BREAST IMPLANT SIZING 101
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Hi Whippetmom,
Did you get my PM?
Robin
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JCS28
Did you find out about your TE style and volume? Tissue expanders do tend to migrate laterally towards the armpits, and this is a very common occurrence. So it doesn't always do. You could send me photos via private message. If you cannot figure out how to do that, let me know and I will send you my email address.0 -
RAK1
I did...just now
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I am sorry that you're having such a terrible time with plastic surgeon issues. This is one of the unfortunate pitfalls of government run healthcare, when it comes close to anything resembling "elective surgery" after breast reconstruction. I am seeing some of this spilling over in the U.S. Revisions, I fear, (at least those dealing with "size" or "shape" )will one day become obsolete. Assymetry will likely always be covered, unless the A procedure my Kaiser plastic surgeon once mentioned in 2010 is now off the menu for me.
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Hello everyone. I've been on other boards here for about 2 months or so now. The time is approaching for me to discuss implants for my exchange and I need some advice. My attitude used to be "whatever my PS thinks best", but I now realize my chances of being happy with the end result is much greater if I participate in a discussion of my options with my PS and make my wishes heard.
I am 54 years old and had DCIS left and chose bmx which was done December 18, 2015. Lucky for me I am TN and required no further treatment once the tumor was removed. I had skin sparring nipple sparring bmx and healing great without any complications.
I am about 5'5", currently 135 pounds (my weight fluctuates between 135 and 145) and my ribcage measures 32 inches. My preoperative bra size was about 34B, though I never really found a well fitting bra....I mostly wore loose sports bras for comfort and a genie type bra if I wore something more form fitting. Generally I was a little too big for an A cup but didn't always quite fill out a B cup. I had mild ptosis according to my PS.
My TEs (placed under the muscle with I believe ADM) are both Allergan 133SV-11 with 200 cc recommended volume. My PS has already told me he generally over fills and my appt next week should be when we discuss implants for exchange since I am already filled to the 200 cc mark. Up til now he has not discussed anything about the implants with me, not even whether I want silicone or saline....all we talked about prior to surgery was my wish to be about the same size I was. Now I'm kind of hoping for slightly larger....solid B or C. I believe I would be able to go slightly larger because the skin is very healthy, not too thin, and I still have a skin crease under the nipple area that needs filling out, more prominent on my right side. Also, if it makes any difference my incisions are in the inframammarary fold. I have not been a very active person for the last 10 years or so......interpret that as couch potato...but want to be healthier once all this is done with.
Sorry I tend to be long winded and probably gave you way more detail than you need or even want. Right now the only thing I'm fairly sure of is that I want silicone implants and would like more projection. I'd love to have implants that don't require a bra to look like breasts.....maybe the anatomical "gummy bear" type. What would you recommend?
Thanks for whatever information you can give me. Everyone on these boards have been so helpful to me, I really don't know what I would have done without all of your support.
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Anniekay80:
With your specific type of tissue expander, and your pre-mastectomy breast size, I suppose you PS could use a low height full projection anatomical, or a moderate height full projection anatomical. . It will all depend upon how much skin envelope availability you have with tissue expansion. If you were to instead go with smooth, silicone rounds, I would recommend at least 400 ccs to 450 ccs in a Style 20 - a high profile implant. The Natrelle Inspira would also be a consideration, as it is one of the newer FDA approved silicone implants on the market and I have seen good results with this implant and women seem to be happy with their results. . I would think the SSF -335 gms to 370 gms would be a consideration. Armed with this information, it is time to discuss with your plastic surgeon, exactly what he envisions using, so that you can decide if you are both on the same page. There is a reason he used that specific short height variable projection tissue expander, and so allow him to tell you what he has in mind.
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Thanks whippetmom for the recommendations. The only thing we discussed before the BMX was that with keeping the nipples he would have to be careful on choosing the implant so I didn't end up with nipples facing easy and west, but facing forward instead. Lately he has told me he will "tweak" the nipples during the exchange so they are facing in the right direction, but his concern was that we hope the TEs would fill out the skin crease under the nipples. The creases are greatly improved but the right side still has a significant crease.
Thanks again for the recommendations. I always research everything before talking to my doctors but the topic of implants is harder to research and find info pertinent to my situation. I already feel better having some knowledge to work with. Now I feel like I can ask knowledgable questions and not Just sit there saying "whatever you think doctor, I have no clue".
Cyber hugs.....
