BREAST IMPLANT SIZING 101
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myhusbandisamazing: Mine is amazing too!
Your TEs have a width of 13.5 cm and I do not think you should have implants any wider than this at the time of exchange. So Mentor Moderate Plus with a volume of 450 ccs would be the absolute maximum for you. They would be smaller than you are with your TEs. Don't worry about your level of fill.
My concern is whether you have excessive skin flaps, since you were so large breasted prior to BMX. Or did he excise a lot of skin? If you do see extra skin overlying the TEs, I think that a high profile style implant would be better....as you do not want too much droop, right? Do you want to send me a private message with photos? Use the landscape icon next to the goggles icon, when you get to the message section. But via private message, not here on the open forum.
Deborah
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Two weeks out from exchange. I'm feeling great! And the PS doesn't even want to see me again until December! Whippetmom called it--Sientra shaped implants, though my PS got one look at the 425s in the OR and backed off to the 370 oval base. Apparently, it was quite a giggle fest with the 425s. Pics posted in the pic forum under road less travelled. Thanks Whippetmom. I honestly don't know how you do this. It's amazing.
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Thank you for replying so quickly. I am really stressing about this. I am really scared of being too big. Do you think once I gain weight I will feel differently.
My doctor did remove a lot skin during the mx but I still have some extra skin on the R side near my armpit. My R breast was bigger than my L so I quess that is why. My PS said he would fix it as much as possible during the exchange.
So If I tell my PS that I want a 420cc implant then I should be ok; not too big? I have not been overfilled? I have this feeling that since I went up 60 more cc today that I am stuck with it and can't go back down.
I would send you pics but recently one of my iphone photos ended up on twitter without me doing it. It is crazy and I have no idea how it happened but now I am a little leery about what pictures I put on my phone or computer.
Sincerly,
Carrie
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Whippetmom! What are your thoughts if PS decides he wants to go with Allergan 20 High Profile Smooth? Nothing was said in terms of volume.
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Galsal: I had to search back to February to find your implant information. So the TEs are pretty narrow. You have thin skin issues....did he use Alloderm or another dermal matrix? You are not filled to capacity...and so I think size might be an issue. I would like to see you get a little more width - and I agree that a Style 20 would be fine....because your PS needs to be assured of good skin coverage over the implants, and sometimes implants with too much projection can be challenging when the integrity of the skin flaps is at stake. I would like to see you get at least 600 ccs in Style 20.
Deborah
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myhusbandisamazing: Yes, Mentor moderate plus profile smooth silicone rounds, 425 ccs would be a very good choice, based on your sizing desires. Don't stress. Your fill level is fine. Just make sure you let your PS know exactly what you want in terms of implant style and implant volume.
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Thanks bunches, WM. No matrix needed, was no radiation done.
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Thank you so much whippetmom!!!
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Galsal: Most of us who have had Alloderm or Strattice or some of the other newly developed acellular products, have NOT had radiation.
Alloderm, Strattice or other dermal matrices are used as a hammock or sling to support the implants, and in situations where the mastectomy flaps are thin or damaged, the graft can cover your implant and reduce the risk of implant visability. Essentially, "acellular dermal matrices can imitate and substitute for a patient’s tissue when there is an inadequate amount of healthy tissue available."
It can be done in the secondary stage as well. Ask your PS if you might be a good candidate for an ADM at the time of exchange. It is very often used in revisionary surgery, so it does NOT need to be done at the time of tissue expander placement. I think studies are showing that there are potentially fewer complications with Strattice over Alloderm, but there are other newer ADM's available (unless they are still in clinical trials) and I know of of the gals on BCO have more information in this regard.
Deborah
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Hi Whippetmom,
I appreciate all your information. I am going in for about my 5th surgery to try to get the implants right this time and would appreciate any advice you can give me.
I am 57 years old, 5'6", 124lbs and my ribcage is 31.5". My original bra size was 34b. I wouldn't mind having a little more projection as I don't wear bras anymore (nice tradeoff) so I need a little extra to really have a decent projection.
I had breast cancer in 2002, lumpectomy and chemo. in 2003 chose to not do radiation, but double mastectomy instead. Right breast had cancer and they took a little more tissue out of that breast than the left breast. They did a thorough job of removing breast tissue so I have about 1/8-1/4" of flesh under my THIN Skin. They scraped the facia off my rib bones so I am very well cleaned out
. I had expanders under the muscle at the time of mastectomy and then put in round saline implants. Had those for a few years and then changed to silicone because of the wrinkling at the top. The silicone, grapefruit shaped implants also wrinkled.
I think we tried one more time with the grapefruit shaped implants before the gummy bears were approved.
Last february we put in the Allergan Natrelle 410 implants. My PS prefers the sientra, but I wanted the Allergan because I felt they would reduce the wrinkling at the top. And it did. I am willing to have the firmer implant in exchange for the obvious wrinkling of the Sientra. Have tried some fat grafting but it was unsuccessful at reducing the wrinkling at the top of the implants. My PS also says I don't have much fat to work with.
