BREAST IMPLANT SIZING 101
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MBJ: It is a matter of using an implant which will give you the same amount of natural drape/droop/ptosis as the native breast. You do not want round, upright and perky on the MX side if it means that you cannot achieve that same appearance with the native breast, right? It also depends on how much your skin has expanded and more often than not, the PS does not even know how much volume he can truly use until he has you on the OR table.
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Kate33-your right Kate, I'm only a full B and it seems huge to me. Your right about the test drive, it's not like it's so easy to go back into surgery if your not happy. 50 years? Your can't be older than 35 right?
vmudrow-I'm going to ask him when I go in two weeks and make sure I know for sure his plan. When is your exchange?
Btw ladies I put my pics up on the forum under bilateral nipple sparing pending gummies-let me know what you think. The first oneg I dow loaded to big and I don't know how to delete it so I hope I don't get in trouble!
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Kay: It is a complete mystery to me! You are the only person who has been unable to obtain info on their TEs....and with gummy bears....the dimensions of the TEs are critical for selecting the proper anatomical implant style and volume. We do not even know the recommended volume of your TEs, right? In looking at your photos, it does appear to me that you have full height TEs most definitely. They appear taller than they are wide. If that is true, then something like the Allergan 410FF @ 425 gms would be nice - 13.0 cm by 13.6 cm by 5.2 cm. Or the 410FM @ 395 gms - 13.0 cm x 13.5 cm by 4.8 cm. You do not want the combination of an anatomical too much narrower in width and shorter in height than the pocket created by the TEs, or you run the risk of the implant rotating in the pocket. If your ribcage is 32 inches, I do think you could use the width of a 13.0 cm implant - in order to not have too much of a gap medially - in the cleavage area. So I have to say I favor the 425 gm implant in the FF style for you. However, I am pretty sure your PS is not going to be willing to use that size of implant. 395 gms might even be pushing it. But let's see what you end up with!
Deborah
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Kay: In looking again at the options...the 410FF @ 375 gms would work - 12.5 cm width by 13.0 cm height and 5.1 cm projection or the 410FX @ 410 gms - 12.5 cm width by 13.0 cm height by 6.0 cm projection. I just do not think that you have the projection with your TEs for the latter style, but again, you might.
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thanks Deborah! I guess we will find out on the 19th, won't we?
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Yes we will and that day will be here before you know it!
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sweetie2040- Aaaww, you really are a sweetie! 0
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Deborah~
its just ME that doesn't have the info on the TE's, but they will be in my medical notes. My PS did say she would either use a low or moderate height implant but i said my preference would be a moderate height. Was pretty shocked she suggested a low height! She wont be using a full height for definate.
I know my TE fill volume was 300ml and its overfilled to 500ml.
Yeah you're right-there's not a hope in hell she'll use anything out the 400 range!! LOL I'll be lucky to get a 350ml!! i really would like to get the MX in about 370ml. But not sure if i'll get that projection so may have to go for the MF 375 ml. She MAY even be more reserved and go for the MF 335ml or the MX 325ml.
If she gives me a choice ,what should i go for? if i have to choose from the 2 higher volumes but MX or MF.....or between the smaller volume MX or MF??? i like the width of my TE's so would like to stay as wide as possible,but i also want as much projection as possible too. I know i will have to sacrifice one for the other,but dont know which way to go.
How do i measure my projection right now? do i measure it from the centre of my chest,out to the furthest point of my TE? Or from the outer edge of my TE where my armpit is? If i could tell how many cm of projection i have right now,i could work out my option better for my implants. This is assuming i even get a say in it!!! LOL But better to go prepared.
