BREAST IMPLANT SIZING 101
Comments
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MBJ - It's exciting knowing your PS is going into surgery with myriad sizes. Nice to have a little surprise when you awake! It has been 2 wks today since my exchange and I am feeling good. Will go for my first walk today although it's hot and humid here in the Chicagoland area.
Michele - Good luck with your appt. tomorrow.
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Giselle: I have many friend who live in or are from Chicago! I am really looking forward to the exchange. Being a Uni, I have been walking in circles from being so lopsided! I was thrilled to see how big they were considering going. I think that the worse thing is going to be the ugly surgical bra they may send me home in!
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MBJ - I was out of that ugly bra the day my drains came out. It was so exciting! You have been through more than I so I can only imagine the nervous energy that's been building up. Am sooo excited for you!!!!
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MBJ~ I had a uni mx from 1/09-11/09. HATED IT. I had my prophy thinking I'd get used to being a boobless wonder. I didn't. However, it was sooooooo much more comfortable to be flat than lop-sided. So happy for you that your exchange is near!
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Michele -- sorry to hear that it's not better but glad you are seeing your PS. Better safe than sorry!
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Michelle: I never wanted to go boobless. Never crossed my mind. I am surprised at how lopsided I am though. Especially when I try to do the balancing excercises on WiFit! Good luck tomorrow.
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Deborah - I haven't posted in awhile... you helped me find a PS for revision. I'm going to exchange the crunchy asymmetric saline implants for silicone on 9/01 (along with some pocket work). Wondering if you can help me with sizing.
5'7" 135#
thanks to tamox ribcage is 30.5" and I'm wearing a 32D with my current Allergan Natrelle saline round/full height 450 cc (filled to 485 cc). One implant is currently under my arm a bit, and both could be shifted toward center... PS will work on this.
I'd really appreciate your opinion, oh wise one!
EDITED TO ADD: I think my new PS uses Mentor. Looks like you usually refer to Allergan sizing. Are they better?
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Gail: I feel you need at least 500 ccs in a high profile smooth round silicone implant. The width will be fine and with the pocket work, they will be in a much better location on your chest wall. 550 ccs would be fine also - depending on if the skin flaps can accomodate this. Definitely high profile and Mentor is fine - the dimensions are very similar to Allergan's Style 20.
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MBJ: Therein lies the benefit of going to a mega-hospital - they can afford to keep a lot of sizes on hand. I like the idea of having access to that varied a volume - especially for a unilateral. Cannot wait...that day is almost here for you!
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Deborah: I had no idea this made a difference, but I am happy that they are doing this! One more week!!!
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Thanks, Deborah.Had my pre-op today. I started at 500cc (didn't want to be too greedy) but the PS negotiated up to 600! She says I have extra skin right now and she will be doing some "trimming" on the inside which will make the pockets a bit larger. It was like being fitted by a seamstress! I should end up about the same size but without the ripples and the shelf. She's going to try 550's too and see what looks best but she wants to go with 600cc silicone. I'll try to post some before and after pics. Thanks for you help!
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Hi Everyone,
I'm from the August Mastectomy group - had my surgery on August 4th and am really starting to get concerned that the tissue expanders that were put in are too big. I am at a large teaching hospital and using a very good PS. I was originally a 34 DD and said I wanted to go a lot smaller - B. We only talked once and I expected to see him again before the surgery but he had gotten stuck in traffic the day of the surgery so one of his assistants marked me. My sister used the same PS last year - hers turned out great so I probably didn't ask as many questions as I should have.
Here are the stats: He put in Mentor Siltex med ht texture contour - style 6200 - 550 CC. At the time of surgery he filled 300CC of saline. He used an alloderm sling
I am 60yrs old - 5'3" tall, 132 lbs. The measurement under my arm is usually 33" but with swelling it is 35. My rib cage at the bra line under the TE is only 31" I have always been petite with small shoulders and rib cage and my breasts were always too big for my body.
Do I have reason to be conerned? Can this be fixed?
Thanks.
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Gail: That sounds great! I did not want to push the envelope...but 550 ccs or 600 ccs would be ideal! I am excited to see what you end up with!
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Nbb: The size of your TEs will be just fine. They are only 11.7 cm in width. I think that implants with a volume of 450 ccs to 500 ccs would be nice for you - standard smooth silicone rounds in a high profile style. You might not need to fill completely with your TEs - depending on how sufficient your skin flaps are since you were larger pre MX. Do not ask for a B cup - because this will be far too small...you probably need a large "C" cup to look like a "B" cup. It is a connundrum - this whole "cup" sizing issue. Do not focus on cup size but focus on what volume will look best on your frame. I believe it will be within the size range mentioned above. Let's see where you are once you are filled to 450 ccs...
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just wanted to update since ya'll have been so helpful!
