BREAST IMPLANT SIZING 101
Comments
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Mothergoose: 500 ccs is a sufficient size for tissue expanders for your frame. Your PS needs to use Mentor smooth silicone round ultra full projection implants. If he uses a memory shape/anatomical implant, he needs to use a medium height high profile implant, in order to obrain maixmum projection.
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Hi Whippetmom,
Thanks for answering everyone's request.
I had my BMX on 10 of this month and have TE's in place. I am not sure which brand of TE's are used for me at this point. I have a post-op visit with PS tomorrow and can try to get some information from them.
I am short lady, 4'8'' and weight around 100 lbs, I was using 32 B/C before mastectomy.At the time of BMX, I know, I was filled in with 150 cc on both the sides. I do not wish for any larger size, I want to remain either 32 B/C. Can you let me know how many Cc's of fluid will my PS need to fill me in ?
Also can you suggest me what am I suppose to ask my PS to obtain 32 C as final output ? Any suggestions are highly appreciated.
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Hi Whippetmom,
You are amazing, your fame and selflessness in advising people extends to Australia! I'd love some advice as I am desperate to maintain my pre-mastectomy cup size after exchange. I am having a prophylactic bmx after BRCA1 mutation identified (unfortunately I have had radiation for a small cancer in 2013. I know this will make things more difficult, I'm not sure if this makes a difference to what size implant I should have - if it is a tighter pec muscle, I might need a bigger implant as it will squash it back towards the rib...?)
I'm 5 feet 4 inches, 138 pounds, 30 inches around ribcage.
I will have Sientra 450 medium height TEs
I am a 34D cup before bmx
I was told that I'd probably need to have the TEs expanded to 600 and that would be my size and then overexpanded by 100 more to help with some hang/fold. I'm just not sure this is going to be enough to get the size and projection I have as a 34D.
He uses Sientra implants with silicon. I've said I would like round as it seems to be the teardrop shape have even less projection.
Any advice would be really appreciated.
Best,
Sarahss
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rampra
Were you able to get the information regarding your tissue expander's? I will need that information.
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Sarahss:
Are the implants in Australia actually Silimed? That would make a difference in sizing.
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Hi,
I'm 5'7 120 32 inch rib cage size.
I am meeting with my BS and PS in a few weeks to discuss skin - sparring mastectomy with immediate reconstruction.
I do not know what type of implants he uses but will ask.
I'm at 32B currently.
Thanks.. I'm just starting this journey so any help would be great.
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Mshel
You will likely want to be in the 400 cc to 475 cc range with implants. Come back to discuss further once you meet with your medical team. Ask what brand and style of tissue expanders the PS typically uses and ask for some size ranges he envisions for you to achieve the results you desire
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Thank you. My doctor didn't mention tissue expanders; Do they always use them? She said it would be one surgery. Does this sound correct?
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mshel, yes, that does sound correct.
If you don't have expanders then your Dr is probably doing a direct to implant procedure. This is where you have the mastectomy and insertion of the implant (with strattise or alloderm sling ) in the same procedure. I had this procedure done about 10 weeks ago but it doesn't seem the norm for some Dr's to do as they need to be skilled in microsurgery. I think that in the US it seems that women usually have the 2 step procedure surgery which involves an expander, to stretch the skin and muscle, then a second operation to facilitate the exchange to implant. Women will generally need 2 Dr's for this, a Plastic surgeon and a Breast surgeon.
I was able to have the direct to implant because I didn't really want a major increase in my bust. Generally speaking the DTI is used if you have either a/ a small bust or b/don't want much of an increase if at all.
When you see your Dr next then clarify whether they are using expanders or direct to implant, the Dr can also give you information on the type of implant they will use and the size of the implants they will take into surgery with them. Most surgeons take in more than a couple of implants and use surgical sizers to decide what size best suit the goal you want. My surgeon took in 300cc, 325cc, 350cc and 400cc implants into theatre with her and I ended up with 325cc implants.
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It would've been nice to go straight to implants since my size didn't increase. It would've saved on having two extra surgeries.
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Hi Whippetmom,
Wow that was really fast. OK, so I found out that yes, they are Silimed!
Best,
Sarahss
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Hi Whippetmom,
Thanks for your response earlier, I think I got the details you needed, here are my details again:
I had my BMX on 10 of this month and have TE's in place. I am not sure which brand of TE's are used for me at this point. I have a post-op visit with PS tomorrow and can try to get some information from them.
