BREAST IMPLANT SIZING 101
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I have been so worried about her, too.
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Whippetmom~ Thank you...looking forward to the demo!
Do you have a prefference between the smooth rounds or the Siltex rounds? I like the idea of narrower and more projection, and will discuss this tomorrow with PS...she might decide on more fill if that's the case.
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Tami: Smooth, NOT textured.
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Whippetmom~ Just trying to have as much knowledge as possible. Is Siltex textured? And what's the reasoning behind getting smooth?
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HI I see lots of talk about the gummies not being approved here is US, but my Doc is at Mayo clinic and using the Sientra (cohesive gel)implants natural contour shape. The largest is goes is 700cc in one style and lower in the rounder style, he will get me to a fuller size using fat grafting before and after. I have a small frame and am 34F, so i would like to be a solid d, my shoulders/neck will thank me. More info and anyone using the sientra would be great.
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No word from Annemarie....really concerned.
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Does anyone have any concerns about the weight of larger implants causing sagging early? They were almost to my navel before mx and I surely don't want that again!!!!! LOL
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Greencowgirl, my PS did the 5 year study for Sientra (J Harrington in Mpls). I have dual chamber Sientra TEs, but she'll be using Allergan implants for me. She'd like to see Sientra have more sizes available.
I'm honestly not sure what the difference is between "gummies" and the cohesive gel...
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chawkins - I didn't speak to my PS about sagging, but due to the fact that I get some soreness if I don't wear a bra, I wear one almost 24/7. At night I wear a Coobie bra, and during the day, mainly underwires since they provide more support. My implant is 700cc. I hope with the constant support, sagging won't be an issue. This thing is heavy.
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ek25 - It seems like a thousand years ago that I was begging whippetmom for advice, but here is what she told me: the TEs give you the basic "footprint" of how large your implants could be. In other words, if you have very wide TEs, getting very narrow implants could cause all sorts of migration issues. Remember, the TEs have hard backs, so ALL the saline is pushed outwards (creating projection), to stretch the muscles and the skin. The implants, however, are squishy all over and will conform more to your chest wall. I had 16 cm wide TEs filled to 620ccs. I got smooth saline implants filled to 700ccs. The PS did some pocket work to narrow the pocket space, and now the 700s are the absolute perfect size for me. (BTW - they are the same exact ones and same exact size that whippetmom suggested for me!)
chawkins - like JamieB83, I have 700cc implants. My PS suggested that I do not go braless, except for sleeping. Sometimes I will wear my Genie bra to bed because I'm in the process of relieving some issues related to my exchange. During the day, I usually wear a good underwire, and sometimes I still wear my JCPenney zip-front sports bra. As for sagging, my Original Girls were huge and hung nearly to my waist. Now THAT was a pain! But my New Girls have a nice natural ptosis (polite word for droop) that doesn't look saggy at all, just normal, while still being perky. I'll still follow the PS's suggestions, though, and continue to wear a good bra during the day.
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Whippetmom, so looking forward to you sharing new knowledge! Not only am I impressed with all you know, but that you are willing to share and put it in a way that is easy to understand. You answer questions I didn't know to ask. This whole thread has been a blessing! This week should be my final fill (at least I hope so) and getting anxious to discuss next step with PS. So done with TE discomfort!
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Tami: Siltex is a Mentor textured round implant. Textured implants will feel firmer and smooth implants more natural. Textured implants cause traction rippling, and rippling is already a challenge after breast reconstruction. Frankly, out of hundreds of women who have come through bc.org, only two or three have had textured rounds and two of these women had them switched out within six months for smooth silicone rounds.
EDITED TO ADD:
Now there might be a benefit of some sort to using a textured round, when the recon patient has had large breasts prior to BMX and perhaps if the skin envelope is quite elastic and large, the textured implant might prevent or at least ameliorate the gravitational pull on the delicate skin flap. Textureds are used sometimes in augmentation for this purpose - to give a bit of a "lift", as the textured implant tends to adhere to the chest wall....like velcro.
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Whippetmom~ Thank you, Thank you, Thank you! Now I really feel like I know what I am talking about. It will make the conversation with my PS today go so much smoother! I really appreciate all you have done for me...and countless others!
