BREAST IMPLANT SIZING 101
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Hi Sista's! Today is the first day that I found this thread and I am so excited! I have been out here floundering in pain with TE fills and thinking something was wrong with me or I was a big wimp. There is a lot to absorb here.
Whippetmom- the time and effort you put in here is awesome! Kudos to you!
Thanks to all of the rest of you for the laughs!
Well, here's my story (short version)- BMX with TE's May 4th. Came out of surgery with 110cc's, first fill in the PS office was 300 cc's. So painful for a couple of days. 2nd fill, 160 cc's and I was down for the count for 3 to 4 days...thought my sternum was going to rip out of my chest (not to mention the sore pecks). Last week, I went in and he wanted to add a little more - I said "uncle" and I wanted to wait until next weeks check up. Looking at the numbers people are talking about on here, I wonder if mine are just much broader and can hold more? Just confused, but I do know it has been very painful. I nursed 4 children (grown now), but my breasts did get large at that time. Other than that, I am a moderate B cup, 5'8" and 138 lbs.
I'll take any advice anyone wants to give me to get through the rest of this process! Exercises, standing on my head, tap dancing - whatever works- lol!
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Wow Kimmie -- 300 cc's in each breast in one sitting? I found 100 ccs painful enough and even with that I was down to 60 cc's at a time pretty quickly. So you have 570 cc's now in each side -- what is the goal? What is the size of your TEs?
Gentle stretching, massage (on the shoulder blade was best for me), and advil was what helped me... but also ABOVE ALL what helped was much smaller fills.
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Thanks Lilah. I am going to ask what size the TE's are when I go next Tuesday. I don't really know what the goal is. PS said, we will know when we "see it". I wouldn't think it would be much more. I'm thinking 75 - 100 at the most. A friend of mine had immed recon at the end of April with some gel implants. She is larger than I am but hers are 750 cc's which she says on her is a large C or small D on her. I would be so content with a moderate C. This is really all still a little Greek for me. I went through chemo treatments which began in Jan. Sad to say, but most of my research previous to now really involved diagnosis, chemo and an action plan. I just thought all I had to do was decide on was BMX and Recon. It's just been a really fast roller coaster, but I'm sure that holds true for most of us.
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Absolutely Kimmie... I think if you reread the info requested at the header post for this thread, once you have all the info gathered Whippetmom will be able to help you. But she does need to know the model #of your TE -- which you can get by asking your doctor.
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Deborah -
I got the information on my TEs. They are Allergan Style FV133, fill volume 400cc. (Which on Allergen's site is width 12 cm, height 12 1/2 cm, projection 5.3 cm The nurse said she sent 400cc, 500cc, and 600cc with to the surgery - I wonder how he decides which to use?
My information: I am 49 and had nipple, skin sparing masectomies on May 6th.
Height 5' 4" Weight 120 pounds Ribcage 31 inches Filled to 230 ccs after 3 fills.
I was a nearly A before and was thinking I would like to be a full B or small C - what do you think?
Thanks for you help -I soooooooo appreciate it.
Hugs, Valerie
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whippetmom wrote:
K - Ohh...I think I want to send you to the top of the class! You are a very good student! LOL! Yes, I think that 650 ccs in Style 20 would be just about ideal for you. You know your skin integrity and I feel quite confident that indeed you could exchange out to this volume of implant, especially based on your 20% overfill status. I think you have to put this number in your PS' head and let him know your convictions about size and volume. If he is "conservative" as you state, he might not be movable to this volume of implant. You need to see where his mind is with this number. I have had some women come to me just this week, disappointed with getting implants with significantly less volume than they had "agreed" upon with their plastic surgeons. I think that he has to feel confident about that 650 number, and this is something you should know prior to going in for the exchange, so that you can know whether you need to manage your expectations. You need to know what number he feels confident with....prior to the exchange.
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just an update for Deborah had exchange today and he used style 20 750cc's
instead of the 650's we had discussed much better than going smaller ..he said I was his first paitent ever who told him what style and size and he wanted to know where I got all my info so now there will be a new lurker..lolNow I have to wait till Wed for the unvailing :-)
thanks again Deborah for all your help to all the lovely ladies here.
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LOL Kw -- a lurker! I love it. Deborah -- you're causing ripples in the world of plastic surgery!
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yeah I think he was a bit befuddled with my talk of SN-N measurments, upper pole ect ect and wanted to find out what info his patient was reading . They only have so much time to spend with each paitent and I know he doesn't discourage being informed just wants to make sure it's not like some of the sites with BAD info.
