BREAST IMPLANT SIZING 101
Comments
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BCnotforme: You know, I think that the anatomical just needs to be replaced with a smooth silicone round and that should be something which would not require switching to a new PS. Otherwise, you are just fine.
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Hello Whippetmom,
Just wanted to let you know I had my exchange yesterday and all went well. My PS ended up using Mentor 350-7004BC Smooth Round High Profile Gel on the left and Mentor 350-800BC Smooth Round High Profile Gel on the right . I was able to loose about 12 lbs before the surgery and as I plan to continue to loose weight he did not want me to end up looking bigger than I need when I get to my goal weight. They are a bit square and flat today but I know given time they will drop and fluff but overall I am happy with the results. I am going to add some more photos to the picture forum later today and get some new one of the new girls.
Your recommendation for the best implants for me was a big help and I felt more in control of what was going on and not just going along with that the PS thought was best. Thank you again.
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Rosebuds: Excellent! They are going to be just fine....just four to six weeks! Cannot wait to see photos!
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Whippetmom: have you ever considered a conference or a series of Webex meetings on this topic? I am sure sponsorship will not be a problem. audience will be a piece of cake.
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whippetmom, that is a huge relief. Thank you. I do really like my PS and that's his plan- smooth silicone rounds on both sides, bigger than the current expander side. Do you think that will be ok? I don't know how many cc's he's planning, but I asked for bigger. You have really set me at ease, I've been so stressed. Thank you thank you!!
Xo
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activern: I am technology-challenged. This is no joke. I have never heard of Webmex. Would this be something like a live chat?
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BCnotforme. Like the Honda guy says, "It's my job to be helpful"!
A little larger is fine.
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Oh I see, it is somewhat like "Go to Meeting"....live conferencing. I think I am too much of an introvert to do something like that. This is how I feel just thinking about being the focus of attention....
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Sandra4611 I'm sorry if this question sounds ignorant. In your picture is the smaller side (your left) the old implant or the new one?
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I know this subject is covered over and over so I do feel rather silly asking it again but it am a little freaked out by the flatness of the implants. I read about the drop and fluff does that pertain to saline implants as well? Also my left is really low does that mean it will stay that way and the right side will be that low too?
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Hi Whippetmom,
Thanks for all your wise advise you have provided!
A few pages back, you had mentioned shaped Sientras. Do you believe there is a lower risk of rotation with these, as compared with, say, Allergen?
After an initial exchange surgery in December, I am having a revision in a few weeks to break up some scar tissue and add more separation between the implants. i will also use this as an opportunity to go with a smaller implant. I currently have Sientra classic base 275cc, which I think is a great implant -- just too big for my small frame. (This might sound strange to some, but on me, 275cc turned me into a 30D.)
Many thanks!
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emmalou: No, I do not think that the risk of rotation is as high as it is with anatomicals. You could go with the Sientra oval base, 210 ccs.
What you have now:
11.0 width and 12.0 height and 4.2 projection
65 ccs less gives you:
11.0 cm width and 9.6 height and 4.0 projection
I feel that the implants are probably too tall on the chest wall for you. Now, the one thing about Sientra that might not be working for you, is that Sientra implants are designed to give the most upper pole fullness. I can see how this would be needed in certain circumstances, such as when the breasts tend to be lower on the chest wall, or if there is quite a bit of ptosis, or is a "lift" is needed to achieve the best results. But in all actuality, with the native/natural breast, projection occurs in the lower pole, not the upper pole, and so for you, this might be overkill. Are you feeling that the height or fullness in the upper pole is bothering you, or is it the overall size of the implants? You could also, instead, go with Allergan Style 15 , with a volume of 234 ccs, or Mentor Moderate Plus Profile, with a volume of 225 ccs. So these are two other options for you.
Hope this helps. You can always email me a photo if you want further clarification. PM me if you want my email address.
Deborah
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Hi,
I am having NSBMX on Wednesday. My PS is planning on using Allergan Med profile TEs with a volume of 400-500 cc. I am 5'5', 165 lbs (but hope to lose @20 lbs before exchange) and 33" rib circumference. I told her I wanted to be a little smaller. I currently wear a 36D, and would like a C, I think. Does the TE seem about right? I know my thoughts will probably evolve as this process moves forward, but I don't want to make a huge mistake at the get-go. Thanks for your thoughts and I'm sure I will be asking many more questions in the future. So thanks for doing this. I really appreciate your advice.
Nina
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Thank you very much, Whippetmom, for the very helpful suggestions.
I will discuss these options with my PS; I suspect he'll lean toward the Sientra oval base -- he didn't recommend smooth rounds for me as he feared there would be too much visible rippling with my thin frame. Not sure if -- with your experience -- you agree with his fear that smooth rounds would cause more rippling than the shaped Sientras?
Once again, thank you for your advice. Such a blessing for all of on this forum.
