BREAST IMPLANT SIZING 101
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cmharris- Lilah's right. It all kinda depends on the state of your natural breast. Mine were sort of perky, so I think I have an ok, but not perfect match to my natural breast with the Sientra oval based anatomical after revision surgery. I had an Allergan smooth round of almost the same volume prior to that and it just didn't have enough natural looking slope to match well to the non recon side. Too much upper pole fullness, too much rippling and distortion. It also seemed flatter and was such a different shape, it never had a hope of looking right.
The Sientra is better in this regard, but it is still slightly perkier and has a little more upper pole fullness than the natural side. In a bra, you can't tell a difference. Naked, you can. The implant has settled a little since surgery 12/17/12 and has become more like the untouched side. Wish it drooped more but I don't think that's ever going to happen. Trying to lose weight I've gained since all the surgeries and will make a final determination whether anything should be done to the 'good' side in October when hopefully I'm at my goal weight.
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I began this journey in March with TE's placed after my BMX. I have allergan 550 TE's. I am still doing chemo so for now we are filling. I ancitipate my surgery to be late this fall. I am trying to gather as much info as I can so that I am prepared when the time comes. I have a great ps who I trust but I want to be able to help make decisions. I am just curious about the pictures people mention, I would really like to see the "finished product". Can't wait until I can say I am finished.
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WHIPPETMOM- Curious what you think, going for bmx today, PS will be placing allergan 450cc or 550cc TEs today, I'm 5'4", 135 lbs give or take and 34" around ribcage
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cateyz2: Well, I am a bit late to the party here....I think you should have the implants which are most appropriate for your frame and which correspond to your TEs. In a perfect world, I would say 550 ccs....
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Michelle: Contact Lilah or nowheregirl for information about the pictures forum.
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35smiling: You will get through this. You have been through a tough surgery! Hoping you keep us posted on how you are doing.
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cmharris: I have a link to Sientra in the thread header. But Sientra implants are not exclusively for breast reconstruction. A good choice for you though, if you can find a size that works. My concern is that they are lacking in larger volume ranges.
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Rose: You need to go with an implant at least 13.0 cm in width.
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Whippetmom,
I will be getting a prophylactic mastectomy and reconstruction hopefully in the next few months after my surgeon and genetic counsellor advised that I am at very high risk of aggressive breast cancer.
Now, naturally I am a very busty girl - I am 5"10" and currently have a 30" inch ribcage but about 44" inch bust. I am fairly deeply ingrained into the plus bust sizes. As I'm naturally hourglassy with wide hips etc too I am hoping to reconstruct to a size that reflects my natural proportions.
I've been perusing the forums for days and am getting thoroughly confused - can you suggest the best options? I've read 800cc being described as a B cup in one thread and a DD in another, and I'm not sure about composite options (initially I was just looking at implants)?
I feel very vain asking, but I figure since I am doing this I might as well get the best breast implants and advice I can.
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Kaidella,
I'm so sorry you've been faced with this decision. It takes courage to face what you are facing!!! Hang in there!!
Whippetmom will have awesome advice for you. I'll just tell you my experience.
5'6", 31" ribcage. Was maybe a small C naturally.
I have Allergan Style 45 silicone implants in 800cc's.
I am wearing a 34G bra now. I look like a good full D.
I would think with your tiny ribcage you will be able to find something appropriate to keep your lovely curves. :-)
The reason that you see discrepancies is that an 800cc on a 30" ribcage will look different than an 800 on a 35, 36, 37, etc ribcage. Bra sizing also changes. For example, if you right now are wearing something like a 32H...but tried on the same style bra in a larger band the cup size would go down. Sounds confusing, but read some in the bra thread and it may click.
Now I will shush and let the experts talk.
Just be encouraged... ;-)0 -
I had a UMX and was originally planning on DIEP reconstruction surgery. But, ive since decided that im not up for a big surgery which will put me out of commission for a few months. So, implant it is. Question - is it possible to get a "good matching set" when youve had a UMX? Also, how do you keep symmetry during the TE phase?
Thanks in advance!
