BREAST IMPLANT SIZING 101
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minus - they bent over backwards for me, and they were pleasantly surprised when I showed up for work again on the day I said I would, 30 days after the last chemo. Sadly, I decided after a while that I could not stay due to the need for additional surgery, twice a week LE therapy, and weekly fills 45 that were a 45 minute drive away - I had to go slow because of all the skin damage, and it was too much. I decided to return the company's kindness by resigning (with a rehire clause) so that someone else could have my job who really needed it to put a roof over their head, and also so that my super supportive co-workers could have some consistency and not have to pick up my slack.
stix - Americans with Disabilities Act. Companies can grant an accommodation to an employee, but it is discretionary to a certain extent, they may not have to do it if it causes them an undue hardship.
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Raleighgirl:
I would say the Sientra shaped....this one...320 ccs or 370 ccs. Once you are filled to 300 ccs, let me know what you think about the size and we can revisit this topic.
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thanks whippetmom
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OK, I could use some sizing help!
1. Your height, weight, ribcage circumferece (measuring under the bra line or under the tissue expanders with a measuring tape).
5 foot 6, 180 lbs (although I'm trying to lose about 30 of that), size 14. Rib cage 35 inches.
2. Tissue expanders: Allergan Style 133MX-14 600CC
3. Also, please advise if your PS has told you that he/she uses one brand or style of implant exclusively so that we can save time in our research.
They use Allergan.
4. Your pre-mastectomy breast size is also important, because it does have some bearing on expansion, tissue expander volume and the need for good tissue coverage over your future implant.
I used to wear a 38 DD. The breast surgeon removed 725 grams from the right side and 710 from the left. I'd be OK with a little less projection than before, like maybe a D or so.
I currently have 700CC in the expanders, and I generally like how they look. 610CC was too small to fill out my swimsuits and dresses. I hear that I'll have to go a little bigger with the implants if I want them to look as full as the expanders? My PS also overfills by 50CC. So what size implants would probably work?
I prefer the idea of the round cohesive gel implants, but I don't know what projection to get or whether to get the textured ones or not.
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hello WHIPPETMOM
I posted a request several days ago on page 435. I am not sure if I posted correctly or if I tagged you correctly for the request regarding help with my implants.
Could someone please guide me to the correct way to do the? ALL of the information requested is in my previous post. Let me know if there is something else I should be doing , please?
Thank you very much and thank you for this amazing resource and your help!
FalconMarks. Teri
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falcon - you are posting correctly. just be patient. we keep whippetmom quite busy with all our posts and PM's in addition to her full time job. I'm sure she will answer you shortly.
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Falconmarks:
I am so, so sorry! Yikes! I DID see your post the other day, but I saw your TE description and knew you have Mentor Spectrum expandables. However, they are infrequently used as TEs (nothing wrong with them...they just are not "technically tissue expanders", so I could not just answer off the top of my head so saved it for later. I just forgot about the LATER part!
So, you say you had large breasts pre-BMX, which leads me to believe you have plenty of skin. The Spectrums are narrow and so if they are in your armpits, it is a placement issue or the pockets are wider than the Spectrums, as they always want to move laterally.
You need to fill to 420 ccs. They will have the following dimensions at maximum fill: 11.9 cm width, 10.1 cm height and 6.9 cm projection. Your PS might have used the Spectrums, because they do tend to create better dimensions, IMHO.
I would suggest Mentor ultra full projection smooth silicone rounds, 535 ccs. Yes, your Spectrums are sufficient to get you there. The dimensions: 12.0 cm wide and 6.1 cm projection. I honestly do not know if I would go the anatomical route with you, based on your history of large breasts and considering that the pockets might be larger than the Spectrums. I am concerned you might be at higher risk for rotation. If you did go this route, it would be Memoryshape medium height, high profile, 495 ccs minimally....to make for a snug pocket.
So you have some things to discuss with your PS. Keep me posted!