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Had my exchange September, 2015 and feeling great. I do have to have some fat grafting done on my left foob. but sizing is great. My TE were 500 cc and my exchange is mentor 500cc saline. I am currently wearing a 32 DDD bra and loving it.
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Anniekay:
Oh absolutely! I glossed over that part about a NAC sparing procedure. The implant style is selected with good nipple placement in mind. So there may be no choice in the matter.
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agrinder:
Congratulations!
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Thanks again whippetmom. I know I may be limited in my choices but at least you have me some place to start the conversation. Reading about everyone else's situations has educated me too. I just want to go in and be able to have an informed conversation with my PS instead of leaving all the decisions in his hands and I wake up from surgery really surprised. I would like some idea of what he thinks is physically possible and what is probable. I felt I was completely unprepared for what I faced post BMX......I had so many panic attacks that first week post op I stopped counting them. I take responsibility for my part of that with my attitude of whatever you think is best......but I also believe neither of my surgeons gave me enough info to be prepared. Almost everything I needed to know to deal with my situation I learned on these boards. Even a simple thing like sleeping on your back.....no doctor or nurse told me this would be necessary.
So, when it comes time for the exchange I intend to be as fully informed as possible. My husband has taken great care of me, but he is still recovering from his stroke 8 months ago. Last minute surprise or changes are frustrating to me but they can completely overwhelm him. I have to be prepared because I can never let go 100%.... I have to protect him from being overwhelmed cause his heart can't take that.
Anyway I thank you again as well as everyone here who has shared their story. You all have helped me more than I can say.
Cyber hugs....
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Oh Anniekay! I am so sorry that your husband is going through such a tough time. I know that this puts additional stress on both of your lives. Please try to relax and accept the process, and do not go to that "overwhelmed" state which just puts too much stress on every facet of our lives. Even when there are appointment and schedule changes, try to roll with them. Do not allow stress and anxiety to take a foothold. Our future health and depends on making that decision to eliminate, as much as possible, stress and all the negativity and inflammation it brings to our bodies. I am praying for you and your husband tonight.
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Thanks whippetmom, I'll take all the prayers I can get! Positivity is my friend.... My husband laughs at how I collect all the positive quotes I can find on Pintrest. I tell him to be grateful that for now they remain on Pinterest instead of printing them all up and plastering our wall's with them!
Cyber hugs....
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I am scheduled for a BMX due to cancer on one side on January 25, 2016. I met with the surgeon and plastic surgeon Friday and that was the next available date. I was just diagnosed less than two weeks ago.My only reconstruction option is implants. I am 5'2" (apparently lost 2" in height) and 118 to 122 in weight. My rib cage measures 29" and my usual bra size is 32 DDDD although I understand that is not something to go by because it is not standard. This will be skin sparing but not nipple sparing due to ptosis.
The plastic surgeon said she was going to do a reduction and lift. She estimated that my breasts had 1000 cc of volume and that the largest implant is 800 cc. She asked me what size I wanted to be and I was totally surprised by that question so I'm looking for a little help. The implant that she showed me was silicone and round and smooth on the outside.
This is going to be under the muscle because she thinks it will give me a better cosmetic result if the implant is covered by the muscle - less rippling because I am thin and she expects my skin to be thin as well.
I also asked something about projection and she said she didn't think that would be a large factor for me because I do not have a lot of projection and my breasts are implant shaped. She is correct. They are wide but don't stick out as much as some.
I am not sure what size I want to be. She said my breasts are too big for my frame and I agree. I have stripper boobs and have a hard time getting clothes to fit. On the other hand, I am afraid too much change (going too small) will be unsettling. But stretching my muscles to get a large implant in sounds painful. What if I cannot stand it? Will I be left with a breast that looks odd - like it has not been filled?
Any thoughts on what size implant would look good but on the larger side? But one that allows me to button my shirts? Also the large breasts tend to make me look heavy. And I have always dressed to camouflage them but everyone knows me as the one with the big boobs. Some people thought they WERE implants.
Do I have to make all these decisions by Thursday? Or can the PS put in the TEs and I can then figure out what looks good?
I have seen pics of smaller busted women and they look great after reconstruction. It seems harder with large busted women.
Thanks for any advice you can offer (especially whippetmom who is apparently the implant whisperer).
And I apologize if I am posting this incorrectly. It is my first post.
