BREAST IMPLANT SIZING 101
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Thank you Whippetmom for posting the info! Especially the link about women who've had previous augmentation! I didn't know this would be an issue! My PS did say that she would use the smooth implants because of the risk of textured implants but we haven't discussed which kind yet, as I go in July to discuss my August exchange surgery. I currently have the Mentor Artoura TE's 375cc and think I should go back with the smooth round implants like I had before but do you think that will be an issue?
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TWills:
I would recommend a smooth silicone round - keeping in mind you have had rads. I just feel that you might need something more pliable and malleable, and I think Allergan Inspira would be a good option. It is a newer generation silicone, unique in that it has a higher fill ratio, allowing for the PS to use a smaller volume implant (by comparison to the standard silicone rounds). This might benefit when the skin is tight and the PS wants to preserve skin integrity. The Inspira SRX or SRF - in the 600 cc to 700 cc range would be a good size for you. Talk to your PS and find out what size tissue expander he would need to use to enable you to reach this goal. Find out if he uses the Inspira line of implants. A Mentor or Allergan high profile smooth silicone round would be a good second choice - in the 700 cc range.
Let me know what transpires after you meet with your PS!
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SjsParks:
I would recommend an Allergan Inspira SRX - extra full projection - in the 650 cc to 700 cc range. Your tissue expanders are relatively small and narrow for your frame, and also small in light of your D cup size prior to BMX. So you need to discuss sizing with your PS. Ideally, it would be the 700 cc to 750 cc range. Depending on how much skin you have, this will dictate also the size of the implant. You could also go with a extra full projection style in Allergan or Mentor, but you would need 800 ccs in those styles/brands.
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tapwhite:
Absolutely - go back to smooth round silicone! There are other options since you were augmented - the Allergan Inspira which has some nice advantages. Something worth discussing with your PS
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Thank you Whippetmom, I'll look into those options. Will those give me fullness/clevageon the top? My appt with the PS is Tuesday, I'll let you know how it goes:)
Thanks so much!!
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dear Whipettmom - i will be grateful for any advice you can offer me. My info
I have undergone a unilateral left skin sparing mastectomy with immediate TE placement . Right breast is healthy and intact and i dont want anything done to it --it has no sag, and its a C cup.
My measurements - height is 5feet 1 inch , weight is 115 pounds, rib circumference below the TE/breast is 28.5 inches
My TE is allergan 133FV-12 , 400cc . My plastic surgeon said he always overfills. ( Right now i am at 260cc )
Will be especially grateful for any tips you can offer --my PS came highly recommended by my BS in New York , both at the same major academic medical center , and he has many years of experience, but he didnt spend any time with me at my postop visit and literally left the room even before he came in --- his PAs and nurses do the fills. On this board, when i google his name , i see that people have criticized his bedside manner but some have really praised his results. Because he spends so little time with me, i feel that i will need to go very prepared with a list of questions for him if i am to be well informed --so i will really appreciate your tips. He has not yet said anything about the types of implants he uses.
As an aside, what are your thogihts about prepectoral implants ? Mine is a subpectoral implant --very painful as the muscles stretch out and it presses on the ribs and the muscles feel weird --the nurse told me that none of the plastic surgeons at my hopsital do prepectoral implants but i see on other forums on this site that women are choosing prepectoral implants and have less discomfort . It does make me think that physical exam for the possibility of local recurrence would be impeded in those women who choose placing an implant over the muscle , but would appreciate your thoughts
Thank you so much for your time!!! Really you are wonderful for the way you give of your time on this site.
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Tara:
My thoughts are the same as yours regarding the challenge of monitoring a prepectoral - over-the-muscle implant for local recurrence. But so many docs are doing this now, there must be a plan in place for monitoring. Perhaps yearly MRIs. My provider would not cover MRIs, unless there is a problem, and so that would not work for me.
As far as sizing goes, since you are doing nothing to the native breast, sometimes asymmetry just is a bit more difficult to obtain. It depends on the skill of the surgeon. If you are with one of the male docs at Sloan-Kettering, they are pretty keen on anatomical implants. If so, the implant corresponds to the dimensions of the TE. I think there is more "fudging" with overfilling your TE and using a slightly smaller round implant, to achieve a little natural droop (ptosis). I like the Allergan Inspira (newest generation of silicone implants) Style SRF, 365 ccs. That or Allergan Style 20, 425 ccs. I suppose a SRX (extra full projection) could be used also, depending on the elasticity of your skin and tolerance to overexpansion. If an SRX, probably 420 ccs. These suggestions are essentially like "winging it" for me, when I do not know what your native breast looks like and I do not have virtual calipers to measure all of the dimensions of that native breast. 😉 It will all depend on symmetry. Symmetry is the goal, not the size of the implant. I am basing the above suggestions on your implant width of 12 cm.0 -
TWills:
Cleavage is all about width of the implants and proper placement on the chest wall. They cannot be too lateral, with too much of a gap in the sternum area, but you do not want them touching each other either. A good PS will know how to achieve proper placement and will make sure that the implants are wide enough for your ribcage.
