BREAST IMPLANT SIZING 101
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Whippetmom, thank you very much for your reply.
Yes, I actually am in the European Union.
3 years ago when I had my left breast mastectomy, the tumor was very close to the nipple and skin, so a skin sparing mastectomy was not an option.
I currently have a tissue expander placed where my left breast used to be, which my PS has already overexpanded at 680cc. The TE is the Mentor CPX, medium height, 14.6 x 12.6, 650cc. My PS says that my skin quality is very good and it has been easy for the TE to be overexpanded at 680cc. The pocket right now is tight but not too tight, I can pinch the skin over the tissue expander. The TE is placed under the pectoralis muscle. I wore a full cup C or a small cup D before mastectomy, so I have a lot of skin on my right breast, which is also ptotic.
Yes, my PS has told me that he will be taking various implants in the OR, I am just hoping for a result in size that will match the size I used to be before mastectomy (hoping for a D cup). I am willing to sacrifice my right breast nipple over a large implant. Do you think that if the nipple was not an issue anymore, I would be able to have large implants placed on both breasts? I want to make this clear to my PS: that I don't want the nipple spared if it will result in small implants/breasts. I have my eye on the Mentor anatomicals, medium height, high profile silicon gel implants, 685cc, 14.5 x 13.6. Do you think I could pull them off, taking under consideration the size of the TE and the overexpansion that has been achieved on the left side and the spare amount of skin on the right side?
Thank you once more!
Sissi.
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Sissyangel:
Hmmm....well, that is a personal preference - preserving the nipple. Frankly, I would preserve both or neither, if the ultimate cosmetic result is the priority. Nipples can end up in the wrong place and it can be very much a disappointment, if the placement is "wonky". It means either compromising on implant size or another surgery to try to correct, and that might not be successful. A mound that is a "clean slate" is always easier for tweaking sizes and styles. 3 D tattoos can be amazingly realistic.
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Ilaam
It is VERY common to augment the native breast in the case of a single MX. You should be granted the ability to have symmetry, by federal law (some states have different verbiage) and if "symmetry" means augmenting the native breast, well there you have it. The implant will be under the muscle, which should not make diagnostics a problem. Hopefully there will be better diagnostics in the next 10 years, other than mammography. 😏. Additionally, there is no reason to exchange a silicone implant every 10 years, unless there is a leak or a problem. A MRI, even if every five years, would detect a leak or problem.
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Thank you Whippetmom,
It's very helpful to have all the info necessary prior to the consultation with your PS. Now, I can explain to him exactly what I want.
I will keep you posted on the results of my exchange surgery which will take place at the end of March.
Love to all!!!
Sissi.
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Hi Whippetmom,
First of all, thank you in advance for being so generous with your time and expertise.
I think my PS is excellent but I like to be informed and come at my decisions fully prepared. I had a skin and nipple sparing BMX in late January, will be doing exchange in late April.
My info:
5'3", 118 lbs, 31.5 inches ribcage
I have tissue expanders currently, Allergen MX-13-T. I'm currently expanded to 280ccs in each breast.
Pre-mastectomy, I was a 34 B. Would like to stay the same size or even a bit smaller.
Thank you again,
MPRinOAK.
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Hello again,
I think I may have misunderstood the instructions..oops! My TEs are 500 cc.
Thank you again...
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mprinoak:
You have a number of options.
If Allergan anatomicals, Allergan Style 410-MX - 445 gms
If standard silicone rounds: Allergan Style 20 - 500 ccs.
The newer Allergan Inspira implants would be nice also. The SSF/ SRF (full projection) around 435 gms or the SSX/SRX (extra full projection) around 520gms.
However, I think you should wait and ponder styles, etc until you are filled to 400 ccs, minimally, to see how you feel about the size.
I don't talk in terms of cup size though. Too unpredictable and too many variables between the myriad of bra options out there.
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Thank you whippetmom! It is very comforting to know that breast augmentation in reconstruction is common. I am not in United States, I am rather in France. I hope I will be granted this solution.
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ilaam:
Oh.....well I will be very interested to know if augmenting the native breast is an option for you. Please let me know how this goes for you.
