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BREAST IMPLANT SIZING 101

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Comments

  • whippetmom
    whippetmom Member Posts: 6,028

    rkham: You can always private message me a photo. Unless you have some ribcage issue - i.e. pectus excavatum/pectus carinatum, there should be no reason that those small TEs are so lateral on your chest wall. The tabs should have helped prevent the lateral displacement of the TEs, but it could be that they were placed that way - perhaps for an anatomical reason. Talk to your PS and get assurance that they will be positioned properly at the time of the exchange.
  • kbh2241
    kbh2241 Member Posts: 4

    Good afternoon whippetmom and THANK YOU for all your help. I've been watching this forum since my diagnosis in April and I guess now is the time to put the information to work.

    I had a BM in early August with placement of Mentor High Profile Smooth TEs. On Labor Day, I had to have the left one replaced with an saline implant due to infection. I've continued to have the right one filled to gauge the size the size I'd like to get to. There's only so much of that I can do before having to replace implant with a tissue expander, according to my PS. No rads and my PS says that I have good skin.

    This is where I need your help: Before my surgery I wore a 36 DD. My favorite style is the Chantelle T-shirt bra.

    My measurements: I'm 5'3 and currently weigh 138 pounds. My ribcage is 33".

    Thanks in advance for your advice.

  • whippetmom
    whippetmom Member Posts: 6,028

    kbh2251:

    I think you have it a little reversed. You have your tissue expanders now and they will be replaced with permanent implants at some point. I need to know the style and volume of your tissue expanders. There are different styles/profiles for Mentor tissue expanders. I am not clear if you're telling me that you have a permanent implant already on the left? Or did you just get it replaced with anew tissue expander?

  • kbh2241
    kbh2241 Member Posts: 4

    Whippetmom:

    Due to infection, I only have a TE on the right: Mentor Artoura High Profile Smooth. The volume is 475cc. I've been filled to 420cc. After a wash out of the left breast pocket to address the infection, the left TE was replaced with a placeholder saline implant. We've continued to fill the right side to get a sense of sizing. We're now approaching the point where I may have to have a new TE placed on the left to achieve symmetry, so I'm looking guidance on how much larger I should consider to determine if I need to have the new TE placed.

    Thank you.



  • whippetmom
    whippetmom Member Posts: 6,028

    kbh2241:


    If your PS uses exclusively Mentor the implant options would be either Mentor High Profile 500 ccs...perhaps 550 ccs, or the Ultra Full Projection, 650 ccs. The only reason I mention the ultra full, is because of your pre-BMX breast size. Howeve, all of that said, it all depends on the integrity of your left skin flap. Your PS will want to take a conservative approach, most likely, to ensure good closure and to avoid any complications.
  • kbh2241
    kbh2241 Member Posts: 4

    Thank you!

  • lilpea
    lilpea Member Posts: 6

    I am 5' 5.5" tall, 125 lbs, ribcage: 28.5, pre-mastectomy breast size: A (wore 34 A bra). I had a nipple sparing BMX on September 26th with immediate reconstruction. Pre-pectoral tissue expanders: Allergan Natrelle 133MX-12-T Shaped Tissue Expander, Moderate Height, Extra Projection (width: 12cm, height: 11cm, projection: 6.3cm), suggested fill volume 400cc. PS filled to 400cc's at time of surgery (with air). I just had my drains removed yesterday and the expanders had deflated a lot so she refilled - I think close to 500cc's - they look like bolt-on boobs now, such a weird feeling/look!, but I understand that the implants won't look like that after exchange.

    I am 47 years old and athletic. PS will re-inflate again in three weeks and then schedule the exchange to the 410 MX shaped implant about three weeks after that. I'm curious what your thoughts are on final implant size for my frame? I am looking forward to having larger breasts, but don't want them too much in the way in terms of exercise and daily activity. I find it so hard to visualize what the final result will be! Seeing the much lower cc amounts in other posts has me a little concerned, but I do understand that body type plays a big role in how it all turns out.

    Thank you, whippetmom and everyone in this awesome community! Although this is my first post, this site has been an amazing resource that I have relied on continually since being diagnosed.

  • whippetmom
    whippetmom Member Posts: 6,028

    The style would be Allergan 410-MX, 370 grams. But another option is the Allergan Natrelle Inspira implant. There is a new cohesive gel which is also a "gummy" implant like the Allergan 410, but it is round and not as firm as the Allergan 410. The Inspira Soft Touch would be my preference, but you will need to talk with your plastic surgeon, because I cannot access sizing information currently. It would likely be in the 350 cc to 400 cc range.

