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BREAST IMPLANT SIZING 101

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Comments

  • LisaK12
    LisaK12 Member Posts: 18

    Update for whippetmom -- My PS is recommending smooth rounds and says she primarily uses Mentor and Allergan but she will use Sientra if it's important to me. She said she doesn't think it will give me the natural upper pole I want though.

  • whippetmom
    whippetmom Member Posts: 6,028

    Shelabela:

    I feel you need at least 500 to 550 ccs in a high profile smooth round silicone implant. This could be Allergan Style 20, or Inspira, also around the same volume

  • whippetmom
    whippetmom Member Posts: 6,028

    LisaK: NOT Sientra. It is Inspira. Allergan Inspira

  • whippetmom
    whippetmom Member Posts: 6,028

    LoveCanada:

    So you would probably want to look at Allergan Style 20, 425 ccs, a high profile smooth round silicone implant, or something equivalent in the Allergan Inspira line, also high profile. Your tissue expanders are extra full projection style and so you could also be a candidate for extra full projection implants, which might help ameliorate some drooping. If so, "X" style implants in Inspira would be my choice.It all depends on your skin availability. But something in the 400 cc range is where you will want to be.

  • whippetmom
    whippetmom Member Posts: 6,028

    GeminiGirl:

    The pain you are experiencing sounds more like the aftermath of the surgery itself, along with axiallary dissection and nerve damage. .The pain you are experiencing in the shoulders is quite common. But please do not suffer in silence. There is something called Post Mastectomy Pain Syndrome, and it affects approximately 50 percent (or more) of women who have had breast surgery. I would suggest that you put a halt to any tissue expander fills, until you are getting the pain under control. When I say do not suffer in silence, I mean tell your doctors - breast surgeon especially - about your pain and ask for a referral to a physical therapist who specializes in post-mastectomy pain syndrome. You really need to get some early intervention to help with your pain, because regaining range of motion and regaining strength to the upper body is extremely important. I don't want you to end up with a frozen shoulder! There are some other remedies which may help, but first inform your medical team about your severe pain.

    Most women fail to complain to their doctors about the pain and doctors - some of them - will dismiss the pain. But PMPS is a real consequence of breast surgery and your pain should not be swept under the surgery table. There is a thread entitled "Post-Mastectomy Pain Syndrome" here on bc.org. And as Minus Two stated, there are other threads which might be helpful to you as you go through this journey. Keep us posted on how you are doing. Here are links to some information which might be helpful:

    https://www.curetoday.com/publications/cure/2013/winter2013/post-mastectomy-pain-hits-a-nerve

    https://community.breastcancer.org/forum/136/topics/747016?page=1

  • shelabela
    shelabela Member Posts: 327

    thanks much Whippetmom!

  • sandj
    sandj Member Posts: 14

    Hi everyone,

    I had a left sided mastectomy in 2013 followed by radiation and a latissimus flap with sientra round base high projection 370cc implant. I had a 235cc sientra on the right non-mastectomy side to balance. I just had an abnormal mammogram with a biopsy scheduled for this friday and seriously considering a mastectomy on the right regardless of the biopsy results. Since I was stage 4 I never thought I'd be in this position. I am overall happy with the sientra especially the projection bumpy consider fat grafting due to the upper pole transition. Any other brands to consider or general advice? I feel like they are a good match overall right now but thinking they may actually be a better match after a mastectomy on the right.

  • LoveCanada
    LoveCanada Member Posts: 87

    Thanks so much whippetmom!!! I am amazed by you!

  • whippetmom
    whippetmom Member Posts: 6,028

    sandi:


    Allergan Inspira implants are the newest implants and that would be my recommendation. They have a higher fill volume and this can help ameliorate rippling, but also can, purportedly, sustain projection and upper pole definition. Also, you can use a smaller implant to achieve the appearance you would get with a larger volume implant by other manufacturers. I have not heard of anyone unhappy with this implant.
  • b001528
    b001528 Member Posts: 9

    whippetmom- thank you. I ended up having 60cc of fluid removed and in the hospital on IV. Now home on Bactrim. Crazy but the breast is still red! There was no evidence of an infection. I hope I can start fills soon. It has been over a month

  • whippetmom
    whippetmom Member Posts: 6,028
    B001528:

    It is red breast syndrome. It is benign. It will self resolve.
  • Gemini_girl
    Gemini_girl Member Posts: 26

    Thank you whippitmom. I will see the Reconstruction surgeon tomorrow. The strange thing is that it is only on my right side where 13 lymph nodes were removed. I have this hotdog looking thing in my armpit and a lot of swelling down that side. She told me to massage it and wrote an Rx for PT. I have been massaging it and it only turned purple. She also removed the last two drain tubes last Tuesday, even though one's output was between 40-50 mLs every six hours. She explained that if they stayed in for more than three weeks I would run the risk of infection. But two days later the hole where the tube was started leaking and saturated 14 paper towels before it finally stopped. Again she said no worries. Do you think I'll ever get rid of the hotdog thing under my arm? Is it lymphedema? It worries me.

