BREAST IMPLANT SIZING 101
Comments
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Thanks Divecat for the info and the quote. It was interesting. You have a great way of explaining things! I understand what you're saying now. I didn't have Alloderm but the PS did warn me it might be needed. Also didn't have nipple sparing. My breast surgeon said that since I had ductal cancer and the nipple was connected to those, he thought leaving the nipple could mean an increased chance of recurrence. That made sense so I didn't object but since then I've seen others with DCIS and IDC who've had it. I suspect the real reason is that it can't be done very easily with gonzo-size FF boobs like I had. The nipple was pretty stretched out anyway. I never lost weight from my breasts even if I lost 50 lbs. But if I put weight on, they just got bigger. What a pain - literally. I used to be able to tell that a bra would fit by putting one of the cups on my head like a cap! Now I have little C's. What a difference!
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whitenack - regarding Whippetmom's comment about the surgical staff 'advocating' on your DW's behalf. That is an absolutely wonderful recommendation. If I read correctly I believe the PS in this case is a woman? That's probably a good thing, in comparison to a male PS determining what HE feels is aesthetically pleasing on a woman's frame.
Just prior to rolling off to the OR for my BMX my anesthesiologist (male) and lead OR nurse (female) came to my room to let me know they were on the surgical staff. I didn't realize it, but since I knew them both personally I had to give my informed consent to have them present for my surgery. I was actually tickled to have people who knew me personally and cared for me there in the OR to take care of me while I was under a general anesthetic.
The male anesthesiologist was at the time part of the M/W/F early morning fitness class I still do at the local gym. I never knew what his occupation was until that day. The female nurse and her husband are actually personal friends. More so my DH and her DH (occasional hunting buddies), but she's young enough that I used to care for her in the church nursery many years ago
. When my exchange got scheduled she was one of the first calls I made to request that she be there for me again to ensure the PS did a good job....lol! I'll be calling her again when my next procedure gets scheduled (mud-flapectomy.......I know there's a medical term but I have no idea what it is!).0 -
Hi Whippetmom,
Thanks for your reassurance. He did keep saying to me "trust me, its just a number, the point is you want a certain look and to get it you may have cc's that are far different than another woman who looks like you or even with the same measurements. We are all very unique in our anatomy. I am hopeful..I showered today and they are flat hamburger buns ( as I have heard so many describe lol)
My best advice for others as i have gone through this now fairly successfully, is to seek out a board certified PS who specializes in reconstruction. MY PS does very little augmentation, mostly reconstruction. As a nurse my belief is that anyone who specializes in one area is far superior than others who have a more varied practice. Just my 2cents
Thanks again for your guidance!!
Mimi
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Without knowing his reputation or patient feedback, I like what he's saying for the most part. On the other hand though he'd not giving any idea of how he's going to approach things. One of the things I like about my PS is that he won't be bound or held to a specific type or CC of implant used. For the most part because of how well things work with the plan based on my own physical structure internally.
It's already happened that my internal structure was different than expected so a different expander was used instead of as planned. Yet I'm comfortable with his work and method. That's the most important part for you, being comfortable with whomever works on you.
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Thanks, once again, for the replies. Are there any articles or resources that talk about the troubles of going with a narrower implant after a wider TE? Something that talks about what how much of a variance is too much? If I am going to question the PS I'd like to have some information to support my position. When I google the topic, I see some general statements that talk in vague terms, but nothing with the specifics I would need to talk to the PS about.
Also, when you say it would take some pocket work to narrow things up, what are you talking about? She currently has an alloderm sling that was inserted with the TE's. Does that help?
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sandra...love your former method of trying on bras! Too funny!
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"pocket work" would mean actually revising the pocket the implant is placed in. Making it smaller, bigger, etc. It may involve more tissue matrix, but not necessarily. If she is going smaller with the implant, pocket work will be very important to make a better fit (like stitching a smaller pocket)....but note it may add to her post-surgery pain and recovery depending what they need to do than a direct exchange would otherwise be.
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Hi girls,
First of all,if I have any English mistakes-sorry,English is not my native/mother language.
I'm 30 years old and I was diagnosed with BC a few months ago (I don't have the BRCA mutation) but my mom was diagnosed when she was young.
