BREAST IMPLANT SIZING 101
Comments
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Nutmeg: you need to get Whippetmom's advice, but I just wanted to say that I have the 45's and they look very natural...no round faky, which is just the way I wanted it. My PS chose them because they gave the best projection for a smaller base width which I needed.
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Tangles,
I had my exchange surgery I believe shortly after yours. I'm a unilateral. I'm not happy with mine either. I had my native breast lifted and PS put a mini implant in there. I say mini because it only had 100cc's. I am like you and didn't have infection. I didn't have a hard time with any of my surgeries. I think we should be happy with our end results. Regardless of whether we suffered infection, etc, etc. we still had breast cancer and I feel we deserve to get back to something that would make us feel normal.
So, don't beat yourself up and go for your second opinion and then make an educated choice.
The most difficult part of the reconstruction is expressing what my desirable look would be and have that transfer into whats available and especially since they have to work with my native breast to match things up.
I'm going to see my PS next week to let her know I'm not happy with the results.
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Tangles,
I probably should add that the mastectomy side had the Natrelle 410 anatomical with 740cc put in and it just does not match my native side. I understand that they won't match perfectly no matter what but I would at least like for them to be similar in shape and size. I question am I asking to much?
Any insight from any of you ladies would be helpful. Most important I'm trying to achieve symmetry.
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Nutmeg, Whippetmom will help you determine if the Style 45s are right for your body. I have them and like them very much. They aren't fake looking at all, they feel at bit wider than my natural breasts but as time goes on and they settle in, that is lessening, and they look great in clothes. I like them!
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Thank you dulcigril. I understand his reasoning behind the teardrop shape implant but it would really stink to go from the full c that I am right now with my tes to a medium b. Its almost like a tease to let me live with these, although hard, bigger beautiful ones for two months. How do I get whippetmom's advice?
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Nutmeg, see #3 in the header above. Whippetmom needs that info to give you the appropriate recommendation.
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MNSusan, I put all of that in my first post but I didn't know if I needed to send it directly to her or just post it on here.
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nutmeg: I agree that you would be disappointed with the Sientra implants. I think that the Allergan Style 45 - 500 ccs, would give you approximately what you have now with the TEs - quite possibly a little larger. They will look fine on your frame. The issue is this: Will your PS object, feeling that he might have implant coverage issues because of the projection of the Style 45? He may want to overfill you a bit if so. But I think that you should definitely discuss this with him.
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Gertrude: Why don't you PM me with your height, weight ribcage, implant information and also, I will need for you to email me a photo. I am going to PM you with my email address. I will help you formulate a plan for discussion regarding any revisions with your PS. But you SHOULD have symmetry and in 2013, it is crazy to end up with results which fall outside the criteria for what constitutes symmetry. Symmetry means breasts which appear similar in size, shape and which finds level inframammary fold placement.
Deborah
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Thank you whippetmom I will ask him again if I can go with the Style 45. He said he would need to fill me more for those but he would do it if that was what I wanted to do. I was also hoping a little wider implant might bring them a little closer together.
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Well, for some reason my left expander sprung a leak...AGAIN! Anyway, having surgery tomorrow. Dr mentioned using Sientra HP. Any thoughts on them?
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Hi, I am scheduled for a one step, implant recon on July 31 or at least I have a few more days to to decide if that is what I want (or no recon). There are many complicating factors, previously radiated skin, blood clots and a BMI over 35 are a few. Right now the PS is saying she will put in 800 something... under the muscle and with alloderm. What I am wondering on this board is if that is the right call or am I asking for trouble? Should I be thinking about this gummi bear thing? Today I am practically immobile with indecision so it is 2 in the afternoon and I sit her in my pajamas trying to wrestle this thing out in my head.
Thanks for ANY help you can offer.
Karen
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Mama, I am sorry you are wrestling with this decision. Take a deep breath! Hopefully your ps is upfront about all your risks and has a plan. I know that a radiated breast is a special concern. I would also be concerned about a one step procedure, 800 is a big implant, that's a lot of space and stretch on skin and pec muscle. Consider a second opinion? You want to be comfortable with your decision. Hugs!
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Do your research on the gummies. I have read that so many are disappinted with their size afterwards. My PS Secretary said many of their clients have complained about how much smaller they were then they thought they were going to be after they had the gummies. On the flip side I did NOT choose the gummies and I am smaller than I expected to be with silicone. It is sure a hard choice. I am going back and forth about getting a second opinion myself about maybe doing a revision. Good luck.