    I will be talking to her about the points you made in your response to me when I see her on Thursday. Thank you for your time and response. I am so happy we have this forum to help us through this journey.

  • whippetmom
    whippetmom Member Posts: 6,028


    Gemini girl:

    It sounds like axillary webbing syndrome (also called axiallary cording). See a PT and get rehabilation started Asap. You need to maintain range of motion in that shoulder. The PT needs to be a PT who deals specifically - or at least in major part - with breast cancer patients. Keep me posted on how you are doing.

    http://www.breastcancer.org/treatment/side_effects/aws


  • HopefulAC
    HopefulAC Member Posts: 46

    Hi whippetmom,

    When you get time please give me your input on how much I should expand TEs for. My PS says he uses Natrelle smooth implants (not textured) and he says implants he puts in are always bigger in ccs than what the TEs are.

    I had BMX 2/8/18 and currently have received 240 ccs each side. I Did learn that I have to do radiation to left breast and that will start in April but they want me fully expanded before I start.(the right one will get deflated by 50% during rads)

    Before my BMX, I was between 34B and C from Victoria Secet but always wore their push ups/underwire ;) I'd like to look like i did before in bras or a tiny bit bigger

    I am 5'3 weigh 125 now but typically I'm at 130-135. My ribcage is 30.5 inches.

    My TEs i have Allegran 350 cc 133FX-11-T

    Thanks for any help.

    HopefulAC


  • Sweet_Pea
    Sweet_Pea Member Posts: 90

    Hi WhippetMom,

    I wrote months ago but we wondered if the conversion size of my ribcage was wrong. I'm pretty sure it's not, because the PS has since told me that because of 1) the narrow size of my thorax, and 2) the narrowness of the base of my breasts, he will not be able to go very large, and I may end up smaller than I was before the mastectomy (I was wearing a 34D, usually wear a 32C but due to weight gain...). This initially caused me to cry for three days, but now I'm getting used to the idea and just want the exchange surgery to happen ASAP.

    He only uses Mentor CPGs for reconstruction (I live in Spain, and they are much more common overseas than in the US, from my research at least). He says I will have the Mentor CPG 323 in my right breast (reconstruction) and a Mentor CPG 311 in my left breast (I decided to have an implant in so he will take out breast tissue to put in the implant and also lift the breast). In my right breast the nipple couldn't be saved, and I don't have the info on the TE (it seems there are cultural differences about what info we generally get).

    I just wondered if you would be so kind as to give me your opinion on his choice, given my stats (it doesn't seem there's much room for change given my limitations in the size department, although I had originally wanted to go a bit bigger -- he said that couldn't happen).

    Height: 5'3"

    Weight: 158 (I know, I'm about 30 pounds overweight right now, but I can't seem to take it off yet...it's not the right time for my body even though I know it would be ideal to get any weight changes out of the way BEFORE the surgery)

    Ribcage: 28"

    THANKS!

  • 1ougirlsdaughter
    1ougirlsdaughter Member Posts: 5

    Hi Whippetmom,

    In January, I posted this:

    I am 61.75 inches tall, 110 lbs, and my rib cage is 29 inches. Before surgery, I wore a 32C, and I'd like to be at least that size. My TE are Allergan 133MX-13-T with alloderm, filled at surgery 300 cc. The PS didn't give me any ideas on what he was thinking other than that he uses Allergan implants. What do you think?

    Your response was the allergan 20 or Inspira 500cc. I am now filled to 400cc, and have surgery scheduled for May. I was ready to ask my ps for Inspira, but my ps left the practice, and I'm with another ps, now. I really like him, but he doesn't do Allergan products. He prefers Mentor. He thinks 500cc is right, as well, in the smooth round.

    My question is do you think I will get as good results from this change in brand?

    Thanks

  • whippetmom
    whippetmom Member Posts: 6,028

    HopefulAC:

    I think you need at least 450 ccs in a high profile smooth round silicone implant. 500 ccs would be better. You should expand to 350 ccs, as your skin permits. 350 ccs fill should certainly be sufficient for exchange to 450 ccs.
  • whippetmom
    whippetmom Member Posts: 6,028

    Sweet Pea:

    The Mentor CPG is fine, if that is the only choice you have. The CPG 323 is a high profile style and that should be a good style for you. You do not mention the volume, and so I cannot comment on that aspect. Also, I would need to know your TE information to compare.

  • whippetmom
    whippetmom Member Posts: 6,028

    1OUGirlsDaughter:

    Mentor is fine. As long as it is 500 ccs, high profile smooth round silicone.
  • HopefulAC
    HopefulAC Member Posts: 46

    thank you!!!!!

  • 1ougirlsdaughter
    1ougirlsdaughter Member Posts: 5

    Thank you

  • Courtneyrivera
    Courtneyrivera Member Posts: 1

    Hello Ladies,

    I was wondering if I have 300 cc's how big of implants can I go? I'm 5'4" 145lbs and band size 32. any information will be greatly appreciated.

