BREAST IMPLANT SIZING 101
Comments
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wench - the photo site is not part of BCO, it is a private site separately run by members. You have to request permission and you will be given access info - not sure who is currently running that aspect - used to be Lilah - you might send her a PM, and the site is maintained by nowheregirl.
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Wench, If you go to the main Reconstruction Forum, you'll see a topic listed called, "Before requesting access to the picture forum." There are instructions there on who to send a PM to (hopefully current). I have read it can take a while to be allowed access. I sent a PM a month or so ago, and have not had a response, but I know it's part of the process to protect the members who post pictures.
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Thank you SK and Wildtulip for the information, it's greatly appreciated :-)
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So the PS started talking size finally, I'm at 700 from my last fill on Tuesday, still at that awkward "just fulled" feeling stage that for me lasts 3-4 days.
He wants to fill to 850, with a desired swap for an 800 round.
That seems awfully big, plus always a little concerned with opting for the max size produced (...think it is more likely to fail??? when I get old and grey and start shrinking everywhere else will I have one stripper boob!)
So the first question...I hear lots of talk of 700 and less talk of 800, but is there a 750? silicone that is. I have been on the Mentor and Allergen web sites but can't seem to see full size charts for rounds, although anatomicals show lots of size charts.
At this fill size 700, I am happy with the volume...so is that an implicit vote for the 800 since the implant doesn't have the hard back of the TE? That an 800 implant will have the approx projection of the 700 TE?
I'm 5'8", 200lbs, and was a 40D. I was my birthday last Friday, now 55.
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Hello Whippetmom,
I finally have a discussion about size with my plastic surgeon and I'm not that happy. I currently have Natrelle 133MX-11-T 300cc tissue expanders, my rib cage diameter is 28", I'm 5'2 and 105 lb. It looks like my doctor doesn't want to fill the expanders past 300cc, saying my skin seems thin and that he doesn't want to risk the scars opening up. He also said this is not breast augmentation, and that they don't try to go much bigger than our original size. He then looked up my file and saw that my original size was one hundred eighty something cc, he said I'm going from a size A to size C, and said "for someone to get that kind of size jump is unheard of". Anyways, I'm currently filled to 250cc and with clothes on, it looks like a big A cup or small B cup to me. I really want something that looks like a full C cup . He said I will be getting the Natrelle 410 implants. What implant size do you recommend and any comments would be appreciated, thanks.
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trmtab: it has been too long since you posted and I have no recall of your MX details. Are you a single MX? If so, the implant goal is SYMMETRY, not volume. An 800 cc implant is not too much for your frame,
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Layle:Sorry....but that is crazy. MY operative report said, "bilateral mastectomy with tissue expansion/augmentation". My implants are larger than my native breasts. I went from a "C" cup to a "DD" cup. MANY and I repeat MANY women on these forums were "augmented" after mastectomy. IT IS HEARD OF! That said, your native breasts were small and you likely are pretty taut in your TEs. So there are limitations due to chest wall anatomy. Don't push the envelope - literally. You want a successful outcome with good skin closure over the implant.But regarding your fill level: There is no reason to expand beyond 300 ccs. Overfilling is NOT mandatory. My TEs were not overfilled. So the implant, if anatomicals are the implant of choice, would be: Allergan 410-MX - 255 or 290 gms. Preferably 290 gms. The anatomicals need to be snug in the pocket. Print this out and discuss with your PS. This is the anatomical implant which corresponds best with your tissue expander size and style. By the way, the TEs are a great style, and the volume is perfectly fine for your frame.
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Sorry, yes, I am a single MX...from a previous post:
"My specs: 54 y.o., 5'8", 200 lbs, ribcage 40. TE: AlloX2-FH15E, Low Pole Plus-Full Height Profile, 600-720cc; 15 x 13.8 x 6.4 cm"
From this you suggested 700 round but an eye to symmetry might change that. I had 1100 removed a surgery, so I will need to do something on R at some point.
I guess I was hoping for anatomicals given my natural side shape/droop...certainly not high and round...and until Tuesday I wasn't thinking any larger than 700 given your suggestion and the size of my TE (max 720)...Tuesday was the first I heard of plans to overfill and go to 800...which pushes me out of the option of anatomicals size wise I believe.
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layle, I had a UMX in mid June with 250cc tissue expander placement. I am small 4"11 27" rib cage. My pre mastectomy bra size was 34b but it was always padded so my true size was definitely closer to an A cup. My PS was worried about thin skin at start of the expansion process but we have just moved along gradually. I am currently filled to 250cc and the exchange surgery is scheduled for Sept. 29th. I will also have a small breast augmentation and lift on the native breast. According to my PS this is the best way to have a balanced result and he believes this will achieve a b/c cup without issue. He was pleased that I was willing to consider the changes to the native breast. (at first I had requested the most minimal amount of reconstruction possible).
