BREAST IMPLANT SIZING 101
Comments
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I'll definitely ask my PS when I see him next week.
What would you like to know? I definitely want to be prepared to ask him. Thanks Deborah!!0 -
Be_Positive: You are in SK, so your PS might be intending to use the Allergan 410s or Mentor CPGs - what we call "gummy bears." Ask the next time you see your PS. If we are talking about silicone rounds though, I think that a moderate PLUS profile would be best for you. Do not forget the "PLUS" after the moderate, because you do not want plain 'ole moderate implants. In this style, I would say Allergan Style 15, 339 ccs [as a minimum] or 371 ccs up to 397 ccs would be nice on your frame. If your PS uses anatomicals, the anatomical needs to match the dimensions of the TEs. So ask and we can go through those options once you find out if so, and also find out if he uses Mentor or Allergan, as they have different versions.
Edited to add: I think it is going to depend on how you feel about your TE size when you are filled to 300 ccs......
Deborah0 -
Well my tissue expanders were filled to 200 ccs during surgery. Waaaay to small if you ask me. I haven't had another fill yet. I was an A cup before and want to be considerably larger.
What is the difference between monderate and moderate plus?
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megcon: Excellent!
You have a couple of options, if your PS uses silicone rounds. I think that you will need either 304 ccs in a Style 15 in Allergan, or in Style 20, 400 ccs. However, I think 400 ccs would be pretty large for your frame. Our best approach would be to see what you think of the size once you are filled to at least 250 ccs. We can discuss then where to go with implant sizing. Ask your PS about Sientra implants. See if he has access to them, as they have a teardrop shaped "gummy" implant and I have heard it is softer than Allergan's anatomical gummy. Worth investigating.
Deborah0 -
kathyhong: Read the header to this thread above. In particular, read section #3, and that will give you an idea of the information you need to obtain from your PS.
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Be_Positive: If you are feeling very small and only have another 100 ccs to go to reach the recommended fill, perhaps you will want at least 400 ccs [397 ccs in Style 15 is close enough] and perhaps even 425 ccs in a high profile Style 20.
The difference between "moderate" and moderate "plus" is projection. The plus version has more projection. The "moderate" version is as flat as a pancake, and in fact, I see that Mentor no longer bothers to even produce a "moderate" version. It is a terrible style for reconstruction, where projection is such a difficult achievement in most cases. But again, find out about silicone rounds vs. anatomicals, because otherwise, all this information is for naught.
Deborah0 -
Thanks Deborah. If I go with the 425 cc high profile, what would I need to have my expanders filled to?
I will ask about the round versus anatomical, but I think I may want the round.
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One other quick question, and this would be to anyone who can answer me - am I supposed to "massage" my tissue expanders? My plastic surgeon never mentioned it, but a cancer exercise specialist told me that I should in order to keep the blood flowing around them.
I did massage them a bit, but not a lot. I've notice that on the cancer side, the breast is a lot harder on the bottom. It was quite bruised from the surgery but is almost gone now. Is this normal, or is that a bad thing? I haven't seen my surgeon since a the one week post-op follow up.
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Whippetmom - Sorry to hear about your injury - ouch! I hope you are feeling better and are on the mend.
Be Positive: hello! Great queston on massaging TE's - I'm curious myself...
EXERCISE: I am also very encouraged about you and other women here's level of commitment to exercise... and I want to start back on exercising, my most favorite one being high intensity yoga. I also want to start swimming lessons next week - as I want to learn to dive.
To fill you all in: I'm now 9 weeks post revision reconstruction, having had Grade III contracture removed; now with a TE in place.
Ladies: how do you manage / modify your upper body exercises, especially those that engage the pectorials? I am quite concerned about doing upper body exercises (especially downward dogs & warrior positions (arms held up straight for long periods) in yoga, and breast stroke, in case I injure my new-forming pocket, or cause the muscles over the implant to harden / displace the implant / or to promote contracture.
I imagine others may want to know about this too
Thanks a lot!
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Another brief question: a few of you mentioned taking a baby asprin and vitamin E after recon, to reduce chances of capsular contracture (you can probably tell it is the 'monkey on my back' of concern!) Am I ok to start this during TE stage, How much do you take of each? Currently I'm taking 400mg Vit E, and no asprin yet as not sure of dosage.. Cheers!
BTW - Congratulations on the athletic achievements at the Olympics of all the nations! Its a very exciting time to be in the UK! Really enjoyed the opening ceremony...
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Hi girls,
First wanted to thank Whippetmom for her continued guidance here. You are so amazing!
I had my exchange a week ago July 26th and decided to share my experience as I seem to finally be happy with my outcome after all that happened. Maybe it will help someone decide what to go for and what to chose and compare.
I am going to be super specific for the interested people. I was addicted to reading other people's stats when I was "in-between" phase.
So my stats: 5'5" - 31' ribcage and I go from 160lb-175lb (weekly
)Purely prophylactic bilareral mastectomy with immidiate implant & Alloderm reconstruction - Nov 26th, 2011, My natural breasts were weighted at the time of surgery: 765cc left and 685cc right which at my height and weight made me a 36C.