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Hello,
Just wanted to pop in to share some stats. 2 years ago I had a double mastectomy,tissue expanders, then with Mentor implants- the new ones at that time (don't recall the model) that were very very recently approved- latest generation. I do remember clearly that I had the largest size, anatomical ones put in with my goal being to be approximately a full c cup or small d. I am 6'2'', and currently measure 36 inches around the rib cage with a BMI of 24 (180 pounds), which is in the normal weight range for my height. Not skinny, but not chunky either.
This did result in a final bra size of 36C- a very full C. The implants are a little wider than my natural breasts. Projection is very good- no "stripper" look at all. The chest muscles did stretch, so they dropped down a bit compared to being newly inserted- but they seemed to adjust to the same location of my natural breasts instead of being a little higher up post surgery. My right side went perfectly- feels great, looks great when wearing a bra. Left side has required multiple revisions, and still not through that process (scarring/encapsulation). I do have some of that wavy look, and currently on the left side you can see the outline of the implant- I assume it is due to being squeezed/encapsulated at the moment. Right side is just a little wavy looking. Not interested in having fat grafts or anything in an attempt to eliminate the mild wavy thing.
Anyway, just thought I would share because there are not many 6'2'' women out there to help "guesstimate" what size implant to use compared to what the final result turns out to be as far as projection and such.If someone needs the specifc model number used let me know and I will hunt it down. Bless all of you ladies out there going through this and I wish you all a speedy and complication free recovery. HT
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Dear happyteacher,
Thank you for all the information you shared. I think I will be having very similar, if not the same, implants as you (mentor anatomicals, medium height, high projection, 685cc-the largest medium height implant). I, too, want to end up with a full C cup (or even a D cup). My ribcage is 33", so you give me hope that I will succeed in having the breast I dream about, the breast I used to have!
Sissi.
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Whippetmom,
Continuing issues! As you know, my PS had a difficult time getting the TE up under the right pectoralis muscle and there was significant bruising and hematoma. The PS said he "tacked down" the right side to hold the TE. My PS continues to get very defensive if he thinks anything I say or ask about can be interpreted as finding fault when I am only asking for information. Thankfully, my breast surgeon invited me to see him anytime, as he knows the PS is not a good communicator. Last week, I went to see the BS for answers. He did an ultrasound which shows that the hematoma has decreased, but is still unresolved. He also confirmed my suspicion that the right expander does not extend upward on my chest as far as the left. Currently, I have 300cc (my TE is max fill of 300) on the left side (that TE has also shifted some toward the armpit up top, which I understand is somewhat common), and 240cc on the right side (I asked to skip one fill on that side 2 weeks ago due to discomfort). Now, my left side is noticeably fuller further up on my chest than the right, but due to him "tacking" down muscle on the right/hematoma side, that TE sits a bit higher and juts out more abruptly without the slight inflammatory fold appearance of the left TE. It projects about the same, but is more compact and not as full further up. Before he added the last fills, he said both sides looked great and about the same to him (they do not look the same), and that they will never look the same. What should I ask him about, and what should I ask him to do? I am worried that the right pocket will not expand sufficiently and in the right places to accommodate the same size implant as the left, with or without the additional 60ccs to catch up to the left.
Also, as I previously told you, myPS plans to replace my TEs with Natrelle/Allergan/Inspira implants, but wouldn't give me any model numbers. I want the best cosmetic result with symmetry as possible and I am very anxious about what can/should be done now and/or at the time of exchange. Will there be a problem if the "envelope" that develops on the left has different dimensions than the right? Help! Should I seek a second opinion, even going out of state?
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@sissiangel Run it past Whippetmom, but I wonder if this implant would result in a larger cup size for you? You are 3 inches smaller around the ribcage than I am, which I believe would result in a larger cup size? My 36 inches was measured with a tape measure, and did not rely on using the bra size to determine if it is asked by Whippetmom.
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Happyteacher, thank you. I have asked whippetmom's opinion and she has kindly replied. I don't mind a larger cup size, I would actually like it very much as I am rather wide at my hips and I would love the hourglass look. After the surgery, I am planning on loosing the weight I have gained during chemos and tamoxifen pills. I am thinking it will be the first day of the rest of my life!!!
