BREAST IMPLANT SIZING 101
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whipitmom - I go for my pre-op for BMX (with Lat Dor Flap reconstruciton) this thursday and I also see my PS for paperwork and discussions of sizing, I am currently between and C & D but would like to be a full D. Can you please let me know what you need in order to help? Thanks
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mwk1 the PMT expanders were the brand my PS used. I don't think they are necessarily custom, just not commonly used.0
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Anyone with TE still very uncomfortable? I had sx 2/9 and had 300cc put in. Still so tight and have not had another fill because of it. Started therapy to help stretch and loosen. I dread my first fill.
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Hi Msbelle,
I no longer have my TEs, but can tell you it took awhile before I was comfortable with them, they never felt great, but it does get better. I found stretching and warm showers very helpful. Feel better soon, see you are from NC, met too.
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Msbelle - I also was filled quite a bit (350cc) at the very beginning and felt tight for about 6 weeks. It wasn't unbearable, just uncomfortable. I had healing complications so didn't have an outpatient fill for many months. Once the outpatient fills finally started they were a breeze for me. My PS's policy is to let the patient call the shots on fills (1-8 weeks apart). Guess I'm one of the lucky ones as I didn't find it a difficult process. Hang in there!!!0
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Oh Blessings I am so happy for you and excited. How long do you wait b4 you can get your implants? Are you getting saline or gel? You will have to tell us all about it. I remember you were my comrade in complaints with these horrid TE and I only started my fills. I am thkg of taking flexeril and TYCo before next fill and then do that on Wed and stay home in recliner Thr & Fri. How many fills did you get Blessings? how many cc are in there? 39 inches would be a lot dont yu think? Dunno were u heading smaller or bigger? Good luck,hope they look awesome.
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Gigi: I sent you a private message just now!
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Hi, Layla -
"The Girls" were a 38DD/38DDD before my BMX. I begged my PS to go smaller. He agreed, but only down to a "C" cup equivalent, so that they would not look too small on my 5'5", 185 pound frame.
Let's see....how many fills did I get?
1) 12/5/11: 180 ccs in the OR
2) 1/3/12: First fills = 100ccs
3) 1/20/12: Second fills = 120ccs
4) 2/3/12: Third fills = Left 80ccs, right 60ccs
5) 2/21/12: Fourth fills = 80ccs
6) 3/6/12: Fifth fills = Left 60ccs, right 80ccs
Just remember - I was a large gal, with huge boobs, lots of loose skin, and very lax muscles. That made some very big fills possible.
Right now I am filled with a total of 620 ccs. My TEs can take 700ccs and can be overfilled. We had a discussion last time about whether or not I was done....He did an exam and determined that I could take one more set of fills to bring me up to 700ccs.
But whippetmom brought up some great questions. I thought about them, and next week, instead of getting my last set of fills, my PS and I will be talking about how this is really enough.
I did have some pain after I was filled to 620ccs. My TEs are as hard as boulders underneath my skin, but the skin itself is soft and somewhat wrinkly. That's a problem, as I started with soooo much extra skin!
Now I will be going through the Optifast program at Kaiser in an attempt to lose about 40 - 50 pounds. That, plus the fact that somewhere along the line I completely mismeasured my chest measurement, leaves me to believe that my muscles have been stretched quite enough to accommodate the Allergan Smooth Saline High Profile Implants that he uses for reconstruction.
OMG!!! I don't have a 39" chest!!! I measured myself not long after my BMX, when I was still really swollen. Right now, before any weight loss, my chest measurement is 34-35".
If I really am done with my fills, I could have been looking at exchange surgery as early as June 13th. (My PS makes his patients wait three months before exchange.)
But when I start the Optifast Program on March 22nd, I will be on the Meal Replacement phase for 16 weeks - that's FOUR MONTHS!!! I won't be starting the Transition (back to regular food) phase until August 22nd. My MO says I won't be allowed to have any surgery whatsoever while I'm on Meal Replacement. BUT - she says that once I've been on regular food for three weeks, I'm good to go with another surgery.
So there is the LONG answer to your short question, Layla!
