BREAST IMPLANT SIZING 101
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Hi WhippetMom!
Seeking your advice on reconstructive sizing. I am 42ys and had a bi-lateral mastectomy in May with Allergan 133FV-11 300cc textured TEs placed. I am 5'9 1/2" and 143lb. I measure 33" under the tissue expanders and wore a 34B prior to surgery.
My PS uses Natrelle implants (saline, smooth silicone and textured gummy-per request I am told with the recent health concerns. He previously exclusively used these). I was told that my skin is looking very thin and tight and that we may not be able to get back to my pre-surgery size. I currently have 230cc. My PS said we may or may not be able to do any more fills in July when I go back. I have been using 'boob lube' pregnancy creams trying to keep my skin as stretchy as possible, going to a PT to try and loosen the muscles and trying to gain weight so I can possibly do fat grafting at some point. Anyone else told their skin isn't cooperating? While nursing two kids I went up to a small 34C, which I loved. At this point I will be happy and thankful to just make it to a full B, cause what I got now is not close to what I had when I walked through that door in April.
My exchange surgery won't be until October/November. Given my measurements, how many cc's should be my goal be and what type of implant would you suggest? Any thoughts on the skin issue? Any advice is greatly appreciated!
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Thanks so much whippetmom! I'm at 400 and feel huge, but I really think it's the width vs. my petite frame. I'm having one more half full tomorrow (just 25 ccs) and then I'm done. Implants should be a little smaller than you suggested, upper 300's close to 400 but it's going to be enough, I hope. Exchange is in 4.5 weeks and I'm counting down the days! Thanks again
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NYMinute:
Please private message me and attach photos. I want to see how tight your skin looks. The TEs are a bit narrow. I think you could use smooth silicone rounds in the 400 cc to 450 cc range. You breast fed, your skin has stretched, so I would like to see how things look.0 -
I am a 57 year old female diagnosed with breast cancer 10 years ago and underwent a double mastectomy with reconstruction. I am 5 feet tall and small framed - I weigh 102 lbs. Prior to my surgery, I was barely a B cup (I wore a 32B bra). At the time, I wanted to be much larger and I currently have Allergan Natrelle high profile silicone implants, style 20 - 350 cc. I am a VERY full 34 B now (I feel very wide) and have regretted my decision for at least 5 years. I wish I had just asked to keep my reconstructed breasts the same size. I visited my plastic surgeon today and the nurse showed my 265 and 295 cc implants. First of all, when I looked online on the Allergan website, I did not see 265 or 295 cc as an option for the style of implants I currently have. I saw 260, 280 and 300. The nurse seemed to think I need to select 295 in order to still fill out the B cup I was currently wearing. She felt the 265 would be too narrow. I don't know what to do and I want this to be my last elective surgery. I was hoping someone could give me some advice.
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Hi Whippetmom,
I currently have 485cc Natrelle Inspira smooth cohesive moderate profile, placed on 2/14/18 w/fat grafting. There is some asymmetry and my PS plans to do another round of fat grafting in the fall to fill in some lost fat and make some tweaks to balance them out.
I was considering getting a higher profile but don’t want to lose the width I currently have. My rib cage is about 33”. Do you know how many more cc’s would be necessary for a high profile (not ultra high)?
These implants feel a bit heavy for me but I’m concerned about rippling if I go with a softer type. So, I think I could stick with the cohesive if I don't go too big.
Thanks for your help!
Ceci
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Never mind! I found the Natrelle Inspira product catalogue and see that to keep the width of 14, I would have to have 605 ccs. Or reduce width to 13.5 and get 560cc in smooth cohesive full profile.
I wonder how much fat grafting can be done to compensate. My PS says one usually only retains about a third of the graft.
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LAL78
I think you are referring to the Allergan Natrelle Inspira, full profile implant, yes? If so, the dimensions of the 295 cc implant have the same dimensions as your Style 20, 350 ccs. So you are not really going to see much of a difference, if any.
My concern is about your problematic width of the implants. It makes me wonder if they are too lateral on the chest wall. Do you have a significant space between the implants? Do you want to private message me and attach photos? If they are indeed just too wide (and these are narrow implants, so in nearly every case I have seen with someone your size, 11.4 cm in width is not usually an issue) you could go to 11.0 cm, but I would not go much narrower. Photos will help.
