BREAST IMPLANT SIZING 101
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A huge shout-out to Whippetmom - my PS ended up going with the style and size she recommended for me - Allergan Style 20 500cc. I'm only a day out, but am liking what I see! I'll be posting my progress in the picture forum (I had my nipples reconstructed at the same time) so hopefully that will help my other sisters who are trying to decide on a plan. Style 20 is high profile and not at all "strippery" on me. Hooray! : )
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Cheryl: Are you measuring under your ribcage, holding the tape measure nice and snug? I think you should have no larger than a 30 inch ribcage. I just feel that if you need a little more width - at least 11.5 cm to 12.0 cm - with the future implants. I do not want your implants to look like torpedos on your chest wall. I know he probably has only used these ultra full projection implants with one or two patients - or perhaps you are the first - since they just recently became available. So ask if he can also bring in the saline sizers for the Mentor HP implant - around 400 ccs/425 ccs.
Deborah0 -
Bishops: I am glad you opted for two stage reconstruction. MUCH better control over the outcome. A 400 cc TE should be just fine to get you where you need to be - which is probably going to be 450 ccs/475 ccs in a HP style implant. Also, with your height and possibly long torso, you too may be a good candidate for a ultra full projection style implant. But I have to tell ALL of you gals, referable to Mentor's ultra full projection style implant - is that I have no experience with this yet. I feel that Allergan's Style 45 has a much better width to projection ratio than does Mentor's ultra, and so until I see some results of reconstruction where this style in Mentor has been used, I just have to ask that the PS also at least try the HP style implant with his patients and let the OR staff determine which looks best.
Deborah0 -
Brownlee: You have sufficient expansions with your 400s to get you to implants in the range of 425 ccs to 500 ccs. It depends on the width of your TEs. The minimum width for 400s would be 12.0 cm and this would mean a 425 cc implant. If you have a moderate height TE, you could have implants with a volume of 500 ccs. If a short height TE, definitely you could handle 500 ccs. So you should be a very nice size with 475 ccs or 500 ccs. Talk to your PS about these different volume ranges - which all would be based on the width of your TEs, your degree of expansion, skin integrity and his willingness to take you to the higher number implants. My TEs were 400 ccs and my implants are 550 ccs.
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Brownlee: Reading further regarding your skin issues. I feel you need to really defer a future fill for two weeks. You might be moving too quickly. Skin integrity is so important. You might think about massaging the TEs with Bio Oil or one of the other natural oils some of the gals use to soften their skin. I never used any oil because my skin was already pretty lax, but a lot of gals back in MY DAY used Palmer's Cocoa Butter cream and Bio Oil. Oh wait...I tell you, I would try coconut oil - a perfect, natural oil to use. As long as your incisions are healed and your sutures have dissolved....this should be fine.
Deborah0 -
Grier: Such good news! Congratulations....I am happy that YOU are happy! Hope to see photos someday soon!
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Whippetmom, you are so right! I remeasured, and I am 30.5 inches around the bottom of my TE's and a little more than 31 if I take a deep breath while measuring. Do you think he might be using ultra high on me because my lower pole is still only as filled out as the top part and because the width of my TE's are only 10.7 (yet I feel like they are a little too wide on the sides, especially my left where I have more of a side boob). I am going to send a couple of pics through PM to you and see what you think. I so want to get this right the first time!!! Thank you again from the bottom of my heart for your help with this!
Cheryl
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Cheryl: I responded to your PM.....email me photos instead....
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Thank you, Deborah (Whippetmom). You are amazingly knowledgeable in this area and have helped me so much. I pray I will be able to report back to you the same way Grier has!
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Dear Deborah (whippetmom) - it's amazing how much you give of yourself. Thank you for helping so many women.
I had a uniMX and the PS put in an Allergan 133MX-14-T (600cc). Following the post-surgical pathology revealing some occult cancer, I decided to have a preventive MX on the other side (which came back with ADH, so I feel relieved). Obviously PS's plan after my first MX was to match my remaining breast (large
, but after I told him I was getting the preventive MX, I said I wanted to be smaller at the end of it all. He put in the same Allergan expander in my other breast and now they are both around 180cc (only two post-surgery fills so far). When I got the second fill this week, he asked "we're going for about a C cup right?" And I said no, maybe a B at most. He said I will probably look a little distorted because of the size of my ribcage and that he might have to do some liposuction below my underarms to make things look good. He then said to make the next appointment for 3-4 weeks and he might do one more fill. My ribcage is 34.5 inches, I'm 5'6", weigh 135 lbs, and he's going to put in gummy bears. Am I making a mistake going for small breasts? I was hoping to be able to run forest trails again without wearing my cast-iron sports bra and still needing to hold my breasts with my hands while running.I appreciate any advice! Thank you so much.
