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BREAST IMPLANT SIZING 101

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Comments

  • KSChadd
    KSChadd Member Posts: 13

    HI and thanks for the reply,

    We did try that and it did not last, it went away and the divot is back and I have slopes in the middle of them again and I know we can't go closer together under the muscle but I think the higher ones with a bit more volume would help both issue, at least that is what he is telling me. He measured and we held them up to me and they do look bigger but not as huge as I thought they would.

    I have wished for a bit bigger but mostly I just want the divot gone and for them to not look like they are falling to the sides even when I am upright. :-P

  • mysunshine48
    mysunshine48 Member Posts: 915


    I have had my expanders in since April 10. I am filled to 590 cc's. I went to my PS yesterday to discuss exchange and Inthought I would get a fill. I have had none during chemo. I have 2 divots or valleys on the top of the right expsnders. I thought he would fill to try to get ribbon these, but he did not. He said Inwas fine for my surgery scheduled for September 25. I am worried I will still hsve these after the exchange with Inspira 650. What do you think about this?


  • Lkscolo
    Lkscolo Member Posts: 40

    Hi Whippetmom,

    I met with PS this week to schedule exchange and I feel fairly confident that I will be happy with what he suggested. But wanted to put it here for your advice as well. I have tissue expanders in both sides Allergan TE 133SX11-T 250cc and was expanded to 300cc. I was small pre-cancer and petite framed. 5'2" 110 pounds and 29" rib cage. I am hoping to come out of this a solid B cup, closer to what I was before nursing kids many years ago! He has proposed Allergan 410 MX375. That is what the nurse wrote down on my paperwork. I hope that makes sense! Does this sound right?

  • Suze72
    Suze72 Member Posts: 11

    Hi all,

    I've been following this fantastic forum for a while now. I'm a bit confused and would love some help with choosing the right implants at exchange.

    I'm 170cm tall, weigh 57kg, 75cm under bust. I'm slightly pidgeon chested and was an A cup prior to my bmx.

    I currently have Naturelle 350cc TEs in place with 310cc saline so far. My surgeon plans to overfill them.

    Ideally I'd like to end up with full C cup to D cup foobs so that I will look hourglass rather than pear shaped.

    At the moment my boobs are sitting out very widely spaced apart, hitting my arms but I'm looking flat in the middle still.

    My PS says that she'll likely use full height Naturelle 410s.

    I'm unsure of whether to go for high projection or ultra high (FX) ones and whether increasing the projection will help to give me a little cleavage in the middle. What would you recommend? Also do TEs often make one's boobs appear "wall eyed" like mine and does this sort itself out once the TEs are swapped for silicone implants?

    Any advice would be greatly appreciated 😅

  • whippetmom
    whippetmom Member Posts: 6,028

    KS Chadd

    You may need lateral capsulorrhaphys, to keep the implants from moving into the armpits. Larger implants may not resolve that issue otherwise. But go for it... And let me know about your results!!

  • whippetmom
    whippetmom Member Posts: 6,028

    mysunshine: Please read #2 in the thread header. I need to know more about your tissue expanders

  • whippetmom
    whippetmom Member Posts: 6,028

    suze72

    I have read a good deal about pectus carinatum and here is some information I have in my files. It would be very helpful for you to read #2 in the thread header and provide me with the exact details about your tissue expanders.

    In the interim, well-known (Beverly Hills) plastic surgeon, Stuart Linder, MD, makes some noteworthy comments regarding placement and size of implants on his website, when it comes to augmenting the patient with pectus carinatum.

    "Below you will see examples of pectus carinatum that are somewhat correctable in patients who have significant pigeon chests or pectus carinatum. In order to reduce this effect, the implants can be placed in the subpectoral pocket. Care must be taken to avoid a pneumothorax and therefore a small cuff of muscle is maintained on the parasternal ridge and along the costochondral junction. Our patients are instructed that cleavage postoperatively will be affected by the carinatum and that the implants will be laterally displaced by the chest wall and that to minimize this there should be less dissection lateral to the areola which will allow for enhanced cleavage and a reduction in the visualization of the carinatum. Deformity of pectus carinatum are seen in my practice monthly; however, the severe cases can make it quite difficult to establish any cleavage unless significantly larger implants are used. Conservative size implants usually lead to lateral displacement of the implants over time with lack of cleavage when patients do not wear bras. Wearing the Dr. Linder Bra, extra small size post perioperative period may help to allow for compression of the implants and an enhanced cleavage as well."