I got:
Allegran NATRELLE 410 Anatomical - a.k.a. "Gummies"
N-27-MX445
445g
Textured Surface
Cohesive Gel
Moderate Height/Xtra-Full ProjectionWidth - 13.5
Height - 12.5
Projection - 6.2 cm*** Absolutely hated the feel and look of them. They were hard like bricks in my chest and I was in constant pain (maybe also post mastectomy) but they were definitely super hard, very rippled all over and most of all looked like breasts that I had pre-puberty, small and barely there, no cleavage. Later found out that these implants must be harder because of their anatomical shape, they have a higher cohesive gel for shape and control.
Unfortunately (or now as I try to see it - maybe luckyly) they had to be taken out due to skin necrosis bla bla bla - so I got expanders put in 2 weeks later:
I got Allergan 133MV Tissue Expanders
Left: Style: 133MV-13 (400cc capacity) - Filled to 500 cc
Right: Style: 133MV-12 (300cc capacity) - Filled to 590 cc
Filled slowly: bi-weekly 50cc each time since my skin was compromised due to necrosis.
Last fill April 2012
___________________________
Just got (July 26th)
Allergan NATRELLE INSPIRA TruForm Round
N-SSX695
695g
Smooth Shell Surface
Soft Touch Gel (TruFormTM 2)
Extra Full ProfileDiameter - 14.5 cm
Projection - 6.4 cm***Ripples just the first day post op and now smooth looking. Very good change in appearance. Interestingly comparing the two the projection stayed relatively the same, more height and similar width, but the result is better because even thought the projection is same to me, breasts look full from both sides, more like natural drop. I don't have very defined cleavage still for some reason but I am ok with that, I think I have large chest-wall or something along the lines. Biggest improvement is the touch, they feel soft and "normal", I also don't have the "fake look" circle top that I was afraid of with rounds. These implants have a TruForm 2 gel which they state being - a slightly firmer than softest cohesive gel - a cohesive gel offering shape control with natural movement and feeling. I am measuring 36C, so they seem to put back in implants whatever they took out originally. It really helps to know those numbers.
So this is in Canada. Allegran for some reason has different names for Canada vs US round smooth implants, so for US girls, the implants I have now closly match Style 45 Full Profile 700cc or 800 (Diameter - 13.5 - Projection - 6.4)
I am going to include a link for Canadian girls for the Allegran Inspira catalogue and for US Allegran
So that's my experience in a nutshell. I do know some people who have the "gummies" and they love them and their reconstruction looks great, but they were not for my body.
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Be_Positive: Your PS needs to determine how much fill and overfill, if any, you would need to reach a certain volume. It all depends on your skin integrity, how your skin is responding to expansion, your ribcage characteristics - and so this is your doctor's call.
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ThisTooShallPass: Thank you so much for sharing your journey. I agree wholeheartedly that the anatomical "gummy bear" implants are not necessarily the best choice for breast reconstruction for many women. It is encouraging to note that your Canadian PS was willing to accept that there are other options and agreed to give you, the patient, the opportunity to choose which device you wanted inserted in your capsular space.
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ThisTooShallPass: Thank you for your clear feedback on your experience... really insightful.
I'm due to have Anatomicals in the next few months, but am slowly being put off by discussions around their firmness. Its hard to tell when just holding one in the PS clinic to decide... but your post is making me think more about having rounds, expecially because you mention you dont get that 'circle top' which I want to avoid...
can I ask - what are they like when you lay down - do they move apart a bit like natural breasts or do they stay fixed in domes on your chest? I ask as I had a becker implant, which I hated, as on me it looked vey fake and like 1/2 a grapefruit stuck under my skin, a look I dont wish to reproduce again!
Thanks!
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Many thanks to Whippetmom! You are a true inspiration and very helpful to those of us needing guidance through our journey!
Be postive: I am too curious about massaging and PT during the TE phase. My PS mentioned nothing about this.
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BuddhaWolf - Mine are definately not like domes. They sort of flatten and slide to the sides a bit. I think with rounds it depends on how thin you are and how your chest is structured. For example, one of my friends at 5'5' she is 140lb and very thin on top, pear shape figure. If you press a finger on her chest, right where the regular chain pendants would rest - there is little padding and you can feel her chest bone. In her case, she has "gummies" and I truly think she might have had that round top if she went with rounds. In my case, I am "big boned" so to speak and even at my lightest (145lb) I have some fat padding all over my chest so that smoothes that circle. I might me crazy but that's my theory.
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Buddha -- gummies (Allergan 410s) will never slide to the side when you lie down. They will point straight up and not move. (That's what my gummy does). I'm just saying... if you had that with your last implants and didn't like it...you may not want the gummy.
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BuddaWolf - to answer two of your questions...
1) When I was finally cleared to go back to the gym after my final fills (620ccs), I went straight to the director of the gym I belonged to. Fortunately, this is the Outpatient Physical Therapy department of the local Rehabilitation hospital, and is open to anyone in the community for a reasonable fee. All the trainers are either PTs or PT aides.
The director was awesome. After a frustrating session with one of the clueless younger aides ("Well, just go do what you used to do and if it hurts, don't do it..") I asked for special help.
