BREAST IMPLANT SIZING 101
Comments
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I saw the PS today for preop visit for exchange 1/3/14. He usually does the gummy anatomicals but did not think they would work well. I asked him what he was going to use and he said style 20 allergans 800cc. I asked about the style 45 and he said he didn't have a problem with that. Thank you Whippetmom for the advice!!! He is going to remove dog ear on right breast On the left side I had radiation and he thinks he may have to give me a drain. The TE sits quite a bit higher than the right.
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Julie, so glad to hear you are home. Rest up girl, then let us know how you are doing.
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Welcome to the squishy side Jtapp! I'm glad it went well for you, keep us posted.
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Jtapp....what a relief it must be to have this behind you! Did he place the size implant that you expected? I hope the pain meds work wonders for you tonight. Get good rest, and keep us posted!
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Hi all,
I'm doing some research for my wife, who had PBM on 11/14. They put in Natrelle TEs, and gave us a device card. However, looking on the card, I don't see which type they used. It says style 133v, but I don't see anything else. There is a big sticker across most of it with her ID info on it and a bar code. I thought about peeling this off to see if the style is below the sticker, but am afraid we might need that sticker at some point (we are flying out of state in Feb). The back of the card has catalog numbers: 18805475 & 18805523. I have googled those numbers and didn't find anything. Am I missing something? Do those catalog numbers mean anything?
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Hi all-I have been reading (lurking) for some time. I had my BMX on 11/14 and my TEs are 600cc (14 diam) (currently at 420cc ea getting 60cc more today each side). Chest measurement is 30-1/2. 5'5, 120ish lbs. Bony chest (can see my ribs). I emailed this and more info to Whippetmom. Would love everyone's 2 cents about exchange sizes.
If I can figure out how to post pics on the other site I will...
Thanks gals!0 -
Observation at 11 days post-exchange: 740 cc's in a TE looks huge...in fact, like stripper boobs. A similar Allergan 410 style FF looks half that size.even though the card says 740 cc. I look tiny now, which is fine with me but a big shock after the half-coconut stuck to my chest for too long. The anatomical shape looks natural and feels like I did at 20. Still amused by the settling they are doing and the tightness that comes and goes, one foob at a time or even one part of a foob at a time. Fascinating to watch. Achy at times but Tylenol chases it away.
No more "gotcha" pain from the pocket work across the bottom of my ribs, thank goodness. Now just sore and uncomfortable there. Upper pole is now aching, maybe from the height of the silicone's anatomical shape vs. the 800 cc saline rounds I had before. Could be it was aching on my upper chest all along but the killer rib pain took all my attention away. All in all, doing ok. Slower recovery than I expected. Can't sleep on my side yet but don't have to sleep in the recliner anymore. Can't carry much, lift a potted plant, or close the sliding glass door...pectoral muscles across my chest seem so sensitive this time. (Again from the height of the 410's??)
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Sandra - glad you're feeling so much better. As for size, I can't speak to the anatomicals, but my PS insisted I wouldn't notice much difference between my 750cc TEs and the 750cc implants. I really don't think he understands the difference in 'fit' between TEs and implants! I mean, he specializes in breast reconstruction, how could he not know this? I'm so glad for this site and Whippetmom's recommendation for me!0 -
Hi all,
First off, let me say this: I realize there aren't too many men (if any) that post on these forums. I realize that some may feel uncomfortable sharing their information with a man. I hope I have not invaded anyone's safe place to discuss these types of subjects with other women. I have spent the past few years over at FORCE and have been fortunate to not have any problems being a male in an all-female discussion. Hopefully I can earn your all's trust as well. I am the type of person that has to have every little detail investigated before I can feel good about a decision. My wife, on the other hand, doesn't have the patience for all that, but (fortunately) trusts me to do the research on her behalf and help her navigate the different options.
So...
They put in style 133MV 400cc, which I assume is the 13cm diameter type. I see that diameter size is quite common on here, and the usual response is a smooth round style 20 at 500cc. I guess we somewhat have the cart before the horse here (since the TEs are already in), but let me share my wife's stats and her goals and see what you guys would recommend.
Height - 5'5"
Weight - 120-130 (before surgery was 130...hasn't weighed since!)
Ribcage -
30"Correction, she is now 31.5". I was using her measurement from about 10 years ago, but she just measured tonight and it has changed. I'm not sure how much of that is due to any swelling she still has from her surgery.She has always been small busted (except while breastfeeding our 2 kids), and worn a 34B or 36A bra, depending on the brand, but never filled up the cups completely (always a gap between her skin and the bra. She has always wanted an extra cup or two, and would wear padded and pushup bras to help fill things out. During the PBM, they removed a little less than 200cc from each breast, and then inserted the TE and filled with 200cc of saline. Since then, we have been back for one fill, where the put in 75cc in each breast. So, right now she is already a little bigger than she is now, but they are much wider in diameter than before.
