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BREAST IMPLANT SIZING 101

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Comments

  • trmtab
    trmtab Member Posts: 871

    boogirl

    Whippetmom will reply with recommendations, but just to settle one issue, I had TE in place for 15 months and I too travel a lot...the TE never set off the airport security. I do have pre-check and global entry, but sometimes those lines are closed so had to go through the normal security as well as expedited security...never a problem. Good luck, TT

  • coachvicky
    coachvicky Member Posts: 984

    I carried a letter on my plastic surgeon's letterhead signed by him explaining that I had tissue expanders. Whenever I checked in I told the agent that I was undergoing chemo and I had tissue expanders. I would show the agent both those letterss. My oncologist had written a letter on letterhead as well. Most of the time the agent would escort me to TSA and talk to a TSA agent. Even when I didn't have pre check I never had to go thru the detectors.

    CoachVicky

  • minustwo
    minustwo Member Posts: 13,389

    I never set off any alarms and i didn't tell anyone ahead of time.

  • boogirl
    boogirl Member Posts: 24

    That is great to hear thank you all. The travel piece had me nervous with the TE's especially with so much foreign travel. I thought the port was metal so it would create an issue - but I'll be sure to get the letters and hopefully all goes as smoothly as it sounds like it has for all of you!


  • star2017
    star2017 Member Posts: 370

    I’m scheduled for my left exchange surgery in a couple weeks. My TE is leaking and so we’re doing it earlier than I had planned.

    Has anyone else’s TE leaked?

  • lanne2389
    lanne2389 Member Posts: 220

    Boogirl, when I had TEs, my PS gave me (via the manufacturer) two credit card sized cards with all the TE info (make, model, etc.), to use for travel.

    On sizing, you'll find that TEs and implants give a wider breast with less projection, so while the overall cup volume might be the same, the shape usuallyisn't.

  • whippetmom
    whippetmom Member Posts: 6,028

    boogirl:

    With breasts as large as yours, you need pre pectoral/sub muscular placement. I had very little discomfort with TEs and I know a lot of women who sailed through the TE stage with minimal discomfort. A great deal of post mastectomy pain has to do with the surgeon’s skill and anesthesiology attention to pain control. I think 700 to 800ccs (700 ccs if you get back to your pre-move weight).

  • boogirl
    boogirl Member Posts: 24

    Thanks so much! That makes me feel much better. You hear a lot less of the good experiences than the difficult ones so I’m glad to hear it’s not always so bad. My BS and PS are focused on pain mgmt so they’ve already taken me through the plan there.

    I don’t know how everyone has dealt with the interim as the TE’s expand and they try to look “the same size” in public, since I don’t plan to share my situation with absolutely everyone I know! If there’s a discussion or recommendations on interim prosthetics as the TE’s expand I’m looking for that info next!

    I’ll post as I go through it in hopes to help anyone else I can. I’m so glad I found this community - it’s the only place I feel like I can prepare myself as best as possible for what lies ahead! I’m a bit of an anal planner type and it helps me to stay calm...

  • BeachSunset
    BeachSunset Member Posts: 2

    Thanks Whippetmom. My PS said the TE takes up about 50cc so if you take your fill level plus 50cc that equals the implant size that would give you the same look you currently have. Regarding how I feel about my TE, I wanted more projection but PS says it's difficult to get projection after Mx. I still don't understand that part. After my last fill, I was in extreme pain so I went back the next day and they removed 35cc, which alleviated the pain. So, my fill level has been 350cc. I think I found the limit of my skin elasticity. My exchange surgery is Oct. 11.

  • whippetmom
    whippetmom Member Posts: 6,028

    boogirl:

    You will already have some fill to the tissue expanders when you wake up from surgery. You will be hanging around the house dealing with your lovely drains for two weeks. 🙄 So I wouldn’t worry too much about how you will be looking in clothing right away. Winter is coming, and you will be able to disguise the lack of volume in sweaters and jackets and scarves. By the second or third fill, you will have enough volume to look fine in clothing. There were a number of us on these forums who were very sad to part with our tissue expanders. We didn’t need to wear bras and they sat up nice and perky. 😉

  • mactaz
    mactaz Member Posts: 592

    whippetmom, I am fairly new to this, diagnosed mid-August. I’m currently getting chemo and targeted therapy but am scheduled for a UMX the end of January. I’m still trying to figure out all the different ways of reconstruction and you mentioned “pre pectoral/sub muscular placement“. I’ve looked everywhere and just can’t figure out what this means, can you please explain?