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Trmtab:
No to anatomicals. It is a misnomer that you are going to get a "natural" breast shape, simply because of the anatomical feature. You do need rounds. I need you to send me a photo via private message so that I can see what your TE looks like compared to your native breast.
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Thanks Whippetmom for your input. I really like the 410mx 370cc because I would like a larger width to fill up more of the gap in between my breasts, I prefer as little gap as possible, right now it seems like there's about 4 cm gap. Also I feel that heigth wise, it can extend downward a little more too. Do you think it will work on me? I don't even know if PS would even agree to give me that size since I will only get 300cc fill.
I've also read about some women saying the anatomical will look smaller than the expander, even if the anatomical implant has more cc. Have you seen that happeneing?
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Lunderwood: Thanks for sharing, good luck on your upcoming surgery. Did your surgeon also recommended anatomical for you?
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Hi all. Whippetmom I would love to have your opinion on implant style and size when you have time. I would also be grateful to hear from anyone else that would like to share their experience.
I am about 5'1", 125 lb (although I'm trying to loose at least 5 more lbs before exchange surgery). My rib cage measures 33". Pre-dx I was wearing a 36B bra.
I had a BMX 3/2015, chemo, radiation, then LD flap (rt) with TE's (both) 6/2016. I have not finished expansion and do not have exchange surgery scheduled. My PS and I have briefly talked about going to implants in the 400-500cc range.
I currently have Mentor textured saline expanders #354-9212 and I believe they are 350cc volume. My PS only uses Mentor and gave me a brochure about Mentor Memory Gel implants.
Initially the natural shape of anatomicals appealed to me, but I read what you said earlier about it being a misnomer. I also recall reading that they can turn in the pockets. Is there an instance when anatomical are recommended, or is it personal preference? Do round implants settle and create a natural shape, or is it a surgical thing, or potentially not achievable?
I hope I included necessary info for you to provide input. I really appreciate your time!!
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I am 37 years old and 5'5. I currently weigh 240#. Although losing weight. My ribcage circumference is at 38 inches a skin sparing mastectomy on April 20. The plastic surgeon reccomended I do saline implants but everyone I have talked to said to not go with saline and go with silicone. I am leaning more towards going with silicone because I want them to feel more natural. Any advice is appreciated.
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Whippetmom - I'm sorry it's taken me so long to respond. I was trying too often to read the forums on my phone, and between me just being so worked up over radiation, reconstruction, trying to get the hospital to work with with me, I was missing posts, and not seeing posts directed to me. I decided to wait till I could just be on the computer, be calm, and then jump back in. My appointments with the PS and RO are Thursday, so I'm going back through and getting my outline of questions together.
The scars I was referring to are the football shaped ones (that's the only way I can describe it) from some of the lat flap surgeries. I could be wrong on what surgeries those are used on. I just reread my post, I was completely rambling. I was referring to scars from having TEs put in, then lat flap done. This is just based on my imagination, not real data.
I don't want to change the size based on weight loss unless I lost a LOT of weight. I don't want my weight to fluctuate again, but I hadn't gotten this heavy in 15 years. I hope to be in more of my "normal" range, or lower, goal weight would be great by surgery. I had asked the PS about losing weight and if that would change any of our conversation or decisions and she said no. I'm not sure if that's because she was thinking, "Sure, I'll see it when I believe it," or what. (lol) I wear the same bra size at both weights.
I just remeasured to see if my measurement had changed. Nope. Still 36." 5'7" (according to the hospital) and now 168ish. 700 still sounds too big? It's been so long since I even held 650s in my hand that I can't remember, almost a year now.
I'm going to ask about the order you recommended. I don't think there's a rush about rads, I had to call to say - hey, aren't I supposed to be starting this and shouldn't I be meeting with someone - not that that means anything. I do believe that the hospital in general waits 6 months to a year after radiation to do anything.
My only concern about getting a second opinion is essentially, where would I go that would be better in Houston than where I am now? There are a list of other great hospitals on the same street, I'm just already at the cancer center. When I left where I was, I knew immediately where to go for treatment.
Thank you for listening and your previous responses. I just reread through a lot of this thread, reread the articles you recommended, as well as the FGT thread and articles. I feel more comfortable that I have a good list of questions like I did for the last meeting because of your help.
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layle: It might look smaller and then again, it might not. We are all built so differently. My chest wall has distinct characteristics as does yours. So there are many factors that come into play. It should be within the realm of possibility that your PS could use that size anatomical, but that is all up to him and to you - pressing him to commit just how large he can go and what volume/styles he plans to order to try out in the OR
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Wildtulip:
I think that a Mentor high profile smooth round Memory Gel would be a good choice - 450 ccs to 500 ccs. If an anatomical, 440 ccs in a moderate height high profile MemoryShape. Your TEs would enable your PS to also use an ultra full projection style implant, but I feel it would need to be at least 12.0 cm in width, which takes you a little above 500 ccs in that style. It is up to you and your PS to discuss these options.0 -
love2reign: Silicone.