I thought I'd have it all figured out: BMX on 12/5/11, then a month later, start my 50cc fills every two weeks until I was at 700ccs. But our bodies have other ideas sometimes. This new plan actually puts me back into the time frame I was looking at in the beginning. I'm just hoping that I will look and feel much better before the holidays at the end of this year!
How are you doing with your fills? Remember, it's not a race.
Many women prefer LOW AND SLOW to prevent pain and complications. Just wanting to be done with your TEs really isn't a good enough reason to hurry them up and suffer the whole time. Maybe if you slow down, you won't have as much pain, and then the wait for exchange won't be as important.
Hope your fills get easier....let us know what's happening!!!
xoxoxo
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Blessings I was the opposite of you. Very small breasts ended up going bigger. (Went from a small 34 A/B to a 34D but look like a 34C. I did not get high profile implants). My expansions were slow about 60cc I was told. I had 10 expansions! The last 4 were so painful I had to take Aleve before I left the office… and I'm the one who didn't take any pain meds after my BMX, not even a Tylenol!
My TE's too were very hard and firm but I didn't have extra skin. I know other larger busted gals did have some skin removed at exchange or later so that is possible.
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I'm adding this to My Fave Topics. Thanks a lot!
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11BC : You are welcome!
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I am very excited to announce that there is now a third company - Sientra - joining Allergan and Mentor who have a silicone gel implant available for augmentation and breast reconstruction. I had hoped that this was a true cohesive gel - gummy bear - implant which had received FDA approval, but I believe it is the same type as we see with Allergan and Mentor. There are two distinct differences Sientra has to offer. One is that there is also an anatomical silicone implant which might be useful in some reconstruction cases. I have an old Sientra/Silimed sizing chart and if it has not changed, the anatomical implants come in relatively limited sizes. But the second lovely benefit with Sientra, is that if the sizing chart is current, the silicone rounds will be offered in volumes ranging up to 995 ccs. This means that you bodacious gals who have heretofore had to stick with 800 ccs in Mentor or Allergan, have the opportunity to choose from this extended volume range.
These implants are now available to plastic surgeons, however, I spoke with Sientra the other day and they are swamped with requests and phone calls and so it may take some some [months?] for some plastic surgeons to accept delivery of this brand of implant. But if you are starting your reconstruction journey or considering a revision, you now have another breast implant option.
At this time, for volumes below 700 ccs, if the chart is correct, I still like the dimensions of the HP implants offered by Allergan and Mentor better than Sientra's HP implant. They only have two styles of rounds - HP and Moderate. But for volumes 700 ccs to 995 ccs, I am very happy with the dimensions and how they might benefit some of you gals.
Big thank you to Carol4, who is fielding the FDA updates for breast implants and PM'd me with this good news!
Deborah
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whippetmom - Questions:
1) Has the FDA approved a true gummy bear implant (Allergen 410?) for the U.S?
2) If so ... if we already have the silicone rounds we will never be to have the gummy because of the imprint left by our TE and the round implant ... is that true?
3) What is the difference between a cohesive gel implant, a silicone round implant and a gummy bear implant? I can never seem to keep them all straight ... so will you set me straight?
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DH:
1. No, the FDA has not yet approved a true cohesive gel "gummy bear" implant yet. I initially thought that they had approved Sientra's "gummy bear" silicone round, but on further review, it appears to just be the standard silicone implants offered by Mentor and Allergan.
2. At least two principal investigators who have access to the Allergan 410 in clinical trials, have reported that the anatomical gummy bear will NOT be a good choice for women who have previously been implanted with round implants - either silicone or saline.
3. Mentor calls their silicone implant "memory gel" and the silicone implants are often called "cohesive gel" implants, because the consistency is much more "cohesive" than previous generations of silicone implants. The Allergan 410 is called "true cohesive gel" or "form stable" implants. The term "gummy bear" was coined by Grant Stevens, MD - a California plastic surgeon who is one of the principal investigators of the 410 device.
