BREAST IMPLANT SIZING 101
Comments
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Thanks! I am glad I asked again. I did not want to be a pest but after I included "upper pole" fulness, I started to see pictures that had low height or moderate height and I liked those results.
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Hi all. I have kind of a weird problem and thought this might be a good place to ask since others here are in the middle of reconstruction. I recently found a large raised area on my chest above my TE's and was really alarmed. It's like a 7-8 cm area that I can feel when standing up, but when I'm laying down it goes away. I had it checked out at my clinic and one doc at first thought my TE's might be leaking. He did a quick, non scientific test where he shined a light on it and said yes, there's fluid there. I had an ultrasound done, but as it turns out, they said it's just fatty tissue - nothing to worry about. The nurse at my PS office said over the phone that if there was a leak it would be deflated, which it's not. So that's great. I'm glad there's nothing wrong, but I'm wondering if the surrounding tissue around this mound was swollen after surgery and now it has gone down, leaving this mound. And maybe it's always been this way and I never noticed it.... Some days it seems more swollen - like when it's hot and humid. So is this just the defect after my skin sparing mastectomies? Or am I going crazy?
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bc101: Wow....I just do not know what that could be. One admission you made makes me suspect it is nothing to worry about, is the fact that it disappears when you lie down and it waxes and wanes in appearance and size. Mastectomy "defects" manifest in so many ways. But IF you see or feel any changes, start making some noise about it and ask your PS to aspirate the area of concern and culture it or biopsy it - whatever is appropriate. It might just go away on its own. I remember that I had sort of a "bubble" like area in my lower pole for a month after the exchange, but it eventually resolved. Keep us posted though!
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Ok, will do. Thanks whippetmom!
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Whippetmom, (or anyone else who would like to chime in
)I PM'd you back in the latter part of April with my sizing for TE. Allergan 133FX-12-T (450cc) SN 191382700 Left and 19138265 right. I am 5'3" weight 108# and ribcage 28.
You wrote back with some suggestions. My PS suggested Sientra textured shape round base 425 cc and said he would also bring in a 370cc. You had suggested the 370. Is 425 going to look too large on me?
My exchange date is set for July 3rd.
Thanks for your help.
Marybeth
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Olaf: What do you think of the size of your TEs? I know the height is probably exaggerated, but the overall volume and width....and how you look in clothes....too large, too small or just right?
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Whippetmom,
I believe I have gotten used to looking at myself with my TEs and size. It's quite a bit larger than what I originally started with (30AA). I can still fit in my t-shirts but it certainly is noticeably different. My PS tells me he has some good help in the OR who have a good eye. I just want them to fit properly. Not asking too much 😁. I keep going back and forth on size.
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Olaf: 425 ccs should be just fine. I am encouraged by your PS' comment that you will have a good cheerleading team of nurses in the OR who can give him their vote.
Edited to add that you will not be any larger than you are now, with 425 ccs implants, and likely will appear smaller. So it might be just the ticket.
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Whippetmom,
Thanks for the reassurance and help! It's certainly helps to have some good advice.
Merci Beaucoup
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Whippetmom, thank you so much for this thread. I was wondering if you could give me some advice on implants.
I just got a left latissiumus flap with an expander placed ( Mentor CPX4 tall height.) It was a delayed reconstruction. I had UMx 9/12 followed by rads 11/12-12/12. I think he plans to overfill to 400-500cc, probably closer to 400cc. I had a left mastectomy only. I will augment the right side at the time of the exchange.
I am 5'0" 100 pounds, 30" ribcage, petite frame, 33 years old
I was a 32/34 B prior to surgery. I would like to go larger.
I feel very confused about round v. shaped implants and which look I might prefer, especially with a non-reconstructed breast on the other side.
Thank you so much!!
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I forgot to add that the PS is planning to put the implant above the pectoralis on the left and below it on the right
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sandj: What is the "recommended" volume of your CPX4? Do you have this information - perhaps on a card given to you at the hospital? I essentially need to know the width of your TEs. I imagine that they are around 11.0 cm...perhaps 12.0 cm...but need to know to accurately determine what you need.
My primary concern is about the placement plan for the native augmentation. Why does your PS want to augment with subglandular placement on that native side? You stand a better chance at symmetry with submuscular placement, but more importantly, it makes mammography much better from a detection standpoint, as "overs" will obscure the mammographic view more so than "unders". Personally, I think that is crazy to place implants on top of breast tissue in a woman with a high risk for breast cancer, and I would insist on submuscular placement. I know he is feeling that he can get the appearance of more volume and projection with subglandular placement, but I would rather err on the side of caution for future detection purposes. This is worthy of further consideration.
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The recommended volume is 350 cc. It's 11.3 wide, 11.8 high and 6.0 cm projection.
Sorry if I was confusing. The native augmentation will be submuscular. The latissimus side where I had the mastectomy will be above the muscle.
Thank you!
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sandj: Thank you for clarifying!
