BREAST IMPLANT SIZING 101
Comments
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Whippetmom...I saw the plastic surgeon today and what I perceived as the left one being bigger is actually some fluid outside of the TE. The PS said to watch to see if it grows larger or whether the body absorbs it. He said that he filled the TEs at surgery to 580cc and thought that that was a good size. I will start chemo at the end of this month so I have a several months to wait for the exchange
My new oncologist said that they looked great! Thanks everyone for your advice. 0 -
Hey girls.
I'm dejected. I think my right implant blew out my Alloderm sling. It is sitting MUCH lower than the left one, and looks gross. The Alloderm is visible as an inflamed band around the bottom of my breast, before the IMF. I can actually feel the weight of the implant on my hand, where I used to feel an Alloderm ridge. Blah!
I'm mad at myself, I feel like I let myself be victimized by the health care providers. This is very painful, I must stay, and I feel infetiony. My appointment with the doctor is 9 am tomorrow.
So, am I going to have to get cut for this?
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Eema: What did the PS have to say this morning?
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CMS: Yes, watch that fluid and if it does not absorb within the next couple of weeks, you want it explored further. Keep us posted!
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Hi girls,
My expanders are Allergan with expansion volume of 400cc. How much can they usually be overfilled?
Whippetmom - I sent you a pm. Thank you in advance.
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ThisToo...Have you read the header at the top of this thread? I do not know if you NEED to be overfilled. Read Item #3 at the top of the page. Let's get all of your information together and then we can determine where you want to be and need to be in terms of sizing.
Deborah
OOPS....Sorry!!! Disregard the above. I just found your PM to me. I must have looked at it with my iPhone and but needed to wait until I got to my computer and then forgot to do so. I'll work on it for you right now!!!!
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Hello whippetmom,
I am new posting in this site and i would like some insight regarding the amount of cc's that need to be added in order to make me look a decent size. I am currently filled to 475cc on my right side and my breast looks less than an A cup. My left expander had to be removed last month because it got infected. My rib cage measures 40" and I have an Allergan 133 SX-14 which is recommended to be filled to 500 cc's.
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mkw1: Your TEs will help us get you where you need to be. The short height extra full projection expanders enable the PS to exchange you out to an implant considerable larger - volume-wise - than the TEs. There are some factors to consider here as well though. If you were quite large and ptotic [droopy] prior to BMX, you will have quite a bit of excess skin to take up with the implant as well. So I would need to know a bit more about your breasts, your height and weight and this might give me some additional data to factor into implant sizing for you. We could be looking in the 700 cc range at the very least, in terms of implant volume. For a 40 inch ribcage, I would like to see a width of at least 15.0 cm and possibly around 16.0 cm. You can share this information here or PM me if you want to discuss this further privately.
Deborah
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whippetmom: Thank you for replying to my question so promptly. I am 5'4". I weight 210 lbs. I am narrower in my shoulders and bottom heavy. My breasts were not too large. I was a b cup before the mastectomy and I was droopy because of my age, I am 54 years old. I also have a prominent ribcage (my bones stick out) The PS said that the mastectomy on my right side (which was the side with cancer) was quite radical, so the skin that was left was thin. As for the left side, which is the prophylactic one, they will insert the TE again, in 2-4 months. Thanks again for your help.
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mkw1: Perhaps you have a pectus excavatum - with your ribcage description it sounds like this? Or pectus carinatum? The ribcage issues need to be taken into consideration, as it typically takes and requires implants with greater projection to compensate. So I honestly feel that you need at least 700 ccs and a high profile implant would be preferred. But if your skin is thin and skin integrity is an issue, this is an important issue and we cannot push the envelope with too large and too much projection. Getting good skin closure over the implant is integral to the reconstruction process. So in this case, something like a midrange profile implant would be a safer option - and you could use at least 650 ccs in this style. I am referring to the Style 15 in Allergan - or Mentor's moderate plus profile implant. NOT a moderate profile implant only. You need that "plus" factor for some projection.
Let's talk when you are filled to capacity and let's see how you are doing and how you feel about the size. You can always email me photos also....PM me if you want my email address.
Deborah
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Well, whippetmom, I've flip flopped again in wanting only a uni...although I fear at the day of surgery my bs will have her way. I fear that in the end I will resent her for emotionally pushing me to do something I don't have peace in doing. Tuesday is the D day. I finally feel ready to get this over and done with. I will take the information you pm me to my plastic surgeon. I haven't had but minutes to talk with him since initial consultation.
I understand there is a second surgery to remove the TE for the implant. How long is this second surgery, and recovery? A friend who had it done said the ps put a drain in when the implant went in...wondering why again? For those who only had one breast removed ... do your implants pretty much match your own natural breast or is there a big difference? For me if they are approxiately the same size it's ok. Do you stay overnight for a single mastectomy or is it a day surgery? Just want to be prepared either way.