    I’m currently leaning towards implants and am concerned with the TE, as I have read it can be very painful. Also, I have seen that some people don’t believe implants work with a UMX as you can never achieve a uniform look with a natural breast and an implanted breast. I’m 5,4”, 138 lbs, 34” rib cage, where 34DD (admit I can never really find a bra that fits well). I am thinking going smaller then having breast reduction on the remaining breast. Also using a smaller implant with fat from other areas to give me volume because I do have back issues and just wasn’t sure if an implant on one side would cause issues. Not sure this is doable, my meeting with PS is the end of October.

    Sorry for all the questions but ny thoughts and information would be much appreciated, I’m just lost in this whole process. Thanks to all.

  • Pippi103
    Pippi103 Member Posts: 2

    Whippetmom-

    Hi!! New to the group andI'm trying to figure out about what size I will be after my exchange on Nov 6..

    I am 5' 4.5", 117lbs, rib cage 29.5inches. I was a small 34B prior and I want to go bigger

    I have Allergen 300cc 133 MV-12 expanders. They are currently expanded to 570cc and will be having a smaller implant placed( somewhere around 510 cc). I believe they are naturelle inspira and he is placing an S (the sample he showed up me was F which he said would not suit me) so I will have more projection.. The expanders look pretty big and high on me but I am nervous I stopped too soon to end up at least a C..

    Side note- the implants are prepectoral, not sub

  • Shoregirl
    Shoregirl Member Posts: 338

    Hello again Whippetmom. Thank you for this thread and your insight. I am seeking revision to downsize my current implants and pad with fat in front of and around the smaller implants. My concern though is the width of smaller implant becoming too narrow for my frame and the pockets. I am between 5/6" and 5'7" (shrunk a bit after recent spinal fusion) and current weight is 155lb. I have a 33" ribcage. My current implants are pre-pec Sientra smooth round mod profile 440cc (SRM440). 13.4cm w and 4.2 projection, giving me roughly a 38D bra size. I was hoping to drop down to a SRM300, but it is only 12.0cm wide, 3.6 proj. Is that an unrealistic goal? If so what size would be more appropriate? I had Inspiras initially, SCX470 which were 12.25cm wide and 6.1 proj. I had them swapped for wider and less proj due to the fact that they were flipping over backwards in the pockets. PS that did the revision felt they were too narrow and projected making them able to flip completely over when I laid down. The Sientra SRM440s are staying in place thank God but I have to have another revision unfortunately because the pocket of one is severely creased causing me pain and the other is a full 2" lower as the ps did not add alloderm to that side. So I will take the opportunity to get the smaller implants I wanted to begin with!

  • meo912
    meo912 Member Posts: 2

    Hello, I found your post very informative and interesting - thanks!

    I am having my implant exchange pre-op next week and I was hoping you could give me some help with sizing.

    I am 5ft 4 inches tall, weigh 102 lbs, and my chest circumference is 27.5 inches. My PS uses Allergan implants. My tissue

    expander is a 133MX-11-T; which is 300cc. The width is 11cm. My pre-mast size was about 34B. The implants will be pre-pectoral.

    I don't want to be much bigger than I was before the surgery. What implant size would you recommend?

    Thanks you again for your post. I look forward to your reply.

    Sincerely,

    meo912


  • whippetmom
    whippetmom Member Posts: 6,028

    MACTAZ:


    I am glad you asked about pre pectoral vs submuscular placement of implants, because it made me look back at the post to see I should have written '"submuscular vs pre pectoral." Submuscular implants are placed under the pectoral muscle (well partially under the muscle - covered by about 2/3 of the pectoralis). Pre-pectoral implants are placed over the muscle. I wish I had time to go into more detail, but I am finger typing this on my ancient IPad bc my keyboard is not working this week, and it is maddening. Search for submuscular breast implants vs pre pectoral implants and you will come up with loads of information. Below is a trial abstract regarding over vs under placement of implants. With regards to tissue expanders, please read my response to boo girl on this same page and then read her response. Pain Mgt durning mastectomy is key.. That said, you might not need tissue expanders if you have a direct to implant reconstruction. You need to ask your PS about ALL options.
    http://www.nesps.org/meeting/abstracts/2016/57.cgi
  • whippetmom
    whippetmom Member Posts: 6,028

