BREAST IMPLANT SIZING 101
Comments
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Divecat - thanks for the article info! I love reading research to help make informed decisions.
Cateyz2 and MinusTwo - Since your PSs were part of the study group, do you know what they say about fat grafting before and/or at time of exchange surgery, especially on irradiated breasts? Did you have FG done? I'd appreciate it if you could private msg me the name of your PS and where they're at; I'd like to get a 2nd opinion since my PS won't FG me and I heard it's a good method to lesson future capsular contracture. Thanks!
Moderators - I like the idea of finding my ideal implant volume with the bag of water in a strapped-on bra, but how does that work if I have TEs which already somewhat fill my bra? I see this method working on a flat chest (i.e. after mastectomy). Any other way to measure volume? Thanks!
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Superbody - The easy answer to your last question is 'ask whippetmom'. You can also try making your own sizers with rice and knee high panyhose. A little math, a little luck and you can approximate the size that you'd like: https://www.youtube.com/watch?v=zvwyW_evlxM
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Thanks, AZ85048, for the neat video - that helps!
Whippitmom - You were so kind to give me suggestions on implant sizing recently. I am waiting to hear back from my PS to see how many CCs they filled my TEs since I don't think they were expanded to the full 550cc volume. Your info was invaluable and led me to read more about sizing. While I wait to hear back from my PS, I'd like to get a 2nd opinion from another PS since mine won't do fat grafting before (or even at time of) the exchange surgery. I read this (new?) technique helps reduce chances of capsular contracture in irradiated breast, which I have. Do you have a list of doctors who practice this, by chance? I'm in the Kansas City area. Thank you!
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I feel compelled to chime in here. I actually have the exact same implants that cateyz2 just had removed.....Natrelle smooth round Style 20 550cc. I chose these over 410s and Sientra anatomicals when I had my revision. I'm just speaking for myself, but I'm quite happy with the smooth round implants. I personally didn't want my breasts to stay the same shape whether I'm lying down or standing up. I prefer a softer implant that "moves" a bit more like real breast tissue.
The same implants will not look the same on any two women even if they are comparable in height and weight as so much depends on torso length, overall chest shape, etc. In essence, I don't agree that 410 or other anatomicals are necessarily better (or worse) than smooth round implants - it's a very individual thing.
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Divecat - Thanks for the study info. Did have a chuckle at one typo of "argumentation" rather than "augmentation", but that's my weird sense of humour! I'm finding this discussion very interesting. Food for thought with my exchange looming!
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vfay49: I would opt for either the Allergan 410, FF-740 grams, or Allergan Style 20, 800 ccs. If you go with the anatomical, he is going to need to securely narrow that pocket, because the anatomical is narrower than the pocket created by the TEs.
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iwannacookie: No...the original TE size really does dictate to a great extent, especially width-wise, the style and volume of implant which might be used at the time of the exchange.
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Great information DiveCat. One statistic REALLY astounds me. This is one of the reasons I am so conservative about revisions. If you have a good result and there are just simple cosmetic nuances that bother you, please learn to live with them, rather than revise (which to me, means removing and replacing implants, as opposed to fat graft transfer, which is not "invasive") because the risk of complications increases so much. Look how the risk rate increases for revision-reconstruction!
with 6 year risk rate (capsular contracture) 10.7% for reconstruction, and 18.3% for revision-reconstruction."
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Superbody:
The only doctor on my list in KC, MO is Jon Rast, MD. I do not believe he is interested in performing FGT, although he is a wonderful plastic surgeon. He has some new partners in his practice now though, and there is a female PS, who might be willing to consider it. It is worth a call...unless you already are a patient of his...?
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Superbody - When I inquired in case I lost an implant due recurrent cancer & ALND surgery & radiation, my PS would NOT do fat grafting. Of course that was a year go so it may have changed. Luckily the implant survived the treatments so far.
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Divecat - I agree the 410s are not for everyone, in my case the outcome was well worth the revision
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Wow--once again I am astounded by the quantity and quality of information here. You girls, and Whippetmom especially, have really done your homework! Thank you all for sharing it.
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As for the "width" as it appears now with my TEs, I'm thinking/hoping it may look better once there's more projection to even it out. Now that you've given me a better understanding of how this all works , I'll be able to ask my PS more pertinant questions when I see her next Tuesday.
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To Whippetmom,
ok thanks. Do you want me to post here or with PM? My PS has recommended I look at Allergan Style 20 and 45. If I want anatomical, he prefers Sientra.0 -
dianems: You can post it here...