Deborah
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sabihah: Okay, for you, Allergan Style 45, 800 ccs....OR.....Allergan Natrelle Inspira implants, the SSX style, 695 grams. The difference is primarily functional, in that the Inspira implants have a greater fill level in a smaller shell. So you have essentially, the same dimensions (a little more projection with the Inspira)but different implant volume.
Deborah
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I could really use some help with sizing. I currently have TE's : Mentor CPX4 #354-9215 (650 cc capacity) filled to 720cc on each side. The dimensions are 14.6 x 12.6cm with a projection of 7.6. I am 5'8" tall weigh 152 and my ribcage circumference/bra strap is 38. Prior to my DMX surgery I had breast augmentation done due to delafted saggy small C's and got Mentor Smooth Round Moderate Plus profile gel; silicone , 475 cc in each breast. This brought me to a very full C. My bra size prior to augmentation was a 36.
I'm almost 6 mos post and came out already filled following surgery with L-360cc and R-420cc. I am currently now filled with 720cc in both breasts and I have one final fill ( last 80 cc /each) this week then my exchange surgery scheduled for end of July. My PS overfills by 10% and does about 2 weeks in between last fill and surgery. My PS only uses Mentor. He knows that I want to be very full C, and since I have wide breasts he told me he already did dermal slings to prepare me for the exchange surgery. We also discussed doing some fat grafting if needed to smooth out skin, minimize any rippling and cover edges of the implant. My PS said that I have healed and done very well in the expansion process.PS is recommending either 750cc or 800 cc silicone Mentor Smooth Round either Moderate Plus or High Profile gel implants. Whippetmom does this sound like the implant style and volume I need for a very full C cup ? I greatly appreciate all the info and your suggestions. Thanks so much!
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I would really appreciate sizing help. I am 5'5", 140 pounds, circumference is 35". I currently have natrelle 410 TEs, capacity 450 cc, reference number is 133 FX12. Right side is filled to 310 cc, left to 290. Left looks much bigger than the right. PS says this is because I've had 4 surgeries on the right side and it's still tight. He says I will have 3 more fills and be readY for surgery on August 19. I'm not so confident I'll be stretched enough, but he seems to be. I was previously a 38 C, and had had augmentation. I could look up the size of those implants if it matters. He told me he will be using teardrop shaped silicone implants, so I'm assuming it will be the Natrelle 410. I'd like to be a little smaller than I was, maybe a large B. Thank you so much
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- CCS648: The corresponding anatomical will be Allergan 410 FX - 360 gms or 410 gms. The latter, preferably. Personally, I would tend to agree with Steven Teitlebaum, MD, one of the premiere clinical trials investigators of the Allergan 410, who has stated in interviews that he would NOT use an anatomical impant with a patient who had previiosly had round implants. He feels it puts that patient at inceased risk for rotation with an anatomical. My concern is that you have pocket discrepancy already, with one pocket larger than the other. An Allergan 410 needs to be sufficiently large enough for the larger pocker so that it is a snug fit. But will that same size anatomical be too large for your tighter pocket? With that in mind, I would personally also want my PS to consider Allergan Style 20 - 450 ccs or 475 ccs.
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whippetmom - thanks for the advice. I guess I was under the impression that he would keep adding more to the right side to even them out. Am I incorrect? And Is there a resource you can point me to with regard to the anatomical replacing round issue? And why do you say the 410 would be preferable?
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Thank you. But why would you suggest rounds as opposed to anatomical implants?
Are there too
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CCS648: Sorry...I misspoke...it was Grant Stevens, MD, another premier 410 clinical trials plastic surgeon (and the PS who coined the term "gummy bears")who advises against using anatomical implants when the patient has previously had round implants.
"The
shaped form-stable gummy bear implants, such as the 410 and the CPG,
are not ideal implants for women who have had previous breast surgery
and have already pockets for those previous implants. Those women have
pockets which are generally too large to safely accommodate the shaped
form-stable implants. However, the Sientra form-stable silicone gel
breast implants, which are round, can be safely placed in these
patients." Quote is in this article:http://www.cosmeticsurgery.com/articles/archive/an~283/
And in Dr. Stevens' interview article re: cohesive implants...
