BREAST IMPLANT SIZING 101
Comments
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dobie --
I saw it. And, I did look into Cipro to see what it was.
Thanks!0 -
Blessings --
Your explanation of drop & fluff came just as I was wondering myself what that term meant. Thanks0 -
whippetmom,
I've read through a good part of this thread, and you seem so helpful. I wonder if you could help us with my wife's implant size. I think her plastic surgeon is pretty good, and seems confident, but we haven't discussed size much yet. He has said that a small implant will be used in her left breast for symmetry combined with a lift on that side to match the reconstructed right breast. Here's some numbers:
Height: 5'-5 1/2" Weight: 130 lbs Rib cage: 29 1/2" She has worn 34C bras in the past, but after a couple kids, shrunk a little to a 34 B-ish size.
The reported size of the breast tissue removed during the mastectomy, if this helps any, was 536 grams
Her tissue expander is a natrelle 133FX-12 with a suggested fill volume of 450 cc. Presently, the TE is filled to 475 cc, and she thinks this seems like about the right size. Does this sound about right? I am wondering what size implant will be needed to approximate this size. I read somewhere that the implant should probably be larger in volume than the 475 cc. Looking at the natrelle website, there are some tables with what they list as suitable silicone implants for a particular tissue expander. They have listed a style 20 in 475 cc, and style 45's in 550cc or 600cc. My 'guess' is that the style 45 in 550 cc might be about right, but I'm just some silly husband who knows more about motor oil and lawn mowers.
Any help or guidance is most appreciated.Thanks much,
Brad
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Brad: You know, I have been doing some recent research into the use of the extra full projection style implant, in light of Mentor making THEIR ultra high available in the U.S. recently. Based on what I have read, most plastic surgeons seem to feel that the Style 45 and now the Mentor ULTRA, is an implant used more for breast reconstruction than it is for augmentation. So it makes me wonder why it is under-utilized. I have recommended it a handful of times in four years, for certain circumstances, but it seems that there is a certain criteria for the use of this style of implant. In your wife's case, I can see how this would be appropriate, as long as the lift and augmentation of the native breast will match the projection of the Style 45. It is because the PS used the FX style TE that this falls into the realm of possibility, that, coupled with your wife's 29 inch ribcage. The 12.0 cm width is good - ideal almost - for her frame - and she has 450 ccs in her TE [plus overfill] and so exchange to a 550 cc Style 45 is quite doable. If she is happy with the size she has currently, I am afraid she would not be happy with only 450 ccs in a high profile implant - and she would have to increase in width, to make up for what she loses in projection - and a unilateral might be limited by the base width of the native breast. So why not run this by the PS? I think it would require a HP style on the native side, but what size would be determined in the OR. The key would be to match the projection and she probably would not have much, if any, ptosis with the Style 45 in 550 ccs, so this is a huge consideration. It would not be an issue if she was a bilateral, but as a unilateral, there is a need for ptosis or droop of the MX side, which usually means "smaller implant". For unilaterals, the PS often overfills, overexpands and then uses a smaller implant, so that he gets the needed ptosis to match the opposing side.
I agree with your thought that the other implant option would be a Style 20 in 450 ccs or 475 ccs, which actually would be a nice size for your wife's frame. It might be the style which is in the doctor's mind as well. But all of this will hinge on how much of a lift he can achieve and how much loft he can get on that native side with an implant. But it is certainly worth a try.
Let me know what you decide to do....
Deborah0 -
Deborah - THANK YOU for the info regarding the research on helping to prevent and heal LE. I am going to send you a PM and I sent you one awhile back as a response regarding the Chicago docs. Love you and appreciate you so much!
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Thanks for the info on drop and fluff. I guess I am very lucky because I am one week post exchange and my implants are not setting high and look very natural already. My left breast does have alittle more round look to it but that is also the side I had radiation on so maybe it will settle a little. DH said they look pretty darn perfect. Went to see the PS yesterday and he was thrilled with how everything looks one week post op. Said I can go to sleeping in the surgical bra for the next week, and move to and underwire for days and in a week I can wear a bra when i want to, although I am sure I will continue to wear one during the day at work. I will see him again in three weeks.
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Whippetmom - thank you so much for your quick response to my question, I will discuss this with my PS. It helps so much to have some direction to take with all this and as I said in the pm, I think it would be so disappointing to wake up from the exchange surgery to be completely devastated wishing you had gained the knowledge to relay what you want as far as implants. Something I hadn't though about until reading more posts is the fact that my implants will take a while to "settle in" and may not look exactly right at first? Patience, patience!
Carrol2 - yes your post does help shed light on my possibilities as well, also, did you select silicone or saline implants? I'm wandering which seems to be the best choice and what are the differences?