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cateyz2: Yes your revision turned out great, I can certainly see why you are so happy with it (and the 410s)!
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Cateyz2: Saw your photos. You look awesome!
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I know that number of cc's does not predict your bra size and what you end up with depends on your dimensions. But is there like a table or an approximator someplace? I am 38, petite, 5'4", 100 lbs, waist - 24", rib-cage - 26". Natural pre-surgery breast size was 32C. Honestly they were probably more like a full B, but because of my narrow rib-cage I had to go to 32 hence up in the cup measurement. Yes I was pretty large naturally for my frame. Bilateral skin sparing mastectomy August'13, chemo finished Dec'13, no radiation.
I have discussed with the doctor about going a size up because why the heck not after all the stuff I went through? Also, knowing that I may gain weight in the next 10 years and that I have no tissue in my breasts, I wanted to enjoy the busty look in my 30s and 40s and look proportional with a few extra pounds later in life as I will not be naturally gaining in my breasts like I used to anymore.
Long story short, I ended up with man boob looking pancake breasts. They are very wide in diameter and have little projection. It's the way they used to look smooshed by a sports-bra. I fit all the same bras, so they are not a size bigger. They are a B maybe but permanently compressed looking. I have to look away from the mirrors when I change for the first time in my life. It's very depressing.
My surgeon as acting like I'm crazy. He says I got 350 cc's which is plenty for my frame and that I AM a size bigger then before. That they look GREAT. He literally practically rolls his eyes when I tell him that I know my body that I still fit in the same bras and all my clothes fit the same. Yeah I know I have a frame of a girl who should have natural AA, but they were a full B/small C! He is always in a hurry and I bet doesn't even remember what I used to look like as it's been over a year. I have talked him into revision. He says he can give me 400 max but now with round implants instead of shaped ones. I don't want another disappointment!
How many cc's do I need to be a 34C, 32D??? Anyone with similar measurments out there? How many cc's did you get?
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IslandGurl,
If you go up in band size, you go down in cup size....but in any event a 32 band would be huge on you! Never mind a 34, yikes. Assuming a 32C cup actually "fit" your breasts properly which will be hard to tell without proper band size, you would have been more like a 28DD (harder to find, but not impossible...26 bands are available by custom).
This is why we don't talk cup sizes on here, because one can be very off as to what cup size they are, what they think a cup size looks like, etc. And the same cc's on two women with the same ribcage measurements, weights, and so on can look very different - our ribcages differ, width of chest differs, amount of tissue left differs, etc.
I have no idea what 400ccs will give you, and it will depend a lot on the implant manufacturer, the width, the style (i.e. high profile? ultra-high? mod-plus?). What I can say is that part of your disappointment sounds like it is in the shape of the anatomical implants...they do have a more "natural" slope that some like, and some don't. Round smooth silicone implants should give you a more, well, rounded, look. I have smooth rounds, Natrelle Inspiras which I think are not available in the US as I never see them on here for US ladies, on a 29" ribcage, in 435cc, and remain a 30E as I was before surgery, though the shape and appearance is different.
Hopefully whippetmom can help you out, she may want to know exactly what model number of implants you have right now, and may want to see photos via email or PM to give you some advice to correct the things that bother you about your current implants, in addition to the other info you already provided. I do know she won't talk cup size with you though! She has a moratorium on talking cup sizes
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islandGurl - The problem with talking cup sizes is that it is so relative. What you think is a b/c cup may not be what your P.S. thinks is a b/c cup. That's why it is important to talk in terms of your previous breast size. The weight (grams or cc's) was recorded in your chart when they removed. That measurement is NOT relative like cup size so it helps communicate clearly what you want. "I want to be bigger (or smaller) than I was before." Again, clear communication is key and cup size is variable and nebulous...not good when you want to communicate clearly.
whippetmom is awesome and has helped so many of us and she can help you too. I'm sorry you're not happy with your results. I may have missed it...but how far out are you from your exchange? Very few of us were happy with the results right after our exchange. They do take several weeks to settle in. Hugs to you.
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I DID read the header and that is what made me so confused. So many choices. At my first visit, last Dec, PS took all sorts of measurements and briefly went over all the options, including with lumpectomy, single side mastectomy and BMX. He told me to come back when I was finished with chemo. My breast surgeon strongly suggested the BMX but was open to discuss if I wanted something else. My oncologist also suggested the BMX, due to family history, but, all 3 doctors really left it up to me after providing all options. When I went back in May, BS said, with the size of my tumor, a lumpectomy was not advised. PS agreed that too much tissue would need to come out for clear margins. I had already decided on mastectomy but, during the 6 months of chemo, I went back and forth, talked to people, and read on these boards, to convince myself that BMX was the right choice vs one-side. I am so glad I did! Now I can get a more symmetrical bosom. As PS says, the important part was getting the cancer out, Now I have the rest of my life to get the look I want. At 57, my breasts had started to drift down due to gravity. it will be nice to have them perky again.
