BREAST IMPLANT SIZING 101
Comments
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Hi Orla - I'm in the UK, and I suspect approaches to breast reconstruction here are much like they are in Ireland. I've found this forum super helpful, but actually quite frustrating at times too when I see how well American women are consulted on what they want from their reconstructions! If you're not treated privately in the UK you do tend to "get what you're given" on our massively overstretched NHS. That said though, it sounds ridiculous that your plastic surgeon is suggesting a reduction. The breast I had removed weighed 280g (corresponding to 280ml), and it was an A cup, so that would be a pretty big reduction for you. Can you get a second (or third) opinion? I wasn't happy with what my plastic surgeon was proposing, so I paid for a couple of private consultations, and I'm very glad I did, as I'm now on the list of a different (NHS) surgeon who seems to be far more willing to take my wishes into account. I also have thin skin, and he said I could have fat grafting to help plump it out. Would that be an option for you? Best of luck to you for whatever you decide.
Greenleaf x
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Greenleaf1, regrettably the government is butting into the healthcare here in the U.S now and the situation you described in the UK will be happening here. Unfortunately, this is our future with Obamacare and it is frustrating to see that so many people are not realizing it yet. I for one am scared and worried about my future medical care.
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CateM, I was an A cup to begin with and was hoping to get to a C with the implants. With my expanders, I didn't need a padded bra for once. But due to problems on my radiated side, I ended up with implants 100 ccs less than the expanders. So I'm pretty disappointed.
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Leslie - What size implant did you end up with? I'm sorry you had problems with your radiated side.
I've read somewhere that it's impossible to end up with an A cup when you have implants because of the width. I'm not stuck on the cup size as much as I'm concerned about the look. I would very much like to look like a 30D when everything settles down because my surgeon told me she was trying to match my volume. She took out 300g's of breast tissue and replaced it with 325cc of implant. I asked if I could go slightly larger/fuller and I guess I got exactly what I asked for, sort of!
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CateM-- ended up with 360 cc implants versus 460 cc expanders. I've just been wearing the sports and stretch bras, I haven't even tried a "regular" bra. But it's not the cup size I'm really concerned about, it's the fact that they're small and I don't really have much cleavage.
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Leslienva, did you discuss placement/cleavage with your PS? I'm doing just the opposite, hoping to go a little smaller because I've always felt too busty for my height/frame. But I'm beginning to get a little nervous that I might accidentally go too small. Did you look at photos of what you wanted the final outcome to be?
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Dearest whippetmom,
First, I just want to thank you for answering so many questions! It must be like a full time job! I am grateful for any advice.
Ok, on to my stats. I am 5'8", weight currently 210 (working on that, actually lost 25 lbs with serious exercise over the last year plus another 10 since my diagnosis & surgery). Rib cage measurement 36.5. I am a big curvy girl, pretty symmetrical with booty, defined waist and big boobs prior to my double mastectomy. Previous bra size 38D, although I will say my breasts were pretty saggy (sigh...). I'm 42 so I guess that happens. I've lost and gained weight my whole life so my skin is pretty stretchy. My previous breast base was 14-15 cm per the PS H&P note.
My surgery was done 11/18. I had a skin sparing bilateral mastectomy (80% of my skin retained) followed by TE placement. I have Allergan 133MX-14-T 600 ml with alloderm slings. Intraoperative fill of 300mls bilaterally. My PS has not said specifically she only uses one brand but pretty much everything she showed me at my original consult was Allergan. She seems inclined to use silicone implants. I specifically questioned her about my concerns about looking too small after the final exchange. She reminded me that silicone implants are currently only available up to 800ml and that she felt like this size would make me a large C small D.
I'm not sure what you mean by grams....my breast tissue removed per the path report was about 900 grams on the right (breast with cancer) and 875 grams of the left prophylactic side.
