BREAST IMPLANT SIZING 101
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Hi, Whippetmom, curious about your recommendation for sizing.
I’m doing bilateral reconstruction. I’m 5’7 160, but usually run around 145. Gained a bunch of weight during chemo that I’m working on losing.
35 inch rib cage. I have Allergan 133-mx/12/t 400 ml tissue expanders. I was a c most of my life, went up to d after nursing twins. D was kind of annoying. My ps uses naturelle implants. I think that’s everything you need? Any thoughts appreciated!
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OMG! I have NEVER posted anything on a forum before. It scares me a little bit. I have read every page on this thread over the months and I think I have the general idea of how the exchange process works. I am having a hard time finding the right implant dimensions that come close to my tissue expanders.
I am 5'2" weigh 127lbs rib cage is 31"
I have Natrelle 133mx-13-T tissue expanders filled to 620cc. Width 13 Height 12 and Projection 6.7
Prior to bmx I had 255 grams natural breast tissue and 300cc implants. Looking to be about 100cc bigger than before but I can't find any implant that would be in the 650cc range with such a high projection @ 6.7. Can you please help me?
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Hi All, You may also want to send Whippetmom a Private Message if you haven't heard from her.
Skaylog, we are glad you got up the nerve to post, and welcome to our community!
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WhippetMom checks in about once a week or two. Could be she is on vacation. Skaylog - she should answer you soon.
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Flynn:
Well, I think you need to perhaps overfill (to skin tolerance of course) and ultimately exchange to a 550 to 650 cc implant, smooth round high profile. The Natrelle Inspira would be my recommendation
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Skaylog:I am glad that you mustered up the nerve to post! Thank you also for doing your homework.
One rarely is able to match the projection of an implant to a "X" tissue expander. The reason is that if the implant is the same projection, there would be a challenge in getting good skin coverage over the implant to close the incision/wound site. I think you can achieve the appearance you desire with a SRX/SSX implant - or an extra full projection style in the new cohesive version. You will want to remain in the 13.0 to 13.5 cm range width-wise. So you see you can get quite close to the projection of your TEs - plenty close in my book!
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Thank you Minus Two and Mods for your input. I have been crazy busy painting my house! I wish I could get TEXT alerts when someone posts
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Thank you Whippetmom! As soon as I posted this I received an error on my end saying the forum received "a fatal error from which it could not recover". I thought I broke the website! Lol. I will definitely discuss with my PS. He and I have a great rapport when we are discussing anything else besides my body. It's strange. I am scheduled for exchange April 11th and whenever I have asked what implants he recommends he usually says he has not decided yet. He is a great doc in my area but I want to be armed with knowledge when it comes time to order "models" for the o.r. I thank you a million times!
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Thank you Whippetmom, that’s very helpful!! Hope your house turned out well!
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Hi! I have been reading in silence. I have so much admiration for everyone on the thread. I just had my second surgery. I had the TE removed and memory shape high profile 555cc implants placed on February 2nd. I’m a little worried because they look so big. Seriously hoping it’s swelling. Does anyone have any input in that area? I still have to undergo radiation- 5 weeks. PS plans to do fat grafting and nipple reconstruction at separate times. Any input is appreciated
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Rozzydozzy
It depends on a number of things. What is your height, weight and ribcage circumference? It might be post-op swelling, which typically resolves within two to three weeks.0 -
Whippetmom,
Thanks for your reply! I was very afraid of posting and joining the conversation for so many reasons. My ribcage is 28 inches and I’m 5’6 tall. I weigh 135 lbs.
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Hey everyone.
I'm a first timer and I keep wondering what cup size I might be after my exchange surgery. I'm worried I might be going too big (even though the expanders look perfect right now).
I'm 27, 5'5", 270lbs, 44(ish) inch rib cage, and before my double mastectomy I was a C cup. I also, apparently, have a deep rib cage? My PS & nurses had problems finding my port the first few weeks of my expansions because it was so deep in there. I had to be fully laid down and tilted back so they could find it... I currently have Allergan tissue expanders (133SX-14-T) and my PS wants me to get filled up to 950cc or 1000cc. Chances are I'll go up to 1000c (currently at 900cc. I didnt start to see any sort of roundness until I reached around 500cc).
