BREAST IMPLANT SIZING 101
Comments
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kimber: I am so sorry you have been through the ringer with your flap procedures. But I agree with your PS - and the implant size range sounds good to me. I think this is what you are going to need, because even with your flaps, you have an insufficient mound for your frame. To put your mind at ease, you could get a second opinion - many of us here have gone this route - just to make sure that there is not something else which needs to be considered. The goal is to reduce the amount of revisional procedures after MX....so you want to get it right the next time. PM me and let me know where you live and I can give you some names for a second opinion.
Deborah
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I was hoping you would respond Deborah! I am very comfortable with my PS and I do trust him, just don't want to look like I have cantaloupes on my chest! I am nervous, but excited. I have spent many a days crying over what my body has become. Surgery is scheduled for May 23, unless I choose to do something different.
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Hi Whippetmom:
Thank you so much for helping me with my decision to consult another PS. I did. Last Friday. I was ecstatic he could see me much sooner. Initially, the appointment was for Apr 12. He agreed that my reconstruction didn't look good. He offered me the choice between swapping the TE for other set of TE or (his preffered/suggested course of action) going directly to implants. He thinks he can already put in a good size implants. He seemed very confident about 300-325, even more. IN any case, he said that if the size did not please me, in a few months, about 6, he would do a revision and put larger ones. But I might be happy with the implants I am getting on Apr 23 (3 weeks from today) so he would save me another surgery. He agreed with you that I need more volume in the lower parts but he thinks he can do this at the time of the surgery.
On another note, I see that you are somewhere in Orange County. I used to live in Orange County too (Stanton) between 83 and 90. I come visit my friends in CA every year so next time I am there, I want to take you out to lunch or dinner. I would be very happy to meet you face to face. You are doing such a great job helping your sisters in suffering.
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kimber: Okay, so you want to stop stressing about this. We have to do whatever we can to minimize and reduce the stress in our lives after breast cancer. You are going to be much happier with your results once you have implants. They will NOT look like cantelopes on your chest! Just take care of yourself and eat healthy - reduce sugar - or eliminate it - eat lots of good protein - keep seromas at bay and inflammation at bay - to give your body a chance to heal without any further complications. Please let us know how your surgery goes and how you are doing!
Deborah
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SMG: Fabulous news! I knew you would get the answers you needed! This is too important and it is better to know and to address it before a disappointing exchange surgery.
I am in Long Beach - bordering Seal Beach. A hop, skip and a jump to Stanton. So please let me know when you come to California!
Deborah
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kimber -
Right now I have in 700cc TEs, now expanded to 620cc on each side.
I'm 5'5", currently at 183 pounds, and in an Optifast program to lose 40-50 pounds prior to my exchange surgery in late summer or early fall.
Trust me - at this size, they're hard as rocks, but they really don't look all that big. Seriously.
LIsten to whippetmom - she's the guru here.
There's way more that goes into choosing implants than just saying "Make me a C cup!" or "Make me a D cup!"
Wishing you the best....
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Thank you ladies! I am trying to be informed in so many ways and I am at a point where I am ready to stop researching! Anything has to be better than what I have now. The thought of another surgery after so many has caused me to obsess, and I know that. My DIEP ended with 7 blood transfusions and back to back surgeries but that is because I have Factor V Leiden as well.
I am focusing on being healthy as I go in and I also hope to take as little meds as possible. I would love to be sedated and not have general but PS said NO WAY. I am also stressing because I have a lump right near my DIEP site under the arm, kind of in the tissue under the arm, but right near the area they added the flap. I was hoping the PS would tell me that it was deaed necrosis, but he said we have to biopsy it
I was beginning stages in many places and have a VERY high hx of bc. Thanks for the advice and putting up with my babble!
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kimber: Let us know when you have a surgery date!
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SMG1954 - I'm glad you are getting the attention and the help you need! Sounds like the new P.S. knows what he is doing! Happy for you!
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May 23 for me, first case of the day! No TE used and I am hoping I am not going to be in a huge amount of pain. My right side has room, but my left is limited in my opinion. PS said we could go that route, but didn't feel it was necessary.
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I wrote here previously about being unhappy with my implants, and now I need a little more advice. To recap, I had a BMX last September with immediate reconstruction with Natrelle Style 133V TEs. They were filled to 500 cc, and I was happy with the size (told PS that I wanted to be a B or C cup). Much to my surprise, I came out of surgery in January with 800 cc Natrelle Style 45, and I'm now a DD. I told my original PS I was not happy with the size, and he said I should wait a few months, then I would be happy with the results. Here we are a few months later, and they're huge, they're heavy, and they hurt.
