BREAST IMPLANT SIZING 101
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Thank you so much. Your answer has helped me a lot!
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Hello again, Whippetmom
Some questions for you:
1. Do TEs and implants run about the same, smaller, or larger from each other? That is, if a TE is filled to 420ml, would the equivalent size implant also be around 420cc? I realize that they will be different shapes, TEs and implants. I am thinking about volumes.
2. How does one decide between moderate and full height, as well as full and extra full projection?
You had suggested for me "Anatomicals in the extra full or full profile in the 400 gm range sounds appropriate."
All of my information is on page 450, posts #2, 6, and 24.
I got the surgical plan for Monday 1/18/16: Allergen 410 anatomicals, extra projection, and there will be "left pocket adjustment" done. Although PS didn't make a big deal about it during our last appointment, he had the nurse make a note about it and it is part of the surgical plan. Another thing PS didn't talk about was size. Nurse said that there will be several sizes available and the PS will discuss with me and we will then decide. Apparently, PS likes to talk right before surgery.
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Mominator:
Implants need to be larger than the TEs, especially when we are referring to silicone rounds. You have a width of 15.0 cm with your TEs and you need to stay in that width range with implants.If you go with anatomicals, the width, height, projection of your TEs have corresponding sizes in the Allergan 410 range. I did not feel you would be a good candidate for anatomicals (your pre-BMX breast size, ptosis = pocket laxity and greater risk of anatomical rotation). I suggested full projection or extra full projection because of your comments:
" I would prefer them to look less like flat hamburg rolls and more forward projecting."
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Hi,
I'm looking for some advice on implants. I have an appointment with my PS on Tuesday (1/19) for my last fill and to discuss exchange surgery.
I'm 5 ft 4 and 3/4 inches tall, 135 lbs, the circumfrance just below my TEs is 31.5 inches. I have Allergen 133M-12 400cc TEs. My PS has not indicated if he uses one brand or style of inplants. My pre mastectomy bra size was 34 A and I barely filled an A cup. I've expressed to my PS that I want to be bigger than I was and that I want cleavage. 😉 But I don't want to be huge.
I'm also concerned because these TEs feel like they are in my arm pits. I'm hoping the implants won't feel like this and won't be as high.
I appreciate your time and any advice that you can give me would be helpful.
Thank you,
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Tina1969
You have a number of options. In Allergan, there is the anatomical 410, which must correspond somewhat to the TEs(I think they need to be a bit larger in dimensions than the TEs for a snug fit), and you would be looking at the Allergan 410 MX - 370 or 410 grams in that style. For silicone rounds, there is the Allergan Inspira line of implants, newer to the US marketplace, and you could look at the extra full projection lineup...the SSX or SRX....415 or 465 grams. Also, the standard Allergan Style 20, 425 ccs to 475 ccs, would be good. The TEs are wide and in the armpits either due to placement issues or migration issues. The fact that they are too wide and presumably too high, should definitely be corrected at the time of the exchange.
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Thank you for your advice. This is helpful.
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Hi Whippetmom, I haven't posted in a while, but I've been keeping up with the thread and I have a question before my last PS appt./possible fill before surgery (which is 2/10) tomorrow. Many have indicated that they "feel" like the TEs are in their armpits. Isn't the shape of the TE (horizontal football) in part responsible for this sensation? Is it necessarily so that migration has occurred or is this odd and continuously inflated shape under our pecs responsible? My PS said that TE placement was based on a combination of using the blueprint (for lack of a better word) left by previous breast tissue and the constraints of my pectoral muscles--the level they end on my rib cage and their overall "area." The TEs do feel wide and high compared to my natural breasts (which were ptotic and had no upper fullness--sadly the volume was nowhere near my pecs). But won't the implants use the same area the expansion created and just form a different shape? (You and others have suggested high- or ultra-high-profile smooth round Mentors to get the volume/projection I want, in the 525-550 range, which would hopefully mimic a full C. I'm 5'2", 110-115 lbs, 30-inch rib cage, previously a full 36 C to 34 D in VS bras.) Or is the "correction" you mention just a normal part of the art of the surgeon once he gets back in? Just wondering, as the talk of migration and TEs being too high and needing to be fixed is a bit unnerving.
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Stix, where are they?
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Hello again, Whippetmom, and thank you for all your advice.
Here's another question for you: Have you heard of having different size implants between the two breasts?
PS had met with me right before surgery and we had agreed on FX410410. He said he would be using the sizers to check before he put in the implants. But I'm reading through the paperwork and I see that my left breast received FX410450 and my right breast received FX410495.
