BREAST IMPLANT SIZING 101
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Hi. I am new to this forum. I would love some recommendations regarding implants, especially if Whippetmom is still available. What a blessing she is!
I am three weeks post BMX with Mentor 2500 Siltex Contour Profile Spectrum 354-2513 expanders. Max fill recommendation is 540cc's. I'm currently at 460 and am not sure if I need to / want to go larger. My ribcage circum. is 30.5 inches. My height is 5'2 and weight is 135. I used to be a 36 or 38 c cup. I feel like I want to return to my old size. I have a wonderful PS but he hasn't explained anything about the exchange.
Thanks very much!
Wendy
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jemama - meant to say that my TEs were filled to 680ccs, not 620.
Welcome, Wendymartha1! Fortunately, you still have some time to learn more about implant sizing before you get to exchange. Has your PS said anything about his plans for the amount of your fills or what he thinks would be appropriate on you?
I think that most docs aren't used to women being very informed. That's why I love this forum so much..... SO much information and experience to be shared!
Hopefully whippetmom will be able to pop in soon.
In the meantime, at your next fill, try asking your PS what his thoughts are about fill volume and implant size. If you are unsure, you can always stop or postpone additional fills until you are more confident that you'll be getting what you want.0 -
Oh my goodness, I am so far behind on these posts and PMs. Thank you everyone for filling in for me!
Jmemama, I need for you to find those Oct posts, and copy and paste them for me again. Your TE info, ht, wt and ribcage info. We will sort it out.0 -
Whippetmom, it won't let me paste, but mine and your original posts on this are from Oct 4-6. Here's the basic info..Thank you!!
Allergen Style #133MV
Width: 14 cm
Height:13 cm
Projection: 6cm
Suggested max fill volume 500cc's (I am filled to 480 cc's)
Moderate Height, variable projection
I am 37 years old
5'3"
165 lbs
ribcage: 35"
My pre-op bra size was 34-36 DD
I would like to be a D cup or full D..if I ended up with DD that would be fine too. I do not want to be a C..I feel I would look out of proportion.
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Wendymartha: You actually have expandable IMPLANTS, not tissue expanders. The Mentor Spectrum implants can be used as permanent implants. Honestly though, most women who have had them, ultimately have had them exchanged out for smooth round silicone implants. You currently have the minimum fill level for the implants. If you feel you are large enough, you will want to either keep them and have the PS seal off the Spectrum port, or exchange out for high profile, smooth round silicone implants with a volume of around 500 ccs. You need more volume with the implants to approximate what you have with the TEs. This volume and style should be very nice on your frame.
Deborah
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jmemama: The style and size your PS is advocating will be too small for your frame and you will not be happy. I would not think of going through the exchange surgery with this PS, if he is resting his laurels on these small numbers.
You need a second opinion.....
PM me and I can help you. Let me know where you live and how far you can commute.
Deborah
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If I have missed any posts requesting information, please let me know!
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Thank you very much Whippetmom! I can't believe I did not know what was inside of my chest :-). Thanks also for the recommendation!
Thank you too Blessings20!
Wendy
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I am very new to this site. I have been reading for a couple of days now and I am amazed at all the strong women that are here. Since I finally got the nerve up to post here goes.
Diagnosed 5/23/12
Bilateral Mastectomy with TE 7/6/12
Exchange to Silicone implants 10/15/12
Where do i begin? Okay, All went well until I had my tissue expander that shifted upward on the cancer side (left). At which time I also developed a severe allergic reaction to TOMOX. Then I had my exchange surgery on 10/15/12. The PS told me he would need to cut some of the extra skin off because I went from a 34DD and wanted a full B, and close up the pocket due to the expander shifting upward and towards my under arm (hurt so bad for months). So now I have my silicone implants and my left side (cancer & shifting side) sits much higher than the right. He did not require me to wear a compression band, didnt wrap me after surgery, and told me to where the surgical bra until next appt. So I did all that. Then I saw him a month after surgery and he confirmed that one was much higher and said we could schedule something for January. WHAT??? ANOTHER SURGERY??? I silently had an anxiety attack and nodded my head. He went on to say we could sew up the bottom in a rounded shape to lift the other breast, or we could put smalller implants in and do more fat grafting to create a more natural roundness. I was shocked for a couple of reasons. One reason, i thought i was done with surgery; the other reason, was that i assumed he would do all the "pocket work" sewing he needed to do in THIS surgery! I thought, "why wouldnt he have closed up the top KNOWING that the expander had shifted?". THEN as though that wasnt enough, after i get home and read the report of what he did in surgery I notice he put in silicone implants that are 500cc. Now someone PLEASE correct me if i am wrong but, if I am 5'3, weigh 140 and used to wear 34DD bra but wanted to be a full B after surgery, 500cc is too big! NO? And now 1 month later he told me i could wear whatever bra i wanted so i put on one i have which is an underwire 34D and it is only slightly big in the cup. Therefore, I must AT LEAST be a 34C which is STILL not a B! So now i have one breast that looks much fuller at the top, sits higher, Im not a full B, they look flat(ish) and not round, and they dont feel as soft as i thought they would
Someone PLEASE help! I dont even know where to post all of this or where to read to see others who have had this happen to them. I want to get informed before we "schedule something for January". WHich i should have done BEFORE any of this but i was so scared.
