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BREAST IMPLANT SIZING 101

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Comments

  • whippetmom
    whippetmom Member Posts: 6,028

    Kwilcockson...

    Please scroll to the top of this thread and read the header - specifically #2. Allergan 410s are anatomical implants, not tissue expanders.
  • SanFranKitty
    SanFranKitty Member Posts: 81

    I just had my implants exchanged for my tissue expanders on Tuesday. I'm 5'6 and 117 lbs and we went with natrelle saline 68hp, which is a round high profile. One at 360 and one at 370 The measurement under my rib cage is only 29 so I don't think they would have been able to get much volume in otherwise. There maybe someone here with a similar build so as soon as the swelling goes down I will let you know what I think about them.

    p.s. Some fat was added from my belly and looks like the above hip area judging my my bruises.

  • kwilcockson
    kwilcockson Member Posts: 6

    sorry. 133fv-11. I looked at the wrong page

  • grandma3X
    grandma3X Member Posts: 297
    SanFranKitty- I'm 5'7" 120 lbs with a 29.5" rib cage. My TEs are 275cc Mentor but we only filled to 260. The PS was worried about my skin. I would be interested in hearing more about your implants and how you feel about the size. I was a small B before surgery and hoping for something a bit fuller after my exchange at the end of Oct.
  • herstrong
    herstrong Member Posts: 53

    Whippetmom, thanks for your thoughts! So let me get this straight - my expanders hold 350, they're overfilled to 400, and you're suggesting implants in the 450 - 475 range? From your post above to kwilcockson, it sounds like you don't have to expand all the way up to the insert size. I'm feeling like I don't need to go larger, but if that's what I need to do to achieve my desired outcome, I'm all for it. It would be nice to get access to the picture forum, but apparently I was denied. It's hard to make decisions when you don't really know what you're going to look like after surgery. I'm hoping to have some cleavage in the end. But for now when I'm in the expanders, I do feel like they're tall a sort of mountain-shaped. So maybe I wouldn't feel as big with an insert where the shape is more smooth and round. I'll discuss this with my PS Monday and follow up with you.

    Thanks,

    Julie

  • Wildtulip
    Wildtulip Member Posts: 470

    herstrong,

    Not to replace whippetmom, but rather to help, from what I have read here a 400 cc expander and a 400 cc implant will not look the same. An expander has a hard back and implant does not. So to achieve the same look, an implant needs to have more volume. Also, if you sent a pm to someone about the picture forum, it can take some time for them to get back to you. They need to make sure you are legit to protect the privacy of those in the forum, so give it time.

  • SanFranKitty
    SanFranKitty Member Posts: 81

    Hi Grandma3x! We are really close in size. I was a large A, sometimes small B. With tissue the expanders I expanded to a good C size. That is what is cool about the expansion process, you can experiment a little with size. I liked the projection I got with the expanders. I will let you know for sure when the swelling goes down. Glad I added some fat. Right now I look six months pregnant even with a binder! Also my chest is pretty swollen. I'm going to have to get creative with clothing so that I can leave the house.

  • herstrong
    herstrong Member Posts: 53

    Wildtulip, I requested access more than two weeks ago. Someone posted that they just received access but I have not been approved. So we will see.


  • kwilcockson
    kwilcockson Member Posts: 6

    how do you request access to the photo forum??

  • Wildtulip
    Wildtulip Member Posts: 470

    kwilcockson, Go to the reconstruction forum and look for the topic, "Before requesting access for the picture forum" and read the info at the beginning of the topic. It gives instructions on who to send a message to, etc.


  • AZ85048
    AZ85048 Member Posts: 1,467

    Ladies: Below is the link explaining access to The Picture Forum. Please keep in mind that it is NOT part of BCO and just two women run the whole operation voluntarily. Please be patient as it takes some time to vet each member who requests access. Fumi and Lilah do the very best they can to keep it a safe haven for those of us with pictures and personal stories up there. I'm sure you can understand that they have to be very careful allowing admission. After all, this is the internet... .

    https://community.breastcancer.org/forum/44/topics...

    As an example for you, I had TEs with the capacity of 450ccs. I now have two Mentor high profile silicone round implants, one is 650ccs and the other is 550ccs.(size difference because I have an uneven chest wall) - and they look the same. So in reality I went 200ccs past the volume of my TEs on one side; and believe me, they are in no way large in appearance. Hope that helps!

