BREAST IMPLANT SIZING 101
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Hi I am new to the site and forum and I understand that wippetmom has a lot of experience in this subject.
I am 3 weeks out from skin and nipple sparing double mastectomy. I have TE, 133 MV-13, and according to the Natrelle catalog they are 400cc's. My question/concern is that 400cc's is not going to expand me enough to obtain my goal of being close to my pre-mastectomy size, which was 36DDD but I'm wanting to be at a 36DD. I am 5'6" and about 165lbs. My other question is approx what cc is going to be the closest to my goal. I am very familiar with Natrelle imlants as I spent 2 years ordering them for my hospital breast cancer patients. I am wanting style 20's. I am wanting to get a better handle on the clinical side of the implants. Any input would be greatly appreciated.
Thank you.
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Btrflysnshn: My TEs are 600cc Natrelle's and I'm overfilled to 750cc. I was not at all happy with the size, appearance or projection when I was filled to 600cc so we overfilled. That extra 150cc made all the difference in the world for me. I'm exchanging to 750cc style 20s next week and I expect to be pleased with the results.
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Sweetandspecial: Thank you for your response. So what is your goal size when this is complete? I'm beginning to think that I am nowhere near the right size exanders to obtain my goal.
Did you delay reconstruction or has it taken that long for the expansion? I see it's been almost a year since your DX.
Thank you in advance.
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Wippetmom: Would also like to hear your thoughts on my previous post. Anyone else that would like to comment it would be greatly appreciated.
My fear is that I end up way smaller than I started out and that is not what I want. I would like to be as close to my pre mastectomy size as possible.
Thank you in advance for your input.
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I am not too concerned about the size of your TEs, if you have sufficient skin flaps. I do not know what your PS based the sizing upon, but if you have quite a bit of skin, he probably does not need a large TE to sufficiently expand where he needs to expand for the future implant. I like Allergan Style 20s also. I feel that you need the larger sizes - 700 ccs to 800 ccs. I do not know if you had experience with Allergan Style 45 - it is the ultra full projection style implant - and 800 ccs in this style would probably give you the results you really hope to achieve. You say you wore a 36 band bra, which tells me your ribcage is around 32 inches....33 inches? The TEs alone are not sufficient to get you to this size of implant. It is the fact that you likely have residual skin after BMX which will enable your PS to use an implant with a range of 700 ccs to 800 ccs. Your PS may need to overfill, and then again, perhaps not. Talk to him about size at an early juncture, so that you can make him well aware that ample volume is very important to you. Keep me posted on how you are doing.
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Whippitmom:
Thank you so much for your input. You have given me some peace and confirmation about my situation.
Yes I do have plenty of skin so that makes sense. Yes I am familiar with the 45's and have been going back and forth with them and 20's. You have helped me make it an easy decision.
Yes I will definitely keep you posted. My next appt with my PS is Monday and I now can go with the confidence I need to.
You are such a valuable asset to these women. I hope you know how appreciated you are.
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Btrflysnshn (love the name),
Just wanted you to know that I had short-height TE's with a capacity of 400, overfilled to around 600 and ended up with Style 45's in 800cc's. My rib cage is 31" and my current bra size is 34G. I'm guessing I look like a D or DD.
Keep talking to your PS and keep asking questions. Never assume that you are both thinking the same thing!
Just wanted you to know that it is possible to have implants larger than your TE recommended fill #. I'm sure there are lots of factors that impact how much. Best wishes!!!0 -
Btrflysnshn: 1) I don't have a specific size goal. My main goal is to look as similar as possible (clothed) to what I did before the BMX. I've worn a few sheath dresses this summer that fit me about the same as they did last year so I think I'm pretty much on track. When I do go bra shopping eventually I have no idea what to expect. They say that most of us were probably wearing the wrong size (too small) before mastectomy so I won't be surprised if a professional fitting puts me into a larger band and cup. 2) I didn't delay reconstruction. My BMX/TE placement was on 11-5-12 with 100cc at time of surgery. I started fills two weeks later but had a lot of pain so we backed off on the fill volume. Had to reschedule a fill appointment here and there because of schedule conflicts. Was at 600cc (TE capacity) late January and when I saw PS late February I told him it wasn't enough. I had a St Maarten trip scheduled for mid-March and he wanted to wait until after that to start the overfill (didn't want me miserable for the trip if the overfill caused discomfort). So, late March started overfilling (3x at 50cc each). Last fill was April 11. My PS requires a 3-4 month wait after final fill before he'll do the exchange. My 3 month mark was mid-July but he had two weeks of vacation planned so here we are in early August, which is why I picked my birthday for surgery day. Aside from the initial few weeks after BMX I haven't had any major pain or discomfort so it hasn't been too much of a struggle to be patient. My PS feels that while you can do the exchange too soon to achieve good results you can never do it too late.
