BREAST IMPLANT SIZING 101
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Thanks! :-)
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Thanks for your patience.
I saw my PS yesterday. I have Natrelle 133 TE that will hold 500ccs.
Thanks for your help
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Hello again Whippetmom!
I just saw my PS this week for my final visit before exchange surgery. I told him how I liked my size when filled to 300cc's (I'm at 360 now). He told me that he'd have implants in at least 500cc's to get to that size and possibly higher. (?) I reiterated that I liked the size at 300—to make sure he'd understood and he told me how your implants will look smaller than the TE's…etc, etc…which I knew, but I am just concerned that there would be such a jump! What do you think?
Then… after I told him I'd like a firmer implant, he suggested a textured round, which I agreed. Last night I started searching back through your posts for your opinions on textured and found time and time again concerns of rippling. YIKES! I guess I'd rather have them be less firm than have problems with rippling. Should I change to the smooth rounds? What makes the textured more prone to the rippling? (My first post to you and your response is below…) THANKS for all suggestions! --Lorie
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I am 5'-2", 120 pounds, and ribcage circumference is 30.5" and I am 51 years old. I have Mentor Siltex medium height contour profile tissue expanders (reference #354-8211) which are currently filled at 300cc.
I asked my PS nurse and she said they usually use Mentor implants. I was happy to hear on the picture forum that my PS was one of the two you had recommended in the Dallas/Fort Worth area. (I'm seeing Dr Heistein.)
Pre-surgery my size was 36C although I was not symmetrical, my left breast being smaller and not filling out the c-cup.
I am one of the rare ladies that actually likes their tissue expanders! If only I could lay on my stomach with these things…I'd be good to go! I think now, at 300cc's, I like the way they look, size and projection wise. I don't want to get much larger if I can avoid ptosis –maybe that's not the word. (I don't want the droop that I had before!) After having these TE's I'd rather go with a firmer implant, not so concerned with squishiness.
My skin is quite thin, so I am concerned about the rippling I hear about. What type implant would you recommend and how much more do you think I should fill to keep the size and projection I have now?
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For you; Mentor Memory shape 345 ccs, medium height, high profile or Mentor smooth silicone rounds, preferably 400 ccs, if you like the way you look at 300 ccs. Doubt you would need to fill further, but talk about these sizes with Dr. Heistein.
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Mich:
You should be at a point where you have achieved as much settling as you can expect for the time being. Over the years, you will see changes, but if the assymetry persists enough to bother you,
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Katie:
Your implants are pretty durable creatures. The general rule is that you don't replace them unless you have a problem with them. However, from a cosmetic standpoint, you could talk to your PS about larger implants. Whether this would be covered by insurance, is up to your insurance carrier. It also depends on the way the PS codes this once submitted to the insurance company.
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SJHovey:
As far as silicone rounds are concerned, I would advise anywhere from 600 mL to 700 mL in high-profile smooth around silicone implant. I cannot comment regarding anatomicals, because I do not know the style of your 500 mL Allergan implant tissue expanders. (Dictating this...mls are the same as ccs.
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Rainflame4
- I think you should expand to 400 mL, and possibly a bit more, so that your PS could consider using a high-profile smooth round silicone implant, with a volume of at least 550 mL 600 ccs in a HP style Mentor or Allergan would be a good size also for your frame. It all depends on the amount of available skin envelope your PS will have, at the time of exchange. I would not advise anatomical implants, because they are dictated in size by the dimensions of your tissue expander. So you might end up a lot smaller than you want to be if you went with them, There's a little bit more room to play with when usingsilicone rounds.
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Lorie:
Textured silicone implants tend to cause what is called traction rippling, especially in thin-skinned patients. I do agree though with the size recommendation of 500 mL. I don't know why you feel as though you need a firm implant , but instead ask for Allergan Inspira "Soft Touch" smooth, silicone rounds, because they are a bit firmer cohesive gel implants. However, they are still smooth not textured
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Hi Whippetmom-I guess it's my turn to ask for your guidance.
Ok, so I had my bmx on May 19. My PS put in Mentor Medium height Siltex contour profile expanders. They are 13.5 centimeters wide and have a fill volume of 550 cc's.
I am 5'11", 150lbs, and had a pre-bmx bra size of 36A. My ribcage measures 32".
I was just wondering how much more I should fill to get to a full B cup? Also, what kind of implant do you recommend to someone who is physically active ( running, insanity, p90x) as I really want to get back into all of my pre BC activities.
Thank you so much for your input. I really appreciate all you are doing for us on the forum!!
Julie
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Okay, just wondering if it would be advisable to get bigger ones or not, based on others experiences and thoughts.
I can't seem to find my measuring tape but right now I am wearing a 36C/D depending on brand. It does have a layer for discretion since the nipples always show so they look a little bigger than they are. I think that size or a tiny bit larger would be more proportional to the rest of me but I don't know what's possible.
