BREAST IMPLANT SIZING 101
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Hello! I am new to this forum, but have been reading a lot of the posts from way back and am so appreciative for the information! I sent TimTam a request for access to the photo page weeks ago and never heard back. My exchange is coming up 11/13/18, so am really really hoping for some pictures to held guide me!
I was a full B prior to my BMX (8/31/18), but that was with a 240cc saline implant (behind muscle) and 120 grams of tissue. (I had a mastopexy with implant placement back in 2005.) I would like to be a solid C, but unsure if that is possible. I am waiting to hear back from my PS on what exact type of expanders I have in, but I know they are the flat top ones, so it looks like a shelf lol. I had 3 fills and I am at 350 cc's currently, which he says is what the expanders are set to have. My PS says I am done, as I think my left cancer breast doesn't have much fat towards the side and I got the feeling he was concerned about that expanding anymore? But unsure. He said the new implants will be 75 cc's more because they need to fill up the upper pole, which the current expanders don't do being flat at the top. So I am guessing he is thinking 425-450 cc exchange silicone implants? Would that get me to a C? My rib cage is 29 inches, I am 5'3", 115 lbs. I am also waiting to hear back with type and brand of implants he uses, but I have a feeling he also uses the gummy bears, because he operated on Maura Tierney and through my snooping, I discovered she has the gummies lol. He is the chief of plastic surgery at UCLA, Dr. Da Lio. My pre-op appt is 10/29/18, so I would love to go that armed with info :-)
Thank you so much for your time!
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hi sister - I can’t offer too much help but my surgeon is Dr DaLio too! My exchange is tomorrow. For me he is using natrelle inspira, but he may also use other types.
Any way, just wanted to say hi/good luck/small world!
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MastectomySister, did Dr Da Lio's office give you any wallet cards for your expanders? (Look through the pile of stuff they sent you home with after surgery 😊). I received cards to use for air travel. If you got them, the info you need should be on there.
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Dawn1982! Thank you so much for chiming in and good luck with your exchange tomorrow! Now I will have to look up natrelle inspira implants to gain knowledge! I am so impressed with Dr. Da Lio and know we are both in great hands.
Lanne2389, they did not give me cards
I emailed his office and hope to hear back tomorrow.0 -
Veggal and Vicki - Thank you for responding to Dawn! She obviously had her exchange before I could respond.
Dawn, please let us know what implants your PS ended up using.
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Mastectomysister:
It sounds as though you have the short height TEs. 425 to 450 ccs sounds about right to me - preferably smooth silicone rounds, since you previously had round implants.
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Thank you whippetmom!! I have my pre op appt 10/29, so will let you know what the MD is thinking in terms of implants, but I wanted to go in with this info and feel good that the size will get me a solid C. I appreciate your help! Also, I have sent requests for access to the pic group, but never heard back and that was weeks ago😔. Would really love to see some pics of my similar size prior to surgery. Any advice?
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Mastectomysister:
I have no connection to the picture forum. I do know that if you applied weeks ago, you had probably not been a bco member long enough for approval. You might try submitting another request.
450 ccs in a high profile or even extra full profile smooth round silicone implant would put you where you want to be. If you want to be more specific, find out about your tissue expanders. If, as you say, your PS is considering something in the 425 to 450 cc range, I am PRESUMING you may have a 12.0 cm wide TE. So if that is the case, and if your PS uses an Allergan Inspira smooth round implant, I would suggest something like 415 ccs to 450 ccs in a full height style or 445 in the extra full height style. Again, this is a hypothetical because your TE information is unavailable.
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Whippetmom, thank you! I am waiting to hear back on my TE info, which should help. I just sent another message for the pic forum. Fingers crossed 🤞🏻
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Thanks Whippetmom for your advice on choosing my implant size. I had my pre-op with my plastic surgeon and he is ordering both SCF and SCX implants in the 300 range. He thinks probably the SCX 340 would be best but he wants to have choices. I appreciate all you do
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hi whippetmom, thanks for checking in! My surgeon wound up using SRF 450cc. I’m day 2 post op and haven’t looked yet. It’s more emotional than I anticipated. They feel a bit small but I know not to pass judgement yet.
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Thinking about you Dawn and hope the implants end up really great for you!
Whippetmom, I got my expander info. They are 350 cpx4 mentor tissue expanders 350 volume base width 12.7cm. I also found out my plastic surgeon uses mostly Allergen Natrelle.
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Hey there! Thank you so much Whippetmom for your expertise and input. Here are my stats:
I'm 29 years old, 5'3" and 135lbs, rib cage is 32" (82cm).
I currently have bilateral Mentor Aesthetic 350cc tissue expanders, catalog no. 354-9212. The dimensions I found are W: 11.7cm, H: 10cm, P: 6.6cm.
My premastectomy size was 36C, and they were droopy and not very full looking (by my standards, considering I'm only 29 and have never had kids). Looking at my operative report - they removed 250g from my left breast, and 300g from my right breast - this left me with an already slightly more full look on the left.
I'm not sure if my PS uses a specific brand of implant, though most of the literature I see in the office looks like Natrelle.
My goal is to be slightly smaller and slightly perkier than I was before. I'm currently filled to 200cc in each, and feeling like if I go any bigger it'll be too much. I tried on an old 36C bra the other day and it fit pretty much perfectly.
Can you advise on what implants I should be considering? I have another follow-up with my PS this week and would like to come prepared with some knowledge/questions.