  • lilpea
    lilpea Member Posts: 6

    Thank you!

  • moodyblues
    moodyblues Member Posts: 393

    Whippetmom, First and foremost thank you for your help.  I had a left mastectomy on March 31, 2017 and had the tissue expander placed, I will have TE removed and implant on Nov 28 2017, thankfully I had no problems with any of it. 

    I am thinking seriously about a prophylactic mastectomy on my right breast and I recently met a woman who had her implant placed immediately after the mastectomy was performed (no tissue expander), I was wanting to do the same thing...I had never heard of that being done before!  When I mentioned the lady to my reconstructive surgeon he said that in some cases they can do that and you would have to be a candidate for that.  How do I know if I would be a candidate for this?  Another question is, when you have a prophylactic mastectomy, I assume that they test the breast tissue for cancer, How long does it take to do pathology on ALL of the tissue?  I want to be sure that ALL of the tissue is healthy before I do a direct implant.  I would think it would take a good bit of time to check all of the tissue right?   

    Thanks for your answers or thoughts on this.  

  • whippetmom
    whippetmom Member Posts: 6,028

    moodyblues:

    They will test the tissue while you are in the OR. The breast tissue removed is the "specimen" they will analyze in the lab.on the prophy side.

    I'm not sure when you say you want to make sure "-all of the tissue is healthy before they do the direct implant" ? You are opting for a prophylactic mastectomy, whether or not the tissue is healthy. The goal of the surgeon is to remove all of the breast tissue and then that "specimen" is submitted to pathology immediately.

    I would not go direct to implant. You will likely be lopsided. You would need to have ample sized breasts to do a direct on one side only, and even then, there are no guarantees for symmetry. That said, your PS COULD use a Mentor Spectrum permanent expander/implant on the right, and this device can be expanded until you match the implant on the left side. When you're satisfied with the symmetry, the plastic surgeon closes up the port on the Mentor Spectrum, and it becomes a permanent implant. Otherwise, I would go the tissue expander route to ensure the best possible results.


  • moodyblues
    moodyblues Member Posts: 393

    Thank you Whippetmom on your detailed response about the direct to implant, I definitely want to be symmetrical.  I want to make this as easy as possible for myself.

    For some reason (chemo brain perhaps) I was worried about the final path report showing something suspicious and having to remove the implant in order to have any further treatment if necessary, I have learned that is not the case.  

    You have been very helpful to all of us on these boards, thanks for directing us and educating us during such a difficult time!  


  • juliempw
    juliempw Member Posts: 191

    Hi whippetmom, One of your old tata friends here. It's so great to see you still here helping people. You amaze me!

    I have a rupture on my left side and I'm scheduled for surgery on December 8th. I'm looking to have him move the implant from under the muscle to over the muscle because I've never gotten used to the distortion when I flex. I currently have Mentor high profile 475. I have a few very mild ripples on one side (only visible to me or a trained eye) and I have a decent step off. I wear Freya 30E. I'm considering changing out the implant to the higher profile and 1 cup size smaller. I look very natural right now and I'm concerned that if I go higher profile, it will look fake thus the possible downsize. What are your thoughts?

  • whippetmom
    whippetmom Member Posts: 6,028

    Hi Julie!


    Well, the issue is maintaining the width (within one centimeter, if going smaller) and going to an ultra full projection implant would mean you would need more volume to maintain the width, not less volume.) SO you are sort of defeating your purpose of going smaller by going to an ultra full projection style implant. You also might continue to have a step off defect with a higher profile implant. I would suggest that you talk to your plastic surgeon about the new Inspira implant. It is Allergan's implant . He would need to switch allegiance from Mentor. 😉 If so, the smooth round full profile 415 cc Inspira is just a fraction narrower but you have the same projection you have currently. That is just an example in sizing, because there also is the new FDA approved gummy bear round Inspira implant, called the Soft Touch. Unfortunately I do not have the size chart at this time. I assume that the sizes would be approximately the same as the other Inspira implants. You might even get a few more centimeters of projection with that implant.

    If I were going for an exchange at this point in time, knowing you have had your implants for about 9 years now and one has ruptured, I would want to go with the latest and greatest, most cohesive gel implant available. This new implant has been available in Canada, Europe and Australia/NZ for many years, so it's well tested. THAT is the one I would choose.

    https://www.prnewswire.com/news-releases/allergan-announces-fda-approval-of-natrelle-inspira-softtouch-breast-implants-300384060.html

    Keep me posted! Hope you are well!