I have not specifically discussed with my PS whether she overfills but I'm guessing she must since she mentioned the 800ml implant. My first scheduled fill is 12/15 and I will question her more than.
My concern is that I'm going to end up considerably smaller than I was to the point that I no longer look proportional. As a curvy girl, this makes me sad. My PS said larger silicone implants were awaiting FDA approval but she had no idea when they might be available. I think I would be fine with big C/small D but I am concerned she might be just appeasing me based on some of the things I have read here. What do you think
- Any recommendations you have would be so appreciated!❤️❤️❤️
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Leslienva - so you are in the same boat as me. Great to have company but it's not great to have this in common. I won't have a cleavage either and that sucks! I'm sorry your last 100cc were ripped away from you. Unlike you I don't know what 400+cc would look like on my frame. I haven't tried any bras yet as my foobs are still flat and firm. You have 35cc more than me and wonder what difference that would make once sized and in bras?
I still have 5 weeks until I can expect to see the foobs soften some and I can't wait. Husband says he's going to take me shopping for new underwear/lingerie. I donated all my old, pretty and expensive bras to a breast cancer charity and like you am left wearing genie bras and sport bras.
When was your surgery?
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CateM, I had my exchange surgery on November 12. I was feeling almost back to normal last week, then on Saturday, I started getting stabbing pain on the radiated side. It's better today. I'll still have to call the PS, tho. I know nerves have to rejuvenate and all that, but it was pretty bad pain.
When was your surgery? I've heard these foobs can change up to six months after surgery. Some women say don't even look at them until several months out, but I don't think they're going to suddenly become larger!
I tried on my old swimsuits while having the expanders and it was so cool to have cleavage. That extra 100 cc looked pretty good...
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Leslienva-My surgery was a month before yours, 19th October. I hope the stabbing pains you are feeling are the nerves regenerating. I have had stabbing pains and have put it down to the nerve endings. It's the itching that was driving me mad throughout the last week. I hope your PS can offer you nothing but reassuring news.
I think I'll be ok with my size if only they 'fill' out more over the next 6 months. I just can't stand the idea of them being this flat for ever! I'll be following some people on the pictures forum who have the same build and implant size as me, if I follow the trend then they should look ok in the end.
I think you will end up with your C cup with the 360cc, I'm sure of it.
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Hi,
I wanted to see what info. you have on what bra size to get afterwards? I am having trouble finding an accurate chart or whatever. So if bust is 39, waist is 31 and hips are 36, weigh about 137 and am 5'4".
Thanks!
Katie
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KSChadd - Hi, Katie. You're best bet is to get a professional bra fitting at Nordstrom's (or the equivalent of that). It's free. I was advised (by Deborah AKA whippetmom) to call Nordstrom's and ask specifically for a mastectomy fitter (as these women go through extensive training to get you into the best and most comfortable size). And even though mine was young - boy, did this gal know her stuff! Those ladies will take a measurement or two but can pretty much tell by looking at you what's going to work and what won't. Another plus to the Nordstrom experience is the fact that they are very knowledgeable about medical insurance. When I called for my appointment, the woman asked what I had for insurance. I told her and she said GOOD! (?) I was clueless. She went on to explain that as long as I got a written prescription for mastectomy bras from my doctor, my bras were covered by my insurance - and Nordstrom's filled out all of the paperwork for me! They will also sew prosthesis pockets in any bra they sell - free of charge.
http://shop.nordstrom.com/c/breast-prosthesis-prog...
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Hi AZ85048,
Thanks so much for the reply!
I never would have thought of going to Nordstrom's and while I don't need the prosthesis pocket I am pretty sure I can get my PS to write a script for the bra, I will call today! I really do need to get measured, I got bigger cause I had gained weight but then I lost some of it and now the measurements are further apart making it harder to fit me.
Also, anyone else move up to larger implants have muscle pain/soreness and tightness more than a month after the swap surgery? They are a lot heavier and I can't remember how the first one were after the expanders but maybe they were like this before?
