BREAST IMPLANT SIZING 101
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myToyStory2: Nothing changes. Praying you wake up with two implants! But if not, this is a journey and sometimes there are twists and turns in the road and there is no alternative but to take them and see what lies ahead.
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Hello!
I thought I'd be able to avoid posting here, but after 3 months with my implants I think it's time to consider my options.
I am 5' 11", 135-140 pounds.
Ribcage is 29".
Previous (and current) bra size 34C.
Had 450 cc expanders placed at NSBMX and fully inflated. I don't recall the model. The lift that I was promised at BMX didn't happen out of concern for the nipples, which turned out to be a non-issue.
Exchange was 6/10 with 595 cc Natrelle 410 FF's.
At time of exchange I was immediately underwhelmed. Wide, flat appearance, poor projection, a bit of a divot still present in upper pole and right side seemed heading to armpit. Look like old lady boobs.
After they settled things were better, but after resuming exercise things appear more flattened, right side is lower than left and redundant skin remains near IMF. They still feel WIDE, especially on the right. Mild ripples mildly noticeable when I wear V-neck clothes. I look horrible in crew necks.
Will likely seek an opinion of a new surgeon as I get the feeling my current PS feels this is "good enough" and does not include me enough in my care. Thinking the Inspira extra projection might be better suited. Am open to any opinions at this time and am happy to send photos of any stage.
Thank you in advance.
Carla
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CarlaEM:
Well, the FF style anatomical is just about the worst on my list of shapes for breast reconstruction. The width to height to projection ratio equals FLAT. If you switched to Inspira - a round implant - you would be much happier indeed. Natrelle Inspira SRF: 630 grams (yes, you have plenty of skin for this implant) and perhaps even the higher projection TRX: 695 grams. Do not pay attention to the difference in volume, because I am looking at dimensions. I explain the grams vs ccs question in the thread header. You might be a candidate for the TRX, with your description of having skin overlying the implants. They might have even displaced a bit, by your description. Please get a second opinion though, before going through yet another surgery. Keep me posted!
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Hi Whippetmom,
I am 5'3, 120lbs, ribcage 30", size 32/34 B prior to BMX done on July 28,2016. I did not have immediate recon due to possibly needing chemo and/or rad. I don't need either. I could not emotionally handle anything else at the time. I am now considering if and when I want to reconstruct. I have an appt scheduled with a PS at Penn. I am very active and don't want to lose any of my physical mobility. I don't want implants getting in the way of exercising, being too wide and going into my armpit or looking like I've had augmentation. I really would like to stay small around a B cup and not bigger than that. Im not sure if I should look at gummy bear, anatomical, round, saline,gel or what. I'm so confused and I'm kind of getting used to the flat look. Im wondering if I go below muscle if it will hinde me. If I would go above muscle it might be hard to detect a recurrence.
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Thank you, WM! All good food for thought. I will keep you posted.
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beanybaby you should check out this thread...about over the pec implants. https://community.breastcancer.org/forum/44/topics/835911
I'm about your size, very athletic, and want small breasts again (A+ or B- like I had before, OK going smaller than I was before cancer and my surgeon knows and supports this)...I'm going with gummy bears, med or low projection and over/on top of the pec. My Bilateral mastectomy was over a year ago...but then had chemo and rads so recon was not an option until now. Hooray you don't need chemo or rads!!!
- xo
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- Andraxo that is avery interesting thread. Why are you choosing gummy bear vs round? How do they check for recurrence on chest wall if above pec? Yes I was very happy I didn't need chemo or rads
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I'm not sure why my stats aren't showing up under my post
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1. I am 50 yrs old, tall 5'11" weight 175lbs, ribcage 35 inches
2. Have tissue expanders, style Mentor REF: 354-8214. 550cc size of the TE and has filled to 700cc.
3. Plastic surgeon provided all my options, I could tell his preference: round, smooth, silcone
4. Pre-mastectomy breast size 38/40-D. I did lose 33lbs over the past few months (back to where I was) so perhaps really a large C?
Dr. stated he installed the largest expander, and that I am "big enough." He advised me the implants will be lower and smaller. I want to fill out my clothes, should I ask for any more fills? What size round/smooth silcone do you think is best? I expect to discuss that at our next appointment. Thank you.
