BREAST IMPLANT SIZING 101
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ihavenoname: Close enough....I know it is a drive...get a consultation with
Dr. Peter Hyans of Summit Medical Group. He's located in Berkeley Heights, NJ
http://www.plasticsurgerysmg.com/about-our-practice/dr-peter-hyans
and/or with:
Ann Leilani Fahey, MD - Camden
http://nj-camden.doctors.at/dr/ann-fahey-drannleilanifaheymd
I have seen their work - beautiful work.
If you want to read #3 in the thread header, I can help you with sizing. Did you have a tissue expander? If so, obtain that information as well.
Deborah
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I do have info on the expander, I just didn't know what it meant. I have a Mentor #354-6216, which is a medium height expander with an 800cc volume. I assume that means that 800cc is the max so if he put in 330cc, I would have 470cc left for the maximum size. I do have the card for my original implants. I am using the same PS and the implant size was 375cc, also Mentor. It says the final fill volume was 420cc. My assumption is that because I had implants under the muscle already, I probably am stretched out to some degree. I didn't feel any discomfort at all during my first fill. Thanks for your help.
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Mooleen: Well, you might be stretched out yes, but it will take more implant to create the volume to match the native augmented breast, because we now need to replace all of that fat and connective tissue which was taken at the time of the MX and replace it exclusively with implant. So, conceivably, you could end up with an implant with a volume considerably less than 800 ccs, to allow for ptosis to match the native breast. If you reduce the implant size in the native breast, this might increase the ptosis factor. What is your height, weight and ribcage circumference?
Edited to add: TE width is 15.6 cm and projection is 8.0 cm.
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Height 5'-6", weight 156 lbs, rib cage 33 inches
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Mooleen: The width of the TE dictates the need for a moderate plus profile style implant at the time of exchange. I would recommend Allergan Style 15 - 659 ccs - and then reduce the size of the implant on the native side to gain symmetry. I recommend the smooth round silicone implants. Mentor has the moderate plus profile also, but you would need 700 ccs to meet the width requirement in that style - and Mentor does not have a 650 cc implant in that style. So discuss all of this with your PS. If you have had saline implants in the past, I do not think you would be happy with a saline implant on the MX side - as with the reconstructed breast, saline implants tend to ripple quite a bit.
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Thank you! I had tissue expander exchange surgery in feb, the silicone implants are very small and very far apart. One feels like it is under my armpit. The office assistant made me feel like there is no hope. I've come to far to just settle, thank you again
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Thanks for the information. I will indeed take it to my PS. I have been in the dark and don't really know what he is doing. I live in Montana and we don't have a lot of choices as far as PS go. He has done other procedures on me and everyone tells me he is a good dr. I am just trying to gather as much information as I can. Again thanks for your help.
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Deborah -- clear your cookies and temporary internet files then restart your computer. I had the same problem but it was taken care of completely once I did that. (I actually just ran the File Cleanup function on my Norton, then restarted). Everything is working now for me.
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ihavenoname: Absolutely, you have come too far and you CAN have results you can be happy with after bc. There are many women on these forums who did not give up and sought revisions and are now elated with their results. Please keep me apprised of how you are doing.
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Whippetmom-can you direct me to any post where folks are two or more years from reconstruction??? Many thanks in advance.
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My recon was in November of 2008. There are many gals on Exchange City who are at least two years post- recon.
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Whippetmom- if you don't mind me asking how do they feel and have they fully dropped?
I still have some hard spots that I am massaging to loosen up. What about nipple reconstruction how long does that hold up? I guess most of my questions are the wait and see type of questions. Can you basically tell us how you feel about your breast now vs. when you first got them done.
Many thanks!!!
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Fighter: My breasts are very soft. But I have also had two fat graft transfer sessions [the last one was two years ago] and this aids in softening things up immensely. I have to wear a high impact sports bra and still hold my forearms against my breasts when we do warm up jumping jacks and running in place, to keep them from bouncing so much. But we can all respond differently to these "foreign bodies" on our chest wall.
I am interested in knowing more about your "hard spots". Are you referring to scar tissue? You indeed can try releasing the scar tissue, but I would ask for a referral to a physical therapist who is LE [lymphadema] trained ONLY - and this type of PT can really be helpful in releasing some resistant scar tissue. But describe for me what you are feeling and where you are experiencing these areas of "hardness"....
Deborah
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whippetmom, how soon after fat grafting did you resume activity and massage?
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Maybe another answer to your question would be....I rarely think about my breasts, except when I am at the gym and then they more than mildly annoy me...LOL! I look at some of these women doing burpees and their breasts are jumping from their waist to their shoulder blades and I want to shout "You are going to be sorrryyy!" I wear a high impact sports bra and still refuse to do a full burpee. I will do the plank part but no jumping out and then up for me. Apart from the gym, my breasts feel comfortable and feel a part of me - feel "real". I never think of them as "foobs" or "fake". My skin, my skin tags, my birthmark, everything there as it was from birth and it is just that they are minus the fat and glands and connective tissue which I do not miss one single bit!
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It's the inner part of my breast along the chest wall at the corners and it feels rather stuff/hard. My PS said it was extra skin. I had revision surgery done and the corners are still stiff/hard. I am thinking time will soften these spots up. I know I am going to need more fat grafting done, but I just want to enjoy life w/o so many Drs appts maybe early next yr.
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Fighter: Just continue to massage with BioOil or the equivalent and get on with your spring and summer. Then, yes, another fat graft session might be all that is required. If at any time you want to send me photos privately, you can PM me and I will give you my email address.
Deborah
Edited to state: But, before you have any further procedures, a second opinion with another PS might be a good idea.
