BREAST IMPLANT SIZING 101
Comments
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Tessa~
My PS didn't expand me much either. Like you, I had very large breasts before my BMX and therefor large skin flaps that didn't need to be stretched. Also, my pec muscles were not too tight and she felt putting in a much larger implant would be no problem. I actually needed to have some of the skin flap removed at exchange...like a reduction scar. Definitely ask your PS why.
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Tessa -- also ask your PS what size implant he/she plans to use. Some surgeons put in implants that are larger than the TEs. So even if expanded to 500 cc's, for example, your PS may be planning to use 600 cc implants. You won't know until you ask!
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Tessa:
Talk to your PS about sizing. Let's see what HE has to say about the proposed volume for implants.
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bluewillowskys - my MO does a very thorough breast/underarm exam to feel for lumps or swollen lymph nodes every six months, as does my BS. I can't imagine how awkward or impossible that sort of exam would be for someone who is ticklish!
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Hi all.
We just got back today from what we think will be my wife's last fill. I say "we think it will be the last fill" because the PS filled from 350 to 425 today and we finally have that "oh my!" reaction after seeing what they look like. My wife doesn't want to be too big, and I think if she went any bigger she would not be happy. To recap the specs, she has style 133MV 400cc, Height - 5'5", Weight - 120-130, Ribcage - 31.5".
Help us decipher my wife's PS discussion today. After this last fill, she said that if we are happy with the size now that we would come back in for one final fill since the implants will look a little smaller than the TEs. She said if you like 400cc in the TE, that translates to roughly a 475-500 implant, so she would overfill to 475 or so and then make the exchange. That I understand, as it has been mentioned here repeatedly (but I mention it here so that you understand there will be overfill). She said she likes the extra high profile style of implants (so I assume this means she's going with the style 45?). She said she uses both Allergan and Mentor, and would have to look at the size chart to determine which implant was closest to the size she liked. However, looking at the size chart now that we've gotten home, we see that it is going to take a 600cc Allergan 45 to get close (12.8 cm) to the 13cm base diameter. For mentors, it doesn't look like they even have a 13cm extra high profile.
So, what do we expect she means? Do you think she plans to overfill to about 475 and then go with a 600cc style 45? Or do you think she will chose an implant with a smaller diameter (which I know is frowned upon)? Or, do you think she doesn't mean "extra" high profile and just means high profile, and would therefore be going with a 500cc Style 20 (which is exactly what Whippetmom recommended, by the way). I didn't want to nail her to the wall on the details today because she was talking off the top of her head and she said we'd discuss everything in detail at our next appointment. Plus, I feel a certain level of trust with her because everything I have read on here about what needs to be done has been exactly what she has suggested. So, I know we can just wait until our next appointment and get the exact details from the PS, but I was wondering if anyone had thoughts on what she means.
On the plus side, we have scheduled an exchange date (April 2nd)!
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SWEETANDSPECIAL: thank you for that info. My mother has had thyroid cancer about 18 months ago and just told me today that they found some more lumps. Its runs on her side of the family too. So besides BC i have to watch for TC....it sucks.Thats why I want to find out al the ways they watch and palpate for lumps of any kind.
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whitenack:
Your question.....
So, what do we expect she means? Do you think she plans to overfill to about 475 and then go with a 600cc style 45?
Response: Yes, this is what she SHOULD.use, if she is referring to the extra full projection style.
Or do you think she will chose an implant with a smaller diameter (which I know is frowned upon)?
Response: She should use nothing narrower than 12.8 cm in width
Or, do you think she doesn't mean "extra" high profile and just means high profile, and would therefore be going with a 500cc Style 20 (which is exactly what Whippetmom recommended, by the way).
Response: Well, if she said "extra" we can only assume she means "extra"...
You will need to have her give you specific style numbers and volume ranges the next time you see her.
I frankly think a Style 20 is best, since your wife is afraid of being "too big"....
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I agree whippetmom. I think 600cc of Style 45 would be way too big. I have been a little worried about the projection, but the last 75 ccs made a big difference.
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Enervas good like that.
Hope all is well today ladies.
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Lori- on jan 8 you posted that it would be good idea for a new thread on tips. Do you know if that happened?
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Smaarty--I have not had a chance to start that new thread on tips. Feel free to start it yourself. I am sure others will glady join in.
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Thanks Whippetmom, I really needed this info. I'm new to the site and very frustrated. Last January I had a
bilateral mastectomy due to BC in my right breast and abnormalities in my left breast. At the
time of the surgery I also had TEs implanted. I had chemo followed by radiation. In December my Dr
started filling my TEs weekly. I have a 510 fill in my right and a 450
fill in my left, but last week I noticed that
the one on the right was flat and the one on the left was still firm. I
went to the Dr today only to find out he had accidentally punctured a
hole in my right TE. He looks at me and says what do you want to do???
