BREAST IMPLANT SIZING 101
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Hello BC Friends! I haven't written in a while, but I have been keeping up with all of you and thought I might pass on some information for reconstruction possibilities and inspiration! I am single, 39, and have no children, and I had bilateral nipple sparing mastectomy on March 9, 2012 because of multifocal breast cancer on the left side and a bad family history. I am an attorney, an athlete (running marathons, softball, golf, waterskiing) and also a former swimsuit winner in several pageants when I was younger. I am 5'6" and weigh 117 lbs. Like some others on here, I am a perfectionist, and the thought of losing my breasts was devasting to me. I went to counseling and grieved the loss of my breasts really hard prior to surgery, which paid off because I am doing really well now. I was close to opting for no reconstruction, but I did it because it would be easier for my boyfriend to adjust to.
Because I knew I would not be happy with the aesthetics of the reconstruction no matter how well my surgeon did, I decided to surrender going for the best look and chose to preserve my strength. Even though I am very slim and have thin skin, I refused to let my PS cut my pectoralis major to cover the implant. He is very talented (one of US News' Top 100), and bless his heart, he does a pretty good job of handling me, which can be quite a task. He placed my implants below the skin only and used quite a bit of Alloderm to form an Alloderm bra below the skin. He had never done this before on a slim person because of the "step off" and rippling, but he is getting fat grafting equipment and will use it in my expander/implant exchange surgery to attempt to lessen that. With the expanders, there really isn't a problem with rippling or step off. I just have the hollows on my chest wall above the expanders.
Most people think my expanders look great. They are well placed, and I had some cleavage immediately after surgery (he placed 280s in surgery because I was a C prior to surgery). Even though I think he did a great job, I don't like the way they look because they don't look like my breasts did, but I am so very happy with what I can do! I started light walking the week of the surgery but minded my PS by not doing anything with my arms at all for the first month. With his approval, I started light jogging and "special needs yoga" 6 weeks after. At 2 months out, I was able to "exert" while running and was cleared for all other activities (and I asked specifically about a lot of strenuous ones). My expanders do not move when I flex, lie on my back or sides, or do any activity. They stay in place like my breasts did. At 3 months out, I was released from physical therapy because I was in the "fully functional" range in all the types of arm motion, and I was doing weight lifting. I am sticking with the yoga for two years while scar tissue is forming. I ran a 15K up a mountain, played volleyball, and also waterskiied at 3 months out. I feel strong and happy, I have no pain, things are great with my boyfriend (a saint), and I am so thankful for all of those things. I am focusing on those things instead of the way the reconstruction looks.
Just like the rest of you, I am wrestling with the size issue as my exchange surgery approaches because it is important. I want to be the same size that I was, and Whippetmom has been so helpful! I just wanted to encourage everyone to do the research on your docs, figure out what is important to you, and insist on what you want/need. My doc looked at me and assumed that the way the reconstruction would look was the most important thing to me, but he was wrong. Of course, I want it to look as good as possible, but the most important thing to me was being able to continue to be active at the same level as before. That was hard for me to figure out, but my boyfriend noticed that I cried everytime anyone mentioned cutting my muscle and saw that was my biggest issue. Now that I'm through the worst of it (for me mx surgery was the worst-thankfully I did not need chemo or radiation), the joy and peace that I have confirm that my decision not to let him cut the muscle was totally right for me.
Hugs to all of you and stand strong with your PS! Make them get it right for you or go to someone who will!
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loulou, Please....I visited Quebec (Je me souviens) and had the best time, they can speak English, everytime I tried to speak French,people would say Are you from the US? They refused to acknowledge the word restroom and forced me to ask for the toilet. I laughed, everyone was so friendly in such a big city,my friends and I even met some US guys on the train/subway thingy. I would go to McDonalds and say" heres my pink money,I really dont know how your money works" and they would just take the payment.LOL...
Anyhows, which ones are you getting for your implants? I am getting Mentor gel 600 cc. I know I will get a card. What else do the docs need to tell me about these devices?