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Michy,
I am still very, very early in this process (haven't had my exchange surgery yet), but I think that most gals would recommend that you get a second opinion. You have time before the recommended surgery in January. I did this in search of a MO; I was not happy with my Breast Center so got three other opinions. If you require yet another surgery, you want to make sure you will get the results you seek. So sorry this is happening to you.
Wendy
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MichyLL - I can't speak to the issue of asymmetry (cancer side higher than the other due to implant shifting) but I can warn you against making a decision for revision surgery too soon.
If your exchange was on 10/15/12, then you are just barely a month out.
SO much is still changing inside you! Swelling, reduction of swelling, dropping, fluffing.....the silicon implant is slowly softening up and conforming to your rib cage.
One thing I do want to caution you about is evaluating the size of your implants by the way they fit in a certain size bra.
I have a box of bras I wore pre-BMX, and most of them do not fit. There is excess material in the end of the cup, which is common with a reconstructed breast with no nipple or areola reconstruction. They are almost always flatter than a native breast.
I am 5'5", 145 pounds, with a 32"-33" chest measurement. (Pre-BMX, I used to have a 40" chest with a 38DDD bra size.)
Since my exchange to 700 cc saline implants this past August, I have been professionally fitted for underwire bras. My first one was a 34DD. My second and third ones were 38Cs. My fourth one was a 34DDD. My fifth and sixth ones were 36DDs.
My point is that with the reconstructed chest, you may need the width of a bigger underwire to accommodate the width of the implant. However, you generally won't have the projection of a natural breast, so even in a 34DDD bra, you may look like a B or a C in your clothes. And with every single different brand you try on, you may wear a different size.
My advice would be to wait for your PS to give you clearance to be professionally fitted for an underwire bra, to wear it every day, and to see what happens to the shape and the "drop and fluff" over the next two months. I've heard of women seeing changes in their New Girls as long as 9 months after exchange.
In the meantime, definitely get a second opinion if you want, but I don't think you should rush into any additional surgery this early in the game.
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Michy: read #3 in the thread header. Let me know the style/volume of your TEs and the style of your 500 cc implants. The volume is actually fine for your frame, but the style might be wrong. I am going to PM you with my email so that you can send me photos.
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Wendy and Blessings2011, your both so so right! I need to stop, be patient and get another opinion in the meanwhile.
I don't know why I didn't write on this site sooner. Its unbelievable how much talking to other women that completely understand makes such a difference!
Sad I waited so long, but so glad I'm here now!
Thank you ladies!!!!0 -
Michy, I am about your size,at 5'4 and vary from 140 to 159. I was really small. I got 550cc and now my B bras are a little small. I wanted to be a C cause I was so small before. I think with the 500cc,that should be enough to do the B. You might wanna get a second opinion. Whenever,I was unhappy with a dr,I called my breast coordinator and got a diff dr.
I also second what Blessings said. hope all our advice helps.
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Hi Michy,
We have a lot in common. Just to confuse you further, I'm 5'4", about 132 and my implants are 400ccs in style 20 for projection. I have my own nips, so that may help with projection as well. My bra size range is 34DD-36D (most often 36C). I'm very happy with my projection. I had one implant shift laterally that was repaired surgically and one that rode so high I looked like I was smuggling a loaf of bread under my pecs.
I had a revision 6 months after exchange with a fabulous PS (I'm not sure if she specializes in revisions, but she could). Most PSs will have you wait that long before considering revision for a number of reasons. Most importantly, you're not fully settled until then. That fixed the lateral problem.
