BREAST IMPLANT SIZING 101
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Hi Whippetmom!! I wrote for advice some time ago, but didn't have all the information you needed until now..lol! I am 5 feet tall, 105 lbs., 32 in. ribcage. I have Allergan #133SV TE's., short height, 300 cc's, (13 x 9.1 x 5.7). I had previous BC in 2001, with lumpectomy and radiation. New diagnosis in same breast Dec., 2009. Had BMX on March 5th.with immediate TE's. I am now filled to 300 on the prophy side, and 365 on rads side. I have CC on rads side and just couldn't take anymore fills. He will have to lift prophy side as there is lots of skin there. He is going to use Allergan 410's anatomical textured, but doesn't seem to want to discuss which sizes he is going to try. My exchange date is Oct. 5th. I don't live in the samecity as him, so communicating has been hard. (got most fills at local PS's office). But he is considered to be one of the best PS's in British Columbia......I'm in Canada. Let me know what you think.
Thank you,
Cindy
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jc3win: Well, if you were starting from "scratch" - without the flap - I would say a high profile smooth round silicone implant with a volume of 600ccs to 650 ccs. But I have no idea how much volume is provided by your flap. So the PS is going to need to calculate also how much room he has to insert an implant without prior expansion. So your goal is to communicate to your PS that you would like to, with your flap plus implant, approximate an implant with a volume of 600 or 650 ccs. So whether that is a 300 cc implant or a 400 cc implant, I do not know. And then the implant is selected for the opposing native breast to achieve symmetry accordingly.
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PICTURES FORUM IS BEING TRANSITIONED TO A NEW WEBSITE AND IS CLOSED TO NEW MEMBERSHIP UNTIL AFTER SEPT 1ST.
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Deborah, this is starrting today??? I was going to post a new picture sans ace bandage since I can finally shower today.
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Kate: Sorry, I missed the first part of your question to me...Yes, I have actually had two fat graft transfer procedures. The first really did next to nothing. The current benefits of the combined procedures, I would say, made it worth the dual procedures. I do have some areas of indentation - especially in the superior medial region, which was entirely resolved with fat grafting. I still have some rippling, but only noticible to moi - standing in certain positions. I had a step-off bilaterally and the prophy side is much improved but the MX side step-off has minimal correction. The most appreciated benefit was the little bit of tummy "tuck" I received as a result of the liposuction. After menopause - or MENOPOT - I developed a little tummy which would not budge with diet or exercise. So it is nice to have this out of my life for good.
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Robyn: Having a one-step is fine, but you want to make sure that you have a sufficient mound after all is said and done. If you have signficant droop, you will at least want implants to fill up the pocket, and after MX, your skin is going to retract and you will have far less skin than you have currently. Telling a PS that you want to be a "C" cup does nothing, unless he plans on taking your C cup bra into the OR. It simply takes more volume than you can fathom, to create a sufficient mound on the chest wall after mastectomy.
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The emphasis on the word NEW membership MBJ....you are an OLD member!!!
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saskabush:
Your PS used a low height TE for some reason. Since the pocket is to be created with the implant in mind, I can only presume he planned for a low height anatomical. That would infer using the following:
410 LM - 320 gm - 13.0 cm wide by 10.9 cm tall by 4.8 cm projection
410 LF - 310 gm - 12.5 cm wide by 10.5 cm height by 5.1 cm projection
I think that you might be able to possibly achieve more volume with a standard silicone round implant, but since you have had radiation, the gummy affords you the lower risk of capsular contracture. It all depends on what the PS is able to achieve. Of the two above, I like the dimensions of the 410-LF better...
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Melissa: Sorry....I thought I responded to your post but I see I did not! I think I would like to see what you look like at this point. You can always email me a photo.
I think that the difference between 375 ccs and 400 ccs would be miniscule, but if your PS is willing to use a 400 cc implant, that would sound great to me. But I always err on the larger side of the implant spectrum when the PS is willing and the skin permits.
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Deborah: I went to Macy's today because I couldn't resist even though I can't wear a regular bra for 6 weeks: 36D in the Warner's This Is Not A Bra!!! I am hoping that I can get a wireless in the same look (the Satin Tuxedo Wireless Bra). They didn't have this size in stock:(
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I have a question. Once you get the TE's, approx how long until the exchange? And how often do you get fills?
Thanks.
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anne: I am no expert and I am sure whippetmom will be on here soon to help you, but it depends on the ability of your skin to stretch and how much skin was left after MX. I had a UniMX on March 20th and just had my exchange on August 19th, just five months total. I woke up with 150 cc's already in but wome women have to wait for the first fill. I had my first fill after surgery 3 weeks later and subsequent fills at close to 100 cc's every two weeks but as it progressed it was lower cc's, three weeks in between, and it started to hurt towards the end and then I said no more when we reached 535 cc's! after this it was about 2 months waiting. If you have large breasts and lots of skin leftover, they may be able to do this in quite a short time. If you have had radiation this time can extend much more. My skin was thin, however, it stretched quite easily. I hope that this helps. If you give all of your details oulined above, whippetmom can assist you better.
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Anne: MBJ answered above. I would add that every PS has an approach to fills, but there is no need to rush through this process. Most of us waited an average of three months after the final fill before going through the exchange.
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MBJ: I wager you will be a different size at Nordstroms though.....
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Deborah: Bigger????
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Well you typically go down one band size and up in the cup with Freya, Chantelle and European bras in general. What is your ribcage again?
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Deborah: My ribcage is 32".
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34DD
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Wow! Who woulda thunk LOL!!! I haven't worn a 34 in years. Maybe I was just compensating with a 36 to get a bra that somewhat fit! Thanks Deborah!