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Layla2525 -- In Quebec "Gummy bear" implants are approved...So I will get the Mentor CPG cohesive gel anatomical shape. My PS will try implants in 300ccs range. My TEs are filled at 360 ccs now. My exchange is scheduled in september.
Quebec is a beautiful "province" and a beautiful city ! I'm happy to read that you had love your visit here ! What is a restroom ??? Hahaha toilet that's the good word !!!!!!! lol0 -
I've started talking with my PS about where I'm going to end up, BMX was done on 5/2. He has assurred me that He can't give me back the same volume I had, which is fine with me, the sagging 38DD wasn't all that attractive. But I'm having a really tough time visualizing where these replacements are going to end up. I have a couple more fill dates scheduled, I'm at 575cc now, what is reasonable for a 50 year old woman that is 5'6, 170 lbs? I sure could use some input!
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Sueoop..
I am about your size and age was filled to 530.. Thought that was plenty big.. Did not realize the implant is smaller than expander.. Really wish I had gone bigger ( was a D) thought I would be happy with a B Did not realize how small a B is.. My clothes do not fit anymore as there is nothing to fill.. When I spoke to PS about making them bigger he said I have to much Rad damage and my tissue wold not expand any more =(
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Sueoop..
I am about your size and age was filled to 530.. Thought that was plenty big.. Did not realize the implant is smaller than expander.. Really wish I had gone bigger ( was a D) thought I would be happy with a B Did not realize how small a B is.. My clothes do not fit anymore as there is nothing to fill.. When I spoke to PS about making them bigger he said I have to much Rad damage and my tissue wold not expand any more =(
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Hi, Sueoop, and welcome to the forum.
When I had my BMX, my PS put in 700 cc expanders. At the time, I was 5'5" and 188 pounds. He planned to fill me to at least 700 ccs, and overfill me to 750 ccs if needed.
I was so swollen from surgery, you couldn't even tell I had any expansion at all. They just sort of melted into my fat.
Then I got a wake-up call from my MO - and learned that excess body fat was producing estrogen... not a good thing for my ER+ cancer. I decided to lose weight.
I asked the PS what would happen if he put in the larger implants (750 - 800 ccs) at exchange, and then I lost weight. He said the implant size wouldn't change. "So I'd have stripper boobs?" I asked....he just smiled and nodded. "I'll get back to you..." I said.
I suggest that you gather up all your information - the make and model of your TEs, your height and weight and chest measurement (underneath your foobs) and let whippetmom know. You can post here or PM her.
She is our resident Breast Implant Whisperer, Guru, and all-around expert in things implantish.
I made the decision to delay exchange while I lost weight, so that my PS would have a better idea of what size would be appropriate on me. Whippetmom has given me excellent suggestions, and he agrees with her.
FYI - my Original Girls were 38DDD, and I just wanted to be smaller!!!
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Blessings! That is my story totally. Before the cancer was found I was going through a season of depression....long story that is, but in short, I gained 20 lb over the winter. I'm 5'5 and about 180 lb now. I am well balanced in shape and was still fairly athletic before surgery.
Normally I am about 160 lb. But before I got to all with my ps about all those details I went into surgery and got these TE. Not sure what size they are, I heard a rumor from the secretary that he ordered either 450cc or 550cc TE for me. But I have to still get the card for my TE.
I haven't really put forth any effort to lose weight as of yet, I was focusing on staying positive and getting through this. And now...PRAISE GOD...I was blessed with my health back! Clean nodes, clean margins, and only DCIS was present, no invasive cancer seen! So with all that now im walking forward with this reconstruction.
Initially I was going for a diep. But my PS knew I was not 100%. So he gave me a deadline, and put down on my surgery orders..."free flap with possible tissue expander placement" so that Id be good either way. After seeking wisdom and peace in God I realized I was not prepared to have that surgery...so I went with the TE and boy was I relieved!! I'm glad I did it, I made the right choice for me at this stage. I'm 33 yrs, so the implant look is fine with me.
