BREAST IMPLANT SIZING 101
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PinkWalker, cc is a (metric) measure of volume; grams are a (metric) measure of weight. 1 cc = 1 gram. They are basically the same.
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Whew - that's a relief! Thank you again Deborah!
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My opinion is that we are so anal about our final size because, perhaps, it is the only bit on CONTROL we have over this whole process. Me, for one, being a control freak anyway....well it's a hot mess! My PS secretary probably cringes every day when she sees another email from me. Today she told me she always arranges to have implants of varying shapes and sizes available the day of surgery, so I feel ok. August 20 is coming soon!
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Beth that's what he told me but since everyone else seems to know the sizes I would feel so much better knowing what was ordered. If it's in the range that I have been hearing is good for me then I can be more relaxed! I will call later! So hard!
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I also sent this message to whippet mom so wanted to post here too for general information in case others are wondering the same.
thank you so much Deborah. I ended up going with everyone's recommendation of going 50 cc over what I liked so am at 475 cc even though he told me I didn't need to. They are too big! Now it's really rubbing along the sides of my arms and skin is so tight it feels like it's going to pop. I only read a little About people having some removed. I thought about having 25 cc removed just to get some relief or even 50 cc but not sure what the issues would be or what it would do to my skin. Any advice? I have two weeks until I get my implants so feel like my skin will be too stretched till then and it is very uncomfortable. I plan on calling later today to see what was ordered so want to know if I should mention this or not. I am hoping he uses your recommendation of 500 cc so they won't be too big.
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Good morning! I need to post this on a few boards as I mentioned it on a few so sorry for any duplications!
I was very happy with the PS consult! I was not sure if I would be told that I was not a candidate for FG or truly, WHAT I would be told. I have a 3D mammogram in October and told her I want to wait until after that just to make sure, would not want to go thru this FG procedure to then get disappointing news from the mammogram but WE KNOW I will get great news, right?!
So, my DH came with me as he does to all doctor visits, he is so wonderful. I am 40 pounds overweight so I knew I had enough fat SOMEWHERE to help refill my left breast and adjust the right one so they look more like each other! I told DH that this is different from lipo where the patient wants to get thinner, the amount of fat extracted for what I need is not going to make me skinny but he had to hear it from the PS, which is a good thing.
The plan is a final consult and prep on October 14 and then it will be scheduled for November. October 23 is the 3D Mammo so I will still have time to postpone if I need to. Need a full physical in October from my primary. She did tell me that for this one, she wants me knocked out and it will not be done in her office and the actual procedure would be about an hour. If I need any "touch ups" she may do them in her office. She explained the procedure which most of us know (light liposuction to the abdominal area, separate the good fat from the liquid, inject via needle into the breasts) - I think it's sort of an "eye ball" approach (as in - OK, they look good). She did explain that some people need several touch ups because they just can't say how much will be absorbed, how much will survive, if there are any areas in the breast tissue that are like pockets and the fat settles in there, etc. I am OK with all of this and truly, if they just look better and there's not a huge difference like now, I probably would not go in for touch ups but I can't guaranty that!!!! She measured both from my collar bone and whatever that measurement was she was pleased with and I don't think she believes my fill will be a big deal - not minimizing the procedure but I understand what she is saying because she sees masectomy patients, etc so for her, I am probably an easy one!!!!!!
Recovery was a little more than I read about - she said plan to be out of work 5-7 days, compression garments I THINK she said for 4-6 weeks, swelling and bruising - - she said even though it's not quite as intense as lipo for weight loss, it is still basically the same procedure.
Anyone have insight on their FG experience?
I feel a sense of relief that I am able to do this. I do not have large breasts, like a B cup (well now an A or AA and a B.....lol). I just want to be able to look in the mirror and "feel" like my breasts are happy!
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babyo20: I did not recommend another 50 ccs fill. You should have listened to your PS. If he felt he did not need to do it, then it was unnecessary. I do not ever advise continuing with fills when the skin is so taut and when it is possible to switch to the implant you want/need at your current fill level.
Deborah
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Dogsneverlie: There is a "Fat Grafting: Pros and Cons" thread....
I have had it done twice to address a divot and rippling. It is an easy recovery....you probably WILL want to have it done twice, waiting 3 to 6 months between procedures.
Deborah
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Sweetandspecial--thanks for the response! I think what drives me crazy is being (as bethq admitted to being) a control freak. I want to know *now* if I'll end up looking natural, or weird, or sort of in between. How will it all come out? Really, I should let go and decide that it will be ok no matter what happens. They're just boobs, right? I am truly happy for you that you love your implants!
I suppose everyone deserves a freak out or a melt down after cancer. We're generally good at soldiering on. When I've faced something difficult--like the terminal illness of a pet--I'm strongest when I'm making decisions, doing research, etc. It's hardest when it's over and you have to sit and feel the loss. I suppose that's the same in this case.
Thanks.
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Elizabethaw - So true.
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vfay49, thanks. I knew this formula was true for water, but didn't know how it might translate to silicone. The link was very helpful. Just trying to satisfy my curiosity. Thanks again.