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Dolcigirl:
Thank you for sharing your experience. That gives me more encouragement as well.
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Sweetandspecial
Thank you as well for sharing. I am feeling much more comforable about this whole ordeal thanks to all of you. You are all appreciated!!!
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Another overfill checking in. My TEs' capacity was 470 ccs, I was filled to 620ccs, and received 700cc Style 45 implants. Its not unusual at all to be overfilled and have implants that are even larger. I was 36C before BMX, and while I haven't been professionally fitted yet, I expect I'll be 36D or DD. I look about the same in clothes, perhaps a little bit bigger. I'm having no problem fitting into my pre BMX shirts, etc.
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MNSusan
Thank you so much for sharing.0 -
Okay, Ive read number 3 above. What I would like to know is, I have 133mx14 tissue expanders, is there an overfill volume allowance? I understand they have a fill volume of 600ccs, but what is the max that an overfill can be done without the fear of rupture?
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KeKe: Sorry you are bummed! I have the sientra rounds (non-teardrop). I had cleavage from the time I woke up from Exchange...still have great cleavage. My PS said I could sorta push them in and down a few times a day in the beginning to ensure they stay that way/& to help them drop a bit...might or might not help she said...
I'm a full B, so smallish, but I'm tiny petite, but I still have cleavage. I was going to try Natrelles but ONLY if they'd have had the Super-High profiles approved in the U.S. and they didn't/don't yet...
I LOVE LOVE my Sientras! They are def/ soft & squishy...and ya can move 'em--push 'em up in a push-up bra, too. They look great in a bikini, also.
I think the teardrops give you a flatter top on the breast...but I'd still give it time...;) Good luck!
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miamimiami65: I have 600cc expanders and I'm overfilled to 750cc with no problem. PS wa prepared to do another 50cc fill if I had wanted more but I was happy at 750. I don't know if there's a published maximum capacity.
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Sweetandspecial.....thank you so much. Someone told me that they can be overfilled to 850/900. My desire, due to my weight; build and height is to have Natrelle 45 800s implants. My doctor will overfill to lets say 500 (for example only) then put an implant in of 400. He feels it gives the breast the natural drop.
Again, thank you!0 -
Miami: before I reached the 600cc capacity of my TEs I started talking with my PS about my expectations based on much of what I've read here. I told him that my understanding was that the final implant size was usually somewhat larger than the final TE fill volume. He said, no, no, usually you exchange for a somewhat smaller implant. That kinda scared me so I started being really frank with him about my expectations. When I got to 600cc I was just not happy with the size, they seemed much smaller and flatter than my originals. When I dicussed this with him he agreed to overfill but warned me they would be 'hard as rocks' (he was right!).
I am so thankful for this site and these threads that empowered me to ask intelligent questions and feel comfortable being my own advocate with my PS. If I hadn't been, I would have ended up expanded to 600cc and exchanged to 575cc implants and would have been very disappointed. As it is I was expanded to 750cc in moderate profile TEs and will exchange to 750cc high profile implants.
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That last post reminded me of a discussion I had this morning. I attended a cancer survivor's brunch at the local wellness center (which is also where I work out, they've got a great fitness center). I happened to sit next to a teacher I had in high school who had a single mastectomy a couple of years ago and is not happy with her implant results.
