BREAST IMPLANT SIZING 101
Comments
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I am having my exchange on December 17 and just had my pre op yesterday. Whippetmom you recommended that I get the Allergen 20 425cc's probably with a high profile. I remembered my PS saying he doesn't typically use the high profile and so I assumed he wouldn't unless I asked about it. But he surprised me and told me he does use them in some cases such as me having a narrow chest. So that will definitely be what he is bringing into the operating room along with a couple choices. I have some rippling with the expanders right now but he told me we should just wait and see. And more than likely the implants will fit in a way that it should smooth that out. I hope so. I was surprised to hear I wouldn't be going off of my Tamoxifen and happy to hear that I would be unlikely to have drains or any heavy bindings! Yay! I am excited for the exchange!
Thank you Whippetmom for your advice! I told him about this wonderful community here online and specifically about you Whippetmom and your invaluable knowledge!0 -
Just had another fill today and we are scheduling exchange for Dec. 29. 2-3 more fills to go. Have not had any problems with them. I am excited about the exchange and praying for no post-op drama, esp. from that troublemaker on the left. PS says I have plenty of skin and she forsees no problem with the implants. She will likely do some FG at the same time to smoothe things out. Thank you for all the support you provide on this thread. Loved the turkey!!
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Hi Whippetmom,
I need to get into the nitty gritty on the implant part - he did not mention tissue expanders however this was my first consult and he recommended the following options: breast lift and reduction on healthy breast (not happy with that option as I would be very, very small breasted, especially for my body size) or lift with implants - I THINK he said implant would go behind muscle, not completely sure, pulling together my questions for him. I obviously do not know much about implants because I did not think I would be going that way - if smaller breasted women go in for implants for enhancement, do they still need tissue expanders? I need to research all of this and make sure I know what to expect..........
Any help/advice you offer is greatly appreciated.
Thank you very much for responding!
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Then don't have a reduction. Just have a lift and an implant on the native side and a larger implant on the MX side. However, you would likely need a tissue expander to get the best symmetry. Just my humble opinion.
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Hi Whippetmom,
I'm very impressed with your knowledge and all the dedication of time on this forum to help women like myself who are still I shock after the BC diagnosis and mastectomy, so helpless and trying to get some quality guidance from someone like you!
I've had BIlateral NSM with immediate TE on 11/7, had drains in till Day 25. The TE is CPX4 by Mentor with target volume of 350 ( I think base is 11.7). I'm filled to 350cc but the projection level seemed to be lower than I want ( not filling my pre-breast feeding 34B bras). I like the width, but want more projection. My PS said they can over fill another 50cc to 400, and if needed. And PS usually use slightly larger volume implant than the TE fill, so he said the implant can be up to 450cc if the full is 400, he will also do Fat Grafting to correct any implant edges.
The PA told me they like using Style 45 or the High profile (by Mentor or Allergan ), I'm nervouse that my PS didn't really hear my concern about the projection, and the wrong size is chosen at surgery.
I'm 5'4", 120lb, wider shower, rib cage is 28. Relatively athletic built with thinner upper body frame.
I would love to hear you thoughts -
1. Should I expand to 400 or 425 in a 350cc TE (Mentor CPX4, medium hight)?
2. Should I go for narrower base, highest projection implant (e.g. Style 45, if so, how many cc?) or (ultra high profile, if so, how many cc, what base width? )
I look forward to hearing your thoughts...
KindestRegards!
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SallyU2014:
Yes, I think you should continue with fills, as needed, to reach the 425 cc to 460/500 cc range with implants. The maximum amount of projection would be with the Allergan Stye 45 or the Mentor Ultra High Profile style implants. I like the Allergan dimensions better, in relation to volume. You would need, minimally, 460 ccs in Style 45 (11.4 cm width as compared to your 11.7 cm width), or Style 45, 500 ccs, with 11.9 cm in width. The next option would be Allergan Style 20 or Mentor's high profile smooth silicone round, 425 ccs minimally, and 450 ccs ideally.
Deborah
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I am experiencing so many problems using my iPad on this website. It makes it almost painful to type anything...takes FOREVER...it is bizarre!! I wish it could be fixed!!!
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Whippetmom,
Thanks so much for your guidance! I hope your iPad start to cooperate again
. Hi Whippetmom and other ladies,
Before meeting with my PS to discuss the implant size, I thought I'd ask if anyone had any experience with "shrinking" or lower projection after exchange from the Saline TE to the silicone implant? Anyone discussed with your PS on the projection goal in addition to implant type, base size and volume? I understand that the exact type of implant is chosen during surgery by PS trying on a couple of pre-ordered sizers, and when we are "under" on the operating table, so if our opinion matters to the PS, it has to be communicated to the PS at the meeting prior to exchange surgery.