WTF!!!
(excuse my language). Those things were hell
to get used to now I have to replace one bc of the negligence of my DR
. So he gives me options:1.) Replace the right TE and start the fills from scratch
2.)
Take out both TEs and put in permanent implants...Duh, how is that
suppose to happen when the skin on both breast
are not stretched equally and I have no idea what size I am?3.) Take out TEs and combine bilateral latissimus dorsi flap w/implants
and he needs me to make a decision by the end of the week
. Have no clue what to do...so overwhelmed right now.I
am so grateful for this forum. I am a veteran and I go to the VA for
all my treatment and every support group at the VA is older guys no
support for the ladies the Drs are all men so I'm kinda swimming alone. I
was thinking about the bilateral latissimus dorsi flap w/implants, but
don't know what to expect and have no one to talk to about it with. I just want my foobs to look normal not like two bricks sitting on my chest and I want to be able to go through the least amount of pain and scarring to achieve that goal.0 -
Hi Whippetmom! I'm new to this thread and just sent you a PM. Hope to get your advice. Thank you for what you do!
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Hushpuppy - I'm so sorry for what you're experiencing right now! I don't know what to tell you except concentrate on the results you want and expect to end up with. If your best bet to achieve those results is with implants then you've got to decide to either replace the damaged one and continue expanding or if an exchange to implants at the present time will give you what you want you could go ahead with that. I have no experience with the tissue transfer surgery so can't even offer an opinion on that. Whippetmom will chime in with questions and/or suggestions for you. She is the implant sizing fairy godmother!
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Hello and WELCOME to the newcomers!!!
Hushpuppy - I've had some problems along the way, but fortunately I've not had to deal with radiated skin so my advice is just a gut reaction to reading your post. Because of your long reconstruction delay due to radiation and chemo I imagine you are totally frustrated by this setback and want to be DONE. But, IF things were moving along OK with the TE process outside of the puncture it seems that a new expander would be much less invasive than having a lat flap. Sounds like it would ultimately take longer, but sounds safer. Like sweetandspecial, however, I did not go through flap surgery so my knowledge is pretty basic. Just sounds like a big jump. Was lat flap something that had already been discussed as an option along the way due to skin concerns or did this just come up after the puncture?
Take care, everyone!!!
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Hushpuppy, welcome. I'm from Wheaton although now in Florida. I too had all my BC surgeries to date done at the VA, four since 2/2012. You're right, they don't get a lot of women through the Breast Clinic. I'm pretty sure there is one where you go. I do know we're quite fortunate they exist.
One of my reconstruction surgeries failed in the operating room. Another had a complication one month later. My options left are - implants, lat flap, remove all the excess tissue/skin from the skin-sparing BMX, or do nothing.
After all of this, I'm going outside the VA for any more Plastics surgery. Most likely I'm going to try the Implant route relatively soon. As was suggested, you need to go with your gut feeling. Why are you being so rushed for a decision? It's your body, your decisions - if you're not ready to decide then stand your ground.
Please do feel free to PM if you wish to speak with another Female Veteran.
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Can anyone tell me the reason why implants are replaced in 10-15 years? If there is nothing wrong with them why would it be neccessary? My MIL had implants in the mid 1980s and has never had them replaced. She didnt have BC, just wanted bigger boobs.
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Hi blue, it all depends, the doctors say they should be replace every 10 to 15 years. I know someone who has silicone for now 18 years and she says she is not going to since they are ok according to her US. I think once i get implants that are right for me i will keep them for as long as possible but you are right that is what i have been told. May be the life expectancy on the implants is just 10 to 15.? which makes $ going back to the PS and manufactures.
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LoriWNY- I did it.
ok ladies, I have added a new topic, "tips, tricks and how to survive this chit". Please check it out, add your 2 cents worth and spread it around. Hope it helps.
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Hushpuppy: What style and volume [not the current fill, but the ACTUAL volume] are your TEs? What is your height/weight/ribcage circumference? Read #4 in the thread header. How lame is that to poke a hole in the TE? Did he even use the magnetic port finder? I need to calculate how much fill you had in relation to the actual volume of your TEs and your vital stats to know what you need. Also, I feel that anyone who has had rads who is going the implant-only route needs to have fat graft transfer at some point, to address the integrity of that radiated tissue. Is your VA plastic surgeon up to the task? So answer these questions and let's see where to go next. You can always email me photos also...Please PM me if you want my email address.
Deborah
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bluewillowskys - I asked my PS how long my saline implants would last, and if I would have to replace them... he said that I'd only need to replace them if there were a problem with them, which he didn't anticipate. In other words, he didn't expect them to wear out.
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Blessings: thank you....thats what i had hoped. If i go the implant route i didnt want to HAVE to do multiple implant replacements. I think ive decided i prefer saline rather than puttin the silicone chemical into my body.To me that would be equal to taking the tamoxifen which was awful. Also several women have said the saline tends to feel warmer to the touch.