She admired my appearance and I gave her the short story on my size (cc) and how I'm over-expanded,etc. When I said I had 600cc expanders but was filled to 750cc she actually said 'How do you know that? How do you know how many ccs you have and what your expanders could hold?' I thought 'uh-oh....omg'. SHE DID NOT TALK AND ASK QUESTIONS OF HER PS!!!!!! She just assumed that because he was the PS and does this for a living that he would know what's best, yada, yada, yada. I'm thinking to myself, OMG Woman! What were you thinking!!!
I know this won't apply to many of you, but ladies, YOU'VE GOT TO TALK TO YOUR PS ABOUT YOUR EXPECTATIONS! H/she cannot read your mind. Ask questions each and every time you see him/her. Remind him/her every time you see him/her of what your expectations are for final results. My PS happens to be pretty conservative in his approach which is why I think a couple of his patients I know came away unhappy (including the one I saw this morning). THEY DIDN'T TALK TO HIM AND ASK QUESTIONS BUT JUST LET HIM DO WHAT HE FELT WAS RIGHT FOR THEM. As I said above, he's conservative......his opinion of what would look good on you isn't necessarily what you think would.
One of these ladies has already had a second exchange with a different PS and the one from this morning is going to be getting a 2nd opinion. If they had only communicated better with their first PS (my PS) they may have come away happier the first time.
My PS probably got sick and tired of my questions, reminders and concerns but you know what? He got on board with me and I'm pretty confident I'm going to end up with the results I've been visualizing, within reason of course. He realized I was doing my research and asking intelligent questions and doing my best to reason things through. He knows I want to understand what the options are and why we're doing what we're doing and why he does things the way he does them as opposed to other practices I've heard about here.
Talk, talk, talk with your PS. If you're not comfortable speaking up for yourself bring someone with you who can help with the dialogue. If your PS doesn't treat your concerns with respect or won't take the time to converse with you, consider finding someone who will.
You've got to live with the results of this process so you've got to do your absolute best on your own behalf. Don't leave it all up to your PS.
Sermon over.......
Love to y'all!!!
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Sweetandspecial
AMEN!!!0 -
Lisa Jayne, what a great job of getting the important message out! Couldn't have said it better my self! You are a wonderful inspiration for others!!
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Miami---I had a TE with a fill of 500cc which is what I was filled to. My PS told me also that he puts in a smaller implant so that I get that natural droop to match the native side. He was thinking around 400cc. Whippetmom suggested I talk to him about bigger, at least 450cc if not 500cc. She thought I'd need the projection from the bigger implant. I asked him to bring a bunch of implants to surgery. Lo and behold, when I woke up, I found out I had a 600cc as well as a 120cc in my native breast. I flipped out thinking I'd look like Dolly Parton (poor Dolly, she's like the bad boob dream!). At my first followup I asked why so much and he said he put in the one he was thinking, 400, and everyone laughed. He put in 450 and still laughter, put in 500 and not so much laughing but he said my body swallowed them. He then put that on hold, lifted the native side, went back to implant and kept putting in bigger till he hit 600 and everyone said perfect. He said my native side then looked sad and depressed so it got 120cc implant for symmetry. And I have to say, he did a damn fine job! And Whippetmom was right! I did need bigger. They are a little bigger than before mx and much perkier and not totally perfect symetrically but in a bra I look like I have 25 year old boobs and I have cleavage for the first time. And I have some pretty good droop as well. Tell him to bring in the whole shooting match into the OR and you should be fine.
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Looking for advice on sizing. I meet with plastic surgeon on Wed. Last I spoke with him he suggested lat flap with TE to implant on the mastectomy side. DIEP is out, since its been done before (DCIS on right side, prophylactic double with immediate DIEP last year followed by reexcision, two lumpectomies, and finally a completion mastectomy on the right side). My left side is a 34B, using sizing info from http://www.justbreastimplants.com/size/ with ribcage measurement of 30, and the remaining breast at 8" along the circumference at the fullest part. I'm 5'8", 135. Breast diameter of the good breast is 12.5-13cm. I think my torso is pretty normal for my size at 15" from belly button to intraclavicular notch. I'm thinking about teardrop silicone cohesive implants, but am open to other options. I have no idea on cc size. I'd like to be a full C or a D when its all over
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Well, I've been gone for a while from this discussion. i had my exchange Dec. 26, 2012 and I'm doing great. But I am needing some fat grafting and this is the portion of bresst reconstruction that my insurance company (Regence BC/BS) won't pay for. even though they paid for it 5 years ago, they just recently said they now consider it "experimental". They won't budge and my only recourse is to write the Medical Director of Regence, the Insurance Department of my state, and to file an appeal on this denial. just wondering if anyone else could weigh in on this. I know it could take more than one fat grafting procedure to get results, so I'm very disappointed at this point. I thought fat grafting was just part of the reconstruction process that is covered under the Womens' Healthcare Act!
