BREAST IMPLANT SIZING 101
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Whippetmom, you are so good to us!
NSM 8/22/16 Allergan 133MX 13-T (500) expanders currently filled to 600. Skin tight over TEs but a little extra above IMF incision.PS offered another 100, yikes.
I am 5'2" 130#. 31" ribs 34 C previous Breast tissue removed 520 and 560
PS suggests Inspira.
I am happy with size but one NAC is out of position. I would appreciate your comments on implant selection especially as relates to the potential repositioning.I dont know how the rearranging happens at the exchange.
Like most others I just want these out from under my arms and best projection in the end result.
Thanks
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Hi,
I had a double mastectomy in October with direct to implant over muscle / alloderm reconstruction. My expectation was that the new ones would be the same size or smaller. That does not appear to be the case - they're either bigger or else all of my shirts and bras have shrunk significantly, and since my husband (per my request) does not do laundry the latter is unlikely. I'm not in love with the new ones - I've always been small-breasted, and the only times I had breasts this size were when I was nine months pregnant. In addition, the new foobs are somewhat uncomfortable still - tightness and pulling, presumably from skin expansion.
Specs - I am in my early 60s, a runner, 5'7, 110 lbs, rib circumference is 29, circumference over the implants is 35. The implants are Natrelle 410 MF, which are definitely small. I used to wear a 34A bra or medium sports bras. My current stock of 34A bras don't cover the foobs, and my sports bras are exceptionally tight - I used to store my ipod/and or phone and/or keys in my sports bra when running, I can't squeeze any of them in anymore. I saw the plastic surgeon yesterday. Her take was that technically these are fine, healing well, and they replaced the tissue with implants that were the same mass as the removed tissue. She is correct on all of those fronts. She did a beautiful job, with the exception of minimal scars and no nipples these are essentially indistinguishable from original equipment, and they are healing beautifully. Her advice was give myself time to get used to the new look, come back in five months, and at that time we could talk about the options - doing nothing, downsizing, or removing them completely. I know me, and I know that it is extremely unlikely that 5 months from now I will have a change of heart and decide that the Betty Boop look is my style after all. However, on the other hand, I have a couple of other issues which increase surgical risk making that not very desirable, and in addition, I am trying to just focus on counting my blessings, which are huge - the cancer was caught early, I don't need radiation or chemo - I am extremely fortunate and blessed.
So I'm looking for both Whippetmom's expertise on sizing along with boots-on-the-ground advice from people who have been down the breast cancer reconstruction road. From a sizing perspective, is there even a good implant to achieve the equivalent of a 34A for someone my age who is relatively active and prefers small breasts? Also, anyone have any experience with revision surgery for downsizing? Did the downsizing work? From what I've read, downsizing of implants is difficult to achieve. And last, while I know the surgeon's advice to get used to the new ones is the smartest and least problematic path forward, the emotional part of me would prefer that the foobs accommodate my lifestyle and comfort zone instead of me having to adjust my comfort zone and lifestyle to accommodate the foobs... like everyone here, I just want to figure out the best way to move forward and get on with life.
Thanks in advance for your wisdom and assistance...
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WJGS - similar size as you, might be 28 inches around, 108, little over 5'7"
I have anatomical over the muscle 290cc implants. My fat from fag grafting reabsorbed so I'm really 290cc. I wear a 30d or 30dd (certain brands). I think I'm small. I'd take yours if I could. I had 100cc fat injected on each side. They looked so good in beginning but that just dissapeared. It did take close to 2 months for me to reach this stage.
However, I am quite active now and having more weight above muscle bouncing around - even in a sport bra- doesn't seem right. When I simply look at myself naked, I nod and think, yep, they look good. Argh, despite the comments to give it time, I empathize with you on feeling frustrated with that when you know you want different. Hope that helps
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WJGS - Since your surgery was so recent (OCT) did your PS say anything about swelling being an issue? Some women have swelling for 3 or more months. If you don't have any post-op swelling and this is your final outcome then I sympathize with your dissatisfaction. Like you said, you know yourself. Whippetmom will be a great help & I'm sure others on this site who have downsized will give you "boots-on-the-ground" advice. In the end you will make the best decision for you. Good luck!