    I do not think you need the Dr. Linder Bra...there are plenty of good European bras which will work. You will always wear a bra. Very likely, some of the Freya or Chantelle bras that provide good lateral support and help move the implants medially, would be the best for you. Even push up style bras should be in your bra arsenal. Frankly, I think everyone should wear a bra after reconstruction. Gravity will take its toll.

    See more at: http://www.drlinder.com/blog/pectus-carinatum-breast-surgery/#.dpuf

    Plastic surgeon options re: pectus carinatum: Comments by a San Diego plastic surgeon:

    "The goals in breast augmentation for these patients are to reduce the appearance of the protruding sternum, while still creating natural looking cleavage. High profile implants (in which the height of the implants is greater than the base width) placed behind the chest muscles (subpectorally) will reduce the appearance of a protruding sternum. This will produce more natural appearing cleavage. However, patients must be aware that the implants may become displaced to the outer sides of the chest over time if they do not wear a bra. Dr. Vincent Marin recommends patients wear a nocturnal breast support garment to prevent this implant displacement"

    There are mixed opinions regarding implant style and type. Some do not feel that the anatomical implant is the best choice for a pronounced ribcage and chest wall. Some prefer moderate plus profile rounds and some prefer high profile rounds. Some feel that an implant with the height greater than the width is preferred (which would mean anatomical or tear-drop (Sientra - or Silimed is the name of the mfr, if you are not in the US). But all plastic surgeons agree that numerous styles and volumes of implants are necessary to take to the OR - to ensure the best implant for your chest wall.

    So gather some additional information for me and let's try to sort this out.

    Deborah

    Just for my own notes...converted metrics...5'8" inches 125 pounds...ribcage 29

  • whippetmom
    whippetmom Member Posts: 6,028

    LKscolo:Your TEs: 11.0 cm wide and 9.0 cm height and 5.9 cm projection

    Proposed MX-370 implants: 12.5 cm wide and 11.6 cm height and 6.0 cm projection. It sounds pretty good to me. I like that the dimensions are larger in the width and height especially, to further reduce the risk of rotation.

    I think you will be a bit larger than a B cup though. I would say a C at least....but don't let that alarm you...

    Deborah

  • Suze72
    Suze72 Member Posts: 11

    Thanks Whippetmom!

    I'm due to see my PS on Tuesday for another fill. I'll ask her for the specific details about my TEs then and get back to you.

    😆😆😆😆😆

  • Eee3
    Eee3 Member Posts: 20

    so, I feel like I am losing my mind. Round or anatomical? I always thought I wanted anatomical but my doctor said he thinks I will be happier with round given my happiness with the look is tissue expanders. He said he thinks I will have a great result either way. But, since my tissue expanders have an anatomical shape - doesn't that mean I like anatomical? Or do the expanders not really shape that much.

    My doctor also said he wants to use a textured round if I go round.

    I posted pictures on the picture forum so you could give me your honest input. Doc said he wants to pull them closer together and lower the fold on right. I also think the right side is somehow filled less than the left side because that breast looks smaller and the expander is much softer on that side. He says not to worry, they will match when he is done. Please tell me what you think.


    Here are our original correspondences so you don't have to go back to look....

    My original message ....

    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?

    Your response.....

    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.

  • Lkscolo
    Lkscolo Member Posts: 40

    Thank you Whippetmom for the reply. That makes me feel so much better. And he chose wider partly because my TEs are too far apart, like I have a big space between them and no cleavage! I hope that size will be enough to bring them closer together and not so into my armpits too! Bless you for all your help and support! Happy

  • annecy
    annecy Member Posts: 24

    Hello Whippetmon- I have been following this thread for a while and I would love to have your suggestions prior to my pre-op consultation with PS on September 10 and exchange scheduled on Oct 6, 2015.

