BREAST IMPLANT SIZING 101
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Smaarty- With my second placement of TEs in October, the PS put 'divots' in; I call them my quilting tucks. I couldn't see them the first couple of days but then they appeared when the swelling went down and I have 3 on each side. The PS said that was to help with the inframammary fold formation and would come out with the exchange. I have alloderm.
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thanks howdidigethere. I was thinking that maybe this is how the IMF was made. She didn't say anything about stitching. I figured someone on the thread might have had the same experience
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howdidIgetthere: Thank you for responding to Smaarty's question!!
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I was diagnosed with breast cancer in my right breast on Nov 26, 2014. I was given the option by my general surgeon to either have lumpectomy with radiation or a mastectomy with no radiation. I had a mastectomy on my right breast on Dec 8, 2014. At the time I was consulting with my general surgeon to schedule the surgery, I asked him about reconstruction. I didn't know anything about it except that it was a possibility. He said he recommended it be delayed for a reason that I can't remember because I was such a basket case at the time. I think it was because I may have to have chemo, which I will find out about next week. He told me he would set me up with a plastic surgeon once we knew where we were. Because my cancer was invasive, my nipple was removed and I assume the operation was not skin-sparing. I am an A/B cup depending on the bra. I have never been unhappy with my breast size because it was nothing that an add- a- cup bra could not enhance. Now that I have this "opportunity", I would really like to increase my breast size up a couple of sizes to a C/D cup. Given the fact that my surgery required the reconstruction be delayed, is increasing 2 cup sizes even possible? During my recovery I have educated myself on all the different reconstruction techniques. If my plastic surgeon does tissue expanders and implants, will my skin stretch enough for a 2 cup size increase? I know every person is unique, but just in general will what is left of skin after a non skin-sparing mastectomy stretch enough for that? Honestly, the reconstruction techniques involving tissue flaps from other parts of the body scare me to death. Thanks.
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Sandgar- I was a little out of it when I posted my measurements the other day. My Ribcage measures 30" not 32". All the other info is correct. Hope this helps!
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meow1970:
I have tried twice to respond to your question but keep getting knocked off the site. Will try later today from my computer.
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whippetmom I should probably include that my PS, Dr. Rishavy is part of Northern Plastic Surgery in Duluth, MN. There is a team of four Dr's there and I have heard good things about them all. I am enjoying the squishy side of things and posted a pic over on the picture site!
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Ladies - is there an active topic where the subject is post MX and TEs or is this where people post about that??? Just trying to find something like the sugery sisters or chemo in month X. I have so many questions, comments and confusion.
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knmtwins, there's a beginners TE thread, don't go to TE troubles unless you're having issues. Don't know if threres a thread for just mx. Just put in search box.
Deborah, those weird divots are disappearing. Strange
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Kntwins, did You find one???? I wanna go there too if you did@!!!
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Kntwins - you can also try "exchange" thread.
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meow1970: I hope that you had a skin-sparing procedure, since your surgeon knew you were interested in reconstruction. I just wonder where you live, since it sounds as if you were not given reconstruction options when you were diagnosed with breast cancer. Nearly every cancer center now provides reconstruction options to a women newly diagnosed with breast cancer, especially if that woman will be having a mastectomy as part of the treatment for breast cancer. In many instances, it is entirely possible to expand the skin sufficiently to allow for an "augmentation" to take place, which is to state that it is possible that you could be larger than your native breasts. Since you are a unilateral, this would require augmenting your native breast with a small implant. I do not know why your PS told you that you needed to delay reconstruction. Did you ask why? If you want to PM me and tell me where you live, I could help you find some plastic surgeons to consult with regarding reconstruction with tissue expansion and implants.
Deborah
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knmtwins and feelingoverwhelmed: There is a TE Primer for Beginners thread, but not currently active.
https://community.breastcancer.org/forum/44/topic/819027?page=29#idx_841
You also could try Exchange City, which is a very active thread.