If you were to ask my wife, she would tell you she wants to be a full B or a small C. I know you guys don't like to talk in cup sizes around here, so let me see if I can translate. She would like to be a size that is not too big, but big enough to make all this worth the pain and trouble. As I have seen termed around here: proportionate to her frame..natural. (Although, I guess "natural" and "proportionate" can be just as vague as cup sizes when you think about it. It seems like the idea of "natural" breast size is a lot bigger than the actual, average breast size.) She doesn't want it to be obvious to the world that she has implants, but she also wants to have something more than she had before. She wants to be able to push them up in certain outfits or dress them down, depending on the occasion.
Her PS is guessing an amount of 400 to 450cc would be where she wants to be, but said it is completely up to her and they will slowly do fills (every 3 weeks) until she is happy with the size.
While I have you guys (hopefully I still do!), let me ask you another question. If, let's say, she gets to 400cc and that is as big as she wants to go, I assume we would have to find an implant that would fill out the 13cm pocket at 400cc? For example, I see the high profile types being suggested more than anything, but at 400cc the style 20 implants are just 11.9cm. This is less than ideal, correct? So much so that it would not be recommended at all, correct? So, she'd have to go with a style 15, which means it would be a flatter implant? So, if she gets to a point where she wants to stop before she reaches 500ccs, she'll have to decide whether she'll be happy with the less projection or just go ahead a get the larger size with the better projection.
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whitenack: Holy cow, you are good! You are figuring this all out quite nicely. I do not mind at all that you are here asking questions on your wife's behalf. Yes, with your wife's vital statistics, tissue expander style and volume, I would recommend Allergan Style 20, 500 ccs. But if she wants a bit more of, what I term an athletic appearance, implants that do not quite project as much might be another option. In this case, it would be 397 ccs in Allergan Style 15. But rather than go to Style 15, if a more natural, not-as-much-projection is preferable, I would suggest looking at Sientra implants instead. The Textured Round High Projection - 495 ccs - has a similar profile as the Style 15 in Allergan and would be a nice option also.
Deborah
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McBeach: I responded to your private message! Sorry for the delay in getting back to you!
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Whippetmom, thanks for your speedy response. I have read almost all of the 311 pages here on the forum and I am in awe of your dedication, as well as your knowledge. Also, your patience.
I don't know if it matters, but we re-measured my wife's ribcage tonight (I was going off old measurements) and it is actually 31.5". Probably not enough of a difference to change your recommendations, but just in case (and for the sake of accuracy), I have edited my original post.
It is funny you mention the "athletic" option. She is a bit of an athlete (played college basketball), and this has been the biggest question mark in this whole journey. Will she be able to be as active as she wants to be (she doesn't play ball anymore but still does the aerobics, etc.) and still be as big as she wants to be? She is obviously familiar to life with smaller breasts, so there is an unknown to trying something bigger. However, I see the common complaint after these surgeries are ladies wishing they had gone bigger. I want my wife to be happy how things turn out since she has gone through the pain and I don't want there to be any thoughts of a missed opportunity or regrets (obviously the number 1 goal is to reduce the risk of cancer, which we have done, so no regrets in that department, but you hopefully know what I mean).
I guess we are struggling with the same thing everyone else has been struggling with. How much projection is enough? I see the difference in projection between a 397cc Style 15 and a 500cc Style 20 is 1cm. Is 1cm enough of a difference to worry about? Then again, 1cm is 25%. Could the flatter Style 15's still be "pushed up" when needed? Could the Style 20's disappear in a modest top (like for church and things)?
I see where you have said that you need another 100cc or so in an implant to match the TE, right? So, if we are currently at 275cc, are we pretty close to what the Style 15 at 397cc would be? If so, I don't think she would be happy going with the Style 15. Yeah, she's happy to be a little bigger than she was before the surgery, but I don't think she's satisfied. If she added another 100cc and started getting closer to 400, my guess is that is where she'd like to start slowing down. At 400cc in these TEs, they have about the same projection as the 500cc Style 20. Would that be a pretty good preview of what the 500cc Style 20s would look like?
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whitenack: I have HP implants...Allergan Style 20, 550 ccs, and I was able to do bootcamp type workouts without any problem. I am on hiatus now because of my rheumatoid arthritis flare...
It sounds as though your wife would be happier with Allergan Style 20, 500 ccs. I advise expanding all the way to 400 ccs and even a bit of overfill, if her skin tolerates and if the PS feels it is necessary to have a little ptosis. I advise filling to capacity, skin tolerance issues permitting, because I have previously described the TEs being like deflated footballs. The deflated football maintains the "footprint" of the football, with the width predetermined. It will increase in height and profile as it is expanded. It is hard to equate your wife's current fill level with a 397 cc implant, although it might be closer at around 350 ccs. The Sientra implant is still a contender, in my book though.