    1. Height: 5' 7" Weight 160 lbs Ribcage circumference :33 "

    2. Tissue expander : April 14, 2015 ( left size unilateral) Mentor CPX 4, Low Height REF 354-8112 350 CC

    Fill: 240 CC at surgery + 220 CC (4 fills) Total : 460

    3. I believe that PS uses Mentor implant not certain.

    4. My pre-mastectomy bra size was 38 B . I am not looking to bet any bigger. PS has suggested to do a lift on my natural breast at the same time of the exchange. I am 65 I haven't decided yet if I want to go through this procedure or not. I am so looking forward to put this tissue expander behind me. I thank you in advance for your help. Annecy


  • whippetmom
    whippetmom Member Posts: 6,028

    Annecy: The goal is not size, but symmetry and balance. I am 65, and I would go for the lift, if I was a unilateral. The degree of comfort in a bra and in clothing would be high on my list of reasons. I think you are looking at a Mentor Moderate Plus Profile implant, around 350 ccs...or possibly 450 ccs in a HP implant. It depends on how much ptosis you will have once the TE is removed. It will be very difficult to match the droop of a native breast, which is why a lift would minimize the size discrepancy and give you better symmetry and balance. I don't think I would recommend an anatomical, because you cannot achieve the degree of ptosis you need....if it is too small for the pocket/skin envelope, the anatomical is at risk for rotation. That means another surgery to correct. A Sientra "shaped" implant might be worth investigating though, since dimensions are not as exacting in that style. The classic which I believe is 12.5 cm width and 425 ccs is the one to take a look at, if you are interested.

    Deborah

  • whippetmom
    whippetmom Member Posts: 6,028

    Eee....looked at your photos....you look great. Comments there about sizing and moving the implants more medially. Otherwise, you are on track for a great result.

  • I_Spy
    I_Spy Member Posts: 33

    Hello Whippetmom!

    I had BMX on 7/7/2015, nipples removed. I am 5'11" tall, 235 pounds (but I have a lot of muscle so honestly I don't look as heavy as that sounds; I'm sure everyone says things like that, but as an example when I'm standing my ribs are palpable and visible and there is definition in my stomach muscles. Nevertheless, I want to lose 35 pounds). My ribcage circumference just below my TEs is 44 inches. I have Allergan 600 cc TE's in; 133 MX-14 (it also says SN 19935295 don't know if you need that).

    Prior to my BMX my weight gain and 51 year age had caused some sagging and spreading of my breasts; I wore about a 42 C or D bra. In my younger years (when I weighed more like 150 pounds and was stick skinny) my bra size was 38 B, but I barely filled the B cup -- and I kind of liked it! Since my BMX, I've enjoyed the way my clothes fit; sort of weird, but I don't mind being flatter.

    Thus far we have filled to 330 cc's. I would say it is just about a B cup, but there isn't a lot of projection if that makes sense; I have cleavage but things are starting to fill "wider" -- I understand that is normal and not to worry.

    Bottom line I don't want to go a lot bigger, but I would like some more projection. I would be happy with between a B and a C cup.

    I hope I gave you all the info you needed! Let me know what you think. :)


  • whippetmom
    whippetmom Member Posts: 6,028

    ispy:

    Yes, I have enough information, but I know your ribcage circumference is not 44 inches! Perhaps 38 or 40....measuring under the TEs, snug tape measure. It cannot be a metal tape measure....🙀

    So I would recommend the Allergan Natrelle Inspira, SSX - 610 gms or 695 gms. The "S" in the SSX refers to the "touch" and feel of the implant, and that this is the soft touch version. The soft touch is a bit firmer than other smooth, silicone rounds, and might be better for someone who has had ptosis pre-BMX. I honestly would not personally want to go the way of the anatomical, if your skin has a lot of elasticity or if your skin envelope is actually a bit larger than your TEs. Hard to say without photos. It all depends on how much skin was removed at the time of the BMX. Do you seem to have some loose skin around the TEs, or is the skin taut around the TEs?

    Also, keep on with fills, as the width remains the same, but the projection increases with fills. Deborah

  • I_Spy
    I_Spy Member Posts: 33

    Hi Deborah:

    I'm using a proper tape measure (used for measuring bodies) and I made it a bit more snug and it is 43".

    The skin is fairly taut around the TEs at this point.

    How much do you think I should fill? The whole 600? Also, any suggestions as to how to suggest to the doctor the particular kind of implants to use?

