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BREAST IMPLANT SIZING 101

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Comments

  • whippetmom
    whippetmom Member Posts: 6,028

    TT::

    The "C" in the TCX does denote this is the newest more highly cohesive gel implant. It is a firmer version - like the cohesiveness of the Allergan 410 anatomical. So it might end up being a good choice for you. The size is the same and the projection is the same. All is good. Let's just see how things shape up. Your risk of complications for a repeat exchange far outweighs your personal risk of ALCL.

  • whippetmom
    whippetmom Member Posts: 6,028

    TT::

    The "C" in the TCX does denote this is the newest more highly cohesive gel implant. It is a firmer version - like the cohesiveness of the Allergan 410 anatomical. So it might end up being a good choice for you. The size is the same and the projection is the same. All is good. Let's just see how things shape up. Your risk of complications for a repeat exchange far outweighs your personalrisk of ACL.

  • trmtab
    trmtab Member Posts: 863

    Thanks Whippetmom. I am in waiting mode and will see how this looks and feels in a couple of months before going for more surgery. Have come to terms that additional surgery has more risk than the ACLC issue, so maybe PS's choice will be okay.

    I am still very bruised/swollen (only 4 days post-op), so the implant looks like a DDD vs my native D...hopefully they will become sisters/cousins and I can decide to do more or not on more important terms.

    Thanks for your help, TT

  • LibraGirl10
    LibraGirl10 Member Posts: 3

    Just want to say THANK YOU to Whippetmom for all you do! I am 5 days out from my exchange surgery and am thrilled to let you know my surgeon was able to fit 700 cc implants in the pockets, despite our concerns about skin integrity. we totally changed from what we originally discussed (mentor textured) to the new Round) SCX implants that came out this year. They are very full and I love, love, love the results! Now, on to nipples and fat grafting in a few months. Thank you!!!!

  • trmtab
    trmtab Member Posts: 863

    So jealous LibraGirl got the CX Inspira last week and I am a bruised up misshapen wreck... so far away from your "love them" ... hope this gets better

  • mapper
    mapper Member Posts: 3

    Whippetmom:

    Thank you for your suggestion, my PS is going to use the Natrelle Inspira SCF I think, I know we talked about smooth and round, is the "F" for full? He did not want to expand my TE's any further because he felt the current skin integrity looked good and does not want to gamble with any more expansion, he said when he does the exchange they will be right in the range that you said: 520 to 560cc's so I am ready to go on the exchange, on November 3 that is, want to enjoy my fall...I do have a question though, I gained about 25 lbs since diagnosed w/ cancer May 2016, have lost about 8-10, but was told not to diet once the RADs were mapped and then not after due to healing, but I am now on a very strict low carb/low GI/GL, high GI/GL diet hoping to shed at least 10 more pounds prior to my exchange, because I now have very severe OA in both knees and will be having a bilateral partial-knee replacement in January, hoping to be able to get into a size 10 dress size (went from a 6/8 to 12 with the weight gain) for my daugher's wedding 5/5/18 (cinco de mayo AND Kentucky Derby day!)...any issues you know of about weight loss at this point, I mean, the expanders aren't going to change so I figured it didn't really matter, right ? I don't see the PS again until mid-Oct for pre-op...

    On a side note, has anyone had any OA issues following chemo? My oncologist assured me the chemo/hormone drugs I was on don't have a correlation w/ OA issues (apparently people on the medication for 5-10 yrs can have issues w/ joints), and I have never had any knee issues, so I am thinking the decrease in my activity level may have allowed the Osteoarthritis to surface, perhaps masked prior by my 6-7 days/wk of exercising 45 min-1.5 hrs each day being drastically reduced suddenly as fatigue and surgery hampered my exercise routine...anyone know of anyone this has happened to??? Even my initial knee X-rays in March to when I had them done again in Aug showed a significant progression of the OA and I am hobbling around like a crippled person awaiting insurance authorization for the one-shot synvisc one injections, in more pain now than any of my cancer treatments caused...feeling quite hopeless at times...thank goodness for my dog to keep me happy though even HE isn't getting walked any more...