Thanks,
Katie
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Hi Whippetmom, I'm looking for your advice as well. I had my bilateral mastectomy on 6/25/15. The PS used Natrelle Style 133MV-13 Series TE, 400cc. They are currently filled to 300cc. They're doing 100cc at each visit.
Height: 4'9"
Weight: 110 lbs
Ribcage: 31
Prior to my mastectomy I was a 34B. I would like to be bigger with good projection. I fear the "wide flat pancakes" that look more like pecs & want to avoid that. Not sure if it's significant but the fills have gone really well so far with no major discomfort. So the stretching of the skin hasn't been an issue.
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KSChadd: Absolutely....you could go up to 650 ccs quite easily. I would not submit to the knife for any less. But your term "gummies" can be confusing, as "gummies" refers most specifically to anatomical implants. Rounds are cohesive gel implants. Which do you have? What style and mfr (Mentor or Allergan) do you have?
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Hi whippetmom,
Thanks for the reply, that's sort of what I was thinking, at least 650 but probably not more than 700 at the most? I don't wanna go too far the other way!
I have the silicone gel implants, I think it's Allergen? We were part of the clinical trial and I have been trying to find the exact Make/Model. I know they were about the middle/average in the size range but I also weighed nearly 20 lbs. less than as well.
I know they are the 'tear drop' shape, under my pectoral muscle, still weird to flex them and it rumples all up. :-P
I am just not sure about what difference it makes with the cc vs the projection? Or are they the same thing?
Thanks!
Katie
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lulu2523:
You might want an anatomical implant or a more cohesive implant which will be firmer on the chest wall. In the anatomical - Mentor CPG MemoryShape: Medium Height High Profile, 555 ccs or preferably, 620 ccs. (Better to have the anatomical a little snug in the pockets to reduce the risk of rotation). Another option is the Natrelle Inspira, (if you can convince him to go with Allergan), as their "soft touch" high profile smooth round might be a very nice option for you. In the Inspira, the high profile SSF 500 gms or 540 gms or preferably, the extra full projection, SSX, 550 gms. Dimensions of the latter are 13.5 cm wide and 6.1 cm projection.
The best test of sizing though will be to have to tell me what you think of the size currently, presuming you are at or close to 550 ccs.
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KSChadd: Well, if you were in the clinical trials, you might have had access to only the moderate height profile. The high profile version of the Allergan 410 has now been approved and it would give you more projection. Sizing depends on the width of your implants currently. You will want to be at or increase the width.
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We all have the pectoral animation.
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No, I am not close to 550 yet. More like 250. We have been going quite slow with the fills because of tightness I am having. (30cc at a time). It has gotten much better though. We did actually go from every two weeks to every week because of needing radiation in about 3 months after ending chemo. I actually won't be getting my exchange for a long, long while
Thanks for the info. I will ask my PS about each of those implants at my next fill this Friday.
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CeCegbp: I think you would get the look you want, since you are so petite, with smooth, silicone rounds. Anatomicals might appear too tall,oval and flat on your frame.. I would suggest Allergan Style 20, 500 ccs, or Allergan Inspira, SRX 435 gms. The Inspira are overfilled...presumably reason for the size differential. Both are high profile style implants
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Thank you so much! This has been so confusing for me. I appreciate your help & the wonderful service you provide for everyone
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Hi Whippetmom! My TE were Mentor CPX4 450cc, medium height with suture tabs. I was filled to 440 ccs and the PS put in 400 cc Mentor Round Smooth 400 cc Moderate Plus gels. I was told I was getting high profile before I went under anesthesia.
I am;
5'4, 127 lbs, 29 inch ribcage.
I don't know if you remember but I went and got a 2nd opinion on my rippling from a doctor you had on your NC list! I was fed a line of caca from my former PS assistant. When I called to get the details on my TE"s she said the doctor didn't write it down in the chart but she knew he put in Mentor high profile TE with a fill volume of 1,000 cc's! Well today I went to my BS today for my 6 month follow up exam and he printed out the OR report for me so I would have accurate and true information.
The new PS (who is great by the way) is looking to put in high profile Inspira implants and just bigger than 400 ccs to help with the rippling issue.
What size Inspira implant would be good for me?
I wanted to give a bit of advice to others. Please understand your PS works for you not the other way around! Let him or her know what you are looking to achieve and have a full knowledge of everything they are doing.
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trailrose:
The Inspira extra full projection implant 520 gms, if it is "doable", e.g. you have a sufficient skin envelope for good closure over the implants.
Oops... somehow missed the ID of your former TEs. Now that I know they had a projection of 7.0 cm, the Inspira extras should be easy peasy.
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Thank you Whippetmom!
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Hi Whippetmom,
Thanks to you for all you are doing!! What a blessing this site and community is...I am so grateful to have discovered you and am AMAZED to see the many people you have helped to guide in this very confusing process of determining proper implant sizing.
I just sent you a PM with my pics and details, but realized its good to post here too so that others can follow and learn from my situation, as i have learned from reading your advice to others based on the info they provided.
