BREAST IMPLANT SIZING 101
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S&S - Right, but I was asking how TE's look in clothing compared to implants. Do TE's sit in a bra differently than implants?
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Thanks Dulcigirl. Were your TE's overfilled? DW's TE's are still somewhat soft and seem to sit on her chest naturally, but she isn't filled completely yet. She has 350cc in 400cc TE's.
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whitenack...yes, they absolutely sit differently.
And yes, mine were overfilled by 200-250 cc's.
At exchange my PS created an IMF (the fold that happens beneath a natural breast). That helps the recon breast hang a bit more naturally than the TE...which were more like a couple of bowls under skin.
Personally, I agree with the 100 cc difference between TE's and implants.
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I am about 6 weeks post exchange and doing well. The surgery went fine and recovery was easy except for a reaction to the antibiotic. I had 4 surgeries in four months (lumpectomy, reexcision, bilateral mastectomy, implant exchange) and I promised myself no matter the result, I'd not subject myself to another surgery. I fully understand that breasts are not perfect before or after reconstruction. And I mainly want to look good in clothes, so I don't care about rippling, step offs, or other slight imperfections. However, I am nonetheless disappointed with my result. Throughout this process I reiterated over and over that I wanted to be smaller. I always felt too large for my frame. I'm 5'2" and 122lbs and was a 30 or 32DDD before.. Needless to say that's a near impossible bra size to find. I am now the same size or larger, without the benefit of real working breasts. I have 500cc Natrelle style 20 implants. This is actually what whippetmom recommended based on my tissue expander size etc. I only had my 550cc expander filled to about 350cc, but it seems to me everything is based on the width of the expander and consquently pocket. It seems I was doomed to a 500cc implant because of the size of the pocket. I just feel upset that it seems no one listened to me. Should the PS have done something to the pocket to accommodate a smaller implant? Should he have put a smaller expander in to begin with? I don't think I'll do anything about it because I really don't want another surgery, and I assume it would be elective (and thus expensive) anyway because there is nothing wrong as is. They are soft and look fine. I just wish they were smaller. Sorry so long. I guess I just need to vent.
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whitenack - don't waste money buying bras for the TEs. They are definitely different - both nude & under clothes. Just go to someplace like WalMart and get something like Danskin sports bras for the interim.
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Thanks MinusTwo. We weren't looking to buy anything, just wondering how things would look under clothing compared to her size now.
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Imadancer Id think you can insist on having smaller ones put in. Tho I know you said you dont want more surgery.
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Imadancer--I can understand how you feel too large and are upset that the PS did not listen to your desires. I too was large prior to BMX and wore a 40D bra, nursed two kids, and was saggy. I am 5' 1" and currently 143 pounds but was around 160 pounds at time of BMX. I also told PS that I wanted to be smaller and he said that I "had to be a certain size to look right." I reiterated to him that I understood what he was saying but that I still wanted to be smaller. Nonetheless, he put in 650 TE's which were 13cm wide and from what Whippetmom has told me, that pretty much dictated that I needed implants that were at least that wide. I only was filled to 450/460 prior to my exchange and told the PS that the size was okay but they were too wide and I would be happy with smaller too. PS gave me 500cc Mentor High Profile Silicone Rounds during the exchange which made me about the same size that I was with the TE's. Since I weigh more than you but am close to your height, I can totally understand how 500cc implants feel too large on you. I am not thrilled with the wideness of these implants and still have the "iron bra" sensation even though it has been six months since my exchange
At my 3-month post-exchange follow-up with the PS, I expressed my concerns and he said that maybe he could put in smaller implants (I wanted to say "duh--I told you that's what I wanted from the start!") but he wanted me to wait another five months and return to him in March which will be 8 months post-exchange. I consulted with two other PS; one of whom really didn't want to step into another PS's work which I can totally understand. The other second opinion PS said that she wouldn't consider operating on me until 1 year from the exchange because she feels it takes that long for a woman to adjust to the new foobs and for the foobs to really "settle." I really don't want more surgery either but there are days when I feel I would be more comfortable being flat! They look fine in clothes but I also wish they were less wide.
