BREAST IMPLANT SIZING 101
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Hello,
I feel like I did a good job of being engaged and informed through my BC journey, took notes, saved every piece of paper and asked lots of questions. Now I find myself confused and a bit overwhelmed. I had my BMX in October and just had TE placement surgery on March 19. I didn't have radiation or chemo. I am at 210 ccs right now and have 2 more fills scheduled. I started with fills of 50 ccs and had to back it off to 30 ccs. So 60 more ccs will put me at 270 ccs. I think PS said these hold 280. I still look small in clothes. I'm a bit worried I will end up smaller than I wanted to be. I am 5' 1" and weigh 118. My rib age measures 32. I know my hands are somewhat tied based on the expanders PS used. How much can you safely overfill? Next I guess we will talk about final implants, I think I'm leaning towards silicone? I just feel naive and uneducated
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hummingbird - well,it all depends what size you told your PS you wanted to be and also showed him a picture. I'm 5', 107 lbs, 30" ribcage and I had 450 cc TE that were filled to 490. I wanted to be C. Send a PM to the implant whisperer (whippetmom). She is our expert and always has the best advice.
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Thanks mjh1! I did PM whippet mom, so I'll be looking forward to hearing what she thinks. I told my PS I wanted to be a B plus or a C but I wasn't smart enough to think of pictures!
I'm hoping 280 can hold 310 and I'll be happier with 100 more ccs The implant discussion is a whole other hurdle.
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@ hummingbirdlover I'm 5'3" 110 lbs, I used to have an augmented breasts before b/l mx that made me a size 32D. I currently have 400ml Naturelle Tes in place and my PS says you can overfill by 50ml and PS can place a little bit bigger implant during exchange. So in your case if your Tes are 280 you can add another 50 ml for a total of 330ml. You might want to ask your PS in regards to projection rather than cup size.
Take care.
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Hummingbirdlover-
I think overfilling of TE's is pretty common. My TE's were 400cc capacity filled to 500cc and with the exchange I had 595 gm anatomicals put in. They definitely do not look as big as the TE's. I was told to stop the fills when I was happy with the projection. Good luck with your exchange!
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You ladies seem so knowledgeable. I just had BMX 3 weeks ago with alloderm sling and shaped tissue expander MX (133 style) 13 diameter max fill capacity 500cc. My orig bwd was 12.5 and 12.7. Very thin tissue left. Concerned that MX 410 implant may be too flat at top as I 'd like to keep the nice upper pole fullness that I currently have with T.E. ( filled 250 from surgery and had first fill yesterday so at present 300cc. I may only be able to go up another 50 or maybe up to 400 as doc doesnt want me popping stitches). I am concerned with smooth rounds that I may show all rippling and edges but may not like flat upper pole of anatomical?. Is the Inspira soft touch line an in-between? More cohesive round ?any advice or when to stop expansion to accommodate implant and best style would be most appreciated!!! . I don't want to overstretch but so afraid of choosing wrong- doc not advising me. Most concerned with shape than size. Don't want obvious coconuts but not flat either in between and what is closest to the TE look. I am happy to send pic if I can figure out how. Please advise I can't figure this out.
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hummingbirdlover:
I don't know of any TE that has a recommended fill volume of 280 ccs. I know Sientra has one that goes to 285 ccs...perhaps this is your TE? You need to find out.
Overfilling of a tissue expander is discussed in the thread header. Please read. Some TEs are overfilled 50 ccs, 100 ccs, 200 ccs, even 300 ccs.....depending on the recommended volume of the TE. A 250 cc TE has a "tolerance" for overfilling quite a bit lower than would a 700 cc TE. Some plastic surgeons NEVER overfill, some always overfill and some overfill if they find they need to for a specific patient. It is really pretty subjective a decision in most cases.
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From the thread header above: I need to know about your TEs....style, volume (not volume you are filled at now, but actual, recommended fill level of that specific TE.
3. IMPLANT SIZING INFORMATION:
If you are interested in discussing implant sizes, make sure you compile and provide us with the following information:
Height, weight, ribcage measurement [measuring the circumference of your ribcage under your tissue expander(s) or under your bra line]. Also, if you have TEs [tissue expanders] - we need to know about them. The style - Mentor or Allergan most likely - and whether they are short height, moderate height, full height if Mentor and style number if Allergan. We also need the recommended fill volume of the TEs - the number of cc's. (NOTE: If you have PMT Corporation tissue expanders or any other unlisted manufacturer, please see if your PS will provide you with the dimensions of such devices.]0 -
Marissima: Please see my post above this one.