When I was in the states (now I'm having my chemo in my homeland) I had a lumpectomy even though the doctors suggested a mastectomy as well.. Back then,I was too confused to take such a big decision.
Eventually,I decided to "think" about the bilateral mastectomy during the treatment.
In NYC 2 plastic surgeons suggested TE (I wanted to go bigger) and here no doctor recommended on them. All the doctors that I've seen recommended to do a one step implant surgery+Alloderm without asking or considering the size that I want.
Anyone had the same experience?
What about NSN?
Thanks!!
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whitenack - My TEs were Allergan 133-MV16s. That means that each TE was 16cm wide.
That was an appropriate size at the time. But because I had lost a considerable amount of weight in between BMX and Exchange, whippetmom suggested Allergan Natrelle HP68-700 saline implants (my doc only did saline) which had a width of only 14.4 cm.
This meant that my pockets were 1.6 cm wider than each implant. That would have left a considerable amount of extra space for the implant to move around in.
Whippetmom suggested that I ask the PS about "lateral capsulorraphies" - a procedure in which the surgeon narrows and tightens up the original pocket he made during the BMX.
At first, he said that I needn't worry; that because of the natural process of developing scar tissue, the pockets generally tightened up after Exchange.
He didn't like to do the lateral capsulorraphies, as it could cause more pain and a longer restriction/recuperation time. But the more we talked about it, he decided that it would be a good idea.
Because the TEs were so wide, without pocket work, the implants would have definitely migrated laterally - fancy words for "they would have slid into my armpits."
He did do extensive pocket work during Exchange. He did not use Alloderm, but he stitched all the way around the pockets in a U-shaped formation. Yes, it was painful, and yes, I had two months of restrictions... but boy was it worth it.
I now have a natural cleavage, the implants move as a natural breast would, but they don't slide off my chest into my armpits when I lie down.
Hope this explanation helps...
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Thanks Blessings. We are talking about the same difference that you had... 1.6cm. Man, that doesn't seem like that is much of a size difference that it would matter. I guess it does, but it still seems like such a small difference.
What did you say to your PS to change his mind?
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Whitenack, Blessings said it perfectly.
I had to have more pocket work when I went for my exchange because I was getting a different kind of implant, not the same kind I started out with. I had permanent round implants placed at the same time of my BMX. No Alloderm. Later I got an infection and one was removed & TE added. At the exchange I got anatomical gummie bears that were a bit smaller than the original implants. Both sides were switched to them, so both sides had pocket work. It certainly adds to the recovery process and causes, at least for me, significant pain around my ribs on each side. But it's necessary so that the implants have the right size and shape of pockets to hold them correctly.
This is why is critical for women to know what implants they want before the TE's are placed.
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Sweet, the paperwork for my "mudflapectomy" (love that term, btw), had the official procedure as "excision of excess bilateral sub axillary tissue". Makes sense, but I prefer your "mudflapectomy".
Been experiencing something odd lately that I don't remember seeing any where. Maybe someone can help me. Had my bilateral exchange last April (close to a year ago), pocket work done on one side last July. I have different types of bras (UW, wire-free, stretchy cups, molded cups, Genie bra, still sleep in post-sx bras). For the last month or two, when I wear certain molded cups (both UW and wire-free) but not all, they fit beautifully when I first put them on. A couple hours later, they don't fit at all, big wrinkles in the cups. The first time it happened, I was wearing a solid color t-shirt and the wrinkles in the bra were noticeable several hours later. Anyone have this or know what's happening?
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Katnat: There is a very helpful and busy thread discussing the topic of a one-step procedure with Alloderm. Here is the link:
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Whippetmom, I've learned that the TEs placed in on Thursday last week are Sientra low-height single chamber 470cc. Fill at placement on both sides was 60cc. That is because the side with thin skin was pretty full at that point.
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2nd_time: too funny. I spoke to my PS's nurse yesterday about the mudflapectomy date (tentatively set for April 25, btw.....yay!!) and asked her for the medical term because I want to sound smart when I talk about it. I think what she said was the same as what you wrote above. I told her mudflapectomy was way more interesting than the medical term so I would keep using that instead. She hadn't ever heard that term before and laughed pretty hard for a bit!