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Oops, key addition to my previous mail. The implants are Natrelle Style 410 MF highly cohesive anatomically shaped 195cc, according to the funky wallet card they gave me - and that seems to be a really really really small implant, which is one of the reasons why I am surprised by the difference in size. JesseJake, thanks for the info - 290 isn't much bigger, makes me think I'm probably a C or D cup now, which certainly explains why my current stock of A cup bras don't fit. I'm worried about the bouncing around too, when I get back to running - but right now they are pretty firm, very little bounce.
Mrs. B88 - I think the swelling is resolved; they were definitely larger to begin with but they seem to now be in a holding pattern. Like JesseJake said, they do look good - the surgeon is truly gifted. They just don't look like me, or what I looked like up until now. Heck, when I first told one of my very supportive and very irreverent brothers I was getting a double mastectomy and that I wasn't planning on reconstruction, he said not to worry, no one would notice anyway. Anyway, thanks for the thoughts - these comments, along with what has happened in our country in the past couple of days, are definitely helping me regain perspective on what really matters and what really doesn't...
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WJGS - Putting your brother's very sensitive (NOT) comment aside, we all want to feel comfortable with ourselves after BC. You're right, a 195cc anatomical implant is very small. I'm wondering if placing them over the muscle makes them more pronounced. I've got 685cc anatomical implants (8 wks post op) & they're under the muscle & not what I'd call large at all. I'm a 36C-Dish. My native breasts were D & DD but the implants will never look like our original girls did.
JesseJake and WJGS - Did either of your PS's mention that over the muscle implants make them appear larger? That would be very helpful info. for all the ladies-in-waiting for exchange surgery. Perhaps Whippetmom can answer that question.
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Ladies - the thread below has such a wealth of information about exchange in the link below. WJGS - swelling can easily last 6 months or more. There are also several threads about 'going flat' or no recon for athletes. I don't know much about implants above the pectoral muscle, but I'm sure WhippetMom will reply when she can.
Exchange City:
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Hello Whippetmom,
I had my bilateral dorsi surgery last October 5, I am almost six weeks post op, I had my third fills three times already, 60 cc each expander. I am now filled up to 180 cc on each breast tissue expander, last filled was Tuesday, Nov. 8, below are my tissue expanders information. Please advise what size and type of breast implants that would be best for me. I have 34 rib cage, my previous bra size was 34A, height is 5 foot, right now is 139 lbs Thank you in advance
- Mentor CPX 4 with Suture Tabs, Medium Height
- Style: 9200
- 275 cc
- 10.7x9.3x6.2cm
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MrsB88, My PS never mentioned anything about whether implants above or below would make the implant appear different in size. It would seem there'd be some difference with muscle being a potentially tighter sling for holding an implant. I do have alloderm as the sling to hold my implants, but above that it is just my skin offering a covering to the implant. That was the reason for the fat grafting. The edges of the implant are more prominent. When the fat and probably some swelling were there the edges were well camouflaged. I can see them more clearly now but only when I'm naked! Also, when I slouch, etc.. Overall, still, I think it's probably quite satisfactory given my choice to go above, thin skin, etc...
We do have a forum where we "talk" quite a bit about over the muscle if anyone is interested. https://community.breastcancer.org/forum/44/topics...
WJGS, I did have your size confused! I thought you meant 410cc. I'm surprised, assuming you are similar to me
, that you feel so big when I'm here thinking my 290s are small. I think I got greedy during expansion and wanted more, more, more! It was fun to watch them grow from nothing. Thinking more on it, I do wonder how much of what I enjoyed so much in the beginning after implant exchange was swelling vs. fat grafting. I truly don't know. I do see my PS on 11/21 to discuss a 2nd round of fat grafting. I am quite curious to see what she thinks of the look and if she agrees the fat reabsorbed. Maybe I've got this all wrong! Given what I can recall over these last 2 months, I feel I decreased quite a bit so as others said, I bet there is a high likelihood you will, too. Plus, since you had BMX at same time your trauma to the area must be much greater and maybe cause lots more swelling. Do you have a lot of bruising? I had some and I would assume that correlates to swelling.Hope you come to love them better!