I am short lady, 4'8'' and weight around 100 lbs, I was using 32 B/C before mastectomy.At the time of BMX, I know, I was filled in with 150 cc on both the sides. My PS used the following TE's : Allergan, 133 MX-12 Tissue Expander, 400 cc,
I do not wish for any larger size, I want to remain either 32 B/C. Can you let me know how many Cc's of fluid will my PS need to fill me in ?
Also can you suggest me what am I suppose to ask my PS to obtain 32 C as final output ? Any suggestions are highly appreciated.
Thanks
ramprat
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SarahSs:
There are a plethora of style options with Silimed. I would suggest smooth silicone rounds with a volume between 550 ccs and 650ccs. A 14.0 cm width would be good for your frame. A projection of approximately 5.7 cm to 6.2cm would be a good range for you as well
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Whippetmom, you are wonderful! Thank you so much, it's made me feel so much better to have this to focus on when my op is so close.
Best,
SarahSs
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Hi, Whippetmom-I've been reading along for about a week, and finally decided to post. I just found out today that my exchange will be on Jan. 19. This is much earlier than I had thought, but I know it has to do with the glitches I've had with the TE's. Here's the lowdown: I completed 4 rounds of chemo on Oct. 26 and had BMX with TE's on Dec. 1. The TE's are Natrelle 133 MV-11-T and 250cc. was written below that on the info sheet. The PS filled each with 200cc during surgery. About 10 days later, I had my first fill of 100cc. each, and by the time I got home I was in excruciating pain. Turns out the fill only stayed in the top pole because the TE's are "too tight" on the bottom. So at the moment, I look like I have upside-down boobs! The PS said he can fix all this during the exchange to implants.
I am in my late 60's, 61" tall, and weigh 115 lbs. My rib cage circumference is 30". Before surgery, I was roughly a 36/38C. I had been a 38D the year before, but I lost about 15 pounds. On the path report, I believe one breast was 285g. and the other 318. My PS seems to prefer Natrelle products, and he is leaning towards anatomical ("gummy bear") implants and once mentioned he thought that 400cc would look good on me. Also, does the fact that I worked out pre-diagnosis and have "strong" pecs impact the final decision? I was told by the PA that it probably impacted the fill.
My pre-op appointment with the PS is this Friday, 1/8. I know I won't hear from you by then, but whatever info you can give me as to appropriate implants would be helpful. I would like to be roughly the same size as before, or maybe between a c and D. I can always have another appointment.
Thanks for all you do,
edtherapist
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KateM - Thank you... i'm hoping I can go straight to implant. I wear a 32B but i'm probably considered an A cup and wouldn't mind going up to a B cup. Hoping I can do it in one step. Thanks.
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Hello again, Whippetmom,
My information is about 18 and 20 posts above on this page 450.
I was able to get most of my questions answered at my PS appointment yesterday.
My implants will be Allergen 410 series silicone form stable ("gummi") anatomical implants. They have texture to adhere. PS mentioned MX high projection or full projection. I don't know what the size will be. I was happy with my fill volume of 420, and at 480 my breasts look just a little too big to me. In terms of width, I told my PS that my TE's feel too wide to me and are bothering me in the armpits. I am a flutist and I need full ROM for my arms. The nurse told me he orders a few sizes and brings them to the OR.
With all that, what size(s) implants do you recommend. You had mentioned the Allergan 410 LX, 625 gms would be too flat. Are we looking at Allergan 410 MX or Allergan 410 FX? My exchange is scheduled for 1/18/16.
Thank you for your help.
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Whippetmom
I am new to this site and have been reading the posts. You seem to really know your stuff. I went for my last fill and have been scheduled for reconstructive surgery at the end of January. In reading the posts I tried to ask my PS questions but really did not get too much info. No where on my pathology is there a weight for what was removed. I have measurements in cm. I asked the PS and she said she would have no idea. I have no idea what company implants all I know is I was filled to 510 ccs (my circumference around is 29 inches and I am 5'3.5") I like the size I am now and the PS said she wants to give me round with extra projection (as currently my kids say I am more round and the projection does not match and I look like I am wearing a minimizer bra) She feels I will look younger (I am 56) Also she said she has to pull me in as currently you can fit a Mac truck between the two TE's. and I feel myself under my arms a bit (although the roundness makes my waist look nicer than it currently is as I gained some weight from the steroids and chemo:( In addition I will be having fat grafting which she is going to do via liposuction through my belly button.
