BREAST IMPLANT SIZING 101
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duvan: I can help you pinpoint the implants that will approximate what you had with your TEs. HOWEVER, I need to know which CPX 4 height you had in TEs. Tall, Low or Medium? I can see why you feel your implants are too small....
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geewhiz: Honestly, if I had it to do over again, I would just go to Vinnie and get a 3-D. I am concerned about a flap for you also....with your radiated tissue and with all you have been through. With a flap, you might get a flattening of the mound....0 -
wow such a plethora of information! Thank you!
I had a left mx 18 years ago and reconstructed with a tram. The tram was always a little smaller than my remaining breast so 4 years ago I had a little implant added to the tram side with Alloderm and a breast lift/reduction on the "good"one. I was just dx with brca and am having the remaining breast mx so my ps is trying to match my tram! I am 5'7" and about 210 pounds (need to bring that down to at least 180) but meantime he says that if he puts in an 800cc silicone round it will match the size and shape of the tram pretty closely... He said my good breast right now looks to be about 900cc and it is noticeably larger than the tram even after the breast lift - very dense breast tissue.
So once my pathology comes back I will have an idea of when the fills will start and how often. At first I worried that 800cc wouldn't be enough now I wonder if it's too much but this guy is supposed to very good... I guess I'll have a better idea once we start fills? I'm a 42d at this point...
He also said I am not a candidate for nipple sparing as the breast tissue will be gone and the skin alone probably wouldn't be able to handle it. He suggested 3D as the best option and I'm fine with that. So many things to worry about...
Do you think I'm on the right track here?
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AlexaP: This is something you need to leave up to the PS, because I do not know the style or size of your implant, and even if I did, I do not know how much volume is created by your flap. I will say that 800 ccs sounds about right to me, in light of the fact that this is the largest smooth silicone round available. You can get a saline implant up to 960 ccs, but that sounds like too much to me. I would not want a tissue expander any larger than 600 ccs though, and certainly no wider than a 800 cc high profile smooth round, which would be 15.5 cm. You will get a much better idea on size, once you start filling that tissue expander. Keep me posted on what TE is used after the MX.
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duvan: Something in your post just triggered my abiility to calculate that you must have had a low height tissue expander. If so, the dimensions were 12.7 cm wide and 6.3 cm in projection. You could have your PS use the Mentor Ultra Full Projection style implant, 590 ccs, with dimensions of 12.5 cm wide and 6.3 cm projection. It does not leave a lot of wiggle room for good coverage over the implant, but he might feel that your skin can easily handle it.
However, since you are in Europe, you might not have access to the same version of Mentor rounds that we do here in the U.S. and might instead have the option of using the Perthese silicone rounds by Mentor. Please verify for me if you have access to same. If so, you could use the following implants: 485 ccs or 530 ccs. I do not have any experience or information about these implants, other than what I see in the European catalogue. Please inquire about not just the availability, but the cohesiveness of the product. If it is too firm, it will have too much upper pole fullness, which is what you do not want (based on the fact that you liked your TE, which had a height of 9.4 cm.)
Talk to DiveCat about her Allergan "Inspira" implants. (She is in Canada - they are not available in the US, but they are available in Europe.) There is a "Responsive" touch version of the Inspira which is pretty soft and would likely not have the upper pole fullness of the Perthese. Here is the catalogue page: You would want 465 ccs or 520 ccs in that style.
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thanks for the info. I'll quiz my ps about the TE. Definitely don't need to be wider than I already am.
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Hi Deborah,
I sent you a PM with an implant question. My exchange surgery is Oct. 28th. Less then 2 weeks! I'm getting nervous. I wish I would of gotten on the picture forum before now, but never figured out how to post on my nook!
I have no idea how I'm going to look. I like my plastic surgeon but we never had a conversation about what I wanted to look like. I sent you all the information, looking forward to your response.
Thank you!
Karmenn
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Karmenn: I responded!
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Exchange was yesterday and the pain is so much less than BMX! He did some pocket work medially, for sure so that is where the most pain is located. I was still groggy when he talked with me so I don't know if he closed the lateral at all. I have Allergan 20 - 425cc. I was expecting 450cc so I hope I like these. I just wanted to look like I did before and have my clothes fit. One thing I don't know is the profile. The surgical vest stays on for 2 days. Then I can take it off for shower only. I haven't taken a peak yet. Glad to have those TEs out. They felt like juice boxes.