I saw the PS yesterday and both he and I are stumped. The redness is still there but no heat or swelling. That side *is* still bigger from the seroma but the tissues aren't swollen at all. The skin looks healthy (aside from being pink). I have no fever and no pain on palpation. The area *is* more uncomfortable but again, it is stretched more (AND this is the arm I use most AND it is my BC side so I'm missing LN, etc). So, basically, it hasn't gotten worse or better. He said (and I tend to agree), if it were an infection resistant to the abx I was on, it should have gotten worse. And, if it were an infection sensitive to the abx, it should have gotten better.
I'm done with the abx as of yesterday and he wants to see what happens. I hate that it is the weekend but, thankfully, he is on-call. We have a plan as to what to do and where to go if it looks worse at any point. I just HAAAATE playing the "waiting game". Plus, it is my DD's 1st day of kinder on Monday. I really, really, really want to be the one who takes her. I will be soooooo POed if I'm in the hospital instead. In any event, that's the deal, just wait and see if it gets worse without abx on board. My last dose was at lunch yesterday and so far so good. (although I slept on the wrong side last night and I was sooooo uncomfortable this morning. I must have flashed myself 10,000 times already this morning but it isn't any more pink than before...)thanks for listening.
oh, Deborah~ I asked a couple of pages back about overfilling and the rationale behind it... can you shed some light on this? I just don't understand... My PS swears by it but I've heard from so many on this board who have good results without having to deal with overfills. thx!!
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Whippitmom - Thanks so much for your prompt reply! I feel so much better now! They look wide on my body which was the original concern. Thanks again for your great advice.
Nancy
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Michele: Extracted from my July 15th post. Valerie asked a question about sizing referable to her fill compared to yours....
Michele's TEs are actually 300 cc volume TEs and so her implants will actually be 100 ccs greater than her TEs. The only thing which is added with this overfill to 500 ccs is projection and the assurity that the expansion will hold with minimal skin retraction when the TEs are removed. Some plastic surgeons just feel they need to overfill every patient and some only overfill when it is needed for some specific reason, and some just do not overfill at all. Not all adhere to the theory of "overfilling." Mine does not. It also depends on the patient's skin flaps. The PS alone can determine the patient's skin integrity and so he or she will determine what is needed to get a patient to a certain volume of implant. You do this long enough and you see how many different approaches plastic surgeons will take to arrive at the same size of implant.
Overfilling also is performed by some to achieve a natural droop or "ptosis",....or to ensure that there is sufficient skin to cover the implant without risk of implant exposure.
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Michele -- oh I just answered your PM and didn't realize you were done with the abx. As long as it's not getting worse or redder... maybe it's ok? That's the thing to watch for. My red spot hurt and hurt increasingly before abx... then the color disappeared progressively over 10 days... and was gone. So though I had no fever it was clearly responsive to abx. You can only do what your PS advises... and just decide it's not going to interfere with your daughter's day, regardless
That's what I would do!Re: Overfilling -- what Whippetmom said
I will add that my PS overfills when using gummy implants because they are firmer and so not quite as flexibile as regular silicone when it comes to placing it in the capsule. She likes to have a bit more room. 0 -
thanks Deborah! chemo brain~~ I had forgotten that I had asked and you had answered before! ha!
Lilah~ Thx for your help. I really appreciate it.
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No problemo -- and oh yeah I hear ya re: chemo brain
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Hello everyone,
I have some questions. Thank you in advance for your help.
Is it true that breast implants of a certain size , lets say 500 cc look smaller in a person post mastectomy compared to one who has regular breast augmentation? By that I mean - if I look up online pictures of women who had breast augmentation with lets say 500 cc implants , and I am looking into having final implants , 500-550 cc - THANK YOU WHIPPETMOM for your help ! Would mine be smaller?
Also , how are the final implants compared to the tissue expanders of same size. For ex TEs filled to 500 cc look the same as final implants of 500 cc? Or woul dthe final implants look smaller?
I am currently filled on both sides to about 510 cc. Can I compare how I look now to how I would look with 500 cc fianl implants? Or would those be smaller.
I apologize if the questions might not be clear enough. English is not my first language.
Thank you !!
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WHIPPETMOM,
You have helped me in the recent past with questions regarding implant sizing, which was SO, SO helpful. Just a quick reminder, I have Kaiser insurance and go to Downey.
You had recommended 550 cc final implants. My PS always overexpands. If I want final implants 550 cc , how much does she need to expand? Knowing that my PS does not like to take any risks, I would guess that she would like to expand to 650 - 700 cc, in order to put in 550ss implants.
What is your opinion ?
I am VERY HAPPY so far with the results of expansion with TEs. I hope to be just as happy with the final implants. I have read here how quite a few ladies were dissapointed with the final size.
Thank you,
Donna (5'5 1/4" , 145 lbs, 32 " rib cage)
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Trytostay -- breast augmentation is not the same as reconstruction; women who get augmented still have BREAST tissue -- women who have had an MX do not. So you can't compare. Search the internet for pictures of RECONSTRUCTION if you want to see photos. But I will say that 500 cc's on me will look quite different than 500 cc's on you... so really even looking at others, unless they have the same body type/shape as you, might not be all that helpful either. I'm sure Whippetmom will be able to answer your other questions (or guide you anyway) but thought I'd throw in my two cents on what little I do know
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Lilah: Thank you for answering
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hi trytostay~ I agree with Lilah. I have a friend who is bigger than me (frame-wise) and she has an aumentation with 400 cc. I'm filled to 465cc right now and look smaller than she does. The lack of breast tissue makes a huuuuuuge difference. Whippetmom will be able to help you... I'm sure of it!