    Pippi:

    Your PS showed you an "F" style Inspira which means "full" projection. But I have no clue what an "S" would be. Perhaps did he say "X" as in extra full projection? 510 ccs should get you into a D cup bra. I know this because you are my height and weight. Now this means a Freya or Chantelle or European style bra. These brands are more tailored for augmented and/or reconstructed breasts. BTW, you might wear a D cup but you will look like a C cup. How is that for confusing the issue even further?

  • whippetmom
    whippetmom Member Posts: 6,028

    Shoregirl::

    I have to say that in my ten years here, I have not heard of smooth silicone rounds flipping in the pockets. I know that this can certainly happen if the skin envelope is too large for the implants, but that is not what you are describing. Why Sientra again? Why not go back to Inspira implants? I think you need to private message me with photos. I cannot fathom why a 440 cc implant would be too large for your frame. So 300 ccs sound pretty small to me. But perhaps you want to be small. I feel you can use the 13.0 cm width though. Your PS would need to revise the pocket to ensure that the smaller implant does not migrate laterally. I would suggest insteadthe Inspira SRM - 375 ccs, 13.0 cm width and 4.2 cm projection.

  • whippetmom
    whippetmom Member Posts: 6,028
    Meo912:

    Well, I would recommend Allergan Inspira, either the full profile SCF 265 ccs or 295 ccs, or SCX 340 ccs. However, I have a question, since you are so petite, and because you want to remain on the smaller side: I am presuming you are at full fill - 300 ccs. What do you think of the size you are currently with your TEs?
  • whippetmom
    whippetmom Member Posts: 6,028
    BeachSunset:

    I read your original post again and read your profile. I don't have the time to read profiles and hope that you gals are giving me all details that are necessary within your first post. You referred to your "TE" in the singular. I did not catch that the first time. Your profile reflects you had only a single MX. Is that correct? If so, the implant the PS uses should be predicated solely upon symmetry. If you plan to augment the native breast, that changes things a bit. But STILL, the only implant style and volume your PS uses (and he should take several into the OR at the time of exchange) will be the one that most closely approximates the width and projection of the native breast of the native augmented breast.
  • mactaz
    mactaz Member Posts: 592
    Thanks whippetmom, I have read quit a bit on sub vs pre but thought you might be talking about something different. I will read the trial abstract.

    Once I meet with my PS and get all the specifics in December if you don't mind I will send you the info and see if you believe it makes sense. He told me prepectorial is not on option due to thin skin.

    Thanks again or your help, I know this site keeps you very busy.
  • Shoregirl
    Shoregirl Member Posts: 338

    Thank you Whippetmom. Funny you say you have never heard of smooth rounds flipping over backwards. That is what my ps said as well! In fact, he didn't believe me even on examination. Thought I was just "seeing swelling go down." He ultimately referred me to Johns Hopkins to consult with a ps about SGAP, as I felt I couln't tolerate implants. The ps at Hopkins said the same thing. Had never seen it happen. But he manually flipped it back over in the office and recommended I seek implant revision rather than flap.

    I like the Sientras over the Inspiras because the Inspiras were just too firm. When I gave hugs it felt like I had rocks on my chest. That made me self concious and I would feel myself pulling back from the embrace. The Sientras are still cohesive, but a bit softer and more comfortable and natural feeling to me. I see I forgot to mention in my 1st post that back in 1993 I had a mommy makeover which included a reduction. I went from a DD to a B cup and I LOVED them!! The smaller boobs opened up so many more clothing choices for me, especially button front shirts! Unfortunately, I had dieted down to an unrealistic weight for the surgery not realizing my boobs would "grow back" when my weight went back to its comfort zone. So for that reason and also I just want lighter, smaller implants for comfort. I have talked with some ladies online that have done this...downsized the implants but filled the pocket with fat to maintain roughly the same proportions.

    I will PM you some pics.