Love, Sissi.
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hi ladies it's been a while since I've posted anything on the site. I do often read posts they have been very helpful for me. I had my exchange surgery two weeks ago and I am a little concerned with the shape. Whippetmom can you please help me I have some questions. I am 5,1 150lbs with A 36 rib cage. Right side was the cancer side and it looks good but My left side is droopy. They exchanged my tissue expander's for
Natrelle inpiras 650cc. Upper pole might need some fat graphting. I don't see my plastic surgeon again until my six week post op visit . Please tell me what is the right questions to ask a plastic surgeon I should have a revision or is it something that can be fixed with fat grafting. Sorry for the typos it's hard to type on cell phone
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Hello everyone, I hope I am in the right place and hopeful that someone here might be able to provide some information that might help me make a decision
I was diagnosed in Feb 2013 at age 43. I had a bilateral mastectomy and had expanders followed by implants. I had 250cc saline implants put in. A week after surgery the right implant drifted sideways and over the last two years I have developed substantial rippling. The middle of my chest looks concave. I decided to visit a plastic surgeon to see if this was normal (a different surgeon than the one who did the surgery). She said they were a disaster...she says that to make them work I need to go bigger and have fat grafting. Then I would have a good result. The issue I have is that I like having a small bust and I cannot imagine how much bigger I will go - she says that I need to go to 350cc implants. I am 5'7" and I measure 31.5 inches around my rib cage. I weigh 130 Ibs. I know it sounds so silly but I have got really upset about this increase in size. I used to be a 34c and found that too big. I don't want to be busty. Is there anyway anyone can advise what sort of size I will be with this increase?
Thank you so much - no where else to turn. Would value your thoughts greatly.
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sister2diagnosed maybe try a different PS one that is willing to make the pocket smaller to accommodate a. Smaller implant. I just had a revision downsized from a 550 cc saline. To. A 440 cc. Silicone although I am not thrilled with the shaped implant I am telling you it is possible to have the pocket made smaller. My pocket on the left was under my arm. Best of luck
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Thank you Jackiegray. I really appreciate you getting back to me. This is the third ps I have seen and all say the same thing:( I guess I just want a sense of how big that (350cc) will look on my frame. Is there any where or any formula that can help work this out? Just to get a sense of what size I would be afterwards?
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SeattleBound: I can send you a list of plastic surgeons in your area, if you do want to seek a second opinion.
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God1st: Remind me again about your tissue expander style/volume
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Sister2diagnosed:
350 ccs sounds better on your frame than 250 ccs! 100 ccs is honestly not going to make that much of a difference in volume. It is a small increase in my book. It is very likely that your prior plastic surgeon created pockets too large for the implants. So I agree with your new PS.
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can someone explain what drop and fluff is? Also does it apply to the mentor memory shape implants. I am 2 days post exchange and they are very oddly shaped. Almost triangular
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I very much appreciate the information here. My PS and I have not yet talked about actual implant size yet. This Friday will reach 450 cc which is the size of my expanders. PS said I could probably go to 600 cc. He says that will really depend on how big I want to be. Basically it sounds like he will stop filling when I say I'm at the size I like. When he mentioned the 600cc I was relieved because that was about the size Whippetmom recommended for implants. The difficult part for me is the my left side looks quite a bit larger than my right side. It's weird because I have more discomfort on the left side but that is the larger side and the side where more skin was spared at the time of my mastectomy. At the time my implants were placed, PS warned me that he was keeping as much skin as possible until the exchange and that it would make it more difficult to tell what size I want to stop filling. My right expander is also further to my side but PS says it is still expanding the appropriate area. I'm trying to find information on how different the implants look vs the expanders. I've read so much and now I can't remember where I read it and can't find the info again. As far as size and projection, are imlants, smaller or larger than the expanders? Is judging size by the look of the expander reliable? I get 60 cc at each fill. Theoretically I could have 3-4 fills left. I notice a difference after each fill but can never envision how much of a change another 60 cc will make? How do we make sense of all this? When Whippetmom recommended 600cc to 800 cc implants I thought that sounded crazy big but now I can see it's really not that much. Ugh - my little head is spinning!
