BREAST IMPLANT SIZING 101
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Hi whippetmom!
I posted earlier this summer...here are my stats again:
1. Height 5' 6", weight 142, rib cage 32.5"
2. Mentor CPX 4 550, 13.2w x 13.8h x 6.9 projection
3. I am typically a 34C when I am good about diet and exercise. A full D when I am not.
I go in for the exchange on Wednesday and we decided on the Natrelle Inspira SRX smooth round, responsive gel, extra full profile in 545cc
Currently, my expanders are at 600cc and they seem too big for me. Specifically, I find that I they make my clothes fit a little tighter. I am more inclined for smaller boobs that bigger.
My questions are:
1. I am only going down 0.2 in width with the Inspira - will that give me any real decrease in size (which is what I am aiming for).
2. Will the decrease in projection make the boobies look smaller?
3. Should I go for the 495 or 525? Or do you think that would be too small?
4. What changes in shape/feel/size should I expect when I go from expander to implant? From what I have read the change can be significant so I am trying to factor in the inevitable difference from going from expander to implant when trying to figure out size.
Any suggestions on what you think would be good and why would be awesome.
(Can someone instruct me on how to post pics?)
Thanks!!!
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Just to add to the discussion - - -
the 495 would be 12.50 width and 6.1 projection
the 525 would be 12.75 width and 6.2 projection
the 545 would be 13.00 width and 6.2 projection
My current expanders are filled to 600 (Alloderm 800 CPX 4 550) with a 13.2 width and 6.9 projection
Help! I am going nuts. I feel like goldilocks. I don't want to make a wrong decision.
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rosebud: Thank you so much for sharing your story and thank you for letting me know that you are now happy with your results. Heed her words gals: Anatomicals and shaped implants do not always look more natural than do rounds. Yes, you need to give your implants time to settle.
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byebyeboobies:
As you can see, there really is very little difference in the actual dimensions of the three implant sizes. The difference really is volume....less mass equates to a smaller "footprint". I think you might go with the middle choice, and perhaps no pocket revisions will be necessary.
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mjh1: Wow....good to know about the 410s in the larger sizes for the X versions. So her new plan sounds good to me
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MsMath: The corresponding Mentor Memoryshape anatomicals would typically be in the high 400 cc range. However, it is quite likely that you have sufficient skin flaps to exchange to a significantly wider and taller anatomical, so perhaps that places you in the 620 to 685 cc range, which would be fine for your frame.Other options are ultra full projection smooth round silicone implants in the 650 to 750 cc range.
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Whippetmom: thanks for getting back to me. I think we are going to go in the middle and plan to use something in the 500's. I don't want them to be too large.
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Hi Whippetmom, what a kind soul you are to do this for us!
As my exchange nears (Nov 12th) I would love your input…
I am 5'4" 110 lbs, ribcage 28" I was a small AA until 2001 when I had implants to a smallish B. The PS at the time said I only had @ 50 cc's of breast tissue and had Mentor Smooth 275's placed under the muscle. The right was filled to 280 cc's and the left to 310 and they matched perfectly.
I had a UBMX, (nipple/skin sparing) in early July and am now filled to 150 cc's. My PS is WONDERFUL (Dr Kristina O'Shaughnesey in Nashville TN) and says I can go bigger if I'd like and is just so kind and encouraging. She used Alloderm during the surgery and the skin has healed beautifully. I have had NO discomfort at expansions. I have 300 cc Allergan 133MX Natrelle Style TE's.
I really want the most bang for my buck at this point. I know I'm not a large person but I always wished I had gone bigger with my original implants (my original PS told me I would and she was right) and now I have that option so I'd like to take it!
I think it's projection that I'm after. The Dr also said she would try to give me more cleavage as I had NONE with my original implants- but I don't think that's as important to me as projection…
Any input you can give me would be so appreciated!!! Thank you!
Freeland
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Whippetmom,
Thank you so much for your help with this.
7/21 chose BMX for DCIS grade 3 with immediate reconstruction. The surgery was skin and nipple sparing
Prior to surgery I was 34ddd, possibly larger because I may have been wearing the wrong bra size. I am 51 and at age 37 had a breast lift and reduction, due to my breasts not returning to anywhere their original size/shape after 2 kids. Through the years of gaining/losing weight my breasts increased in size. I am very confused as to what size implants I should be looking at. I want to look proprtional to my body size.
I am 5'5", 142 lbs
Rib cage measures 32
Expanders are Allergan 133MV-14-T 500cc
I don't know the type of implants or size my surgeon is looking at other than they are planning to expand me to approx 500cc.and use silicone.