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Frill: Yes, you do have the "football" shaped scars quite often with a flap procedure. Everything fades in time though, just remember. I thought you were referring to scars from fat grafting. I think you would still be fine in the 700 cc range, but that is up to you and your PS.0
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Thank you, whippetmom. I really appreciate your input!!
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Whippetmom please advise- I am so bummed- I've been expanding all summer and got to 300 and my skin and alloderm pocket just won't go any more. The last 3 weeks it has been too tight to put any more saline and in fact they offered to take some out I'm in such pain. I said no. I was going for at least 400 implant based on your recommendation in June, and I will be getting only 300. My breast width is 10 and I'm 5'2. My ps is very skilled with fat grafting and he will do this at the exchange to add 50 cc. to each side; Then he can do it again later to add more. I am concerned I'll be a lot flatter than I wanted but I guess my body is just not meant to be larger. They took out 200g which was a b. At the mast. What do you think I'll be with 350? I'll ask before surgery if I can go any larger but I think pocket and skin will be too tight. Anything else to ask about or advice
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Ann: Sometimes it's just "is what it is" with breast reconstruction. You might get a 300 cc or 350 cc implant now, but fat graft transfer will help considerably - especially if done twice - and a year or two from now, when the skin has stretched and relaxed, you would likely be a candidate for implants in the 400 cc range
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Thank you Beth! I hope you had a nice day at the beach and that you are feeling back to normal soon
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you have to keep adding fat on a yearly basis
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Layle, did you come to a compromise with your doctor? I also have a small rib circumference at 29 inches. I was about a large a before my mastectomy. PLus I'm a mom so they weren't quite what they used to be. I just filled till the size felt right. I went for a bra fitting and I am a small c according to my measurements. WHile we may not get exactly what we want, it is nice to at least get close
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Hi all! I'm so excited that 4 years BMX, I am finally in the reconstruction phase. Due to the massiveness and aggressiveness of my cancer, my PS strongly advised that I wait at least two or three years before starting the recon proces, especially after radiation on the right side. Then it was too expensive. Anyway, here I am going through the process. Boy, did I ever recently just realize how much I missed having boobs until this surgery and process! I had tissue expanders installed July 19th and my last fill today, totaling 400ccs. Here're the detes:
- Inserts - Allergan 133FX 350ml. Width: 11 cm. Height: 11.5 cm. Projection: 5.9 cm.
- Measurements - Height: 5'7". Weight: 150 lbs. Rib cage: 32"
- Brand: PS uses Allegan implants
- Bra size: Previously 36C.
I thought I was at about the right size at 350ml. But I thought no matter the outcome, I'm going to be upset about part of how it turns out (the "feel", appearing fake, wrong size, being too old for younger-looking boobs, etc.) Anyways, I thought if I'd be unhappy about size, I'd rather have the girls be a little too big rather than a little too small. I just have a hard time picturing what they're gonna look like when they're done. I would rather have some fatty, natural-looking boobs with clevage than two bowls that resemble owl eyes. BTW, I'm 52 years old and in a "it's complicated" relationship.
I have an appointment Monday with my PS to discuss phase two. I may choose to "deflate" 20-30 ccs, so we'll see. At this point, I'm wondering if the "tear drop" shape may best meet my desired outcome of CLEVAGE. Thoughts?
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It is a misnomer that you will get a better shape with teardrop implants. I do not like the full height anatomical that corresponds with your TEs. It tends to look tall and flat in the pocket. It is the height to projection ratio factor.
I think at least 450/475 ccs in a height profile smooth round implant would be good. Style 20 in the standard rounds. The Inspira (Allergan) are also good for you - 465 grams preferably
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Hi whippetmom...I want to start by thanking you for all the help you are giving everyone on this subject, it's so confusing! My question...my TEs are 300ccs, my ribcage measurement is 31", 125lbs. 5'4". I am aiming for a large b, small c. About the same as before. I feel like the TEs are kinda smaller than I thought, but it's hard to tell since they are wide and oddly shaped. Are implants usually the same size as TEs? I just don't want to downsize after all this hassle. Also, what size implant would you recommend?
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kwilcockson: Without knowing your style or mfr of tissue expander, I cannot comment fully on what implant would be best. But I think you want to be in the 425/450 cc range with implants, if smooth silicone rounds. It is very common, with your TE volume, to exchange out to implants at least 100 ccs greater than your TEs. This is because we look at the dimensions of the TEs as compared to implants, and it most often, with silicone rounds, requires larger implants to match the dimensions of the pocket created by the tissue expanders. I do not know about anatomicals for you, because it all depends on the style and mfr of your TEs. Your PS might prefer Mentor over Allergan. So once you obtain this information, we can revisit this and revise the suggestions accordingly.
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whoops..they Are allergen 410. 300cc
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