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Hello Whippetmom,
Went to PS and he is talking about adding approx 100ml to new silicone implant. Was very direct and clear about what I wanted. I think he heard me this time. Will be getting high profile to increase projection. DH thinks I was too forceful but HEY ITs MY BODY and I think I should get what I want!! Anyway, went to the hospital today to do pre-op screening. Surgery is on 26th. Wish me luck and thanks for all your help.
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Hello Whippetmom,
Went to PS and he is talking about adding approx 100ml to new silicone implant. Was very direct and clear about what I wanted. I think he heard me this time. Will be getting high profile to increase projection. DH thinks I was too forceful but HEY ITs MY BODY and I think I should get what I want!! Anyway, went to the hospital today to do pre-op screening. Surgery is on 26th. Wish me luck and thanks for all your help.
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every8th:Okay, but this makes no sense at all. I really wish you would get a second opinion though. I just want to make sure you do not wake up from surgery and there is an "oops, could not fit the 300 ccs" note pinned to your hospital gown. It is NOT a matter of just throwing in another 100 ccs - the implant itself has to be the right implant. He cannot just promise you a HP with 300 ccs - that implant will be too narrow for the pocket. So I think he is pacifying you with a promise he should not keep.
Your TEs: Mentor low height 350 ccs: [Per your PM to me last week]
12.7 cm width and 6.5 cm projection.
Mentor HP Implant - 300 ccs - 11.1 cm width and 4.5 cm projection [far too narrow!]
Completely inappropriate. You would need the following Mentor HP to match the width created by your TEs...
HP 425 ccs - 12.5 cm width and 5.0 cm projection
The other option would be a Mentor moderate plus profile implant:
Mentor MPP: 350 ccs - 12.5 cm width and 3.5 cm projection.
Back to the drawing table. You honestly do not want to go through another general surgery until you have all of your ducks in a row.
Deborah
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RoBo47, I missed something, are you not a good candidate for tradional silicone or sailine?
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robo: The Sientra implant recently FDA approved is not a form stable cohesive gel implant like the Allergan 410 or Mentor CPG. It is a cohesive gel, but on par with the silicone implants manufactured by Allergan and Mentor. The Sientra implants are not "gummy bear" implants - which is the endearing term coined by Grant Stevens, MD about the Allergan 410. Sientra does have a gummy bear implant in clinical trials, but it is a round "gummy", not an anatomical shape and it is not yet FDA approved. However, Sientra DOES have a quasi-anatomical shaped vs. tear-drop shaped silicone implant, in addition to the round gel, which is now available vis a vis the FDA approval granted a couple of weeks ago. The "shaped" Sientra implant might be a good option for you.
This Illinois doc has the Allergan 410s - and mentions Sientra implants in his blog. He might just be posting news updates, and most plastic surgeons will not have ready access to Sientra products. I spoke with Sientra recently and they were absolutely unprepared for the FDA approval when it was granted. So they are just fielding calls and requests and it may take months before doctors can actually take delivery of the product.
http://peterjohnsonblog.blogspot.com/2012/03/new-line-of-breast-implants-will-soon.html
Deborah
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robo: Tell me again about your TEs - style, volume, etc. Also, isn't there a PS at Northwestern who has the Allergan 410? I think Dr. Kim? I personally think you can get your small, natural results with a silicone round and on a patient with a bony ribcage/thin body habitus, the gummy bear can be pretty firm and rigid. I'm just sayin'....
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Hi Whippetmom!
I had my implant surgery yesterday. I was hoping for Style 20 Allergan and that's what you had recommended too. 325 to 350 cc. My PS put 421 cc style 15 though. Apparently a better match for me. What do you think? Remember that I had TE filled to 240 only and my previous PS wanted to overfill by 50%.
Simona0 -
simona you can read the specs here:
http://www.justbreastimplants.com/breast_implants/natrelle15.htm
http://www.justbreastimplants.com/breast_implants/natrelle20.htmIt appears your projection is reduced by less than 1cc (.3c-.6cc) which seems pretty minor but your width is wider/fuller. I have style 15 and I'm quite happy.
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Simona - I have Natrelle Style 15 implants as well and I'm very pleased. Sounds like your PS may have taken both Style 20 and 15 into surgery. Has he/she explained why the 15s seemed better for you?
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Robo, good for you, doing your research and getting what you want! Good luck, I am not thin on top, but following my BMX, felt very thin on top. I had 2nd round of fat grafting on top of implants last week and now have very natural and fuller boob on top. I have round, silicone, high profile implants.
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Lago and TinaT
Thank you for sharing that you also have style 15. It seems that my PS's preferred implant is style 15. He told me he would do what's best for me. Originally, when he measured me, he said he saw a width of 12 cm for me but I see that this particular model is more than 13 cm width. I suspect he needed to fit the pockets created by the TE. I did not talk with him much after the surgery because I was too groggy. I will see him post op on Apr 19. He mentioned to me when he first saw me that after 6 months, if I wanted something bigger, he could do that, do even a few sizes up. I don't know if it's worth it though. Right now i cannot really tell because i am in a sports bra and have some dressings underneath.0 -
Simona: That is a fine size for your frame. Often the PS just does not know what will work best until he has removed the TEs and is using the saline sizers to see what works best. He planned for a 12.0 cm or less implant and found he needed 13.0 cm. So I am happy this part of the journey is over for you. Now on to healing! Please let us know how they look in a week or ten days. Remember that they can look pretty strange for the first ten days after the exchange.
Deborah
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BTW simona I don't know your frame size but I'm sporting 1 size smaller than yours.0