    (Hi, Deborah! Here's a puppy for you to drool over...) Heart

    image

  • kwilcockson
    kwilcockson Member Posts: 6

    Thanks AZ, that does answer my question about the expanders.

  • JessieJake
    JessieJake Member Posts: 170

    Hi again Whippetmom,

    I posted way back in April but things changed slightly since then. I'm scheduled for exchange on 9/7. Getting nervous!

    Originally you suggested possibly "high profile style anatomical, such as a MF style 255 gms or possibly....might be stretching it...a. MX style 255 gms."

    At that time I had only 140cc in my TEs but I ended up with 200cc in each. At my pre-op today we did indeed decide on the anatomical. I think I was a little tired as I didn't get the specific name or model. She did say it was high profile. When I asked how big she was thinking for the implant she said possibly 250cc-300cc. I told her assistant after my PS left that I really hope she'll use 300. I don't want to lose size (but I sure want a better look than what I have with these TEs now!). My PS did say something about going bigger than my TEs to make up for port, etc.. on the TEs.

    I am 5'7 1/2", 111 lbs, ribcage is 28" under bra line. My TEs are Allergan model 13mx-11-T, 300cc capacity filled to 200cc. over the muscle

    Thoughts on that? I think I'm going to follow up to make sure my preference is clear.

    Thanks!

  • Journey2014
    Journey2014 Member Posts: 65

    Hello,

    I have pre op appointment for September 26, 2016 for latissimus dorsi surgery for both sides. Can I ask my PS questions on TE details/information already? Or do I wait until my pre op exchange of TE to implants?

  • minustwo
    minustwo Member Posts: 13,354

    Journey - if you'll scroll up and read all the headers, you can post your information now. IMHO, it's good to have some idea ahead of time what you're getting into.

  • Journey2014
    Journey2014 Member Posts: 65

    Thank you MinusTwo for your advice


    Hello Whippetmom, here are my information.

    Pre-mastectomy: I wore 34 inches, cup A

    Height: 5' 0"

    Weight: 140 lbs.

    Rib cage circumference: 35 inches

    My PS uses offers mentor memory silicone gel and shaped textured memory shape for breast implants.

    Please advise. Thank you.




  • whippetmom
    whippetmom Member Posts: 6,028

    Sorry for the delay in getting back to all of these new inquiries. I will begin answering this evening.

  • whippetmom
    whippetmom Member Posts: 6,028

    ThumbsUpThat is one itty bitty whippet pup, AZ.....

  • whippetmom
    whippetmom Member Posts: 6,028

    JessieJake:

    The actual corresponding Allergan 410 anatomical would be a MX-290 gms or 320 gms. But I gave sizing suggestionsfor the MF style, because I was not sure if you would get enough projection since you were underfilling. So IF your PS can use the MX style, that would be great. Anatomical with a width of 11.5 to 12.5....so there is a range and your PS might take in two or three sizes to try out in the OR.

  • whippetmom
    whippetmom Member Posts: 6,028

    Journey: It depends on how much volume is created by your lat flaps. You might only need implants in the 250to 350 cc range. It also depends on how tight your skin envelope is and the size of tissue expander your PS is able to utilize. Sorry I am unable to give you more information at this time. Your PS might not even know this yet....and it is because of your small breast size that I am wavering.

    Are you having lat flaps to gain volume or is it because you are having radiation? If it is the latter, then this factors greatly in the ability to determine final size.

  • whippetmom
    whippetmom Member Posts: 6,028

    Journey: I would like to also note that your original question was whether you could ask your PS about tissue expanders and implants at this early juncture, and I would say absolutely. Let your PS know you care very much about the ultimate results and share what you hope to achieve with reconstruction.
  • Journey2014
    Journey2014 Member Posts: 65

    whippetmom - thank you for your advice, I am having a lat flap due to radiated skin on my left cancer side. This is my second attempt of tissue expander reconstruction, my first was on January 2016 but the irradiated left cancer side split opened and I had cellulitis on my right, that they end up taking them out.

    I was expanded up to 330 cc but the skin did not fuse together and split opened.