For the high rider, I found a massage that pushed that implant right into it's proper position. I tried them all, trust me. Here is a youtube of the massage, but please be warned. This is an augmentation patient, and she's topless. It may be difficult for some of us to see. Also the comments are really vulgar. Check with your dr to make sure massage is appropriate for you.
Lastly, for this latest surgery, I had to wear a surgical bra for at least 6 weeks. I found something this time around that may be coincidence or may have some truth. I think that bra helped shape the girls into a pointier shape (which I really wanted). So this time around I've been on a mission looking for those old fashioned pointy shaped bras. They're ugly as sin, but if it's helping solidify my shape, I'll keep wearing them for another 2 months (I'm 2 months out from revision).
My advice to you is to start looking for a possible revision PS. You may not need it, but it's good to line things up just in case.
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I'm new to this too but I've read so many wonderful things, I am hoping that the gurus here can help me with my sizing too?
I'm 5'10", 128 lbs with a 28 inch rib cage. Pre uni mx I wore a 32 DD which I thought was too big for my frame. I definitely don't want to be DD in my reconstructed side and know (ugh) that I will need a redux and lift of the non effected side. I don't want it to be reduced *too* much in the event that I end up needing a mx in the future on that side( I want to be sure I have enough skin on that side left for that potential eventuality. I currently have a naturelle 133mx-13t nw filled with 430 ccs....when I asked yesterday about the capacity, I think the p.s. said 500 ccs.
I think that I'd like to be a small d?0 -
Layla2525, thank you so much for your input! It makes me feel better to hear that after all is said and done I might still end up a B.
Crescent5, what does "20 for projection" mean? How do I find mine? Unfortunately my PS says no massage, which I don't get, but I'm going to physical therapy starting Friday . As far as another revision DR. I will definetly be looking for one first thing next week! I wonder if anyone here knows of one in or near Boston.
Merlcat, you are in the best hands here. These women are very very resourceful! Best of luck!0 -
Michy there are different styles for different projections. Mine are high profile, which are style 20 (allergen).There are other numbers for different projections/profiles. Yours should be on the card they gave you. My revision PS is in Boston. I'll PM you. Oh geez, I just noticed you're from Methuen. I should have given you my PS's name earlier! She's at MGH.
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Merlcat: Your PS is choosing the right size for you. I would say 475 ccs or 500 ccs in Style 20/Allergan.
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Whippetmom,
I'm getting a second opinion from another PS regarding finishing my reconstruction due to cant wait for my Ps I call to get status update because the Sientra are on back order and they never call me back....the new one uses Mentor Memory Gel implants was woundering what you thought about this brand..are they as good as the Sientra implants..0 -
Thank you so much for your input! It'll be interesting to see how much more saline my rs fills my the with next week when I go back.....
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I'm back and still unable to make a decision
I have been unhappy with the lack of size & projection since my 7/5/12 implant exchange for a uniMX, on a f/u visit with my PS I told him that and he said he could do a revision. I asked what are you going to use "a bigger implant", he didn't clarify but said they have different shapes. That was they extent of his answer, I have been less than pleased with the lack of communication. So tentatively I was set up for revision 12/21 with him.
But I decided to seek a 2nd opinion this time with a woman, who I absolutely adored. I think she spent over and hour with me, going thru each aspect, including the lack of upper pole fullness, a divot on the side and the look of a "stuck on implant" lack of inframammary crease definition. She did however, say that the mastoplexy side was a good job, and wouldn't want to touch that. She suggested the possible removal of implant, place expander to generate more skin, and place larger implant/ with high profile, and fat grafting to upper and side of breast. I was enthused by her plan but not so sure about changing back to an expander and going that route again. She also was first to talk to me about fat grafting. One problem with going with her is that I definitely have to wait for after 1st of year as she has no surgical openings (and I would like to be able to get this done in 2012 due to my deductible having been already met).
SINCE the two PS differed so very much, I thought I might as well get a 3rd opinion and see where that would go.
