BREAST IMPLANT SIZING 101
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Miss Mama Bear...Do you want to email me/text me photos? You can also upload them in a private message to me.
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Hello everyone
I've been MIA. I had a few issues post op. I just woke up from a nap. I'm feeling a lot better. I read all of your responses and don't even know where to get started. It was a nice reality check for me. I could say so much but I wanted to check in with you all that I'm not MIA... and more than appreciate my new found friends. I can't wait to update you all on what's going on. Life is an interesting ride. Love,
Mary
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hi Mary, welcome back.
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Hi Whippetmom and others -
I was recently emailing with another board member in my town that had gone to Dr Namnoum, as I had. Dr N placed a larger implant in me and grafted around after I had a bunch of BRAVA work done by Dr Khouri for post-radiation reconstruction. Dr. N at the time said that it didn't seem BRAVA was making much difference. But now when this other lady just went, he recommended using it on a modified schedule then grafting. I found that so interesting. Such an ever-changing area.
I am doing well several years post rads and fatgrafting with implants. My skin is pink and healthy. I still haven't done nips, but I really want to! It is interesting to think that perhaps BRAVA might increase blood flow and make the nipple surgery a bit more healthy? Hmm.
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Ladies!
I just wanted to chime in and second what whippetmom has said about losing weight rather than trying to get larger implants. I always read so many posts here saying things like "Right now I weigh XXX pounds, but plan on losing..." or "I'm currently at XXX pounds but need to lose at least 30 pounds more...."
Most of you have heard my story, so I won't repeat the whole thing. But the bottom line is that I had huge TEs inserted in the beginning because I had no real intention of losing weight. MY MO changed that. I had to stop fills early, as whippetmom said I already had the necessary "footprint" I needed for the implants I should get when I reached my goal weight.
Thank goodness I did. I stopped at 620ccs, then went away for a while to lose weight. When I returned, my PS was astounded. He said "Now that you're so small, those TEs look HUGE!" And they did.
Whippetmom also recommended lateral capsulorraphies, which my PS initially said no to, but did anyway at Exchange. I am SO glad he did. The TEs were 16 cm wide, and my implants were 14.4cm wide. That would have left a nice big space on either side of my implants, allowing them to slop all over my chest, especially under my armpits when I was lying flat on my back.
He did the lateral capsulorraphies (pocket work) and I am SO glad he did. I did end up with 700cc smooth round, high profile saline, and I love the shape and the way they look on me. And no, they don't flop around on my chest!
If there is ANY chance you will be losing weight in the future, and plan to get TEs and implants, this is vital information that your PS needs to know ASAP.
And if you do have TEs or implants and are feeling somewhat small or flat, I can assure you that losing any amount of abdominal fat will increase the look and projection of the implants considerably.
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Thanks for your advice whippetmom ... I would have replied sooner but to tell you the truth I've been pretty depressed since reading your reply to my post. I think I knew what you were going to say but just didn't want to accept it just yet. You see, I had direct to implant surgery last year, May 7th, and my PS used 750 cc Natrelle style 20 ... Just like you suggested. But I felt very heavy and droopy. No perkiness or upper pole fullness. They just kind of drooped ... In my opinion. Just not the look that I had hoped for. I was VERY clear with my PS what my expectations were and I was not happy with them at all. So, at 6 months in November I had a revision and he was supposed to give me a lift and use an implant which would give me the upper pole fullness. I have no freaking idea WHY he would have used a moderate profile implant!!! Now I have fat, wide, flabby looking droopy breasts and I'm so upset!! So I was really, really hoping the 45 style would be exactly what I was looking for ... narrow and full perky breasts. I just don't know where to go from here. If he hasn't gotten it right so far ... maybe he doesn't know what he's doing!