  • coachvicky
    coachvicky Member Posts: 984

    TrmTab,

    It will get better.

    As WhippeMom wrote to me early on "stop looking!"

    I said to my husband recently that I have finally come to see these as my breasts. It just takes time to heal.

    Coach Vicky


  • reyepsf
    reyepsf Member Posts: 5

    I'm 5'6", 175 lbs (up about 20 lbs from normal), 34" ribcage (usually wear a 34DDD, but currently, after lumpectomy on left, a 36DD is more comfortable). My mastectomy with beginning of reconstruction (expander placement) is scheduled for October 3rd. My final meeting with my breast surgeon before hand is September 27th. Hoping to be informed enough to know what to ask. He uses the Natrelle brand and gave me brochures on the Natrelle Saline-Filled Implants, the Natrelle Silicone-Filled Implants and the Natrelle Inspira Implants. He didn't give me anything about their highly-cohesive silicone implants or their anatomically shaped Silicone-Filled Breast Implants that are teardrop-shaped. From what I've read, even though I'm asking for a reduction and a lift during reconstruction, I think I'll still be too large for optimal results from the teardrop implants. I'm hoping he can come back and do fat grafting above and around the implants to make them look more natural. I think the highly-cohesive implants are nicknamed gummies? I didn't get to feel those or any that had a textured shell, so I can't form an opinion on them. Of the implants he had in his office, I'm leaning towards the smooth silicone implant, but I'd love to hear from others who have the various Natrelle implants to get pros and cons. I usually wear a size 10 clothing, but I'm in a 12, sometimes a 14, now, but hoping to get back into a 10 soon. I think I would like to be on the large side of a C cup or maybe the small side of a D cup. I think that would be proportionate. I'm tired of my back, shoulders and neck always hurting from the weight of my breasts, but I was an A cup in 4th grade and a 32DDD by Freshman year of college. As much as I've hated them, I don't think I would look like "me" if I go too small. All of a sudden, I'm becoming fond of my breasts now that I'm facing losing them. So, I'm going into this thing blind. Any pointers about the implants? Saline? Silicone? Cohesive? Highly-cohesive? Smooth? Textured? Size/cc? Profile? Classic round? Inspira? Teardrop? Fat grafting? Acellular dermal matrix like Alloderm? What kind of incision? A friend of mine had a skin saving mastectomy with a lollipop incision. There are so many different type incisions used for other breast surgeries, but most doctors seem to only offer the one that just cuts straight across the breast. What's up with that? Mine is supposed to be skin saving and I'd like the anchor incision (not to save the nipple), but I don't know enough to know if that's even something I should even ask the doctor about. I know I have plenty of time to decide on most of this, but I'd like to know what to ask the doctor before the first step of the reconstruction during the mastectomy surgery in 2 weeks. During follow up breast MRI after lumpectomy, a teeny spot was found on my right breast so this will be a double mastectomy. The spot didn't show up on my mammogram and took hunting to find via sonogram. The lump on the left that was positive for cancer was hiding behind a cyst so I missed it. I have horrible fibrocystic disease so getting rid of that is a silver lining. A Sentinel node biopsy will be done on the left where the larger lump has already been taken out, but I'm not sure what my oncologist is planning to do about the right. I know I should just be thankful that, as of now, it appears that my cancer is pretty tame, but I don't want to go through the reconstruction and wish I'd asked more questions or done things differently. This is my first post, but I can tell it won't be my last! Thanks, y'all!!!