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Hi. I'm new to this forum. I can already tell that 'whippetmom' is THE woman with the implant sizing information with whom I'd love to connect. I had a prophylactic bilateral mastectomy 2/23/15...with the horizontal incisions running across the middle of my breasts. I am wondering which direction to go for implants. I am 5'6" and weigh 140#. I have Natrelle style 133 tissue expanders (133MV-14-T). My ribcage is 30" in circumference. My expanders capacity size is 500 cc's (I know they can be overfilled). As of 2 weeks ago, I am filled 500cc's. I would like to be a full 'C' or a small 'D', a bit larger than I am now, also desiring a fuller upper pole. My current 'shape' with the expanders is that my breasts do NOT appear perky...but rather a bit lower, and extending a bit laterally beyond my ribcage to the side (my PS said this extending beyond the ribcage is a natural look). I want to have full breasts - since I get to choose my size - but don't want them hanging to my elbows in a few years! (I think that can add so much weight to how a person appears.) Basically, I like the look of what a push-up bra does. Any ideas? I definitely want silicone implants. I think my PS had thought I'd be a good candidate for the anatomical implant...that is until I told him I wanted a fuller upper pole. Thank you in advance for any ideas you can offer. I appreciate your help.
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Hi everyone. I'm new here, and never thought I'd be posting here because I had such a "positive" experience with my mastectomy and TEs. I was pleasantly surprised with the way the TEs looked, especially because I was so small-chested before. I always thought I was a B before and Victoria's Secret even sneakily measured me as a C on my 40th birthday last year, but I knew that was never actually true. I was probably always more of an A+ with a little weight and a good A when I was really skinny. So, I was super excited to have breasts for the first time in my life, and especially after nursing 2 babies for about 2.5 years each. The TEs were definetly hard and fills would leave me breathless for a day or two, but overall, the process wasn't much of an issue for me and I enjoyed the way I looked. The PS would always tell me that I had such a "good result." She's really an artist. Anyway...
I had Natrelle Style 133 TEs (133MX-12-T) 400cc capacity
I have no idea what those numbers mean except for the capacity and that my breasts were a 12 diameter. The TEs projected so nicely and after settling, looked so good. I was originally going to stop at 325ccs, but 2 weeks before surgery at my post-op, I told her that I realized that only "felt" big but weren't actually big and I wanted her to fill them more. She filled them to 375ccs and that was the last I saw her before surgery. I was very happy with the size of my TEs and how they looked on my chest. My original goal was a "B+/C-" and I wanted them to look more natural, so I chose anatomically-shaped implants.
My exchange was 4/29 and I haven't had my follow-up, but I was told that everything went really well. I know she did a very little bit of pocket work on my R side to even them out all the way (although they looked great already). She told me that she was giving me 375cc Natrelle high profile anatomically shaped implants. And this is where it goes south.....
I was unprepared for all the emotions that this surgery would bring up. I see from other posts that this is common. I'm super depressed and it has taken me by surprise. I was SO happy with my pre-exchange look that I couldn't even imagine how great I was going to feel and look after with that pressure gone and more "real" looking foobs. As of today, I feel really sad. I feel like although the pressure is gone, they look wide and flat and look really small compared to what I thought I was getting. They look SO much smaller than my expanders and I'm so afraid that I'm going to have to have a revision!! (and I thought I was finally done!!) I'm guessing that I probably only have an average B right now after they settle, not even the full B/C+ that I was originally looking for (and thinking I was aiming small). I know that they're supposed to change over time, but I can't imagine that they could even possibly become what I hope they will be.
I would love some words of encouragement or even realism if any of you have any. For reference, I'm 5'6", 130 right now (usually 125), athletic/very strong chest/arms/shoulders, measured 32 at Victoria's Secret before but surgeon put a post-surgical bra on me that is 34B. Is that enough info?? Please, please help. I'm so discouraged. My boyfriend of 3.5 years left me for another woman immediately after MX and it really affected my self-esteem. I felt so encouraged by the TEs and now my self-esteem is plummeting again.