What I'm wondering now is...if I get these TE inflated to 800cc which is where the doc wants to take me...and then once I lose this extra weight that I know will come off again, will I then look unbalanced? And im unclear about the whole TE to implant difference. If i have 550cc TE in, do I have to minimum go to 550?
I think I'm getting gummy bear implants, that is what I asked for and the ps said that in silicone that is all he uses on his patients...
But what is high profile too?0 -
Nan - My sister in size!!!
Yes, Praise God....so glad for your final dx!!!
What you really need to know is the exact dimensions of your TEs. For example, mine are 16 cm wide. That was to fit my very wide chest at the time. I measured 39" right after my surgery, when I was swollen up like a blimp in addition to all my extra, er, padding....
The reason this is important is that the PS creates the pockets inside your pectoral muscles to fit the TEs he inserts.
What I am facing now is the fact that the implants I will probably get are only 14 cm wide....not a HUGE difference, but there will need to be some pocket adjustment done so the implants fit right, and don't migrate to my armpits when I lay on my back.
The question I was asked many times was how determined was I to lose the weight? Well, pre-BC, the answer was "not very."
But faced with 5 years of Arimidex (a whole 'nuther story) I wanted to make sure that not only was my estrogen level as low as it could be, considering that I'd gone through menopause AND had a hysterectomy, but I also wanted to get down to my "normal" weight so that the PS would have the best body to work on at exchange.
And I really didn't want stripper boobs.
When you think of implants, don't just think of cup sizes or ccs. Like TEs, the implants have dimensions. They have width, they have volume, and they have projection.
When an implant is considered "high profile", it has more projection than a lower profile implant. We're not talking a lot, but depending on your size, it may make a difference in how satisfied you are with what you get.
Implants will always be flatter than TEs, because implants are squishy all over. TEs have hard backs, and are designed to push out in front to stretch out the muscle and skin. So to have adequate projection (and this varies greatly from woman to woman depending on body type and preference) you would need more ccs in an implant than what you have in your TEs.
It really doesn't matter if you got big TEs you got at the time of your surgery. You are not locked in to that particular size. A good PS can do some additional pocket work, and make sure you get the look you want.
I could be filled to 800 ccs in one of the implants I was considering, but I was starting to fear that the weight alone could be uncomfortable.
My PS uses only saline implants. The benefit to that is that he can deflate the TEs, remove them through a small incision (in my MX incision) then insert the deflated saline implant, filling it after it's in so he can see what looks good. Most PSs will take a variety of sizes into the OR to make sure they have choices.
What's exciting is that after four months, I'm ALMOST at my goal weight. I started at 204, and I'm down to 157. Just 12 more pounds to go, and I don't think that's going to make much difference in my implant size. And that 39" chest? It's now 32".
Seriously, if you haven't given your measurements to whippetmom yet, please do so. You can PM her if you don't want to post them here. She is wonderful about making suggestions that you can then take in to your PS. That way you know ahead of time what you'll be getting.
I see mine next week...and am hoping for an exchange date in August!
I'm excited to follow your progress!!!
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p.s. Whippetmom - how did I do on the explanation?
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Ossa:
You need to find someone in your province who does fat grafting.
http://www.lipostructure.com/dr-sydney-coleman-presents-treatment-of-radiation-injury
Do not give up. I think you need to be a squeaky wheel.
http://www.nesps.org/abstracts/2009/24.cgi0 -
Blessings: You did just fine!
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Sueoop
We are not far apart in weight/height & age. I am 55 yrs old, 5'7" and 162 lbs (I usually wore a 38C bra). I had a uniMX in Feb with a TE placement. After talking with PS I decided to have the native side lifted to achieve better symmetry. I told him I didn't want to go any smaller, so during the exchange surgery he did a breast lift (just took skin & not breast tissue).
I have a very long torso and he used a moderate plus profile, smooth round 450 cc gel implant. I had surgery on 7/5 and not completely satisfied with the results. I am not sure if that size is what he thought matched up to the native breast the best but I will have to give it some time to drop & fluff.
