks & try again. If we can match the remaining silicone implant (Allergan style 45 500CC) & I like how it looks & feels, we'll leave it in. If not, we'll swap it out for silicone. Ribs 32", height 5'5", wt 155.
I have bilateral lat flaps & had rads on the side with the removed implant. I had skin integrity problems on my non-rads side as well during the TE expansion process, which is why I ended up with 2 lat flaps.
Thanks for all of the great info in this thread.
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Ladies,
Just out of curiousity what are you doing for bras during the pre-fill and fill period. My old bras are underwire ones and I was advised that that would bother me. I tried them on and width wise Isee prior posting on very wide feeling) but it is puckering in front. I tried to buy a bra and realize I have worn the same type of bra for the last 7 years because I loved it and I am out of practice. There is a store about an hour from me and they specialize in bra fittings and I loved what she gave me and stuck with it. I am sure that I will go back there once I am done...but just wondering what folks do in the interim.
Claudia
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DLL: I would look into the Mentor Spectrum contour profile textured implant. It could probably approximate the dimensions of the Allergan Style 45.
http://www.mentorwwllc.com/global-us/Breast.aspx
Also, ask your PS about the Becker expandable implant, which comes in a number of configurations and includes saline and gel/saline combos. There is a contour profile in this implant also. There is a gel "Spectra" expandable, according to Hilton Becker, MD, who designed the Mentor Spectrum. Now I see that there is an ongoing clinical trial for the Becker expandable gel/saline, and this might be the "Spectra."
http://clinicaltrials.gov/ct2/show/NCT00750685
The Becker expandable implant is available, but it is very expensive [about $2,200 per implant] and so would only be used for breast reconstruction purposes. Someone seeking breast augmentation would not want to pay for such an expensive device.] So your PS would have access to this. HOWEVER, I am not sure that the dimensions of the Becker could approximate the projection dimensions of the Allergan Style 45. You certainly could investigate this further or have your PS investigate this further.
http://www.beckerbreastimplants.com/
It might be that the Spectrum is the best choice for you and in the presence of your lat flap, would probably work just fine.
Let me know what you decide to do.
Deborah
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Claudia: Honestly, I wager that most of us did not wear a bra during the TE stage. I did not. I think perhaps I should have - and the bra which seems to me to be a good choice is the Warner "Elements of Bliss" wirefree bra. But please do not wear a wired bra during the TE phase of reconstruction!
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Thanks so much, whippetmom! I'll see what he was planning on using.
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I learned about 410s from the info on this thread. And only learned that they were available because I questioned my PS - it wasn't volunteered. I am still weighing the pros and cons.
Whippetmom, thank you so much for all the information you share here.
p.s. Rhino is a mini-Rex ... when I told him there was another rabbit on this site, he just had to see for himself.
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whippetmom, can you explain princess-and-the-pea syndrome? Is it just that a woman with a bony chest is more likely to feel the te/implant as uncomfortable? Also, is it thin women who more likely have bony chests after the mx? I thought it had to do with how much tissue the bs removes? Is it predictable that thinner women will be bony after mx? I wish I had known more about these things before my surgeries in '07.
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Claudia - I did the same as hillck at first. Wore a lightly padded almost camisole to give them shape. I have dog ears on both my breast and this rounded them out a little. I like the snugness also. For some reason, when I don't wear something during the day, I get very sore. Tried it last week and had to come home and put something on. Anyway, I was in line at Micheal's one day and there was a display of Ahh Bras there. I decided to try one and am very glad I did. It fits snug like I like but has grown with me as I received my fills. It has been the most comfortable for me. Hope this helps.
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Hello
I am going for my exchange in Jan. I filled to 450cc in both breasts...I am going to see the doctor on Wednesday to talk about sizes, shapes etc...for the eschange...I havent seen many people talking about shapes. What shape is the best shape? Anatomical or round? Smooth or texture? I would like to get the most natural shape possible and I am getting silicone implants.
Thank you.
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Thanks everyone...I did buy those Ahh Bras a few months ago and the challenge is pulling them on but agree that they work well.
Another question for you...has anyone had an issue with the new x-ray systems and metal detectors at airports? My doctor said that the TE has a metal piece where the fluid enters. I have the card to show but am wondering if anyone has had problems prior to their exchange. I typically travel every week so I am used to the normal routine but after watching the news this past week with those poor women I was wondering what I might be in for when I travel in 2 weeks.