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Ceci: Good job! Yes, you would need 605 ccs. Maybe 560 ccs. Fat graft transfer is a less invasive option. How much it will approve asymmetry, I do not know. I know it could certainly help.0 -
Hi Whippetmom,
I'm so glad I came across this thread!
5'4" 103 pounds (goal is 108 lbs) 27" ribcage
Had previous augmentation from A cup to 30DD, implants were 350 silicone, 20 years ago.
I currently have Natrelle style 133LV-14-T TE's in both breasts. MFR volume is 350 cc.
One breast a lot of skin was taken, including nipple so surgeon has advised that the skin can only stretch so much.
I'm at 385cc. Our goal had been 425cc. Doc said to see him in a month (2 weeks from now) to see if we will do one last fill. Seems my skin is stretched as far as it can go. I have a feeling we may not be able to do one last fill as it's really hurting on the affected side.
He mentioned our goal is Inspira implant 14 cm SRF 600 cc but reminded me it depends on my skin. PS and I haven't discussed textured or smooth. He mentioned fat grafting and lifting my unaffected side.
I have no idea what 600 cc would put me at, if we can get that in there having been expanded to only 385 cc and if SRF is best choice. I'm hoping to return to the size I was before mastectomy with projection. I'm loving the pics I see of extra high profile but it's my understanding Inspira SRF is high profile but not “extra"
I would love to have your input
Thanks so much!
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NYMinute, I feel like I'm in the nearly the same situation. I'm 42, 5'11" 140lbs and was a small 34B before all this. My expanders could hold 450cc and my goal was 400cc but my PS cut me off at 330cc. She said I'm stretched to the max and my skin can't take anymore. I was disappointed. I didn't want to be huge but was hoping for a full 34B. Now I'm just so ready to have these expanders out that I don't care as much. I've been having really bad back pain so maybe staying small will help with that. Anyway, I'm curious as to whether you were able to get any more fills. Just curious about your experience and wondering now that it's been a few weeks if its worth trying one more small fill. Thanks!
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Hi Whippetmom.
I am BRCA2 positive and had a double mastectomy with tissue expander placement. I had exchange surgery three weeks ago and feel very flat although width is ok. This is not what I expected. I've talked to my PS and I go back in late August to discuss exchange and replace. I'm very concerned about getting the right size this time. I am a full B now but would like to be a C.
I'm 5'4" and 120 lbs. Rib cage is 29.5 inches. TE were Mentor and overfilled to 275cc and MR#6694854. Before mastectomies I was 34B. My current implants are Mentor Smooth High Profile Memory Gel Xtra 355cc.
I would appreciate any help or insight. Thanks so much.
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Jojo, it took a couple months for my implant
to look nice. You may feel differently by the end of August.0 -
Plumeria:
Well, 600 ccs is a considerable implant for your frame. I am 5'3" and weigh 116 pounds. My implants are high profile 550 ccs. You are smaller than me and so 600 ccs should be perfectly fine. I wear a 34 DD bra -sometimes a 32 or 34 E. So you would be around a 30F or G in a European bra.
BTW, European bras fit the best. Like Freya or Chantelle - my favorites. The conundrum is, you LOOK smaller than your band/cup size, but that is one of the mysteries of breast reconstruction sizing. 0 -
JoJo: Please private message me with photos. With 350 cc full Mentor implants, you should not look flat. I want to see what is going on.
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Whippetmom, help, I had a DMX and te's placed on July 3rd, I am having horrible pain in the top and sides of the te's it feels like they are too tall and too wide for my chest, the pain in the sides is in my armpits where there must be cartilage and the top its so sore I can't even touch the skin there. I'm sorry but I don't have info for you on the te,' s I barely remember the PS saying he filled me to 40%of my desired goal during surgery
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Hello all...This is my first post, I have been reading posts on this forum for the last few months and have found it so helpful in making sense of this difficult time in my life. Thank you for sharing your stories and advice, expertise and recommendations....heartfelt appreciation:)
Whippetmom, I have BMX scheduled for Sept 13th. Having LD flap recon and TE’s placed. I am 42 years old, 5’7, 142lbs and measure 30.5 around the rib cage. I am a small B now, would have been a fuller B before breastfeeding my 2 kids:) Hoping to achieve bigger breasts if possible with this surgery, not huge but definitely fuller and with less sag. My PS uses Allergan, and has recommended “small” TE’s (he has made a note of 400 cc capacity) with the aero form expansion system. We didn’t discuss type of implant at the initial consult but he has written Allergan 410 in the notes.
