BREAST IMPLANT SIZING 101
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Does anyone feel like their TE look too small after full expansion? I have 600cc TE and still, feel extremely flat and am worried about the size of the implants not being large enough..I am worried that a 750 to 800 will not be enough if they say yup need to go up about 100cc in implant yo equal TE..I am wondering if I need go go sigh saline in a larger size...anyone else feel that way?
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Mariel: Do you want to send me a photo?I looked at your stats again and 750ccs or 800ccs - HP smooth round silicone should be fine. But let's make sure everything looks right with the TEs. PM me if you would like to send a photo.
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I wish I had found this thread before my reconstruction, but now I fall squarely in the "too-late-to-do-anything-about-it-now" category.
I had a BMX last September and received my tissue exanders at that point. They were eventually filled to 500 ccs, and since I was happy with that size, the PS stopped filling and said I would probably be a candidate for 600 to 650 cc implants. As background information, I'm 5'5", 145 lbs, and have a 34-in. ribcage. I was a larger 38C before surgery, and I was really looking forward to downsizing. I told my PS numerous times, let's shoot for a B cup! He said that there was no way to guarantee cup size, but he would do what he could to make everything look good.
I went for my implant swap three weeks ago and came out with 800 cc Allergan 45 implants, and I absolutely hate them. I asked the doctor why he went for such a large size, and he said that the width was a bigger factor, and if he'd gone with a smaller size, there would have been a lot of skin puckering and wrinkling, and you would be able to see the outline of the implant. He said once I'm fully healed in another five to six weeks, things will settle, and everything will look better.
My question is, is he correct? Were these the right size for me, and will they feel better at some point? Right now I feel like I have two baseballs on my chest, and I think they look cartoonish. My husband assures me they look fine (but he has to say that, doesn't he?!). I went to try on bras, and I'm back up in the C and even D cup range in some styles, and I'm absolutely devastated. I'm actually beginning to wish I had not opted for any reconstruction, because honestly, this has been much more emotional than I originally anticipated!
Thanks for any insight!
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thank you whippetmom..I sent you a PM..I would love for you to look at the pics and confirm your opinion ..you are awesome!
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Joanna: Well, that does not make sense, because Allergan Style 20 in 650 ccs is 14.2 cm in width - which is what you have with your 800s, and they would have been the perfect choice, if you were happy with your TEs. You could still swap them out for the 20-650s. You will need to wait two months anyway - so give it this amount of time to get used to the size and if you are still unhappy, swap them out. It will all be fine. Trust me, many gals before you have had this happen and have gone back for a "redo"....
Edited to state that if you had excess skin - which is quite common with many of us - maternal droop, etc., he might have felt that the higher profile 45s would fill up the pockets more appropriately. So this would be understandable, as you would have rippling if the implant is too small for the skin flaps. But if you want to send me photos....you can PM me for my email address...Just an FYI....most women complain about the exact opposite issue - which is that they are too small after the exchange. So you might grow accustomed to the size. I would suggest that you go to Nordstroms, if you have one near you, for a proper fitting. A good bra could change your mind about the new girls.
D
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Thanks for the reassurance, whippetmom. We do have a Nordstroms nearby, so maybe I'll stop by and see if they can help me out. I just find I am so angry that the PS did this without even talking with me about it beforehand. Or afterwards! I had to bring up the subject. It would've been so nice if he had said, "Hey, I know you wanted a B cup, but here's why I needed to use the larger size." I can't help but think that most PSs are so used to women wanting to augment as opposed to reduce, that perhaps my request to go smaller fell on deaf ears. Or maybe I just had unrealistic expectations.
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Joanna: Your insurance company might pay for your bras. Nordstrom can bill your insurance company, if so. So check before you go. Also, call ahead and make an appointment - just ask for an appointment with their most experienced fitter and tell them you have had breast reconstruction.
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Very excited to have my exchange surgery scheduled for Monday the 13th. I too am concerned about not liking the size but, I am so happy to make progress that size is really secondary to me now. What could I expect from this next step? Any advise? Thanks for listening
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Deborah,
So thankful for your advice. I talked to my PS yesterday. He said we would have a more indepth conversation next friday about implants and choice. But I am a planner and I like to be prepared. I asked him the width of the TE and he didnt know off hand. I am assuming he doesnt get asked those questions b.c the office told me that our hossy uses a standard mentor TE. And the office couldnt answer the question as well.