I weigh more than I ever have in my life , so the best thing I could do to reduce the estrogen (as I am ER & PR positive) would be to lose some weight. Perhaps the implant will look better than, but the native breast will then probably become smaller. I have been walking and trying to eat better but I don't have a lot of will power to forgo the ice cream & cheese. Lo, I am a Wisconsin girl .
Just keep asking lots of questions, although PS didn't offer much, he kind of wanted to do what he thought best. I hope he is right in the long run.
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Blessing.. wow impressed with your weightloss. way to go..
Whippetmom.. My PS has agreed to do fat grafting. trying to find pictures of before and after fatgrafting to see if there is a difference. So far I have not had any luck..
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Ossa - thank you! I haven't had "real food" since March 22, 2012. Many of my friends (and even people in my weight loss program) can't believe I've had the discipline to do this, but for me, this was my breast cancer treatment.
I joined the Optifast program at Kaiser, and it is tightly monitored. We get regular lab work, physician's exams, and must weigh in every Wednesday night and attend a support group/class. The "Fasting" phase lasts for 16 weeks. We are heading into "Transition" where real food is slowly added into the diet over the next 14 weeks.
Following that, there is a one-year followup phase, where we still attend weekly groups, but no longer need the medical support. I am off ALL my meds except for thyroid, and all my labwork is now normal.
I call it my breast cancer treatment because after my BMX, I didn't need chemo or rads. But I was ER+, and at the urging of my MO, I did the only thing I could to immediately impact the remaining estrogen in my body - I lost weight and started exercising. (I'm post menopausal and have had a hysterectomy.)
The MO told me that this alone would further reduce my risk by 23%.
So in that sense, sticking to the program was a no-brainer for me. And honestly, I haven't felt this good for 20 years!!!
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Ossa: The fat grafting is more for changing the integrity of the previously irradiated skin - softening it - allowing it to respond more like natural tissue, thereby allowing and paving the way for a larger implant potentially. I am looking at FGT for YOU, like a skin treatment, more than a volume enhancing vehicle. It can add volume - but over time - a couple of sessions would be needed - perhaps more. So I just want the bad skin to become good skin so that you can perhaps up that implant volume.
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The gummy bear -- aka the Allergan 410 -- IS available in the US in trials (which are pretty widespread and not restrictive). I have a gummy bear and I live in the US. If your PS is a participant in the trials then he/she can use them if you want them. They are firmer than most cohesive gel implants. They are anatomical in shape and are textured (due to the shape, the textured surface that adheres to your skin is designed to keep them from moving around once implanted).
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Thank you whippetmom
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yes add me to the lsit trying to lose weight to prevent recuerrnce and to make my implants look bigger.
I am 5'6" 166.6 (went to weight watchers today)
I was a 34DD now I am a 36D. They look really good but I feel so fat my self image is skewed.
so before I get my final surgery for nipples and fine tuning I made a deal with my PS to lose at leat 24 lbs by end of september.
I am very motivated. I even got new sneakers!
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Good for you, Carrol! You can do it!
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WooHOO, Carrol2 - now go rock them new sneakers!!!! 0
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I'm in the "lose weight" category, too!!! I wore a 40DDD before my BMX in May. Never again!!! I'm aiming for a C-D cup at best, and aim to lose the weight to balance my new puppies. :-)
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Carrol2
please tell me you secret , how do you lose 24 lbs by the end of Sept??? Do you change all of your eating habits, how much exercise can you do? Also does your weight accumulate in the stomach area like so many of us??
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Thanks for all the encourgement I loved seeing that this morning.
My big secret is weight watchers, going to meetings gets my head in the right place. I lost it all a month before my diagnosis 2 yeras ago, but it took me 6 months at about a pound a week. so this time I am working so that should help with the broedom eating. I also had a trainer last time so I was accountable in two places. I will probabaly sign up for the trainer again soon.
It's all in my head I just have to stay motivated to write everything I eat down, control my portions, exercise, and plan ahead as much as possible.
