BREAST IMPLANT SIZING 101
Comments
-
Ladies - yes - the TEs should correspond with the width of the permanent implant the PS plans to use at Exchange.
In my case, the PS used much larger implants, because I was so much heavier post-BMX. Neither one of us anticipated my losing so much weight. (Iwent through a weight-loss program suggested by my MO.)
Because of the radical change in my body measurements, whippetmom was insistent enough to have me 1) stop fills immediately, 2) choose a different size implant, and 3) insist on the PS doing lateral capsulorraphies....often called "pocket work."
Initially, the PS agreed that I should go smaller in the permanent (saline) implants. However, he said that he didn't like to do lateral capsulorraphies, as the difference wouldn't be that small, and that usually, in the healing process, the pockets themselves create a bit of scar tissue that minimize the space between the implants and the pockets. He also said it would cause more pain, additional restrictions, and longer healing time.
But I took in the Allergan catalog and my calculator, and nagged him incessantly about how I did NOT want my implants under my armpits.
So on Exchange day, he did do extensive pocket work, did do the lateral capsulorraphies (essentially stitching a U-shaped pocket so that the implants would not migrate in either direction), and gave me the the exact same implants as whippetmom had suggested.
Yes, there was more pain. Yes, I had a few minor complications. Yes, I had more restrictions, and a longer healing period. But I am SO GLAD that whippetmom knew her stuff, and that the PS listened. My 700cc saline implants are soft and pliable, yet I can lie on my back, and they don't fall into my armpits.
So ladies...before you even get your TEs, see if you can have that conversation about what implants your PS plans to use at Exchange. These are all important issues, and measurements do count.
Also - please think carefully about whether or not you plan to lose weight in the future. It can make a HUGE difference in how your implants look.
0 -
Thanks Deborah, I will talk to my PS again.
0 -
I forgot how to get on the picture forum again, can some one send the link?
0 -
Blessing thank you, I need to ask about the lateral capsulorraphies, cuz my implants do migrate to the sides when I lie on my back that is why I wear a bra allbthe time, cuz it gives me burning pain when they do that. Thanks again
0 -
Ninany: Saw your pictures! You are looking great! See my comments on your thread on the Pic Forum.
0 -
Whippetmom- I was reading old threads trying to find pics of the implants I may get and I saw some references that I did not understand. What is "bottoming out?" Does it happen often? If your PS used Alloderm, does that make any difference? Sorry to ask such basic questions and it has probably been answered before but I could not find a specific explanation.
Thanks,
Ally
0 -
Salina888 - have you already gotten permission to access the Picture Forum?
If so, go back to your BCO Private Messages, and find where you received your access and instructions from either Lilah or nowheregirl.
That's the easiest way to get into the Picture Forum, as it contains both the site information, plus the passwords you will need to enter.
If you have not yet received permission to gain access, and are interested in doing so, go to this thread: https://community.breastcancer.org/forum/44/topic/805466?page=1 and read the very first post under the blue box (which was accidentally deleted by nowheregirl.)
0 -
Whippetmom and other ladies, thank you for creating and posting to this thread. I am new to this thread, but I have been reading the posts. It's very helpful. I had delayed reconstruction surgery on April 29. The left side is LD flap with TE and right side is TE. I had 240cc filled so far, but since I am super skinny on my upper body, already feel so tight and too high (full) like two bowls covered on my chest. I am afraid they will look very unnatural after getting the implant. Whippetmom I need your advice if I should continue the fills and what kind of implant I should get. I am 5'4 tall, 113 pounds, 29 inches rib cage. My TE style is 133SX, the total of the fills is 350cc, I am getting 60cc every two weeks. I can send you a couple pictures by private message to show how they look right now if it's ok. Thank you so much for your help!
0 -
Xinghong - We have a similar build and when my TE's were filled it looked like you describe … bowls on my chest.