When choosing the 410FF 475's, I was so concerned about having a ridge at the top like with the round implants that we went too big. My mistake. My intent is not to be big....just to look like a girl.
The size we put in were the 410FF, 475cc, 13.5 wide, 14 high and 5.3 projection.The height makes them look like huge breasts on the top......I sent you photos in the private message. The projection is okay...wouldn't mind a little more, but could live with the 5.3.
On the left breast the implant pushed through the inside muscle so in June we added some Aloderm to support the implant. That should have been my first clue that they were too big! Ugh! The implants look bigger on the left side also, because of the extra tissue that was left in that non-cancerous breast.
So now what I see is that the implants are way too tall and too wide. Both of them. They bulge at the top instead of having a nice slope down. They come together too tightly in the middle. Both breasts hang over the side of my ribcage too far....but how far they hang over the sides is only visible by me and my husband for the most part, so that is not as critical a measurement to me.
I am going in soon to have them replaced again. I have evaluated what size I think would work in the allergan 410 style. I was hoping to be able to get the 410 FX or MX size that would have a projection of around 5.7, but the FX models are only in trial right now in the US and are not available. Depending on what you think would work for me I may try to get into the trial.
So my question to you is what size implant would you recommend in the Allergan 410 based on my measurements and the desired outcome I have described above and the photos of what I would like to look like that I sent to you privately. I would appreciate your advice for both the 410 FF/MF and the 410 FX and MX considering if I could get into the trial. I would greatly appreciate your thoughts on what size you believe would be right for me. I would prefer to stay with the firmer allergan 410's to prevent the wrinkling.
On your private note you will notice from the side view of the 2nd photo how much the implant protrudes at the top. I am thinking that a shorter implant would eliminate that and give the breast a more natural look. How much shorter is the question. So I would appreciate your recommendation based on my measurements above and the photos below. I have also attached some photos of what I would like to look like.I prefer to have about 1/2-3/4" of space between my breasts. Does that make sense?
I appreciate your time in reading this and providing your experienced opinion. Thank you so much. Pam
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Thanks, WM! I'll ask. It's the right side that keeps being the trouble maker. I can easily see it might need it. PS still finds it quite ironic since the BC side is the left.
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Hi Whippetmom,It sounds as though you are quite the implant expert and I would greatly appreciate your insight on implant selection for a likely revision.
I exchanged my TE's back in August and PS put in Allergan 410 FF at 655cc. I'm about 5'9 and 165 (ideal weight is closer to 150-55); rib cage 33/34 with a medium/large frame I guess. I'm OK with the current size (I don't want to be larger than a C) but I'm not crazy about the shape-- I prefer a perkier look with upper pole fullness. I expressed this to PS before exchange. He said he could get a perkier look with upper pole fullness with a shaped implant like the Allergan 410 but it didn't happen in my case. Also, I'm interested in an implant that will be a little softer without significant ripples if this is even possible. I'm prepared to do fat grafting as it will likely be needed in any case (my current implants are hallowed on the right side, and rippled a bit and so they would need fat if I were to keep them).
I'm not sure what other information you would need but please let me know. I can also private message you pics so that you get the feel for my chest/frame (I have a larger chest plate/bone that's hard to describe but this may impact how the implants will appear?).
Thanks,
Jane
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Whippetmom...Hi! I think I have come to the right place to ask some questions. I am 5'8 and 145 pounds. I just had exchange surgery on September 16th and I am so disappointed with the results I can't sleep. I had a BMX on January 23rd, 2014. I had TE put in. They were Allergan 133MV-14. At that time I talked to my PS and told him I wanted to come out a full C. I was a 36 D cup before BMX. I already had 425 saline implants put in previously before my diagnosis. I was expanded to 540 cc and then my PS said that was enough. He said he could put up to a 600 cc implant in at time of exchange to bring me to a full C. I went through radiation and came out good the other side of it. In June I saw the PS again and we discussed size again. He said my skin was too thin for saline as I was showing rippling with the TE. He mentioned the Naturelle 410 FX implant. It was 560g or something like that. I know it was one size below the 615g. I thought that is what we agreed upon. Fast forward to the week before September 16th when I got my surgery date. I happen to ask the receptionist what the PS had ordered. She told me he had ordered the 410 MF, FF and FM styles and ALL the sizes were SMALLER than my TE size (540cc). I asked for the PS to call me to clarify which he never did. I called again and the receptionist said we would have time to discuss before surgery. I was nervous and said the sizes sounded too small and were not what we discussed. Silly me I put my trust in him. I asked again before he came to make the markings on me and he basically told me I get what fits! Here I am 4 days post surgery and I just want to cry. He put in Natrelle 410FF 535g. I am nowhere near a C cup! I do not feel swollen or anything but if there is internal swelling I'll be even smaller soon enough. The dimensions of the 410 FX are the same as the FF just more projection! Why didn't he use these? I have no clue where to go from here. I see him next Thursday and I have to tell him I am not happy with the size. How do I approach this? I know he will just tell me to give it some time to settle but I read the cohesive gels don't settle much. They don't drop and fluff like the saline rounds. I am just beside myself after all the anticipation of finally being done with all this...