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Jackiegray:
"Drop and fluff" is a term created long ago by the breast augmentation crowd....to reflect how the implants can settle and take on a different appearance and more natural appearance. Doctors do not use this term and I do not use it, because this is not breast augmentation. In breast augmentation, since women are going larger and the breast envelope is smaller, the implants often sit up and ride quite high on the chest wall, and appear very taut and/or flattened in appearance. With augmentation, it takes a while for the native skin and tissue to adjust to the implants and so those galls do experience what they call dropping and sort of filling out or not being so compressed and gaining projection.
Your anatomical implants might take longer to "settle" into the space provided by the TEs....sometimes months. They do not "settle" the way round silicone implants settle. I also believe that rotation can occur pretty early on after the exchange to anatomicals, if the pocket created by the tissue expander is larger than the anatomical, so this is something to watch for over the next month and to perhaps wear a supportive bra to keep the implants in the desired position. If you want to email me photos....thinking perhaps the placement is not right....private message me and let me know.
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Ringelle: There is no hard and fast rule regarding whether implants are smaller than or larger than the tissue expanders. It depends on the volume and style of the TE, the amount of skin envelope you already have, and the volume and style of the implants used at the time of the exchange. If your PS uses 650 cc implants, I think you will be just fine. Maybe 700 ccs. If he used implants with a volume of 450 ccs, you would be a lot smaller than your TEs are currently. Some of this stuff just cannot be explained.
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Hi Whippetmom, I had Mentor cpx 400 expanded to 630cc
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God1st:
I would suggest that you link photos via private message (using the landscape icon next to the goggles icon in the task bar). If that does not work, you can request my email address. I have no idea what is going on with that one implant. The size sounds fine....but you were overfilled quite a bit...just not sure if perhaps that one pocket was overly large for the implant or what is going on.
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Hello Whippetmom! I have been at this reconstruction thing for quite some time and have followed and sincerely appreciated your advice. I was one of the very early folks doing implants and radiation and had a handful of fatgrafting rounds with Khouri then Namnoum in Atlanta - both of whom I consider brilliant. I am about 5 years out from implant surgery, multiple exchanges, with no contracture on the rads side after final fatgrafting. I made the decision to use groin skin for nipple recon and the color is a perfect match, I doubt I will get tattooing. If I can figure out how to post in the forum, I will try to take some pictures. It's been a long journey, but I think the recon part is finally done. Thanks for all you do for us. You are an angel!
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Whippetmom - first and foremost, I too am a whippet mom!!! Love them as much as the grandkids and think the breed is hilarious - silly, sweet dogs with tons of personally
I had a prophylactic DMX Feb 22. I had a breast reduction prior (May 2015) and that was when I was DX with atypical hyperplasia. Genetic testing plus atypical landed me in the 44% risk so I decided to proceed with the DMX. I am currently in the reconstruction phase and things are going well
Hoping to get some insight into final staying. My PS is awesome and very informative, but I forgot to ask her some questions at our last visit and though y'all could help
My main question is about final sizing - I'm 5'6", 175lbs, was a 38D after reduction. My expanders are Nutrelle 133MX-13-T. I'm currently at 400cc and can expand to 500cc or 550cc with a little overage
She explained that they can put in a slightly larger implant from the expansion amount - but by how much? I'm thinking I would prefer 650cc, but can they do that if I am only expanded to 550cc? Based on where I am now, I Idealy would like to be a 38D again, but a 38C is fine as well
This experience has been good - mainly bc I don't have cancer and this is about me taking control. I can't imagine how hard it is for those DX one week and surgery scheduled the next. I am amazed by their strength...
Thanks for any info!
-Christine
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geewhiz:
Of course I remember you! Thank you for returning to update me on how you are doing! I am so very glad to hear that fat graft transfer has resolved your capsular contracture issues. It sounds as though you are almost at the end of a very long - seven year - journey. So glad you hung in there!!
Deborah0