Diane0 -
Whippetmom: here is what my PS had to say about the TEs and implants.
They are Allergan 133 MV - 13 (medium profile) 300cc. I am expanded to 330cc. My rib cage is 32" Is there anything else you need to know? PS told me to consider a higher profile silicone implant, Allergan Style 20 or 45. If I want shaped silicone, he prefers Sientra. After the last fill, I looked down and said I thought I looked big enough. He told me to go home and try on my clothes to see what I thought. (I am able to fit into my old bras which is why I initially referenced my cup size.)
Thanks, Diane0 -
Mustered up my courage and posted a photo of my TEs on the picture forum, if anyone is interested. I have Allergan 133MX-13 filled to 500cc.
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3littlebirds - You look great! Don't worry about the TEs being a little wonky - almost everybody's are. They serve one purpose - to stretch the skin (well, that and to torture you in the process), but the good thing is that they're temporary!
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Whippetmom, Thank you for your
input. I feel confident that with the anatomical implant, Dr. G will
securely narrow the pocket.Sandra4611, I have been reading
some of your posts regarding the Allergan 410 Implants. I believe they will be the implants I will be
exchanging to in November. I find your
story interesting because you have actually experienced having both the
Allergan 800 cc Style 20 and the 740 Allergan 410 FF Implants.cateyz2 and MinusTwo, I am happy
to hear that you are both pleased with the 410's. Thank you for sharing your experiences.DiveCat, Thank you for sharing
the research on the 410's. I liked the
last paragraph of your post. In the end,
all we can really do is read and consider the research, weigh the pros and cons
of the implants we are considering, listen to our plastic surgeon, and seek
counsel from helpful individuals like Whippetmom.TinaT, I am still trying to decide between the 410's
and the Style 20. The things you like
about the smooth round silicone implants appeal to me also, which is what makes
the decision so difficult.0 -
Islandgurl:
Something went awry with the implant selection or with the placement of the implants, because on your frame, 350 ccs (if we were instead talking about a high profile smooth silicone round) would be quite ample, and larger than a "B" cup bra. (Basing this on several gals who have your vital stats and I know what size bra they are buying now).
So, all of that said, your comment about your ribcage and need for a 32 band bra, tells me that there is something else going on, which changes the sizing dynamics. Could you send me photos please? You can send me a private message and link photos by using the landscape icon, which is next to the goggles icon in the task bar just above this post. If that does not work, I will give you my email address.
Additionally, we need to find out the exact style of your implants....essential to know the width and projection you have currently. You might have been given a plastic card with that information at the hospital at the time of exchange.
Deborah
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islandgurl - for some perspective I'm 5'5" 107# 28.5 in ribcage and have 325cc style 20 allergen round implants.
I wear a 30D bra. I look like a b cup in clothes, though. You're in good hands with whippetmom.
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Thank you so much for your replies! Yes. I got a card. Not sure where it is. I did mention it was a teardrop shaped implant. Or did I forget? My doc said with how small my ribcage was he was constrained with what he could give me in terms of a shaped implant. And reading your explanation I understand it. Wish I researched before surgery. Or that he discussed it with me. I just trusted him.
Yes I did wear 32C pre surgery and maybe with how narrow my ribcage is (26") if I ever got properly fitted I might have been told I was 26DDD or something like that but 32C or even 34B on the tightest hook fit just fine and easier to shop for. And I am a mother who nursed for over 2 years, so I know my breasts have been in the D range. So having skin sparing mastectomy and having had enough skin for a D after nursing I was surprised I couldn't get a size bigger than I was.
To top it off the right one keeps rotating. I get a sharp bump in my cleavage or at the top. So it seems as though I could handle a larger implant. I think maybe as shaped implants that would make a C or a D and fit my ribcage are probably not available in the US he gave me something that was more like a 34B on an average sized woman. Which looks too wide and too flat on me. I just wish it knew that and gone for the round kind.
Your article actually has been the most informative piece of information I was able to find and I cannot thank you enough. I'll try taking pix and uploading them. I had a close nipple margine so they actually spared them initially but took them during the what was supposed to be a final exchange. Thank you this site is the best!
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