Part of me is grateful that I am cancer free and that I can put on clothes and no one who doesn't know me would not know that I had a BMX, but part of me wants to be comfortable with my body. I also feel that my PS should have done something to the pockets at the time of the exchange to narrow the pockets especially since lefty drifts too far left and now I have a divot at the top near the center (cleavage area) on the left. My PS did recommend fat grafting but I don't feel I want to invade another part of my body--cancer has already taken too much of my body away from me. The second opinion PS told me that she is not a fan of fat grafting; she thinks I really require a lateral capsuloraphy and a release of some of the pectoralis muscle on the left near the center which will bring lefty a little more toward the center and address my divot. I do believe that it is the law in the U.S. that our our insurance companies must cover any revisions necessary post-mastectomy. I have not had any issues with my insurance thus far so I feel I am lucky in that respect.
Please do not settle if you are not happy! Give yourself some time, do lots of research, ask lots of questions, maybe get a couple of second opinions, give yourself some more time, and then do what you feel is right for YOU.
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LoriWNY - My situation was very similar to yours, but fortunately, I had whippetmom's intervention in between TEs and implants.
I was about 60 pounds overweight at the time of my BMX, and had no plans to lose weight. So the PS put in Inamed 133-MV16 TEs... they were 16 cm wide!!!
Fortunately, after my MO convinced me to lose weight, I started corresponding with whippetmom. She is the one who told me to stop my fills at 650ccs, pushed for smaller implants, and a lateral capsulorraphy. At first the PS said he doesn't like to do those, as they can cause complications. But with my 700cc saline implants at 14.4 cm wide, he had to do a LOT of pocket work at Exchange.
The bad news was, it hurt a lot, for a long time. The good news was, my New Girls never migrate under my armpits when I lay on my side.
Anyone who is still having that vice-grip sensation months after Exchange (I did - I never, EVER got that "ahhhhhhh- relief!" sensation with my TEs out) should really consider either physical therapy, or if you have it available in your area, Myofascial Release Massage Therapy.
MFR breaks up scar tissue, stretches out fibrosis and knotted up fascia that have the effect of shrink-wrapping your muscles and causing horrible pain. It's non-invasive, can often work wonders, and is worth a try.
Lori - your last paragraph says it all.
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Whitenack,
There really is no comparison between a TE and an implant, in my experience. The TE's won't help you figure out how you're going to look after the exchange. Sorry, you just have to wait. I had one TE and an implant on the other side so I can give you a good comparison. It was SO obvious in clothes even though they were virtually the same in cc size. As others have said, they don't sit in the same place on your chest and are not shaped the same. (Thank goodness.) A full TE looks nothing like a breast...unless you have weird hooker boobs.
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Blessings, you said it perfectly. No "ahhh" of relief for me either, but I'm only 4 weeks out from the exchange. In my experience, the revised pocket work at the time of exchange caused the intense pain I had up until very recently. It really feels like the PS picked up a baseball bat at the end of the exchange and let me have it across the lower ribs. If people can settle on the kind and size of implants they want before the TE's are put in, there won't need to be any pocket revisions later. My 800 cc silicone rounds had to be changed to a little smaller but taller gummies due to an infection that caused me to lose one implant and not be able to accommodate the same one at exchange. I'm not sorry I have these new kind of implants, they cover up my upper pole divots, but could have done without nearly a month of miserable pain from the revised pocket work.
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Blessings--Thank you the info. I did do several PT sessions which helped immensely mostly with right arm issues (cord-like sensation from elbow to armpit) since the ALND but it did not give me any relief from "iron bra." I continue to do the PT exercises at home nightly and have been receiving weekly Graston massage therapy for my arm for a few months now. I have seen much improvement with the arm issues since starting Graston. During the last two Graston sessions, the therapist started working in the armpit and the pectoralis mucscle (upper breast) area on one side. I am starting to get a little bit of relief from "iron bra" and hope that it continues. I have tried to find a myofascial release therapist in my area who will work on the breasts but have been unable to find someone. I even asked my regular massage therapist and she told me that she did not do "breast massage" nor did she know anyone in the area who did, however, she will concentrate on my upper chest (above the foobs) during my monthly massage appointment.