Emma
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JackieGray, my left side (on the right in the picture) is the smaller "new implant" side .It has a lot of swelling on my upper chest which is normal at this 2 week stage but more pronounced because of adjacent muscle repair incisions. That sort of "puffs things up" and makes them higher. When the swelling goes down and things relax, it will appear a bit lower. Projection is the same as the other side, which is 4 months old today. My Allergan 410 Style FF 740 cc implants only project out 2.5 inches. That's a big change from my natural FFF's but I like my smaller foobs and the freedom that goes with them.
Although surgeons try to make the implants even on your chest - including sitting you up during surgery to check, just like natural breasts, they can be different when they heal. Sometimes the tissue on one side is different so the support is better or worse. For the most part it's no big deal - certainly not enough to undergo a revision surgery.
Nearly everyone is surprised with how flat implants are. I used to call mine "man boobs". They were squarish mounds. Then they went to a kind of flat-top football shape where the width was the first thing I saw because the swelling on the top was gone. I will be getting fat grafting on my upper chest to restore some of the fullness that disappeared when the breast surgeon scraped me down so completely at the BMX (including the fascia on the pectoral muscles) that I look like skin over bone across the top of my chest...completely flat.
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Hi, Jackiegray - Yes, saline implants do the ol' drop-and-fluff as well. At Exchange, there is a lot of swelling going on internally, and most implants tend to ride higher up. But as the swelling goes down, the implant is allowed to move downward ("drop") and settle into the pocket the PS created at BMX. Then, the implant begins to find its permanent home on your chest - spreading out to conform to your ribcage ("fluff"), and assume a more natural looking breast mound.
One reason implants can look so flat is because that's just the way they are designed. Basically, they're just round baggies filled with saline or silicone. Your natural breast came to more of a point at the end, because the nipple/areola complex (NAC) added a "pointy-ness" that implants don't have, even those labeled "high projection".
If you had a skin and nipple sparing BMX, or had nipple/areola reconstruction, you might find that the implants better mimic a natural breast, but since all the fatty and glandular tissue was removed during BMX, the implants may never look identical to your Original Girls. But they can look really, REALLY good.
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Nina: The tissue expander size range sounds fine to me. I can envision that you would want to end up with high profile implants, around 500 ccs or 550 ccs, using a smooth round silicone implant, for example. You would be able to reach that amount, even with a 400 cc TE. I would advise that you refrain from focusing on cup size and don't mention it again to your plastic surgeon. Otherwise, you will end up with a B cup and look like an A cup, because he will err very small. Cup size is not important with reconstruction. You want the implants to look appropriate on your chest wall and to have sufficient projection. With breast reconstruction, you could wear a "D" cup bra, but in clothing look like a "C" cup. Once you have surgery, let me know which volume TE he ended up using and I can refine the implant sizing further. You should be motivated to lose that 20 pounds, because I am basing sizing on 145 pounds....and the implants can only look better as you lose weight.
Deborah
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emmalou...
So you are the Emma who sent me photos last week. We DID discuss that 210 cc Sientra implant! I think that is the best choice for you. I have gone over every possibility, as I know you have, and that is THE implant for you. I think you will be happier with less height to the implant. Make sure you tell your PS, absolutely not to a 12.0 cm wide implant!
I look forward to a report and photos after surgery!
Deborah
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ok ladies I have an appt Friday with PS! I am 5'6 and 191lbs. I was a 38C and the docs removed 700cc of tissue during my skin sparing DMX. MY PS immediately injected 650cc during surgery. I have had one fill of 100cc each since surgery day Feb. 18th. I feel like I'm smaller still now and debating getting another 100cc fill before exchange surgery on May 13th. I want to end up some bigger then I was but at the moment it's so hard to tell. Any suggestions?
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MereMere...are you going silicone or saline? The biggest you can get with silicone is 800ccs, so that is something to consider. Even if you fill to 850ccs, if you go silicone you will still have to go to 800ccs and likely will look no bigger than you do right now with TEs at 750ccs (TEs have more projection than implants). You might want to discuss possibility of saline if you are concerned about size at this point.
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Actually, that is not always the case, and might not be so for MereMere. This is why it is important to know the style and volume of the TE. For the most part, I don't care a whit how much someone's TE is filled, because "fill" can represent "underfill" or "overfill." This is why I always want to know the actual style and recommended volume of your TEs. The calculation is not measured by how much you are "filled" to at this point, but the manufacturer's recommended volume of your TE. Essentially, it is important to know the width and projection of your TEs - with width being the most important.
What if MereMere has 500 cc TEs overfilled to 750 ccs? In this case scenario, an 800 cc HP smooth round silicone implant WOULD most likely be larger than her TEs.
Please read #3 in the thread header above and provide me with the data regarding your tissue expanders. We can go from there.
