BREAST IMPLANT SIZING 101
Comments
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Scottie....Mentor or Allergan or Sientra smooth silicone rounds. In Mentor and Allergan, high profile or moderate plus profile, and in Sientra, I recommend the high profile rounds.
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sunandsnow....Yes, I need the TE data
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Hi ladies,
I had my exchange June 2014. I'm noticing that my left breast is drooping down quite a bit more than my right. Any possible reasons for this? My ps wasn't concerned when I saw her a few months ago, but I was and still am. I am going on jan 13 for a fat grafting consult. What would help the drooping? What would cause it?0 -
Mommyathome: Can you privatemessage me a photo?
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Whippetmom,
I just got this. I'll will definitely private message you this weekend or tomorrow!! Can you tell me how to do that? I emailed you pictures before can I use that email again?
I think it's changed from the last time I emailed you awhile back. Let me know if you agree, please.
Beverly0 -
Beverly....just use the same email
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Whippetmom just sent 5 pictures. Please let me know what you think. I have my appt on Tuesday with ps to discuss fat grafting will this "fix" these problems? Do you see what I see?
As you know, my ps and I haven't always seen eye to eye. If I'm seeing something that's not there I don't want to push the envelope so to speak. But if there is a problem, and she doesn't address it I need to go elsewhere! I appreciate any feedback you can offer0 -
Whippet mom: Disappointing post-op/ pre-op with the PS today. PS still wants to stay around 200cc in a high profile, my current fill amount, and feels that is more important than the pocket dimensions. She doesn’t want to attempt even a small fill even though I was once at 250cc. There are horizontal creases in the expanders on both sides irritating the current incision lines. She may attempt a fill during the exchange to see if the skin will tolerate more. She said that she will take sizes into the exchange surgery from below 200 up to 225 and I asked that she take in a 250 also.
Even though I asked to see the implants, I got out without seeing or recording exactly what she is going to order. I will email her for that exact info. We also discussed other options which include the various flaps to get more skin coverage. She recommended that I move forward where I’m at and consider a change in another year if I’m not where I want to be. Very discouraging.
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hi Whippetmom,
Back in September you gave me your input and told me to come back when I'm done with fills. Well, I'm at 530ccs in my Natrelle 133FV-13, 500cc TEs. To refresh your memory I am 5'5", 157lbs (normally 147lbs), rib cage is 36". I have fairly bony chest with broad, but defined, back & shoulders. I carry most of my weight in my hips/butt/legs.
Currently I'm up in the air about sizing. While I'm enjoying the larger size, I am pretty annoyed with the side boob I have going on and they're right up under my clavicles. They bug me in the gym especially when doing push-ups/chaturanga moves, though I do understand the implants won't be so rigid. My native breasts were naturally very far apart (but small) and I have at least 4 fingers width in between my TEs. My PS can get 3 fingers in between them.
You had recommended Allergan Style 20, 550 ccs or 600 ccs, or Allergan Style 45, 650 ccs for smooth silicone rounds. My PS is saying he'd like to bring them in about 1cm closer on each side and is recommending Allergan style 115, 507ccs, 14.5cm base or Mentor Moderate plus 500cc, 14.1cm base. He says this will give me a more natural appearance and the bigger base will help even out my upper body with my hips. However, I'm losing a whole cm of projection. Not sure if that will matter much though. I don't want to be so big that I'm forever cursing them in the gym, but I also don't want to be too small and regret it.
I tried to talk to my dad about it last night (he's a former PS). He was obviously shocked when I mentioned the sizes the PS recommended. His words "those are huuuuge!" and ended the convo. My husband is absolutely no help...just says I look great no matter what. (Sweet, but not helpful!) My girlfriends are all saying I look huge and all ask if I'm done with fills. Not sure if that's just because of the hamburger bun appearance or what.
I just don't know if I'll be happy with a moderate plus profile. Is anyone ever happy with moderate plusprofile? I would never consider a revision later except for a medically necessary reason, so whatever I end up getting is it. I'd really appreciate your input again. I can send photos if needed.
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Sunflowercat:
The moderate plus profile implant and the high profile implant are the two most popular and commonly used styles for breast reconstruction when silicone rounds are used. I would definitely recommend the Style 115 in Allergan, as it is a textured implant and we just see too many problems with traction rippling, which is a high risk with textured rounds. implants render a favorable result. A Mentor moderate PLUS implant would be fine - 500 ccs. The HP Mentor or Allergan, 600 ccs, would give you the same width though. As for your dad's comment: Well, yes, if you were getting an augmentation, 500 ccs might be considered on the larger side of the spectrum. But with breast reconstruction, it takes larger implants to create enough volume on the chest wall. Your implants just need to be moved more medially with a pocket revision and with a lateral capsulorrhaphy, which secures the lateral (armpits) area so that the implants do not migrate laterally after the exchange.
Deborah
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howdidigethere: I am confused about the sizing, in relation to the width of your TEs. a 250 cc HP implant is so much narrower than your TE width. It is always a little disappointing to hear the suggestion that someone just go forward with the exchange and revise at a later date. I would like to avoid revisions, not plan ahead for them, if at all possible. You could get a second opinion.
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Whippetmom: I will PM you some pictures. DH also says I need to get a second opinion.
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You have a very supportive DH!
You know, perhaps there is some reason why such a small and narrow implant would be your only option, but I just feel you should have someone else confirm that this is the case. It just seems odd to me....and worth evaluating further.You can email photos or link them in a private message, by using the landscape icon next to the goggles icon in the task bar above. PM me if you need my email address.