Claudia
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CMS2011 - I traveled when I was in TE phase. I went through metal detectors and a full body scan unit and I had no problems. I did have my info just in case. The body scan was at the Detroit airport, where security screening is pretty rigid. Remember that it's your right to ask to be taken to a private area if they decide to give you the full pat-down. I was prepared to do that, but fortunately it wasn't necessary.0
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CMS I flew from KC to Chicago with TEs and no problem.0
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patriciaho: There are a number of threads - one very busy one in particular called "All About Gummies" which you should visit. These gals either have the anatomicals [called "Gummy Bear" implants here in the U.S]. - or they are considering the anatomical style. The anatomicals are only available here through certain plastic surgeons as they are still in clinical trials, not having yet been approved by the FDA. The anatomicals have a somewhat textured surface which is necessary to lower the risk of rotation. The recommendation for silicone rounds is smooth. Textured silicone rounds are really not recommended for breast reconstruction as they cause traction rippling.
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Thanks so much again, whippetmom!
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I just had my last fill and am at 420 cc. My PS said that I can schedule my exchange in February. Has anybody gone smaller for their exchange? I am feeling like 420 is too much and about 350 would be better. Whippetmom, I am 5'4" and 130 lb. with a 31 inch ribcage. Do you think that 350 would be too small?
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OK Gang, Whippetmom, Estepp anyone who saw my posts on the pic forum (6 weeks post excahnge). I had posted that I was a bit dissappointed with the results. Somehow I thought the exchange meant we were done. I don;t know why I thought that. Now that I see how common revisions are I feel much better. I also feel better because I got a second opinion from Dr. Raft, He said it looks good so far. There are things he would fix, same as my doctor told me pretty much. But he said comparatively he felt I got a very nice fold, good cleavage, and a very natural slope. He said if I wanted bigger implants that might work but then we would risk more droop. So that explains why my doctor would rather wait and see to the end before he would make them bigger. I would rather be perky and small than big and too droopy. I am also wearing an underwire bra for the first time today. I got some at SOma where I work. Today I am wearing the Nadia vansihing back bra. It's so odd but it feels more like me now. So all in all feeling a bit better about things. I am still a work in progress. let's hope I can get a few shots at fat grafting through all this.
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Carrol: Glad you feel better about things and time will tell. You have plenty of time to decide about revisions down the road!
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soccermom: What style and volume are your TEs? They are at 420 ccs, but I do not know if they are underfilled or overfilled....??
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Whippetmom, they are Allergan 133-MX fillable up to 500 cc. the width is 13 and the height is 12.
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soccermom: Okay....good size for you. Here is the thing: Let's say you were happy with the volume you have at present. If so, you would need at least 600 ccs to approximate the volume of the TEs. Even though you are underfilled at present, the TE "footprint" is there. You have the width and most of the projection. So, since you want to be somewhat smaller, I personally think a 500 cc smooth round silicone implant - high profile - Allergan Style 20, for example, would be nice for your frame. If you are feeling this is too much, the other option is 371 ccs or 397 ccs [I would go with 397 ccs] in Allergan Style 15. With either style, you will look quite a bit smaller than you do currently with your 500 cc TEs. You need an implant with a width of 13.0 cm. Just to give you an example, I am pretty close to your body type - 5'4" tall, 125 pounds, 30.5 inch ribcage. My implants are Style 20, 550 ccs. In clothing I have the appearance of a "C" cup.
Deborah
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Wow, that's why I asked you Whippetmom! Such good information. I'm going to mull it over and look at the Allergan website. I also have pics to share just haven't had time to resize and post. Thank you!
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Thanks Whippetmom for all of the detailed info. I just had my TEs exchange on 12/5. I am 5'5" and 155lbs (hoping to go back to my 135!!) I was filled to about 400ccs. I made it very clear that I was more concerned with 'location' than size and wanted perky rather than bigger. But my PS put in 500 cc silicone mentor moderate profile implants. They seem bigger and lower than I wanted. Will this change over time? It's only been a week. I am going in for postop this week. I feel vain being unhappy over this when I should be happy that I'm almost to the end, but I thought that this was the silver lining of the journey. Do you think she did the right thing?
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tricia: Do not lament one more minute about being "vain"! Girl, this is important in terms of your emotional recovery from breast cancer. Let's try to figure this out. So I need to know if your PS indeed used a "moderate profile" or "moderate PLUS profile" style implant. Do you have a card or anything with that information? If not, call your PS' office and ask for the catalogue number or the style number. If it is Allergan, it will be Style 10 or Style 15. This is very important information.
Also, what is your ribcage circumference - tape measure under the implants with a nice snug measurement.
Let's get this sorted out before you go back for your post-op...
Deborah
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