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Wipplemom and others,
Please help --my statistics are as follows: 5 ft tall 105 lbs 28.5 to 29 inch rib cage measurement, 14 inches from belly button to clavicle notch. I am 52. I always been tiny (except when on tamoxifen) with large breasts. Due to a congenital disease called non-classic adrenal hyperplasia, I have long legs, arms and neck. I was supposed to be taller, but hit puberty at 9 and stopped growing after the grown spurt that makes kids look like colts,so I am a little short waisted, but most people don't realize I am so short until they stand next to me. Before I nursed my children, I was a 32 h. Before breast cancer was a 32 g. I had a left nipple sparing Diep with implant in 2009 - 2010. I had to gain 15 lbs for them to do it. I have had over 30 surgeries because a well known hospital left part of a Doppler device in my chest which took 4 years to find. It caused MRSA and Psuedomonis infections which resulted in the lose of my 3rd rib and part of my sternum. My left side is still a 32 g. A year after my initial diagnosis my genetic testing finally came back. I have Cowdens disease. Initially they told me I only had a 2 percent chance of cancer on my right breast. Now my risk is 85%. I kept refusing to do the right side because of the trauma I was going through with my left side. I recently had a scare and don't want to lose the opportunity to do a nipple sparing mastectomy, so I am having surgery on 5/21. I have already had the right size lifted. I later had a 400 cc implant put in to restore the fullness I lost because of the lift. My PS does not like the ultra high Implants, but will use the second highest mentor implant. He is going to use a narrow 750 cc expander with 800 cc implant, but he is unsure if it will match the size of the other side. I wanted to see what you think. Thank you for your help.
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NOLA....Ahhh...you did not say you were a "one step" previously. That makes a huge difference. You probably were not at all a candidate for a one-step. Honestly, now that I see you LIVE in NOLA, you are right there with the cream de la cream of reconstructive surgeons who can do what is necessary to give you beautiful results. Make an appointment with Dr. Dellacroce....he will know exactly what to do for you. Do not be depressed! Make a phone call to Dr. D's office tomorrow.
http://www.breastcenter.com/our-doctors/dellacroce/
Sorry....here is a better link:
Deborah
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hi everyone
Not sure where to ask this but maybe someone can share there experience with "double chamber" expanders? I had an expander placed on the left side yesterday (right side has bad direct to implant still to be exchanged later, left side was flat after complications) I haven't had a chance to talk to PS yet, I'll see him in two weeks but he mentioned this double chamber helping to expand the lower part of the breast since it was so tight. I'm not sure what fill volume is, but he said it would accommodate fills much larger then the right side (450). Wow, this is so overwhelming! Any feedback would help. I'm not sure of any info on the expander, I'm getting it when I meet with him but I'd love to hear some positive experience with theses
Thanks
Breezyh
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BreezyH: You probably have a Dermaspan tissue expander, which allows the plastic surgeon to expand either the lower pole only, the upper pole only, or both poles, in order to achieve expansion and fullness where it is necessary. Typically though, it is the lower pole of the chamber which is the chief focus with breast reconstruction. Projection of the NATIVE BREAST is in the lower pole. So artificially expanding the UPPER pole really is rarely a necessity with breast reconstruction, but lower pole expansion often is woefully lacking with most tissue expanders. The Allergan and Mentor short height/low height TEs do provide this lower pole, as opposed to upper pole, expansion, but the SSP Dermaspan TE has a leg up in this arena it seems. So it is a perfectly acceptable choice for your particular case BreezyH.
Dermaspan Dual Chamber Tissue Expanders
Anatomy of the Breast...
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Whippetmom, what a great visual! Took me a while to understand all that initially, could that diagram be something included in the header info for the newbies?
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I need to revamp the entire thread header. I just need to get a "round tuit" and I just seem to be procrastinating....
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if it's not just an easy C&P add, don't do it! You're busy enough, don't want to add any more to your plate!
How are you feeling, by the way!
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Oh my... whippetmom, your reply went to the next page. I kept refreshing and wating for your response but never saw the new page.... >.< chemo brain. I will message you.
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Heather: In your case, you are trying to gain symmetry with a mound which includes a DIEP flap and a 400 cc implant. I do not know how much "volume" , height or projection is represented by your DIEP flap. So it will be up to your PS to try a number of implant sizes in the OR. I agree that a Mentor "ultra full projection" would not be appropriate at all for you, as it only goes to around 590 ccs and it is too narrow. So perhaps a high profile smooth round from 650 ccs up to 800 ccs, if he truly believes that 800 ccs might be the number. It seems like a lot of implant - a WHOLE lot o implant for your frame. His OTHER option is an Allergan Style 45, which has a narrow base but a lot of projection, and probably around 650 ccs to 750 ccs would be worth investigation. It depends on how much projection you have on the DIEP side, because this does have significant projection. You can always email me photos (PM me for my addy) or post a photo to my private message box.
Deborah
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Thank you 2ndtime...I am feeling better each day.
I REALLY need to revamp the thread header....this week. It is a mess and no wonder no one goes there for information. 
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I will pm photos tonight. Thank you.