    Courtney

  • MD_mama
    MD_mama Member Posts: 1

    I am 5'-9" tall, 155 lbs, ribcage is 31 inches. I had BMX on 2/28 with TEs put in. They are 450 cc Allergan 133FX-12-T.

    Before surgery I wore 36D bras. I always felt my breasts were a bit too big for me. Now that I get a chance for a do-over I would like to go smaller. I am a jeans-and-t-shirt kind of person, I don't normally wear fancy or form-fitting clothes. Would love to be able to go bra-less and have "average" bathing suits and bras fit me and not have the breasts spilling out. I am also not a big fan of cleavage. Makes me self-conscious.

    The doctor put in 240 ccs initially in the TEs and they felt great! I could take the bra off in the evenings when the pain from the straps started to really wear on me (no pun intended) and was comfortable. However the TEs were square, weird looking, with weird corners poking out. I went to the PS last Friday for the first fill, and on first look he said he thought I looked about right and that after the permanent implants were put in that I would be where I wanted to be. But then he equivocated and said he could also fill them a bit more, it was up to me. I thought that "a little" fill would probably be fine and help round the breasts a bit so I told him go for it. He filled them to 300 ccs each. Afterwards it did not feel good, but I figured it is normal, just everything stretching out. So I went home and put on my old bras (all of them!!) and they all fit perfect!! I am back to a D cup (per Maidenform, Bali and Champion). It seems so weird because from reading the forums it seems that 300 ccs should NOT be a D-cup. Is that vanity sizing on the side of bra manufacturers?

    Anyway, I am going back to the dr. next week and he is going to take the fill back out and put me back where I was (240 ccs).

    I would like your advice re: permanent implants. Doctor says he will go with silicone. I would like a natural look, so the top can be a bit flat and then it mounds towards the bottom. Having them protrude out would be nice but I would prefer little or no "sag" (like, I won't be able to hold a piece of paper under the breast. Pre-op I could hold a notebook!!). I realize that the sag will happen with time.

    Thank you!!

  • coachvicky
    coachvicky Member Posts: 984

    I wanted to share part of the posting I wrote in the Nipples Forum.

    I got my 3D tattoos last week. You can read the whole story in the Nipple Forum.

    Here is the biggest learning ... I never could grasp the size of my reconstructed breasts. I have Mentor Classic Style 45 round, moderate profile, silicon, 600 cc each with 6.1 projection. Now that I have my areolas and nipples I can grasp the size of my implants. Before I had no reference point(s).

    I feel whole once again.

    This was a great experience (despite the pain). I love the way that I look. Sometimes I just raise my shirt, look, and cry joyful tears.

    Thank you WhippetMom for all of your counsel and help on this journey.

    Coach Vicky


  • star2017
    star2017 Member Posts: 370

    I’m 5’2”, 125lbs (but I think I’m carrying 5-10lb more than I should). Rt mastectomy with TE, about to get prophylactic on left when I do the exchange. I will be undergoing radiation after surgery.

    My TE: Mentor medium height CPX4 550 cc tissue expander, filled to 350.

    PS said I need a 13cm wide implant. I’m planning to go with the round gummies. He was flexible about brands but recommended the Sientra due to a lower risk of rupture.


    I’d appreciate any insights and recommendations you have

  • Rjmjt120
    Rjmjt120 Member Posts: 12

    HI Whippetmom,

    I am 5'4" and 200 lbs. I am currently a 42 D. Getting a bilateral mastectomy on 5/9 with tissue expanders or straight to implant (also a tummy tuck). What do you suggest?

    Thanks so much! :)


  • whippetmom
    whippetmom Member Posts: 6,028

    Courtney: What style are your implants? See question #2 in the thread header above

  • whippetmom
    whippetmom Member Posts: 6,028

    MD mama:

    I would suggest Allergan Natrelle Inspira implants - in the 450 to 525 cc range. High profile or even extra full profile would be fine. I am wondering if you had a lot of skin excised. Typically there would be large skin envelope to fill up, when there was a larger breast with considerable ptosis (droop).


  • whippetmom
    whippetmom Member Posts: 6,028

    Star2017:

    If Sientra, the smooth round high profile implant, 505 ccs. But actually, it also depends on the style of your CPX 4 TEs. I would like to know the width of your TEs. I think you could achieve better projection with an Allergan Natrelle Inspira, smooth round high profile, but plastic surgeons have their favorite reps in various lines. I do not know of any study or trial which shows Sientra with a lower rupture risk than any other brand

  • whippetmom
    whippetmom Member Posts: 6,028

    Rjmjt120:

    Unless your PS performs the full "Allobra" (full Alloderm or other matrix coverage) approach, I would recommend tissue expanders. I think you want to be in the 700 cc up to 800 cc range, smooth round high profile, preferably a highly cohesive round like Natrelle Inspira or Sientra HSC.

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