I'm so sad. Thank you so much for understanding and helping.....0 -
Ahhhh....okay....so, my TEs were moderate height/xtra projection. Now I'm beginning to understand. She said she was only giving me full projection implants (not extra), so that's one difference. I would still love to know what I have exactly (will get card at follow-up on Wed when I get drains pullled), and what size you would recommend for my goals whippetmom. What a wonderful resource we have in you!!!
And in return, I'm a Doctor of Oriental Medicine and have an immense amount of information about how to heal beautifully with very little scar tissue if anyone is interested. My MX went so well, I could hardly believe it. And my scars are SO minimal!!! I'd be glad to trade information.
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Last post...sorry. I measured as best as I could 3 days out of exchange with drains and all, and my chest circumference is 30"
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drjaymi - what you're feeling is perfectly normal. It is quite an emotional rollercoaster. You're not even a week out yet so you still have a lot of drop and fluff to do. While none of us want to have a revision, it is too soon for you to worry or even think about that. Right now just give yourself time to heal. Hang in there and reach out if you need us. I'm sure whippemom will be along shortly to answer your implant questions.
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marvella: I don't know about that "extending beyond the ribcage is a natural look" comment, but that is NOT true in all cases. You don't want ribcage reveal, which is where the implants are too narrow for the chest wall, but also, you do not want a huge gap in the cleavage area, and TEs have the tendency to migrate laterally during expansion. Your description of the placement...especially that they seem to be placed quite low, makes me want to see photos before you have your exchange surgery. You can attach them in a private message to me or request my email address. I think the new Allergan Inspira implants or Sientra rounds might be your best choices, but let's discuss this further once I see what is going on
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drjaymie: You will be a great resource of information for many of us here on bc.org....so hope you stay around to help in your area of expertise.
Okay, with anatomical implants in the design plan, if you use a MX style TE, the corresponding implant would be the MX anatomical implant at the time of exchange. The tissue expander style needs to be chosen with the corresponding anatomical in mind. If you plan to use a MF, then the corresponding tissue expander would be a a MV style TE.. So here are the dimensions for comparison:
Your MX-400 cc TEs:
12.0 cm width and 11.0 cm height and 6.3 cm projection
Your 375 gm Allergan 410 MF style implants:
13.0 cm width 12.0 cm height and 5.2 cm projection
What would correspond to your TEs:
Allergan 410 MX - 370 grams
12.5 cm wide and 11.6 cm height and 6.0 cm projection.
Or
Allergan 410 MX- 410 grams
13.0 cm width and 12.1 cm height and 6.1 cm projection
That said, perhaps your skin envelope was too tight for good skin closure with the MX anatomical. It is worth a second opinion.
I would suggest looking at Allergan Natrelle Inspira smooth round implants, 465 gms or 510 gms - extra full projection - SRX or SSX style. I am honestly not certain if they have both the soft touch AND responsive gel options available here in the U.S. yet. You may need to find a PS who is currently using them. Newly FDA approved.
Also, widely available would be Allergan Style 20, 475 ccs, which would be 12.6 cm wide and 5.5 cm projection. Even though the projection is not much more than the 410, the way it fits/sits in the pocket (and the fact that it is not so rigid)will give you the appearance you had with your TEs.
ADDENDUM: You should wait at least three months for any revisions, and this gives you time to see how these implants settle out for you.
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Drjaymie-
I felt very much like you the first few days after my exchange. I was depressed and did not like the way my implants looked. I had my surgery April 2nd. My TE'S were filled to 500 and I had the 410 anatomical implants 595 gms put in. Since the swelling had started to subside they look so much better and I am really liking the shape. You should really give it more time before you judge how they look because they will change. I will post pictures on the picture forum when I can figure out how to do it:)
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It IS true that most of us were depressed, upset, emotional and unhappy after the exchange. It takes a couple of months to process everything, allow our bodies to start healing, and to start exiting the emotional rollercoaster we have been on since the mastectomy.
So hang in there gals who are new to the aftermath of the exchange.
