BREAST IMPLANT SIZING 101
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dancingdiva: The implant-based reconstruction failure rate is actually quite low, however, risk factors are higher for women who have had radiation, and/or are obese, the latter findingpart of a more recent study. A study was performed at Massachusetts General from 2004 to 2010 and here are the results:
Out of 1,962 patients followed over a period of six years, "the total reconstruction explant rate was 3.2% (62/1952). Following explantation, 32 patients had delayed tissue expander insertion after an average of 150 days (range 22-305 days), 6 had delayed autologous flap reconstruction after an average of 139 days (range 93-213 days), 13 patients had no further attempt at reconstruction (average follow-up 817 days), and 5 patients were lost to follow-up. Of the delayed tissue expander insertions, 26 were successful and 6 had recurrent infection resulting in implant loss."
I think you would be looking at smooth silicone rounds in the 500 cc to 600 cc range.
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Stix: I have no idea. I did not say it....the plastic surgeon who responded on realself.com made the comment that it is more "rigid" than Alloderm. But anatomical implants are more rigid than smooth silicone rounds and most women are fine with that trade-off. It is ALL so very subjective. What is tolerable for some, might not be tolerable for others.
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Smaarty: Congratulations! Cannot wait to hear the report after the unveiling. Are you kidding? I cannot remember anything! Menopause and Tamoxifen hijacked my brain years ago. I
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Divecat
Let me see what i can find out and do some measuring. Thank your for your response. I did find out that he put in 250cc on the table and now i am at 370cc and my expander goes to 550 but can be "overfilled" up,to 600cc but Im guessing that would be way to big for me so we wont even go there. Will find out brand.
Thx!
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Hi Whippetmom,
It's been a while (July) that I reached out to you for implant advice. I went to my pre-op appointment yesterday with my PS and you were spot on once again. He is going to go with style 20 HP smooth round either 450ccs or 475ccs....exactly what you suggested. I just want to thank you for helping me and all of us women here on BCO. Because of you, I went into my appointment prepared and confidant. Exchange is Dec 17th, a week from today. I cannot wait to get these hard TEs out. So excited to be getting new foobs for Christmas!
Thanks again for all that you do. You're an angel!
Much love,
Joy
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I had my exchange Nov 7 and feel I should have gone a little bigger. I was expanded to 450cc with 400cc te's. My ps used 425cc allergen hp round. I go back in February and wondering how difficult it is for them to go larger and will I need new te's first. Thinking of going with 500cc hp round to achieve a c cup. My ribcage is 29 and I'm 5'4 127. Can anyone offer any advice or experience.
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sandgar,
Don't talk cup sizes! I have a hard time believing you are only a C cup with 425 rounds. I have a 29" ribcage, am 5'4", and about 115-118 lbs...my 435cc Allergan rounds (also a high profile) have me wearing a 30E. So, I am thinking you might be wearing the wrong size bra.....which is why we don't talk cup sizes here...nor should you talk them with your PS as many are pretty clueless as well as how bra and cup sizes work. A C cup would be a 3" difference between your ribcage measurement and your over bust measurement...I am guessing your difference may be more than that.
Express to your PS that you are unhappy with the size and see what is possible. Depending on your skin elasticity and the like, 500ccs might be possible; you shouldn't need TEs again but that all depends on your body. 75ccs is about 5 TBSP spread over the entire implant so not a huge amount. Whippetmom knows this stuff much better than I, but I have seen many women with similar stats end up with about 500ccs.
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divecat:
I still need to get the info to see what whippetmom thinks but I do want to tell you that I agree that most women are wearing the wrong bra size but I have always gone to a specialty bra boutique or Nordstroms in the past and been professionally measured each year so I think I am in the right size? But who knows?
Funny thing about my reconstruction surgeon talking cup size ( and I know they don't normally) is when I went in and was talking to him about cup size he felt my breasts quick and said, "what are you now a small C?" Which was exactly right. I laughed at him and told him he could do part time work at a traveling carnival if he ever wanted to hit the open road, like guessing peoples weight. Lol! Enjoy your evening ladies and I read through all the things needed and will know more after my fill appointment Monday and get that all for whippitmom.