I've read on RealSelf site by a couple of girls received silicone implant reconstruction, that due to the pec muscle pressing on the silicone implant, the actual projection shown on our body is quite lower than what's on manufacture's catalog? With the same volume, the projection could be ranging from 4cm to 6cm. Is it advisable to err on the high side? Of course I don't want mine to be too percky that becomes a focal point when people see me.
Another question is, how long do we need to wait (after the implant exchange surgery) till we can travel (e.g. take a cruise)? Anyone has any complication that need to be addressed right away by the PS, or usually can wait for a week?
Thanks in advance for sharing any of your experience or thoughts.
Kindest Regards,
Sally
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Sally, I had a NSM in April 2014 with reconstruction July 2014. I am 5'3" and 107# and was a 30AA. I was filled to 450cc and my PS used 425cc Sientra shaped implants. I feel like I did not lose any projection etc. But then I was so small to begin with, that any size implant would have been bigger than what I was originally (my BS removed 100 cc). But I certainly don't feel smaller than my TEs. I know that I am of the minority that has felt that way.
As far as traveling, I would leave that question up to your PS. As he/she can see how you are healing etc.
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OK. Thank you Whippetmom.
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whippetmom,
I have been having the same issues with this site and my iPad. Sometimes it even freezes on me. It only started recently but it is very frustrating...and is ONLY on this site...so I don't browse here as much.
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Yes, Divecat, ONLY on this website! It is so odd. I cannot use the photo upload icon, nor the icon to link another webpage....
feeling sad....0 -
Whippetmom & DiveCat - I don't have an iPad but have seen some chatter about problems. Are you posting to the Mod on the glitch site? Link below. They do pay attention.
https://community.breastcancer.org/forum/93/topic/787232?page=58#idx_1733
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Sally: Don't overthink the issue of projection. It sort of "is what it is"...Chest wall characteristics of the individual play a role where projection is concerned. You will get more projection with a Style 45, but it will be narrower in profile.Honestly, the Allergan Style 20 or Mentor HP implant happen to be the implant used the most for breast reconstruction, when silicone rounds are used.
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MinusTwo.....I messaged the Mods about my problems....I know they are working on it. It has been weeks though, that I have been having problems, so I thought it was just my Ipad. I was relieved to learn that I am not alone. I just hate using my laptop. It is old and so bloated with programs that it runs hot, heats up my legs, and sounds like an iron lung machine is running in the room
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Dogsneverlie: Also....for as many women whohad issues with tissue expanders, there are just as many, if not more of us, who did NOT have problems with TEs. I loved my tissue expanders and mourned losing them. Perfectly sized coconut shells, no bra required, those were the days. You can do this....
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hi Deborah, having ipad issues since Apple upgraded the OS. I can post pics and even did a link the other day. But sometimes it freezes up and I lose what I was going to post. I think it a combination of BCO and apple.
Well, I go in tomorrow at 10 am, should be home by 6. Wish me luck, I don't want to do this again! I'm a little afraid to look at them when I get home. I would hate to be disappointed by how they look. I know I need to wait a couple of months to see how they settle. I'll let you know how it goes
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Dogsneverlie-Some of the photos that these sites show are not women who have had mx or bmx. They are real boobs with implants, so they tend to look better. I know looking at my boobs and looking at my sisters, I wish that I had real ones still. My sister has real breasts with implants. When I told her what size my implants are she said the look smaller than hers. Then you have to go into the conversation of breast tissue vs no breast tissue.
Whippetmom- I agree, I loved the size of my TE's, they were perfect! Other than the feeling of the iron bra all the time. Speaking of TE's, what is the shelf life (no pun intended) on TE's? How long can they stay in? I know a woman who has had her TE's in for almost 10 years. I know my PS said that TE's should really stand for Temporary Expanders rather than Tissue Expanders. I'm curious if there are any health SE's from keeping them in that long. I know there isn't any issue with silicone leakage but what about the saline evaporating is that possible? These are just some of the things I wonder about. Never was a boob person until I got BC. My hubby and I will play the game of real or not real. ha
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Thank you very much!
Mentally I am becoming much more comfortable with the idea of implants; the PS told me I have pendulous breasts - never knew there was a term for my breast shape! Of course I did a Google and yes, there they are, PENDULOUS breasts!!!!!
I know that they have been this way all my life so visually I will need to remember they will be higher and "rounder" - - I'm sure that will be quite an adjustment for me but probably a great one, right?
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Hello All
I really need some opinions on strattice. My P.S that did the implant revision says strattice will make the breast feel like a thin piece of cardboard underneath. She tried alloderm and it didn't work- the implant is still too low and lateral. She said we could try strattice- but, mentioned that she doesn't know if I will like the feel/movement of the breast afterwards.