Until the surgery, I won’t know if I need radiation, I hope not but it is definitely still on the table due to DCIS in margins from lumpectomy.
I have read this entire thread with great interest. Any recommendations for me?
Best Regards,
A
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Hi Whippetmom!
First time poster here
I had a bilateral mastectomy on May 29th. Invasive Ductal Carcinoma. ER+ HER2-. Saline temporary expanders were put in, over the muscle, at the same time. I see that my doctor made the list for over the muscle recommendations, which made me happy. I'm very happy with results so far.I am 5'10", 150 lbs, ribcage is 32". Pre-surgery I wore a 36C. The saline expanders are Allergan Select Tissue Matrix, 500cc moderate height expanders filled to 400cc. I am basically the same size now as pre-surgery. I would like to go bigger, full D, but I know they don't use that terminology. My PS only uses silicone gummies. After reading everything on here, I am thinking non-textured Allergan Natrelle Inspira, but really not sure about going with a "round" implant. Any suggestions on how many cc's to request to be a large D or anything I am forgetting?
Thank you!!!!!!!!!!!!!!!
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Not whippetmom, but I am about your height/weight. I have over the muscle Natrelle Inspira SCX in 615 and 650. I now wear a 34DD. To look at me, I'm not "huge" and I really wanted the projection the SCX gives me. As my PS said, "Tall women need to have everything front and center." I am pleased overall with my results.
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Hi there! I am hoping to get some help. I’m having a bilateral mastectomy on July 31 and I’m focusing on my size for after. I am 5’1”, 130 lbs and rib cage is 29” (measured from right under my breasts). My surgeon is going to use under the muscle Allergen tissue expanders and size is 11-12 at the time of the mastectomy. Then after he will use mentor sientra (I was told he could use gummy bear or reg to be discussed later). I do not know what size I am currently since my cancer was found during a routine reduction. I am wearing a medium sports bra but still swollen. I’d like to be a large B cup(I think) and before my reduction I was DD/small E. Can you please help me??
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Whippetmom,
I am SO grateful to have discovered this forum! I will be having my exchange surgery in the next month or so, and am finding myself so stressed by the decisions about what size implant should be used. I am 5'5'' and weigh around 145 lbs. My rib cage measurement is 34 1/2" and I have Natrelle tissue expanders, 500 mL, style 133MX-13-T. I am currently filled to 420 cc and I feel that they are bit too big and bulky looking for me, particularly because I am short-waisted so I don't have a defined waist. Unfortunately, the fill bringing me to this size was a double fill so I was unable to see what a slightly smaller size looks like on me. I was originally a (saggy) mid B cup before my surgery and asked to go a bit bigger and fuller. I would be terribly grateful for input as to what would look proportionate for my size.
Mary
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taragervais...just reading through this and we have similar body types. I'm 5'11" 140 lbs. My expanders can hold up to 475 but they stopped filling me at 375cc because my skin was too stretched. My exchange is scheduled for next Wednesday and I'm getting the non textured Allergen Natrelle Inspira. Inervous about the roundness but my PS says they're the most comfortable and being so tall I can pull it off. I likely will be an average B cup so if you're looking to be a D, you'll probably need more fills. I was bummed I had to stop but now I'm just ready to be done.
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debsmisto:
You should not be at that level of pain with tissue expanders. Sorry, but your PS needs to answer for that one. If you do not get answers from your PS, call your breast surgeon and complain to him/her. My own PS said to me ten years ago, when I told her what some women on bc.org we're going through: me " If you are in significant pain for some reason, I have done something wrong. There is no reason women should be in excruciating pain with tissue expanders".