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Hi Mamalyon, please refer to header info above. Either post the info directly on this thread or PM Whippetmom directly so she'll get back to you faster since this seems to be time-critical. She needs the exact info to help advise you correctly.
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Mamalyon: You did not say whether you are having a bilateral MX or if only the one breast is involved. If you are a unilateral, it is difficult to state whether 800 ccs - in whatever style - might give you symmetry with the native breasts. But that said, there are some instances where a one-step with Alloderm is the best possible option for reconstruction. If this is so, in your case, then you might as well go for it. I have to say that if your PS can use a 800 cc implant, you must have ample skin to do so, and this is one of the positives which many women do not have when it comes to a one-step. The gummy bear implants which are available now would probably not give you the volume you need and so a 800 cc silicone round would perhaps be better. Your PS is making this determination based on what will work best for you. Do you want to PM me privately and let me know the name of your PS and where you live and perhaps I can give you some further insight into this issue.
Deborah
But that said, if your PS could perform fat graft transfer at the time of MX, this could greatly improve the integrity of the previously irradiated skin. Please discuss this with him.
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Thank you everyone for weighing in and reassuring Mamalyon until I could respond!
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Hi Whippetmom,
I'd love some feedback...Wasnt sure whether to post or send you a PM...
I'm 5' 2" and weigh 167 (unfortunately). I was a DD since kids and D all my life before that. I always felt too big at a D (at that time I weighed about 128) I would have had a reduction but I was afraid of surgery.
Fast forward -- no choice about MX and surgery, so I'm going with implants....
I think I'd like to be a C. I think PS thinks bigger is better because of my weight, which I'm hoping to lose, but who knows...
So, I am 5' 2", 167, rib cage 38.
My expanders are NATRELLE style 133V (133 FV-12) 400cc's
I am over filled at 600 and 680.
I will be getting silicone implants, probably gummy type, maybe tear drop.
How many cc's do you recommend? I feel too big right now, but friends & DH say I'm not...
I'd love any feedback you can give.
Thanks!!!
Dana
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So after TE trouble (infection and 6 weeks on antibiotics) I'm finally coming to the homestretch. I had my last fill last week and now will be on the waiting list for the exchange surgery date.
I have a question about fills. I have a 250cc TE and had last fill to 300cc. The first few days it felt and looked too big to me (family and friends thought it looked great) but now a few days getting used to it, it seems to have "shrunk" a little bit. I am flat on the other side (have not reconstructed that breast yet) so I have to stuff that side with bra inserts and pads to somewhat match my growing side, so I definitely notice a difference. Not much, but enough that I had to remove one layer of padding from the other side to make it match. Is this normal that it goes down a little bit? Could it just have looked a little bigger initially because of swelling from the fill? Or do you think I might be looking at a leak? Would a leak go down faster than that? Ughhh...I'm really starting to hate this!
My other question deals with the exchange to implant part. If I want the final look to be similar in projection to the TE, do I have to have a larger implant than the final TE fill? I'm thinking the answer from reading other posts is yes, but I'm still kind of confused.
I currently have a Mentor CPX3 tall height 250cc style 7300 TE filled to 300cc. PS doesn't think my skin will be able to do much more stretching, so I'm not sure what that means in terms of implant sizing.
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weety - Not sure about the leak concern but I do know that right after a fill I felt huge but then after a few days I didn't feel so big. Not sure if that is what is going on with you but I think what you're experiencing is 'normal.' But if you're concerned that you've sprung a leak, call your PS and let the professionals take a look and give you their opinion.
I also had a 250cc TE. I was filled to 310cc's and received a 325cc implant and I was NOT as big my TE. You are correct that you do need a larger implant than your final fill if you want to achieve that same size. Depending on your size (weight/rib cage circum) ... 50-100cc's more. My skin was stretched to the max and my PS could only manage the 325cc implant even though I wanted to be a bit bigger, my skin wouldn't allow it.
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Thanks, Dawne. If I didn't have the non-reconstructed size that I've been stuffing to compare it to, I would have just thought it was my imagination and the illusion of "getting used to the bigger size that it starts to seem to be the new normal" phenomenon. I KNOW it is smaller because I had to remove stuffing that was there 2 days before.
Hopefully it is just swelling that disappeared.
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I have to agree with dawne, with my last few fills I felt like they were huge and then after a few days they would seem smaller, but if you have any concern about it at all I would go see your PS. Its much better to be safe then sorry!