Right after my exchange, I had a lovely slope but as the swelling went down I do have a step off from my bony chest to the implant. It is not as dramatic as the TE but there is a step-off. It really bothered me for a while but I'm used to it now. Some women opt for for grafting and that can really help with the step off if it really bothers you.
0 -
Estel, can I know your TE and implant information?
0 -
Blessings, good post!
0 -
Hi Whippetmom,
I was hoping to get some advice on sizing. I am 5' 10" and 143 lbs.
I had my PBM 11 days ago and got 200cc in my TEs. Today I had a first fill of 50cc. They took out 320 from one side and 370 from the other. My expander is 550 Natrelle 133.
So I would like to be a bit smaller than before, or maybe the size of my smaller breast. My ribcage is 33" (or 32" if I pull tighter). Right now the expanders look quite wide and flat so its tricky to imagine how it will look as an implant. My PS does not over expand or under expand, though he brings 3 sizes into surgery. Is this enough info?
Thanks for your thoughts.
0 -
Xinghong - I don't remember my TE information … I had my exchange surgery approaching four years ago and I don't know where the card is that had that information.
My implants are style 20 High Profile Allergan 325 cc's. I am 5'5" and 110 lbs.
Edited to add:
I found the post where I first inquired about what size whippetmom would recommend for me and found my TE info:
It is here: I have an McGhan 133MV-11 (250cc) Tissue Expander.
0 -
Thanks Estel! Great information. You only got 250cc filled and got 325cc implant and you are saying you have a step off from your chest to the implant. I will have 350cc filled in TE, not sure about the implant yet. I am afraid it will be too much to get 350 cc filled. That's why I am here to ask for Whippetmom's advice.
0 -
No, that not what I am saying. My TE's were overfilled to I think 310 cc's but I don't remember exactl.
What I am trying to say is that we have a similiar build and the bony chest thing that you are worried about does get better after the exhange. And if you are not pleased with the results fat grafting can help
0 -
I see Estel! Looks like I have more homework to do. I will check information about fat grafting. Anywhere I can see your reconstruction pictures?
0 -
Ally: Doctors answer that question....Alloderm can help mitigate the problem....prevent it from occurring, but it CAN still happen with the use of Alloderm....
0 -
Xinghong: You have a short height extra full projection TE style, which tends to look very bizarre as it is expanding. But it is a good style of TE....and a good choice for you. I think you probably would be looking at an Allergan Style 15, (midrange profile) 304 ccs or 339 ccs. Your TE width is 12.0 cm and either volume would look very natural on your chest wall. You may not have any issue with a step off deformity, because of the type of TE your PS used, so you can cross that bridge if it occurs after the exchange. You also could go with around 400 ccs/425 ccs in a Style 20, which is a high profile implant, but it all depends on what you are hoping to achieve with reconstruction. Based on how you are feeling about the appearance and the roundness, I think you might prefer the midrange profile. Also, your flap is going to provide some of the "mound" on the one side, so the implant needs to be selected to give symmetry on the other side. That is up to your PS to decide. You can PM pictures to me if you like.
Deborah
0 -
lalli: You probably have a FX style TE? The only other 550 cc TE in Allergan is a SV style and it is 16.0 cm wide. So please verify. If it is the former, I would recommend Allergan Style 20, 500 ccs. It takes more implant volume to create a mound than the volume taken at the time of MX.
0 -
Thanks for the link!
0 -
Thank you soooo much Deborah! We are so lucky to have you here to help! I will send you photos shortly.
0 -
Thanks Whippetmom.
Yes my expander is FX. Specifically 133FX-13-T.
Do you really think I'll want a 500cc implant. They only took out 310cc and 370ccs and I'd like to be a bit smaller as that was a C/D cup for me (I don't think I ever wore the correct size bra, so i'm not sure exactly). Right now with 250ccs in my expander they look quite wide and flat so its hard to imagine how they would translate into an implant with similar volume....thanks for your help.