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evebarry,
I am sure whippetmom will be along to answer your questions soon. I hope you will get what YOU want, not what you BS wants!!! I am a BMX, but that was MY choice. You can always go back for the other breast, but you can not put it back once it is removed. Realize your BS can not do anything you do not agree to.
With reguards to second surgery, most woman have TE(s) filled until they reach the volume needed then second surgery to put in saline or silicone implant. I did not have any drains with exchange. I stayed 2 nights in hospital with my BMX with TEs, but could have gone home after one night. Most ladies have exchange surgery and go home the same day. Best wishes to you.
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evebarry - The MX with TE placement is the tougher surgery. The exchange surgery (to replace the Tissue Expanders with implants) is much easier. You WILL have drains with the MX and the TE placement. It depends on you, your body, your PS on whether or not you will have drains with the exchange surgery. If you do, it is likely it won't be as long as the drains with the MX. You will have the surgery for the MX and TE placement and then stay the night, be out the next day. The exchange surgery ... I was in and out in 5 hours and on my way home.
I know this has been a really tough decision for you ... it is for all of us ... in the end you have to do what is right for you .... I opted for a prophylatic on one side because if you're going to go through the pain (there will be pain whether you have one or two) go ahead and go for the two. But YOU have to do what you feel is best. You will not have perfect symmetry with your natural breast ... that is impossible ... but you can get close. A lot of women, to gain symmetry, will have some kind of lift or augment to their natural breast.
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whippetmom: I looked on the internet at pictures of pectum excavatum and carinatum and I do not think I have that condition or perhaps I just have a mild form of that condition.? I had good medical care while growing up and was never diagnosed with either of those chest abnormalities. I will PM a picture to you later on today. I had another 120 cc's added yesterday and the breast is starting to look a little fuller. It looks surprisingly small for almost having 600 cc's total, but maybe this happens because I am overweight with lots of belly fat.
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evebarry: Christine and Dawne-Hope have said everything I could say....
We will be thinking of you and praying all goes according to plan. Please come here after the surgery to let us know how you are doing!
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mkw1 -
You know, a number of women have shown me photos in the past three years and I mentioned pectus excavatum [pectus carinatum seems to be less common] and they have gone back to their doctors and asked about their ribcage anomaly and the doctor tells them "yes, you have pectus excavatum." If it is a mild form of PE, patients often never are told or never hear this diagnosis in their lifetime. Spinal anomalies [lordosis] can also cause a prominent ribcage, by virtue of body dynamics. But then again, the lower ribs on some individuals just flare outward, without any predisposing conditions therefore. Our bodies are unique instruments and many of us have little quirks, but they all should be factored into the reconstruction equation.
I will PM you my email address...
D
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May you all be richly blessed by the God of all Hope this holiday season!0
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Well, I just had my last fill at 650cc. I now have to wait 6 months for the exchange, reduction, and lift. It seems like a long time, but they are making me wait so the RADS skin can heal more. That will be more than a year with the TE and the lopsidedness. I guess I just have to be patient and follow along here to see what else I can learn. Thank you all for the knowledge.
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Whippetmom-I had my exchange surgery yesterday and ended up with a Mentor high profile implant with 600ccs. Just like you said I should have. Just wanted to thank you again for all your advice you give us on these boards! Happy holidays to you.
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Happy Hanukkah & Merry Christmas to all of you. Thanks for your your advice and friendship. Hope 2012 will be a banner year for everyone. Jan
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mammalou: The time will go by so quickly! Have patience - it is good advice to wait six months!
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jbennett: Congratulations! Please keep me updated on how you are doing and visit the Bras 101 thread - you need to be working on that aspect next!
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Happy to be living in the USA. THESE IMPLANTS ARE NOT AND HAVE NOT BEEN USED IN THE UNITED STATES. Please note though that French government is now advocating removal and willing to pay for removal of implants by this manufacturer, who used industrial grade silicone in their inferior implants. These implants were marketed and used throughout Europe - with most usage going to Great Britain. GB, however, is denying there is a problem and so far has refused to address the concern.
http://www.reuters.com/article/2011/12/27/us-breastimplants-fda-idUSTRE7BQ03M20111227
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Amen Whippetmom. My heart breaks for those women affected.
Thank you for all your help to everyone.
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Thank you. I have some questions for my PS, which will be a releif to him. He seemed concerned that I had no questions. Now I have plenty. What I know so far: 180 ccs at the time of surgery, he expects to fill to 700 - 800. Anticipates silicone. He did mention that there are all kinds of options we will discuss a littel more at each visit.