I think you are going to want to be in the 350 cc to 450 cc range with high profile smooth round silicone implants. It all depends on how much of a "mound" and volume is provided by your lat flap. There is currently no FDA-approved anatomical Allergan 410 available which matches the projection of your TEs....if you are in the U.S. I just think that I would not want to go in that direction. Sientra shaped or round implants might be a possibility - worth discussing with your PS. With unilateral reconstruction, symmetry trumps size or volume or even style of implant. But I think that the 400 cc range is certainly attainable with the style and volume of your TE.
Deborah
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Hi everyone--I'm new to this thread and I have some anxiety about what implants to get! I'm 29 years old, 5'5, 28.5 in ribcage, 116 lbs and currently have the allergan 133FX-12 tissue expanders (12width/12.5height/6.3projection). My left TE is filled to 405cc and my right TE is filled to 445--reason being is for some reason my right breast isn't rounding in towards the center as the other breast and my PS wanted to fill to 'push it out' more. I feel like I'm not getting any cleavage because my breasts just stick straight out and almost a little out towards my arm more than they do to the center. Also I feel like I'm too full in the upper pole (and also uneven).
Anyway--this whole time my PS was kind of pushing towards the gummy bear implants, but now I'm having second thoughts about whether I should do the gummy bears or silicone rounds. I think the idea of having breasts that 'move' a little more seems nice, but I'm concerned about the rippling. Also--do any of the implants 'push up' in a push up bra? Or would they just look awkward or not move at all?
If any of you can share your input on silicone rounds vs anatomicals that would be greatly appreciated! I'm sure this is an old conversation and did try searching through the forum but couldn't find a thread--sorry!
Thank you so much in advance!
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DQ77, I had them both and there is not a huge difference in my mind. The Allergan 410 Style FF 740 cc gummy bears are a little firmer, but nothing like a full TE. They are not hard at all. Actually both kinds have been just fine. They both move around and there is cleavage. Neither of them projects much compared to a TE. I see some additional upper pole fullness with the gummy bears, but it's slight. We changed from Allergan Style 20 800 cc rounds to the 410's because they are so much taller and I needed some "padding" on my chest to cover several pronounced low spots (divots) that felt sore all the time.
From a consumer standpoint, there is not enough difference one way or the other to recommend one over the other. They both work.
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DQ77 - I have the same TEs you have and I am filled to 450. Saw my PS yesterday and will replace with Sientra textured shape round base, either 370cc or 425cc. I was originally a 30AA (5'3" 108#). My exchange is scheduled for July 3rd. And yes, lots of upper pole with the TEs, but that will all change after the exchange.
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Whippetmom,
Thank you so much! You are such a wealth of knowledge!
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Sandra--thank you so much for your input! So it seems for you that both implants are pretty similar--did either of them feel better in or same as well? Did either ripple more?
Olaf--are you getting the sientra textured shaped rounds high profile? Any reason why those were chosen over the allergan 410s? Goodluck with your upcoming exchange--let us know how it goes!!
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Hi whippitmom,
I have some time before exchange but thought I'd start this process. My ribcage under my TE's is 30". I am 5'4 and weight 114. My TE's are Allergan 133FX-13-T and will be filled to 550 CC. I am currently at 375 CC and this size is good for me. I do know that the permanents will look smaller but I don't want to be much larger than I am - so first question is do I have him continue to the 550 - will that be about what is right?. I want a bit of cleavage and currently do have that with the TE's. I am currently thinking I want round silicon as I am concerned with the anatomical not sitting right and or shifting in the pocket. I am looking for perky but squishyish - I know not a word LOL. I would love to hear your thoughts.
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DQ77,
He measured and then looked at the booklets with the available sizes. He did mention that he thought for smaller women (not necessarily height) the 410's are harder to fit properly. Plus I do remember him saying a while back that he had recently used the Sientra textured shape round base and was very pleased with the outcome. Yes, high projection. Will keep you posted to outcome.
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ALLERGAN ANATOMICALS
I don't know why these plastic surgeons are using the FX style TEs, if they are even remotely considering the Allergan 410. That is, unless you are in Canada or Europe or Australia or New Zealand, OR your PS was involved in the clinical trials and has access to the Allergan 410 FX style IMPLANTS. If they do not fit the above criteria, plastic surgeons here in the U.S. ONLY have access to the 410-FF, as the closest "fit" to your style of TE. The FX style is not yet FDA approved in the U.S. So, here are the numbers, using the FX-450 cc TE for example:
Allergan Tissue Expander Dimensions
FX-450 cc
12.0 12.5 6.3
Allergan 410 FF - 375 gms
12.5 13.0 5.1
THIS is the implant which corresponds to the dimensions of the FX TE:
Allergan 410-FX - 360 gms
12.0 12.5 5.7
So I would advise against using the Allergan 410, under the above circumstances, because it places you at increased risk for implant rotation. And trust me, these anatomicals do rotate.