So she had to call the hossy and ask them the brand and style of TE. Now that I have that information I feel a lot better about my choice. So the TE is a Mentor Siltex Medium Height 6200 350cc. So I did more research and found the TE to be 11.7cm. So with your advice I will go with the MemoryGel Smooth Round High Profile 350cc. So my next question how far should I push the TE. Right now I have 230cc in each. I am still a little sore from last friday's fill but not bad. I am fearful of thin skin some have talked about. I dont have alot of extra skin. How much more would you recommend...thanks! 0 -
jepsj5: Your PS is the best judge of how much fill your skin can tolerate. It sounds to me as if you are doing fine - and your PS will likely want to continue with fills until you are at the recommended level. I would recommend that you continue with fills, skin integrity permitting.
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Thanks Deborah! I appreciate you sending me a PM. I called the PS office and they said I am planned for a 280cc with 10.6cm diam. The surgery is tomorrow morning, so I think it is too late to change. I will speak to her in the morning at the hospital and see what she thinks of at least going to 300cc (if she has them with her). I have told her over and over that I want to be a B cup and conservative. She said ok many times but then said she really can not base it by cup size. I was to buy that size bra and try it on and if it fit and I liked the way it looked under a tank then that was where we would be for size. The 280 was an exact B bra size. Cross your fingers for me! I hope I havent suffered through all the fill up pain for nothing...
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Good luck tomorrow B123!!!!
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Please let us know how you are doing after surgery...
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Whippetmom, you are an amazing resource for us here! I was hoping for some more of your advice on fill volume and what size and type of implants would be appropriate for me now. I provided my measurements way back on page 154. I have mentor siltex 450 cc expanders (thats all I know about the expanders) that are currently filled to 300cc and 250cc. I had expressed to my PS that I wanted to stay on the smaller side (both breasts weighed less than 250 g on pathology from mastectomies) and he said that we are close to being done with fills. He has always said that we do not have to fill to the maximum of the expanders. Do you feel this is enough volume for my desired result, or should I push for more fills? When I had initally asked if I would be getting gummy bear implants, he said yes. On further discussions, however, he said I would be getting round implants at time of exchange, not anatomicals, and that we could decide on the different type of profiles before the exchange.
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Hi Whippetmom - Can you help me with implant sizing? I currently have an expander that is filled and I am almost finished with Radiation. The PS is going to wait at least six months before completing the reconstruction. I had a LMX and I am still natural on the right. I am 5'6", weigh 140 and have a 34" ribcage. The expander I have is Allergan 133MX-13-T, 500cc. It is filled to 470cc now. The PS had to do a rush fill so I could start Radiation and can possibly fill more. I'd like to be a full C when finished. Thanks. Carolyn
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bobeena:
Your TEs are either 12.3, 12.7 or 14.0 cm in width. We are hopeful that it is one of the first two and not the latter. If you went with a high profile smooth silicone round, you would need at least 475 ccs in Allergan or 450 ccs in Mentor. If you went with a midrange profile/moderate plus profile style - you would need 371 ccs in Allergan or 375 ccs in Mentor. I cannot envision any of these options being too large for your frame.
Can you tell me how the size of your TEs appears to you currently? Too large, too small or just right?
Deborah
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Carolyn: It all depends on the native breast. If it is small, are you going to augment with a small implant? Do you have quite a bit of droop - and if so - will you have a lift? The MX side implant will be chosen with symmetry in mind. You need an implant with a width of at least 13.0 cm - and so this means an implant with a volume of around 500 ccs - 600 ccs, if high profile - and around 400 ccs to 500 ccs - if midrange or moderate plus profile. If you have considerable droop on the native side, the MX side needs to be overfilled and the implant would likely be smaller than the TE - so that you could come as closely as possible to getting some ptosis - droop - on the MX side. But in the end analysis, the sizing really is predicated upon the size and appearance of your remaining breast.