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Whippetmom --
Since you've started posting the manufacturer links on your original thread page, I decided to take a look at them as I've not seen what an implant actually looks like. Remember, I have my bmx scheduled for 9/18. Anyway, while I was on Allergan's site just browsing, I came across the Style 410s, Cohesive Silicone Matrix implants. At the bottom of the section it has a Caution statement that these are investigational devices. Do you know anything about these particular styles? Is it because they are shaped? Also, do you know anything about their Biocell technology? I know I'm getting a bit ahead of myself here, but I really liked the shape of these.0 -
I'm asking this for a friend so may not have all the details. She has had a mastectomy and was given an implant that is too large. They have since switched it but it there is an area of rippling about 1". She is going in again to have this hopefully fixed. The new breast is also too low. Is it usual to have to go back like this? Should she see another PS?
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For anyone interested, I just updated my thread on the picture forum. I had nipple sparing BMX and my exchange to implants was one year ago.
Thanks again to Deborah for her dedication and advice!!!
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Whippetmom and all, I need some help, please. Have a friend with tissue expanders who is in pain, has some muscle spasms, and is super-sensitive to cold (in this case, air conditioning, since it's still summer). In fact, she says the cold is what triggers the spasms/pain. Her exchange is scheduled for December and she's worried about how she'll deal with the cold after that. Since I've heard women say the implants are cold, is this going to be an on-going problem for her? Any hints, suggestions, words of encouragement--hope, in other words?
Thanks!
Binney0 -
Vik -- the Allergan 410 is what is known as the "gummy" implant. It is firmer than regular silicone rounds and, because of that, it comes in an anatomical shape. If you want to read more here on BCO there is a thread called All About Gummies which has more info. This implant style has been in wide use in Europe and Canada for 10 years but is in "trials" in the USA still (though god knows they must be getting close to finishing by now, as I have one and my exchange was in 2010 for goodness sake)! There are many surgeons who have access to these implants via the trials and, given it's wide use outside of the US, is not really all that "investigational"... many women are very happy with these implants though just as many (near as I can tell) find them too firm.
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Deborah,
Thank you. You said that she wouldn't have much ptosis with a 550 style 45 implant. Is that relative to the 475 cc's that she is presently filled to? She has another fill tomorrow. Another 75 cc's or so, which will put her at 550. I wonder if that will be enough, or if one would want to be at 600 for a 550 cc implant? I'm sure it is different for everyone.
She is getting a little tired of the expansions I think. She says that it hurts some. I can imagine that it does with all that stretching.
So probably to match the size she is at now, maybe a 500 to 550 cc implant will come close to the 475cc tissue expander?
Thanks again,
Brad0 -
I am the second from right whose face isn't blurred with the wild red hair. I used to be bigger than my co-workers, but I think I look small with these TEs. Tomorrow is another "fill" day. I'll be at 700 ccs. I'm getting anxious, because now I'm trying to decide on my short, fat little body whether to stop or go a little more. I can't wrap my head around how these TEs correspond to implants after they "fluff." I see some photos of women with very large implants, and they are like 500 ccs. Others at 800 ccs look nice. ARRGGHHHh..... I know body dimensions, style, brand, etc play the most part in sizing, but how in the world do I make a decision???? My PS is great, and lets me decide on the projection I'm happy with. But, I'm kind of confused, because I know they change. Wahhhhhh....
Deborah, you were right that anything below 600 ccs might be too small for me. I'm thinking 700-750? Help!
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Lilah --
Thanks for the info on gummies! So, you have one if I read you correctly? What's your take on it? For some reason I was thinking it was only those by Sientra. Live and learn!0 -
I have one, yes Vik. I'm a uni so I only have one implant. It's firm. I love that there are no ripples and GREAT projection. And I love the anatomical shape of it. But I wish I had jiggle. And softness.
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Greenmonkey- would you consider a ps in Nassau County? Alot of Dr's I work with recommend Dr. Ron Israeli. He's in Great Neck. Check out his web site. His speciality is breast reconstruction after mastectomy. He is also voted top 100 docs.
Good Luck
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Binney4'
I saw your post about your friend and the cold making the muscle spasms worst. I too have a TE in and find cold brings on an awful spasm . Luckily , the last few months haven't been too bad as the summer has been good but I live in Canada and it's already starting to get cooler. I don't yet have a date for my exchange and also wondering how I will deal with the next couple of months. I find I cannot walk down the freezer aisles in the supermarket as the cold starts the spasms! I have been wearing a lot of scarves to hide my unevenness and this helps with the cold a little.0 -
Lilah --
Sounds like there are some trade-offs with the gummies. I thought the shape they depicted on the website was very natural looking.0 -
vik11 - I had bilateral surgery and I chose smooth round silicone. BC seems to be a journey of tough decisions, plusses and minuses and tradeoffs! Each woman has a different vision, I guess. I wanted to look like "pre-BC" me and I wanted drape and ptosis in all positions (upright, lying down, etc) that seemed to come with the smooth rounds and not the anatomicals. The choices can be overwhelming!0
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Vik -- yes that's right. I would say that if you are bilateral you probably will be happier with smooth round.