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Mardibra: I, too had a uni mx and DIEP is out of question. I have had my TE for 5 years (long story). I am naturally a 34C, 5'7" 125-130lbs. I had few to no no problems with symmetry as long as I was dressed. It is impossible to have symmetry with a TE and a natural breast when you are naked. Dressed - for me, initially, I had TE before rads and tops that had constructed bras and regular bras worked fine. In fact, I even wore sports bras and still looked ok. Even though my replacement TE was not as filled as the first, I still didn't need to pad the natural breast to achieve a natural look. I did add a little padding occasionally to the TE to round out the front (it lays kinda flat). After radiation the story changed. The TE rose up on my chest enough to no longer look ok with just a bra and padding ot round out the TE. Also my PS overfilled the TE for a few months so that they were no longer similar in size. Some of the overfilling was to stretch skin to allow for some natural sag for the recon.
To achieve symmetry after rads, I have had to wear push up bras and add padding under the natural breast to give them the same height. The push up pads do not affect the TE because it is high enough to not be affected. They do give some substance below the TE so that I don't look like my breasts are pushed up under my chin. Unfortunately the TE now makes my natural breast look flat. THis requires padding with enhancements under and off to the side of my natural breast. And yes, I have had some issue with shifting enhancements. So far in 5 years, I have never had one peek out in a low cut blouse, but they have come close. Because they have when I wore other types of blouses, maybe it is because I am more diligent checking to make sure nothing has moved.
Because a lot of people do not understand recon unless they have had it or someone close has, I have had some people stare at me disbelieving and swear that I was lying about having MX or not having recon. Yep, true .. true.. Had one person try to tell me that I just didn't understand diff between lumpectomy and MX .. LOL
I am nto sure whenI will get my recon scheduled, but I, too am concerned about implant symmetry with a natural breast. However, to be painfullly honest, I am so adamant abotu saving the one breast that I have left, I can settle for a little assymmetry. It helped to have the assymetrical TE all these years. LMAO
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Hi Mardibra (love your screen name!). Yes- you can get good symmetry. I have a mentor medium profile 500 which really matches my untouched breast well in size. I am happy with it.
As for the lopsided TE phase, I just got through that- it ws a challenge! I got fitted for a bra and swimsuit top that both fit the TE well and then we put a pushup pad under my other breast to match.
I was bodacious during that phase for sure, the TE just seemed crazy big. My Husband loved it. But now I'm really glad I am back to being "regular-sized me (C cup, and he is still happy)"!
Good luck0 -
I haven't been on this forum in a while! I kind of gave up trying to decide what implant sizes I wanted and just trusted my PS, and I'm very happy with the results. I had umx and my te was filled to 350. My replacement for that was a 340 silicone high profile, and he put a 180 low profile silicone in my left for symmetry. Both natrelle. I look very symmetrical and surprisingly natural. Aside from the fact that I'm missing a nipple on one side you can barely tell that they're fake. And I just had my exchange a week ago (on the 23rd), so I'm looking forward to improvements as they settle. The only disappointment is I wish I had more cleavage, and I can't push my breasts together very much.
Mardibra: for the interim period with my huge expander (which wasn't that huge but was bigger than my native breast and looked pretty big on my small frame) I lived in genie bras and I just put a pad on the native side to match. I got a cheap set from target, it worked for me. Good luck everyone and happy healing to those post surgery!0 -
Mardibra,
Welcome! I have a little different experience than most. I had UMX back in '96 with no recon. I had the 2nd mx back in Oct. Initially, only 100 cc's difference, but both sides nowhere matching, not even in a bra. My insurance covered front close hook & eye bras, but they also covered what I call mini-prothesis: like a little "cutlet" that came in a pouch with fiber-fill that I could adjust during expansion phase. Glad I didn't have to pay anything for these because I needed the cutlet for only a short time, but still use the front close bras now (around the house and very comfy for night/sleeping) - much more comfy than the adjustable-strap surgical bra I had after exchange. Hopefully that can work for you too.0 -
Great to hear that everyone has been able to handle the asymmetry with little disruption/inconvience. Im hoping I will have the same experience. Im taking the summer off an then going to the PS in September.
One more question....how long did it take for each of you to get to the maximum TE fill amount? I hae no clue if its a 4 week process or 4 month process!
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Mardibra, I would think it depends on how much you start with and what the desired results are. For me, I have mx on Halloween (great day for that!) with 250 cc in recent side and 150 cc on previous mx, started fills 12/10, last fill to 720 cc's on 2/21. My PS waits 2 months after fills and had exchange on 4/19 to Mentor 750's. All PS's have different ideas about how much max each fill and wait time between last fill and exchange. I'd ask at next appt. Others will have different experiences. Hope this helps.