LOL, my mom thought I was going to go "Dolly Parton". I was pretty much boyish looking prior to this. I'm not sure she ever quite got past thinking of this as an augmentation. I can relate to what your brother said to you, though! I think a friend said something similar, but in a joking way - so all good.
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Just to chime in...I had my exchange June 10 of this year. I have Natrelle 410's as well. I have had volume loss (decreased swelling) in the last couple of months. I can tell by trying on bras that didn't work in say September, but now fit just fine.
The docs say it takes 6 months to really be able to assess what you've got. At this point, I would agree.
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Ladies - the Exchange City is a great thread to follow for issues about swelling, side effects, disappointments, etc. It's not at all uncommon to wait more than six months after surgery for various changes to settle. Their motto is "walk away from the mirror".
https://community.breastcancer.org/forum/44/topics...
Note - Allergan 410 is a style number, not a size.
Journey - Whippetmom will need the rest of the info listed in the header - your height, weight, measurement of your rib cage (not your breasts), etc.
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thanks minus two, hopefully our shares are welcome wherever place
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Oh of course jessie. There's just a ton of good info at the Exchange site about the surgeries, the side effects, the healing time, the long term acceptance of the implants, discussions about making changes, etc.
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I will be posting responses tomorrow. Sorry for being incommunicado...
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JessieJake & WJGS - Look forward to continuing conversation on Exchange City!
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Journey: I am sorry, but I just do not know what size implant you will need with your dorsi flap. I think that, absent the dorsi flap, you could use implants in the 450 cc range. Will your skin flaps and overfilled TEs get you there? I do not know. Certainly you could user implants with a width of 12.0 cm, which would put you in the 400 cc range. You might need that with the prophylactic side, and then a smaller implant on the flap side.
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WJGS: You have very small implants. Possible the smallest. I think that your implants appear larger because they are over the muscle. I do not think over the muscle placement is for everyone, and if you want to be small, you need a low projection implant. You eventually get used to the implant "animation" with "unders" and after 8 years, I barely notice it. I can do virtually everything I did prior to BMX. However, I DID have fat graft transfer which might have some bearing. I think you could go smaller, if your PS used a 410- ML or LL style, lower volume. The key seems to be lowering the projection but maintaining the width and to be close to the height of your current implants. You don't want to reduce the dimensions of the height too much, or you risk rotation. . I would also suggest Inspira round implants, smooth round low height - less volume than your anatomicals and 2 cm less projection. The anatomicals you have area also very rigid and so they do not compress much in your sports bra. You would have more compressing of the implant with something other than an anatomical
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Keiki: Well, you could go with an Inspira extra full projection, 560 ccs or 580 ccs. I think you would be happy with that size range.I cannot recall if we talked about sizing in our private messaging, but sizing also depends on the placement of the NAC on the mound.
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Have I answered everyone? I want to thank all of the gals who helped answer questions in my absence. There is nothing I could add! You are MUCH appreciated!
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Hi Whippetmom,
I appreciate your input, I had my 4th fill today, I am now expanded at 240cc each breast. By the way, I have Lat Dorsi surgery in both of my breasts. PS said he's planning to overexpand my 275cc tissue expanders for three more times adding 60cc on each TE.
When it's all said and done, I will be expanded at 420cc each breast tissue expander.
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Whippetmom: Thank you very much! You may be right - over the muscle placement may reduce compression, which would certainly be a logical explanation for why an implant that small seems larger. Thanks also for the info on what may be more akin to what I had - very useful, and greatly appreciated.
MinusTwo - thanks for the info on Exchange City - JessieJake, Mrs.B88 - it sounds like a good place to continue the conversation.
Thanks to everyone for input and insight - it is so helpful...
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Hi whippetmom...I am looking for some advice on implant sizing. I am 62 year old, 5'7", and weigh 138. My Ribcage Circumference Is 33". I had BMX with tissue expanders placed 11/2/16. The expanders are PMT Corp., round, 600 cc volume, model 3612-04-IR. My PS says he has them specially made for his practice. I was filled to 350 cc bil., during surgery. I had a previous augmentation prior to BC dx, about 14 years ago. My BS was able to save the capsules and PS used to place the expanders. My question is amount of fills and best type of implant. I was a 34DD prior to mastectomy , but now a small C is looking good to me. I don't want to wear a bra!! PS choice of implants are Allergen 410 silicone Gummies, anatomical shaped. I am concerned as I have read the above post about pocket being too big for previously augmented breasts. My appointment for first fill is this Friday, and I just needed some advice for correct direction to go. Also radiation to begin on left breast only, after fills completed. I realize this side will be filled 50cc more. Thank you in advance for your help! This site has been so comforting as I made my way through chemotherapy and surgery.