  • whippetmom
    whippetmom Member Posts: 6,028

    ispy:

    I would expand to 500 ccs at the very least. Print out the info on your TEs, highlighting the dimensions, and do the same with the Inspira. Show them to your PS.

    TEs

    http://www.allerganacademy.com/SurgeonEducation/Re...

    Implants

    http://www.simplybreastimplants.com/breast_implant...


  • I_Spy
    I_Spy Member Posts: 33

    Okay thank you so much. :)

  • annecy
    annecy Member Posts: 24

    Good morning Deborah,

    Thank you so much for your prompt reply. I'm leaving shortly to visit my mom on the East coast. Upon my return, I will have few more questions relating to the type of "implant". I greatly appreciate your help and suggestion. Lise

  • Suze72
    Suze72 Member Posts: 11

    Hi again Deborah,

    I've just been back to my PS for another fill. I am currently at 400cc and she is looking for a max fill of 500cc if we can.

    My TE's are Mentor CPX moderate height contour profile siltex 350cc with a width of 11.7m, height 10cm and projection 6.6cm.

    Mt vital statistics are underbust 29 inches, height 5 ft 8 and weight 125 lbs.

    I'm mildly pidgeon chested and so tend to have little or no cleavage.

    My PS says that she'll try to open my pockets further medially within the limits of my pectoralis muscles to try to position my implants closer together. My TE's are almost 3 inches apart at present. She has also recommended anotomical shaped implants to try to give me some upper pole fullness +/- fat transfer.

    What implants would you recommend? My PS uses both Mentor and Allergan.

    My thanks in anticipation,

    Suze



  • Czechmate47
    Czechmate47 Member Posts: 12

    Hello! I may not have all the stats you need, but do see my PS tomorrow and was hoping for your quick thoughts or at least questions I should ask.

    I had a BMX a couple months ago with immediate expander placement. I'm 5'11,161 pounds, and had been a 38DD before the surgery. I've been aiming for around a D cup and everything had been going great up until a couple weeks ago. I

    have Mentor expanders, and I think my PS was aiming to put in 650 or 685 Mentor MemoryShape implants later this fall. I was happy with how I looked but PS decided to do one final fill to 710 ccs total. A few days later I had a lot more pain than usual on one side after expansion, and next thing you know I had to have serous fluid drained off one side, and then yesterday ended up in surgery to check things out, remove some old and a few new blood clots, and reinsert a J/P drain. (This side was always an overachiever...I had had the last of 4 drains in on that side for just over 7 weeks.) PS removed 100 ccs of saline from the expander on that side and had said he was concerned about the skin thinning a bit in one area, about 1/4 inch thick in one small section.

    Sounds like now I may not make it to a D without doing a lat flap, which I don't want to do. For now he did leave the other side's expander at the larger volume and I still have to see him for postop eval. At the last fill he had put in 60 ccs on each side, and everything was going ok before that. Do you think there's a chance he might consider adding 50 back in, and splitting the difference since he took out 100?

    My main concern is that I want a certain amount of projection...I want to notice my bust more than my abdomen when I look down and I wanted to get as close to the old me as I could...was NOT counting on 2 full cup sizes smaller...and I know with implants I'll lose some of the projection provided by the expanders. I think the one side looks great...it's just this pesky other side! Any advice, even if it's just that I need to get over it? Sorry...today was a bad day for me. :-(

  • Msmath
    Msmath Member Posts: 38

    Hello! I am trying to decide what type of implants I should get. Here is my info:

    I am 5'4" 188lbs the circumference of my ribcage is 35.5" and my pre BMX bra size was 38C. I currently have Mentor TE's style 9200 350ml. I hope you are able to give me some insight on what type of implants I should look at getting. The biggest decision is whether I want the anatomicals or the round. I will also be having fat grafting done I am not sure if that will make a difference.

    Thanks,

    Rachael


  • whippetmom
    whippetmom Member Posts: 6,028

    Czechmate:

    No anatomical! No "Memoryshape'! You will not have symmetry. If you had ample skin flaps and a prior DD, not sure why he needed to overfill. This is why the implant mfrs forewarn plastic surgeons to assess skin integrity during fills. I would honestly go with silicone rounds, like Mentor rounds in the ultra full projection style, or Allergan Natrelle Inspira, extra full projection. Cannot say what size because I do not have your TE details. You can also get a second opinion before going forward with the exchange. I would not negotiate on additional fills. This is not going to make a difference.