Tami
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Hi whippetmom, I am new to the site and going thru the reconstruction phase, and boy do I have a million questions. I have been following others responses of you and you seem to have a great deal of expertise so I was hoping you could give me some of your advice. I am mostly looking for information on how big I should go for my exchange surgery. I had a BMX in Nov with nipple and skin sparring and my PS put in TE's filled to 500 cc's. I was an A cup before and I would like to be a heavy C cup knowing the sizes are not comparable to the cc's. I would like to know what cc's are best for my frame. I am 5'4" and my weight is 167. My rib cage measurement is 34". I currently have Allergan TE's, 133FV-13, 500cc's. I have had 3 fills and are now at 635 cc's. My PS and I have agreed on the Silicon implants and I believe he will be using the high profile ones. My plan is to lose at least 20 lbs. Hope I have given enough information for you to give your opinion! Look forward to your response!
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towarn57:
Allergan Style 20 with a volume of 500 ccs would be appropriate, width-wise, but I think you could use around 600 ccs in a HP style implant. You also are a candidate for Allergan Style 45, with a volume of 650 ccs. The weight loss plan can only benefit the appearance of your implants on your chest wall. A great incentive to lose weight! A twenty pound weight loss would narrow your ribcage down to around 31 or 32 inches. Discuss these implant sizes with your PS.
Deborah0 -
Hi Whippetmom -
I've had my final fill and my exchange will be at the end of March! You have such a large following here, so just to remind you - I have Allergan 133MX-14-T (600cc). I'm 5'6", weigh 135 lbs, ribcage 32.5-34.5 (depending on whether exhaled or inhaled...lol...) My final fill volume is 460cc and he's going to put in a set of Allergan 410, I don't know exactly what size. I held one of them and they are textured. He said they don't bounce and I probably won't even need to wear a bra. He has some pocket work to do and he might have to do some liposuction below my underarms to make things look good. I told him I had been reading and talking with very experienced people and was recommended to be in the 400gm range, and he interrupted and said "Are they doctors?" He's a bit of an oddity and fairly full of himself, but he's considered a "top doc" and people journey from afar to use his talents, so I'm going to trust him. I have one more checkup before the exchange and I'll ask about the exact implant size. I hope all of this sounds like a good volume for me, and that it is enough for your recommended 400gm range. Thanks a million for all your expertise!
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nesw: I do not know what to say to that. I just know that medical treatises are clear that when a doctor plans to use anatomical implants like the Allergan 410, they should have foreknowledge regarding the style and volume they intend to use, and select the tissue expander accordingly. You don't just "wing it"! So ask him what style and volume he intends to ORDER for the surgery, based on your TE stylel and volume and dimensions. You have every right to know this. It's your body and you do not want multiple surgeries to get it right.
Deborah0 -
Could anyone who had pocket work done tell me if it limits range of motion or causes permanent discomfort. Thanks, Marta
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I had minimal? pocket work done and a reduction exactly 4 weeks ago today and got the all clear to resume normal adls and have no problems with my rom.
No pain whatsoever:) may you be as fortunate as I!0 -
bcs22- I had pocket work done almost 3 mos ago with my exchange. I did not have any ROM issues. When you had your BMX were you given a list of excercises to do afterwards? If so once you are approved to lift or raise your arms over your head you may want to do a few of them. I had complete ROM 4 wks after my BMX and have never had any issues since. Check with your PS about exercises, you can also find the approved post mastectomy exercises at ACS.org I believe that is correct website for the AMerican cancer society.
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Hi Whippetmom - you're so right. I just talked to my PS's nurse and I asked for the implant specifics. She said he has written Allergan MX 410 520 for me. You had recommended in the 400gm range and this one sounds like it might be 520gm? I told him I wanted to be smaller than before (I was a large 36B) and I don't know how small the result will be for this. I currently have 133MX-14-T (600cc) expanders filled to 460cc, which is my final volume. I see him once more for a checkup on 3/21 and my exchange is scheduled for 5/10. They wanted me to exchange in April but I'm a high school AP and science research teacher and the exams are in the first week of May.
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Also, he just yesterday told me that the Allergan 410s are not approved yet for use in the U.S. and that I am going to be part of a 10-year study. I totally don't mind, but I'm very surprised that wasn't one of the things I was told at the intitial consult. He did say at the time that he uses exclusively "gummy bear" implants, but I've never been through this before and I'm supposed to figure it out for myself? Not actually asking, just commenting on how little he says to me overall. An odd one.
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Nesw -- the "gummy" always means the Allergan 410 (though there are varieties of cohesive gel implants). Though still officially in "trial" in the US, the Allergan 410 has been in WIDE use in Canada and Europe for well over 10 years. Many women in the US have access to these implants as part of the trial, at this point, so I wouldn't be discouraged by that. You're right, though, that you should have been informed. I have a gummy (I'm a uni) and know a lot of women who have regular silicone. The gummy is much firmer (less squishy) than a regular silicone implant, though of course far squishier than a fully expanded TE. When you lie down, for example, they do NOT move. Some regular silicone also doesn't move, as I understand it, but since I don't have one of those I leave that to others to remark upon.