My surgery is 01/26/2015. I think I am in good hands. Top hospital in NY. Does this all sound good? Is there anything I am missing or should be asking?
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ramprat
Well,since you do not want to be too large, I would suggest implants with the range of 350 mL to 425 mL.
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edtherapist:
Could you send me photos? It sounds more like TE failure than some issue with tight pecs. If pectorals were culprit, they would be resisting fill to the upper pole. Not having sufficient lower pole expansion can be problematic for implant placement. The lower pole is where projection naturally occurs, and you need this for a good result. . I would not go through the exchange until this gets addressed. It is something that cannot always be fixed at the time of the exchange. I don't want you to end up with too small implants, because your doctor tells you that (oops) he couldn't fit anything larger during surgery, because of that tight lower pole. If you are 60 and a:D cup at one time though, you should have abundant skin flaps, so I would like to see how the TEs look. You can link them to me by private message, or via my email address.
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PNY: I like everything your PS has had to say thus far, I.e, extra projection, round implants, fat grafting, moving implants more medially. I cannot comment on size, because I do not know the original volume of your TE', but where you are now in terms of fill sounds good to me.
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Mominator:
Anatomicals in the extra full or full profile in the 400 gm range sounds appropriate. Rounds in the 400 cc plus range would be good also. It sounds to me as though your tissue expanders have migrated laterally, and this is something that the plastic surgeon should and indeed must correct at the time of the exchange.
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Are Mentor or Allergan implants best for reconstruction? Having a hard time deciding between the round or anatomical. I do want projection but do not want high sitting big round look! Any suggestions?
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MotherGoose - Everyone is different & surgeons prefer different things. If you read through the points in the header, you will be able to compile & provide the personal information that Whippetmom needs to make a recommendation.
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Thanks, Whippetmom, for your guidance and suggestions. Met with the PS today, and he also thought the Allergan style 20 round would be the probable implant. He is thinking between 425 and 475 cc. What he does during surgery is try a round, then an anatomical. Then he decides which shape works best. He brings 4 sizes of each type. He does fat grafting if necessary. Too bad I'll be asleep during all this and won't be part of the actual decision making. Surgery is 1/19, and I'll let you know how it goes.
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I'm trying to decide between smooth and textured silicone implants. Any comments?
Thanks
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I had my skin sparing BMX in August of last year and have been steadily losing weight before my reconstruction starts. I have been given the green light to begin and have a surgery date of Feb 3 to place my expanders. I'm 5'8" and currently 195 lbs (I only see myself loosing another 20-30 pounds after reconstruction if possible) My ribcage is 39.5". I have a large, muscular frame and broad shoulders. Prior to BMX I was 65 pounds heavier and I was about a 42DD. After 6 months of being flat (and I don't wear my prosthesis much) I really don't want to go back to my original size or anywhere close. I just want some shape back. My pre-op appointment is on Jan 22 and I'm figuring this is when we will talk about more specifics. Up to this point we've only talked about my weight and different surgery options. Anyway - I'm hoping to have better understanding of what we will be talking about and what my options are by my pre-op. I don't know what kind of implants or expanders my surgeon uses but I have a feeling from the posters on the walls that they lean towards Mentor. Just a hunch. I don't know if this helps but I have two sets of prosthesis. They aren't the same brand but one is a size 7 and the other is a size 4. When I wear them, I tend to wear the 4's. Any help or advice would be appreciated. Thank you!
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Mothergoose:
Either Allergan or Mentor are fine.
Anatomicals are more exacting and the sizing and "profile", which translates to projection, is all dependent upon the style and volume of your tissue expanders.0 -
Angela: If you are referring to silicone rounds, choose smooth over textured. Textured implants nearly always cause traction rippling. If anatomicals, they all have a textured surface.0
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Ringelle: Much of this depends on the amount of skin envelope you have (since you were large breasted prior to BMX) and that envelope needs to be filled up to some extent. So I think you need at least 600 ccs in a smooth, round Mentor moderate plus profile implant. This would give you the width you need and enough of a mound. You could go up to 800 ccs and still never be as large as you were prior to BMX. I do not know how prostheses translate in sizing. Perhaps someone else has an idea.
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