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on 8/24/16, i had a bilateral skin sparing mastectomy with immediate reconstruction w TE.
I am 41 years old, 5'5", 150#, 32"ribcage.
My expanders are Mentor Artoura ultra high profile 650cc
SN 6981804-035
My previous bra size was 32DDD and my goal was to be a regular D with silicone implants. My PS said we are shooting for 500cc implants.
I've had two fills so far and currently have 420cc in left and 440cc on right. I'm scheduled for another fill next week but I have been in so much pain I don't think I can bear the pain and discomfort anymore! It feels like my ribs are being crushed into my lungs and my muscles are ripping off my ribcage. I know that sounds dramatic but i'm really struggling.
If I stopped here with 420/440 cc's, what is the maximum size implants can I expect and what cup size would that be equivalent to, approximately?? I really don't want to be smaller than a full C but can't stand these TE! Please help. My PS is out this week. Thank so much in advance
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Welcome, Traismom! We hate that you had to find us, but really happy you did! You'll find our community and this particular thread a very supportive and helpful place full of knowledge and great advice.
If you have any questions or comments for us, do let us know.
Kind wishes,
The Mods
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Traismom - have you tried on one of your old bras? My PS told me to try on a few different bras with my TE. He said it would give me general idea where I was in the expanding process. I had my TE filled to 630cc but at exchange he put in 750cc silicone implants. I haven't tried too many bras but I think I am a 34DD right now
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thanks for the reply, alex276!
I have tried on old bras and I'm not too far off. Cleavage looks good at top but not as much projection. I would be ok if I remained the same size as my current size w TE, but it's my understanding that with the implant it would belook smaller.
I'm glad to hear that you were able to have a larger implant compared to the size of your TE. I thought they needed to overfill the TE beyond the size of the actual implant...
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purple: Well, your PS used the biggest tissue expander he wanted to use. There are larger expanders. Your TEs have the following dimensions: 13.5 cm in width and 7.4 cm in projection. Based on your ribcage, you could certainly handle 14.0 cm in width. I would recommend a smooth round silicone implant also - Mentor ultra full projection, 750 ccs. The dimensions: 13.7 cm width and 6.6 cm projection. I am concerned when a PS tells a patient she is "big enough", when the patient is not in agreement. That is, unless, the patient is unreasonable about what is feasible for her skin integrity and body habitus. But you had fairly large breasts pre-BMX and so I do not think you fall into that category. I would not go through the exchange until you are very confident that you have conveyed this thoroughly to your PS and that you have agreed upon the implant your PS will use. There always are variables and perhaps some anatomical reason why a certain size implant cannot be used, but you are expanded to 700 ccs. It is not unreasonable at all (barring some unusual complication) that you should be a candidate for a 750 cc ultra full projection style implant.
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Traismom: WHERE YOU ARE NOW....420/440 ccs, YOU ARE FINE FOR A 500 CC HIGH PROFILE SMOOTH ROUND SILICONE IMPLANT. I put it in caps to emphasize that this is not going to be a problem. Your TEs are 13.0 cm in width and a whopping 8.2 cm projection, at full fill. So let's say they are in the 7.2 cm projection range now. That is still much more than a 500 cc smooth round silicone Mentor, high profile, which has dimensions as follows: 13.2 cm width and 5.3 cm projection. In addition, I presume you still have ample skin flaps, unless your PS performed a huge skin excision at the time of the mastectomy. I would not go any smaller than 500 ccs though.
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whippetmom: Thank you for your analysis, so empowering!
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whippetmom:
Thank you so much for your insight! One more question for you: do you think 500cc implant would be the max for how much i'm filled so far, or could I go a little larger to 550?
THANK YOU!!