I went to speak with a bra fitter at Nordstrom the other day who terrified me because with my expanders filled to 350cc she said I was dd. Although she claimed to understand reconstruction, I dont think she understood the process. Nevertheless I left feeling more confused than before I came in.
Any info you can provide would be great. Thank you so much.
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Hi whippetmom,
Here are my stats:
1. Height 5' 3", weight 134 lb, rib cage 32.5"
2. The expander my Plastic Surgeon put in is Allergan 133MX-13T , width 13 x height 12 x projection 6.7 cm
3. When I lost weight, 15 lb in 2013, which is 119lb, I can fit into a 34D bra although very tight. When on 134 lb, I was a 36D before the double mastectomy surgery, which is 3 weeks ago on Aug 11st, 2015. I don't like to be a D cup. I wanna a 36B cup now.
I will go in for the exchange 3 months later. I haven't decided what implants type I should use.
Currently, my expanders are at 275 cc and the left side seems already a B cup to me. I wanna stop here or even take out 25 cc. My right breast, the one had cancer, however, is caved in at 4 o'clock position where my tumor was located at, deformed, like having a dent. The 275 cc doesn't make the right breast like B cup yet. And the shape is weird, not round at all. I wonder if my pocket is created correctly on this side.
My questions are:
1. Right now, I feel the expander are so hard and expand laterally right underneath the armpit. Do you think the surgeon gave me a too wide expander? I wanna going down in width when they swap in the implants - what kind of implant do you suggest that could give me any real decrease in size (which is what I am aiming for).
2. It looks like the decrease in projection doesn't make the boobies look smaller. I went to bra store to try on different bras. 36B could not cover me. The projection is not there, however my footprint of the breast is still quite big that requires a 36C to cover up the breast, but there's a lot space empty since I don't have the projection for a C cup.
3. Should I stop now at 275 cc saline now? What amount of cc you suggest me to put in for a 36 B?
4. What changes in shape/feel/size should I expect when I go from expander to implant? From what I have read the change can be significant so I am trying to factor in the inevitable difference from going from expander to implant when trying to figure out size.
Any suggestions on what you think would be good and why would be awesome.
Thanks!!!
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Dear rmarsh4 and TNBCat37,
Welcome to the BCO community. We are glad that you both reached out here. Keep posting and let us know how else we can support you.
The MOds
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Has anyone ever asked their medical provider to join their insurance network?
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Freeland:
I would say wait until you are filled to 300 ccs and then make that final decision regarding size. But offhand, I would suggest Allergan Natrelle Inspira TRX or TSX - 340 or 375 gms, or Mentor Ultra Full Projection: 430 ccs, IF it is possible to go this large and IF you can get symmetry with the native breast.Mentor's "ultra" rounds have more projection than Allergan's in the volume range you would be needing. It all depends also on how big of an implant your PS can safely use on the native side.
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rmarsh4: I had to laugh about your terrifying Nordstroms experience!!! Every one of us who have gone before you, know either the horror or delight of hearing you are in the double digits in a cup size. BRA SIZE DOES NOT MATTER! Throw that mindset out the window. Breast implants and especially implants after reconstruction, require a larger cup size. Who cares if you are an "F" cup, if you look proportional and have the look you want in clothing. I wear a DD or E cup and look like a C/D cp in clothing. If you get to 500 ccs in expansion and like the appearance (not bra size) I think you would be happy with Allergan Style 20, 600 ccs. It is a good silicone implant style and volume to match your TEs. However, if you feel too large at 500 ccs fill, you could go with a lower profile Style 15, around 533 ccs. If your skin is pretty lax and based on what you describe, I know it is, I would not suggest anatomicals, because they are more likely to rotate in a pocket that was so ptotic (droopy) prior to BMX. Just would not go there personally. When you reach 500 ccs fill, let me know how you are feeling about the size and appearance and we can refine the numbers.
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TNBCat37
You asked:
1. Right now, I feel the expander are so hard and expand laterally right underneath the armpit. Do you think the surgeon gave me a too wide expander?
Tissue expanders tend to migrate laterally when they are filled...and if they are not placed entirely correctly. They can and should be moved more medially at the time of the exchange. It might be necessary for the PS to perform what is called a lateral capsulorrhaphy bilaterally, if for some reason the pockets are too wide for the implants. The TEs are absolutely not too wide for a 32.5 inch ribcage. My ribcage is 29 inches and I have the same width implants.
I wanna going down in width when they swap in the implants - what kind of implant do you suggest that could give me any real decrease in size (which is what I am aiming for).