I know the nipples will have no sensation, but what about the rest of the breast skin?
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blue - I talked to my PS at my appointment on Monday and asked her why mine (silicone) were so cold. She said that right now my body is still treating them like a foreign body (one month out from exchange). She said they'll warm up and become body temperature eventually, just not right away.
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bluewillowskys - Keep in mind that a saline implant has a silicone shell around the saline... so there will be some silicone in your body - just not inside your implant.
My PS says the reason he uses only saline implants is that if he has to remove an implant for any reason, he must make an incision nearly as big as the silicone implant.
However, with a saline implant, he can drain off the saline before he removes the implant, and it can be pulled out from a very tiny incision. A new implant can then be reinserted through this small hole while it is still deflated, then it can be filled with saline to the desired ccs after it's been placed.
My implants feel warm (body temperature) all the time.
As for sensation, I have none directly over the horizontal BMX incision line (scar). But I do have sensation above and below the line, even if it is a bit dulled in some areas. (Although there was that one time with the strapless sundress that slid down a little too far without my noticing it....
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Hi Whippetmom,
Thank you for sharing your knowledge with us! I am new to this site and already learned so much by reading the postings from everyone here. I am hoping you can help me too with the implant sizing. I had a BMX on Oct 31 of last year and am in the expansion process. I am 5'7, 125 lb, rib cage of 29.5 and my TE is Mentor Siltex Medium Height Expander 354-7213, 450cc, 12.7 cm, 10.8 cm and 7.0 cm. I just received my third fill and am at 235 cc. I hope to be done with my fills by the end of February. I go every two weeks. My doctor prefers Mentor and will use a Mentor implant. From what I gathered from reading all the postings, the width of the implant has to be at least the width of the TE or greater. So, if my TE width is 12.7, then the best options for me from Mentor would be the silicon smooth round high profile at 450 cc at 12.8 cm or 475cc at 12.9. What do you think of 500 cc? Is that right? Also, my doctor mentioned he will put in a bigger implant than the TE. I look forward to hearing your advice. Thank you so much for your help.
Jennie
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1. I plan to live to 100 so unless my implants have a 49 year life expectancy I may have to swap out at least once before I hit my age goal
2. I'm five and a half months out from exchange to silicone implants and my breasts are still quite consistently cool or cold to the touch. They do get warm occasionally but I haven't tried to analyze the common denominator for the warm times.
3. Hushpuppy - This isn't a race so absolutely do NOT let your PS rush you into a decision until you've had a chance to do your research and get all the input you need until you feel as comfortable as possible making that decision. If he continues to push you it's time for a 2nd opinion.
Love to all!
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Blessings: thankyou for your input...i think i like the idea of the saline more now based on what you wrote about the smaller incision if needed to replace.
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Whippetmom
I've been a lurker on this board for a while and this is my first post. I had a bilateral nipple sparing mastectomy 5 weeks ago. I have tissue expanders -though I don't know which ones, I think Mentor. I've had two fills and am currently at 350cc (I left the OR with 200cc). I am 5'9" with a long torso and about132lbs. My ribcage is about 30". There is a large gap between the expanders -though this was how I was before the mastectomy -thin boney. I was previously about an A cup. I would like to be a full C or small D. Is this even possible? My PS thinks my skin is maxed out now at 350cc though maybe could go up to 400cc in the expanders. He does not over expand. He said he plans to put in a silicone implant 400 or 450 mentor high profile. Do you think this will get me to the size I want or is it just not possible? Do you have any suggestions? Thank you for your advice!
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Hi pm2013,
Sorry you have to find yourself on BCO, but it offers so much information, support and friendship that those in life can't understand. Check out some of the other topics and threads. This is a great one with which to start.
Just checking this thread and saw your post. I can't answer all your questions (Whippetmom is our main implant angel, though others are quite knowledgeable). Contact your PS's office, you should have been given a small card (like a credit card) with TE info. These, as well as implants, are medical devices so you should be given all this info. If you can't get the card, get the info from the surgery report - you are legally entitled to this info. This info, along with your desired results, are also used to determine appropriate implant sizes. Also ask your PS if he/she uses Allergan or Mentor implants, they are not necessarily loyal to either brand (mine wasn't). Then Whippetmom can help you more accurately.
About TE-gaposis (my words): my native breasts were wide apart so little cleavage. My TE's were also wide apart. I had a list of desired results I wanted from the implants for my PS, one important one was for implants to be closer together/cleavage. And that's exactly what I got.
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pm2013: Mentor HP 450 cc implants might be fine...just depends on the width of your TEs. Perhaps a moderate plus profile implant would be preferable, in order to get the width you need, if you need better skin coverage over the implants. Where your nipples end up on the mound is also very important and so implant sizing is also guided by that as well.
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