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Lori, Google myofacial release therapy plus your city and see what comes up. You may have to travel a bit but it will be worth it.
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Thanks LoriWNY. I agree that the implants are way too wide, but it seems that's a problem everyone complains of. My PS never said I had to be bigger or a certain size, so I assumed I'd be able to get what I want if I just stopped the filling process early (which I did - I was filled halfway at BMX and had one fill 3wks later of 125cc). I did not understand until it was too late that everything is based on width not CCs. So what I'm gathering is that he could have adjusted the pocket for a smaller implant at the time of exchange, but it would have been a much more in depth surgery. And I guess that would be the case if I wanted a revision now. I'm just not sure I can put myself through that for cosmetic reasons. But then I think about the fact that I'm stuck with these for 10-20 yrs and get frustrated. I know insurance has to cover all stages of reconstruction, I just wasn't sure if it counted when there are really no problems other than I don't like being so big. Anyway, if anyone can learn anything from this, it's you have to know what you want before you get the expander and insist on it. And look at the width not CCs when considering sizing. I asked a million questions and did a lot of research trying to get at this information, but didn't understand everything until too late. The nurses kept telling me I didn't need to overwhelm myself with information about implants at the first consultation because I wouldn't be getting them for so long. But clearly I was right to worry. I just didn't ask the right questions or get at the right answers. Oh well. I go back to the PS in March. I don't think it would help to bring it up before then. I'll definitely talk to him if only to get my frustration out and hopefully help future patients. He really does seem to want to make me happy, but I guess there was a disconnect. I think part of the problem is most women want to be the same or bigger, so they're not used to people like me!
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imadancer: I think most of us are so focused on just getting the dam$ cancer out with the mastectomies that we don't ask about TE's in time to make a choice. I know that was true w/me. So no matter what I told my PS about wanting to be SMALL, even 6 months later at exchange I still didn't really understand the concept that HIS original choice of TE size set the stage. While I love the cleavage and the shape, and they look fine under clothes, I was seriously considering a re-do before my BC recurrence. Now I've lost 60 lbs due to chemo that I didn't really need to lose - and I wish even more that I were smaller.
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I never tried on a bra while I had TEs. They do not "mold" into the cups of a bra. If you like where DW is now, you need 475 ccs or 500 ccs in a HP style silicone implant.
I agree with what Sandra said above.....
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I currently have TE's filled to about 430 cc. Initially, I was obsessed with the idea that I needed a bra....not for support, but just that I needed one somehow (old habits die hard?). I ended up wearing non-supportive nursing sleep bras so that I would feel like I was wearing one. It was silly....it is so much nicer to NOT wear a bra! Wearing a sports bra seems kind of bizarre to me. When I was wearing the post-surgical cami, it was too tight, and it was torturous for me. It caused 90% of the pain I experienced, I assume because it was pushing on those hard TE's and jamming them into my rib cage and whatever soft tissue is there. TE's are very uncomfortable, but when I had that "compression-like" thing on, it was horrible. I had an "ahhhhh" moment when I took it off. Wearing a bra on TEs is like wearing a bra on my elbow...kind of useless and bizarre, and it just doesn't fit. There's no bra that is going to do anything to these TE's except maybe cause me pain from them! Just my opinion!
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at the most I wore cami's with the TE's.
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When I had the TEs I felt I had to wear something. Partly out of habit and partly to help cover up the nips (I had NS BMX and they liked to stay alert). I found an amazing bra/cami and they are one size fits most so as I expanded I could still wear the same one. I think I read about it in a workout magazine and thought what the heck, glad I did! Check it out - the Coobie bra:: http://shopcoobie.com/ - many styles & colors to choose from.
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That Coobie bra looks identical to the bras I was wearing with my TEs but mine were No Boundaries brand ($4.97 at walmart).
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MinusTwo- I'm so sorry about your recurrence and chemo. I've been so lucky to not have to go through anything more than surgery. I am thankful for that. I guess if having too big breasts is my worst problem, I'll survive! ;-) Just hope I can educate others that the tissue expander size determines everything.