I am happy to answer questions also.
Debora
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whippetmom - your link goes to page 29 of the "TEs A Beginner's Primer" thread. We actually are up to page 35 now, although I admit we've devoted a lot of time to cute pics of Moonflwr's new grandbaby!!! So yes, we ARE active!
knmtwins and feelingoverwhelmed - come on over to our thread! You might have to read through a few (ha!) pages to see how we all coped with our TEs, but it's full of great information and support, and laughter, too. Smaarty is right... the thread for TE problems is devoted solely to that... the "Beginner's Primer" has more to do with "now I've got 'em, what do I do with 'em?"
Here's the link to Page 1 - happy reading! https://community.breastcancer.org/forum/44/topic/819027?page=1
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Thank you Blessings! I am unable to direct link from the task bar! Glad the thread is active
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i so wish I had read all this three weeks ago. I would have gone for bigger size. Thank you for
all the info.
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have to share:
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Whippetmom
I have been granted access to pic forum but not able to figure out well how to see pics. I had one step BMX with Alloderm, skin sparing , both nipples removed. The radiated side needs fatgrafting and the other side needs mudflap removal and its sagging
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Lindacam:On the Pic Forum, go to "Under Construction" and then you can see individual posts.
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Hi all. New to the forum and this is my first post. I had bilateral skin sparing mastectomies on 10/15/14 with tissue expanders placed. I have Mentor CPX4 medium height expanders which hold 450ccs.dimensions are 12.7x10.8x7.0. I was filled to 200cc at time of surgery. I had my first fill 3 weeks later of 60cc and have been getting fills every 2 weeks. I am currently at 430cc. I am 5'2", 120lbs, rib cage is 30.5"curvy, petite build in my late 50's. Prior to BC I wore a 34 DD or 32DDD. I have expressed to my PS that I would like to be a full C to a D cup. She says I would probably need about a 600cc implant and would over fill my expanders bigger than that. I have a friend with Mentor 480cc ultra HP rounds that looks great. I think I will be happy with the 535cc ultra HP by mentor . Dimensions are around 12.1x6.3. I am concerned about how much my expanders can be overfilled. My PS likes to over expand by 50 to 100cc over implant size. Any thoughts or advice?
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Hi Gatorgrl, and welcome to Breastcancer.org! You've come to the right place. We're so sorry for what brings you here, but we're so glad you've joined us, and we're sure you'll soon find the answers you're seeking from all this wonderful and experienced ladies here.
The Mods
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Gatorgrl: I would recommend 590 ccs in the Mentor Ultra - closer to the width of your TEs. Good choice of implant though!
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thanks Whippetmom. My PS is recommending the 600size. It seems so large based on where I am now and what she would expand me to prior to exchange. I want to be done and recovered before a 2 week trip in late April. At this rate I would have a minimum of 6 weeks to overfill then another month to wait. She says why not wait till after my trip but the idea of living with the TE until mid May seems unbearable. It seems like filling a 450 cc expander to almost 700 is crazy! From a dimension standpoint what type of difference could I expect visually between the 535 and the 590 in the Mentor UHP? I appreciate the time and effort you put in to this. Thankful to have the resources of strong women like you.
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Gatorgrl: I wanted to respond to you because I just had my exchange on December 17th and we are close body types except I was an A cup prior to BC. So I wanted to go up a few cups and I have a very athletic shape 5'2" 112 lbs. broad shoulders, definitely junk in my trunk! lolSo I had TE's that were 300cc's, my Dr. told me he overfills too and to just let him know when it seemed I was happy (not easy to do with those weird shaped, taught expanders) Anyway I ended up over filling to 475cc's, and I thought I looked whoa....I was prepared for him to put in 450's or 475's knowing that they would look smaller after exchange and they do! I trusted him however, to pick the final size because he took several sizes in with him and decided in the OR! I know that is crazy and amazing! If he had told me he would put in a 545cc's implant beforehand I would have been like, um I don't think so, because I would have assumed I would look ridiculous! However, in the end I received the Sientra 545cc HP and I could not be happier. They are very close to my TE size which I was use to by the time the exchange surgery came around! I probably have a little more swelling still but hopefully in the end they will be about what I see now and if I measure using the 3 measurements I am about a 34 D. My ribcage is 29". I know that I have different implants then you are looking at but the overfilling and the uncertainty of what to do this is similar and also mine are round high profile implants!