I went to another PS today who said that cosmetically, everything looks fine, although he would not have used such large implants on me. In order to "downsize," he will need to remove some skin, and I will possibly have drains after surgery. Plus, he said that there's a much greater risk of capsular contracture with each revision. Now I'm confused: Do I go ahead and take these risks and go to a smaller size, or should I just accept what I have? Also, the new PS uses Mentor Memory Gel silicone implants, and he said I should bring some pictures to show him how I'd like to look afterwards. Any suggestion for where to find such photos? Also, what size should I consider? He said he would lean towards 400 to 500 cc but that it would depend on which style of implants I wanted (narrower, high profile or wider lower profile). I am 5'5", weight 145 lb., and have a 34-inch ribcage.
Thanks for any advice!
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Joanna: I think you need to send me photos. PM me for my email address.
Your 800 cc Style 45s have the following dimensions:
14.2 cm width and 6.7 cm projection
I would recommend a decrease of 150 ccs to Allergan Style 20 - 650 ccs.
14.2 cm width and 5.9 cm projection.
I do not recall your pre-BMX breast size, but I do not know why your new PS feels he would need to remove skin, unless you have a lot of ptosis currently. The decrease of 150 ccs would be perfectly suited for your frame.
If your TEs had a fill volume of 500 ccs, an exchange to 650 ccs would have given you the similar appearance you seemed to like with your TEs.
Deborah
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whippetmom - another member suggested I post here b/c you are a wealth of knowledge on recon/inmplants
would like to get an opinion - i did chemo/lump/rads. I did not do the bi-msx at my first surgery b/c at my hospital (in canada) they will not put in any expanders/implants if you are having rads. I had to have rads whether i was having a msx or lump b/c of LVI and being a grade 3. So it was suggested that i do my rads, heal and then do my bi-msx in about 5-6 months.
I understand that my options are limited now b/c i have a radiated side. The PS said TE's would be placed but she would have to use muscle/fat from my back to create a sling on the radiated side. I really don't want this, i think i would prefer to use alloderm? are they amt of fills they can do limited b/c i had radiation? i naively thought i could go direct to implant but that is not going to happen apparently
any advice would be appreciated
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rozem: Are you limited to using this plastic surgeon? Please PM me and let me know where you are in Canada.
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Whippet mom-
I am so impressed with your service to women and hope you can offer me some advise as well. I am considering mx of right breast after dx of PLCIS in same breast which was tx with lumpectomy and rad about. 5 yo for ILC. PS said she could do skin/nipple sparing with immediate placement of a cohesive silicon implant. I am 5'11,188 lbs and wear A cup. Rt breast a bit shrunken from rads and lumpectomy so looking forward to symmetry. Don't need to go bigger. Option of BMX but not really ready to give up both yet. PS said this route left all other options open for future if i dont like implant. I am so new to this don' t know what I don't know. Any advise or comments? I live in Detroit area.0 -
dobie: what is your ribcage circumference- measuring under the bra line/inframammary fold.
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Rib cage measures 34 in.
I have always been happy with the full shape and perkiness of my breasts even though they do not have a large "projection" if that makes any sense. I am definitely pear shaped having little fat in my upper body and carry my weight in my butt and thighs.
I am interested in your opinion about advantages of implants over other procedures. I am concerned about the seemingly continuous need for more procedures for adjusting, tweaking and replacing. But like the idea of keeping options open in case a future left mx becomes desirable or necessary. I am a young healthy 60 yo. Young enough to care but old enough to consider risks of ongoing procedures 20 years down the road.0 -
Something crazy is occurring with my access to bc.org. I can only access from my iphone and then only wirh limited function. For example, I can see on dobie's profile page the history of her response to my question on April 8th, however, it does not show up on the page I view via my iPhone. It is almost as if everything, including my private messages, are frozen in time at some point yesterday. From my computer, I get the message that bc.org is under scheduled maintenance and will be back up in 45 minutes. But it has been over 24 hours now that I have been seeing this message. I don't quite know what happened Could someone ask the mods for me? Maybe if Cindy or one of you gals who have my email addy could ask..
Thank you!0 -
Something crazy is occurring with my access to bc.org. I can only access from my iphone and then only wirh limited function. For example, I can see on dobie's profile page the history of her response to my question on April 8th, however, it does not show up on the page I view via my iPhone. It is almost as if everything, including my private messages, are frozen in time at some point yesterday. From my computer, I get the message that bc.org is under scheduled maintenance and will be back up in 45 minutes. But it has been over 24 hours now that I have been seeing this message. I don't quite know what happened Could someone ask the mods for me? Maybe if Cindy or one of you gals who have my email addy could ask..
Thank you!0 -
After my exchange surgery I was very disappointed, I went from a full d/dd to a b cup. I went back to my ps who told me to live with them for several months, and think about it. I went to another ps who will schedule another surgery to replace my moderate profile implants with high profile 650 ml. His asst told me I will never have a natural looking breasts since I had bilateral mx, is this true? I have waited to have nipple reconstruction till I get the implants right. I did not have radiation. How large can they go without any breast tissue?