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kaidella:
You need to communicate to your PS your desires regarding sizing. I personally think that you want a width of around 13.0 to 14.0 cm with your TEs, and ultimately, implants that maintain that same width and have a significant amount of projection. I feel that Allergan's MX style or SX style of TEs would be a good option, but it depends on your chest wall characteristics, current breast base width, etc.
A couple of questions:
1. Are you large breasted as a result of cosmetic enhancements, i.e., augmentation, or are they au naturale? This makes a huge difference in terms of TE expansion.
2. Did you communicate your sizing desires to your PS and did you interview at least two, if not three plastic surgeons?
Now, referable to your question about how 800 ccs could be different on one woman vs. another:
From the thread header above:
There are so many factors which determine how implants will look on any one individual, e.g., your ribcage circumference, whether your chest wall is bony or if you have a fair amount of adipose tissue surrounding the chest wall.... if you have any ribcage deformities or other structural issues which might impact implant placement. We can sort of "project" where you might want to be...or estimate the implant volume which you could "aim" for - so that you can sort of look at the prize ahead of you. .
BREAST IMPLANT SIZING IS SPECIFIC TO YOUR VITAL STATISTICS
Implants of a specific volume will look different on A 5'10" 176 pound woman with a 35 inch ribcage, than they will someone who is 5'3" tall, weighs 110 pounds and has a 29 inch ribcage. So height, weight, ribcage circumference, body habitus - all of these things come into play when determining what style and volume of implant will best fit someone's frame
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Dulcigirl said it well kaidella....
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Thank you to the "uni-gals" for answering Mardibra's questions....
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Thank you ladies! I'm hoping to get this process started in Sept and be done by next spring. Crossing my fingers!
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Mardibra--The lifesaver for me were the kind of bras that 2ndtimearound is talking about. I got mine from the breast center where they have the shop that sells wigs and prosthesis. Insurance usually pays for this stuff. I got the type that hooks in the front and has pockets for the "chicken cutlets" or any other type padding. Six months after MX and I'm still wearing them because they are the only comfortable bras I can wear for any length of time. I actuall wear them 24/7 because I need the compression to help with residual pain. I used the cutlet on the TE side even though it was the bigger side because it actually gave me the droop I needed to help match my native breast. The woman that runs it knows exactly how to make you match, or at least she should. I cried all the time about my asymetrical boobs till I saw her and she got me all set up. At exchange I got a 600cc high profile Mentor in place of the 500cc TE and I got a 120cc added to the native side with a life for symmetry. Thought they wouldn't match at first but now 10 weeks out they are almost perfect. I do feel the implant is just a little too big for me. It seems to be a smidge over under my arm but my PS assures me it's actually smaller than native side and I just have to get used to it. My oncologist explained it a little better....he said it's like when you get a filling and have novacaine. You feel like your lip is huge but look in the mirror and it's not. He says it's the same with the MX foob. I have so much numbness not only the foob itself but under my arm that I THINK it's oversized. He said as my feeling returns, I won't think it's too big. We'll see!!
And Ashell, I was very disappointed with my lack of cleavage after exchange surgery but am now finding that I have more than I thought. I think what is helping is that I do quite a bit of massage to soften them up and I push them together and hold for 30 seconds a couple of times a day. (I play with my boobs quite a bit these days!!) The massaging helps soften them which I feel makes them droop a bit better thus matching better. Now keep in mind, this is just my opinion and it's not scientific!! I also massage my scars as well as my breasts each day with Palmers Cocoa Butter. My implant is already quite soft!
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Oh, Lilah: Thank you for bringing up a really important point: post-exchange depression.
This is generally a happy thread, as we’re all looking forward to getting our New Girls. With everything we’ve been through, it’s not too much to ask for just a LITTLE perfection, is it?
We happily look forward to just one more surgery – that last one – that will give us back the bodies that cancer took away.
But often, the results of our exchange are not exactly what we had anticipated. Add to that the uncaring remarks of the “I’m done here” PS, and the effects can be quite devastating.
Ladies – for most of you, your exchange will be WAY simpler and WAY less painful than your MX. Most of you will be thrilled and relieved, not only with the immediate relief of TE pain, but with a beautiful outcome.
Just understand that sometimes, satisfaction with our exchange results takes time and patience.