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2yorkies:
I simply go by testimony by Grant Stevens, who is one of the premier experts on the Allergan 410. Dr. Stevens has used this implant longer than any plastic surgeons who were NOT part of the FDA trials going on long before they received FDA approval in 2012.
I would look at the Allergan Inspira, SRX, in the 560 cc or 580 cc range.
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journey: You can always private message me and upload a photo so that I can see how things are looking at this point
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whippetmom- thank you for the information. I will discuss with PS at next appointment.
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Just had my pre-op ...
I am now having Allergan SRX 800...I had been doing all my studying on the Mentor 800 UHP...misstake.
In looking at the Allergan site there is the SRX and an SSX which is slightly stiffer...thoughts on one versus the other???I'm 5'8" 210 was wearing a 40D bra before MX...currently filled to 800 (overfilled as TE was sized 600-720)
TE dimensions: 15.0 x 13.8 x 6.4
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TrmTab: In the U.S., it is only the SRX which is available at the present time. But I like the style and volume for you.
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Hi Whippetmom
I'm new to the forum and trying to navigate the world of reconstruction after mastectomy. I had a Bilateral NSM in October, after diagnosis with invasive lobular carcinoma. I wished I'd had more courage to join the forum before my surgery, but I joined now. Before my surgery I was a 34-36 A, and athletic, and told my PS that I didn't want to be too large, but larger than my current "A".
Now on the other side of my surgery and healing well, I am worried that I won't even be a large "A". My PS used 250 cc Natrelle 133 TE under the muscle, and I am currently filled to 200 cc, and I am barely where I was before surgery. Can the TEs be filled beyond 250, but by how much usually? My ideal would to be a solid b-cup, and I'm wondering if the 250 TEs are going to get me there and what size implant would get me the look I am hoping for? I guess I'm worried that with 50ccs to go on each side that it won't make a huge jump to a "B".
Perhaps I can get some feedback on whether I will get close to a B? Thank you for all of your expertise in this area.
My stats
TE: Natrelle133, 250 cc, the little wallet card doesn't tell me anything but the catalog number for each side ( let me know if that is useful information).
Height: 5ft 4"
Weight: 120 lbs
Ribcage just under TEs: 30"
Previous bra size: 34-36 A
PS uses Allergan implants, I haven't asked if he overfills TEs
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BleuJay:
Yes, your TEs can be overfilled. I think they can be safely overfilled to whatever the tolerance is with your skin envelope. So if you take expansions gradually, it is likely you could get another 100 ccs or 150 ccs in your TEs. I think you need implants in the 400 cc range. Is it possible to get there? Yes. Again, your skin integrity dictates how far you can expand. You need good skin closure over the implants. But many gals who had Allergan 250 cc TEs ended up with 425 ccs in a smooth round high profile implant. I think you would stand a better chance of going larger with rounds than with anatomicals, because the anatomical is rigid and fixed and you can "fudge" a bit more with the softer silicone rounds.
Another important point would be the STYLE of your TEs. Are they MV or MX or SV or SX? That would tell me a bit more about the dimensions of your TEs.
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Hi Whippetmom,
I have changed surgeon and am back to square one on choosing implants. This surgeon is more flexible on what I want. My question is, which BRAND of implant would give me the best projection? I currently have Allegan expanders 133-mx-11 and I'm filled at 380cc. My rib is 29", I'm 5'2 tall, 106 lb. I'm hoping to achieve a full C cup. I was looking at getting the 410 anatomical at 370 cc because it seems to have higher projection than the rounds and the width of 12.5 seems to fit me. Do you know if the other brands other than Allergan are good to use if I'm seeking good projection? I'm open to both shapes. I appreciate your help.
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