My right breast has always been larger than the left (during mastectomy 812 gm was removed from the right breast and 666 gm from the left), but I was expecting to receive the same size implant for both breasts. The right does seem a bit bigger than the left. PS did a lot of pocket work in both breasts, as both breasts are really sore and have been putting out a lot of fluid in the drains. I saw the nurse yesterday and I will see the PS tomorrow.
I'm not upset nor angry at anyone. I'm just really surprised.
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Hello again, Whippetmom, and thank you for all your advice.
I just got back from my post-op appointment with PS.
As we expected, Plastic Surgeon had to do a lot of "pocket work" on both breasts. Also, PS removed some fat tissue that was just under the skin on the lower halves of both my breasts. The fat was keeping the skin stiff and slowing down the healing. The fat was "not exactly necrotic" but it was "definitely not happy" where it was. I don't know how much total he removed, but it was a lot. PS said he removed about 50 grams more from the right breast than the left. So that's why he put a bigger implant on the right side to even them out. PS thinks the breasts look even now, or perhaps the left is possibly slightly bigger.
Both breasts are really swollen, but are starting to shape up much better. I am happy with the results.
Thank you for all your help!
Mominator
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pch:
Malpositioning of the tissue expanders is fairly common. It is sometimes due to the pocket being over-dissected, which causes the pocket to be larger in certain planes than the tissue expander. In nearly every instance where the TE migrates, it will be lateral or superior.....towards the armpits or upward on the chest wall. It might be due to pectoral resistance...I suppose this is to be expected in some cases. It might be due to a chest wall deformity of some type. Mentor and Allergan started using "suture tabs" in their tissue expanders, to help prevent displacement. I see the tab versions used about 50% of the time. The pocket to be created by the tissue expander should be guided by the plastic surgeon with his or her eye towards the future implant to be used. It is not always the case that the tissue expander alone will create the space for the implant. If you had a significant breast size before mastectomy, or if you had ptotic breasts, your pocket may be larger because there is still an excess skin envelope...or the skin is pretty elastic and a larger implant may be needed. My tissue expanders were 400 ccs and I needed a 550 cc implant, because my skin was pretty elastic and the PS needed to fill up that extra space. So my end result was larger than the tissue expanders. Hope that 'splains it.
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Mominator: It is not at all uncommon to use two different sized implants. That is a very small differential - 45 ccs. It sounds as if your PS did indeed do a lot of pocket work, and how good of him to do it all in one fell swoop, rather than have you come back for a second procedure to perform the revisions. It is worth being a little more uncomfortable to get it as "right" as possible at the time of the exchange. Congratulations! Keep us posted on how you are doing.
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whippetmom- thank you so much for your recommendations. I had my pre-op this morning and even though I won't get to talk implants and sizing for a little while I felt better prepared with questions. I do know now that they definitely use mentor expanders and primarily mentor implants
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Hi,
I haven't posted in a while. I finally met with my PS and talked more details.
I'm 5'7 120pounds 29 inch ribcage, A cup.
The PS wants to use expanders under the muscle and then gummy bear, tear drop textured implants making me a B cup in the end. I had originally thought I liked the round, high profile. What are you opinions?
Thanks
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mshel:
I would ask your plastic surgeon to consider trying both the round silicone and anatomical's in the OR. You should not be limited just to anatomicals. Rounds might look better on you than anatomicals, and vice-versa. Enlist the aid of the OR nurses, to be your advocates, to tell the doctor which stylethey think looks best. But tell everyone beforehand, what you are hoping for - size wise and appearance wise .
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Mshel,
Hi and welcome. Usually if you are small to begin with, annatomicals work really well. They don't go up to very large sizes at least for now. I am 5' 5" 145 lbs 36 band width and was a b cup. I was filled to 420cc and have 475cc Allergan 410 gummies. I am very happy with them. I told my PS I wanted to stay around the same size. He listened and did a fabulous job! I had no complications. Your surgeon must be very experienced in this implant. They are firmer than rounds but have a very natural feel to them.
Robin
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Thank you. Am I correct in thinking I do not need to make this decision until the expanders come out?
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Mshel: You need to discuss these decisions regarding size and style either before your pre-op or at the time of your pre-op. The PS will be ordering the style and sizes he plans to try out in the OR. If you want until the TEs "come out", you are too late to weigh in on the topic. It will be a done deal by that point.0
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I had my exchange. PS used Allergen, Natrelle 45-500 implants (with fat grafting). She did make the large gap between the two somewhat smaller but I guess i pictured me looking differently. Even with the high projection they look somewhat flatter than I thought they would. I was never large chested so I am not looking to be too large. I know everyone says it takes some time for them to "fall" and settle. Does that mean they will look even flatter or smaller?