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bcs22 - I had my Exchange in August 2012. The PS did a ton of pocket work (removal of excess scar tissue, release of the pectoral muscles at tops and bottoms, and lateral capsulopexies/capsulorraphies on both sides) because my implants were significantly narrower than the TEs he had initially placed.
Most women will never go through this much work at Exchange.
My ROM was fine, but five months out, I still have that Iron Bra feeling, which is being treated by a Myofascial Release Massage Therapist.
You may always feel something different because your implants are placed under the pectoral muscle, so when you flex your pecs, your implants may shift as well. But I think the brain can adapt to anything, and after a while, I think this can be normal feeling, not "discomfort".
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Hey guys..it has been a while..have been on different board..so my exchange is scheduled for 4/23 (yessss!)..I am at 500cc and on cue w/whippetmom..she has been great!!! lord knows i have been second and third guessing my TE size/fills!! so what is the benefit to getting the gummys vs silicone? is it shape, feel, look or just depends on the person whether gummys or silicone is best?? Also did does ps know beforehand if he will need to do pocket work based on implants chosen and TE appearance? I don't meet with ps until late March, but have been thinking about questions already...!!!
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nesw: Your PS is right about the implant volume. Back in January I said that you had to AT LEAST be in the 400 gm range.....essentially inferring that nothing smaller would be appropriate. The 520 gm Allergan 410s match the dimensions of your TEs. Your PS, apart from being uncommunicative, sounds like he is skilled in using the Allergan 410s and he knows what he is doing. I do like the fact that he challenged your wanting to be quite a bit smaller, informing you that he did not feel that what you described would be appropriate for your frame. This is a very important factor to consider with breast reconstruction. I think the size will be very nice for you.
Deborah
EDITED TO STATE: If you are on the pictures' forum, look at Ericavw's photos....
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Whippetom,
i had a skin / nipple sparring bx in december. i'm petite and was an "a" cup prior to my surgery and was told i would be a big "b" little "c" after exchange. I am just under 5" 3" and weigh 97 lbs. i love my ps but am concerned about my end result. the te's i have are the allergan 133MV with 250cc. i have been filled to 300 cc's. i thought last week was my last scheduled fill. although my ps said i should stop when i was satisfied, i felt like that is what he had in mind for me. the problem is that i am happy with my left breast, however, my right breast looks so much smaller. in all the research that i have done, i thought that you should fill greater than what your end result will be because you actually look smaller after your exchange.
my ps said he would order high profile, 325 cc and that would account for the loss at exchange.
when i discussed my concern that my right breast was smaller than my left, and that maybe i should fill (stretch) that more, he said he would fix that at exchange and it wouldn't be a problem at all, however, now he is ordering 300cc & 325 cc to make up the difference. wouldn't that make me smaller than i currently am now? how can i make sure that i am not going to lose volume? if my right breast is smaller even though they were both filled to 300cc's, how can i make sure i will be happy with the end result? I don't want to be as small as my right breast.
totally confused.
Appreciate your input.
movingforward11
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Thank you Whippetmom - I feel satisfaction and great relief that my PS is doing the right thing for me. So many stressful decisions in this whole journey. I've written for access to the picture forum to take a look, as well as post my own photos. Thanks again for your expertise!
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Movingforward11, you are actually the first person I have seen since I have been on this forum who has the same amount of fill in your TEs that I do-- 300 cc's. It seems that everyone else has much more. I also had skin/nipple-sparing PBMX and also want to be a little bit bigger than I am in my TEs. My scheduled exchange is March 20; when is yours?
You are really petite, so what size do you feel you are now? I feel like a small or average C, I guess. I am 5'6, 125 lbs. Read the top of the thread and give Whippetmom your measurement under your TEs, and she will let you know what size would be good for you. I am 30 and 1/2 at the bottom of my rib cage, and she thought 500 would be best for me. I know that my doctor is bringing several different sizes, ranging from 350 cc's to 535 and that he thinks he can replicate my TE size with a little more projection added.
Nesw, I also just gained access to the picture forum and plan to post pics soon, I just have not had time when I get home from work, and have been busy the last couple of weekends.
Cheryl
Edited to clarify-- I am 30 and 1/2 in. around my rib cage at the bottom of my TE's, not the bottom of my rib cage.
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Looks like FDA approved the Natrelle 410 today - I believe that's the gummy bear implant
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