Much to my surprise the 3rd PS (a male) said he thought my 1st PS did a pretty good job, he said that he could see some of the problems I spoke about, but said he would have felt badly if this was his work that I was unhappy with. He said yes he could do some revision, but very slight. He even suggested waiting for a bit to see if the implant changes how it looks. He also said that maybe I would be a good candidate for the Sientra "gummy bear" implant as it has a more conical shape, however, these have not been available in my area as of yet (central Wisconsin) and didn't know when it would be. He also mentioned that I should check with my insurance company as all revisions may not be covered just because we think the breasts are not symmetrical. He said that it could be considered more cosmetic than trying to just achieve symmetry, even though my original diag. was MX for dcis. I have a foob created by a silicone implant I guess I should be happy with that.
SO as you can tell I am just as confused as I was to begin with. ANY THOUGHTS ON THIS OVERLY LONG POST would be gladly welcomed.
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janice: I do not like the dismal perspective of PS #3. Here is what the law provides:
Breast Reconstruction Defined
Breast reconstruction is covered under insurance as a result of the passage of the Women's Health and Cancer Rights Act of 1998. The law mandates insurance coverage for breast reconstruction and the alteration of the opposite breast for symmetry for women who have undergone mastectomy.
If you need to get it done this year, go to your original PS and have him clearly outline what he will do and what implant - volume and style - he intends to use. Otherwise, go with the female PS and do what is necesssary to obtain the best result possible. The PS submits the paperwork to the insurance company and it is all in the "coding" and verbiage they use which ensures coverage.
Deborah
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Thanks Deborah,
I did call the 1st PS and was told that he has ordered Mentor high-profile silicone implant in sizes from 535 - 590 ccs. My expander was 133 LV-14 and the original implant is a smooth round 450cc moderate plus profile gel. What are your thoughts on the implants sizes proposed?
I asked about fat grafting and was told it can be done, but like I've heard before it doesn't always take. Does anyone know why that is and what is the percentage of optimal results? He said he wouldn't do that at the same time of revision it would have to be at later date because of increased chance of infection.
Can't wait to put this behind me and quit fretting about it all.
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Hi Deborah, I had LD surgery last Tuesday Nov 20. I had TE in both sides but I would love your help with sizing and implant decision. I am going to my follow up appointment with PS tomorrow and I will give you all the details when I get home.
I am 5'5", 120 lbs and small frame. I have done really well with recover for only 7 days, all drains are out and I am feeling great, I love having some shape back.
thanks Nicole
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Janice - I haven't had fat grafting I've just read a lot on here...you're body absorbs the fat. All our bodies are unique, though, and who knows at what rate your body will do it. It seems odd to me that he won't do it at the time of exchange? Do you have a history of infections? Personally, I would opt to go under anesthesia as little as possible and do it all at the same time...if you don't have extenuating circumstances. It seems like most women need two or three rounds of fat grafting for optimal results.
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I am going to swap out my current implants to Sientra teardrop shaped. I was told by the doctors office that the larger size in this style has not come out yet. Their office will get them in February. I currently have 650cc's and want the same size, but more projection. I am hoping the ripples and divots I have will lessen with the Sientras.
I have had one round of fatgrafting, but the fat has hardened and turned into small lumps around my current implants. Doc will do more fatgrating when he puts the new implants in - I just hope the fat doesn't lump up again.
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I have rippling and it makes me crazy. Currently I have silicone. I have had 1 round of fat grafting and while it did fix one area, it reabsorbed in the other areas. My ps said he won't do it again. The ripples are too deep to fill. I don't have enough fat to transfer. The only suggestion he has is to switch the new sloped gummy implants, but it seems these implants have their own issues, ie heavier, firmer, can rotate. Anyone have any alternative advice? Maybe I should just give my self a hug and move on... Idk
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Quick question about expanders and implants: Do you need a Sientra expander to go to a Sientra implant or can you start with an Allergan expander and get a Sientra implant? Or does the expander have to do more with what shape you are getting (teardrop vs. round).
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Implant choice
Hi Everyone,
I'm having my " exchange surgery " thurs 11/29 and wondered if you have any recommendations for implant choice. I currently have mentor smooth round spectrum saline adjustable implants. They are filled to 500 cc's. I am switching out to silicone. I think my surgeon likes mentor. I'd like more cleavage as I'm bony in the middle and have a depression at the top of my right implant which also slides slightly to the right when i lay down. Very small imperfections but since they can be improved I'm going for it .My rib cage is 29 1/2 inches 5' 3 & 5/8 inches tall 123 lbs Also having some scar tissue released and some fat transfer to fill in some areas. Also they are above the muscle. Thanks, Karen0