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Dear Whippetmom, Thank you. Your information is so helpful, and I wish I would have found it sooner. What a blessing you are to so many. Here is my brief summary -- In February of this year, I underwent a prophylactic mastectomy for breast cancer prevention. Two weeks ago, my TEs were removed and were replaced with Natrelle 410MF 335cc implants. (My TEs were filled to 360cc, and I told him at my final visit before exchange that they were way too big.) I am 5'2", 115 lbs and a size 4 Petite. My chest measurement just under my breasts is 29.5".I had repeatedly asked my PE to please just give me full A cups. (I was an empty A before.) Well...I think I am least a full B - maybe a C. At my post op appointment, I expressed my concerns to him, and he encouraged me to wait ot 6-8 weeks for swelling to decrease and for implants to settle. He said we could talk at that point. He took 3 sizes into surgery and said that he tried the 295s during surgery, and he went with the 335s becasue the 295s looked too narrow. He said that he thinks I will be happy. But, I strongly doubt that these will decrease to an A. So...can 335cc 410s possibly be an A on me? (They seem to be way too wide.) How do I know what to ask for in the exchange? Will I create new problems if I now go for the smaller size that I asked for? Should I try to get him to exchange them sooner? I would appreciate any feedback that you (or anyone else) might have. Gratefully, Catchturn PS - I am glad to send photos if that would be helpful.
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Kay: Well, there so many options in the 410's - So I suppose my preference would be the MX @370 grams or the MF @ 375 grams - probably the MF - because your TEs do not look like they have the extra full projection aspect. Also, I recall that you mentioned on the pictures forum that your TEs are completely submuscular - which means partially under the pectorals in the upper pole and under the serratus and abdominus rectus in the lower pole. I seem to recall one BCO member telling me her PS always added another 10% volume with this type of placement, because the implant is compressed more than with the partial placement [pectoral] only and the implants have a tendency to appear smaller with complete submuscular placement. Something to discuss with your PS. This is an excellent placement method, by the way....if this is what you have....it is like having an internal bra to help support the weight of the implants.
Deborah
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Catchturn: You do want to wait at least 8 weeks before going back for revisions. It would be helpful to know what style and volume of TEs you had...so that we can compare dimensions.
With your specified desires, the 410 ML @ 220 gms would have been a preferred size...enabling you to maintain the same width...12.5 cm...but with significantly less projection. But it all would depend on whether the style and volume of TE your PS used would have accomodated that style/volume of implant. I am going to PM you so that you can send me photos. Also, please try to find out what style of TE your PS used.
Deborah
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DEBORAH~ yes as far as i am aware they did the full submuscular on me. That's what they planned before my Mx anyway.
Hmm.... i will mention to my PS about the implants being compressed more with this method. And i will ask for either of the 2 sizes you mentioned above. May as well start high them try and barter!! LOL If i ask for that size and then explain my concerns about it being compressed and losing projection! I will let you know what she says and what she aims to use.
If it ain what i want she'll be in the boot of the boobmobile!!
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Yes Kay, and little does she know, but a crazy-woman will have the boot key!
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Thank you, Deborah, for your feedback. Wow! You are suggesting that I needed 1/3 less to get what I wanted. I am very concerned now that a revision will mean that I have saggy breasts that have been stretched too much -- far beyond what I asked for all along the way (both surgeries and the expansion process). I asked my PS this at my post op visit, and he assured me this wouldn't be the case if I decided to go smaller. It seems like, if I am certain that these are too big, then I would want them out asap instead of waiting 8 weeks. As you requested, I will send you pictures. I would appreciate any feedback you might on have on what problems I might have with decreasing the size by 1/3. Thank you for so generously giving your time and knowledge. What a valuable resource you are.
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Catchturn: I am concerned about the pockets being too big for a smaller gummy also, now that the 320's are defining the pockets. I think I would need to research this a little bit more - because you do not want to run the risk of implant rotation if the pockets are predetermined for a larger anatomical implant. I personally do not know of anyone who has exchange out for a smaller anatomical. Your pockets would not be too large to downsize to a standard silicone round - I think that just maintaining the same width would work for you.
I do not know that you would necessarily need to downsize to a 220 gram implant either - it sounds pretty small to me actually - but that was the one style/volume implant I pulled from my list which had the same width as the implant you have currently. We can refine this once I see the photos.