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hi Whippitmom,
Hopefully you can help me get a grasp on all of this. Bare with me and my long winded details. I am a tennis player, walker, paddle boarder, kayaker, athletic but not too...Had my exchange sept. 15, 2016, feeling anxious and unhappy with results so far. I started to get your advice on implant exchange in March 29, 2016. I never followed through with anything because when I went to visit with my ps she was quite forward with anatomicals being her suggestion for best results for someone who has had rads. Also, I expressed that I wanted to look natural but loved the look of the fullness of the TE's , roundish looking that I liked with good projection and upper pole fullness.. Loved them..even with unevenness and no nipple and slight rippling. The PS and nurse practitioner.. Both said I would have more upper pole fullness with anatomicals.. So that's what made me go with their suggestion even though I didn't really understand it.. (Intuition was that rounds would look pretty close to what I looked like with TE's but what do I know about these devices). Weary and still on overload. I had a mastectomy on right side( nipple removal), Sept 8, 2015 for bc with a tissue expander put in at that time. It was a naturelle 133MV-12.. I think 300 expander(does that mean that's it's suggested capacity?). Followed by 28 rads. slight contraction, skin looks really good and was filled up more when I started fills for prophylactic. I then had a prophylactic nipple sparing mastectomy April 5, 2016 with a natarelle 133MV-12 expander as well. From what the secretary told me yesterday, the end fills were: Right(rad side) =370, Left =310. looked pretty evenly filled..( right side was maxed out for fills.. All doc agreed). For my pre mastectomy size, I can only give you a bra size until I go back for follow up from exchange on 9/28/16..not even sure if she even has my pre mastectomy size. I bought 36B padded, consistanly, but usually didn't fill out cup. 34 A was always too tight and made me look narrow with no side breast. (Made me look more hip heavy with 34 A.. 36B more comfortable and balanced my upper body to lower body... Hope that makes sense). Nursed 2 kids 25 yrs ago. No upper pole fullness. Never went for proff. bra sizing. I also measured my day of exchange with TEs, think but not 100% sure.. Going on memory.... Measured 32" under breast and 37 1/2" - 38 1/2", could have been more. I was so anxious I would lose my TE look to a low projection flat look as she prepared me that this will probably be end result and I would not be happy.. No wonder why I didn't want to give up TE's..
AFTER EXCHANGE : 32" under and 36 1/2"
Surgeon used FX-410360 anatomical silicone implants. Also fat grafting for upper pole..
I am so upset because I did not write down and I am not 100 % sure I'm giving you proper measurements with TEs in. I just so wish I had used my intuition and followed through with you prior to exchange to see what your thoughts were. I may be able to find out at the Soma bra store as I was measured and bought bras from them this summer. Maybe they wrote it down and keep records for customers. I was so weary, so tired, not confident in myself and made the decision that I would go with her suggestions since she is a very prominent PS and would be guilt ridden if I did something different than what she said and had some problems, it would be all my fault. Well, I know it's only a week and I still have tape on but I put my reg bra on, no padding, from this summer and I don't look anything like I did with TEs. It's a very natural look. A flatter look and not much upper fullness. I felt that the round TE's actually balanced out my shape.
I am 5 2 1/2" 122 lbs. longer waisted. I have pics prior to mastectomies.. Also pics with TE's and waiting to get tape off next week to take more pics.. I don't want to sound like a crazy woman.. I just felt so confident with the TE's . Even without wearing a bra, clothes looked and felt much better. Finally no padded bras.. Just bralettes and I looked like I had breasts.. Not big but feminine. Round shape upper pole fullness ... Not droopy, flat ones like prior to bc (was always a bit self conscious of them). Maybe my expectations are unrealistic but I would like to send all pics to you next week and have you review them and let me know your thoughts. I feel that your opinion can get me to a good thought process about all of this and what do do from here. Whether you say to hold off for a while or say," I agree with you and what your trying to express and maybe you should consider...... ". I think your experience is so valuable. Really, who do we have all to turn to. Who better than you and this BC forum to find out what other woman's experiences are. I have been flying on a wing and a prayer even though I am diligent with researching. Finding the wind in my sails blows away quickly any given day with "what next" pertaining to a bc diagnosis and treatments. I think I just ran out of gas at this end. Had horrible SE with all chemo and AI,s and can not take the meds suggested as I literally could not function on any of them (AI's) ). My confidence with my body(nippless and rocking TE's gave me hope to continue to temple my body and feed it with love and nourishment. Sounds crazy but it gave me confidence and a look that made me forget what I had just been through this last 18 months. I am just sorry I didn't use my judgement and follow through with you sooner.