Deborah
Edited to add: Plastic surgeons answer this question....
http://www.realself.com/question/medium-plus-profile-or-high-profile-implants-breast-reconstruction
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Whitenack - I'm about 5'8", 175 lbs, 52 years old and was also a high school athlete (except I weighed just under 120 back then). I have 750cc implants in the Allergan style 20 high profile and I love them. I'm a 36 or 38 bra band, depending on the manufacturer and about a D or sometimes even DD cup. After the 6-week restriction period for both my BMX and the exchange to implants my PS gave me the all clear to do anything and everything I want to in terms of fitness activities. The new girls cause me no problems whatsoever and do not get in the way of anything I want to do physically, from aerobics to running to push-ups and planks and bear crawls and squats and walking lunges and even handstand pushups (if only I were strong enough and didn't have arthritic hands). YOu name it, my group class instructor has had us do it. If your wonderful wife still wants to be an athlete I say go for it!
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Thanks again for the reply. I don't see a 495cc option in the Sientra textured rounds. I see a smooth round option at that size. Is that what you meant? Tell me more about the Sientra option...what is the benefit of this style? Can you talk more about the "more natural" look? Does that mean a more gradual slope from the upper pole? I'm not sure she knows whether she wants a more natural look or not. She doesn't want to look like she has two grapefruits attached to her chest, but she has also said that she has lost some upper pole fullness since breastfeeding and would like to get that back. I'm not sure how that translates to what style she would prefer. If she goes with the more natural look, I assume she could still achieve a fuller upper pole look whenever she wanted to by using different kinds of bras? If so, a more natural look would give her the best of both worlds. However, if the natural implants will pretty much hold their position, even in a pushup bra, she might not be happy that she doesn't have that fullness when she wants it.
Her PS mentioned at the first consultation that she won't be able to place the implants terribly close together due to her physique. Not sure if that means we should prefer a certain style over the other due to this? I assume she was just speaking of how they will naturally sit, and not while in a bra? I assume they could still be, ahem, pushed together to achieve an acceptable level of cleavage if desired?
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For all of those new to the subject of implants, you are wondering what you'll look like after surgery. Please read (or re-read) Whippetmom's header for this thread. There are links to the specifics of each manufacturer's products. Find yours and write down the width, height, and projection of the implant you are getting. Then convert those centimeters to inches - there are plenty of easy converting websites, just Google "centimeters to inches." You many be surprised.
I have Allergan 410 style FF "gummy bear" silicone implants, 740 grams. (F for full height and F for full projection.) You would think that would be a "prominent" implant since it's one of the biggest available. However the projection (how far they stick out) is just shy of two and a half inches. Much less than I thought it would be. Converting grams to ounces, I know each implant weighs a little over one and a half pounds which is the same as my full 740 cc TE weighed although the TE's were huge and looked like stripper boobs. These implants are just the opposite - they look quite natural. My implants are quite wide, a bit over six inches, and very tall - six and a third inches. They are anatomically shaped so they are like a teardrop...they slope down so they project more at the bottom the way a real breast does. Even though they are a lot smaller than I expected, the size is good. It's only been 12 days so the shape is still "fine tuning."
Also from re-reading Whippetmom's header, I found out that it was quite normal to feel so emotional. Tears have been pouring out of me after this surgery. It was months ago when I read that was to be expected and I had forgotten. So everyone - do yourself a favor and re-read the whole header. There is so much great information.
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Thank you S&S! That is good to hear. I think it will be important to her to get back to as normal as possible in terms of what she can and can't do. How does your size compare to before surgery? Were you used to having a larger bust to begin with?
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Hi - I am now five days post exchange with Sientra shaped implants. Thanks VERY much to Whippetmom - so grateful for her time and advice.
It's too early to give a verdict, but I think I'm pleased. Much happier than with the TEs.
Has anyone had an issue with feeling ripples along the side of their implants ? They are not visible, but I can feel them along the center ridges between the two implants (along my cleavage line.)
Thank you,
Emma
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whitenack: The Sientra rounds would hold their shape better than the Allergan silicone rounds. This video is comparing the Allergan 410 anatomical vs. the Allergan smooth silicone rounds, but you get the idea...
http://www.drpfeifer.com/gummy-bear-implants-new-york-city.html
Does your wife have a chest wall issue, such as pectus excavatum or pectus carinatum? This does impact placement and so you might want the more pliable and soft standard silicone round implants.
Yes, Sientra Textured Round Smooth, 495 ccs. The textured rounds in Sientra might be fine also. I honestly do not know much about the "textured" surface of the Sientra implants as compared to the Allergan or Mentor "textured" round implants. I rarely see textured round implants [Allergan or Mentor] used for breast reconstruction. Too much traction rippling.