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Thank you all so much. I think once I get these stupid drains out, I'll feel a little better too. I have total MX PTSD from the drains and it's bringing up way too much and makes me feel so unattractive. I really wish I would've chosen round implants now. My PS talked me into the anatomicals because I'm just a natural person to begin with ,and she said that I should take the option b/c I have it, b/c I'm naturally slim and "a lot of women don't have the option of doing anatomicals because of their proportions." She said that I should take the option because I have it....meaning in her professional opinion that if your belly projects out further when looking at your profile, you can't do anatomicals because they don't project out far enough to be further-projecting than your belly. And she said that she thought I'd have some wrinkling and rippling from the rounds because I'm thin as well. I wanted them because I could avoid these drains and b/c she would've gone in through the existing scars and I really didn't want new scars. I have inframammary incisions now b/c I chose anatomicals. So, I have new scars to deal with AND drains....and I'm not even sure I like them. I will have follow-up on Wed to see what implants she actually DID place in me, and that will answer a few questions. Thank you all SO much for your support and advice.
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Oh my gosh. It gets worse. I just noticed when I took off my loose-fitting shirt and noticed that my nipples are in 2 totally different places!! Through my tank top that I'm wearing on top of my bra my R nipple is about half an inch below my L!!! It was very slightly lower with the expanders but if I lifted that side up and placed it correctly in my bra, I could level then a bit. Now I can't even begin to level them and they are SO FAR off!! Oh no.......my nipples are really sensitive and are always hard. This looks terrible! Is this something that settles? I'm so glad I have a post-op on Wed.......Ugh!!!!!!
The expanders (or pockets) were slightly off before as well. When I wear a tank top, it pulls to one side and doesn't sit straight on my chest and I keep having to pull it back to center.....and shelf bras aren't level either. It was clear that they weren't in the same place.
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Also...for those of you who have access to picture forum, I'll post pics so you can all see what I'm talking about as soon as I'm granted access. I asked for access yesterday, so from what I understand, it'll be awhile until I am granted access and can post there or can see what others are experiencing.
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drjaymie: You can always private message me and attach photos. Or send them via email. Y
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Okay. Pics sent to you.....i think.
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Got them. You look great drjaymie!
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Drjamie - "wide and flat'...yep, that's me. I am THREE MONTHS POST-OP. Nothing has changed. I wanted high B, low C. I recently bought some B cup bra's...nope! Too big! My breasts don't come close to filling-out the cup. I don't mean to sound like a Debbie-Downer, but for some of us it simply doesn't work.
I was so distraught over my diagnosis that I did not ask the right questions. My PS basically decided what SHE thought would be best for me.
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jilly59: Now that the new Allergan Inspira implants are available, that would be a good implant option for a revision. What does your PS say currently about a revision and exchange to a different style implant?
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Awwwwwh, Jilly59, I hope things settle in time for both of us and we end up with what we want. I, too, wish I had found a forum like this BEFORE and not after surgery. I feel like there was so much that I didn't know. Have you sent a pic to whippetmom? That was really helpful for me. She's such a great resource. All the emotions around this are just so difficult to maneuver, huh?
I called my PS office today and told them that my drains were barely draining and asked if I could have them out today, not Wednesday. They agreed and I'm now drain free!!!!! Stitches and all won't come out until next Monday, but I already feel better. Now, if I could just get some of this swelling to go down and lose the 5-month-pregnant looking belly that I always get from antibiotics!!
I got my official card today and I'm happy to say that although she said she was using high profile implants, I actually have the MXs!!! She told me that I was only filled to 340 before surgery and that the best looking implant on me in surgery was actually the 370, so I officially have bilateral Natrelle MX-410370. That answers a few questions. So, a revision for better profile isn't going to help anything. I shall now patiently wait for the swelling to go down and the "drop and fluff" that I hear so much about.
Thank you all for helping!!!!
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whippetmom,
You mentioned the Allergan Inspira implants for jilly59 what are the advantages to this style? My surgeon used Natrelle style 10 270cc so as to fill out the lower pole.but I lost projection with this.
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I have WAY too much upper pole projection and I have anatomicals! I expected this to ease but it's been 3 months! My upper and lower are the same projection. Sponge Bob for sure. When I speak to PS about my concerns she says nothing. At my visits, she just flits in and out, like a bee.
The implant card they give you after surgery? Mine was BLANK. So you see how this is going. I presented it to my PS and she had to dig thru my chart to complete it. Sigh.
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I also wanted to add - although my PS may be great with cosmetic reconstruction, she fails with BC patients. Bedside manner totally off.
Wish there were PS's that do nothing but BC patients.
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