The director researched my surgery carefully (BMX w/TEs) and came up with specific exercises that would help stretch and strengthen the muscles in my upper body that had been cut and changed. He also told me what to avoid. He said that by doing these things I would not further injure myself or damage the TEs. I felt very confident that he had taken the time to do this, and that I was doing the right kind of exercises.
Now my exchange is scheduled for August 22nd....am I worried about the pain? NOOOO!!! I just want to know how soon I can get back to my water aerobics class!!!
2) You asked about whether or not implants stayed pointing straight up when you lay on your back. I know this probably doesn't relate to you all that much, but it's a question I asked my PS when we discussed my implant sizing. I'll be getting Allergan High Profile Smooth Saline Round implants. The width will be narrower than my TEs, by about 1 cm on each side. He does not do any suturing to make the pockets narrower, as that can cause a longer recuperation, and problems down the line. He said that the normal scar tissue formation tends to make the pockets smaller eventually anyway.
He said that when I lie on my back, my implants would move slightly, like a normal breast. They would not stick straight up, nor would they point East and West, or disappear under my armpits.
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I don't think my implants move when I lay down, ( smoothe round silicone since Oct. 29th 2012), but they don't really stand straight up either. I have a great amount of droop, jsut right, so they look very natural.
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Blessings2011, my exchange is 8/21. After what I've been through, i am not nervous at all. Just the opposite, I am excited. I anticipate the pain to be not even close to the mastectomy and a little bit more than the lumpectomy. 16 days and counting! We will recoup together.
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Blessings2011 - Would you mind sharing what exercises they told you to do? I'm always looking for new exercises.
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Dawn Hope I had gotten some great exercises for range of motion from the ACS.
Here is the link to their site. These really helped me after my bmx and after my TE surgery. I had full range after my excahnge surgery so did not need to do them.
http://www.cancer.org/Cancer/BreastCancer/MoreInformation/exercises-after-breast-surgery
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Moleen we will be exchange buddies, Aug 21st
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Ok sherryc. See you then.
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Hi Whippetmom,
I finally have an exchange date in early September 2012. Have been in the TE process for 1 1/2 years, and have spoken with you about my options before I healed completely.
To recap: BMX on 3 FEB 2011 and filled in the OR to 350ccs. Developed necrosis and delayed healing in right incision. Right TE removed 6 JULY 2011; incision healed fine. No infection. Right TE put back in 1 DEC 2011 and filled in the OR to 200ccs. (Left TE was fine and remained at 350ccs.) January 2012 I again developed delayed healing in right incision; tiny spot opened up along old incision line. Whippetmom suggested I look into LAT Flap and as I was gathering info for that, miraculously, my incision healed. Last month (July 2012) I had my first (and only) fill... 50ccs each side.
I currently have 400ccs in left TE and 250ccs in right TE.
My PS said he will try for 400cc high-profile implants but due to my skin integrity on right side he may go smaller. I'm not a skinny girl, I have hips, so could use more volume up top — but it is what it is.
My stats: Natrelle 133 MX-13, 5'5" 160 lbs, 31.5" rib cage. What would you recommend for me implant-wise? Thank you so much!
-Renn0 -
Renn: I think 400 ccs in a high profile implant will be too narrow. You need width more than projection, if you are limited in volume. So 400 ccs in a moderate plus or midrange profile implant, like the Allergan Style 15 - would be preferable. Your TEs have a width of 13.0 cm and the 400 cc HP implant is only 12.0 cm in width.
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rennasus I have similar measurements I am 5'6" and I weigh about 160 right now (been losing a pound a week on weight watchers trying to get to 140), and I have a 32 in rib cage. I was a 36DD pre all this. I got 600cc and I am now a 36D in bras but I look more like a C. I am farily straight not curvey in the hip area. WOuld love to hear what cup size you would like to be.
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Whippetmom: OK thanks! I will make sure I get 13cm in width. You are right, 12.0 sounds too small in width. I'm just hoping he can squeeze a 400cc implant into a 250cc TE!
Carrol: I was a 34/36C prior to BMX so on the small side for my frame. Trying not to go smaller than that but I am limited by the reality of my skin integrity. I suspect I will come out of this a B. (I would prefer a C)
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Rennasus - I'll say it again.....yahoo! I'm so excited for you. Our Feb 2011 BMXs seem so long ago to me. I just can't believe how you've managed all this time stuck in healing phase. I know you've helped so many others on the TE Trouble thread just as Whippetmom does here.
I have Natrelle Style 15 (moderate plus) implants. I've lost weight since exchange so the very minor rippling I had is now more noticeable, but overall I think my PS made the perfect choice for me by using the Style 15s.
Congrats!!!
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Renn, I have 400cc high profile and when I read your post, iI thought "If limited in volume, TOO NARROW, GET MODERATE PLUS" and then read Whippetmom's same recommendation. Of course, hers come from educated knowledge. I can only tell you from my experience that even on my 29 inch rib cage, the things look like missles coming off my chest. I probably would have been better off with MP myself. The slope on these things looks like a right angle some days, and a little more width would probably look better anyway.
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