You really cannot go down too much in width, without pocket narrowing. And if pocket narrowing does not "hold", you end up with potentially more rippling and implants back in your armpits again. I would suggest that you go with a round, smooth, silicone moderate plus style implant, perhaps Allergan Style 15, 371 or 397 ccs, or Allergan Natrelle Inspira implants, high profile - SRF or SSF, 435 gms. Despite the difference in volume, either implant style will have approximately the same dimensions, and will approximate what you have now with your TEs. If you go with anatomicals, the anatomical needs to fit the footprint of the TE, and I think they would be too large and you would not be happy. The implant I personally would choose for you, would be Allergan Style 20, 475 ccs or500 ccs, but I am "reading" that you do not want the projection. So this is why I have recommended implants with a projection under 5.0 cm.
2. It looks like the decrease in projection doesn't make the boobies look smaller. I went to bra store to try on different bras. 36B could not cover me. The projection is not there, however my footprint of the breast is still quite big that requires a 36C to cover up the breast, but there's a lot space empty since I don't have the projection for a C cup.
Read what I said to Freeland (the post above yours) about bra sizing....
3. Should I stop now at 275 cc saline now? What amount of cc you suggest me to put in for a 36 B?
I do not discuss cup sizing. You might be a 36 B in one bra and a 36 C or 34 D in another. It is a useless exercise after breast reconstruction. What does it matter what size bra you are wearing, if you are happy with the size? I think you should continue with fills, HOWEVER, if you have ample skin flaps, you might not need too much more filling. But honestly, that is up to you and your PS. You need to fill out the expander a bit more. Think of the TE like a deflated, hard football. It has pretty wonky, weird edges and a strange shape. It smooths out as you fill that football. If the TE is truly misshapen, especially on one side, there is a possibility that the TE has displaced or rotated. Something to discuss with your PS.
4. What changes in shape/feel/size should I expect when I go from expander to implant?
Much softer, much better shape, more comfortable.
From what I have read the change can be significant so I am trying to factor in the inevitable difference from going from expander to implant when trying to figure out size.
Right. I think we covered that above.
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I am trying to appeal my insurance company to pay in network for my out of network second opinions. I am presenting cost of all my surgeries/revisions. Does anyone know if I present the cost of what the surgery cost or do i present the cost of what the insurance company paid the hospital.
I work at this hospital. The people that are reviewing the appeal also work at the hospital and they say nay or yay in whether I can get outpatient coverage at an in network rate.
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Stix: There is someone discssing that topic now in the insurance forum...
https://community.breastcancer.org/forum/113/topic/834046
You might even ask on the NOLA threads..
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Thanks to whippetmom and everyone else for all the information and especially helping me know what questions to ask my reconstructive surgeon. I had a bilateral mastectomy in April and just finished chemo last week. Exchange surgery will be in October.
1) height 5' 7 1/2" (used to be 5' 8 3/4"). weight 155-160 pounds. ribcage 32". age 60.
2) tissue expanders Allegan Natrelle Style 133, 133MX-12-T, 400 cc (filled to 420 cc)
3) PS is planning to use "Gummy Bears" Allergan Natrelle Style MF-410, full projection, moderate height. He will have several sizes on hand during surgery to try on to see what fits best.
4) pre-surgery size: 34DD (full). Want to go down one size to 34D. That is just what I seem to be right now. I can even wear a normal 34D bra! Clothes and my new swimsuit fit better too.
I want to be sure we are on the right track. It is nice being a little smaller than before, and not sagging. Even though expanders are hard and funny-shaped. (Also good to have both sides the same size.)
P.S. Re Nordstrom's: I had an excellent experience buying mastectomy bras with a young and highly trained specialist before my surgery. Too bad that all their mastectomy sales associates are not so qualified.
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I am so thankful for you whippetmom. Surgery is a little less than a month away and it's difficult to get a straight answer from my Ps's physician asst. Sure wish I could try these on for size! PS opinion is that anatomical vs regular gummy bear is a personal choice.
Here is my info:
1. 5'9" 165 lbs ribcage 36" age 55
2. Tissue expanders are Mentor Extender CPX3 medium height. 550 cc filled to 550
3. PS thinking either using Mentor Rand (I think that's what she wrote??) silicone OHRA? High profile 650 cc OR Mentor shaped (I think she left out the word anatomical?) medium height high profile 620 cc
4. presurgery size was 38D but I was a 34 B when I was younger and thinner. I want to reserve that option! lol And I would like to be smaller than a D cup
GREATLY appreciate your expertise! We are so blessed to have you in this group. xoxoxoxooxoxxo
Becca
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thank you whippetmom
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Hi Whippetmom and my Foobie sisters, I have survived my last fill. My 350cc Mentor CPX moderate profile TE's have been overfilled to 500cc.