My good reconst. side is a bit firmer than my side that needs the revision. But, I don't want strattice to be put in the bad side and it to feel like cardboard. Anybody know anything about using one side with strattice and not the other and how it will make it feel differently??????
When I asked her what people say after she uses it in one side and not the other for instance bottoming out- she said she really doesn't use it that often...
thanks. any opinioins please
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hello everybody and whippetmom, looks like I'm joining this thread. I'm just finishing chemo in 2 wks and at of jann I will be having a mx on left side, still don't know if I'm doing it on rt side or getting reduction. I'm a 34DD or G right now and I don't want to be that big. I met my PS today for first time and he actually said that form yo body frame a 34 D would be good. How would I go about seeing how this even compares with u my actual size? He will be using silicone cohesive round implants.
Should he know before the operation what brand TE he will be using? He said that when he puts them in they will already be like a size c cup. Was not expecting that. And he will be using alloderm which apparently helps with the capsular contraction. I'm new at this.
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Dogsneverlie: It will take you about a minute to get used to not having pendulous breasts! LOL
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dancingdiva: Too little information. What is your height, weight and ribcage circumference? Not your bra band size, but the measurement around the ribcage under the breasts. Your PS will determine what TE to use based on your native breast width and also based on how much of a reduction is undertaken on the remaining breast.
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Stix: Here are some comments made by plastic surgeons about the difference between Alloderm and Strattice. If you google "Strattice vs. Alloderm" you come up with a number of links to the realself.com website where plastic surgeons answer these questions. Here are some of their answers to questions about the difference between the two products
"I have used both products for breast reconstruction with tissue expanders/implants after mastectomy. Alloderm is human derived acellular dermal graft and Strattice is a porcine derived dermal graft. Both products are made by LifeCell. I do not feel the word "rejection" applies to these products. These products are "acellular" therefore your body should not reject them. The term to use is "incorporation." These grafts have no intrinsic blood supply, therefore your body has to vascularize the tissue. If it gets vascularized, it gets incorporated. In my experience, the incorporation rates between the two are the same. Alloderm is more pliable then Strattice. I have had more drainage from using Strattice vs Alloderm therefore I have had to keep the drains in longer using Strattice vs Alloderm. This is the main difference I feel."
"Both Alloderm and Strattice are acellular dermal matrix tissue (ADM), the former from human tissue and the later from pigs. They both can help tremendously in breast reconstruction and are used extensively. The Alloderm is more pliable and stretchable versus the Strattice which is more rigid. There is no extensive double-blind study comparing the two and it is largely surgeon preference for usage. It seems that the Alloderm is incorporated a little bit earlier than the Strattice."
"Both products are what are called an acellular dermal matrix, which is the full thickness of skin with all of the cells removed. They become incorporated as your own living tissue and work as a sort of living internal bra. Alloderm stretches a little bit more than Strattice and seems to incorporate into your tissue more quickly, which are favorable properties for breast reconstruction especially when a tissue expander is used. Strattice is used more often for revisions of breast augmentation for things such as bottoming out or for coverage of rippling when the tissues are thin. Given your history, it sounds like the Alloderm may not have taken quickly enough and Strattice would not be a better alternative. Other brands of acellular dermal matrices don't really incorporate at all so that isn't the way to go either. It is important to have a suction drain in place to help the graft get started and this is typically in for at least 7 days and often more."
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Thanks whippetmom-
It doesn't really mention of how the two differ in regards to "how it feels".... One of my P.S. says it will feel no different the other says it will feel similar to a thin sheet of cardboard under the skin. the P.S that mentioned cardboard stated that we are at a good point right now - if we don't put the strattice in b/c once you put it in you cannot get that cardboard feeling after you put it in out. The article mentions neither...
So, I am confused???
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Stix: It is going to be "firmer" and more "rigid" than Alloderm. It is a trade off. Which is more important, how it looks or how it feels? You could do nothing and wear supportive bras 24/7 like many of us do. Additionally, there is no guarantee that the Strattice will correct the issue, right
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hi whippetmom, I'm 30 inches rib cage, 5 feet 2 inches, 130 pounds.
Do implants always take? I'm worried about removing good breast and then implant fails. I can't do anything else but implants....I don't have enough tissue I think.
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what do you mean by rigid? my good recons. breast is firm or tighter. But, rigid? Is it going to feel like cardboard? ?
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hi Deborah. I got Mentor memory shape 334-1455. Med height, mod plus profile. 585cc. Haven't gotten a good look at them yet. But what I saw looks good. I'll know tomorrow when I take a shower. Thanks for all your help. Hope this is last time! How do you keep us all separate!? Haha.
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Question... When you massage your implants can you feel bumps? Not like a lump but like the implant has bumps on it?!.... Or is it supposed to be smooth? I have allergen style 20 750 cc0