    Deborah
  • dogmomerica
    dogmomerica Member Posts: 4

    Hi! Just wanted to say this site has been insanely helpful for me as I navigate the breast cancer and reconstruction world. I’m 29 and was diagnosed 9/7/17 when I was actually preparing for prophylactic mastectomies after testing positive for BRCA1+. I had my bilateral skin sparing mastectomy with TE placement 9/29/17, and chemo beginning in the next 2-3 weeks. Here’s my info:

    Height: 5'2", weight: 110, rib cage circumference: 28"

    Tissue expanders: Natrelle 133SX-12 (350cc capacity) Width: 12cm, Height: 10cm, Projection: 6.3cm. Currently had only 2 fills and at 110ccs. PS says he can overfill and make me whatever size I want. They were left empty at the time of surgery because I am “tiny” and he had some trouble closing up. They initially seemed very wide on me but I think that has improved with fills, although they still stick out on the sides under my arms

    PS uses Natrelle Implants, and I am interested in the Inspira (if that’s what you suggest)

    Pre-mastectomy size: 32A/30B but want to be around a C when it’s all said and done - I was always very self conscious about my small breasts so if I can get them “custom made” I’m going for it!

    Thanks in advance for your help! The 110ccs I have now seems close to my “natural” pre-mastectomy size. It’s amazing to watch them grow with each fill and it’s great to already feel better in my clothes. My husband is amazed by it, too! :) I’m planning to have exchange surgery around May, so I know I have plenty of time but I’m eager to see what my final implant options are!


  • juliempw
    juliempw Member Posts: 191

    Thank you, Whippetmom! As always, you’re so helpful. I’m definitely interested in the newer implant. We’ll see if he’s willing to switch allegiances...

  • whippetmom
    whippetmom Member Posts: 6,028

    dogmomerica:

    I think you want to be in the 365 cc or 385 cc range with an Inspira fullprofile implant. You and your PS can discuss which "feel" would be best for you - whether it is the soft touch or the firmer cohesive gel.

  • amtreb
    amtreb Member Posts: 14

    Hi whippetmom-hoping to get some implant sizing assistance so when I see my PS next I have a better starting place for the final implant size discussion:)

    I am 5 weeks post nipple sparing BMX with TE's ABOVE the PEC as we are doing Pre-pec implants. Scheduled for exchange Jan 9th

    here are my stats:)

    42 yr, 5'9", 150 lbs ribcage measurement approx 32 inches

    breast tissue removed- RIGHT 276g, LEFT 292g (left had cancer, right preventative)

    I have a long chest/torso and athletic build, very little fat in chest (its all in my love handles and saddle bags:)

    I have Natrelle TE now w a max fill of 400cc and thats what they are at now, but I do not know the style number. We have discussed using the teardrop shaped gummy implants Natrelle Allergen 410s. Reading on here there is mixed reviews on the appearance of them.

    I was pretty small before (the post nursing 2 kiddos deflated boob thing) probably on a good day a small B. I would like to be a nice C without them looking droopy but I also don't want round bubble boobs!

    Any suggestions would be great! I asked permission to the photo gallery but if anyone has photos of PRE PEC TEARDROP/ANATOMICAL implants I can't see to find much online.

    Thank you :)

    A

  • whippetmom
    whippetmom Member Posts: 6,028

    There is virtually no difference in appearance between anatomicals and rounds with breast reconstruction. The only time I really can tell, is when the anatomicals are full height, and then they look different. I want you to read the first part of thread header. If you were to go with a round implant, you are looking at a high profile implant from 450ccs to 600 ccs., depending on whether it will be Inspira or the standard Allergan. You cannot use a too firm implant, because since you have overs, you want to avoid a step-off defect


  • amtreb
    amtreb Member Posts: 14

    Thank you Whippetmom!

    I have read and discussed the risks with the textured implants w my PS and my MO. The risk seems very low and neither seem to think I should base my decision on that.

    If the Inspira rounds give a similar look I guess why bother with the anatomicals?? If doing round the Inspira would be the gummy bear type silicone and would that be a softer feel??

    I had no idea there were so many implant variations! Fake boobs were never on my radar :/

    Thank you again for the input! Very helpful!

  • dogmomerica
    dogmomerica Member Posts: 4

    thanks Whippetmom!! My BS thinks I won’t make it past 300ccs or so before I start to feel huge, but I want to make a good choice and be happy with my end result (who doesn’t??)

  • kgirard411
    kgirard411 Member Posts: 11

    I had spoken with Dr whiffed and he said to wait a year. When I called again they said he was no longer taking “insurance” cases, so I was referred to Dr Temple Oberlie. I just saw her and we are discussing Becker’s... wondering if these are newer than the old ones. I would have option of round or teardrop but can’t find many pictures. As you can see, 2 yrs later I am still unhappy with my results which are too small for my curvy body. Try buying a size 16-18 swimsuit with breasts that don’t fit an A cup!