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whippetmom you need to clear your cache and cookies from your browser. I had the same issue the other day.
ihavenoname my new breasts don't look like my old ones (I went bigger) but they look pretty darn good. If not for the scars I don't think the average person would be thinking they are fake… but you really can't expect your PS to do as good as job as mother nature/god. It does sound to me though that a moderate profile was not what you should have been getting. I'm sure when whippetmom fixes her tech problems she will chime in.
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dobie: if you have a single MX, the focus is on gaining symmetry with the opposite breast. This becomes less of an issue if you augment the size of your native breast. If you had a BMX, I would estimate that a moderate plus profile implant with a volume of around 550 ccs would be nice. It could be achieved as a uni, with augmentation on the native side with a smaller implant.
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ihavenoname: What a dismal prognosis from the nurse! Many if us have lovely breasts after reconstruction and are happy. It depends on the skill of the surgeon and maybe you just have not found the right PS. Where do you live?
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Okay, so I mananged to somehow get back on. I have to go through my email notifications to get on....but at least I can see updated posts.
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I think I found a way to get in temporarily. Thank you Cindy. PMs are okay now....
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Cindy: Oops. Disregard the above. I cannot access my private messages at all. So if anyone needs to get in touch with me privately, please contact Cindy [hillck] by clicking on her name and she will give you my email address.
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Yesterday I had my first expansion from my single MX. I had implants in my breasts before and was/am a DD in my right breast. I told the PS I don't want to be a DD and expect to have the implant adjusted in the right breast in the end. Yesterday the PS put in 330 cc. How much do they put in to achieve a C and how much do they usually put in each visit? Can't wait for this process to be over. The expander is uncomfortable.
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Mooleen: You need to read the heading to this thread, above. Here is an excerpt...
4. "WHAT CUP SIZE WILL I BE?" OR "WHAT SIZE IMPLANT DO I NEED FOR A "C" CUP?"
I CANNOT PREDICT CUP SIZE. PLASTIC SURGEONS - THE SMART ONES - ADMIT THAT THEY CANNOT PREDICT CUP SIZE WITH ACCURACY!
It is very difficult to determine cup size with breast reconstruction patients, as volume does not easily translate to a specific bra size. There are so many factors which determine how implants will look on any one individual, e.g., your ribcage circumference, whether your chest wall is bony or if you have a fair amount of adipose tissue surrounding the chest wall.... if you have any ribcage deformities or other structural issues which might impact implant placement. We can sort of "project" where you might want to be...or estimate the implant volume which you could "aim" for - so that you can sort of look at the prize ahead of you. Most of us have found though, that it is better to continue with tissue expansion until you have reached a desired volume and appearance, and then compare these dimensions with the breast implant dimensions found on the links at the top of the Exchange City thread in the Breast Reconstruction forum.
BREAST IMPLANT SIZING IS SPECIFIC TO YOUR VITAL STATISTICS
Implants of a specific volume will look different on A 5'10" 176 pound woman with a 35 inch ribcage, than they will someone who is 5'3" tall, weighs 110 pounds and has a 29 inch ribcage. So height, weight, ribcage circumference, body habitus - all of these things come into play when determining what style and volume of implant will best fit someone's frame.
QUESTIONS FOR YOUR PLASTIC SURGEON:
In the interim, here are very important questions to pose to your plastic surgeon. Ask your PS if he/she tends to place you in an implant with a volume larger than the TEs, or if he/she prefers to place you in an implant smaller than the TEs. If your PS likes to overexpand - overfill - ask about this. It is important to know what is in your PS' mind about where he intends to go with your reconstruction, because this will assist us in calculating to what extent you require expansion in order to exchange to the desired implant size and dimensions.
Based on everything I have read in my nearly two years of researching breast reconstruction, the tissue expanders SHOULD be placed by the PS with the foreknowledge of the approximate size and style of implant he/she intends to use for you down the road. It should not be "let's just throw this tissue expander on her and see where it takes us." The WIDTH of the tissue expander is a very important consideration. Proper placement of the tissue expanders is a very important consideration. Please discuss these issues with your PS.0 -
Mooleen....330 ccs during an appointment fill might be extreme in some cases. Most of us fill at the rate of 50 ccs to 100 ccs every week or every two weeks - and every two weeks is preferable in some cases. There are different schools of thought on fills, but for the most part, the PS does not appear to be compensated for "fill appointments", so perhaps he/she is motivated to get you filled and on to the exchange as soon as possible. I hope this is not the case out there...
Obtain the information I need [read Item #3 in the header also] and I can help you further.
Deborah
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Central nj
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