BREAST IMPLANT SIZING 101
Comments
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whippetmom- glad I stumbled across this thread- what a godsend you are for those of us trying to make the right implant choice! I would love your opinion- my situation is different from most I've read about. I had breast augmentation in 2007-silicone implants, below the pectoral muscle.I am 5'5", 113 lbs & went from an A to a small D cup. In Nov/13 I had a bilateral mastectomy & my surgeon was able to remove all the breast tissue & keep the implants in place. I am scheduled to see my PS to discuss an implant exchange & subsequent nipple reconstruction in a few weeks. While it's been nice to have some shape I have lost all the volume in my upper chest & my implants are very flat and low (no cleavage)!. At my last visit my PS recommended a shaped implant but from what I have read that won't give me the fullness in the upper pole I'm hoping to recover. I"m wondering if a high profile round might be a better choice?Thanks in advance for any advice!
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hi Summer70, please read the thread header and provide Whippetmom the info she needs to better help you.
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summer70: What is the style and volume of your implants?
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bcnotforme, Im switching out the same, 410s to a smooth round, possibly 15s...in June I think. Will have lipo for extra tissue at the same time. Tho my 410s are probably generally the right size, for ME they are too big, so want less size and projection. He said theres not point going to a smaller anatomical.
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aviva5675, interesting you are switching for less projection, as I want more. I just came home f hospital after having one of the teardrops, allergan 410 , removed for infection. Pls keep me posted as to what you decide.
Whippetmom, well I lost the left implant to infection. PS put an expander backmin til we decide on revision. He said he just put rounds in another patient that he had planned on using allergan 410, but decided rounds looked better, and he and patient are very pleased. He said I'll get a nice natural slope with rounds, and squishy, too. The trenches he said have to do with my pecs being affected by the teardrops, or something like that, I was quite drugged at the time. I asked him what kind of rounds he wants to use for me, and he said like which company? And I said which style. But we got interrupted. He uses natrelle and allergan from what ive seen in the office. You suggested allergan style 20, 550 cc I believe. Will these give me a nice projection? I feel like a nervous nelly...
Many many thanks!
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I'm embarrassed to say I don't know the cc's or make of my implants- apparently I was blissfully ignorant when I was augmenting for purely cosmetic reasons. I'm using a different PS this time but I suppose either he or I can find out from my former PS. I do know that they are smooth, round, moderate profile silicone. My ribcage is 28", I'm 5'5", 113lbs. Thanks for any advice
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summer70....Let me know when you find out. I need to know the width of your implants to help you further. I believe a high profile smooth round silicone implant would be preferable, but this all depends on the width of your implants, since they essentially created a pocket, as would tissue expanders.
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bcnotforme: I am concerned about your infection and reinsertion of a TE before the infection is cleared....
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hi whippetmom, I didn't ask him why he put a TE in, but he did say the infection didn't look too bad. He said he flushed it real good. The breast today is not pink at all, but I'm watching it like a hawk. Hmmm, just felt it and is still considerably hotter to the touch than the right breast. Will keep an eye and call him if it does not change.
Thank you, whippetmom, and if there's something else I need to do or ask PS that I'm not thinking of, will you let me know? So thankful for you.
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Will do- thanks, whippetmom.
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FAT GRAFT TRANSFER AFTER RADIATION
I have been talking with so many lately regarding fat graft transfer as worthy of consideration, if you have had radiation as part of your treatment regime. Many of you are facing implant failure or you are experiencing complications or cosmetic disappointment, because of traumatized radiated tissue after breast reconstruction. I have been researching diligently and I found that Dr James Namnoum in Atlanta, recent co-chairman for the 30th Annual Breast Surgery Symposium, presented a lecture last month, entitled "Reconstruction of the Radiated Mastectomy, Fat is the Key to Success." I am going to try to find more information about that lecture, but my question is this: Why are not more plastic surgeons getting on board with this? Drill your plastic surgeons about this gals, if this applies to you, and if you do not get answers from your doctor, move on and find someone else who is willing to explore this with you.
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Whippettmom,
Hi. Quick question. I had immediate reconstruction after BMx on jan. 29. I had short height extra projection tissue expander 133-sx-14 allergan 550cc placed. How many ccs would you typically use total? I was a 38c/d before surgery. I'm 5'2 and about 190 pounds.
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I'm hoping for no problems when I get my exchange on April 9th. I had radiation to the left breast 9 years ago. Hopefully, all will go well.0 -
Whippetmom - Thank you so much for calling out fat grafting for radiated tissue as an emerging trend. My PS is convinced there's compelling evidence to support this approach before heading down the path of a more invasive flap surgery. As you know I'm one of those women who had two fat grafting sessions BEFORE my T.E.s were placed. I agree we need to really start challenging our PS's on this issue. Fortunately I was able to find a progressive PS who is willing to be on the cutting edge of this approach. While I don't consider myself a trailblazer, I did have to be willing to take some calculated risk. Worse case scenario, if it doesn't work, I've only lost some time....and belly fat thanks to the two lipo sessions I've had so far.
I'm only 4 days into my TEs, but so far so good. If anyone's interested, I've posted photos of my progress on the picture forum.
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Raelan and whippetmom
I too am happy that my PS believes in fat grafting and has been a big proponent of this as an option to flap surgery. I am so lucky I found him!!!!!! I'll have to see what happens down the road. But , as of now, I am happy to have my small mound on the left. The upper fullness that was achieved with just 1 fat grafting makes me look more natural in scooped tops (with the help of a prosthesis of course) I see my PS again next month to discuss our next step!