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I have read through this forum (for the most part) quite often since my bmx on October 22 (2012). What an amazing wealth of information!! I had tissue expanders (allergan 133MX-12, 400cc) put in at the time of surgery. I have had fills about every 2 weeks or so with my (potentially) last fill one week from today (Monday the 28th). Right now I am at 320cc each side. My PS said they can overfill the expanders if I so choose, so it's really up to me when to say "stop." This kind of makes me nervous, because I don't want to mess anything up! I'm pretty close to where I was before bmx (34C), which is kind of what I was shooting for-about the same size (ish) as before.
So after I get the fill next Monday, we will be talking about scheduling a surgery date and talking about what kind of implants I will be getting. I already know I want silicone, but I know they offer the gummy bear and the regular silicone...but which to choose?! I have no idea where to go from here. My PS is wonderful and I plan on asking her lots of questions, but I don't even know where to start! What's everybody else's experiences? What works/looks the best? Does me being an avid runner have anything to do with size/type?
Any help/advice anyone could offer would be SO appreciated!!
BTW-I am 34, 5'11" 150 lbs.
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nesw and runnermom,
Every woman has to find what she feels most comfortable with. I am someone who is happy to be smaller than I was before BMX. I'm a casual jogger and find this size great. Trust whippetmom to guide you!
My measurements and Implants:
I am 5'7", currently 135 lbs, rib cage 30 inches, previously 34D or DD.
Mentor CPG Gel Breast Implant Cohesive III, (silicon anatomical shape), Tall Height, Moderate Plus Profile, 270 cc, 11cm x 10.5cm. Now wear bra sized 34B-smallC.0 -
Ladies - just a word of caution.
You will never find a better place than this thread, or a more awesome guide than whippetmom to assist you in determining the most appropriate size for your permanent implants. She is our true Implant Guru!
But I wanted to bring something else to your attention. So many posts here deal with cup size, and if you read carefully the information in the headers at the top of each page, you can see just how difficult it is for your idea of cup size to match a PS's idea of cup size, and how in the long run, projection (or lack of it) is the issue that makes most women the unhappiest.
Here's another issue: width. Each TE has its own width, which is constant, considering the construction of the hard back. This begins to determine the width (or "footprint") of the pocket that your PS creates at the time of your MX. This is the pocket where your permanent implant will eventually reside in several months down the road.
When I had my BMX, neither the PS or I had any idea I would be losing weight. All I knew was that he put in 16 cm wide TEs because that's what looked appropriate on my then-large body. (Obviously, I hadn't yet visited this thread.)
But as the months wore on, and I began to lose weight, my chest measurement began to go down. When my fills reached 620ccs, and I finally visited this thread, whippetmom told me to stop!
The problem, she said, was that there were no saline implants (and my PS used only saline) that were 16 cm wide. The best I could get would be 14 cm wide implants....and if they were overfilled, the width would be even smaller. (Imagine a flat balloon. As you fill it with air, it assumes a round shape and becomes narrower.)
So that really caused me to dig deeper into the implants my PS had planned for me.
Initially, he told me that there needs to be at least some movement of the implant within the capsule (or pocket). That's what gives the implant a natural look. At best, I would have 1 cm free play on either side of each implant.
But the downside is that with too much free play, the implants can migrate.... in my case, laying on my back, they could be resting under my arms, pointing east and west, instead of standing up nicely and looking perky. This could also result in having quite a bit of space in between my implants.
I ended up having quite a bit of "pocket work" at the time of my exchange. My PS took a lot of time and did a lot of extra work to ensure my implants were well-seated in the pockets, which he had to narrow. He also stitched around each pocket to avoid any migration. Good planning from the get-go can eliminate much of this.
Most surgeons will place TEs with an eye towards the eventual permanent implants they will use.... so many times, if you show up in his/her office just before exchange, saying you want this implant or that, there may be issues. That's why whippetmom is so adamant about getting the exact details and dimensions of the TEs you have already.
I wish I could encourage anyone facing a BMX or a UMX to visit this thread ahead of time, if only to see just how complicated the process of choosing an appropriate tissue expander and permanent implant is. It goes WAY beyond "I just want to look bigger" or "I just want to look smaller".
Again, I commend and thank whippetmom for all the research, studying, planning, and commitment she has to helping us in an area where we start out knowing nothing!