After my double mastectomy I gained about 20 pounds but I plan on losing that, and then some. My dream is to get down to 200lb, I look and feel good there... that said, will I look absolutely ridiculous after my exchange surgery? Will I be a DDD or something? I told my PS I'd like to be around C (D is fine, too) so he's well aware of this.
Just confused and looking for any kind of light in this dark tunnel. Thank you.
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Hi - I am still pretty drugged up from surgery today but had planned on getting Mentor smooth round plus 500cc with fat grafting. But when I was discharged I was handed a card that said my devices are Allergan Natrelle Inspira Cohesive SCM 485cc.
I would not have agreed to Allergan because of the risk of lymphoma. Perhaps these are not anatomicals? I know there’s tons of info on here about this, but I am too upset and pissed to read everything right now. Can anyone please fill me in on Allergan Natrelle Inspira Cohesive SCM? It seems some people like them? Mine are flat and look saggy and have only been in me for a few hours.
SOS.I haven’t cried this hard in many many years.
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Ceci-246...I'm not the expert, but the BIA-ALCL (implant associated lymphoma) is connected to the textured implants and you received a SCM (Smooth shell surface, highly cohesive silicone gel, moderate profile), not an anatomical textured one. I have an Allergan Inspira SCX (similar but with a extra-full profile) and I specifically choose smooth to avoid the risk of lymphoma. Hope others can help you with more information.
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Rozzydozzy:
So it is sort of a subjective issue when it comes to size. You are in the size range with your ribcage and height to weight ratio, that some women might feel they are too big. Some women would feel they are too small! Mine are 550 ccs and I am 5'3" and 115 lbs and 29" ribcage and I like the size. It also depends on the style of your anatomicals. That could make a very significant difference. What style are they?
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Amya90:
Do not breathe another word about cup size to your PS! There is no way a PS can predict cup size. That ship has sailed.It is all about what looks right to you...what looks right on your chest wall/frame. You need larger implants because of your ribcage characteristics. It is an anatomical issue which needs compensating in both style and volume. You will need 800 ccs in a ultra full projection style implant. If you get Inspira implants - the largest ultra full in that line.
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Ceci: over70 is absolutely correct! All is good! You have an excellent product and no worries regarding this implant
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Thank you over70 and whippetmom! I am so grateful for your help and this forum. Can you tell me how Cohesive gel is different?
update: my doctor just called, apologized, explained his process (that he will now change to discuss in detail various brands and types), and answered all my questions. That was good. But this forum is great. Thank you wonderful women
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I pray today is better for you and you have comfort with your surgery and implants.
Coach Vicky
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I appreciate your prayers Vicky! I am so much better today.
I’ve had a number of surgeries (and woke during surgery once so have to get heavy doses to keep me under) but yesterday was the first time that I awoke after surgery completely revved up as if I had been given amphetamines. It was weird and made me super anxious. I couldn’t rest or sleep. So I think the good cry was in order - especially since it was the only time I cried about this ordeal since diagnosis.
My doctor called and talked with me for 40 minutes, answered all my questions, and thanked me for helping improve their communications with patients.
Thank you for your support!
Ceci
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Ceci..so glad that you are feeling better after the long discussion with your doctor.Thanks for letting us know.
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I am so happy that today is better for you.
Is there anything that you can share with others so that waking up without what someone expected would not happen to them?
I have heard that some PSs take more than one type of implant into surgery in case something won't work.
Coach Vicky
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I posted this in the Latissmus Dorsi Construction page but have not heard from anyone so I thought I would ask here. I had my appointment with my plastic surgeon today. I am 5 weeks post rads and we were talking about my reconstruction surgery. I had a BMX with tissue expanders and ALND. The non-cancer side was a nipple/skin sparing. After I had chemo and rads. My cancer-side TE has always sat higher than the other side and it looks like rads has pushed it up even more. It is larger and higher than the other side. She is suggesting I think about having the Latissmus Dorsi with implants because she thinks I will have better results. She said she would use a round smooth implant which would stay in place better with this procedure. Have any of you had this procedure with implants?
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Hi Vicky,
I would recommend that women ask their PS if they take more than one type into the OR, and what types the PS is considering using. Early on I asked what type and was told they only use Mentor. My PS explained that they only used Mentor since 2005, but he recently started using Allergan's newer Natrelle Inspira because they have a higher fill volume and have less rippling for women with thin skin (pre-pec). He said he originally thought he'd use the Mentors because he likes how soft they are, but would have to wait and see when he went in to take out the tissue expander how thin my skin actually was. He said it never occurred to him that I would care which brand because they are similar types of silicone. And the scheduling folks only send out Mentor patient brochures (that includes a mandatory consent agreement that you are agreeing to that product after careful consideration) because that's what they've been doing for 13 years.