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The best start for reducing belly fat is to reduce carb intake and especially get off of all refined sugars, which includes sugar substitutes [Splenda, Equal, etc]. There are plenty of healthy sugar alternatives [RAW honey, brown rice sugar, Stevia [liquid form is better], coconut sugar [most of these you can now get at Trader Joes and certainly in health food stores] and pure maple syrup - NOT Mrs. Butterworth's! But learn about which "good" sugars have a higher glucose spiking ratio than others. I pretty much get my sugar through fruit. Sure I cheat about every couple of months, but feeling good and having a flat stomach makes it worth staying on track. I now have a flat tummy - as flat as it was when I was in my thirties and I am 62. It is agonizing to get off the refined sugar circuit, as it is addicting...and you will go through withdrawal if you eat as much sugar as I did one year ago. Oh, and EXERCISE, EXERCISE.....gotta do it.
http://www.forbes.com/sites/jennifercohen/2012/03/27/6-ways-to-burn-your-belly-fat-fast/
One major incentive is that the more belly fat you lose, the larger your implants will look on your chest wall. No surgery required....
Deborah0 -
Loulou: You asked about my measurements. I think I am really a strange combination because normally 270cc would be a small 34B cup, but I cannot fit into any 34B cup (the cup runneth over). I am only 7 weeks post-mastectomy so things may yet change. You should check with Whippetmom who is the expert!
This in my info...
My measurements : I am 5'7", currently 128 lbs, rib cage 30 inches, previously 34D or DD. (Euro/French size: 75E).
My implants: Mentor CPG 332 Gel Breast Implant Cohesive III, (silicon anatomical shape), Tall Height, Moderate Plus Profle, 270 cc, 11cm x 10.5cm.
These were placed totally sub-muscular in a one-step process (immediately after double mastectomy) using the usual pectoral muscle for the top part, and for the under part the serrata anterieure muscle, and fascia only from rectus abdominus. Note that this did not make any scars on my stomach to elsewhere and has not affected my abs at all. My PS does not like to use Alloderm or other matrices as it is another foreign substance and with complete sub-muscular antibiotic delivery is more complete and blood vascularization happens more quickly. This was important in my case as I had to reduce skin and move nipple up on one side and reconstruct nipple on the other side (using excess breast skin).
I have been fitted for bras at Manor (a Swiss department store with large lingerie section) and Belladonna (chain of quality lingerie brands Triumph, Calida, Chantelle, etc.) and also by my PS and I now definitely take a small 34C cup (Euro/Fr: 75C).
Hope this helps! Fearlessfoot
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45 minutes ago whippetmom wrote:
One major incentive is that the more belly fat you lose, the larger your implants will look on your chest wall. No surgery required....
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Ladies - I can second that!!! When I stopped my fills at 620 ccs, my TEs just sort of melted into my fat belly. I knew they were big, but you just couldn't tell.
Now that I'm 50 pounds lighter, they seem HUGE to me!
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Fearless : Thank you so much ! I PM you !
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Good afternoon ladies - my friends over on the June 2012 mastectomy board rec. that I check in here with my questions/concerns. After reading some of the posts, I think I have found the right place!
I had a BMX on 6/20/12 and I had my second TE fill this morning. I am up to 240 cc's in each breast. I am 5'2" and weight 115 pounds. The PS asked me what size I'd like to be in the end. I asked him what size they were now and he said with next week's fill I will be a full "B" cup post-exchange surgery. Pre-surgery I was a "lower case C cup" I explained to him that it is kind of difficult to gauge if I am happy with this size right now they're look and feel like "square" boobs. I know in the end I have to be happy/comfortable with what I have. Ladies with TE's thoughts on this?
Thank you
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emilybrooke.. your implant will look smaller than TE..I was filled to 530cc had I known I would probaby hadtwo more fills BTW i called my TE foob Spongebob (squarepants) My implant foob I call barbieboob (Fake boob no nipple)
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Deborah
Thanks for the tips on omitting sugar from the diet and hopefully slimming the tummy area. You certainly don't look like 62 in your picture. You must be very committed to exercise and diet. I need to become more motivated like you.
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