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SweetandSpecial - I paid $60 for 2 Coobie bras and padded inserts at the Faith and Hope shop. I wore them over the holidays and not one time since then. That's about $15 for each time I wore a bra. Feel free to smack me.
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I got a ton of Genie bras after my BMX. They worked with my ever-increasing TEs, and worked after my Exchange when I wasn't cleared to wear an underwire yet.
Now, two years out (underwire no longer "required") I'm STILL wearing them!
Sure got my money out of those bras.... LOL
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Me too, Blessings!
Got my Genies at Bed, Bath &Beyond with a 20% off coupon, so probably around $5 each. I wore them during TEs with the foam thingies to help smooth things out. Now I wear them while riding my exercise bike. They are great sweat absorbers.
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That's it. Where are my Bed, Bath and Beyond coupons?
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WW - don't fret, just add it to the 'lessons learned' file!
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Whippetmom,
Thanks so much for your help before. I am writing again to check in again, as I have met with my plastic surgeon now so know more about where things are heading for my PBMX.
Though I am naturally larger breasted (32DD) my BS and PS have talked and determined they think I am a good candidate for NSM, with a subcutaneous procesure (incision via the IMF). I really did not think I would be, and was a bit hesitant to do NSM, so this has thrown me for a bit of a loop since last time I talked to you! Anyway, I have decided to give NSM a try after talking more with the PS and see how it goes.
I am 5'4", 120 lbs, 29.5" ribcage (all re-measured all this morning). I wear a 32DD. No known chest deformities. I do have a "wider" ribcage/shoulders from side to side, rather than a "rounder" one or a thicker one from front to back. My breasts are a little more wider spaced. I also do have some asymmetry (described further below). Let me know if it would help to post pictures in the Picture Forum of me now, and I will start a thread in there.
Measurements taken with my PS this morning do confirm I have some asymmetry between the breasts (distance from the clavicle area he measured from to nipple is a bit more on right (21 v. 23 cm), and the right is also larger with a bit more skin (1 cm more from under IMF up to nipple)). He believes some of this MAY resolve itself as my right breast is just heavier/has more tissue and is pulling on the connective tissue and elastic skin more so it may kind of "bounce back" if the heavy tissue is removed. If not, he can do a revision later to remove some skin from above the nipple and do a little lift, once I am healed...he does not want to do both in same surgery to hopefully keep blood supply stronger. He can also remove some skin from under the IMF during the surgery to even things out.
While we did discuss going smaller than I am currently, he does worry about the tradeoffs with removing more skin, due to the incision and NSM, so we are going to aim to get it to keep the size more comparable to the left side. I am happy with this as I think it will keep me proportional and still work for my active and athletic lifestyle (and again, if pictures will help let me know as I know descriptions only do so much!
At this point, he is planning to put in Style 6200 Siltex Medium Height Tissue Expanders (Volume of 550 cc, Width 13.5 cm, Height 11.7 cm, Projection 7.4 cm). He does not really "overfill" but will likely fill the TE's to the 550 cc, and then put in a Mentor Smooth Round (he likes to wait a few months after the last fill). I don't know which one for sure at this point, but he did mention we would likely end up with a volume of 500 cc. He does not like to use the form-stable/true cohesives for reconstruction as they look really good, but he does not like how they actually feel and move. Anyway, I am guessing I am looking at the Moderate Plus or High Profle? But it seems like to be a 500 cc in Moderate Plus would be too wide?
Thanks in advance for your help!
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Dive-Cat: Yes, please post photos on the Pictures Forum. I think that the TE style and volume will be fine. Nothing larger. I think 550 cc HP implants would be a better choice after TE expansion, but let's see your photos and see how you do with expansion.
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Hi there,
I would really appreciate your help with sizing of the natrelle 410 implants. I am having immediate reconstruction, no TEs, so direct to implant. I am 5'6", 125 pounds, with a 34 C bra size. I am ok with going down to a size B or a smallish C. What ccs would you recommend for final implant size, width, projection, etc.
Thanks,
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Thanks Whippetmom, I posted a new thread with a couple photos in the Picture Forum: ""PBMX to TE/Implant (Pre-Op Photos Only Now)"
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