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Well, thanks again, Whippetmom
! I called the Breast Center and then filled out the medical history forms and faxed it all in. I'll be speaking to Liz tomorrow about scheduling a consultation. I'm excited and feeling like there may be some hope left for me after all!0 -
thanks whippetmom!
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Whippetmom, so you're not procrastinating, you're healing. As much as you do for us, you deserve a break too. Rest up
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Hi. I had radiation before my DMX. I have capsular contracture on the radiated side 3 months after the surgery. Anybody know how long to wait to get this fixed?
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Shaped Implants Require Precise Pocket Dissection and Placement
- Shaped implants require precision in pocket dissection and placement. If a round implant spins, it is still round. No change in breast shape will result. This is not true for a shaped implant. If the implant turns, the breast will change shape. If the surgeon makes a pocket larger than the implant, and places a round implant, the implant may shift or spin within the pocket. Not a problem, as the breast won’t change shape. If the surgeon creates a pocket larger than the implant and places an Allergan 410 implant (or a tear drop saline implant for that matter), the implant may shift or turn, changing breast shape. That is not good. So here, precise pocket dissection within less than a centimeter tolerance is important. The implant must fit easily but precisely into the pocket. This is not hard to do, if you know how and are experienced at atraumatic pocket dissection. I have been using an atraumatic techique to create the pocket since 2004, and have extensive experience with shaped saline implants. Placement is also an issue. I believe that shaped implants should have a slight tilt to them to achieve optimum aesthetic results, and this is based upon my experience with them. This is true whether a saline or silicone gel shaped implant. As sometimes I also lower the inframammary (breast crease) fold, properly setting the crease level is essential with the Allergan 410. So for me, from my first Allergan 410 implant case forward, working with a teardrop-shaped implant is nothing new to me. The surgical technique, simply put, must be more refined, meticulous and precise.
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NOLA: There is an active thread for women who have gone to NOLA and are going to NOLA. This is the name given to The Breast Center in New Orleans....You might want to join that thread. You can gather a wealth of information on that thread....
I am so happy to hear that you are going to have an appointment there soon! Please, please keep me posted!
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lindacam: Before going through an exchange surgery, I would advise that you have your PS try fat graft transfer to try to lower the grade of the capsular contracture. Perhaps removal of the implant will NOT be necessary. Once you have a development of capsular contracture, you are at even higher risk for this occurring again. So I would rather get that downgraded - or attempt to do so - before switching you to another implant.
Read my thread "Fat Graft Transfer and the Radiated Breast"....here is one link....
Fat Graft Transfer.....radiation and capsular contracture addressed
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Thanks whippetmom. I had drains in for a month and developed an infection so I think this helped cause the CC. It is Grade 3 right now. Would putting fat in at the time of an exchange helpful.
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Yes.
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Thanks Whippetmom for the note on shaped implants!
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grammakathy: There may be more of a margin for tweaking the width of the implants with Sientra shaped, because the rotation risk is not as much of an issue, and perhaps not an issue at all. I have never seen a rotated shaped Sientra (although they have not been available as long as the Allergan 410s), but I have seen far too many rotated anatomical Allergan 410 implants in the past five plus years. Also, I would rather stick needles in my eyes than be my plastic surgoen's first or even TENTH patient to undergo use of the anatomical implant. Every PS out there who has been involved with the clinical trials of the Allergan 410, uses the term "learning curve" when it comes to utilizing the anatomical device. I would want my PS to be well beyond that "learning curve"....
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The only "downside" with Sientra, and it might only be a downside for some, is that the Sientra implants were designed to provide upper pole fullness and so this might not be desirable for some women. I am 63 years old and I still find it appealing, and that might be a choice of implant for me, should I need a revision down the road. The term "mature breast" still sends shivers down my spine. As we age, and the skin becomes more lax, we could use this little assistance offered by one of the Sientra implants. Something to put on the back burner....
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whippetmom - I've never been one to wear a push up bra or even show cleavage! But I was overwhelmed by the impact I felt with a divot and scar across my left breast after my cancer mastectomy surgery. The next step was the prophylectic mastectomy and TE placement on both sides and I felt so much better immediately, even with a fill of 120cc. My left (cancer side) definitely shows upper pole fullness now and I really don't like that. The right side is lower and feels right. With the size I am now (420cc), I can fit into my clothes so much better and still show that I have a shape. And having firm breasts again at age 64 and after having two babies, is wonderful. I will discuss all this with my PS, who is wonderful. Thank you!
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