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Wink22: it is hard to predict what size implants should be used along with flap reconstruction. The size obtained with the flap is essentially what dictates the implant volume which can be used. 400 ccs for the TEs sounds about right though. The size of TE DOES dictate the size of Allergan 410 that can be used, because the 410 anatomical needs to precisely for the pockets created by the TEs.0
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Whippetmom, thank you for your reply:) I have started keeping a (now quite long) list of questions for my next PS consult. Learning more everyday! Thank you x
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Thank you for your replies! I had my PS fill my implants to 550 ccs. I think this is a good size for me, but the upper pole is so flat that they look like "bolt ons". I have no cleavage. I may change my mind on the round implant and go with the tear drop shaped ones. I'm trying to take into consideration that they will do fat grafting later on. Will see what PS says at my pre op appt.
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Hello sizing sisters,
I'm in the midst of bi-lateral tissue expansion post preventative mastectomy and starting to stress about implant choice and possibility. My details:
Measurements: Ribcage, 32inches 5'4", 145-150lbs but heading back to my set point of 125-130ishlbs (rough 2018).
Originally wide set breasts that were 34B or 36A (def wasn't sizing myself officially).
TEs are 133FV Natrelle 300cc
Currently filled to 330ccs and nurse and PS seem to think I'm "done" or maybe 1-2 more mini fills at most. I think I"m pushing and they'd stop. I just dont feel like I have any projection, can I get some more with the implants or am I not gonna given the TE shape? I cannot tell where/how I'll feel size wise. These TEs feel firmer and sort of swollen but don't really look like I've got "a rack" in clothes. PS says she can get me nice shape and some cleavage but do I stop expanding here? WHAT do i ask? What do i do?
With appreciation xo
Jess
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Whippetmom,
I am SO grateful to have discovered this forum! I will be having my exchange surgery in the next month or so, and am finding myself so stressed by the decisions about what size implant should be used. I am 5'5'' and weigh around 145 lbs. My rib cage measurement is 34 1/2" and I have Natrelle tissue expanders, 500 mL, style 133MX-13-T. I am currently filled to 420 cc and I feel that they are bit too big and bulky looking for me, particularly because I am short-waisted so I don't have a defined waist. Unfortunately, the fill bringing me to this size was a double fill so I was unable to see what a slightly smaller size looks like on me. I was originally a (saggy) mid B cup before my surgery and asked to go a bit bigger and fuller. I would be terribly grateful for input as to what would look proportionate for my size.
Mary
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Jess:
Those full height tissue expanders just take on a funky elongated and flattened shape. I recommend Allergan Inspira smooth rounds, SRX or SCX 34 ccs or 370 ccs.
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Hi,
I got a right mastectomy in January with immediate implant recon (no TE) and PS selected mentor cpg 322 cohesive III medium height moderate plus profile 255 cc, the idea was to make it as alike as possible to the other one, but they are not symetric now. At that time I was overwhelmed and never minded about shape nor size, I just wanted to be cancer free and as similar as I was before the surgery.
The outcome is ok, the clevage is nice, and with padded bras and clothes you cannot notice the difference. Although the implant is a little bigger than expected, the shape is not what I expected, the lower part is too perky and do not have a natural drop shape, PS said it would eventually drop, but it has been 7 months and not happening, and after the clevage ends is too flat up to the nipple. I wonder if a higher profile would make it less flat?
Now my BS has recommended performing a prophilactic mastectomy on the other side. I am planning the surgery for mid September, and still have to visit the PS, the initial idea that was commented with him, was to have the same kind of immediate recon with direct implant, in the left and a revision and fat transfer in the right one.
So I do now want to review my options regarding the sizes and types of implants, now that I can have the same size in both sides. I am 5,2" 120 pounds and 29" of toraxic box.
I have always been a barely B cup, and I would like to go for a Full C now, maybe 350-400 ccs?
I would be very grateful for your input.
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Whippetmom, Thank you SO much for this perspective and recommendation. Helping soothe my anxiety that no matter how much I fill I'm going to be flat. The recommendation is super helpful for empowering me in the conversation(s) with my PS. thank you for the invaluable resource you are to this community!! xoxoxox Jess
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