Dr. Mele, a San Francisco PS, adds this:
"The biggest difference between Cohesive Gel Silicone Breast Implants and Gummy-bear Silicone Breast Implants is the filling. Both types of breast implants are filled with medical grade silicone. The difference is the viscosity of the gel. Cohesive gel implants have a viscosity somewhere between liquid and solid. The silicone gel inside a Cohesive Gel Implant does not flow like water. It will not squirt, or even freely run, if the tough outer shell is punctured. The cohesive gel likes itself, and wants to remain together. It can be forced out with pressure, so it is not a solid; however, the newer cohesive gel implants are much easier to remove after a rupture than their more liquid-like predecessors.
While both resist flow, a gummy bear implant's filling is the consistency of its namesake. It is a soft solid that has memory. It can be compressed, but will return to its original shape spontaneously. Even when cut in half, the semi-domes will maintain their shape. If compressed, they will flatten, but when the pressure is released, the semi-dome shape will return. The term for this is form-stable."
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To make it simple....there are only two types of silicone implants. The standard silicone rounds offered by Mentor, Allergan and now Sientra, Sientra's new lineup of "shaped" implants, and the non-FDA approved "gummy bear" implants.
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Thank you!
So then Allegran Natrelle silicone implants, not the 410's (what I have) are also cohesive gel?0 -
Yes, and gummy bear implants are cohesive gel also, but they are form stable cohesive gel implants and they are not yet FDA approved.
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Thank you so much for the wealth of information. I've had a double mastectomy on feb 14, 2012 and the cancer was on the left side. Before surgery, i had an A cup. I am 5' 3" and weigh 110 lbs. My ribcage measures 31 ". I am now filled to 180 cc. From the card that I was given, I have the Allergan style 133v tissue expanders. The doc says he would like to place 240 cc implants (silicone). He wants to expand me to 360 cc. From what I read in other places, usually there is a tighter correlation between the cc in the expander vs the cc in the implant and sometimes the implant is Bigger than the TE. I am confused. I told my doc I wanted bigger breasts. The thought of bigger, shapelier boobs is what kept me motivated and now I am worried and depressed. Ok, depressed because of the fact that my left boob does not match the right. I think there is something wrong with it. The expansion occurs more toward the upper part and the bottom part does not seem to fill almost at all. The doc says he can "usually" do adjustments when the exchange is performed. In the meantime, fillings in my left boob are way more painful in this left side. What do you think?
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SMG my exanders looked strange. I called them stripper boobs. They were too high and also a bit square. The look great now. My PS over filled my TEs (tissue expanders) so he achieve ptosis (a little droop) so they would look natural.
Whippet mom can give you advise on the size of the implants. It also does depend on if you are using high profile or mid profile (what I have).
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SMG if it makes you feel any better my TEs were so different in size and one was way higher than the other. My excahnge was almost even in a bra they look even, but there will be alittle tissue removed on one side when I get my nipple surgery done.
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SMG -
I have Sponge Bob Square Foobs. Seriously. If I raise my arms, they kind of look like loaves of French bread.
In the beginning, I don't think the bottom halves expanded at all. But they sure did under my armpits!
They're kind of like balloon animals, actually....until you are really full, the saline just goes where it wants to.
All the TEs are doing now is creating a pocket for the new implants to go.
As for sizing, wait til whippetmom answers your post. She really is the expert here. There's a TON of information that goes into choosing the right permanent implant!
In what way are your left fills more painful? Do you feel the needle go in? Or do your muscles hurt more on that side afterwards?
The needle pain I felt was minimal, but it did change as the shape of my TEs changed, and moved underneath the skin. Sometimes the port would be under a numb area, sometimes not.
If you are having muscle pain, you need to alert your PS. You can either go "Low and Slow" to reduce the amount of fills you get each time, or he/she can prescribe meds (muscle relaxers or Valium) to reduce muscle pain. One thing that helps me is a nice hot shower before bedtime.
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SMG: I have a number of things to discuss with you. You do not need to stress about this because you are not going to have your exchange until you and your PS are on the same page regarding your results. 240ccs is not sufficient for you. I need to know which style and volume OR the width of your TEs. The are 133v - but either MV, MX, SV, SX and so on..followed by a "11" or "12" perhaps. I think you need closer to 325 to 350 ccs. But let's find out about your TEs.