  • MrsB88
    MrsB88 Member Posts: 77

    reyepsf - Whippetmom will be able to give you a lot of helpful info. on many of your questions. I just want to comment on one from my personal experience. Size. Going into mastectomy, I was a 34D on the left & a DD on the right. I am 5'5" & at the time I weighed 120 lbs. I thought it would be nice to go smaller. Big mistake for me. I had a lot of left over skin but my PS didn't reduce it so I came out of it with 420cc moderate profile flat pancakes. No projection but still a large circumference area. From the side I looked flat. The only volume was at the top of the implant so I wore tank tops that showed some fullness with unbuttoned shirts over them to eliminate my side profile. Fast forward 6 yrs., I developed capsular contracture on the right & implant failure on the left. I had revision surgery a year ago & my new PS put me back in expanders to stretch the skin & gave me 680cc implants that look great! I've gained quite a bit of weight since mx & now wear a 36 C/D bra depending on the manufacturer & bra style. If I lose the extra weight, I'll probably be a 34 very full D. Implants fit into bras differently than natural breast tissue so it's not an apples to apples comparison but I have a great balance of projection & fullness. Now my T-shirts & fitted blouses look good & my side profile doesn't look flat.

    My implants don't feel heavy & I do have an alloderm sling for support. Like you, I also have a bad back & neck but don't have any problems from my implants. I encourage you to have an in-depth discussion with your PS re the size issue. Going from a DDD to a C is a pretty significant reduction so make sure your PS explains how he will give you really good projection & fullness without the extra skin issue. Wishing you the best of luck on your Oct. 3rd surgery & a smooth, easy recovery!

  • kae_md99
    kae_md99 Member Posts: 394

    whippetmom

    so my PS plan to use Natrelle Inspira Cohesive gummy on my exchange next moth... i initially asked for saline implants since i thought they will be lighter but he said it has too many complications. i want a lighter one since i was small and i dont wanna go big and right now i am filled at 280cc with no more additional filling. PS told me that de did not really expand my skin and he will just go with whatever skin was left post bmx... any thoughts on these kind of implant? also can you explain the projections? i do not get that. i have decided to get the smooth round ones as opposed to the textured ones. thanks!

  • whippetmom
    whippetmom Member Posts: 6,028

    mapper: You will need to discuss your diet concerns with your doctor. Just get plenty of good quality protein though

  • abdrowota
    abdrowota Member Posts: 4

    I had a bilateral mastecomy last May and went direct to implants (Natrelle 410 Highly Cohesive Anotomically Shaped Silicone filled), which I thought would be fabulous- no tissue expanders like my mom and other friends. Cancer was on left side (with sentinel node biopsy), prophylactic mastectomy on right. Both sides are very firm and feel like wet sandbags, but shaped like hamburger buns that extend more on my sides than I am used to. My right, non-cancer side, is "jacked-up." it's much higher and I can feel the muscle stretching on the top part of the implant, not far from the base of my collarbone. I saw my PS on Monday who says we should do a revision. He says we can do the same type of implant as before (see above), but with a lower height (which wasn't available at my first surgery), or we can do a smooth round. I am 5'8", 150 lbs, and active. Before BC, I wore a 34 b. My ribcage circumference is 31" I just want to be comfortable and look natural/athletic. Any advice?

  • rkham
    rkham Member Posts: 3

    whippetmom,

    Hello

    Thanks you very much for all your help and information.

    I had a bilateral mastectomy on Sept 5 with TE placement with 50cc fill at the same time. I am 5 ft tall, weight about 97 lbs give or take a few and have a 28/29 ribcage measurement. TEs are 133SX-11-T Natrelle Style with a 250 fill and the PS says can be overfilled to 275.

    Catalog# 133SX - 11 (Don't know what the T is for on mine as it's not in the catolog?) Suggested Fill Volume 250 cc

    Width 11cm Height 9cm Projection 4.7cm

    Any suggestions for me?

  • cyclegal
    cyclegal Member Posts: 49

    Hi whippetmom, before I give you all my info for your opinion, I wanted to see if my scenario is applicable for the advice you give. I had nipple sparing BMX 4 weeks ago and have airXpanders over the muscle and alloderm. My exchange is scheduled for 11/6, implants placed over the muscle with fat grafting. What do you think? Thanks!