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Valerie: 500 ccs in a high profile smooth silicone round sounds like a good choice for your frame. I would not go much smaller than that - so I hope he errs on the 500 - 600 cc side of the implant spectrum for you at the time of exchange.
kw26: Thank your PS for me for being so darn cool about making sure you were happy with the size of your implants. I was not expecting 750 ccs...but if they are appropriate for the pockets and look good on your frame, I am very happy. I hope you will email me photos or post them on the pictures forum. Congratulations!
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Just a note..
If there are any rads/implants ladies here.. I wanted to let you know that my rads breast DID drop about 1/4 .. WAHOOOOOOOOOOOOOOOOOOOOOOO
Now the non rads breast is only 1/2 inch or less higher that the rads breast!
Radiated breast with implant almost NEVER drop and fluff.. so this is a small but happy milestone!
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Wahooo Laura!
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Go Laura, go Laura, go Laura!!!!0
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Deborah -
So if my expander holds 400cc and you think I need 500-600cc implants does the PS need to expand to 500cc? or will they fit if expanded to 400cc?
Thanks, Valerie
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Valerie:
It sounds as though your PS intends to overfill your 400 cc TEs. If the nurse ordered 400s, 500s and 600s for the exchange [I presume you meant these were the three sizes of implants he ordered, right??....or were you talking about the size of TEs he was considering prior to surgery???] then he probably does overfill. If you have pretty good skin flaps with expand nicely and stretch out nicely, exchanging to 500 ccs or 550 ccs would be doable, especially if he does overfill.
Clear up that comment you made previously about the nurse ordering 400s, 500s and 600s...
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Deborah -
It was TEs that the nurse sent in 400s, 500s, and 600s for the original surgery. So he put in the 400s. Don't know if I have good skin flaps - was not quite an A cup before surgery, if that is what you mean by flaps. I only have 230ccs in now, next fill next week.
Thanks for your help,
Valerie
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Valerie: I just went back a couple of pages and saw your first post with your vital statistics. So....475 ccs or 500 ccs might be as much as would be feasible then. It all depends on your skin and how well it responds to expansion - and also it depends on your plastic surgeon's willingness to use implants larger than the expanders. Let's see how your expansion proceeds and how well you do with fills. When you get to 400 ccs, let me see your photos and we can discuss this further. I think it is important to communicate to your PS that you would like for him to expand you out as much as your skin can safely tolerate, as you would hope to be able to exchange out to around 475/500 ccs. See what he has to say about this. Find out early on in the process what is in his mind...what his plan is for you....what he is willing to do for you....
Your skin will tell us what is possible. So take the fills slowly...
Deborah
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I had an interesting chat with my PS, which provided some info on sizing of 410 gummy implants. Approaches may be idiosyncratic and vary from PS to PS but this explanation made a lot of sense to me. Unlike regular round implants where the size may be partially dictated by the woman's wishes for size/fullness/projection of the final reconstructed breast, the gummy implant size is a surgical decision. The implant must fit just right in the pocket. The pocket size has been determined by the TE size, which has been derived from the chest measurements and individual body habitus. The implant does not smoosh very much, so if it needs to be crammed in during the insertion process, it will both lose its nice shape ( one of the main reasons for the cohesive gel in the first place), and will also have a change in "feel" and be very hard. Overexpanding during TE stage allows for extra skin and muscle to close nicely over the implant which has a different shape than the TE. Hope this is useful. (So for those awaiting exchange to gummies (me), while losing sleep over your current TE discomfort, don't add to it with muddling about how big you want to be; as you probably don't have much choice!)
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Jerusha -- very interesting! My PS only said she likes to expand by at leat 150 cc's larger than the implant... but did not go into that detail about it (I clearly asked the wrong question
She did say at our last meeting before exchange that she would try her hardest to implant the MX 685 but it would depend on the pocket... which, in light of what you wrote, I now see why she said that. Maybe the fact that you are a doctor makes the surgeon a little more forthcoming? I don't know. I have found with three surgeons now that unless you ask the exactly right question (no matter how nice they are) you don't always get all the answers. Anyway I found that very interesting indeed. My expansion to 850 cc's is clearly the reason why the 685 now sits so nicely in my body (no smooshing ... perfect shape). Thanks! 0 -
jerusha~thats really interesting and explains alot!
after my next (and probably my last) fill,i should be at the 450 mark.Given what Lilah said about her PS liking to do a minimum 150ml overfill,i will be lucky to get my 300'S =(
I think the nearest to it is 290ml and next up is 325ml.Of course,this is without knowing fully what EXACT size/style TE i have in.Will hopefully clarify that next thursday.I want her to go to 500ml with my TE but 450 is a 50% overfill (300ml TE's)so im not sure how safe that is or if she'll even consider it. I can but ask.......I will also ask how many ml's she likes to overfill be in comparison the the implant.