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DQ77:
You are small framed and I agree with Olaf's plastic surgeon regarding "small-framed women and the fit" of Allergan 410s). If you are the one in five for whom the anatomicals work just fine, well, that is good news. But I don't want to gamble with those odds. The Allergan smooth round silicone implant or Sientra rounds or shaped implants are a much safer bet. You have a couple of options with the Allergan Style 20 or Allergan Style 45 (the ultra full projection style implant), and something around 475 ccs in Style 20 or 500 ccs in Style 45. Look at the links I have provided in the header to compare the dimensions of these implant styles.
More on Sientra implants in my next post....
Deborah
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Hi whippetmom,
I am not sure if your last post was an answer to me? If so, I am lost LOL. I don't want anatomicals as I fear rotation. Maybe I don't know the question to ask?
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SIENTRA IMPLANTS - COHESIVE ROUNDS
Disclaimer: This is just my personal impression and opinion of Sientra round implants. I reserve the right to stand corrected, once I have more evidence to the contrary!
Sientra rounds are great if you want upper pole fullness and can handle upper pole fullness (especially if your breasts naturally sat lower on the chest wall or you had quite a bit of ptosis/droop) but they do not have as much projection as the Allergan smooth rounds. Women with a shorter sternal notch to nipple distance - short torsos - would probably not be good candidates for Sientra rounds, because these implants are designed to give upper pole fullness and height, and you don't want implants sitting around the clavicle. It is not a pretty sight. ( Incidentally, I.would have been a good candidate for the Sientra rounds.) They are limited though in the size range, which I hope changes down the road.
Honestly, as far as Sientra implants are concerned, to date I have observed just a few cases where Sientra implants have been used. FDA approval was only five months ago, so there still is a significant learning curve. I feel that for women who do have skin laxity, had larger breasts pre-MX and/or had quite a bit of droop, the Sientra shaped, and likely the Sientra rounds, could be beneficial from the standpoint that they are more cohesive and firmer and maintain their position a bit better against the chest wall.
Deborah
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Thank you whippetmom!
That is really weird that my PS decided on those TE style for me if the implant isn't even available...when I first met with him before my surgery I didn't even know that TE style type can affect the outcome (I think I was still shocked with having BC and focused on getting it out). Now that I have had more time to look through the forums there are just so many more questions that I have. I was looking through the catalogue links and saw that the sientra TE's let you control the lower and upper pole--which in retrospect seem nice since I feel like I have too much upper pole and not enough lower.
For you ladies that have that Natrelle style 45 do they eventually settle down or do they sort of keep the 'pornstar'-ish round shape (I would like the projection but fearful of the balls-on-your-chest kind of look)?
Whippetmom I look forward to your post on Sientras! I was able to see the shaped sientra in my PS office and it looked like it has better projection than the 410s but seems to wrinkle a lot when I set it in my hand. Not sure if this is visible once they're inside of your bodies though.
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SIENTRA shaped implants:
If you are on the smaller end of the spectrum and if you are looking at implants in the 480 cc range and lower, I really like the dimensions of the Sientra Oval and Sientra Round shaped implants. Very nice width to projection ratios....
Again, I am only speaking from the standpoint of dimensions, as I have only seen photos from gals with Sientra tissue expanders and I think one shaped implant thus far. I do not honestly recall that it looked that much different than the results one would achieve with a silicone round. 0 -
DQ77...I have seen rippling with Allergan anatomicals....so no one is safe from rippling! It is a matter of having thin skin and/or creating too large a pocket for the implant. There are a few gals who visit this thread who have Style 45s and perhaps they will see your post.
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linda505: It was not for you! I see that you are NOT choosing anatomicals and I applaud your decision.
Oops....lost the last part of my response to you...
So referable to your question: With those full height TEs, I do not always feel it is necessary to fill to capacity. I feel that sometimes it places too much pressure on the pectorals and on the thin skin of the upper pole. I think you would be happy with Allergan Style 20, 500 ccs, and so likely have sufficient skin expansion already for this style of implant. Discuss this with your PS. He might want you to go up another 50 ccs to 75 ccs.
Deborah
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There are a plethora of plastic surgeons who are trigger happy about the anatomicals, because they were so long in achieving FDA approval. There was such a hoopla about them....and they were touted as being the end-all-be-all of breast implants. But the plastic surgeons who are most experienced about using them in clinical trials, KNOW that they are not a one-size-fits-all implant. There is a criteria to follow when using the anatomical implants. Grant Stevens, MD and Steven Teitlebaum, MD are the two principal Allergan 410 clinical trial docs, and they BOTH say that the dimensions of the pocket MUST be created specifically to match the dimensions of the anatomical implant.
"Anatomically shaped implants such as the gummy bear implant project more on the bottom than on top, mimicking the shape of a natural breast. If an anatomical implant rotates because the pocket holding it is too loose, it causes a distorted appearance that does not occur with round implants."
Dr. Stevens also advises against using anatomical implants when the patient has previously had round implants.
"The shaped form-stable gummy bear
implants, such as the 410 and the CPG, are
not ideal implants for women who have had
previous breast surgery and have already
pockets for those previous implants. Those
women have pockets which are generally too large to safely accommodate the
shaped form-stable implants. However,
the Sientra form-stable silicone gel breast
implants, which are round, can be safely
placed in these patients."0