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SEPTEMBER 13th! Whoo-hoo! Exchange date is set! He ordered Allergan 20's -375cc for me. Thanks, Deborah!!
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Michele: Wonderful news! That day will be here before you know it!
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Deborah..i am gonna ask your advice before I go for the last fill next Thursday..as I will have to decide by then and get an actual date. If you remember me..I had my TE replaced with a new one in July. My photos are also on the photo site..but if you would like a newer one, Please let me know
I am 5'1' weight 125 lbs. My ribcage is 32. I now have a Mentor Siltex med ht 354-6214
w-13.5 / h -11.7 / proj-7.4
fill size is 550. I am at 480 right now and I am happy with size, projection etc.
my PS thinks I have approx 200 cc of tissue in healthy breast. he told me to choose a size on the MX breast and he will augment the other to match..
what's your opinion ??
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The problem, T&C, is that your PS would never be able to match the projection of your TE currently. The TE projection is exaggerated - there is no implant to match the projection and it is solely to aid in expanding the breast as much as possible so that the skin has good implant coverage and to allow for retraction. The closest you could get to the dimensions you have currently would be with a 650 cc Style 45 in Allergan, which is an extra full projection implant. But getting symmetry with the native breast is key and that Style 45 is a really tall implant and I just think it is safer to use with bilaterals. So I think you should stay with the high profile implant. It would take at least a 500 cc HP - or a 550 cc HP implant - to match the width you have currently, and it is a good width for you, BTW. Now your PS could use a Mentor Spectrum expandable implant in the native breast, so that he can get as close as possible in symmetry with the MX side. Nedeza and SandySunshine - see their pics on the forum - had their PS' use this method for unilateral recon. I am not sure how much droop you are going to have with your native breast, once he has that implant inserted, and so he will want a little droop with the MX side which means a smaller implant possibly. I definitely feel that the high profile implant is the one you would like best. So I would ask your PS to take in two sizes at least - 500 and 550 HP - since you are happy with the projection you have currently and you want to retain as much as possible. The PS could use a smaller HP or MPP implant in the native breast if you want to stick with silicone. The Mentor Spectrum expandable is saline. Hope this was not confusing. Just wanted to give you all of your possible options.
Deborah
EDITED: I went back and looked at your photos. I feel that you also need some lateral pocket revisions at the time of the exchange - just to make sure that the implant does not migrate towards the armpit. Between your 360 cc to 460 cc fills, the pocket seemed to widen quite a bit. Are you sure your ribcage is 32 inches? You are measuring under the TEs? You look smaller in the photos....
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Kate and Deborah, I, too, have ripples. My PS says he can take care of with fat grafts which he does a lot of. He'll do at the time of areola/nips (next Friday!). I feel like I need a lot of fat on my prophy side to cover not only the ripples which are not too visible but the feel of the implant is my biggest problem. Can you guys actually feel the skin of the implant easily? I actually have a place where the implant skin comes to a point near my arm! And if I put my palm on the foob, it feels like a baggy of jello, but I can feel the baggy. I am wondering if fat grafting can take care of this? Interestingly, when I am laying on my back, or even a little reclined, the prophy side feels firm, no baggy feel. Thoughts?
Related to another sister's question, I had flap surgery and my PS expanded me the same on each side and put in the same size implant. The difference for me is the flap side is much firmer. deekaay
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Can you get TE's while undergoing chemo? Or do I need to wait?
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You have to wait Anne. They don't like to perform surgery on you till at least a month after finishing chemo. (Or: prior to starting chemo).
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Thanks Lilah. That's kinda what I figured!
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Whippetmom,
This is the first time I'm posting although I've been reading messages for a couple of months. Last summer I had ovarian cancer, had a hysterectomy, and went through chemo. I found out I'm BRCA 2 positive and the genetic counselor told me because of my family history that I had a 65% chance of getting breast cancer. So, at the end of June this year, I had a bilateral prophylactic mastectomy with LD flap and TE reconstruction. The PS put 200 cc of saline in at the time of surgery and so far, I've had 2 fills. Right now I'm at 370 cc and we're thinking that is all I will need. I was a 36C before surgery and would like to stay the same, if possible.
On the TE card I was given, it says Allergan 133MV-12 Tissue Expander 300cc. I am 4' 11" and weigh approximately 128 pounds. My ribcage measurement is 32.
Even though I've had the same amount of saline put in each side, I don't think I'm the same size in each one. I put on the bra I used to wear, and right now the left side fills the cup completely, but the right side doesn't seem to be totally filled. Is this something I should be concerned about?
I would appreciate any advice you could give me about implant size. I know at my next appointment which is in a couple of weeks, I will be discussing this with the doctor.
Thanks,
Ann
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Ann: If you are happy with the TE volume you have currently, you will need an implant with a base width of 12.0 cm most certainly, and I think that the Allergan Style 20 [high profile smooth round silicone] implant would be best, at 425 ccs preferably, but certainly at least 400 ccs in the same style. At 400 ccs, you would have 11.9 cm width and 5.0 cm projection. Another recommendation would be the Allergan Style 15, which is a moderate plus profile implant, in 339 ccs. The dimensions would be: 12.4 cm width by 4.2 cm projection. This would reduce the projection quite a bit...but allows you to maintain the width, which you need. It all depends on whether your PS is willing to use the higher volume implant. But rather than volume to volume, we are comparing TE dimensions to implant dimensions and the 400/425 cc volume should be attainable. Talk to your PS about this...
Deborah
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deekaay: I have some thoughts about your implant....but my brain is just fried tonight and I am going to hash over these things with you tomorrow when I have a fresh perspective...
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