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emmalou....If you are feeling and not seeing visible rippling, it is just likely that you are feeling the implant through your thin skin. It might be that a shaped implant would be more palpable in the pocket, because it retains its shape in the pocket and does not fill in the "dead space" within the pocket created by the TEs. Don't know if that makes much sense, but I can visualize it....
It likely will all settle though....give it two weeks. I would not much worry about what I feel, as long as everything looks good.
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Whitenack - prior to BMX I was wearing Victoria's Secret bras in a 36D. After exchange to implants my shirts and blouses, etc fit and look very much the same as they did before BMX. The new girls are shaped differently than the originals and obviously feel much firmer than the originals after two pregnancies and 25 years of weight gain and then a dramatic weight loss, but when I'm clothed (even in gym clothes or a swimsuit or pjs) anyone who doesn't know my recent history would never suspect I'd had BMX with reconstruction.
I will say that thanks to this site and Whippetmom's recommendations I was very proactive in communication with my PS about my expectations. He would have used implants about 25% smaller in size than what I insisted upon and I would not have been nearly as pleased.
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Oh, I see. I didn't realize sientra were the gummy bear style. I am familiar with the Allergan 410, but had pretty well written them off as a possibility due to the firm feel, anatomical shape and keeping their vertical shape when laying horizontal. Didn't realize gummies came in round options...just thought they came in anatomicals. Are you recommending them in our case because the ARE firmer, and would not jiggle as much during physical activity?
And sorry for asking again, but we are talking about the smooth right? You said "Sientra Textured Round Smooth". Yeah, I had heard you don't like the textured versions as well, so I'm pretty sure you meant to just say smooth, but want to make sure. I hate assumptions.
She has no chest wall issues that I am aware of. Nothing looks abnormal to my untrained eye. The PS didn't name a condition (that I remember), she just said the new breasts would not be perfect, there are no such thing, and since her natural breasts were far apart her new breasts would also be far apart. She said that is one drawback to keeping her nipples. Otherwise, she could put the implants anywhere on her chest and then just find where the nipples should go.
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OHHH....that was incorrect then. I meant Sientra High Profile Smooth Rounds....not textured.
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Hi Deborah, I finally found out what my TEs are today. I have allergen 500cc, style 133MV 14. We are overfilling a little so I'll be at 550 on January 7. My exchange is scheduled for February 19. He said we will talk about the implants when we get closer to the surgery date. He has mentioned silicone. gummy bears. I guess I'm asking what you'd recommend now? I'm 5'6", 195 lbs and 37" around ribcage. He knows that I want to be smaller than I was. Also he said I might have a little ski slope look when done that he could fix with fat grafting caused by how the BMX was done. I'll decide on that later if it bothers me. Thanks.
Sue
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Smaarty: What do you think of the size you are currently with the TEs?
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I'm at 400cc with today's fill. Not bad, definitely the girls are coming back. More than a good hand full. I can see a cHest now in my clothes, no longer flat. I looked up the measurement and the projection will be about 2-1/2". Seems a little short. Hard to tell. I don't want to be a d cup again. They seem broad across like a football. The underarms bug me the most. He said that probably won't go away even with the implants.
Right now it's 1am, feeling weeping for some stupid reason and can't sleep even though I'm tired. Not really hurting, just a little achy. And I'm worried about the exchange that's 2 months away! I only get one shot at this, so I'm whining, oh well, this will pass. Thanks for any suggestions. He does seem to be open minded about listening to me.
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I can send you a pic tomorrow if you'd like.
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Smaarty - please don't lose sleep worrying about only getting one shot at this.....that's not true. It's very, very common to have a further surgery or two to revise the results of the exchange. Could be fat grafting to fill in 'divots', could be fixing the underarm thing (aka: mud flaps and I'm having that done in 2014), could be another exchange to smaller or larger implants. There are all sorts of things your PS can do after exchange to tweak your results if there's something you're not happy with. That being said, please know that it's also very, very common to be quite emotional leading up to the exchange surgery. You're not alone there, many ladies have posted about being weepy and anxious prior to this surgery.
My personal recommendation would be to work with Whippetmom regarding your expectations for final results (size, projection, etc). She's usually spot on with her recommendation for implant size and style that's best for your physical frame.
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It's also very common to be weepy and emotional AFTER exchange, so be prepared!
It is such a difficult process, emotionally. It takes time to adjust and accept and move on. It's so very helpful to have this community as a support system. A few weeks ago I went back and read some of my earliest posts not long after my diagnosis. It was interesting to see how much I've learned and how similar my emotional journey has been in comparison to what I see others posting each day.
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My exchange is next week and i am so anxious. Also feel a bit upset its all a different feeling cuz this time I feel i just want to get it right and for some reason i worry. I am worry about the drains, the drive home after the surgery, everything i worry. Its very hard not to.
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