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whippetmom, does it not matter whether they are round or anatomical? As far as fullness on the upper part I mean. I guess that's what I was thinking. I do not want anything unnatural looking, would just like a little more fullness than I had with my 45 year old bio's.
I think I need to look at photos, I just don't think I have what it takes to gain access to the photo thread I saw referred to on this site. I look around but any ideas?
Thank you!
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Well, you can achieve cleavage with rounds and anatomicals, if the latter are placed properly and are the right size. As far as the pictures forum, you need to contact Lilah. Lilah is her screen name. I hear it takes a long time to get in. Just do a search from the left blue column and then enter the username Lilah.0
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Whippetmom, thank you much!
I also found another cami at Kohls, this one has removable pads within the shelf, figure this may work for any of our sisters who have undergone nip recon.
Cyber hugs!
http://mobile.kohls.com/product/prd-2908489/junior...
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Dear Deborah,
First of all, I find it so inspiring that you choose to share your time, energy, knowledge and wisdom with all of us. So: THANK YOU. Thank you so much. Here's my info, I would appreciate any and all advice, although my options might be more limited, since I'm from Chile.
I underwent a unilateral mx on june of 2016, with immediate TE placement. Went through chemo and rx, which caused the skin to tighten so much it was impossible to expand beyond 180cc. Two weeks ago, my original TE was removed, the surgeon "cleaned" the area (he had to remove marble-hard skin, as he told me-- guessing that's CC?) and I got a new TE placed and overfilled to 350 cc during surgery.1.
Height: 5'4
Weight: 140 pounds (this is heavy for me-- I'm usually 134 or so).
Ribcage circumference: 32.7 inches2.
Natrelle Allergan, 133 FV
N-67-133FV11
300cc (so it's already overfilled!)
3.
I haven't asked my doctor the exact kind of implant he will use, but I know it wil be textured silicone. Not sure I can request another kind, in my clinic, but I'd like to be as informed as possible for my appointment with my PS on Tuesday!4.
Always been an A-cup. At one point my PS said my right breast was around 180cc.
By the way, I know thing are done differently in the US. I know I could have theoretically had the whole reconstruction done before rads, which would have saved a lot of time and prevented CC, for all I know-- alas this is the way they do things here. They actually DEFLATED my TE before rads so that the volume wouldn't interfere with radiation (for some reason).
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Just to give you an idea -and I do realize cup size is impossible to predict- I'm aiming for a full B cup. My current TE (filled to 350cc) already feels very large to me, yet my PS says he will keep filling, and "we can decide the size later".
Thank you so much in advance for your advice!
Cheers from Santiago!0 -
twentyfour:
I only have access to the sizing charts for the US, UK, Europe and Australia. The sizing charts will likely be different in SA. They certainly are different between the US and other mentioned countries/regions. I can only use the European chart therefore. With your full height TE, the corresponding anatomical would be 290 grams, minimally, going up to around 375 gms. If you have the Allergan Inspira line in SA, there is a textured round, and likely it would be in the 325 gram range. Of course, this is all presuming you are augmenting the native breast. The PS would use a smaller implant for that side. Whatever size brings symmetry. Symmetry trumps size.
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Imkopy2: Ohhhh good find! Even better - more support I am ordering a few of those puppies!
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Whippetmom - I had my exchange surgery last year and after settling, I noticed that they feel very different. One side is much squishier than the other and has a lot of rippling. Both ID cards that I was given after surgery say Mentor 300 cc smooth round high profile, but one card is yellow and the other one is blue. One card says MemoryGel and the other card just says Gel. Do you know why the cards would be different? Are these different models or maybe one is an older version of the same implant? Thanks for your help.0
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grandma3x:
That IS an I interesting finding. We are now in what is considered the "fifth" generation of silicone gel implants. The "fifth" era started in 2012 and 2013. At what point did Mentor start calling their silicone implants "MemoryGel"? Was it in 2012? If so, I guess it is possible you have a fourth generation implant. Now I may be entirely in left field and this is just me trying to pull of a good answer for you to the difference in ID card color and difference in description of the implants you received. I certainly would ask your PS' office. The labels from the implants are placed in your chart. But why that one side seems "squishier" is unclear. If you do not get a clear answer from your current PS, then seek a second opinion, especially if you are thinking a revision might be in your near future.
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Update for you, WhippetMom, and another question that I'm hoping is asked on the right Forum.