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Blessing.. Thanks for the laugh.. I my expander looks exactly as you describe yours.. Never thought of sponge bob quarefoob, but that explains it perfect, and the under armpit "fills" defiantly there.. Sure glad the position of expander is not the position foob will be
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SMG-I saw your post on CSN and responded over there ... So glad you found whippetmom. My left side was my cancer side. With my BMX, it was always the left side that hurt more than the right through the entire fill process. I took Flexeril (a muscle relaxer) and it helped greatly with the pain of the fills. Others take Valium, which does the same thing. Very few of us looked 'normal' with our T.E.'s ... I looked rather freakish ... Lopsided...too far over to my armpits but all was fixed with the exchange.
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Whippet mom! I'm thrilled with the Sientra news!! I'm calling my PS tomorrow!
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MTnester: Absolutely! With your current width, you could have either HP 895 ccs or HP 945 ccs! The projection would be 6.4 cm and 6.5 cm respectively.
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I am ecstatic! Beyond giddy. I could do cartwheels, and I really don't know how to do them lol!
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Well I got so hooked reading all these posts I've stayed up way too late, but since I am up and gathered all my information I decided I better at least get an opinion.
To whippetmom:
I am 5'5, 125-128lbs, ribcage 30 and my TE's are Allergan Natrelle 133MX-12 400cc. I am currently filled to 480R and 460L (had L TE replaced on 2/8/12 so still a bit out of sink on fills)...I was a C prior to BMX and told PS that is where I wanted to be again (and not to listen to my hubby regarding DD)...my PS had initially told me we were going to 600 or until I decided I was done with fills. . My PS did explain that we would go bigger so he has "room" to work ..but not sure where I need to be to get the final product I want. PS doesn't seem to be one of those that will make me wait 3mos after last fill for surgery..a month ago he said probably 1st of June - but I think my fills have gone much better than anticipated since TE replacement 2/8.
I am going for another fill on the 21st and I am hoping to get a firm "exchange date" as I have a very busy schedule coming up in May/June.... Honestly my surgery date feels more important right now than my bra size does..My daughter said a firm B up "where they belong" would probably be just as good as the C I had before - I think she may have a point???
I am hoping if there is anything more specific I should ask about that you can provide some guidance!!
I find it amazing how much we find out "AFTER" surgery and during treatments that I feel we should now "BEFORE"...I realize we are in a hurry to get the cancer out and get things started but I didn't even realize there was such a thing as NS mastectomy...
BCO is awesome - I have spent the last 7 mos just reading and it has brought me a ton of peace and laughs..love the humor on here - seriously if we can't laugh at some of this we would probably all be miserable....
Thank you - you are all amazing women!
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Whippetmom
I have just starting this journey and maybe I am too early to be asking questions. My uniMX was 2/23 with TE Allergan 133LV-14. I have only had one fill of 70ccs since initial surgery and will be seeing the PS tomorrow for next fill. I too was hoping to match remaining natural breast 38 small C. I am 5'8" 160 # with a long torso Do you sometimes make suggestions based on age, as some of us who are mid 50's and that have had uniMX are going to find that remaining breast will continue to sag as we age?
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Thank you whippetmom, for your help on this. I am going for my first fill tomorrow. I am 5'3" 125 pounds. I wore a 36B bra before all this. My PS is the head PS at MSK (memorial sloan kettering) he has zero personality, which didn't bother me during our "meet and greet" but that has since changed. He's very short (physically and verbally), very dismissive of my concerns or questions. I didn't see him before or after my BMX and he delayed my surgery by 2 1/2 hours. When he arrived 1 and 1/2 hours late for my first post op appointment, he was in and out in under 2 minutes. Said he filled me during the operation but can't remember how much.
I got the card so I know I have 133FV-12, 400cc allergan TE.
My right is completely different from my left. The right is expanded much more at the bottom, right above the bottom of my rib cage. If I measured correctly my rib cage is 33 inches. The TE feels too big for me. I hate the PUFF under both arms. Intially I thought that it was swollen from my surgery but I now know its the TE. It lines up to the back of my arm
I don't want to be large, at the most a full B.
Question: who does your fills? nurse or dr? I can't imagine my "rockstardoc" taking time out of his busy schedule to fill me.
And what should I be asking going into my first fill?
Thank you for your help. I have a bad attitude at this point, and I know this is not helpful.
Shannon
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