BREAST IMPLANT SIZING 101
Comments
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Rayhanna:
With only four days to go, I know your PS has already ordered the implant sizes he intends to try in the OR.Hopefully he ordered more than just a 350 cc implant to try out in the OR. I think 350 ccs to 425 ccs sounds good, although even though you are a B cup, your skin has stretched and an implant needs to take up the slack. Some plastic surgeons use the textured Sientra implants for women with significant ptosis, but we have no idea WHAT brand or style your PS has ordered. However, you can call his office and ask the nurse or assistant to pull your chart and tell you what brand and style(s) and volume implants he has ordered for you. Then come back here and we can discuss.
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Has anybody had non-dissolveable sutures put in for bottoming out?
If so, did you develop any complications. Does anyone know how common this is? thanks stix
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http://www.poustiplasticsurgery.com/case-of-the-week/category/breast-revision-surgery/bottoming-out/
http://www.realself.com/question/dissolvable-sutures-for-capsulorrhaphy-effective-bottomed-implants
Stix: Did you search the internet with this question? I did a quick search and in five minutes came up with a slew of hits...these two an example....
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thanks whippetmom- Yes, I saw those websites.
I was curious how many people on this site had perm. sutures (non-absorbable) and 1. complications such as suture spitting, continuous discomfort, itchiness from sutures, a suture reaction, an infection or the sutures just not holding occurred with anyone on this site. And, how many had ADM along with this?
thanks, Stix
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Si
Stix, yes, I have had two stitches trying to poke out. I just "readjust" the expander area....I know, sound weird....and gently push the stitch over so it is not pushing out. So far that has worked. I sure don't want ant more cuts. I am hoping this will work until exchange surgery sometime in September. I do not know what ADM is. Alloderm? If so, yes, I have Alloderm around the expanders.
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So, I had my appointment with my PS. She said she could put bigger implants in if I wanted, but wouldn't want to go a lot bigger due to my thin skin. Or she could do a fat graph to take care of the ripples. She said even if I got bigger implants I would still have the rippling. Said she wouldn't want to do anything until August or September in order for my body to heal. I hate the thought of anymore surgery! I'm thinking that maybe I'll just do the fat graph and keep the implants. Anyone have experience with fat graphing?
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mysunny - fat grafting is surgery. It is lipo without the contouring benefits. I'm still hurting some from mine on May 2nd. My nurse says patients report pain from the lipo much longer than they do from the transfer. You my want to speak to your PS about it some more.
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thanks knmtwins - I will definitely speak to my PS about it and request that I get the contour benefits. I'm going to do my research on this. So, we're you happy with the results
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MySunnyDay - I had an odd situation where one of my TEs deflated, so I had surgery before we were expecting it. My implant was put in on the left and a new TE had to be put in on the right. I also had VERY wide breasts, so... I'm not happy at all with the implant side, as it is too far towards the armpit, and I now have a dog ear in the sternum area, so I'm guessing not all the fat grafting 'took'. Seems this is not unusual. So when I go back for the implant on the right, he will do pocket work on the left also, to try to make it more centered, and I'd think will also do more fat grafting. As to contouring, he didn't leave weird gaps or anything, but they can only do the lipo to get the amount of fat they need for the reconstruction. Some women chose to pay for 'full lipo' at this time, since they are already there. With three kids and surgeries stretching out over two years (out of pocket has been a bear), so the extra for a 'real' lipo job is not in our budget. Seems everything with BC is a marathon not a sprint and costs tons of money. I just need to remember this. According to my local BC Support Group, my surgeon is a protectionist, so will work had to ensure they look good to him and me. I haven't heard a complaint about his final outcomes.
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mysunnyday - insurance wil only cover removal of as much fat as is needed for the graft, that is why you don't see cosmetic benefits at the donor site. Taking a great deal more can be grounds for an insurance denial. If you want cosmetic lipo you have to pay out of pocket and many plastic surgeons will not combine it with a breast revision
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Whippetmom,
I know we had this discussion months ago but now I'm a month out from exchange. I stopped fills in Jan. at 250 - 300 cc due to pain from the fills. I'm wearing size 36 bras and they are tight. I'm a full B to small C and like the the size and shape of the expanders. I go in on the 14th for pre-op with PS and to talk implants. I was considering silicone b/c was told that they require MRIs every couple of years for possible leaks (peace of mind to me). Saw BS today for check and she said no MRIs but still recommended silicone. I want as much profile as possible. I know some new implants are out now and welcome your thoughts. I know I wand round.
I will them research and go to PS prepared, unlike my BMx with TEs.
thanks
Scottie
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I'm due to have my exchange surgery towards the end of July. I have expanders in now 133MV-14-T filled to 500 cc. My dr suggest a 500 cc implant high profile round . I want more projection than what I have now. I do like the size I am with expanders. I'm a 34D cup. I really dont want my exchange to put me smaller. I was a 34B pre-op. My ribcage measures 29 inch and i'm 5ft 8inch 120 lbs. Very small framed. What size implant would give me the large C small D with more projection?
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Scottiemom : I need your TE info again. Please see #2 in the thread header
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Whippetmom. . .I will have to wait and ask my PS. She never told me. I may be able to call her office and ask for the info though. I will try that next week.
Thanks,
Scottie
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agrinder: 500 ccs in a standard Allergan HP round will not be sufficient, if you like where you are now. You want Allergan Style 20, 600 ccs. It takes another 100 ccs at this TE volume to approximate what you have with your TEs. The Natrelle Inspira implants are also a good choice and you could get the optimum projection with an extra full projection SRX or SSX 550 gms or 610 gms. It all depends on whether you have sufficient skin availability to allow forgood closure over this higher projection style implant. The HP version is a SRF or SSF 540 gms.