New to this site, recently completed a prophalactic nipple sparing mastectomy, with tissue expanders in place until early next year when scheduled for a transfer.
TE are Allergan Naturelle 133MV12, max fill 300cc (PS says we are done filling at 440cc). At current 440cc, i feel i am about the same size (though distributed differently), as pre-surgery. He used the new silk mesh product for support instead of Alloderm.
Im 5'4", 147 lbs and rib circum 34".
Pathology report says removal of 520g (left) and 280g (right). since i have been filled evenly to 440 each side, at this time i am currently looking uneven and the left side, though "tighter" side at each fill, is now also significantly smaller looking than the right. not sure from the picture, if you can tell if it has rotated (and if this is a problem or not), but it does seem to be strangely placed at this time vs the right side...
Final consult with PS early next week, so wanted to get your thoughts on a few questions i have:
1. PS has stopped filling at this point. Checking whether ok to stop fills now or push for more filling of the left breast due to the unevenness at this time...can this be corrected at time of transfer or is the pocket mis/undershaped now going to result in an uneven final outcome.
2. PS is suggesting under muscle anatomical gummy bear max size 640cc. Before this final suggestion, originally mentioned an under muscle round silicone HP 600cc.
Being that I want to be a size larger than presurgery, and am seeking good projection (more than current tes)..like the push up bra look vs natural so thinking round silicone and not anatomicals.
Is it safe to assume that if i was ~500g removal, then to add a cup size i should be in the 700cc implant range?
Also saw your recent comments re: recently approved new ultra HP Inspira available in the summer, and wondering if i might be a candidate for this given my dimensions and desired outcome...if not ultra HP, could you recommend an alternative HP silicone option that you think would be best suited for my frame?
thank you in advance!!
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Kyliem:
I responded to you privately, but I want to share my thoughts for the benefit of others and also to reiterate that the size of the future implant is dependent upon the available skin envelope created by the tissue expander. Your PS told you that the largest anatomical available in the style you would need is 640 grams max, but I highly doubt he has any plans of using an anatomical that large. Your TE dimensions are corresponding to an anatomical with a maximum volume in the 400 gm range. You might be able to go to a smooth silicone, the Inspira 550 grams or Allergan Style 45, 550 ccs...but I believe it might mean correction of the TE on the left. Another key issue is selecting the style and volume implant that will allow the NAC to end up in the best possible place on the mound.
Talk with your PS about that left TE and your size desires. You will not be happy in the 400 cc range, based on what you have revealed thus far.
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Thank you Whippetmom, will do...i appreciate your insight and quick response. It is so helpful. You are amazing!!!0
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Angie4: You have turned off your private message function somehow. I cannot reply.
My second response:That changes my view considerably. Give the implants another two weeks to settle. If they are still flat, let's discuss further.
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Hi Ladies,
Have my appt. with my PS and he said I have Allergan Natrelle 410 MX 550 14.5 but that we can go to FX 775cc 15.5 width and 16 tall to fill in the divot I have at the top of the left one where the cancer was and to make them fuller all around.
I would love any thoughts, opinions, experiences you all have had? Is this too big? I have wished I had gone bigger from right after my final surgery but I don't want to go Too big.
Thanks!
Katie
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Hi Whippetmom! I have followed this thread for a long time and have read all of the wonderful information you have given to these women. Now I am in need of some advice.
I had a bilateral nipple sparing mastectomy with tissue expanders done in December of 2014. My tissue expanders were over-filled to 500cc. I had my exchange surgery in april of 2015 with Natrelle 410's and fat grafting. For the most part I am happy with my results but I have some issues that I will be having fixed. My nipples are not symmetrical, I have some ripples on my right side and my pockets are too close together. I also do not have as much projection as I would like. So I will be having a revision to address these problems. I asked my plastic surgeon if there were any new implants available with more projection and I was told that there are not in the anatomicals. He said that we could use the inspiras instead. So I am considering switching to these and am wanting your opinion on size and if using the round implants would put me at risk for more rippling. I would like to be a large C or small D.
- 5'8", 140 pounds, ribcage: 30"
- I have Natrelle 410 anatomic implants 595cc. (FF410595)
- Prior to my mastectomy I had 339 cc silicone implants and was a 34c/d.
Any advice would be much appreciated!
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CaliRN: Good choice. The Inspira SRF or SSF full projection, 630 gms, or the SRX or SSX, 610 gms or 695 gms. The dimensions are essentially what you have now, it is just that the Inspira implants are overfilled and so therein lies the size differential. So you just need to decide whether you want more projection - 5.6 cm with the SRF or SSF and 6.2 cm and 6.4 cm with the SRX/SSX. Your PS alo needs to be assured of good skin closure over the extra full projection style. That might be a bit much Please discuss with him.
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Katie: That proposed implant sounds huge for you - width-wise and height-wise. Why not fat graft transfer? That took care of my step-off (divots) defects bilaterally. I just fear that the FX will appear very oval. But if that is what your PS proposes, and if you want more volume, I suppose that is the way to go.
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