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Yes, from what I've ready whippetmom is the implant-master! And I can't wait to "talk" with her about all this. Wow...so much information.
I hadn't really thought of the pockets that the TEs are in being where the implants would lie, but that makes sense. Mine are a little further apart than natural, with my left side sitting a little further out than the right. Not noticeable to anyone but me I don't think, but still. When I had my last fill I asked the PA about the space in between being so wide and she told me that the PS would most likely be able to release more in the middle at the exchange in order to have them sit closer together.
I also have issues with my right (ca) side because of where my initial lumpectomy was done 4 years ago (3 times). My scar is right on the bottom of my breast, like where an underwire would lay...my tumor was almost out of the breast tissue. So since being worked on so much at first, it is sitting different than the left side. Almost flatter on the bottom. And I don't like it.
Again, the PA said that the PS would definitely be trying to release some of that tissue and make all this look better. After all this, I just want cute, perky "breasts" and I'm just so afraid of not getting it right or messing something up! Thank you all for your advice, it is SO helpful!!
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Hi Deborah! - long time !Hope you are well.
Quick question, I see a few references to itchiness right after surgery but I've been itchy right from the get go and that's just past 4 yrs. now! Especially on the right ( cancer) side. Saw my PS today and he said that he has other patients experiencing the same thing but wasn't sure what it was caused by. He thought maybe certain foods. I know when I have spicy food it gets worse, but geez, this itchiness is unbearable sometimes even without the spicy food! Any ideas on what it could be and are there any other ladies out there that have the same itchiness so long after surgery ( and the antibiotics) that go along with it?
Terri
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nesw: I think your ribcage measurement is off. Your ribcage should be measured nice and snug under the TEs...it should be closer to Fearlessfoot's ribcage circumference. She has Mentor anatomicals. When you say "gummy bears", you are referring to Allergan anatomicals or Mentor anatomicals, correct? In the states, you would get Allergan Style 410s.
Your TEs are 14.0 cm in width and so the implant needs to maintain that width, which would probably put you in the 400 gm range, at the very least. The dimensions of the implant need to match the dimensions of the TEs, if you are using anatomicals. So verify this and we can check the catalogue and see what might be appropriate.
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Runnermom: I would recommend Allergan Style 45, 500 ccs [an extra full projection style smooth silicone round] , or Allergan Style 410 - "gummy bear" anatomicals - MX-370 grams. The sizing is quite different between the two "types" of implants. I would prefer the Allergan Style 45, if I had my druthers....
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Runnermom: As an addendum....if you need a wider implant, and it might be the case, I would recommend Allergan Style 20, a high profile smooth round silicone implant - 475ccs.
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Terri: I think that extreme itching in the breast area, at or around the scar, in particular, can be part of the whole complex of issues under PMPS - Post Mastectomy Pain Syndrome, which is now called "Post Breast Therapy Pain Syndrome". Most physicians just don't even want to discuss this with their patients - perhaps because so few physicians are well-informed about this condition.
http://www.cancersupportivecare.com/pbtpshandout.php
I would try the holistic route though. I don't think it is food based. Try herbs like basil, mint, thyme, calendula, rosemary, tea tree oil, lavender, which can be purchased in concentrated oil based form and you can make a mixture of these oils [I use Rosewater as a base] and put it in a spray bottle and then you can use this after you shower. [I actually use these ingredients with good relief for one of my dogs with major skin allergies.] It is worth a try....
So sorry you are being distracted by all of this itching....
Hugs...
Deborah
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Blessings.....
Thank you....0 -
Dear Whippetmom - thank you very much for responding. My PS told me I have a broad ribcage - if I pull the measuring tape extremely tight while fully exhaling, I can get my measurement down to 32.5 inches. I imagine that's why he put in the 14 cm and 600cc capacity TEs? I'm in the states and all I know about the implants are that they are teardrop shaped cohesive gel "gummy bears". I guess that means they are the Allergan 410 anatomicals. If I want to stay kind of small, I might have to go with a wide implant to fit the pocket? Again, thank you so much for your expertise.
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kayb---message blocked to you, sent forward to person discussed, Hugs and thanks. sheila
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I have just had my last fill in my expanders today!! I'm now at 500 cc's. My PS says come back in 6 weeks for a checkup and he will probably book my exchange surgery then. Looking at some time in mid-March and I cannot wait to get this damn thing out! I'd like some advice on implants. My PS hasn't really talked about this with me and says he hasn't decided yet which ones he wants to use. My stats are: I am 5'5", 148 pounds with a ribcage of 34". I have in the Allergan Natrelle expander ref #133MX-13-T. It's supposedly moderate height and extra projection with a 500 cc fill (which I am at). I was wondering if you had thoughts on the type of implant I should look at. He did say he'd be using the "gummy" ones. A little more info: I had Stage IIa, grade 3, no lymph node involvement, BRAC Negative and Oncotype DX of 15 so no chemo or radiation (thank God!). PS says I've healed up great in the 6 weeks since surgery and should be exchanging at about 14 weeks post-surgery. I would geatly appreciate any advice and thank you!!