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Carpedium911
I do agree you might need some skin reduction and as much of a "lift" as is possible with a BMX. The implants need to sufficiently fill the remaining skin envelope. I think that your PS could also consider the newer Allergan Inspira silicone rounds. Also, when there was/is significant ptosis and skin slackness, textured Inspira rounds might also be a consideration. Allodern should be discussed, as a supportive sling. I would look at the extra full projection in any version of silicone round. Not "full" but "extra full" projection. I would say 600 ccs to 700 ccs. It would be nice if your PS could perhaps use a short height tissue expander, which will not expand the delicate, perhaps thinner tissue of the upper pole. Perhaps staying within the 12.5 to 13.5 cm range, assuming that is approximately the width of your native breasts. Keep me apprised of what your PS has to say. You should have this sizing discussion before the BMX.0 -
Thank you! I guess I will have to send the PS a message because the next time I see her will be the date of surgery. She is very good but I am very concerned about getting the best cosmetic result possible
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Whippetmom - I am 5'7", weigh 136 lbs and my rib cage is 29.5". I had a UMX with Mentor CPX4 Medium height 275 cc TE. I was a small B cup before my surgery. I plan to have a prophylactic MX in May and the exchange for both sides this fall sometime. I told the PS that I wanted to be a fuller B or small C after the exchange. I carry most of my weight in my hips and would like to look more "balanced". Any suggestions? Thank you!0
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Hi Whippetmom- I has been a long time and glad to see you are still here. I am 5 years out and having my implants exchanged. I was wondering about your opinion on what size. 5 years ago I was 5' 61/2", 117lbs with Allergen style 20 280cc's(if I remember correctly). Now I have gained a couple of pounds and at 125. There is a new style that my PS likes that became available in June of 2015. Allergen something. They are filled more if that makes sense. He is recommending 310 or 340 cc's. He thinks I should go with the larger ones. He will also be doing some fat grafting and adding it near the top of the implants because I am skin and bones. He feels there will be a more even slope. What are your opinions on sizing for me? Thank you,Eula
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Hi,
I am hoping for some input on what implant size to ask for. I had a double mastectomy due to a gene mutation in early January and have expanders now.
I am 5ft 9 inches and weigh 133. I measure 30.5 inches around my ribcage under breasts. I wore about a 38D or 36DD before, though I had lost some weight and prob could have gone to 38C or 36D. Anyway I would like to stay my same size or bigger if possible. But I also love the idea of not sagging and would definitely sacrifice some of the softness of natural breast tissue to get fake ones that stayed in place better.
I have mentor expanders, artoura, high profile, 475cc, currently expanded to 590cc. It says TEXP130RH on my card. I love my size now but worry that if the PS puts in implants of a slightly smaller volume (this is how he does it) I will look a lot smaller since I know implants look smaller than expanders of the same volume anyway.
My mastectomy breast weight on the path report was 550g per side (actually 532g on one and 577 on the other so it averages to 550). I want more than that!! Unless it would increase the chance of complications like one of the implants bottoming out or something, I do not want to be too greedy and ask for too much and then have a complication.
My PS does all kinds of implants but mentioned he thought about a shaped implant for me (the teardrop I think) and I said I liked the idea of a slightly harder and form stable implant. But I also want to look big like I do now. I am so happy with these huge things and they look totally normal in clothing right now.
Any advice on what size to try to get? I am going to try to get my last fill tomorrow to get to 690cc so he can use an implant of about 650cc but do you think that is too much (or would increase chance of complications) and I should just go for 550cc implants and it would look enough like 590cc in expanders ?
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Carpediem911 and mdepaul, welcome to Breastcancer.org, you've come to the right place! We're glad you found us and this incredible group of individuals, and hope you find here the information and support you're seeking.
Please keep us posted on how everything is going, we're thinking of you!
The Mods
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I am new to this site, so I am not sure how to use it, but I need guidance a about implant sizing and possibly shape. I had a skin and nipple-sparing double mastectomy on January 6, 2016. (DCIS, stage zero, but with a high (70) oncotyoing score, so my husband and I chose surgery as we are both afraid of chemo a d radiation, and I would have had to take tamoxifen for years after avoiding hormones all my life (bc pills taken for only 3 years total). Path reports after dbl mastectomy and 2 nodes biopsied showed no node involvement and thankfully, no chemo, radiation or hormone tx needed.
Currently, I have Natrelle style 133V, Series: Tissue Expander Matrix with 240ccs of saline fill on the left side and 180 on the right due to a hematoma that is still resolving and was painful, so I skipped one fill 2 wks ago. The surgeon had trouble getting the expander up under the muscle on the right side, and it looked like it for weeks while bruising traveled down my right side until resolved. Pre-surgery, I was a B in width but not a full B in projection, and smaller on the right side (plus I had 2 benign biopsies on that breast). Getting bras to fit and getting some projection has been a long-time challenge. For the last several years, I dropped the underwires and just get lightly padded ones.