Yes, your smaller TE should be filled and overfilled, if necessary, and allowed to hold that shape and be symmetrical with the other side.
The pockets need to be snug for the anatomical and so the 410 gm size would be better assurance in this regard.
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Sunkissed....Not sure about your comment or question....
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I'M so sorry. Below i have copy/pasted previous conversations! My expanders have been filled to 420 left and 450 right (for some reason they now look even) and am wondering about when to stop with the fills and why you recommend round over teardrop? Also which silicone substance do you recommend - cohesive, highly cohesive? I now almost fill a 34d bra. So would i still need to fill to 500-600 to get implants you sugested below. And would that be around a 34d. I heard implants appear smaller than TE's i guess from muscle pressing them down.
Following are our previous conversations: i am 5'3", 147 lbs, 29" circumference and 57 years old.
The TEs I had put in 4 weeks ago after bilateral mastectomies are PMT Integra 650 ml. 240 was added at initial surgery. I have not had a fill yet because i have a small area on one incision that is not infected but is still leaking the tiniest bit of fluid.
My PS mentioned he could use mentor, sientra, allergan or any brand cohesive silicone implant.
I was 34b prior to surgery.
Can you give me an idea of the implant style and size that might best work for me. I was hoping for a d size cup with a natural look when standing, laying down,etc. But dont want them to make me look fat. Or too unnatural. I gotta say the TEs are quite uncomfortable. Especially where they fold.
Which style?
Jun 7, 2015 09:16PM whippetmom wrote:
Sunkissed:
Disregard. I see that both styles have similar dimensions. I would suggest Mentor ultra full projection smooth silicone rounds, 535 ccs or 590 ccs, or Allergan Style 45, (also a full projection style) 500 ccs to 600 ccs...essentially the volume that places you in a 12.0 to 12.5 cm width in this style.
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Sunkissed: I suggested the Mentor smooth siicone rounds, because I feel they would give you the look you want. Your TEs have a projection of 10 cm! There is no anatomical implant which has anything close to that amount of projection, and it does not appear that the pockets have nbeen created with anatomicals in mind. It is recommended and documented that the skin envelope should not be overly dissected or overly expanded beyond the dimensions of the chosen anatomical. I do not think you would need to fill beyond the maximum fill of your TEs. Nearly all of us who have gone before you have implants which have a greater volume than were our tissue expanders.
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Sunkissed: Another option....since your PS will use any mfr, is the Allergan Natrelle Inspira, the smooth ultra full projection style, which would be a SSX or SRX, 465 gms. Inspira implants (silicone) are overfilled and can thereby produce more fullness in a reconstructed breast, Sorry, I don't know much more than thatthey are widely used and favorably so, in Canada. They are now FDA approved in the US. Grams essentially convert the same as ccs, it is just that the former is a measurement of weight/mass and the latter a measure of volume.
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I am gradually adding more content to the thread header. So newcomers to this thread, please check for updates.
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WhippetMOM
Thank you for all of your research and input! It is GREATLY appreciated and never taken for granted!
I will let you know how things turn out over the next few months.
Teri
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THank for the info. You are making this so much less confusing! No i never intended to project 10 cm!!6 cm sounds good. I just wanted around a 34d! And i am just about there with 420/450 cc.
So i will discuss further with ps and maybe get one more fill. He does want to slightly overfill. Thanks again! You are a doll!!
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You are both quite welcome. Keep me posted
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Whippetmom- I wanted to thank you for recc. doctor's in the NC area. I went for a 2nd opinion on my rippling and really like the new PS. He not only has nice bedside manner but is very knowledgeable. My next appointment is in September to look at the newly approved Inspira implants! Looks like I'll be scheduling a revision surgery in the Fall.