  • whippetmom
    whippetmom Member Posts: 6,028

    Journey: Having previously had radiation plays a huge role in the choice of tissue expander. I am glad I asked. It will depend on how the flap takes and how that changes the integrity of the skin envelope. I would definitely discuss fat graft transfer at some point. It is not anything new.....has been well known for years that stem-cell rich fat can improve the integrity and texture of previously irradiated skin. You can google this and find information over the Internet.

    http://www.plasticsurgery.org/news/2012/technique-...

    http://www.plasticsurgery.org/news/plastic-surgery...

    Major cancer centers like Johns Hopkins use fat graft transfer for breast reconstruction. So please discuss this option with your PS

  • reckless
    reckless Member Posts: 50

    Hi whippetmom,

    I actually already had my EX, but do not feel comfortable, the implants seem too big (size and appearance OK, but too close to my armpits, especially the left one). PSordered implants in a number of sizes, but selected the largest ones during the surgery. Can you please advise if a different implant would be better in case I decide to do a revision? The details are below. Many thanks!

    Height 4'11"

    Weight 116 lbs

    Rib circumference 30"

    Base diameter 13 cm (measured by PS; although she put in 13-13.5 on the implant order form)

    TE: Mentor Artoura High Profile 500 cc, filled to 530 cc

    Implants: Mentor Memory Gel Smooth round ultra high 650 cc silicone

    Bra size pre-mastectomy: 36 DD

    Current bra size: 34 D or 36 C

  • Yaniza
    Yaniza Member Posts: 83

    To grandma3X , I am 5'7' and about the same weight. I have tissue expanders in now. I am curious to know how much your expanders were filled. I am at 200 CC each now.

  • grandma3X
    grandma3X Member Posts: 297

    Yaniza - I'm filled to 260 ccs. My expanders are 275 but the PS said I'm done.

  • whippetmom
    whippetmom Member Posts: 6,028
    Reckless:

    You will need to talk to your PS about narrowing the pockets and bringing the implants more medially. It is possible that the pockets are larger than the implants, and if so, the implants always will migrate laterally. In any case, you will need what is called a lateral capsulorrhaphy, and this would be performed bilaterally. It is a securing of the skin envelope laterally, and if necessary, opening up the medial area just slightly - never ever too much or you will end up with symmastia, which is very difficult to correct. But honestly, for your frame, you need to keep the implants fairly narrow. So it is a pocket revision essentially, utilizing the same implants. I would honestly get another opinion before going for a revision. Just to get a differing viewpoint on correction. Also, you need to be wearing a bra with good lateral support and this will help keep the implants from migrating into the armpits. Hope you are wearing a bra - with the weight of your implants and pre-MX breast size.
  • reckless
    reckless Member Posts: 50

    Thank you, whippet mom. Yes, I am wearing the post mastectomy bra the hospital gave me 24/7. Also wear a wireless sports bra from VS sometimes, which seems to give better support. They did enlarge my breast pocket on the left, according to the surgery report. I'll speak to the PS and will get the 2nd opinion, but how soon the revision needs to be done? Tired of the surgeries, TBH.

  • Journey2014
    Journey2014 Member Posts: 65

    whippetmom - thank you for your advice. Do I ask for fat grafting before the lat dorsi surgery or while the PS is doing the tissue expansion?

  • Kristen3_0
    Kristen3_0 Member Posts: 4

    Hello again, Whippet Mom! I thought I was all set in my decisions and now that my surgery date is only three weeks away I'm having doubts. Can you please answer a couple more questions for me? I would really appreciate it.

    My expanders were filled to 475cc. They feel very large and sit up really high, which I know is common. It makes me look much heavier than I actually am and bothers me. Is this something that will still be an issue if I go with the 475 HP round implants? My chest space isn't very big and I'm not looking for the upper pole to be this voluminous.

    I met with my PS on Tuesday and told him I was worried about the size so he ordered 375, 400 and 425 Mentor HP Gel and 455 Ultra High Profile to try in my surgery. Since I expanded to 475, do you think it will still look good if I go with a smaller implant? Ultimately what is the difference between high profile and ultra high profile?

    Does a PS typically replace the expanders with the same size implant (475 to 475)?

    Will the sizes he's considering still make me look like a c cup in clothes? I've tried getting access to the photos on this site but can't seem to figure out how to do it. Does a good push up bra for special occasions have the same effect as it did with natural breast tissue?

    It's been very hard for me to understand how things will look in the end. Thank you so much for your help.

    Kristen