  • Jcdd
    Jcdd Member Posts: 5

    Hi whippetmom: I had bilateral mastectomy (not nipple sparing), with Allergan Natrelle 300cc style 133FV Tissue expanders. I am 5'6 and 117 lbs with a 29 inch ribcage. My former boobs were a small A. I do have a pear shape with larger hips and a small upper body. I had a lot of radiation on the right and developed capsular contracture on the right with the TE. My PS filled to 240.

    I am leaning towards a smooth round. Are my options limited because i only have 240 fills? What would you suggest? Thank you in advance for sharing your knowledge with us newbies.


  • noodlesmom
    noodlesmom Member Posts: 36

    Hi rkham-

    I'm far from an expert, but am about the same size as you and have been concerned--from the start--that I would come out with something too big for my frame. I am filled to 240cc's. Also started with 50 or 60 and then was finished after 2 fills. Considering I was a AA before BC, it feels big. Too big for what I was used to and for my frame, It's personal, I know and it's all relative, I guess. I tried on a dress recently and for the first time EVER, it was too tight across the chest!

    I am actually scheduled for my exchange tomorrow morning and my PS plans to use natrelle smooth round. He's bringing 3 different sizes ranging from 195-220cc's. and 2 projections (moderate and high profile projections), I don't know what I'll end up looking like, but please feel free to PM me and I can fill you in.

    Everyone on these forums is incredible about sharing information and whippetmom truly is the expert so no doubt she'll be able to offer more guidance.

    Good luck to you!!

  • whippetmom
    whippetmom Member Posts: 6,028

    reyepsf:

    You will want the Natrelle smooth silicone rounds. I think the Inspira line would be a good choice for you. As for sizing, implants in the 700+ cc range, extra fullprojection would be something to discuss with your plastic surgeon. You will have too much of a skin envelope, based on your breast size, for an anatomical implant.

  • whippetmom
    whippetmom Member Posts: 6,028

    image


    kae:


    The various implant "profiles", using the example term "high profile" or "full profile" refers to the degree to which the implants project off of the chest wall. This diagram explains it for you. Sorry… There are probably 100 other examples on the Internet, but I changed the privacy settings on my iPad because my grandson is getting to that age where he's curious, and now I can't look up anything having to do with breasts. I cannot remember the privacy passcode and there is no option for changing my passcode. So off to Apple I will have to go. 🙄

  • whippetmom
    whippetmom Member Posts: 6,028

    abdrowota:

    You need a smooth round implant! The reason being, if he plans on using a lower profile anatomical, your skin is now stretched beyond the dimensions of that low profile style. and that anatomical may very well rotate. For all that we know, based on your description, it might have rotated already. It takes a very skilled, artistic plastic surgeon to do a one step. It also sounds as if you have capsular contracture of that one implant. Did he mention that to you? Frankly, I would get a second opinion at this point. See someone else for a consultation before going back into surgery. If you want to send me photos you can do so via private message.

  • whippetmom
    whippetmom Member Posts: 6,028

    rkham: I would look at the Allergan Natrelle Inspira implant (a smooth round) in a high profile, 285 ccs or 295 ccs. The dimensions of those implants most closely approximate thoseof your tissue expander.

  • whippetmom
    whippetmom Member Posts: 6,028

    cycle gal: Yes. Give me your info - vital stats, info/volume of the AirX TEs and tell me where you want to be from a size standpoint. Since you have had a nipple sparing procedure, it would be good to know what size your breasts were prior to mastectomy. With a NAC sparing procedure, symmetry and finding the mplant style nand volume that allow the nipples to end up in the best place on the mound trump anything else.

  • abdrowota
    abdrowota Member Posts: 4

    Thanks, whippetmom. I sent you a PM with a photo. I tried to attach more than one and it does't look like it worked. I don't think the implant has shifted. I had a hematoma on my right side and I think that may have affected the healing. I sneezed, coughed, or laughed too hard...let me know if your opinion is the same about using smooth round after you see my photo. I definitely don't want to look like I am wearing a coconut bra. I also want the muscle on the right to settle down.