I am a lawyer who has recently been involved in cases regarding informed consent for participation in research, so the issue of what I actually agreed to matters to me, particularly if something were to go wrong.
I visit this forum often and it seems to me that women do ask their PS lots of questions, shop around for PSs depending on pre-pec placement, etc. I didn't do that - I like my PS, I trust him, and even though he failed to communicate with me, I feel like he makes good choices for me (he fought my BS to keep my nipples and then used aeroform TEs so my recovery and range of motion has been excellent). He said I was the first person to complain about the consent form and patient brochure and thanked me for bringing the issue to his attention so he can be more specific with patients. I told him that my experience on BC.org showed me that there are many many women who care about the details, research various brands, and consider their options seriously before agreeing to permanent implants.
As to the size and shape - he suggested that I buy a bandeau to wear over my bra above the breasts to help the implants drop into place.
Ceci
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Ceci-246
You write an informed story.
I am, however, sadden when I read: "He said it never occurred to him that I would care which brand because they are similar types of silicone. And the scheduling folks only send out Mentor patient brochures (that includes a mandatory consent agreement that you are agreeing to that product after careful consideration) because that's what they've been doing for 13 years."
These are our breasts! Of course it matters.
Based on WhippetMom's recommendation, I had to communicate very directly with my PS to get the rounded shape I wanted. He told me that he "preferred a more natural slope on an older woman." I replied."Are you freckin' nuts? I am going to look bought and paid for after what I have been thru." I got what I wanted. BTW my PS is awesome. I think he feared that I wanted a Dolly Parton look. Thanks again, WhippetMom for teaching me.
I had to contact the company directly to get the reference materials I wanted for the same reason that my PS's office does not often use what I wanted.
I have not seen a forum on BCO about informed consent or direct communications before surgeries. Would you consider posting your story on a forum like that or starting one. I want your story shared. This this can happen to a lawyer involved in an informed consent case, who else might this happen to?
I used tube tops from Amazon.com to hold my new breast in place. They come in a variety of colors, fit snug (read the reviews), and are fairly inexpensive. And as WippetMom shares, get a good bra fitting afterwards.
Coach Vicky
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You all might find this "exchange" thread useful. Anything & everything that can possibly happen during & after exchange has been discussed, as well as great support through the process.
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Hi Vicky,
I would be happy to start a new forum or topic so that this thread can go back to the topic of sizing and the excellent advice from whippetmom.
Btw, he may not have said exactly those words about patients caring about the brand - I think he was saying that he considered it his call and didn’t think to ask. While we were waiting for the OR, he looked up the sizes closest to the 500 I asked for, and asked me to choose between 485 and 520. That would have been a perfect opportunity to say “I’m thinking of using Inspira and their sizes are 485 and 520.” He acknowledged that his thinking and hospital processes need revision and thanked me for bringing this issue to his attention. He is the director of breast reconstruction so it’s his job to change the processes. He said he was always more focused on the hospital consent documents and thought the patient brochures were boilerplate FDA mandated language. He asked me to review the Inspira brochure and compare it with Mentor - if I felt so inclined. I am glad my PS realized how clueless he was and will implement new procedures.
I agree with you completely that these are our breasts and we should be given as much info as possible. My friends think that most women probably don’t ask and just trust their doctor, but I haven’t seen much evidence of that. Instead, I have seen very informed questions and highly educated considerations like your insistence on getting the implants that you want for yourself. Again, I’m so very grateful for the amazing women here.
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I was told about 800cc being the largest silicone implant but I was still no where near comfortable at 800cc so I chose to continue filling, even if it means getting saline. Next Tuesday I'll be up to 950cc and the last Monday of February I'll be done at 1000cc... And to be honest, I feel so incredibly ignorant about the different kinds of implants. I feel so out of the loop about things.
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Whippetmom,
I’m noticing a decrease in size with the swelling coming down. They are medium height, high profile, memory shape (mentor). I saw my PS this week and he mentioned my left side may shrink after radiation and I may need a revision after that.
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