Thanks Ladies!
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sandgar: I agree with Divecat....with a 29 inch ribcage you should be in a 32 band, which might change your cup size. However, cup size is irrelevant...it is a matter of proportion and how you feel about the size. As Divecat stated, a 500 cc HP smooth silicone round would be appropriate for your vital stats, as well as your formerTE width and volume.
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ojoyjoy.....So happy that it has worked out for you and that we are all on the same page!Keep us posted on how everything goes!
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Or maybe even a 30 band! I find most 32s to be too loose for me on my 29" ribcage - okay for a sleep bra but not for regular bras or sports bras
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Hello All,I have been off-line but wanted to update everyone regarding the "shapers" I had been trying to get information about.
As per my PS the saline gummy bears being used as shapers is a method that has been developed to get a more natural shape for the silicone implants that will be used in my final exchange. In using the gummy bears he gets the scar tissue shape that he desires and then places the final silicone implants. I viewed his results photos and decided to move forward with this method.
I have been keeping photos of each step and will post them once we have gotten to the final result.
Thank you all for your advice and support along the way.
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Erinjmp, my PS talks cup sizes also (and he was spot on with my size too), he says he doesn't talk cc size because every woman is different...go figure lol
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RAM: It would be great if you could get some mfr and style numbers from your PS. There is no such thing as a "saline gummy bear" implant. There are saline shaped tissue expanders, such as the Sientra TEs....and TEs made by SSP Corp. The term "gummy bear" refers to the consistency of the cohesive silicone used in the 410 and CPG anatomical implants and the Sientra anatomical and silicone rounds. There are saline shaped/anatomical implants though. Perhaps this is what your PS intends to use
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Hi Whippitmom,
The following were used as "shapers"...Mentor Siltex Contour Profiles Moderiate Saline 500cc's
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RAM: So he is using saline breast implants as "shapers". Got it. It will be interesting to follow you to see how he does this. Keep us posted!
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DiveCat, regarding my current size, I was a B cup before bc and tried on my old bras and they fit so that is why I think that's my size. Sorry for referring to cup size again lol! My surgeon didn't seem too thrilled about re-doing anything anyway so we'll see.
Has anyone had scar revision? My scar from necrosis surgery after bmx is wider and has a dart on the end toward the middle of my chest. Wondering if that can be fixed.
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good luck happyteacher!!! Speedy recovery and perfect outcome!
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RAM--Wow! Saline breast implants as shapers instead of tissue expanders sounds like a more comfortable way (for the patient) of performing breast reconstruction. I hope this has some promise and catches the attention of other plastic surgeons performing breast reconstruction. Keep us posted on your progress/results.
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LoriWNY: I had tissue expanders. Upon removal of the expanders he is using the saline implants to get the shape he wants which he feels is a more natural shape. He will leave these in to form the scar tissue in the shape he wants then use a silicone implant for the final exchange.I will keep everyone posted and sent pics of each step in the process upon completion.
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LoriWNY:
Well, there is direct to implant (which I had), but not everyone is a candidate for it. Going direct to saline implants and then to silicone implants would just be a form of direct to implant with a revision later. Not sure direct to implant is necessarily always more comfortable - no TEs yes, but I often hear some say the upfront recovery is a bit more difficult as you are stretched to final size already and usually have a lot of pocket work done (Alloderm, etc). I don't know as I can't compare as I never had TEs and had a pretty smooth recovery. And some have had little problem with their TEs.
TEs have a purpose for women who need expansion for whatever reason and can't go direct to implant, as they have a very different purpose than implants. As RAM2013 advises, she did have TEs to expand. Her PS is first doing an exchange to saline implants and then an exchange to silicone implants. I have honestly never heard of her PS's process before she talked about it earlier in this thread and will be interested to see the results. I imagine he must first break any capsule that formed around the round TE though (as capsules do form around the TE), as otherwise he would just be putting anatomicals in an already round formed capsule and would not get that shaped scarring he is aiming for. I readily confess I don't quite understand it when there are anatomical tissue expanders available as well as just shaped silicone implants, and an extra surgery would make me a bit nervous, but I am still interested to see the results and whether there is a difference between those who go from TE to final implant immediately once both have had time to heal.