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Dana: Well, 400 cc implants with a width of 12.0 cm seems pretty narrow for your ribcage. I just cannot envision anatomicals with a width of 12.0 cm being wide enough for you. I suppose a shaped Sientra implant might be more appropriate, but it just seems to me that you need a volume of at least 500 ccs in order to have sufficient projection and a sufficient result, from a proportional standpoint. Do you want to send me photos? If so, PM me for my email address.
Deborah0 -
Weety: I personally think that you would be fine with Dawn'e Hope's size....around 325 ccs, smooth round silicone implants. This should not be difficult, because you have a tall height implant and I think you should have a sufficient skin envelope for nice closure over the implant. Make sure you discuss and get a commitment regarding sizing before the exchange surgery.
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weety I asked this question many times and never really got a great answer. I also asked my PS if I like the 550cc should I get 600 or will the 550 give me the same look as the TE. He said no if you like the 550 go with the 550. SO I did. BIG disappointment. I look much smaller then the 550TE looked. SO if I could do it over with I would have gone larger then what looked good on the TE. I was so afraid of going too large and now I am smaller then the pre cancer size I was.:-(
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Dawne-Hope is right. In order to match the size you are happy with in your TE's, you need to go with an implant that is larger. I had the anatomical shaped TE's & my PS said that they accounted for 75-100 cc's of volume on their own, that make you bigger right off the bat w/o any fills. I was maxed out at 570 in fills & PS used a 655 cc implant; the result is a pretty exact match in terms of size. I took measurements & tried on bras at the end of expansion & then did the same after surgery just to see. Though the look is different w/the implants, the measurements are pretty much the same.
Perhaps various expanders account for different volumes (?) I'm not sure how much weight the round ones would be. But, I had always heard you have to go bigger in implant because the TE's have thicker shells that make them a little bigger. I also read somewhere that with the gummies specifically, you have to go up in the width and projection especially (above the projection of your TE's). I don't know why PS's arent more forthcoming w/this info to patients when women are constantly reiterating that they want to be the same size as their TE's! It seems the gummies are a PS's preference in reconstruction but they should be more honest about the outcome or make the appropriate accomodations to match your TE's, when using them. Maybe because they're still pretty recently FDA approved & some docs simply don't have enough experience w/them yet.
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Whippetmom: I had my last fill (780cc) this past week and I told my PS that I wanted more projection and not the flat hamburger look. I mentioned the 800cc Allergan 45 soft round silicone implant and he told me that with he was afraid with the skin stretching that I would have to sacrifice a little of the size or projection. He said he would need to do a little smaller implant so that I could have projection. He said he could put the 800cc in but that my skin may be so tight that it would flatten it out. He said there would be some drop and fluff, but he couldn't be sure how much. I told him I did not want to sacrifice the projection. I feel that the size I have now is plenty big enough, but I just need more projection. Is he right about this? I'm hearing on here that if you go with the same size as TEs they will look smaller and you have to go larger to get the same size. Now if I want the same size as my TEs are now with more projection will I need a smaller implant, the same size or larrger? I will have one more visit with him before my surgery. Decisions, decisions.
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My first post to share with others but read numerous post prior to my surgery and am grateful for the insight I received. Bilateral mastectomy with immediate reconstruction done on July 17, 2013. I do not have patho report yet but pretty sure that my choice allowed me to bypass further medication and radiation treatment. I was hoping to look very similar to my pre-surgery look which was a 36A. I had the teardrop gummies implanted. My tissue removed weighed 325grams and implants were 370. He plans on doing a little touch up work with fat grafting and I will need nipple reconstruction on one breast. I currently have 4 drains in and swelling has decreased some. I am doing better than I anticipated. I was able to go and watch my sons baseball games this past weekend with naps between games. I am taking painmeds at night to sleep but am able to get through my days without it. Excited to get the drains out and that process should start on Thursday. Thank you to all of the women here supporting other women - heart warming indeed!
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CMD glad you are doing so well. You are a trouper!! I was in bed for a week and then some. After being on these boards I am beginning to think I have a very low pain tolerance!!!!!!!!!!
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CMD: I'm impressed too! There was no way I could have been going to ball games 2 days after surgery! I have a pretty good pain tolerance but even so I struggled off and on with pain problems for a good month after BMX/TE placement and all I had to start with was an initial 100cc in the TE's......you jumped immediately to 370cc implants, yikes!
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