I’d been on the forum for quite some time before exchange. I’d written whippetmom in this thread regularly and bugged her endlessly until she helped me understand exactly what I was facing with my exchange. (I had some unusual complications.) I knew very well that what I would see in the mirror immediately after exchange was not what I would see as time went by.
But still – when the bandages were removed for the first time, I wanted to cry. I just wanted that tiny bit of perfection, and I didn’t get it. And my PS didn’t get it, either. His response? “What is it that you want? I think they look really good!”
He had placed the same exact implants that whippetmom recommended. He did the same intricate pocket work procedures that she recommended. It should have been perfect, and it wasn’t.
I chose to hang in there, though. I chose to have faith that things would work out one way or another.
What it took for me was 1) finding a myofascial therapist to work on the significant asymmetry; and 2) giving it time. Five long months after exchange, I finally found the symmetry and natural look that I had hoped for. And most importantly, I found acceptance. They were no longer my Foobs, they were my New Girls.
Other women choose to get a second opinion, or a revision. Generally, if you have been reading this thread, and seeking input from whippetmom, and have a PS who is willing to work with you, your chances of a wonderful outcome are very good.
But please – if immediately after exchange, they are not what you hoped for, do not be discouraged! Many changes will be taking place in the days, weeks, and months down the road. If you take pictures, your photojournal can help document those changes. And if necessary, revisions are possible.
Personally, I would have been lost without whippetmom’s guidance and support. It is the knowledge and compassion of women like her (and all of you!) that makes getting through this possible.
Have faith.
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Blessings.....so blessed to see you posting here!
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Blessings, you couldn't have said it any better! Thanks!
What i would add is this: I read somewhere (was it this thread?) that emotions after exchange can be compared to postpartum blues. After all the time and pain prior to exchange, it leaves a lot of physical, mental, and emotional changes. Another perspective of the reality of bc. Wanting to over this part so quickly but it just takes time and patience. And for me, at times, I'm tired of being tired and patient. I want this stage over with so I can somewhat return to my life prior to bc. For me, that totally won't be the case as I lost my job during this (which actually isn't a bad thing but have no idea what's coming next). Another thing, I feel that I haven't had a lot of control during this whole process (lots of choices and decisions but not as much control over my life) and seek to regain that. I have been so grateful for all the support, experience, strength, hope and friendship along this journey! That has made it so much easier this time around0 -
Lala: Thank you for the tip, I will definitely try that! I have done the whole push my breasts together thing but my mom was concerned that I would mess up my implants doing that.
Blessings: Thank you as well, you said it perfectly. Even though I am mostly happy with my results and so releived to be rid of the expander, I found myself crying the other day out of nowhere. It was just the culmination of everything I've been going through the last 7 months.
I posted on the picture forum as well if anyone's intersted in seeing.
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Mardibra: I had my TE placed and filled at the same time as my mx. It was painful, but was nice to wake up to the same size I had. Unfortunately , that TE failed and was replaced. The next one was not filled to maxx and took about 6 weeks to fill. Some weeks I had more fill than others due to healing, pain, doc pref, my preferences, etc. Then I had my rads and the rest of my chemo. Since then, my recon has been delayed numerous times for a variety of reasons. My 1st PS started playing around with size. He kept trying to talk me into enhancement and going larger. Each time he insisted that I need more fill, I tried to talk him out of it. I finally found a new PS. I hope he is as great technically as the first, but at least he listens to me regarding size and my native boob.
C
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blessings! so happy to hear from you. I've been wondering how you are.
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2nd Time -- I'm pretty sure you heard that 'post partum' comparison from me
I've been saying that for 3 years now (since I had my exchange)!Blessings -- sorry you had such a journey/ordeal but glad to hear from you and glad that you are happier now.
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whippetmom Can you tell me if the TE are suppose to HURT LIKE HELL when they are overfilled?? I had my final fill 10 days ago and the pain is not letting up. I feel like I have had pain the entire time with the TE while I hear others have no issues with them. Could the TE be too large for my frame?? I can take pain meds but we all know with that there are side effects to deal with and not sure whats worse, the TE pain or the side effects of pain pills!! Some afternoons I just lay in bed and cry it feels like I just had my mastectomy!! Have any of you other gals experienced this much pain with the TE?? I see no sign of any infection or anything like that. I guess I am going to just have to suck it up and deal with it until June 25th
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