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Mastectomysister:
Allergen Natrelle Inspira SCF or SRF 450 ccs. 485ccs if you want to go a tad bit larger
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Thank you whippetmom! I had my exchange preop today and my PS was initially leaning towards SSF 415's, but when I requested SRF 450's, he said he would bring the SSF 450's into the OR and try to make those work, since he nowknows I'm worried about being too small. He wants to use the SSF as he says they ripple less. I have such thin skin and little fat, so I'm sure that is a concern. I think we are on the same page though, which feels good. Fingers crossed it all goes well. He was impressed I came in knowing what I wanted with the implant numbers! 😘
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Mastectomysister:
Super! 450s!! SSF is just fine. One is a bit firmer than the other, which might indeed help with rippling
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WRIGLEYBO
WrigleyBo:
You will be in the mid 300 cc range. With this size, youwill be as small as you are currently. The implant width needs to match the width of your TEs, and although underfilled, they are still 11.7cm wide.
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Thanks for the speedy reply Whippetmom! So, will I need to keep getting filled in that case? I guess I don’t quite understand how I could end up at my current smaller size if I keep getting filled...? Let me know if that doesn’t make sense, it’s just hard for me to wrap my brain around. Thank you again
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Hello! So thankful I found this thread! Thank you, Whippetmom, for your expertise. Here are my stats:
I'm 44 years old, 5'6" and 160lbs, rib cage is 33.25 inches (84 cm). I currently have bilateral Allergan 133 MX-12 400cc tissue expanders. My premastectomy size was 36B, and they were not very perky after nursing 4 babies.
I know my PS uses Allergan implants (silicone). My goal is to be larger and perkier than I was before. I would like to be a "very full C cup," but not huge where boobs are the first thing people see when they look at me
I'm currently filled to 425cc in each, and one nurse last week told me my implant should be between 600-700cc to achieve my desired size and a different nurse today thought it would be 500-600cc. I'm assuming maybe it's somewhere in the middle? My PS also indicated the implant will be slightly larger than the TE fill amount (50 cc?) so that the fit is tighter. Have you ever heard of this?
I will start radiation in a couple weeks as soon as my TE fills are complete, so my exchange won't be until around June. Can you please advise on what implants I should be considering? Thanks a million for sharing your knowledge and expertise!
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What are your thoughts onpre-pec reconstruction?
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Bird - please read the header and post your specific measurements, weight, etc. as requested - as well as any procedures done so far. For example - the specifications of any expanders already in place. The type of implant always depends on the individual body and often the extent of the surgery.
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I had expanders and now have subpectoral implants. I am not asking about size. I'm asking what Whippetmom thinks about the new movement in breast reconstruction to place the implant on top of the muscle (prepec) rather than under.
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WrigleyBo
You might not need to fill much more,. Look at it this way: Your TEs are 11.7 cm width and 6.6 cm projection at full fill. Currently, they are probably 11.7 cm width and maybe 5.8 cm projection. The filling adds height and projection to the TEs. An implant at 345 ccs is 11.7 cm wide and 4.8 cm projection. You are already there. If you have sufficient expansion and your PS feels you have good skin expansion for coverage and closure over an implant, where you are now might be sufficient. But wherever you stop, wait at least a couple of months for the exchange. Give the skin time to retain the expansion you have had to date.
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HoldingntoHope:
I agree with the first nurse. 600 ccs to 700ccs.
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Bird-Of-Light
I really do not have an opinion regarding pre-pectoral vs sub-muscular. I suppose I do when it comes to skin integrity and whether the woman is a good candidate for pre-pectoral placement. Not all would be considered a candidate for pre-pectoral placement. I also wonder about detection of a recurrence on the chest wall, if the placement is pre-pectoral. Many insurance companies do not cover MRI scans after mastectomy/breast reconstruction. Mine does not.- that I do know. I just do not know if avoiding implant animation is the exclusive reason for pre-pectoral placement, or if there are other worthy considerations for choosing this placement over submuscular placement. Sorry I can not be of much help here.
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From what I've read - the main reasons for choosing prepec reconstruction are that it is a more natural placement of the implant and that muscle strength is preserved. It is also less painful than placing an implant under the pectoral muscle and does avoid that "animation deformity" with use of the chest muscles.
It seems that most local recurrences are not at the chest wall and are most commonly near the site of the original tumor or near the incision line. I think this would be of more concern for someone who's tumor was close to or on the chest wall. Most insurances cover MRI's to check for implant integrity at certain intervals. That may not be the same as assessing for recurrence.
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I think we also need to consider that only the top part of the implant is covered by the pectoralis muscle in subpectoral implants. The majority of most implants still sit on top of the pec, sometimes reinforced by Alloderm.
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NotVeryBrave:
Thank you for responding! Excellent information!
As far as MRIs for implant integrity - I have Kaiser here in CA and they do not cover MRIs unless you have a reason to suspect rupture or degradation of the implant which might necessitate removal/replacement.
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Thank you for your reply, Whippetmom. Is the size (cc’s) of implants different with pre-pectoral vs sub-pectoral? I neglected to share that my TEs are pre-pectoral. I met with my PS today for another TE fill, and he thinks 475 cc’s (where I am after today) will give me a “full C cup.” He said the implants will be approx 50 cc’s larger than the amount in the TEs, so I’m guessing around 525 cc’s? Does this seem too small? Thank you for your help!
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HoldingOnToHope:
It might well be that 500 ccs with sub-pectoral placement will allow the implant to project more than a 500 cc implant compressed by the pectoralis musculature.
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