  • whippetmom
    whippetmom Member Posts: 6,028

    shoregirl:

    You had the Inspira SCX model. I am recommending the SRM model which is the smooth responsive gel implant. It considerably softer than was the SCX. Responsive being the key word here.

    I’ll wait for photos.

  • Shoregirl
    Shoregirl Member Posts: 338

    Thank you Whippetmom. I didn't catch it the 1st time you were referring to the SRM Inspira....that there are different levels of firmness. My Sientra is called SRM too. While they are softer than the Insp SCX they are still quite firm. I don't believe they have a range of responsiveness like the Inspiras do. I will check with my ps to see if he has samples I can feel.

  • Dawn1982
    Dawn1982 Member Posts: 7

    Hi there Whippetmom (and all!)

    I'm scheduled to have my exchange surgery on Friday, and I'm feeling a bit nervous about whether or not I've thought enough about the implant size and projection.

    I'm 35 years old, bilateral mastectomy in March. I'm 5'4 and 150lbs. My rib circumference is 32in. Current expanders are allergan 133SV-T; 350cc fill; I think 12.5 diameter.

    I used to be about a 34F or 36E (in the european brands) and at time of mastectomy (after chemo) they took about 500 cc of tissue from each side. I'm a size 8-10 in most dresses (sometimes 12 in pants).

    My surgeon prefers to use Natrelle Inspira, and has suggested SRF-450 or SRF-485 (to be decided in the OR). I asked about SRX (more projection) and he said it would potentially be too 'Newport Beach'....

    I just don't want my implants to feel flat, especially since I'm a little curvy. Do you think the SRF will be okay?

    Thank you so much in advance for your help. After everything, I just want to feel at home in my body again.

    xo

    Dawn

  • veggal
    veggal Member Posts: 261

    I have Inspira SCX in 615 cc and I am 34 DD. I was a saggy 54 year old when I had them put in. I don't feel that they project too much, especially with the fat grafting in the upper poles.  They are fairly firm, but I also have no visible ripples. 

    Hope this helps. 

  • coachvicky
    coachvicky Member Posts: 984

    Dawn,

    I don't post much here BUT ...

    If you want to be a "Newport Beach" look that is YOUR call not your Plastic Surgeon.  By law you must be reconstructed to your prior self. Go for it!

    Coach Vicky

  • Dawn1982
    Dawn1982 Member Posts: 7

    thank you both, VegGal and Vicky!

    I think the trouble is it’s hard to imagine either way (SRF vs SRX). C’est la vie. I so appreciate your support and answers. <3

  • boogirl
    boogirl Member Posts: 24

    To your point Dawn, I have some of the same questions when starting to think (wish!) to be at the implant/exchange stage vs just anticipating my journey starting soon.

    Is there any good site or resource to see reconstructions *with* the implant info, or to see the “Newport Beach” look or any other? All the threads talk about projection and profile and various implant brands/models, but is there any way to see how they come out (recognizing that the PS’ skill of course and the initial patient’s situation / type of surgery will have bearing as well! Plus their height / weight etc info that Whippetmom uses to advise us so well). It’s such a visual thing at the end?

    I haven’t signed up yet for the closed forum on photos, but is that kind of info included? Or somewhere else like manufacturers sites or something? Most reconstruction pics don’t seem to share that - more info on nipple tattoos it seems than actual implants and “tech specs” on the reconstruction.


  • Shoregirl
    Shoregirl Member Posts: 338

    Dawn, check out the Natrelle Size Chart, the dimensions for all the various styles are listed. You want page 9. I am also 150lb, 33" ribcage. The Inspira 470 SCX gave me a DD cup. I asked my ps to bring a range of sizes into the OR and use his judgement. I ended up too big for my taste!! Sorry you are going through this at such a young age. Best wishes for a smooth recovery!!

    ETA sorry we are all going through this!!


  • Dawn1982
    Dawn1982 Member Posts: 7

    Thanks Shoregirl - that's super helpful. I'm going to go into it with reasonable expectations and see what happens! I guess I didn't get to pick the first pair, so ... haha. Fingers crossed tomorrow goes well!

    Boogirl, let me know if there's anything I can help with as you prepare for sugery(ies)!

    Agreed - sorry we are all going through this, but so grateful we have each other.

    <3 -D