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Thank you so much. I see my surgeon on the 15th of July. Can I have a 600 cc implant without being overfilled. I have 500cc now. Or should I be telling my Dr I need another fill? I am a little too wide. These 500 cc are in my armpits.
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Had bmx 6-12-15. Placed Natrelle 133mx 500cc tissue expanders. PS put in 150cc at time of bmx which look like the 36A cup I was prior to surgery. I am 5'8". 145lbs. Wishing to go to B cup. Was guessing 350cc as my goal and would expand 50cc a week for a month then exchange surgery hopefuly in Sept. (dr using the natrelle 410 gummy bear silicone implant) Do you think that 350cc sounds reasonable for a b cup on me? BTW I am thin on top if that makes a difference. Thanks!!!
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agrinder. 600 ccs in a Style 20....yes....the dimensions match those of your TEs. Up to your PS if you need another fill, but in most cases, not necessary. The tissue expanders might be migrating laterally and your PS can move them a bit more medially at the time of the exchange. I would see if your PS could get the Inspira implants.
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pharmergirl:
The Allergan 410s need to match the dimensions of the pockets created by the TEs, or they might/will/could rotate.The MX style TE would translate to a MX style anatomical. This would mean 410 grams minimally, 445 gms ideally. Just the right size for your frame.
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Thanks mysunshine. ADM- I have had alloderm and strattice without success of bottoming out. The surgeon called it bottoming out. I don't think I would have called it bottoming out. Maybe because the majority of the implant would be under the nipple (if i had one)?
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Hello Whippetmom et al!
I would love some suggestions/advice on implant size/style. I had nipple/skin sparing BMX and now have Mentor Medium 450cc TEs filled to 380ccs. I am 5'1", 124lbs and I am just under 30" around the ribs/under the TEs.
I used to be a 32 B and was totally fine with my previous size. I wouldn't mind being smaller than my current TE fill level. My PS has suggested anatomical implants but I am concerned with them rotating/shifting, but I definitely don't want super fake looking breasts either.
Thanks for your ideas and for sharing your experiences!
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hello,
I would love any input you have on my situation. I am 5'7", 130 lbs and the measurement around my rib cage right below the expander is 30". I have allergan 133mx-13t and they're currently at a fill volume of 400cc.
I was a very full b, small c size prior to my surgery. I would like to be a nice c after surgery. My ps has been discussing the natrelle 410 with me or the natrelle round as my best options. What size do you think would be best to achieve this?
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Hi mersk and eee! Welcome!
We're sure whippetmom and others will be by shortly to weigh in with their advice.
We just wanted to say hi and welcome to this incredible community!
--The Mods
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Mersk: It is not really your "fill" level that will determine the future implant size, but the dimensions of the tissue expander. I personally would recommend Mentor smooth, round high profile implants, 450 ccs. You will be smaller than you are presently, because while the width is the same, the projection of your TEs is 7.0 cm, and the projection of the implant is 5.1 cm. This would create a nice, natural appearance for you. Alternativelu. the aatimical wouldneed o be a 495 cc high proile implant and you might be larger than you would like. I would stick with the silicone rounds.
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Eee3
You could go with either the anatomical or the smooth, silicone round in Allergen Natrelle. In the 410 anatomical it would be either a 410 gm or 445 gm MX style implant. In Allergan Style 20 -a high profile implant, it would be 500 ccs. Because you have an ultra full projection style implant, you could go with an ultra full silicone round, but the best option there would be the Allergan Inspira, SSX or SRX, 520 grams. Don't be confused by grams vs ccs....as it is the dimensions of the two devices that matters here.
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Hi Deborah!
We chatted a little over a month ago...as a refresher, I have Allergan 133-MV-12-T TE's and prior to surgery was an E. I am 5'7, 128 lbs and my rib cage is a 31. I am now filled to 380 cc's and done with fills (yay!). However, my PS and I seem to be a bit at odds over which implant I should be selecting...
I communicated that I do not want boobs that look completely fake - but I still want some upper pole fullness. I had some ptosis prior to the BMX, however, the PS did a really good job of pulling skin together (like a bodice of a dress) so I have no excess skin hanging anywhere. But he feels the best implant for me is the Mentor Memory Shape (either 330 or 375 cc's). I was really leaning more towards a round, as I felt like I could get that upper pole fullness. In your opinion, will his recommendation get me enough of the fullness/projection? I'm trying not to get hung up and overthink this issue, but I guess this is the one thing I want to go right ;-)
Thank you for any insight and wisdom!
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Thanks for the info! Just one follow up question, I feel the width of my TEs are too wide. They stick out on the sides, I feel like my I can't put my arms against my sides because the TEs are in the way. But I feel they are separated enough, that is not too far or close together. Would you still make the same recommendation? I really appreciate your insight.
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whippetmom: thank you so much for your input. Do you think that I need another fill before I do my exchange. I was thinking that I am still in a b cup status. I also don't feel like they project very much. They seem very wide and flat to me. Which implant do you think would offer the most projection? I would also like it to still look as natural as possible. Wow, I guess I want it all now. Thoughts?
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Eee3: Why did you stop filling? If you are not having TE troubles and your skin integrity is good, continue with fills. You should be fine now, if you stop, with Style 20, 500 ccs. You would want to continue with fills, perhaps, for the Inspira. Have no idea about anatomicals....you might not need much more, because your dimensions are likely close enough to those of the 410s. Your PS is the one who should know how much more is needed for any specific implant
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Mersk:
Based on your height, weight and ribcage dimensions, 12.7 cm does not seem wide at all. Do you want to send me photots? You could probably go to 425 ccs in a Mentor high profile smooth round, which is a bit narrower. The pockets need to be secured laterally, so that they do not continue to migrate in that direction0