I am a little over 5'2", average build, more of a straight figure / always bigger in the waist, but not in the butt or thighs. My normal weight has been 120-122, but due to emotional eating and inactivity, I am up to 134 -the most ever in my life (other than when I was pregnant with my son 20+ years ago) and I am very unhappy with how difficult I know it will be for me to lose it!! I will turn 60 in April, but look younger and better than average for my age, plus I am energetic and active.
My PS said he will use round silicone implants - I don't want saline - (unsure of the brand at present). He said those were my only choice - due to my build? I am not entirelysure. Per the PS, round ones tend to flatten out (less projection) and he said that would be my biggest complaint (especially since I have never liked clothes that are fitted at the waist. He did not give me other shape options, although he uses them in augmentations. I don't know if he built or uses a "sling" like I have read about elsewhere. He did "tack" down my muscle - I think in 1 or 2 places to hold up/in tbe expander. I don't want to be significantly bigger and not fit in my clothing, but I do want more a bit more projection than before, and hopefully, an easier time getting bras, perhaps without padding! His suggestion was a full B or small C. Please share your guidance with me!! And thank you for giving of your time and effort to women likeme! SeattleBound
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Welcome SeattleBound. I am sure you will get good advise here. I know I did and I appreciate so much.
My PS also felt round silicone implants would look best on me. I am 5'3" and weighed between 115-117 before chemo and steroids. Now I am stuck at 128 and the sugar cravings are insane. I just have to put my mind to it and get back to wear I want to be.
I had my exchange 4 weeks ago and PS used Natrelle S 500 round silicone The S is for the extra projection). So far I am think they look nice. My only thing is I wish she would have been able to pull them just a drop closer together. (I never had cleavage but now thought it might look nice:)
Good luck with whatever you do.
Phyllis
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Wow, I am impressed with how quickly you posted a response! Thank you for sharing! I live in a city where choices of PSs who do reconstruction arelimited. That has been a concern for me. I am trying to determine if round implants that lay flatter are being recommended because they really are the best choice for my situation, or because my 50 something surgeon has no experience in the use of newer implants with reconstruction. Not that I can necessarily do anything about that, but I want to be as knowlegeable as possible! Scarey stuff when (hopefully) the results are permanent!
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SeattleBound, Whippetmom is the implant guru/whisperer on this thread. She is amazing and very knowledgeable. You should get her input.
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I thought I was doing that when I originally posted. Now I can't see my original post?? Where can i find it? Never mind. It was on tbe previous page! Do I need to send a message directly to whippetmom?
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Seattle - Whippetmom doesn't check in every day, but she will answer soon.
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I am here...working on responding to new posts.
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grandma3X
You have a couple of options, if your plastic surgeon is using Mentor implants. Your tissue expanders have the following dimensions: 10.7 cm width, 9.3 cm height and 6.2 cm projection. If he used the Mentor Memoryshape anatomicals, I would recommend the medium height high-profile style, 345 ccs. The dimensions are: 11.5 cm width, 10.8 cm height and 5.8 cm projection. The other option would be Mentor Memory round implants, and I would recommend 430 ccs in a medium height Ultra high profile style, which has the following dimensions: 10.9 cm width and 5.6 cm projection. I also feel that the high profile style would be good - one of the most commonly utilized styles - at least 375 ccs: 12.0 cm width and 4.8 cm projection. It is all going to depend upon the expansion of both skin flaps… the availability of skin that the plastic surgeon has to adequately provide coverage over the implant. Since you are a long way from the exchange to implants, I would suggest that you come back here after your PMX, after expansion of that TE, and let's see where you are at that time.
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eulabt:
Good to hear from you!
Your plastic surgeon is talking about using the Allergan Inspira implants, which I think would be a very good choice for you. I agree wholeheartedly with his sizing plan and I think you will be happy with your results!0 -
SeattleBound:
I'm sorry that you had to wait so long for answers, however I am so glad Minus-Two and Phyllis jumped in to give you some reassurance. I envision that you probably will need to be approximately the same size as Phyllis is-around 450 ccs to 500 ccs. Please read #2 in the thread header above, as you did not provide all of the information I need to be a bit more accurate with my suggestions. As far as round implants are concerned, I think your PS has made the best choice for you.
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