Deborah
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Whippetmom, Here is the information on my TEs...Allergan 133-MX filled to 420cc. The width is 13 and the height is 12. My PS is going with 450 cc, style 20. I noticed that the diameter of the implant is 12.4. Does that mean he will have to do some pocket work or is that .6 cm small enough that the implant can move around? I have a hard time visualizing exactly what the pocket is like and how the implant fits in it. I know he is moving my left food a little more medial. What do you think? Thanks for your help.
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Hi Whippetmom et al - I really need some advice. I am having a double mastectomy on the 21st. I have a wide ribcage - 39", but am a B to C cup. I told my PS that going smaller is great with me. I probably have some extra skin since I am about 50# lighter than I used to be, but I can't really tell it because I don't really carry a lot of extra weight in my bust. Do I need to tell her to go ahead and take the extra skin now? I like my breasts because they are low profile and don't get in the way - I would be devastated if she put much larger high profile breasts on me. She did order expanders specific to my size. Thank you so so much for any help you can provide!
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Soccermom: Why didn't your PS just use a 133MX-400 cc TE, if he planned on using a narrower implant? I think you need a 13.0 cm implant, personally - like a 371 cc or 397 cc Style 15.
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Farmerlucydaisy: Do you have quite a bit of droop? If so, I think you need to ask your PS if any redundancy with your skin flaps will hinder your desire to have smaller implants. I think you want a moderate plus/ midrange profile style implant, wirh a width of around 15.0 to 16.0 cm. You can email me a photo and I can tell you what to expect.
Deborah0 -
Thanks whippetmom. I feel The TEs are about right, but I am already larger than before. My co workers say I look great, so I will have to take their word
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Hey everyone, Had the exchange done yesterday!! I woke up near the end of surgery.. YIKES! Bandaged so much that i feel like dolly parten.. I dont even know whats under there. Lots of pain on the upper part but nothing like the BMX! Thank you all for your advice and comments, it helped to know what I was walking into.
Deborah: I asked the PS again right before surgery about the sizing and such and she was still on board with the same plan. I hope she was right! Fingers crossed..
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bobeena: So, if you went with a 475 cc high profile implant - Style 20 in Allergan - you would be a little smaller than you are now with your TEs. So this might be a good size for you. That is, IF your TEs are in the 12.0 cm range in width.
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B123: Congratulations! Keep us posted on how you are doing!
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Whippetmom, Yes, I don't know why he chose a 13 cm TE. I had saline implants before the BMX and they were 12 cm diameter! I have my exchange on Tuesday. Do you have any advice for me to talk to him about? I can only assume that he will have to do some stitching in the pockets. For some reason, I'm already thinking revision in the back of my mind. Darnit!
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What gel implants available in the USA have the cohesive gel? None. Is there photo I saw of an implant cut into looking like a chicken cutlet ...is that a gummie bear? So..the ones in the US have the gel that oozes out if it springs a leak?
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Layla the US has approved cohesive gel implants. What they haven't approved is the gummy bear which is more anatomically shaped. There are trails going on now here in the US.
I have cohesive round gel implants as many other ladies do. I don't know if they even use/manufacture the non cohesive silicone implantsanmore
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Farmerlucydaisy -
I, too, have a larger chest size (39") and prior to my BMX in December I was a 38DD/38DDD. I told the PS I wanted to go smaller!!!! He said based on my size, he would not go any smaller than the equivalent of a C cup.
I was worried that after the BMX, my chest would look like deflated balloons. But his way of doing things is to NOT leave a lot of breast skin, especially skin that might flap over. This just leads to more problems and a greater chance of infection.
I also had quite a bit of armpit hangover and side boobage. He said whatever was leftover at the time of exchange (where he would do SOME) fat removal); he would take care of in the clinic setting, as I would have to roll over into different positions so he could mark the fat that had to go.
Congratulations on your weight loss!!! I am faced with having to lose about 40# before my exchange surgery, so my PS has the best idea of what size permanent implant to give me. I sure wish I had done that before now, but oh, well.
One bonus to having large breasts removed, and pectoral muscles not being in the best shape: my fills are very easy to tolerate. I thought I was having fill-related pain last week, but we figured out it was from sleeping in a wonky position.
Prayers for a successful procedure for you!
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Holy crap, B123, I can't believe that you woke up near the end of surgery. I hope they fire your anesthesiologist - that stuff isn't supposed to happen. Hope you are feeling well today!
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