I would love any feedback from other bc sisters as well.. Please don't mistake my perception and description that we can not be beautiful woman without breasts or perfect ones. There is no such thing. I am a realist. We were also born and live with breasts (some more endowed than other) and unfortunately it's something we as woman identify to. My femininty is attached to it.. I'm not saying I could not adjust to or without them but I don't want to if I don't have to.. I so hope I expressed myself correctly as I would not want to speak for anyone else or diminish any one else's feelings. I am the type of person that if everyone else is happy I'm happy!!.. Feeling grateful ! Just weary!
Remi50
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Remi - Whippetmom will be along, but just wanted to let you know we hear you. Looks like your exchange was only last week. This is the time to step away from the mirror. Hard to do, but it will probably be at least a month & maybe longer before all the swelling & other issues from your surgery resolve. Yes, you can have a revision if it comes to that, but most docs require at least 6 months before new surgery. It looks like you have provided the info Whippetmom will need when she gets back to her computer, so hang in there.
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Hi Remi,
You made some points that certainly align with my thoughts on reconstruction . I'm going to slow this process down until I get as much information as I can possibly get. Even though it's hard to get dressed with these hideous bumps on my chest it's getting to be that time of year when it will be easier to hide... as in ... bulkier warmer clothes. I will be leaving for Montreal on Tuesday for a consult with a very experienced reconstructive surgeon so next week hopefully I will have had proper measurements done and a written consult to refer to. My feeling is that I will probably have to have 2 more surgeries since the first one was all under the muscle so it is impossible to do a simple exchange. I feel like I shouldn't care so much but I do.
Yaniza
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Hi Whippetmom , notwithstanding the time and the pain and inconvenience of an extra surgery I can't help thinking it would be better to start this process with a proper dual plane surgery and the right size tissue expanders ... and then do an exchange. Does this sound sensible to you?
Right now the plan , of my current ps, seems to be to get me into surgery as quickly as possible and do an exchange and make the permanent implant decision while I'm unconscious. I haven't outright contradicted him but that isn't going to happen.
Thanks,
Yaniza
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traisman: Yes, I think you could very likely go to 550 ccs.
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Yaniza....answering you first....shorter answer!
I honestly do not know how you would go from a complete submuscular to a dual plane, but your Montreal doc will know if it can be done. I know it is quite technical and in my sister's case, with her complete unders at seven years out, the new PS did not want to convert to a dual plane. She got a much better result the second time, and honestly, I think she is happy with the results. I was sort of disappointed, but it seems it would have been more extensive surgery and she/we are in our 60s and sort of over it as far as extensive revisions are concerned. At least until I bottom out or something....! So what you have in your favor is that you are just newly out of reconstruction and so it might be an easier fix. You have desire on your side and my sister just wanted more symmetry and volume and correction of bottoming out bilaterally. Yes, amazing that complete unders can bottom out! So have that consult in Montreal and let me know what you find out!0 -
Okay Remi....I am working on your question. I need to get some dimensions and will post shortly
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Remi50:
Okay....snap out of it! LOL! We have ALL been where you are now! I did not want to give up my tissue expanders either. Cried the night before the exchange. It is okay for you to feel this level of "sadness", and it is some weird conundrum that many of us experienced after the exchange. It was a "let down" in some aspects. Do not despair, because it can all be resolved. As Minus Two stated, you do need to give it time, to observe any changes that might occur over the six weeks. It takes longer with anatomicals. The most distinctive difference between the tissue expanders and anatomicals, is the height of the anatomicals. So the width to height to projection ratio of a full height anatomical, often makes it appear flatter. I am not a fan of the full height TE, but yours IS a FX, which means you have a little more projection - more than your TEs, actually. Your TEs: 12.0 cm width, 11.0 cm height and 5.2 cm projection. Your anatomicals: 12.0 cm width, 12.5 cm height and 5.7 cm projection. If someone loves the round shape of their TEs, and they have a moderate height TE, I think this would have better translated to a MX, rather than a FX, but that is my unprofessional opinion.