Thanks Deborah for the help.0 -
dianems: You have high profile implants. It sounds good to me! Do not be shocked when you have the unveiling. They can look pretty misshapen...especially since you have significant compression with that vest you are wearing. Hang in there! Take photos weekly so that you can appreciate the progress!
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whippetmom, I tried to respond to your message but it's says my account is limited in the messages I can send. (?)
I canceled my surgery yesterday via voicemail so I'm sure they'll call me today. I'll find out my TE size and let you know. Maybe I have no other option than to go with what he said.
Thank you for all your help!
Karmenn
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Hi whippetmom! Finally got my TE info. It's a medium height 430. They're 14.5 wide. The rounds are off the table as I don't want another surgery in the new year. What do you suggest for a shaped implant? I'm filled to 595 now.
I appreciate your help.
I have no idea how that all got on the crossed out font thing! Lol
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whippetmom, Thanks for the heads up about how I will look. I wasn't so nervous with the TE since those were temporary. But, hopefully, these implants will be in for some time. PS tried to improve that tenting issue I had at the sternum. It may be just the way my body is shaped but, I am hoping for a better cleavage than before. Thanks again
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Eek! What do you mean by "the rounds are off the table as I don't want another surgery in the new year"? What do rounds have to do with "another surgery"? You are being railroaded by your PS....I don't know what to say about this. You can have an anatomical or you can have silicone rounds. You have the option. It is not rocket science. (Sorry...ticked at what they are doing to you!)Your tissue expander info is incorrect. There is only one tissue expander which has a volume of 430 ccs, and it is a Sientra TE, but the width is 13.0 cm. Mentor has a moderate height TE with a volume of 650 ccs, and a width of 14.6 cm. Allergan has a 500 cc moderate height TE with a width of 14.0 cm....So I am not going to try to guess what you have. You need to know for certain. They did not help you at all with this information.
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Has anyone had any issues flying with their TE in? I emailed my PS and he said make sure I carry my implant card stating I have an implantable medical device. Well...I was never given a card so he is mailing me a letter in case the metal detectors are tripped by the metal backing on
the expander, he said that should work. Just curious as to anyone else's story on flying. Thanks0 -
Karmenn, can you go to the hospital and get your records because your TEs sizing should be in your records. The hospital gave me a card with the info but when I had my exchange done (at a different hospital) they neglected to give me my implant information. I went to the records office and got a copy of my surgery report which had all the information.
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Kfinnigan, I can report no problems at all with TE's & airport security personally. I've read this question a few times on BCO and all that answered said the same thing. The screening device did not find them.
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Thank you Olaf I'll try that. Or calling again. I'm sorry whippetmom I meant because I can't afford to have to meet another high deductible. So that choice was mine. He does his fat grafting 3 months after exchange. I'll try to get correct TE info tomorrow as I have an appointment with him Monday and I want to know what you think first.
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I fly to Europe with my TE in place with no problem. I want through multiple security systems and no issue was raised ever.
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Thanks ladies!
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Just to pass along what someone else on these boards said - do carry your implant card with you ALL the time. If something happens and you have to be taken to emergency, docs will need that info.
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Good advice, Minus. Not long ago GalSal was in a car accident and one of her implants was damaged.
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hello
could i have a list for new york as well please?
i need a second revision with implants after prophylactic mastectomy
thank you
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liliane1: I sent you a private message....but I will also state here that I would like for you to give me a bit more information about your results, e.g., what you would like to change...what concerns you have...and the name of your PS in NY. I have a huge list for NY and I would like to narrow it down for you. You can PM me this information.
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I found a webiste of a plastic surgery group in Spokane, WA, showing some pretty excellent results using Allergan Style 20 and Allergan Style 45 implants. A few of these were delayed reconstruction cases.
Use of smooth round silicone implants in breast reconstruction
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Great link Whippetmom! Gives me a good idea of what to expect as you suggested this type of an implant for me and I think I'll be getting either 475ccs or 500ccs.Thanks for sharing!!