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Hi,
I am new to this discussion board. I had my exchange done 12/3/14, I saw my doctor yesterday for bandage removal , my implants are nothing what I was expecting or discussed with the doctor as to what I wanted to look like. I was expanded to 500cc which I was very happy with how they looked , I chose to put in the natrelle 410 and he choose the style of MF410 with only a 470cc, when I asked him why only 470cc were put in ( I wouldn't have known but I saw it on my hospital bill) he responded with that was the closest to 500 . These look like wide flat pancakes on me. I could go on and on about my disappointment but my question for anyone is did insurance pay for the reconstruction to be re done when you were not satisfied with the results?? I have to get theses replaced with something different, I believe he should have told me I was not going to get anything near what I was expecting to look like with choosing these shaped implant, I trusted my doctor.
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Bbetty, it's a shame you weren't able to get some info about implants before your surgery. Then you would have known that what you see is completely normal. They look like the top half of a hamburger bun at first - wide and flat. I called mine man-boobs. The good news is that your implants will change in ways you might not even notice unless you take photos. But in a couple of weeks they will look better and in a couple of months they will take on their intended shape. Hang in there. You are normal.
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thank you whippetmom. Ur like a whiz!
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I am new to this board also. OMG, BBetty, I could have written your post!!!! I had my exchange on the 4th. I went into a huge, deep depression all last week. (very unlike myself). I did nothing but cry and stopped eating. Had I done more research, I could have saved myself a whole lot of anxiety. Definitely read the information Whippettmom contributes on the Exchange City thread. She is wonderful. I didn't know that the implants take several months to settle to their final location and shape. Nobody told me anything preop. I had done so much research on every other aspect of my treatments, that I just let the implant thing go and I should have asked more questions. Anyway, my post-op appointment was yesterday and I went to see my old PS the day before, just to get his opinion before I talked to the surgeon who did this job. (I had had some elective PS done four years ago, and I trusted old PS to tell me the truth)
When I talked to my old PS Thursday, he told me that he thought the job was beautiful and that given how tight the irradiated skin side looks, he thinks the implants should not have been any bigger. However, he suggested that I ask the current PS
1. Does he expect the breasts to change in the coming months?
2. If I still want bigger in 6 months, would he be willing to consider a revision if the skin will tolerate it? (by the way, insurance will pay)
Then Friday, I went to my post-op appointment and much to my dismay, it was the PA I saw and not the surgeon. PA is a lovely person and said the same thing the old PS said. She said she thinks I am bigger than say- and she told me to switch to a real bra as long as it doesn't have underwires and gives good support.
The best news is this......On the way home, I asked my husband if he would take me to the mall so I could buy a real bra. I went to Victoria's Secret and asked for a fitter with experience with people like me. A girl named Jasmine was the one! She initially took one look and said "DD." I couldn't believe it. This wasn't actually the case, but it was the impression she got with clothes. (I thought I was an A/B.) She was an expert! She told me she wanted me to only buy one bra and come back in three months or so as the breasts change shape and we would work on making sure I had an excellent fit. She noticed that one side was dropping already and she explained that given more time, the breasts will drop and the bra size would increase. She feels I am a 34 C but says I am between sizes right now because some B's fit, but not as well as the "C" I ended up with She worked with me for an hour, and made me feel like million bucks. Jasmine was thrilled to help me and told me I "had made her day" because she loves working with people in my situation. She really did know what she was doing. I wore the bra out of the store and husband was impressed. We went to his staff Christmas party last night and one girl (I had shared this angst with her prior) thought boobs looked terrific.
I would still like to be slightly bigger, but I have calmed down. BUT.... BBetty I am with ya Sister!!!!!