Thanks all!
Katie
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Me again.
My original implants were 450 ccs each. Then (for many reasons) I had revision and (again for many reasons) went up in size on the implants. The second time I ended up with a 550 cc and a 650 cc. My point is, if you're only a month or so out from exchange, I'd say wait a while longer for the fitting - it will be worth it. You're still swollen and things are still settling, whether you realize it or not. I waited more than three months post revision and the entire trying on bras experience, although pleasant and very informative, left me feeling sore and kind of raw (for lack of a better word). But the best part after you know what size you are in different brands and which styles work for you - eBAY!0 -
That makes sense, I will try to be patient! I mostly want to know cause I am hoping that a sports bra that fits might help ease some of muscle strain, y'know?
I got one but the band part is too big but the boob part is too small :-P
So it sorta helps, I guess it feels better than nothing but yeah...still uncomfy.
Thanks again!
Katie
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Hiya, I was wondering while you were recovering and things were sore and whatnot, was the incision site kinda lumpy and tender as well? I am assuming it's the sutures in there that are just taking forever to dissolve and it does contribute to the entire uncomfortable thing, especially being at the bottom underneath, this time.
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KSChad - you might try the Exchange thread. Lots of discussions about recovery there.
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Thanks!
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CateM, maybe it's the compression of the sports bra that's also making me look so flat. I saw my profile in the mirror yesterday at work and wanted to cry. Even my coworker asked what was wrong, but I didn't go into it with her. I'm hoping this drop and fluff that everyone talks about shows me some better results!
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Leslienva - I understand exactly how you feel, you're not alone. You aren't even at 4 weeks post exchange yet and I was as hard as rock at 4 weeks. My foobs couldn't be manipulated no matter how hard I tried. t'm now nearly at 8 weeks post op and I can sort of squish the wee foobs. I've been collecting pictures of other women's reconstructions and those pictures really help to settle my mind on what my end result will be. I know I'll never have cleavage but that's ok, it can't be perfect but I'm ok with that.
I won't shop for bras and get fitted until I'm at 3 months as AZ85048 (catchy name )
suggested. By aiming for Tuesday 19th January I've given my mind permission to not worry about it. 0 -
CateM, where do you find the photos of reconstruction? Most I've found look pretty good. I wish my scars were at least symmetrical, but one is higher than the other. It seems that the scars are always symmetrical in the photos I find. Right now my left (radiated) side is larger than my right. I'm guessing maybe it's still swollen. Even so, my right side had looked pretty good with the expanders. It's sad to see it so "deflated"!
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Leslienva - I've found some on the images on http://www.realself.com/Breast-reconstruction/revi...
Real self is a site that shows you pictures of all different surgical procedures, from reconstruction with DIEP or TE's to Breast augmentations with real patients, its super helpful for people like us. I also have been given access to the picture forum that some ladies on here have been putting together. You can speak to women who have or are going through the same procedure as you. If you are brave enough you can also post your own pictures and ask for advice. Don't worry the site isn't public and the administrators do everything in their power to keep it secure.
You also have to remember that unless you are looking at pictures from Realself or from the picture forum linked to this site then you are most definitively looking at foobs that are about 6-12 months post op. You are basically looking at the end result and that was my issue too. How are we supposed to know that our foobs are looking ok at a certain point in time when all we see are the end results. Someone once said to me that breast reconstruction isn't a procedure it's a process.
With regards to one sitting higher I hear this is normal too because the pectorals release the implant at different times because they are separate muscles. Maybe in a few months when your foobs drop and fluff they will cover your asymmetrical scarring.
I know its hard but really time is the only way to see if your result is something you can be happy with.