I know nothing else. So....off I go to ask questions on 1/11, date of first fill.
As they say, I'll be back.
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Hi Ladies, I had DMX on 9/20/11 with TE's. I was an AA before and am going for a B cup now. I am at 320cc with hopefully 50cc more to go on 1/3/12. Exchange set for 1/23/12. My PS initially told me he preferred silicone for recon patients and that is what I was expecting. I called today to get the details on what was ordered for me and was told that high profile saline were ordered. I don't know if this is an error or not and Dr and Surgical co-ordinator are unavailable for consult until next Tuesday 1/2/12.
My question is this - any input on silicone vs saline? Everything I have read sas silicone is better and I want to be prepared in case the saline order is not a mistake. He has ordered textured implants - any input on that?
Also, they are only waiting 3 weeks after my last fill before doing exchange. Is that long enough? I have been fairly tight throughout and have a slim frame, I am 5'7" and 130#.
Any input on FG to soften the look of the implants? I have anatomical TE's in and have quite a shelf. PS wants to do FG to soften. What was the recovery like from the lipo and did you have good results? Did the FG last?
Any imput would be so welcome as I am getting really nervous about this whole thing. Is anyone out there happy with thier results and not living in pain from the implants?
HELP!!!! I am near panic with this impending surgery - just when you think it's safe to go back in the water!!!!!!
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rubalou: Silicone is preferred, and also preferred is SMOOTH, rather than textured rounds. Textured round implants tend to cause a good deal of traction rippling - especially in recon patients. Three weeks out from your last fill does seem short - when most of us waited two to three months. It all depends on how well your skin has responded to expansion though. Maybe your PS feels you are ready. FG to contour at the time of exchange is fine. There are no guarantees re: how long it will last. It will take several months to know whether what is grafted will be retained. Many of us are happy with our results and we have no pain or discomfort after reconstruction.
Deborah
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SheChirple: I am so glad your PS wants you to partner in decisions regarding reconstruction. How refreshing! Keep us posted on what he says after you barrage him with questions!!!
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Cindy: Great minds think alike I guess! Cindy....got my Freya Pollyanna and I like it! It took a month to get here from GB. I still want to get the Faye....keeping my eye out for one on Ebay! 0
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I just wanted to give a big shout-out to whippetmom for all her help and advice before my recent surgery.
I knew I was getting a BMX with TEs, but aside from that, I really had no other information. I knew my PS did some fancy measuring during our first appointment, but he didn't really explain what he was doing. (I've since learned that all I need to do is ask, and he's happy to explain.)
I've always had large, dense, droopy breasts. I was wearing a 38DD bra, but truthfully, it probably should have been a DDD or F. I told the PS that I wanted to go SMALL - and he said with my body type and size, he wouldn't want to go less than a C cup.
Well, I PMd whippetmom with my measurements, and she came up with some great questions to ask him, and some suggestions of her own as to what size might be appropriate for me, including TEs that could be filled to 700 ccs.
The PS emailed me back right away, answered all my questions in detail, and gave the same answers as whippetmom had given me previously!
I'm now 3 weeks out from surgery. In the hospital, I peeked down the front of my tight Ace bandage, and saw........a teensy little cleavage!!!! He inserted Allergan INAMED 133mv-16 TEs (700 ml, moderate height, variable projection, saline) with a potential fill capacity of 700, which can be over- or under-filled. He had filled my TEs to 180 ccs in the OR. Final implants (three months after my last fill) will be smooth saline.
I am actually fine with the way my little foobettes look today. The skin is a bit wrinkly, and he wouldn't get any prizes for fine stitching, but the incisions themselves look to be healing well. I was afraid I'd have "deflated balloons" on my chest because I had so much excess
skin, but he took off most of it to avoid later necrosis and seromas. What's funny is that right now I have the same size chest as I had as a pre-teen....and this is prior to my first fill on January 3rd.Something I noticed early on....I had a huge amount of swelling in my upper abdomen, especially after the drains were removed. Everything felt hard and immovable. But the swelling is gone, and my foobettes have really loosened up. The TEs are definitely hard underneath, but the skin above them feels good.
Now I have to get serious about losing weight. I can definitely tell that this will change the outcome of my final implants. If I lose weight now (maybe 35- 40 pounds, ugh) it will give the PS a better idea of how much to fill, and what size of permanent implant to put in. If I wait to lose the weight until after the exchange, I could be looking at some considerable boobage!
So back to my original intent - thank you SO much to whippetmom for all your expertise!!! I now feel confident that I am a partner - rather than just a patient - in my reconstruction process.
p.s. I am 5'5", 188 pounds (thank you, Christmas goodies), and my band size is 38"
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