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Trailrose
Wonderful! Please keep me apprised of your journey! So glad this was a positive change of direction for you.0 -
Hi Whippetmom, can you give me your suggestions?
I'm 5' 6", 138 lbs. Rib circumference is 31 1/2 in. My pre-surgery bra size was 36B, a full B cup (but a bit saggy from breastfeeding).
My expanders are Allergan 133FX-12-T 450cc. They're currently filled to 375 on the left and 340 on the right (right pec was more prominent, so they look symmetrical now). I'm expecting one or two more fill appointments, typically I get about 50ccs each fill. Right now I feel like I look about the same as I did pre-surgery as long as I'm wearing a bra that pads a bit in the front of the foobs. The expanders are definitely more flat than my natural breasts were. I'm looking to be a small C post-surgery, but I don't like the flatness I'm seeing right now. I want more projection. I've noticed that a lot of after pictures seem round but a bit flat-surfaced, too. I'm wondering if I need high profile implants for that. My PS tends to use Allergan rounds, which I'm totally fine with. What do you think?
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Hello Whippetmom –
I am new to this forum and I posted a few days ago on page 436 and I am not sure if I did not post my request correctly or tagged you wrong requesting help with my implants?. I just saw my PS and went for my last fill and now awaiting my exchange surgery before end of this month.
All of my information (type & # of TE's, height weight, breast size prior ) is all in my previous post. I am getting concerned that my implants will be too large?? Just looking at some of the other ladies and they smaller amount of cc's. I am shooting for a very full size C.
Feeling little bit overwhelmed and wanted to find out what your thoughts, recommendations are.
Thank you again for your time and for providing such an amazing resource along with all your help!
Cpn70/Christi
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Summerangel
Full height tissue expanders tend to really flatten the mound. Very little lower pole expansion. I recommend Allergan Natrelle Inspira extra full projection smooth, round implants -465 ccs to 520 Gms. Also good would be Allergan Style 45 (also a smooth round extra full projection style) 550 ccs. Implants are more often than not, 100 ccs or
so larger than theTEs.0 -
cpn70
Yikes! I am so sorry! My email notification was inadvertently turned off for a day. You are not too large. My question for you is: are you happy with your size now? I agree with your PS, but I would suggest only a high profile or extra full profile. I think you might be unhappy with the projection of a MPP implant. In a Mentor HP, 700 ccs or 750 ccs, and in an ultra full projection, 800 ccs.
Your ribcage circumference is measured with the measuring taunder the tissue expanders. Could you verify this measurement for me?
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Dddd
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Hi Whippetmom –
Thank you so much for getting back to me. I have met with my PS this week and we did my final fill bringing me to full 800 cc in each breast.
To answer some of your questions: Are you happy with your size now?Yes, I really liked the size I had with my expanders filled to 720 cc, before the final fill. I definitely would not mind a little more. I am shooting for a very full C. Right now being at 800 cc they are big and wide and uncomfortable ( and into my armpits more on rt side then left) but I know it is only temporary so keeping mind realistic and know that I will be losing some projection.
My PS said no MPP for me since it will not be enough. So he is thinking Mentor High Profile for me. He also told me that he will moving my rt breast pocket in toward my sternum to make them more even and then adding some stitching on rt side by armpit to minimze any side boob from happening. Since he only uses Mentor , he said he typically brings in 3 diff implants into surgery( 700cc, 750cc and 800 cc) to see which one will look the best. I told him to please focus on 750 cc or 800 cc since I am worried that I will too small with 700, since I know how I looked in 720 cc.I will definitely ask him about Ultra High Profile in the 800 cc as well, thanks!
We also talked about FG and PS said only it is was necessary since he thinks that I will have enough skin along with the high profile for upper pole fullness. If I need it after they settle then it will be done at next reconstruction along with nipple.
You had asked me to re-mesure my ribcage, I put my bra strap size in error. Sorry about that. I re-measured and I have a 34" circumference.
Thank you again for all your help, your time and your valuable insight!
Christi
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