Deborah
Edited to add: In answer to one of your questions...you are probably filled sufficiently at this point anyway, since, as Dive Cat states, 800 ccs is the largest volume of silicone implant available at this time. With saline, you can achieve a maximum of 960 ccs.
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whippetmom..
I am not trying to tread toes...my main point was just to clarify whether she was going silicone, because if yes, in that is case an extra fill might not be required to get the max size silicone she can and that if she is very concerned about being bigger than she was she may want to discuss the limits of silicone versus saline with her PS.
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Whippetmom, I'd like to ask your opinion, or that of anyone who may have needed two different size implants...?
I had my exchange surgery seven weeks ago, I had a skin and nipple sparing BMX last summer. My tumor was on the left, and the BS did shave away part of the pec muscle during the surgery to get the best margin. Since that was the cancer side, it seems like she was more aggressive on cleaning out that side, even with the TEs that side looked different than my "good" side. My PS put in 350 mentor round high profile implants (I'm four eleven and 100 pounds). The good side looks perfect. The bad side is smaller. There is a difference in the projection and also it is slightly less full on the bottom (width wise). The PS feels it's because thee is less fatty tissue covering that breast. Fat grafting is an option but I don't really feel confident that it will truly solve this....he also said we can put a larger implant on that side.
So, my question would be, if I go that route, is it possible to get a better "match"? I'm afraid of making it look worse than it does now. It's not a horrible difference, but it's noticeable to me.... I know I shouldn't be so focused on this and be grateful to have gotten through all this but I just never expected that they would look so different. And of course I have the inevitable nipples pointing in two different directions, rippling.....I can live with those things and I guess I can live with the difference in size if I have to but I'd like to find out if it's possible to fix. How would the PS know what size will match....he told me that when they sat me up in the OR the implants looked fine and there wasn't any noticeable difference.
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Hi Whippetmom
So I finally talked to my PA at my PS office today. Here is the down and dirty for you...
I am 190 lbs and 5'6". I previously had very full C to small D cups with minor drop. I nursed 3 boys.
I currently have Metrell ( I believe that is right) but maybe she said Mentor. 13 cm width med height 400 cc expanders.
She did say during surgery that my BS was able to save a good amount of healthy tissue and fat under my skin and I was not at risk for my skin being too thin or stretched.
My PS only fills to about 80% what you want to be. She said they normally insert 75 -100 cc larger than the expanders.
I am currently at 280cc and am looking to do about 2 more fills of about 40cc each. I asked about going more but they don't like to do more than that.
The PA said she was thinking around 475 -500cc implants for me at the most. They would use either Allergen Nuetrell 410 or Allergen Nuetrell smooth round.
I am leaning towards the smooth round as I want squishier boobies in the end.
Can you help me understand about how much I want to expand to in order to fit the 475-500 versions of these. I am looking at being around 360 after two more fills.
My PS likes to wait 4 weeks till he does the switch so we are looking at the end of May for my surgery. Either May 22nd or May 27th.
Thanks for your help!
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DiveCat:
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Pamela: I need to see a photo. I have sent you a private message.
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KGSN: Well, you AT LEAST need Allergan Style 20, 500 ccs, in order to match the width of your TEs. This seems like a small size for your frame. How do you feel about the size?
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Hi Whippetmom
Not to sound funny but I carry my weight very well. LOL Most people would not guess that my weight is what it is. I always have to tell the nurses to keep moving on the scale.
I have asked friends and they have said I look like I am about 50% there. I think I am smaller just because I don't have the drop part. I am happy to share a before and current picture if you think that would help at all. I just don't want to be too small. That is my fear.
I am meeting with my PS next week to talk. I wish he would do more than 40cc every 2 weeks. I think this is my biggest frustration. If I could get him to do 50 or 60 cc two more times I think it would be better. His PA was pretty strong against it.
I should add that I have lost about 15 pounds in the past 2 months and would like to loose another 25 before I turn 40 in Oct. This was a goal prior to all this fun cancer stuff turning up!
What would your suggested volume be for me because I see you said at least.
Thanks
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KGSN: If you are on a weight loss regime, 500 ccs will be just fine. I would MUCH prefer that you lose weight, than press for a larger implant. When I said "at least", I meant, 500 ccs is the right implant to match the width of the TEs. 475 ccs is just a tad narrower, and why not go with 500 ccs, to make it a perfect match? Just another 25 ccs to make it a nice round number.
I will PM you my email address....
D
PLEASE VERIFY: If you have Mentor TEs, the volume would be 450 ccs, not 400 ccs, and the width would be 12.7 cm. If that is the case, you should be getting implants with a volume of 550 ccs. Are you sure your TEs are not Allergan?
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KGSN: I just noted who you have as a PS. I have read his book "Reoperative Plastic Surgery of the Breast" from cover to cover many times! The pages are dog-eared from referring back to sections of that treatise. It is so cool that he is your PS!
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