I know it is hard to be patient especially with your trip coming up but I would say don't rush the process. Whippetmom knows her stuff and has great recommendations! Also if you have access to the picture site I am on there as are many other women and this might help you with your decision.
Good luck! Who knew how much time one would spend thinking about all of this and the process involved!? Be well Gatorgrl! I hope this helps!
lulivesay
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thank you lulivesay. This helps put my mind at ease.
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Gatorgrl: Then why not just go with high profile instead of ULTRA HP, and go with 500 ccs. They would look very natural and would be a good size for your frame. The issue is width. You want to be at the same width or somewhat greater than the TEs for a nice snug fit. Talk to your PS about sizing.
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thanks Whippetmom. The more I read this forum, the more I suspect you are right on with your original thought. I do want the projection which is significantly more in the ultra than the HP. Thank you for explaining about the width. I am going to talk with my PS about the ultra hp.i have 2 friends with them in a 430 and 480 and both women look awesome for their frames. For those done with the exchange, do you think I would feel up to taking my trip5 weeks after exchange.
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Whippetmom: Your response to Gatorgrl was an answer that I was looking for. Same width or slightly larger width on the implant for a snug fit.
Whippetmom helped me with TE sizing in October. At 5’2” and 105 lbs., and small frame, the PS suggested Mentor CPX low-height 11.4 cm 250cc would work to give good results. At the time, I thought the PS would be able to overfill to 350cc. I had an infection scare 5 days post-op but antibiotics cleared the redness. 50cc at surgery, followed by 50cc fills until reaching 250cc on December 2. Because of pinkness on one side above the incision, no fill was done the following week and on December 19, 50cc was removed. After a recheck on January 2, I am still pink and no fill. Holding at 200cc.
At next week’s appointment, the PS will evaluate as to whether any more fills will be possible due to thin flaps and thin skin. I may be presented with the option of exchange at this size as I am already scheduled. I did ask about fat grafting and will discuss again. With the Mentor information, it doesn’t look like there will be many options available and the size will be small and flat. This is my second attempt at reconstruction as I had infection with the first attempt. Any ideas?
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Hello I am new to this forum and looking for what appears to be great wisdom from you ladies here. I am newly diagnosed and scheduled double mastectomy with hope for immediate recon. Both my plastic surgeon and Oncologist believe I am a good candidate for this.
I was hoping Wippetmom (guru, you appear to be!) can help me know what to do regarding sizing.
I am 5'9, consistently have weighed between 145-150 for the last 5 years.I do not expect tissue expanders. The bra line measurement is 31". I wear a size medium usually, size six/8 pants. Have been a b most of my life but enjoyed while nursing having a fuller breast. I never imagined getting breast implants but now that it is a choice between that or no breast I believe implants are right for me. I don't know how to decide about CCs and such.. HELP! I am a runner and hope to continue running as soon as possible. I would like a fuller breast but don't want to feel top heavy. Gosh, I don't even know what I am saying except that I really need help!
Thank you so much in advance for any advice and wisdom.
Sonya
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howdidigethere:
If you need to hold at 200 ccs, that should be sufficient for a number of options. You would probably be a good candidate for a Mentor HP implant, around 300 ccs or 325 ccs - same width or a little more than your TEs, or even Sientra, smooth round HPs, perhaps 335 ccs. You have enough projection with your TEs for good skin coverage over the implants, it would seem. So discuss these sizes with your PS.
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