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Hello all!
I just wanted to post a quick update, and give another thankful shout out to Whippetmom. I had the exchange completed yesterday and stayed overnight. My PS did you strattice and explained it was to add support. I have the newly approved Mentor anatomical version. I can't get to my card right now, but if someone is interested in the model number I can track it down. There were previous posts asking about how it feels so I will speak to this aspect. Prior to the exchange my tissue exapnders felt like bricks, and I had constant tolerable pain from them and the port on the left side. Going into the exchange I was nervous that the stiffer anatomicals would hurt and nearly asked for the softer options. My PS reassured me that it was going to be plenty soft. It seems to be. I can only touch the top part of the breasts right now, but was super excited to feel a soft squishy type sensation. I was happily surprised at the softness level. It seems to be perfect balance between softness and structure. The pain on the boan that caused me so much hell from the TE's is now gone. Losing the ports helped too. I did get 2 drains, and the PS explained it was because of the strattice. He described that if we didn't do the drains then fluid will build up and the implants will be at risk of hydroplaning. Both my husband and I feel that my implants do not have nearly as much projection, but I wonder if it seems that way only because I lost the coconut shell look. I am wrapped up to tight to see the area above the bra band to get a true sense of this. My husband clearly wishes I had a bigger size put in, although he truly is just grateful all is well. He told me today htat even if I went totally flat it wouldn't matter to him. That made me feel a lot better. I feel so fortunate to have a hubby who gets what unconditional love is!
The exchange hurt more than I thought it would, but with pain killers it is manageable. I can't imagine that I will be ready for my classroom in 3 weeks though. I trust my doc though, and if he says I am ready off I will go.
Thank you again Whippetmom and the others who post here. I would have pretty much freaked out about the strattice had it not been for the board. I also would have been more disappointed with the size, but the board prepared me for accepting the reduced projection. My heart is filled with gratitude for all of women out there!
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Hi everyone! Just posted this on Exchange City but thought I may get more responses here.
I'm hoping to get some help in determining what size/style implant to go with. I currently only have 1 expander in place. I'll be exchanging that within the next month or so and then having the lat flap done sometime in the future(thanks to rads). Here are some stats to help..
5'3, 118-120lbs(normally 110-115)
Petite frame
I was told I have Allergan style 133LV or SV(forget which) expander, suggested fill volume of 200ccs.
Currently expanded to 240ccs.
My current PS uses Mentor implants, but would be open to using something else if I wanted. I want projection, as I'm petite and want the most bang for my buck. I really love the size of my expander and would like something as close as possible.
I don't have very much skin to offer so we have to stay "small", although currently I feel like I'm expanded to about a full B.
PS suggested tear drop shaped implants since I don't have extra fluff up top, but I don't want to lose projection, so right now I'm wanting round silicones. I also wasn't that impressed seeing a Mentor 250 tear drop implant in his office. It just looked small under my tank top.
Any advice? I've been mulling over this decision for months. Now that we're getting close I want to be confident and know what I'm going to wake up with. Help!
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happyteacher: Congratulations! So glad you are feeling good and happy with your results
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Windingroad: Well, a Mentor high profile smooth silicone round with a volume of 300 ccs matches your TE dimensions nearly perfectly, but it depends on how much volume your PS can achieve with a flap. Hopefully he would use a small implant along with a flap
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Hi Whippetmom, I don't think he will be going above a 250 implant. Just to clarify, I will be getting a TE at the time of the lat flap(several months from now), expanding, and then exchanging for a hopefully matching implant.
PS said he would either put high or ultra high in depending on how they look. I guess I'm just worried that an ultra high 250 implant will look like a narrow torpedo, but I also don't want a smushed pancake.
I'm not interested in fat grafting to fill in any divots above the implants, so that's weighing on my mind as well.
I think I might see if he can just order a few of the options so I can see them in person. After living for 3 years without reconstruction, I'm finding it next to impossible to have realistic expectations. And honestly, I don't really know what I want in my end result because it's been so long that I've been without. Very frustrating!
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