Talked to my PS today in detail. She is using the Inspira cohesive gel implant. Smooth and round. But one thing she mentioned is that my nipples will likely point to the side a bit. (I had NS-BMX.) Is this typical? She seemed to suggest that revision later or something like that does not work for this issue. (We're targeting max 300cc implant, maybe even a little smaller.) She just wanted to prepare me for the nip issue, which I appreciate. I'm almost wishing I had sh*tcanned my nipples, to be honest!!! Forever erect (TMI, I know) and pointing to the outside. Lovely!
Thanks for all you do!
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EastcoastTS - I also had NS (although SMX) and it has looked slightly to the side since surgery. Although, mine is smooth...never erect unless I touch it (my bit of TMI)! LOL! I'll be following this as I'm also curious about the question you pose.
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EastcoastTS:
That is a pretty common cosmetic issue with NAC sparing procedures. But nipples pointing slightly east and west will not be unusual. Many natural breasts have outward pointing nipples.
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Eastcoast- I just went to Third Love and ordered a bra from them, one of the characteristics included East/West type of breasts. May just be a new version of you but certainly not odd by any means
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LOL. OMG, the stuff we have to deal with aside from actually getting the cancer out!!!
THANKS for all the responses. I can't wait to see what the nips look like after Exchange. And celeb nipple photos. The joy of BC.org. I love it.
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Whippetmom,
First of all thank you for the time you spend on these boards. I have been reading previous posts on this thread and it has taught me a lot. I come seeking your advice. I had BMX with expanders on May 18 2017. I was diagnosed with IDC Triple Positive Stage3A back in Nov 2016 at the ripe age of 41. Completed chemo back on April 6th.
Height= 5'3 Weight=209lbs Ribcage under TE's 39"
Tissues Expanders= Natrelle Allergan 133mx-13 500cc I am currently filled to 540CC and hope to reach 660CC before starting radiation. Should I push to get to 700cc? In clothes my TE's appear small with not much projection at 540CC so that is why I am wondering it 660CC is going to have enough projection once I exchange to implants. Am I anywhere close to where you think I should be?
Cup size before Bmx was DD but I don't want to be that big. I would like to be a big C or small D.
My PS uses a lot of Natrelle though I am not sure if it exclusive. She specifically mention Natrelle Inspira. I am leaning toward silicone smooth round implants.
Thanks so much!!
Dizzygirl
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DizzyGirl:
I cannot comment regarding overfill capacity prior to rads. It is all about skin integrity and it is up to your PS. However, I do think that, yes, Inspiras will be the best for you - but in the 700 cc range MINIMALLY - Style SRX (maximum projection). You have sufficient skin flaps to get you there, if you were a DD cup previously!0 -
whippetmom-- I had a bmx in January. They were supposed to put my TEs in then but there were some complications. I'm scheduled to get my expanders September 7th. I won't see the PS again until sept 6. I'm just wondering if I need to know anything about the TEs at this time? Also, I will need your help in choosing implants in a few months. Thank you so much for helping us.
3Bear
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3Bears:
Well, find out what style and volume of tissue expanders he plans to use. Since you do not see him until Sept 6 and surgery is the following day, it tells me he has already has ordered the TEs or he has written in your chart what needs to be requisitioned in September. Call your doctor's office and ask the nurse to tell you what size and volume tissue expanders your PS plans to order. Ask her if this is recorded in your chart from your last visit with him.
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whippetmom - I can't thank you enough for your support during this trying time. I am in a panic trying to decide on a size for my implants.
I have gained 50 pounds this year as result of quitting smoking and the extra weight isn't helping with my decision.
I am 5'8" 220 lbs, and ribcage circumference is 40 inches.
I have Mentor TEXP120Ruh expanders and the volume is 800 ccs. My PS likes to use Allergan implants and likes the "gummie" style.
I am currently filled to 625 CCs and thought I would be good at 700 CCs but I feel like I look flat at the moment which is very discouraging.
Any guidance you can give me would be greatly appreciated.
Elkay
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Elkay
Whippetmom will reply, but I am nearly the same size as you...5'8" 200 lbs and 39" ribcage...I am filled to 800 and will get 800 Inspira...and am smaller than my native R breast. If your expanders can go to 800, I would at least give that a try if your skin can handle it...or at least go beyond the 625 you have until you are more comfortable.
TT
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TT -Thank you for responding so quickly. When I left the PS office today for my fill, we discussed filling to 800 CCs. Sounds like that may be the way to go. I will wait to hear from whippetmom and see what she recommends.
I will keep you posted!
Elkay
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Elkay: I agree with TT. 800 ccs, Allergan Inspira, SRX or SRF, whichever looks best. It is always preferable for the PS to take in at least two options. The SRX has more projection than the SRF
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Whippetmom Thank you! With my fill last Friday and my fill yesterday I am up to 690cc. Yeah! These last two fills have made a noticeable difference in my clothes and profile.
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