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Those are some awesome results. Thanks for the link Deborah!
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Dear Whippetmom,
I see how many women you have helped in their decision making regarding implants. God bless you!
Wow! I wish I had found this site a few months ago. Now at the 11th hour I am panicked! I am scheduled to have my exchange surgery in a couple of weeks and I am so worried. I am so afraid of the results. I have read online that one should have their expanders overfilled to ensure that the final result will not be smaller than the look of the expanders. Now I am worried that I overfilled too much since my PS wants to put in ultra high profile implants. I am also concerned about being smaller than I would like. Can you help me determine if I am on the right track? (my bra size before the bilateral MX was a C cup and I have been hoping for a C-D cup. I wore a 32-D when I was younger, before I had children).
I am 5'3" tall and weight 112lbs. I have a petite frame. My chest measurement (around my ribs and below my TE's) is 31." I currently have 450cc tall height TE's which I kept on a filling. My surgeon never told me that they were 450cc expanders, and stupid me, never asked. He just said to fill as much as I wanted. So I filled a little more than I wanted thinking that this was the thing to do to make sure they wouldn't be too small. All along through the filling process I have asked about projection since the expanders seemed so round and flat -- of course until I blew those balloons up! Now I am wondering if I have gone too far. I definitely don't want to go any larger than I am! my 450cc expanders now have 600cc of saline in them. My surgeon is planning to put in Mentor smooth, round, ultra high profile 590 cc implants. I currently have about 1 1/2 gap between my expanders that he says he will fix during the exchange surgery. I think there is a little give as far as moving them toward the center of my chest, but not much. I currently don't feel like the expanders are in my armpits. I have quite a "shelf" with the expanders filled as they are. I am wondering if I will have this and more with the ultra high profile's.
The projection issue is what is confusing me. I looked on the mentor website and saw that my 450 TE's have a width of 12.3 cm, 12.9cm high, and proj. of 6.5 cm. The Ultra High Profile implants have a 12.5 cm dia. and a 6.3 cm proj. I am thinking that my current projection must be more since the expanders are filled more than 450cc's. Am I correct in thinking this? If the 6.3 projection is a little less than what I currently have, then think I will be happy with these. If it is the same projection as my current expanders, or more, I am a little concerned.
Please let me know if the implant size my surgeon is choosing sounds about right. I am so afraid that I will have an unnatural look. Not that any implants after a mastectomy look natural,..but you know what I mean. I read somewhere that ultra high profile implants can have a tendency to drop over time and stretch out the breast skin, that if implants are too big for your frame you most likely will experience problems in the future. I have also heard that some women are absolutely thrilled with them and feel they look much better than the other options!. Your thoughts?
I greatly appreciate any insight you might have, or help you can give. Thank you!!!!
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409anne: Eeek....where did you read online that tissue expanders need to be overfilled to ensure that the final result will not be smaller? That is at best, an urban legend! There is no truth to this...not one bit! Not everyone needs to be overfilled in order to get implants the same size or even larger. It all depends on the individual. I was not overfilled, and MY implants are larger than were my tissue expanders.
The full height TEs really are designed to provide upper pole height and fullness and to expand the skin in that area. Overfilling really does not add much at all to the projection. With the full height TEs, overfilling just seems to displaces the TEs laterally and creates more height on the chest wall. The Mentor ultra full projection is a good style choice for some people. I think that the high profile smooth round silicone implants are more widely used, because they just seem to work well for breast reconstruction and for most body types. I would venture to say that when I see women with tissue expanders up near the clavicle - riding too high on the chest wall - I am inclined to feel that ultras might not be the best choice. I am not sure that this is the case for you...but if so, perhaps we could talk about another style as well, so that your PS could try several styles out at the time of the exchange.
Do you want to private message me and attach some photos? You can use the landscape icon above, which you see when you are posting, messaging, or replying to a message.
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Finally will join the Squishies Club today. PS plans on using Allergan 20 Round Smooth Silicon High Profile. Although the starting point will be 600cc, he believes with the width of my chest that I'll wind up with a 650 or 700 to maintain where I'm now with tthe TEs.
Unless I'm mistaken, this is pretty much on target with Whippetmom's suggestion for me. Yeehaw, let's get this show on the road!
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