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Wow, I'm reading these posts, trying to get my head around this since my hope is to get reconstruction at time of surgery. To take things back a few steps: From comments made, seems as if TE are put in, and implant types are figured out later on in the process. True? I'm wondering why everything isn't decided from the get-go. Also, I am a bit intimidated about knowing details of implants--types, sizes, process. Aren't PSes supposed to be on top of this stuff?
I've met with one PS who went throughly over my options, and pros and cons of each. How many times should I expect to meet with the PS prior to surgery?
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ReneeinOhio..... Because implants are generally inserted behind the chest wall muscle, you need the expanders first to slowly stretch this muscle. Once the expanders are filled to more or less your desired size , then they will be exchanged for the permanent ones. Good luck and come back here.. These girls are awesome for help and support.
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There is so much information here to digest! I am miserably unhappy with the results of my "reconstruction". I am 248lbs, 5'6". Ribcage is 43 inches. I already have my implants in (Natrelle, silicone, style 20, 800cc implants) but I went from an H cup (36H) to barely a C cup. I am so frustrated! Of course, 800 cc is the biggest sized implant offered, so do I have any other options? Or do I just have to suck it up and deal with my new smaller size? My expectation is that i would be pretty close to the same size as I was before.
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Hey there, it is so nice to have great information all in one place! I have looked around various places and find conflicting information, so it is a bit confusing. I soo appreciate all your clear, concise information! I had bilat mast 12/3 with Allergan tissue expanders placed with 200cc to start. They are 133v series, catalog number 133mx-13. I think max is 500cc. I am looking for a full C cup. I was a very small B prior to surgery (could even squish into some A bras). It is very difficult for me to assess volume/size because of the odd shape of expanders and the fact that they are sticking into my armpits!
I am 5'3" and weigh 116-118. My ribcage is 28". I have a longer torso and short, thicker legs (grrr..!). I am at about 400cc right now. I get about 50cc per fill. Not sure on implant type yet, but will be silicone. My PS stated we would look at options together once I felt the volume I have with expanders was what I wanted. He does not put in smaller implants. States that port on expander also takes up a some space that is not accounted for in cc amount. What are your thoughts on expander cc to achieve a full C or even small D? It is difficult for me to imagine my current hockey pucks(!) as implants/boobs! I discussed my goal with my PS prior to surgery of a full C cup, but he also wants to me visualize the volume on me to be sure I will be happy. Both my surgeon and plastic surgeon have been wonderful and I am so grateful for their expertise and remarkable kindness and caring. Also can't believe the love and support from others since being diagnosed. How amazingly strong these women are is inspiring..so thank you!!0 -
mamatwinz~I'm kind of in the same "boat" as you. I'm pretty sure I have the same TEs as you, maybe 1 size larger, being they go to 550. (they are over filled to 600/650). You can PM Whippetmom, she is THE Implant guru here!! Give her all of you sats, scroll up to the header on this page, and give her all of the info that she requires to help you out. She does wonders for picking out implants. I'm 5' tall, 109 pounds with a rib cage of 28", and low and behold, my PS and I picked out EXACTLY what she recommended!! Good luck!
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Thank you..I just sent PM to her!!
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Ladies,
It is best to talk to your PS in terms of what size your breasts were before ... smaller, larger. Cup size is very subjective and what you think is a "C" "D" "B" cup may be different than what your PS thinks. And most of us were wearing the wrong size bra before diagnosis and we don't know what we're talking about even though we think we do.
Know too that your cup is likely going to be larger than you think because of width, not projection. I wear a "D" cup but look like a "B" cup in clothes.
It's better to talk to your PS in language that you both understand and both have the same definition...talking in concrete terms instead of abstract languge: "I want to be smaller than I was before." "I want to be larger than before." "I want to be the same size as before." >> Is more helpful than talking cup size.
I told my PS that I wanted to be where I was before and we achieved that ... although my reconstructed breasts don't have the projection of my natural breasts. In your chart, the CC's of breast tissue is listed. Work from that number, not cup size.
Communication is key here and using subjective language (cup size) is not going to guarantee the best results.
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