  • Jcdd
    Jcdd Member Posts: 5

    Hi whippetmom: Thank you for helping us and sharing your knowledge. After doing chemo, I had a non- nipple sparing bilateral mastectomy (jan/august 2017). I had 300cc Allergen Natrelle TEs placed, style 133FV-11, and they are filled to 240cc.

    I am 5'6 and 116 lbs. my right TE has pretty significant capsular contracture from radiation. I am eligible to have exchange surgery in mid-November. My left TE seems like it is placed really low on my chest, but PS says he can even this out at exchange.

    I am leaning towards smooth round, to at least give me a little shape in my upper body. What would you suggest? Can i get implants that are bigger than 240ccs? We only filled that much because i had to hurry to get to radiation due to residual disease after surgery and chemo. Thank you!

  • Jcdd
    Jcdd Member Posts: 5

    whippetmom: i should add that i had an A cup prior to surgery. I've always had a pretty shapeless upper body so i actually wouldn't mind a little shape now, even if I have no nipples, lol😊

  • cyclegal
    cyclegal Member Posts: 49

    Hi Whippetmom, I had to wait to meet with my PS today to find out what type of airxpanders I have. So, here is my info:

    nipple sparing BMX, tissue expanders above the muscle

    I am 5'7", weight 135-140 (athletic physique- broad shoulders), ribcage measurement 34"

    Small AirXpanders, 400cc

    Previous bra size: 34B (I would like to be bigger, more like a nice C with a natural appearance)

    My surgeon uses Sientra implants, and we discussed going with the 20646-370RB (textured shaped round base high projection). With fat grafting, she estimated the total volume would be around 400cc. I was really happy with her explanation and fully trust her - I just wanted to see what you thought. Again, these will be over the muscle. Thanks so much!

  • whippetmom
    whippetmom Member Posts: 6,028

    Jcdd: I think that you should talk to your PS about using the Allergan Natrelle Inspira implant, and, skin integrity permitting, he should be able to try a SRF or SRX style - 295 ccs to 340 ccs respectively. They key is asking him to take several sizes into the OR. You could also ask him about the newest FDA approved cohesive (first round "gummy" type implants) - approximately the same volume. The capsular contracture issue is worrisome, because it puts you at risk for this occurring again. I feel you should go to one of the radiation forums that would be addressing any of the nuevo methods for taking care of irradiated tissue. Fat graft transfer is the best (in my estimation), but it sounds as though you have little of that commodity.

  • whippetmom
    whippetmom Member Posts: 6,028

    Cyclegal:


    It sounds on the small side for your frame. I think at least 425 ccs in that style would be my recommendation. If you are fully expanded, you will not have anywhere near the projection you have with your 8.0 cm projection AIRX TEs. How do you feel about the size of your TEs currently?
  • cyclegal
    cyclegal Member Posts: 49

    Thank you, whippetmom :) . I looked up the projection difference for the expander and the implant, and there is quite a difference! I will have to discuss this with my PS at my pre-op appointment. One thing might be that while I am happy with the current projection of the expanders (I am nearly full), I do have thin skin, and my skin is quite tight to accommodate the fullness. So perhaps that is one reason she is suggesting the 370. The next size up is the 425, and she commented that she thought I would be too large with those (more like a D or DD), maybe deviating from the natural look I am seeking? While I weigh 135-140 lbs, I think a lot of my weight is in my muscles in my legs, so I don't have a large frame. I wear a size 4-6 in clothes. Does that change anything about your advice?

  • rkham
    rkham Member Posts: 3

    Whippetmon:

    I just had a fill last week and am now at about 190-200cc with my TEs. One thing about them as I have a very small upper body (I'm Asian) and my PS said they were the smallest available. They stick out on the sides a little and seem to be very far apart in the breast bone area. Does anyone know is this normal? I downloaded the more recent Allergan catalogs and found out the T on the end of 133SX-11-T stands for Tabs that are on the edges of the TEs, I guess to keep them in place.

  • Jcdd
    Jcdd Member Posts: 5

    Thank you, whippetmom!

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