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TinaT & Lilah --
Thanks for your input. I think you are right. I, too, am hoping for that natural drape as a result. Mine now are not round and I want to go larger than I am now. Not huge, mind you, but something I feel good about, shape wise and size wise. That is, after all, what we all want in the end, right? I guess that is why so many ladies are going wirh the smooth, round.0 -
I was lucky because my PS has been right on target the whole way and my foobs look great. I had my post op on Tuesday and in his words "I nailed it", which he did. The folds etc are perfect. I had rads on the left so that has given us some obstacles but he has done great with it. DH can't believe how great and natural they look and feel. Deborah has been great with all her information because all the recommendations that she gave reaffirmed everything my PS was tellling me. I know that I fully trusted my PS but I had so much anxiety over all of it that Deborah's reaffirmation helped calm me down about how things would turn out.
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onedownoneup - part of our homework is speaking with others who have already been down this road. I don't think you'll find to many fans here if you put down someone who has helped so many.
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onedownoneup - I speak only for myself in response to your post. Each woman and each plastic surgeon are unique. I had to have bilateral MX so I believe there were more options for me than someone having unilateral surgery. On the other hand, I had nipple-sparing surgery, which puts some limitations on things as it's an obvious goal to have the nipples end up in proper position.
Did I rely heavily on my PS for guidance, listen to his recommendations, and follow his instructions to a T? Absolutely. However, he gave me the wonderful gift of having some control and making choices during the process. At my very first appointment he asked, "If I waved my magic wand over you right now, what would you see? We'll talk about the ways we can get you there." While I was in tissue expander phase we had an open dialog about how I liked the size, keep going?, etc. Certain things were not negotiable, others were totally in my court and he wasn't going to decide those things for me. He ultimately chose the implants, but it was after lots of back and forth discussion. He told me ahead of time which styles and sizes he was ordering to try out in surgery. His goal was to get me as close to my expectations as possible.
I think it's great that you are satisfied with your outcome. I understand your point that we need to let the PS do his/her job. However, I think there is a place of compromise between "cancer treatment" and "breast augmentation".
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Well said kayb...
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it seems the thread was temporarily hijacked.
I trust my surgeon, but needed to know how to explain what I want(no career changes planned, if you get my drift) understand how people prepare to make a decision by discussing their situation with someone and others who have been on the receiving end of the surgery. If you don't mesh well with a doc, there's a sign to move on, but due to insurance, location or lack of knowledge/fear of medical situations, some don't realize there may be many other options available. It is a delicate situation, just as things are here on the boards- sometimes things are said in error or taken out of context or completely misunderstood. Glad we can back up to clear the air and appreciate how much time and care was put into crafting and maintainng this thread.
Thank you whippetmom, your suggestion was the 400cc mentor HP gels, they were put in this morning. Feeling pretty good and await the unveiling in the morning!0 -
kayb, TinaT, and JamieB --
You are all so spot on with what you had to say! Okay, so I've yet to have any surgery done, and I AM doing my homework so I CAN work with my PS. I will know soon enough if we will be "working together" for the best possible outcome for me (I meet him next Friday for initial consult). I will certainly listen to everything he has to say, but at the same time I have really come to appreciate the experiences and insight found on this thread, not to mention a great admiration for Whippetmom and her gift of giving and helping us gals! So, where's the problem in that, onedownoneup? I don't see one!0 -
dizzyone: I am sending you a private message. I would personally get a second opinion, if only to be reassured regarding the surgeon's "planned" revision for your friend. I would want to know how he plans to address the pocket to implant size discrepancy.
Deborah
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Hi Binney:
This is an excerpt from the informed consent I signed before my BMX and tissue expander placement..
Skin Sensitivity-Itching, tenderness, or exaggerated responses to hot or cold temperatures may occur
after surgery. Usually this resolves during healing, but in rare situations it may be chronic.
You know, some plastic surgeons are now using Botox to address the painful spasms some women experience with tissue expanders. Most seem to use it at the time of TE placement, but I imagine it could be done at any time during the expansion process. I think that this sensitivity issue will likely resolve though. I am typing this and just happened to see that you have PM'd me....I'll answer there as well...
Deborah
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