Thanks
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PNY: Typically they do not look smaller, but certainly, implants can look rather compressed right after the exchange. Let us know how things look in two weeks
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Compressed is actually a better description of how they look. I will keep you posted.
Thanks
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Hi I just had bilateral skin sparing masectomy with tissue expanders and alloderm over muscle on 1/28/16.
The PS filled me up to 240cc
I believe it was mentor arturo high profile 375-475 - they said can fill 30 % over that. He said implant is tear drop and should look more natural but wondering what this looks like as far as bra size or to my body type
Im 5'6 and 180 lbs now but hoping to lose about 20 lbs - told PS i just want a full C not spogebob square pant boobs
Before surgery I was b/c cup with weight gain. still waiting on path reports from SLB and tumor size to hopefully rule all rads.
~Tina
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good afternoon. I just had my exchange surgery consultation. Looks like I'll have my exchange surgery on March 10.
I currently have Natrelle 133mx-12t expanders with a fill volume of 400cc. My radiated side is filled to 400 and the other to 350. We are going to try anatomical silicone implants at 420 or 470.
I am 5'4 with a 33inch rib cage. I was a 36a before surgery. How will these implants compare to what I had before
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Tina....I do not know which style of TE you are talking about. Sorry
However, the size sounds pretty small for your frame - even if you lose 20 pounds. I think that if your PS is looking at anatomicals, you would need to be in the 650 to 700 gm range with that style. The anatomicals are specific to the dimensions of your TEs though, so you should verify exactly where your PS is going with sizing.
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Patty..
The corresponding anatomical is a MX style, and it seems that your PS gave you MF style sizing. I think to be in the MX - 410, 445....perhaps even 520 gms, if he is looking at increasing your width to 14.0 cm - would be good. Ask your PS why a MX style TE (moderate height, extra full projection) and a MF (F meaning "full") implant, instead of a MX style. Your projection matches the MX style anatomical.0 -
thanks! I *think* the move to MF is due to the extensive capsular contracture I have after radiation treatment and concerns around healing and ability to support extra full projection. I have also gained quite a bit of weight since the expanders were placed. and Ihave always been "thin and wider-framed (like a billboard)." I will ask him though.
Do you think these are a bad choice?
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This resource is wonderful! Thank you all! I was hoping to get some advice on my current situation. I had a double mastectomy with TEs placed on Dec. 14, 2015. I have recovered well. I have only had 2 expansions, and my PS thinks the tissue is too thin to do anymore. The size is OK, but they are uneven. I am happy with the left, but the right side (BC side) is smaller. He is now wanting to talk about DIEP or TRAM surgery, but I really don't want to do that. The PS was not able to do nipple sparing so my scars are right across the breasts. The scars look good already though. But I can also see the expanders sticking out on the sides. I guess my skin is just really thin. Also, I'm 5'7" and about 135 pounds. I am still doing chemo, so my exchange surgery won't be until probably May or June at the earliest. I was a 36A before surgery and only want to be the same or slightly larger (small
. But really now I just want them to be even so I don't have to pad one side. I know I have Natrelle but am not sure which number. I'll have to look it up later. Any advice? Do you think waiting a few more weeks and slowly filling just a little more might work? Or should I reduce the "good side" and just stay small? Any other options? Thank so much!0 -
hi ladies just stopping by to say hello.
I am comparing PS to bad mechanics I feel as if they take 3 zise implants to the operating room then that is just to fake they will try the 3 zises. They then take the smallest one and use that so they know we are not going to have good results and next year we ll be back in their table . Sorry to say but it is my experience with bad ps and I read so many post here of many going through the same problem
Sending you all hugs and lots of strength
I wish to find a good mechanic but due to the bc history here in Canada no Dr will take in someone else patient so I just have to keep trying to see if my mechanic decides one day to improve my issues .oh in a conversation I mentioned the 3 zise implants he had the day of the oparation and he said oh no one try zise we do it by eye we have much experience there is no need to try several . Then I said then why have several ? He said oh in case something goes wrong like a plan B.
Sorry for venting I lost all respect for ps in my city.
Love you all
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Enerva, I've wondered that myself because I came out a lot smaller than my TEs. When I asked my PS, she said she was worried about my radiated side not supporting a larger implant, even tho it supported a 440 TE (she put in a 360 implant). But then she said if it held up, we could consider going larger down the road. Like I want more surgery! Grrr...
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