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Vik11: I have Oregon Regence BC/BS also. Just had my exchange surgery this past Friday - drains out today maybe! In one of my pre-exchange discussions with my PS I mentioned the possibility of fat grafting at time of exchange, and he said 'insurance does not pay for that'. So I was a bit bummed too, since it seems to be a fairly common requirement. Don't know yet if it will be needed by me in the future, but I would sure be interested in what you find out! Do you think the new healthcare coming in 2014 will change this?
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Rose -- I'm in Salem too. My healthcare insurance agent is a good friend of mine. I've chewed Regence out and plan on filing a complaint with the OID (Oregon Insurance Division). I urge you to do the same. you can go to their website at www.insurance.oregon.gov to get a complaint form. Other than that I can tell you that I believe PacificSource, ODS, and Healthnet pay for fat grafting. Our business renews in Feb. 2014 so will look at switching to one of those carriers then. I'm holding off now because if the first graft doesn't take, the second one will be paid for if within the same year based on my max out of pocket. Interestingly enough, Regence paid for fat grafting five years ago up until very recently! They are now claiming it's experimental! They just don't want to pay and that's pretty low. i did get a cosmetic quote from my PS and it's not bad, but if I have to go for more than one graft, it then gets expensive. I'll talk to my agent friend about 2014 changes, but agents are going through massive training at this point in order to get up to speed on that crummy ObamaCare. It's my understanding nothing is for sure at this time with possible repeals.
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Have any of you needed to lost weight, lower your BMI, before PS would do reconstruction? I need to lose the weight anyway, so I am on board with that. However, I am older and very busty and like my cleavage. PS said I could not have the large breasts I have now, 40DDD, as reconstruction does not include, does not work, at that size. So, after weight loss, I will have smaller reconstruction plus breast reduction. I am feeling doubly grieved. Loss of both familiar breasts in order to do this.
Interestingly, radiation oncologist said the PS said in notes "no reconstruction." I hope that he meant only for now, as that is not what he told me.
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Holly,
It's hard to accept the changes, BUT if you do lose the weight the reconstruction you DO have will look larger. Implants are only approved up to a certain size. My silicone implants are 800cc's, but because my ribcage is small they look HUGE on me. And I have plenty of cleavage. I have 15-20 pounds to lose right now and it is NOT coming off easily!!! Grrr!! But the most important reason for me to lose the weight is that I will be healthier AND my body will produce less estrogen. My cancer was estrogen positive. I do NOT want to help it out at all!
Blessings has an amazing weight loss story. I hope she reads your post and replies. Very inspiring! Meanwhile feel free to join us over in the Wednesday weigh in group. Very supportive accountability. There is also a good Daily Exercise thread. All levels welcome.
If you are unsure of anything in your records call your doctor's office and ask them to clarify. That way you won't be wondering or worrying.0 -
Well, hello girls......I've been home from exchange surgery for a couple of hours now and feel really good. Exchange went marvelously and from what I can see so far (with the mastectomy bra on) they look pretty damn nice! I exchanged from 600cc TEs that were over-expanded to 750cc to Allergan Style 20 high-profile 750cc implants (exactly what Whippetmom recommended, I might add!). A few internal twinges of pain but nothing serious as yet. I think the drain tube sites will be what causes me the most discomfort. They do feel softer but I'm not 'man-handling' them too much just yet
lol!So......YAY!!!!!!! I've been so patient with this whole process and not obsessing about getting to the 'finish' line, I can't believe I'm actually here
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Sweet and Special, so happy to hear! Now, just rest up and relax.
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Congrats Lisa Jayne! Rest and relax now,
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