As you can see, they're very 'coconut-like' in shape and very widely spaced, living partly under my armpits. I reckon that I may just have room for a third one in the middle at present ;-).
They do look funny naked but look quite good, although too spaced, in clothes. I have more balance with my hip measurement now and I fill out my more fitted clothes well.
Deborah, you very kindly provided me with your recommendations on which implants might suit me. One of them was the Mentor CPG moderate height, high projection gummies.
My PS loves the Mentor gummies and wants to use the CPG 333 tall height, high projection gummies for me.
Do you think that they'll be ok instead or was there a particular reason why you felt that the moderate height would be better suited to my measurements?
I haven't seen or heard much about this particular model.
My PS says that she wants to do some work to my pockets further medially at exchange and will go wider than my current TEs, which are only 11.7cm, to give me more cleavage. She is also planning to do some fat grafting at the time.
When comparing the moderate height and tall height Mentors that the tall height implants are 50cc greater in volume than their moderate height sisters for any given width and projection.
Will this result in better cleavage or do you think that the extra height will look unnatural on my 5ft8 body with a 29inch underbust torso?
Any comments or suggestions from anybody with experience in the tall height implants would be greatly appreciated too 😊.
My thanks ladies,
Suzette xo
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Queen Celeste
I would not agree with the MF style of anatomical. It does not correspond with the dimensions of your tissue expanders.
Your TE:
400 cc MX-400
12.0 cm wide 11.0 cm height 6.3 cm projection
MF style anatomical
335 gms:
12.5 cm width 11.6 cm height 5.1 cm projection
375 gms:
13.0 cm width 12.1 cm height 5.2 cm projection
MX style anatomical:
370 gms:
12.5 cm wide 11.6 cm height 6.0 cm projection
410 gms:
13.0 cm width 12.1 cm height 6.1 cm projection.
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Rebecca54
You will have significantly more projection with theMentor MemoryShape (Mentor does not call them anatomicals) than you would with Mentor rounds.
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Suzette: we do not have access to tall height full projection Mentor shaped implants here inthe U.S. Only tall height moderate plus profile. So what your PS recommends sounds fine to me.
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Hi there Whippetmom, I learned about you on another thread and I'm so thankful for your expertise. I didn't pay a lot of attention to sizing before my exchange (mistake). I wanted to be a full C, and I was happy with the size of the expander (looked like a full C to me) and so tired of the rock on chest-wall pain I had with it. But almost 3 weeks post EX, my implant on the MX side is ripply and much smaller than the TE. The natural side is smooth and natural shaped but even smaller than the MX side. Symmetry is OK I guess.
5'8'' 139 lbs -- "athletic" build age 49
34-36 B-ish cup depending on my weight before MX. Fairly deflated/flat chested after kids
chest measures 29.5"
TE was 300cc filled to 340cc (sorry can't get the brand specs out of PS nurse)
Implant on MX is 440CC, natural breast lifted with 150CC implant. Both low profile and gummy bear I believe (again details are hard to get)
If this is enough detail for you to form an opinion, I would love to know what you think. Is the implant too small for the space and that could be causing the rippling (I know thin skin is an issue but the expander looked good)? Am I being unrealistic and this rippling is just how it is? I am trying not to panic but from what I've read these ripples are not going away on their own and I want to be more educated and prepared to discuss details when I see my PS for 6 week f/u appointment. Oh and I had fat grafting on both sides and it looks to me like it took pretty well.
Thank you for sharing your wealth of knowledge with us. It's invaluable.
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Ok. since were on the subject. I have extra high profile naturelle 650. A PS wants to change me to mentor high profile 650 (or poss. 600 or 550) whichever works best in the O.R. Will I have a significant amount of less projection with the mentor?
Thank you
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Thanks Whippetmom,
I'll post some "after" pics!
Suze xo
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Nocalmom:
An implant - shaped/anatomical - with a volume of 440 ccs vs grams, could be either Allergan or Mentor. They both would be a moderate profile, which just might not fit the dimensions of the pocket created by your TEs. Sometimes, in the lower profile/projection styles, they tend to look flatter on reconstruction patients. I honestly would need more information. You have every right to obtain your TE and implant data from your doctor's office. They are implantable, registered devices.
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Stix: Not significant. Perhaps the PS feels that the wieght of the implant will be better distributed in your particular situation.
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It only took me four tries to edit my post! GRRRR.....Hate the mobile site
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