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Hi Delta D,
I am in a similar situation. First, do not panic. This is all re-doable. Yes, frustrating but you are not stuck. I am on about my 5th or 6th surgery since 2003. Not to scare you, but the gummy bears were not available at my first 4 surgeries and I was trying to get the rounds to work. I was also hoping that this last february surgery would have been my last....but alas, I chose the wrong size and didn't get a good read from my PS, who is a good friend also. A little mis-communication on my part. But don't fret....just another little bump in the road.
Are you in the States or somewhere else. I also want the MX version of the 410 but the X versions of the 410's are not available in the US yet. They are still in trial and I think it is expected to end in 2020. I ended up with the 475FF and they are way too tall and wide for me, so I am also going in for a change. I am also asking for sizing recommendations from whippetmom.
I think there are several things going on for you right now......when I was only out a year I was very emotional, thought every little pain was the big C. I gradually spun down into a deep depression over 6 years.....started probably when I was diagnosed and wish I had recognized it early on as once I started taking my antidepressant my world changed back to normal....watch for those feelings....don't suffer as I did for so many years.
As for replacements.....it will be good to wait for a while to let you body recover....then you can replace what you have. The good news is that you have something in now that you can gauge better where you want to be when you order your next implants. Your next surgery should be your last....take hope in that.
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DeltaD - This is Julie. I answered your email earlier. When I was first unwrapped, they looked very flat. I can already tell that they are getting a nice rounder shape. When I talked about swelling, I was referring to how swelling on the side can make them seem even wider. I can tell that is definately going down too. We are both less then 2 weeks out from exchange, so still lots of changes going on each day. We have the exact same implants. You worry you went to small, and I worry I went to big LOL. So far, I have to say I am liking them. Having some incision issues, but other then that, they are looking better every day. I think it is way too soon to really know.
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Hi! Thanks for the reply. I am in Canada and the FX are available here as far as I know as that is what we had previously discussed to put in. I didn't sleep a wink last night. the whole thing with my PS kept going over and over in my head. I am just so frustrated with how it all was handled.
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Hi Julie! I'll send you pics of mine via email and you will see how different mine look than yours! I know I have to be patient but I can tell they are going to be too small.
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Jane...I will respond to your PM tomorrow. Had more PMs tonight than I could imagine, so I am late getting here.
I responded to everyone else who also dupe messaged me.
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Whippetmom
I had my exchange done on Friday 9-19. I got Mentor 350-5751BC 575cc implant. Thank you for all your assistance through this whole thing. I'll post pictures in the picture forum later. Even after just 72 hours, I'm pleased.
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Thanks whippetmom. I completely understand and will look forward to feedback when you have time. I'm also PM'ing you some pictures now.
Enjoy the rest of the weekend!
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Pamwmontana brought up something I've been concerned about--she wrote, "Right breast had cancer and they took a little more tissue out of that breast than the left breast."
I had a BMX--(right side was prophylactic). TEs are in and are currently both filled to 350ccs, but my breasts look and feel different from one another. It appears (to me) that there is still some breast tissue on my right side. I have that impression because the inner breast feels sort of "normal"/fatty, while my left breast feels and looks like it is only filled with the TEs. I also have quite a bit of sensation in my right nipple, while I have none in my left.
I was under the impression that a BMX meant that ALL of my breast tissue would be removed. I understand that it's possible for a few cells to be left behind, but would the surgeon really leave in a portion of the breast?
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Pam and Delta....Responded last night to both of you via private message.
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Jane: Could you private message me and link some photos? The volume and style of the anatomicals should have given you some upper pole fullness, so there is something else going on. It is either due to your chest wall anomaly and/or implant placement. We will figure it out.
Deborah
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Oops..never mind Jane...I see you already sent them!
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BigT16...So glad you are happy with your results! Congratulations, and cannot wait to see photos!!!
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iwannacookie: The breast tissue - fat and connective tissue - should have been removed bilaterally. No reason to leave any behind on the prophy side. I would talk with your breast surgeon about this. You should still have follow up with your BS every six months for the first year or two...and this is a very good question. You can also obtain copies of your medical records - specifically the operative report for your BMX - which should describe how much tissue was removed and how the tissue was dissected off the chest wall. It is good to have those records in your possession. We all should obtain copies of our records - all of them - and keep them for future reference and for future generations.
Deborah
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twoam...thank you for helping Delta...
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Thank you WM. I have sent you another PM with more photos as I still need your wonderful advice.
Thank you....Pam
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My pleasure. Delta has helped me a great deal also. Oddly we are almost the same age, height, weight and have the exact same implants. Hers look way better though, and I am very jealous!!!
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Whippetmom!!!!
I hope you still remember my pix and my questions. I could not find my implant card and called my PS office last week. They were going to call me back with my style specs.... They did not. I finally managed to get a hold of them and all she told me was that I had Sientra 350E whatever that means... What do you think of them and what should I get since they are rotating and have too little projection for my taste? Thank you for any input you and other have!
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