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Gatorgirl:
It is true that 800 ccs is the largest silicone implant currently available. I would, however, advise the Allergan Natrelle Inspira implant, perhaps in the textured version of the ultra full projection style, 800 ccs. If you are working on a weight loss regime,, this would be quite a good size for you.
http://www.simplybreastimplants.com/breast_implant_sizes/natrelle_inspira_trx-tsx.html
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whippetmom,
I went in to see my PS for my first fill today. She also suggested the 800 cc Allergan Inspira. Feeling a little more confident now. Thank you for your advice
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Hello Whippetmom, you have an amazing thread here.
Here's my information: I'm 5'2" and my current weight is 142. My rib cage measures 32".
I had a prophylactic bilateral nipple-sparing mastectomy on November 11.
My PS used Natrelle Style - 133V Series 133SX-15 Tissue Expander Matrix, 650 ml capacity. It was filled with 420 ml during surgery. There was plenty of skin spared (more details below*.) TEs have not been filled since surgery as I had some areas that needed to be debrided. He plans on a fill next visit (Thursday 12/17).
I do know PS prefers the "gummy" style implants, but I don't know the brand.
My pre-Mx bra size was between 36D and 38C, and I weighed 146 the morning of surgery.
*Here's alittle extra information: for the last several years, I had pendulous, ptotic breasts. My heaviest weight was 190, and my biggest bra size was 38DD. Then I lost nearly 50 pounds. My goal weight is between 125 and 135.
I know that 812 gm was removed from the right breast and 666 gm from the left. There were flaps of skin removed as well. Currently, my reconstructed breasts are about as big in volume as I think I would like. I would prefer them to look less like flat hamburg rolls and more forward projecting.
I already told my PS that I don't want to be as big as I was pre-Mx.
What size range would be good for me? I would like to be a 36C, although I realize that you don't like to use bra sizes as a measurement.
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Mominator: If by "gummy" you mean anatomicals, the corresponding style and volume would be the Allergan 410 LX, 625 gms. I think this will be too flat in the upper pole for you though. That said, because of your pre-MX ptotic breasts, there may be sufficient skin flaps to use something like a MX style or even FX style, if he needs to do so. There are round silicone options, and I would recommend that you consider something like a Natrelle Inspira, perhaps the TSX - a texture ultra full projection style implant, 750 gms. I can see the need for an implant with "structure" which will adhere to the chest wall. Your TEs are 15.0 cm in width and I am recommending implants which match/correspond to that width.0
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Gatorgirl:
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well my incisions are asymmetrical but then the native boobs were as well. That is just what I look like. It is so easy to obsess about parts of our body but.. maybe its best that we don't.
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whippetmom,
Thank you for all of that information.
I told PS before he started that I am pleased with the volume, but would like more projection. I also want the implants away from my armpits. Left TE feels that it has moved towards my armpit and sit ticks out a little bit from the side. When I move my left arm, I feel I'm brushing against my breast. It is also poking me in the middle of my breast. PS said he could see it just a little bit, and it would be corrected at exchange. He also had the nurse take pictures of my breasts from the sides.
He said all of that (volume, projection, armpit) is good to know. I'm under the impression that we'll talk more before exchange.
He said he always overfills from the desired volume so that the pocket will be big enough. Today was my first fill since surgery. He added 60 ml, so now I'm at 480.
The nurse showed me Natrelle anatomicals at the end of the visit. I don't know what the size is, or what are his preferences and options. I have so many more questions for next visit.
Thank you for all your help
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I had a bilateral mastectomy 30 days ago. Ihad a breast lift with implants two years ago. I am 5'4" 135 lbs. wore 36D before surgery. When I had my initial consultation with the plastic surgeon he said he could get close to my original size . He put in 500cc mentor tissue expander. I have no idea after reading your blog what the height of the expander is. He has overfilled to 550cc at this point and I feel I have no projection and he tells me I will lose some when we convert to implants. He is now telling me there is no way he can get the projection I had. He has only discussed Mentor implants. Can you please help me ask the right questions or do I need a different plastic surgeon?
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