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I am fairly new to this site. It all seemed to happen so fast. I was dx just before Thanksgiving and was very scared. I met with the oncology surgeon and then the PS within the next week or two then I had to decide to have the surgery almost immediately or wait a whole month until after Christmas.Because of my anxiety I opted to have it done Dec 12. I had a right MX and a TE placement. I did not know about differences between silicone and saline and I never heard about the gels. I did not know what to ask the PS, and he did not talk at all about different types of implants in my pre-surgical visit.
I do not know what type of TE I have or how much was put in during surgery - I have had two fill of 60cc each. I need to learn more about pro and cons of the different implants. If you know of a different blog that would help, please let me know. I see the nurse practitioner for my PS Monday and I want to go in with enough information so I can ask the right questions. (I will definately ask about the TE and the total amout so far) I have looked at the breast reconstruction information and that is a good stating point.
Thank you for any help you can give.
Sue O (sueo45)0 -
Sue045: Find out which mfr, style and volume of TE you have. Ask your PA/NP next week:
1. What implant manufacturer or manufacturers the PS uses (some are aligned only with Mentor, some Allergan, some Sientra, some one two and some, all three).
2. Did your PS place this specific tissue expander with a plan to use a certain style or type of implant? For instance, does he intend to use an anatomical implant? Does he intend to use smooth silicone rounds? Does he intend to use a Sientra shaped implant
3. Ask about using a smaller implant to augment the native breast, in order to get better symmetry, if necessary. (Or, if you hope to go a bit larger than you are currently).
4. Do you need a lift (mastopexy) of the native breast, in order to get symmetry?
There are a number of threads on bc.org regarding "silicone vs saline" and the topic of anatomical implants.
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Whippetmom -thank you for your input. I do already know that I need mastopexy and a reduction on my native breast. I have been a D to DD and I would like a little smaller.
I have printed your questions to take with me tomorrow - thanks again.
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Thanks Whippetmom for looking at my photos and reassuring me that another opinion is needed!
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Sue: Obviously the question about going larger does not apply, but getting enough expansion of the TE to get you into an implant which will allow for sufficient ptosis (droop) to match the native breast is the primary goal. With uni reconstruction, symmetry trumps size
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Let us know what happens mommyathome. I also had drooping.. I am wondering if it was similar to mine. I am having mine fixed next week
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Stix,
What are they doing to fix it? What have you already had done? Did u have implants in or like tram...? Did they say what caused it? Good luck! I hope you get good results0 -
Whippetmom,
Had TE placed on left for Uni reconstruction on Dec 2nd. 30" rib measurement, 5'2" @ 105lbs. Expander is Allergan-MV 133 12" 300cc. Currently filled to 290cc, one more fill and then I see PS on if I'm full enough as he overfills. Ideas on implant as we have to match native? Only an A cup before so a small implant will be added added/augmented to right side at exchange
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Mich71: You have several options, which would be based on using a smaller implant on the native side for symmetry. For the TE exchange: Style 20, 400 ccs, Style 15, 304 ccs or Sientra smooth round, 405 ccs (although there might be too much upper pole fullness...depending on what is achieved with your native breast) or textured shaped oval high profile, 370 ccs. If an Allergan anatomical is to be used,Style MV, 335 gms.
With unilaterals, I can only speculate on what might work, as the key is symmetry and so the MX side will need to mirror the width, height and projection of the augmented native breast.
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Whippetmom- I was told that there was a newer implant that has a better projection than my Mentor Smooth round HP. Do you know anything about that? I'm having a revision later this year and would like something that has more projection.
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Chrisrenee: Well, it is not exactly "newer", but more recently (almost a year ago) introduced in the U.S. It is Mentor's ultra full projection/profile implant.
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Whippetmom,
I saw my PS last Friday and we are going ahead with an exchange from smooth rounds to 410s. He said my width will remain the same but he will give me a bit more projection to try and put some more tension on my skin to smooth some things out. I am actually fine with my projection and size but more interested in addressing the bumps
I will ask him what he ordered closer to surgery but thought I would pick your brain first so I know what I should be expectingI currently have Allergan Natrelle Inspira SRF435s which are 13cm wide with 4.9cm projection.
Looking at the Canadian Allergan chart for the 410s, it looks like I have 4 options in my width:
FF130-425 425g 13cm wide 13.5 cm height 5.2 cm projection
MF130-375 375g and 13cm wide 12.1 height 5.2 Projection
FX130-450 450g 13cm wide 13.5 height and 6.1 projection
MX130-410 410g 13cm wide 12.1 height and 6.1 cm projection
Thoughts? My thought is PS is leaning towards extra-full projection as the full projections would only give an extra 3mm projection, not enough to add that desired tension? As a refresher I have a 29" ribcage, am 5'4", 115-118 lbs.
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Divecat: I would not waste time with anything but the MX anatomical. The FX and FF are out - too tall for your chest wall - and you are sacrificing too much volume with the MF to make any difference. However, if your skin has stretched to some degree, since the exchange, your PS might even consider going up to the MX445 grams...just to ensure a snug fit, since it does seem that your pockets are larger than your current implants. Just a thought...want to make sure you take every precaution against rotation.
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....Ask him to order both MX sizes.....
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Thanks Deborah! That was helpful
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Thank you Whippetmom! Friday is my last fill I hope so I can schedule exchange so I appreciate your wisdom
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GatorGirl - I took a cruise 4 weeks after my exchange. PS did a lateral capsulorrhaphy so I had restrictions similar to after BMX : no lifting, pushing, pulling etc..... There was some muscle pain around the edges of the implant but, I don't know if that is normal or due to the extra pocket work. I had to wear a bra under my swimsuit and couldn't sleep on my side. Of course, ask your Dr. but I felt well enough to go on my trip.0