    Any thoughts on Becker’s? And round vs teardrop??

    Thanks

  • kgirard411
    kgirard411 Member Posts: 11

    I had spoken with Dr whidden in 2015and he said to wait a year. When I called again they said he was no longer taking “insurance" cases, so I was referred to Dr Temple Oberlie. I just saw her and we are discussing Becker's... wondering if these are newer than the old ones. I would have option of round or teardrop but can't find many pictures. As you can see, 2 yrs later I am still unhappy with my results which are too small for my curvy body. Try buying a size 16-18 swimsuit with breasts that don't fit an A cup!

    Any thoughts on Becker's? And round vs teardrop??

    Thanks

  • whippetmom
    whippetmom Member Posts: 6,028
    kgirard:

    Here is the reason for the discussion of using the Becker Expander/implant: Dr Oberle can expand you further until you reach the desired volume/size and then seal the port and it becomes your permanent implant. A pretty novel option, since you need to be quite a bit larger. (Read more about the Becker option below). No to the anatomical/teardrop. You already have a pocket formed for a round implant. I think also you would be Iimited as to size and not be happy with having general surgery for just a minute increase in size. If you have sufficient pockets to go larger, Allergan Inspira would be my preference. But if you have fairly taut skin, the Becker might be the best bet. More information on the Becker:

    "Device: Mentor Smooth Becker 50 Expander/Breast Implant
    The Mentor Becker Expander/Breast Implant is comprised of two components: the Becker implant and the injection dome/fill tube. The breast implant is available in a smooth surface. It has a low bleed, gel-filled outer lumen and an adjustable saline-fillable inner lumen. The silicone elastomer fill tube is pre-inserted into the dual self-sealing valve system at the time of manufacture and is joined to the injection dome by the connector system at the time of surgery. The inner lumen can be gradually filled with saline over an extended period of time via the fill tube by injecting saline through the injection dome. Once expanded to the desired volume, the fill tube and injection dome are removed through a small incision under local anesthetic, and the prosthesis remains in position as a breast implant.

  • michelept
    michelept Member Posts: 8

    Hey all.......I'm going in on the 28th of this month for a COMPLETE replacement of my replacements. They've kinda shifted and really look awful. I CANNOT FIND THE STUPID CARD THEY GAVE ME.....I'm SUPER small...I think either 125 or 150 ccs.....how can I find who's implants are in there now, and what size they are? Medical records? They're also going to fix what I call the "bee sting"....a bundle of nerves under my right arm that are horribly painful...they're going to deaden them.


    Thanks all..........I'm 5 years out.....in pain and fatigue from the Arimidex... but still here!!!.

  • whippetmom
    whippetmom Member Posts: 6,028

    michelept:

    Go with Allergan Inspira implants. Smooth rounds.

    Your medical records from your mastectomies and reconstruction (Operative Record) will contain that information.

  • reyepsf
    reyepsf Member Posts: 5

    Follow up question. I had a skin sparing, nipple sparing mastectomy on 10/3/17. My Plastic Surgeon 'installed' 500cc Natrelle Tissue Expanders. My next fill is tomorrow. If I double up and get 120cc, it's supppsed to be my last fill. I'll be at 480cc. I'm not sure if my PS will overfill or if I want him to and I'm not supposed to see him for 3 weeks after this last fill. That said, what do you think about the Natrelle Inspira Soft Touch? I'm concerned that the cohesive gel will be too firm for the look and feel I'm going for, but I'm also afraid of the Soft Touch rippling. From what I've read online, I think I'd like the Natrelle Inspira SoftTouch Gel Smooth Round Full Projection SSF breast implant. What are your thoughts? Anyone out there have them? If you considered them, but went with another Natrelle Inspira Round Silicone implant, what did you choose and why? Thanks.


    I tried to post photos of front view and side view in sports bra, but I'm getting an error message.

  • Kay_November
    Kay_November Member Posts: 1

    Is there a "port"on the Allergan Inspira Natrelle breast implant, style SRM-600, SN 22265061?

  • whippetmom
    whippetmom Member Posts: 6,028

    Kay: No. It is a permanent implant

  • whippetmom
    whippetmom Member Posts: 6,028

    reyepsf:

    The Soft Touch Inspira is certainly one I would personally be interested in, and I have somewhat the same thoughts as you about the recently FDA approved truly cohesive gel. I do not want rigid implantsI have not talked yet with anyone who has the latter, although a number of gals have posted that they would be getting the "gummy" round.

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