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Absolutely - and don't get me wrong. I had meltdowns and worried and obsessed about implant size too! Once I found Whippetmom though, and started communicating very openly with my PS, I really didn't worry too much about it again. He gave me the size I asked for and actually bragged to the surgical nurses about me picking out my own implants!
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Whippetmom,
I have an appointment with my PS on Aug 11 to discuss FG. I have some of my expander and implant information and I was wondering if you could advise me if the size of implant I have was an appropriate fit. I am not second guessing my PS just wanted your input. It has not dropped and fluffed yet, it has been 7 months since my exchange and you had mentioned before that you thought FG would help with that. I had a lift on the native breast at the time of the exchange.
5 ft 8 in tall, 200 lbs (was 180 at time of exchange but gained wt thanks to Tamoxifen), rib cage is 39 inches
My expander is Mentor 6543404 LH 550 cc. I got this information from my medical record as the OR specimen when the expander was removed ( I cannot remember the total fill volume)
My implant is a Mentor smooth round mod plus profile gel 750 cc
Thanks for your input
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Tessy: The implant volume seems fine for your frame. I cannot say whether this was the implant which would give you the best symmetry, because I do not know what your native breast looks like. Do you want to PM me photos? Use the landscape icon next to the googles icon oo above. But send them via private message.
Deborah
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My incisions are horizontal as well. I remember my one week check up I ask the surgeon why the stitching didn't look as neat as my lumpectomy site and she said it would look better! She was right I am amazed at how smooth and thin the line is and like others hate to think about them going back in there. I do have one white dot that has become visible these last two fills, has anyone else had this? It is healed over still so I don't know if it is just where a stitch and now my skin is stretched so it is visible! Anyone have this so many weeks (12) out from surgery??
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I have been seeing that some PS don't overfill by 50 once you are at the size you are and some do. What has your experience been with TE size vs implant size in those cases where he doesn't overfill. Mine does not. I am about 25 cc more than I would have gone had I not been on this site since he told me to fill to where I like then stop. I listened to all of you though so overfilled by 50 but was so uncomfortable and so afraid of being too big that I went in to have some removed. Thus rather than be 50 over and have a 475 in a 350 TE I am now at 450.
Wondering how final implant size was affected for those who did not overfill their TE. Thanks!
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Babyo--I was filed to 460 (with 650 expanders) and received 500 implants. My PS talked me into filling to 460 when I was comfortable around 400-425. He wanted me to be bigger--I wanted to be smaller. I told him that the 460 TE's were fine in terms of projection but I felt they were too wide for me and smaller would be okay. He didn't "hear" me and gave me the 500's and did NOT perform any pocket work during the exchange. I am not very comfortable, still feel too wide (exchange was 13 months ago), and hope to have a revision after the first of the year to smaller implants (with a different PS).0 -
babyo20: From the header to this thread! You have enough fill!!!!!!
1. TISSUE EXPANDER - OVERFILLING AND REASONS FOR DOING SO:
Overfill is sometimes performed and it can be done so for a myriad of reasons. It can be done because a PS always does it in his practice [which makes no sense to me]; it can be done for assurance of good implant coverage with the skin flap; expanding out the skin a bit more so that a larger implant can be used, or in order to achieve ptosis [droop], especially in unilateral recon. It is not necessary in all cases to overfill and some docs never overfill, some rarely ever and some always do. But for those who are small-breasted prior to MX, it often is necessary, so that there is good skin closure, if a larger volume of implant is needed or if symmetry with the contralateral breast is required for ptosis and symmetry.
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Newbies - just to add to what whippetmom said about cup size - that is not the language that the PS speaks. Once a breast has had all the tissue removed, and is under reconstruction, cup size kind of flies out the window.
The docs will communicate in terms of ccs, and if you really want to have a good conversation with your PS, it will benefit you greatly to give ALL your details to whippetmom (either here or in private) and then go online to look up the actual catalog for your type of implant.
These catalogs - whose links are at the top of each page - will show you the exact specifications of each implant: make and model number, width, height, and projection.
PRINT up the pages that describe your recommended implant.
Take a look at the exact model whippetmom has recommended, then look above and below for the smaller and the larger sizes. Chances are, the PS will be taking both of them into the OR on Exchange Day, just to be sure that your body and ribcage contours (which are not always obvious through measurements alone) will accommodate the implant and give you good symmetry.
If there is anything that is really important, it is the size of the TE that is inserted at time of mastectomy. THAT is the time that the PS has already considered the type and size implant he will use at Exchange, and will be creating pockets to accommodate that implant. You want that TE pocket to match your future implant size as much as possible.
Cup size is deceiving, as whippetmom has explained. Be very careful about nagging your doc for a specific size. Descriptive terms are better, and in the end, implant sizing is a total combination of science and art. (Which, I might add, whippetmom excels at.....)
Like I've said before, I can wear a 34DDD, 36DD, or 38D, all underwires, without impinging on my implants, depending on the manufacturer and style of the bra.