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Galsal....Let's see how you feel about the size when you get to 470 ccs. I think you might need more width with future implants, but that TE should afford the ability to use implants with considerably more volume.
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What would you estimate the projection to be on a 400cc 133mv overfilled to 460? At 400cc, the projection is 5.6, and a 500cc 133mv is 6.0 but that is spread over an extra cm.
We are really starting to like the look of DW's TEs over the past two fills. We aren't sure if we like it because of the size or the shape. The past two fills really started to push them out instead of to the sides, which has really caused them to look like real breasts instead of the deflated footballs, as whippetmom describes.
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can anyone tell me what amount of "space" does the TE take up? I am getting close to being done with fills and have PM Debroah (many thanks) and want my permanent implants to have the same projection and fullness as my TE that being said my PS does not put more volume into the implant than what was in the TE. So I want to know how much more should I have in fills to accomadate for the thickness of the TE
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hi ALL-
Has anybody had their tattoo removed by laser? If so, what were the results??? Any replies would be helpful
thanks, stix
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Hi Whippetmom,
I haven't checked in lately. I am scheduled to have my exchange surgery in two weeks. You have been so helpful. You suggested the Allergan 45 implants because they have more projection than Allergan 20. I am definitely interested in the projection. My PS suggests Mentor Ultra High Profile. My expanders are filled to 600 and I have a 33 inch ribcage circumference. What are your thoughts on the Mentor UHP - projection, safety? Thanks so much. Pinklotus
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Jackie,
What is the make and model of your tissue expanders? That will be needed to answer your question.
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Sorry. I provided that information way back to Whippetmom, but glad to provide again.
I have PMT Integra # 3612-22-2 tissue expanders since my bilateral mastectomy. The dimensions are 10X13 cm with a projection is 8.5 cm. I am a 5'7 1/2 and 145 pounds and measure 33 inches where my bra band would fit. My expanders were filled to 600 cc in each on Dec. 23 and am in limbo right now allowing the chest muscle to relax. I overfilled since I was a b before. I am going to a full c, at least that's what I'm hoping for. Thanks.
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whitenack: I really have no idea. Perhaps a millimeter or two? Miniscule. You are also gaining height to the TE with the overfilling.
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Jackiegray: I suppose, if I am interpreting your question accurately, and according to your plastic surgeon's method, you would need to overfill to 500 ccs - for either a Style 45, 500 ccs or a Style 20 500 ccs.
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pinklotus: I prefer the Allergan Style 45 ultra full over the Mentor ultra full...primarily because Mentor's version only goes to a 12.5 cm width. The width to projection ratio is not as favorable, IMHO, as Allergan's.
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pinklotus: I feel that the Mentor ultras are too narrow for you. I would go with Allergan instead.
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Thanks whippetmom! I wondered about the narrowness but was impressed with the projection. I know the Allergan 45 550 implants are 12.4 in diameter and 6.1 projection. He will determine what looks best when I'm under and said he'll try a few sizes. I will ask for 600 which is what you recommended for me before in Allergan 45 and hope he can although he usually overfills and put 50cc less implant in. I meet with my PS this week and will tell him I prefer these over the Mentor UHP. I appreciate it.
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My plastic surgeon put expanders and expanded to 400cc. He would not put more because my skin was stretching lower in one area then the other. I also noticed that the expanders stretched my skin a little different on each breast. During exchange my surgeon was able to go 100 cc bigger and replaced with Allergan natrelle style 20 500cc. I'm 5'3 135 lbs. It looks natural, but I am not quite a C, more like a full B. I also noticed that one looks a little bigger then then other, I think its because the expander stretched a little lower then then other. I'm wondering if the other one will stretch out to match? It seems like one is a little higher, and if I push it down will it be even? He said I'm still swollen because it hasn't been a month yet. Has anyone notice a little difference in size in their expanders and silicone implants?0 -
Salina88 - Oh, yes, it will change. You're still swollen in places that you don't even realize. I know I didn't . I'm just about 8 and a half weeks post exchange and some of my swelling is just going down. Give it a little more time and best of luck to you!
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Thanks AZ85048!
That gives me great comfort! 0