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Hello Whippetmom, I'm new to this forum... I wish I'd have seen it sooner... Thank you so much for all the info, I started going through this thread but there are so many pages so I though I better post my specific question... my bilateral mastectomy surgery is on August 18th with TE's and Alloderm, and I've already seen the plastic surgeon last time before the surgery on last Thursday... I left his office feeling a bit down
a little about me - I'm 32 years old, diagnosed with cancer on my left breast, BRCA1 positive.... I now have 34D breasts, they hang a bit low when I'm without a bra, but I love how they look in a nice bra and love how I look in clothes... I'm pretty devastated about loosing them now
... I'm 5'4", 134lb, I measured right under my breasts (I guess its the rib cage?) and got 31"-32".... I asked my PS if it will be possible to bring me back to D and he said that I will probably be a C..... then I asked what size TE's implant he is going to put in and he said 400cc... which sounds kind of small, but then he said he uses the highest profile implants for breast reconstruction, and that it goes by the size of my chest and body frame and that he doesn't want to put a too big of an implant because he doesn't want it to be sticking out on the sides of my body and he doesn't want me to look like a striper.... now I'm worried that I will end up with small and flat breasts... there is not much I can do now since the surgery is in less them a week and I cannot change PS, I didn't have many options in the first place, I could only see two PSs which are under the Cedars Sinai medical group and accepted my insurance... please let me know what you think, according to my sizes and measurements, will 400cc be too small or is it enough to bring me up to at least a full C cup? Thank you so much for your help... 0 -
Venus: It's never too late! If you feel you need to make a change you can always postpone surgery! Whippetmom will help you and don't let the PS rush you into surgery doing what he/she wants! They are supposed to return you to a reasonable shape and size compared to what you had before and also give you what you want, within reason and if it's possible. I am a 32" rib cage but I was a small B, my dr's expanded me to 535 cc's and my exchange surgery for next week I will get anywhere from a 300 cc for my non-mastectomy side to a 600 cc for my MX side. I wanted to go bigger and to get more symmetry with my remaining breast There are always things like skin integrity involved in the decision of how big you can go. Did you have radiation and did your skin stretch easily? Also, how long have your expanders been in for? My 400 expander was overstretched 135 cc's and was put in 3/20 and my surgery is on 8/19. You;ve come to the right place for help!
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Whippetmom, I was wondering if you could help me. June 10 I had a bilateral mastectomy with tissue expanders. I'm currently filled to 600 cc. Not sure what type. My rib cage is 31 inches, I'm about 5'4" and 150 lbs (trying to lose weight, but it's so hard!). Measured from outside, the base width of the expanders is around 15.5 cm, projection about 7.5 cm. My PS doesn't think I should go bigger; I'm not sure. I don't want my foobs to be obviously fake, but I was barely a B cup before and would like to be at least a little bigger. Plus, I have a big booty and would like to be more hourglass shaped than pear shaped!
I like the fullness and projection of my expanders. I'm worried implants the same volume will look smaller and I'll be very disappointed. Can you give me a rough guesstimate on what size/style of implant to ask for? Also, what's the difference between high profile and mid profile? How does it affect the finished 'look'?
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Donna: Lilah answered your question re: implant sizing with augmentation vs. reconstruction. With regard to your second question, #2: You have had rads and so much of how far you go depends on the integrity of the rads skin flap. You have a 450 cc recommended fill TE and so I would think that you would not need to be overfilled more than 600 ccs in order to exchange out to a 500 cc to 550 cc implant.
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Venus: I think that your PS is perhaps quite conservative and does not understand that the end result - the cosmetic result - has as much to do with our "healing" as does the pharmacological aspects of treatment. You will not be happy with 400 ccs as the ultimate implant size. You will want 500 ccs or 550 ccs in a high profile, standard smooth round silicone implant. Either size would be appropriate for your ribcage/chest wall. With your ribcage and current breast size, it seems he could use a 500 cc tissue expander, but if he feels he can only fit in a 400 cc, perhaps your PS could overfill and exchange you out to the larger implants. Especially since it sounds as though you have the skin flaps sufficient for the larger implants. Your role in this is to let him know exactly what you want to achieve. Tell him you would like for him to do what it takes to get you to the implant volume specified above. Give his office a call on Monday and clear all of this up before the surgery.
Incidentally, I am 5'4" tall, weigh 125 pounds, have a 31 inch ribcage. My TEs were 400 ccs, overfilled to 425 ccs and I was exchanged to smooth silicone round implants - 550 ccs. As long as there are not extenuating circumstances, e.g., the need for radiation, It can be done, especially in light of your current breast size.
Check back with me after you talk to your PS.
Deborah
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