AND - bottom line - your "permanent" implants are NOT permanent. If you feel they are way too small, or way too big, there is always revision surgery, which many women have. Usually it is for pain, poor symmetry, pocket defects, etc. rather than just dissatisfaction with size. But they can be changed. However, it is vital that you get the best match you can prior to Exchange, so you are satisfied with your outcome.
After all you have been through, this part is not a matter of life and death.
Wishing you all the best!!!
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Hi Whippetmom - I went for a fill today. My PS's NP who does the fills for him informed me that my PS does not over fill and he also does not put an implant in bigger than what I've filled to. You had said in a PM that "you thought I would be happy with around 450 ccs or 475 ccs in a high profile smooth round silicone implant - Allergan Style 20, since your PS uses Allergan. I think this would place you where you want to be size-wise." I hope my skin can handle to be stretched to 450 ccs or 475ccs. I know that the implants are smaller than the TE's. How many ccs smaller would you estimate it to be? Any thoughts or suggestions? I'm going to post my fills thus far on the picture forum tonight.
Thanks,
Joy
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joy, where did you post your pics at? Our Te is about the same so wondering your size and how they look!
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babyo20- I'm working on resizing and will post tonight on the picture forum. I need my fiancé to take a picture of the fill I just had today when he gets home for work. They should be up in a hour or two
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What is the picture forum?
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Two weeks post op revision left side... hmmmm. It looks pretty good...i think i may like it better than my 2010 mx. Rx. Side. Shapes are different. ..yet look better than it did prior to the revision... has anyone ever had a revision of the opposite side after they previously revised the other side.... does that make sense? I am really fed up with this... suggestions please. Thx.
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whippetmom I was overfilling so I could get a bigger implant since they settle over time. I want the end result to look like a full c so thought I had to stretch the skin more to achieve that. I don't want my skin to be so tight they won't fit . That is why I wanted to fill my 350 to 475 since I was happy with the size at 425 but now that I'm at 450 I like that too
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blessing thanks for the detailed information! Some of that I have never heard of so was nice to heat that. Like the size of the TE not overfilled matters rather than the size of final fill then, my TE and implants they might use are just about the same in size so does that mean it will fit better?
Could they do pocket work to get a bigger implant to fit or to make a smaller implant look bigger
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Tessy - the Picture Forum is a totally separate website from BCO. It was started by a member here, and access is allowed only by permission of nowheregirl or lilah.
Here is the link - even though the header was accidentally deleted, all the info you need is in the very first post. You may want to read all (9?) pages just to understand what this forum is all about.
https://community.breastcancer.org/forum/44/topic/805466?page=1
Once you have read all the details, the next step would be to PM nowheregirl or lilah to request access. They are the only ones who can do this.
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Hi, baby020!
One of the words that whippetmom frequently uses is "footprint"... meaning that there are three dimensions to consider when inserting a permanent implant into an already-created pocket: width, height, and projection.
I am no expert when it comes to how much leeway the PS has in trying to insert a bigger implant into a smaller pocket, but I know a whole bunch about trying to put a smaller implant into a bigger pocket.
This is where it comes down to good research as to the best possible size beforehand, so that you will not need extra pocket work at time of Exchange.
I do know that the PS has some ability to release more of the pectoral muscle to accommodate a larger implant, but I'm not sure this is the best method. Like I said -I'm no expert.
However, what you DON'T want to do is put a smaller implant into a much bigger pocket.
That's like buying a pair of size 8 shoes to wear on your size 5 feet. They'll do nothing but slip around inside them.
Fortunately, the PS CAN make the pocket smaller at Exchange.
When whippetmom advises ladies to not overthink things, she's right. She knows exactly how nerve-wracking it is to go through BC treatment, and FINALLY - getting your permanent implants is like a small reward for everything you have endured. You want them to be PERFECT! I know I did!
All I can say is show your PS whippetmom's recommendations, see what his are, and if they match (YAY!) and at some point, just have faith that between the two of them - whippetmom with her expertise and knowledge - and your PS with his ability to actually SEE you, plus the fact that he'll try several sizes on you, will come up with a good outcome for you!
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I love you
I just needed that reassurance from people who have been there. You both have been do helpful too I am now the size I love but still go back and forth in my head wondering if I dhoukd have kept that extra 25 to stretch more. I am a perfectionist and you would think after all we have been through we would be grateful for this not caring. But instead I want then just right. Like everyone says we go through so much that this is something positive we have some control over. I did check out my implant size vs et size and I guess I need to just tryst my PS who doesn't need to overfill who I constantly tell I wNt to be a full C too. It's like I feel that if the end result is much smaller that I will have my boobs taken away from me once more so don't wNt that to happen and that is what I worry about
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Sometimes I think this whole process is God's way of saying - hey, you folks need to remember who's in charge here. We can only do our best in terms of research and communication with each other and our doctors and then at some point we have to quit the obsession and waffling between this and that possible outcome or imperfection or option or opinion, then make an informed decision and make up our minds to be content until we have a good reason not to be. It's mentally and physically exhausting to keep going round and round and round about things. Easier said than done, though, I know!
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