  • whippetmom
    whippetmom Member Posts: 6,028

    Rachael: If your Mentor TEs are only 350 ccs, they are very small for your frame. Are you sure that 350 ccs is the right volume? I

  • mjh1
    mjh1 Member Posts: 263


    hey Whippetmom, my surgery date is finally on Monday and saw my Dr.Choi yesterday for pre op in which I learned that the Natrelle 410's in the MX or LX style that we were planning on using are not available in anything over the 400 gm range . I don't know why they list them in their catalog if they don't manufacture them right now.  Got a look at the new Inspiras and they are really nice and soft.  We talked about them at great lenghth but she didn't feel given the rippling that I already have and the muscle detachment that that would be a good fit for me.  Right now the plan is to change the 525 Memoryshape MPP I have now to Mentor Memoryshape 550 HP along with the capsularaphy and FG she has planned.   

  • Msmath
    Msmath Member Posts: 38

    Whippetmom yes I sure about the TE they are small My PS said one is a little overfilled to 380cc the other one is right at 350cc. We spoke before my BMX and I expressed that I was interested in the anatomicals so she wanted a small pocket. When I last met with her she said my actual implants would be almost double the TE size probably around 550cc's

  • Czechmate47
    Czechmate47 Member Posts: 12

    Thank you for getting back to me so quickly! Could you explain why you feel the MemoryShape would not result in symmetry?

  • whippetmom
    whippetmom Member Posts: 6,028

    Czechmate:

    The anatomical implant needs to fit the dimensions of the pocket. So if one pocket is small and one pocket is larger, what size implant will he use? If the implant is too small for the larger pocket, the implant is at risk for rotation. The round implant is far more "forgiving".......and the chance of being able to go a bit larger is more plausible with a round implant, vs the anatomical. I would want to know exactly which style and volume of anatomical he plans to use, if you stick with anatomicals.

  • rosebud77
    rosebud77 Member Posts: 7

    Hi there Everyone, I have been an avid reader of this thread since my initial exchange and I was in communication with Whippetmom (she is wonderful) as I was sooo depressed.I posted this same message in another forum ( breast reconstruction)- this morning . I was responding to a lady who was unhappy with her gummies but later found them to be okay after they settled in. Another reader related her continuing dissatisfaction with hers. . I had the same problem with the Sientra gummies I got last December (2014.) I thought I would finally share my experience with you guys as well..

    My implants (december 2014) were hard as rocks, kind of a moundy shape, and very uncomfortable. I swear, I wanted the tissue expanders back! HA HA HA. I'm thrilled for the lady on the other thread found that her implants softened over time. Unfortunately, mine didn't, so after 8 months- I had a "do-over." (august 13th 2015). My PS agreed to it because I was rock hard and very very unconfortable and I had given it 6 months before even considering it.

    The "exchange of the exchange" was completed three weeks ago with more typical "rounds." I think they are Allergan- I don't have the info card yet. I know they are high projection and although I had a frank conversation with my PS about the shape, size, etc., I didn't care what brand he used. . Anyhoo- I LOVE them. The shape is better, the softness is already tons better- even after one day they felt fabulous!........the comfort level is phenomenal.

    Even my PS admitted at my one-week post op appointment that they look a lot better even though he thought they were dandy before. My advice to everyone is to do your due diligence with research prior to the exchange. Read Whippetmom's postings. I researched every other aspect of this breast cancer journey except the implants. However, in my PS's defense, I was the one who insisted on the contoured gummies in the first place because I wanted something more natural. My PS said he didn't usually use them but would bow to my wishes. Turns out the "rounds" are more natural looking and feeling- IN MY CASE. Everyone is different. Either way, it is IMPERATIVE to give your new implants a few months to settle in before panicking - regardless of which type you go with. I'm sure that the contoured gummies are great in many cases. Like I said, everyone is different.

    PS THANK YOU WHIPPETTMOM FOR TAKING THE TIME TO TALK TO US ABOUT THIS SUBJECT.

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