Deborah
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Whippetmom, I will be having right side mastectomy June 30th. Already had my first visit with PS but was upset because I had just been informed by my surgeon about a third mass so I did not ask many ? of PS. He told me I would have TE because of previous OR's. He will not do left breast until later. Is it usual to wait until reconstructed side is done before doing other breast? I am hoping to talk to him again pre Or and ask all of the questions that you suggest. Thanks so much for this forum cause without it I would be LOST!
Carol
PS- my daughter just rescued a whippet! They are great dogs and cute too!
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Odinsmom -- what are you having done to the other breast? For what it's worth, I had MX and TE in December on right side.... then exchange on Right and reduction/lift on Left in May (at time of exchange, in other words). Though some doctors do reduction/lift at time of MX, most don't. If it's an augmentation it can also be done either at time of MX or at time of exchange... it really depends on what you are doing. Women who have augmentation of healthy breast with a specific saline implant (one that has a port and allows for adjustment of size of implant) DO have that done at time of MX/TE but that is because of the adjustability. My PS said doing reduction at time of exchange had a better chance of matching. With TEs they don't always know for sure how large you can go until you go through the process (limitations can happen due to skin and/or muscle having limits, etc). I'm sure Deborah can write something more intelligent and specific but thought I'd comment since I did have this experience.
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odinsmom: I had an MX on my left side in March with a TE and I will have my exchange to silicone implants in August. I will have my natural side done with an implant to match. As I am small breasted and don't have any sagging, I will not require a lift. This is pretty standard unless they use the saline, as Lilah stated above.0
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I chose bi-lat without rads but with chemo. I was given this choice due to staging. I had a bi-lat and was left with a concavity of my chest on both sides. Because the chest wall was sunken, my implants needed to be larger than what would eventually be seen on outside. I had expanders with pain that I suffered through for six months. Despite the pain, I would do it all over agin. In fact, I may have to have them replaced in twelve years, or so. The expanders were blown up with saline to be 30% larger than the final implant size. I then had permant ones of 425 put into one side and 370 on the other ( if I remember ). This is due to the fact that I was uneven to begin with and perhaps due to the original tumor site high on the chest wall. Also, due to the "divit" after the tumor, I chose the tear drop shape gummy bear implants instead of the round size to fill in the "hole" in upper quadrant of breast. The breasts are the same to look at after healing. I was not fully comfortable with the implants until a full year and a half after the final surgery. I was still very active, but not fully comfortable during that time. I did do the tatoo nips. I recomend them! It gives the eyes something to focus on to make the scars less visable. I wound up with C cups and I never wear a bra and I enjoy wearing a bathing suit. Pics can be found on Dr. Letteri's website in Spartanburg, SC. I get top billing as of this week. I love my doctor. He was a perfectionist and it shows. I am very grateful. Good luck and God bless.0
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Odinsmom: I think Lilah and MBJ addressed your questions above. I think referable to specific questions, I would ask, do you feel comfortable with this PS? With a single MX, it is key to achieve symmetry with the native/natural breast, and so the surgeon's focus should be placing a TE which mirrors the base width of the native breast. The size and degree of expansion required will be based on a number of parameters, referable to your desired size, within limits, and what will be done with the native breast. Reduction and/or lift and/or augmentation with a smaller implant. So I would definitely communicate to the PS what you hope to achieve from this. Let us know if we can help further.
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Lisa: Simply amazing! I am not sure exactly which photo was yours though....was it the first one which comes up on the recon photo page? But the whole issue of concavity and how it occurred is a medical marvel to me. I am surprised that the TEs did not compromise the problem by compressing the ribcage even further. Well, this surgeon's name just went on my "preferred" list and for that I am grateful also!
My family for many generations hails from the Greenville/Spartanburg area. My ancestors are all buried at the Tyger Baptist Church cemetery in Taylors. My first cousin, Bennie Lee Sinclair, was the poet laureate for the state until her death ten years ago. I was born in Rutherfordton, NC - just across the state line...