0 -
Hi Whippetmom,
I'm scheduled for natrelle 800cc ultra high profile silicone implants over the muscle with a strattice or alloderm internal bra, covered with fat grafting. Previously I had an 800cc mentor submuscular that bottomed out and a lift and reduction that dropped less than four months after TE swap. I have a lot of movement of the implant from being under the pec, as it is now. I also have a lot of hypertropic scarring. My new PS says my strength and appearance will be much improved. What is your opinion/experience/advice.
Thanks,
Wolfhoundmom
love those sighthounds!
0 -
lalli: You could instead exchange out to Allergan Style 15, 397 ccs. This is a midrange style implant.
0 -
wolfhound mom: I race with wolfies through LGRA - Large Gazehound Racing Assoc. They race at the same meets as the whippets.
I do not know of this as an approach for the repair of bottoming out, but if the implant animation bothers you, it is a clear solution. I worry about detection issues though, from a recurrence standpoint. Much easier to detect if unders, rather than overs. Have you discussed this with your PS?
Deborah
0 -
My TE's are over the muscle and my implants will be also. I never thought of this aspect until my exam in the survivorship clinic after I completed treatment. They said I'd just have to press harder. I'm starting to regret having it done this way although it wasn't my choice - that was my PS's method. At the time I wanted to get the BMX done as quickly as possible so I only 'interviewed' one PS and then changed providers to a well known cancer clinic. I have my pre-op appt. on the 15th and will ask him about it, but it's too late now, right? Anyone else on the thread have it done that way or heard of others who have?
0 -
bc101 - I have read posts from a few other women on BCO who have had implants placed over muscle, but I can't remember their names and it was a while back. Perhaps you could start a new thread to find others who have gone this route?
Some women have direct-to-implant under muscle reconstruction without stretching the muscles so perhaps it's possible for you to change course if that is what you decide. My best advice is that if you are having doubts you should address your concerns before proceeding with any type of surgery.
Best wishes!
0 -
Hi Whippetmom,
Hmmm, so you are suggesting either Allergen 20 500cc or 15 397 ccs? Can you give me an idea of how they would each look...maybe thats too general a question. But they sound like very different implants.
As a reminder, I'm 5'10, 145 lbs and my ribcage is 33". I had 310 & 370 taken out and have a 550 fx expander in. I'd like to be a little smaller than i was before.
Thanks so much for your thoughts!
0 -
Wheeptmom, ok so I am happy cuz i sign all paper for the new Ps. Consent forms etc but I feel sad cuz he had no clue as per when is the date. Basically he said I need to wait for his secretary to book the date now. He told me to call her. I called her as soon as I got out of the door lol and left a msg telling her all forms were signed and that i am ready just need her to find me a date as soon as possible.
there you go that's how it is here in Canada 🍁 .;) I have to say I am impressed with him he seams to know exactly what needs to be done. He said the implant she used it's no round one and that's why i lost the fullness of the upper poles. He told me he could look for round implants and then will let me know which one he suggests he has no access to sientra or mentor. I still told him I will need to have the style # and volumes in order to search an have an idea since he has no implants to show me . ANY way am glad cuz i feel he will do his best to make things better.
I asked him about the pockets work to prevent the implant from migrating and he took notes. Asked him about fat grafting and he took notes so he said he will do his best to help prevent the rad side from contracting again by using some fat injections. Overall I feel as if I am in better hands. I will let you know as soon as I hear the date and the implants style and volumes which he will use.
0 -
lalli:
Dr. Stuart Linder gives a good description of the various styles:
Allergan Style 20 vs. Style 15
The benefit of Style 15 for you, is that if you are afraid of too much volume, this gives you the width you need in a lower volume implant. It is what I often refer to as a more "athletic" appearing profile for reconstruction. Cannot describe it much more than this, as implants will look different on one chest wall as compared to another. Best to ask your PS to bring both into the OR and enlist the nurses to be your advocates for one or the other.
Deborah
0