Will let you know what we come up with!
Babs
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Mommyathome: I think you could use Allergan Style 20 - 700 ccs, minimally, and so whatever the PS needs to do to get you there. Honestly though, your short height TEs were designed to allow you to exchange out to a considerably larger implant, because of the exaggerated projection. So I would think it is up to your PS to determine if you need expanding beyond 550 ccs in order to exchange out to that size implant. I think that anywhere from 700 ccs to 800 ccs will be the implant volume to discuss with your PS. How he gets you there, is up to him.
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Thank you Raelan and Babs. We are following your progress!
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Whippettmom,
So are you suggesting to fill to 700-800 cc and then choose at least allergan 20-700ccs? I know the ps said during the exchange they bring in 3 implants to "try out". One 50cc more than the te, one the same size and one 50 cc less than te. Is this typical?
I was thinking of going to 700cc in the tissue expander if I can- assuming my tissue/skin remains healthy. Then I would suppose they would bring in to the OR a 700, 750 and 800 implant. Would this still be the allergan 20?
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No, I did not suggest that at all. You might not need to expand beyond the 550 ccs of your TEs to get you to implants with a volume of 700 ccs. I would suggest expanding to the recommended volume of your TEs though, which is 550 ccs. If your PS feels that he needs to overfill, in order to get you to a 700 cc implant, that is something HE needs to determine. Personally, I think that the TEs you have, filled to 550 ccs, should get you there.
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Ok thanks Whippettmom. This is all so confusing to me. I have 600 in the left and 450 in the right. Maybe I should just catch the right up to 600, heal for 3 months and plan my exchange. I met w the ps assistant yesterday. I'll speak to my ps to see what she thinks is best. I am certainly sore after that last fill.
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I'm so upset ! MY FOOBS TURNED OUT HORRIBLE!!!
They're WAY too low on my chest! It's like a flatland between where my neck ends and the foobs are. I put on a tank top and it looks TERRIBLE! You can drive a truck in between them. My main complaint is how LOW they sit and there isn't the fullness at the top I was told I'd have. I WAS HAPPIER WITH THE TE'S ! I cried all last night. It's a done deal now and I'm stuck with the equivalent of man boobs.
Freakin cancer treatment is bad enough. I was hoping to at least have decent looking breasts out of it. I'm so sad.
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Tessa,
It is VERY common to feel like this right after exchange!!! I cried for two weeks...at least!!
Your pec muscles will relax a bit, your swelling will go down, and SOMEHOW that causes the implants to look more full.
Can you tell us which implants and what size? Bra instructions?
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Dulci is right, Tessa. It is WAY too early to tell...you are only a couple days out of exchange. I am pre-surgery but have seen this time and time again in stories from other women (and in photos). Many are disappointed, but most really do see them "drop and fluff" over time. After your expanders are out (which are much harder than the implants and resist the pressure of the muscle better) and implants in, your pecs will be "squishing" your implants down. You won't have fullness where the pecs are yet, as the muscle needs to really relax (and swelling needs to go down). It can take weeks or MONTHS for things to settle, and most surgeons won't consider revisions until they really have had that time to settle. At that point, then either things may be great, or it may be decided that you need a different size/model implant.
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On the right I have Allergan style 20 600 cc's. The left is also style 20 but 650cc's.
The main problems are that they sit VERY LOW. It's like they're resting on top of my stomach. So there's all this flat area up top where breasts should be. I tried on all kinds of tops and dresses and I look like a man up top. I'm so depressed and disappointed.
Not to mention they look like flat hamburger buns and they're so far apart you could drive a truck through them.
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TessaW...are you on the picture forum? If you look through the threads you can see many had the "hamburger bun" look early in the process and things look much different as time goes on. Your pecs are going to be squishing the implants "down and out" a bit at this point so it is hard to tell what you may end up with for upper pole fullness.
Did you ever get recommendations from whippetmom about model/size? What was her suggestion?
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Divecat, I hope you're right in my case. I've been to the picture forum but I've never seen anything like what I ended up with. I cry off and on constantly. I'm so embarrassed. It looks terrible. They're sitting WAY TOO LOW. It's like they're resting on top of my stomach.
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Hey,Tessa! Post pics on the pic forum when you can. Then Whippetmom and others can tell you if they actually ARE low, or if this is the pecs being tight initially. As soon as your PS clears you for a bra you may want to get them supported so they stay up. But take a good breath and step away from the mirror!!
You SAID you liked mine....and you have just what I have!!!
Give them some time to settle in.Pictures on the pic forum. Front and side! That's your homework. (((((Hug!!)))))
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Tessa: Please, as others have state, post your photos on the Pictures Forum and/or email them to me. I will PM you my email address. I want to see what is going on. And, to the contrary, this is NOT "a done deal"!
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Mommyathome: Is there a reason one side has not been filled as much as the other? Are the TEs symmetrical in shape and size right now? If there is assymetry, if one is smaller than the other, just stop with fills on the one side until the 450 cc side is filled to 600 ccs. You can always email me photos anytime so that we can see where to go with this.
Deborah
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TessaW - Aw, Tessa, I know exactly how you feel - most of us do - because I was you three months+ ago. I burst out crying the first time I saw me. All flat and squished high (and low). Post those pictures. Heck if you want a good laugh (and it sounds like you could use one) go look at my thread "A Work in Progress..." now there's comedy! Don't worry, whippetmom can fix anything! I am a believer!
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