Back to the breasts: Could you explain further why it took a year and a half to feel comfortable with the implants? Others who have the anatomicals and are questioning their choice would be happy to hear of your experience. Also, since your PS has access to CPGs and 410s, does he have an opinion regarding which version of anatomicals he prefers? Thank you so much for sharing this with us!
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Lisaellen: Beautiful job! Thank you so much for sharing!
Deborah: I would have preferred to get the anatomicals, but since none of the dr's I am able to see do it, when I need to have these changed out in 10 years, would I be able to switch then? Will I still get a good look without them? I'm kind of freaking out about the round implants and being a uni.
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MBJ: You are going to be just fine! You could use the Mentor Spectrum expandable in the native breast which would give the doctor more control over symmetry....
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Thanks Deborah. I'm just scared of ending up with two completely different looking breasts. Too much time on my hands and I see how great these women look with the gummies and I just wish it were the standard instead of being something only a select few can do. I just wish I had the option and the waiting is making me crazy and I just feel so out of control of the outcome.
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Thanks all for answering my questions! Now I understand why the native breast will be done later after TE on mast side. I'm not sure how comfortable I am with PS as I only saw him once and was an add on to his schedule. It seemed like he was quite disappointed that he could not do a DIEP flap and seemed to be taken aback by my previous surgical scars. I hope to be able to talk to him regarding questions I have but feel awkward about it. Does the PS measure the base width of the native breast prior to OR or during?
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Mine must have measured in the OR because I don't recall being measured prior... but then of course since you (like me) are a uni... they can always measure the remaining breast and match it.
Did I miss or forget something you posted earlier Odinsmom? What are the previous surgical scars?
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arrrrgh...
I can't take this... I'm soooo sick of being confused. I saw my PS today (I'm now at 445cc) and after an exam, he declares that he thinks I should go for 350-375cc implants?! WTH? *I* had asked for smaller implants and then he convinced me that 400cc would be better. Deborah agreed so I went with his advice. Well, now, he said that I am "smaller than he thought" and that I'll look like I've had a boob-job with 400cc. If I want to look natural, I need to go smaller. (Just to jog ya'll's memory, I'm small: 5'0" and a size 2. HOWEVER- my ribcage is freakishly big for my height- 31 cm...)
He also said that it would be "safer" to go smaller than 400cc... That my skin is really stretched. Well, duh... this is delayed recon...
I get what he's saying but I am so sick of thinking about all of this. Up, down, up, down....
So thoughts? Ideas? FWIW~ He did say that up to 400cc, he'll do whatever I choose. I just need to let him know at the next visit so he can order my implants...
And, Deborah~ He was planning to put Allergan 20's in me. He mentioned that he almost never uses 45's... Almost always 10's or 20's. So, yet again, you were on the money!
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Michele...I had to laugh a little....your ribcage is NOT "freakishly big"! Let me look at your numbers when I get back to my computer this afternoon...I will get back to you.
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Deborah- LOL! But, it *does* look big for my height (and lack of hips). My mom even commented on it several times when I was totally flat. I had that lovely starving-child look about me... wide ribcage (with all of the ribs showing) and rounded belly. Not cute. But now... I look like a porn actress so it's all good!
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Hello Deborah,
Thank you for the advice you gave me about 3 weeks ago. Just to remind you, I have Kasier insurance as well , and go to Kaiser Downey.
I would like to run somting by you. My PS just told me today that she can go with the expansion as far as I want. Initially I had understood that my expanders had a max capacity (so to speak) of 450 cc. I was worried since I was already over 300 cc with the expansions , and looking small.
Today she told me that she can expand as much as I want. My stats are 5' 5" , now 145 lbs (but as always planning to loose about 15 lbs) and circumference under breasts 32".
So , is it true what the PS said about the expanders?
Thanks,
Donna
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