Here is what you can think about over the next six weeks. If you are still unhappy, switch out to rounds. Options would be Allergan Style 20, 450 ccs (yes, that size will work) or Natrelle Inspira, style SRF or even th extra full SRX. I need to somehow get the US Inspira implant information. I have been using the Canadian/European version and it does not translate. I just cannot get the PDF from my pad. You would be looking at implants with a width of 12.5 cm width and 5.3 cm to 5.7 cm in projection.
ADDENDUM:
I was finally able to find a conduit to download the US Inspira catalogue. Fairly significant size differences. So, with Inspira: SRX - 445 gms or SRF 450 gms. I
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Hi Whippmom. thanks for the info. I guess I might be just tired but I am super depressed at the idea that there might not be any way out of this mess that was decided upon when I was unconscious.
Yaniza.
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Yaniza: Don't worry or feel depressed, because you do not know yet what can be done. The WORST that can happen is that you get new implants but they are still complete unders. The key is the skill of the plastic surgeon. My sister's second set of implants look much better than the first set, and they are still complete unders. I may be totally in the dark about what it will take to convert to a dual plane, and it might be a simple fix. It might mean tissue expanders again, but I know you are willing and ready to do that to get the results you want. Do not speculate about what we do not know. Wait until you meet with the new PS. Then he will give you something to speculate about!
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Whippetmom, of course you're right and with your help I have allowed logic to prevail. I too don't expect perfection at the end of the day just an improvement. It's gratifying to know that your sister's situation improved even with all unders.
Gratefully , Yaniza
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WOW.... YOU ARE A GIFT☀️☀️☀️ I wish that I could have settled my mind down right after the April 5, 2016 prophalctic and converse with you. BIG MISTAKE.. I may have had to agonize about making another decision but at least I could have had time to process what you and a lot of incredible woman offer with compassion, experience and technical expertise on this thread. I was immediately faced with the fact that hemo onco wanted me back on a AI 6 weeks before this surgery.. I was consulting with my breast surgeon because I was left so sick from the initial anazatrole. They were very against me starting another AI so close to surgery so I was concentrating on building my physical strength and agonizing over oophectomy decision. (Still haven't made it yet). So that was something I had to deal with immediately out of the gate from prophalctic mastectomy.. Followed by letting everyone step in and coordinate my only daughter's wedding shower... wedding July 30. (was postponed from last July due to my bc diagnosis). TOTAL OVERLOAD. Upon my breast surgeon's request(she's awesome and an angel), I was also in discussion with a gyn onco about oophectomy because of horrible SE from AI 's and inability to tolerate them. Next two AI's turned out to be as debilitating. Tomoxafin no go because I had a stroke 6 weeks before finding out I had breast cancer.. I was 49 at the time, healthy so I thought, played tennis, run/ walk, kayak , etc (work full time) and no residual effects. I had to step back and take a deep breath and a leap of faith. So I made another consult with ps and discussed at length with her 2 nurse pracs. They basically said it was out of my hands. That it would be a mute factor due the fact of seeing what things were like once inside. I was relieved not to have to make another decision as I still have many more to make. I also felt that they said I would have more upper pole fullness with anatomical so I kind of thought maybe this will work out the way I want it. Is that a true statement about anatomicals giving a fuller upper pole than rounds? Then the The million dollar question, " am I totally overthinking this?". At what point do you step back and have faith and be grateful to have reconstruction even if it's not perfect. For some reason I can't let it go and embrace what I have. We may have no idea how things will turn out and many of us woman catastrophize the worst. (Speaking for myself but I'm sure many of you can relate). I don't mean to go on and on.. we all have a story and one worth hearing!!! I am enamored with your knowledge and wisdom you have to offer all of us. Thank you so much for responding to me and I will send pics to you within the next few weeks..Feeling Grateful for all of you!! Maybe things will turn out ok.. Taking one day at a time and realizing it's OK to want more!! Time however can maybe help with accepting all of this! I have to practice being patient and stop and smell the roses!! I learn something worthwhile and positive everyday on these threads!! I will strive to give back as much as get here!
Remi50
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Me too RemI. I wish I had joined this forum before my surgery but everything was happening so fast that my brain was on overload. And we still have to deal with the day to day.
Whippitmom, on a different but related topic... what is bottoming out?
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