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For what it's worth, Kay, my TE was a 600 ml model and I was filled to 850 ml.
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Kay - my TE's are 400cc and I am expanded to 570cc.
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oops, wasnt done... my TE's :400cc, expanded to 570cc, will probably get 410gm or 445gm MX,possibly 450FX . Lilah had 600ccTE's, expanded to 850cc, with implant of 685gm. Both implant (Lilah) and implant possibilities(me) up 0.5 cm from diam of TE. Seems like about the same formula. Both at same hospital, so maybe an "institution" trend. Kay, I know you are trying to figure this out. (Me too!!!). Hope this helps with the mystery factor.
Lilah, hope you don't mind me re-iterating your stats! I think it helps to see there might be a pattern...
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No problem Jerusha! I will add this relates mainly to the gummies (the differential) as far as I understand it. (Which, Kay, I understand you are looking at but am mentioning this for those ladies who are NOT getting gummies).
Jerusha -- I think you are up this week! Sending good wishes for happy results
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lilah+jerusha~ so neither of you had a 50% overfill then?hmm......
im just trying to work out the % difference betwenn the final TE cc and the gummy weight in grams. I mean,my BS said to get a 500gram implant (gummy) you'd have to fill the TE to 700ml. But do grams and ml's equate to the same size?? So he's looking at reducing the size of the implant by about 45%,compared to what is in the TE?? URGH! my heads mashed with all these figures! I dont even know if im working that out right! so if i het to 450ml in my TE then i can be looking at bout a 250ml implant????????????????
noooooooooooooooooooooo!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Im gonna go cry now.............!!!!!
ahhh haaa!! unless that much reduction is only needed cus the 500grams implant is larger!!! Maybe the reduction will need to be LESS for a smaller implant.Maybe only a 30% reduction??in which case i would be bang on target for the 325gram!! (so long as i get the MX)
oooh i feel better already! **now just to convince my PS......**
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Oh my goodness Kay -- I'm not a math person
My PS said 150 ml larger than gram size (she said gram to ml was equal). So I had 850 ml in TEs and 685 grams. 685 was as large as they come in the MX size or I might have gone larger. I think it entirely depends on the pocket and what the PS sees once they open you up and remove the TE. My PS said she would TRY to use the 685 but there were two smaller ones she also said she would bring in... just in case. I was relieved when I learned she was able to use the 685. So, it seems to me that if you have 450 ml in your TEs you may very likely fit a 300 gram implant into your pocket. If you want to be certain, go for 500 ml. (So yes it makes sense to me that to get a 500 gram you need around 700 ml fill in TE).
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Whippetmom -
I had my TE (unilateral right) put in March 2010 Allergan 133MV-13 - filled to 120 cc at surgery then filled three more times (right now I am 360cc) - I am post radiation. My Ps would like to fill another 60 cc then exchange in August 2010. My rib measurement is 35 inches and I'm 5'8" 155 pounds. I'm fairly happy with how the TE looks now - although a little high, it has filled out the lateral defect well from my mastectomy and I have good cleavage. Can you PM me your email so I can send you my pictures?
Thanks,
Karyn
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whippetmom: Thank you for your response. As you can see by my late response I do not get on the computer as often as I wish. I actually have a 1 year old and a 2 1/2 year old that get 99% of my attention. I appreciate you letting me know the system, and I do agree that it must remain private out of respect for the other women. I will continue to check in on the discussions and hopefully help someone else after my procedure. I am actually scheduled for July 1st, so I'm getting anxious to have my journey moving along. Thank you again for your answer!
Jen
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Jen: Any time you need information, please let me know. You can always PM me as well.
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Thank you whippetmom - I will be in touch! I want to make sure I get any info I can for my exchange (first surgery 7/1/10, so exchange maybe in winter), and girl you know your stuff!!! You should be very proud of helping so many women! I read a lot of your posts on here and am continually amazed at your dedication and knowledge! I send you a big {hug} for all your love and passion for helping others!
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Jen: When you get some free time [like you have any, taking care of kidletts
], let me know where and with whom you will be having your PBMX. I could give you some idea on implant sizing if you send me your vital statistics and ribcage circumference. PM me this information privately.... 0
