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BREAST IMPLANT SIZING 101

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Comments

  • Diana67
    Diana67 Member Posts: 4

    Thank you for your post and open discussion. I’ve been diagnosed with BS in 2012 and had DMX with reconstruction. Allergan smooth silicon filled implants with spared nipples. By now my implants moved to sides, left pockets. One was shifted to left from the start. My MO advised to do revision, with smaller implants, move it the center. Had visit with my PS, my initial concerns about recall was ruled out, but my PS originally he did not seem to see any visual problems. When I expressed my concerns about shifting implants he scheduled me for exchange implants and fat graft. With a new study that has just come out i’m nervous about implants in general. I’m wondering if anyone has done implants for fat graft only exchange?. No muscle- due to my blood clotting mutation for me it’s not the option. From implants choices if it’s the only way to do it- has anyone had natural look and can advice on best options? I’m grateful to outlive my implants. Hope I can achieve close to natural look and be more comfortable with the way way I look. Thank you. Please feel free to reply here or msg me privately.

  • Meow5
    Meow5 Member Posts: 1

    Hi Whippetmom,

    Firstly, thank you for all your continued help on this forum! You're an angel.

    This is my first post on the forum. I have been reading posts through my Cancer journey and have learned so much from all the ladies here. You are all amazing warriors!

    I have my final appt on Wednesday with my PS before getting exchange surgery in early January. Any help you could give me would be very appreciated, as I'm really worried about making wrong implant choices.

    Here's my info:

    1. Height - 5"4 1/2

    2. Weight - 120-125. I weigh more than pre chemo and also have very overfilled expanders so don't know if that accounts for any of the extra weight.

    3. Ribcage- 29 inches

    4 They took out 245cc breast tissue which was left from my lumpectomy last year (mastectomy was earlier this year) . My pre cancer breasts were perky I'm a unilateral and masectomy was on the left breast which was always smaller than the right. I used to wear a 34b bra (but not sure if that was my correct size). My left masectomy was skin sparing but non nipple sparing. The first surgery (lumpectomy) seemed to reduce that breast to what looked like 1/2 that breast

    5. Expander info: 133 plus MX 400cc

    Ref 133P- MX 12

    SN- 22741042

    Initial fill at surgery was 100cc

    I'm currently overfilled to 740cc as my PS was trying to expand me as she will be putting a small implant on my Right non masectomy breast for symmetry. My non cancer breast was almost symmetrical at around 550cc but she expanded me quite a bit more.

    She is thinking of using truform 2 implant from Allergan. I don't know if that's the soft touch or not. But we don't currently have the truform 3 approved in my country. She usually uses Allergan but is open to other options.

    I would like to visually be a C cup. Right now my expanded breast seems too big and I'm padding the other side to try and match. But I like the profile of that expanded breast when I wear clothes. it's strange how without clothes it looks like a big ball on my chest but with clothes it looks more normal So I'm unsure what type of implant will give me a similar profile.

    My ps was saying she usually uses the Full profile as the extra full has a tendency to flip. Have you heard of that happening? And what cc amount would you recommend for me. My ps was previously saying maybe low 700 or high 600's. But I've been reading posts on here and doesn't that sound too big for me? Also the expanded breast seems to be going into my armpit. I hope the final implant won't be like this.

    Is the mentor extra a good option? I'm trying to pick something that is cohesive as I want to avoid rippling as I'm Prepec. Or would the truform 2 from Allergan be a better choice? Are there differences between the mentor one vs truform 2 with regards to firmness of the implant?

    Sorry for all the questions. But I feel confused and worried about all of this.

    Thank you in advance for any help/ advice you can give me.

  • whippetmom
    whippetmom Member Posts: 6,028

    Shell:

    Your tissue expanders have the following dimensions: 14.6 cm width and 7.6 cm projection. I would recommend Mentor Xtra Smooth Round silicone implants, 755 ccs, which have the following dimensions: 14.4 cm wide and 6.7 cm projection. More importantly, I would strongly suggest that your PS perform one fat graft transfer to the previously irradiated skin at the time of the exchange. The, I envision a repeat fat graft transfer around 6 months later. The rich stem cells from the FGT will help soften the skin and begin to heal the damaged tissue. I know of nothing else that works so well to help regain symmetry after radiation.

    Deborah

  • whippetmom
    whippetmom Member Posts: 6,028

    Diana:

    Typically the cause of lateral migration of the implants is due to over dissection of the pockets at the time of mastectomy. Also, it can occur when the implants are too small for the pockets created by the tissue expanders.It may not be that your implants are too large, just that the medial space might need to be opened up a bit, but also, more importantly, bilateral capsulorrhaphies need to be performed to secure the pocket laterally. Otherwise, new implants will just migrate towards the armpits again. You could go slightly narrower with implants, if you like, if indeed the revision includes narrowing of the pockets.

    Medial dissection is a VERY delicate procedure. If it is opened up too much, you can end up with symmastia, where the breasts meet one another and this is almost impossible to repair. So make sure your PS is very good with CORRECTIVE breast revisions.

    Deborah

  • whippetmom
    whippetmom Member Posts: 6,028

    Meow5

    Well, it is not easy and nearly impossible for me to size unilaterals. Everything with a single mastectomy hinges on symmetry. Symmetry trumps size. I think that 700 ccs plus seems like a lot for your frame. I was thinking more in the 600 cc range. Your pocket is over expanded and seems huge, because your PS is trying to achieve some ptosis (droop) on the MX side to match whatever ptosis you have on the right. So honestly, the goal is to achieve symmetry. This means finding the right size and profile implant for augmenting the native breast. I do not know anything about Truform....I need to read up on it.

    Your PS sounds pretty savvy and is thinking artistically, vis a vis the over expansion of the MX side and consideration of the cohesiveness of the implant. I leave it in her capable hands!

    Deborah

  • 08172016
    08172016 Member Posts: 2

    Dear Whippetmom,

    Thank you for all you do for us and Happy Holidays! I was hoping that you could recommend the proper size implant for me.

    My PS uses mentor implants. My current TEs are mentor smooth high profile 475cc / 13cm wide / 13cm high / 6.8cm projection. I am 5’7”, 155 lbs with a rib cage measurement of 33”. My pre mastectomy bra size was 34b (I was 145lbs then).

    I’m in the process of weekly TE fills and am currently at 410 cc.

    I would appreciate any advice you have.

    Thanks,

    Lorraine


  • VaLaMichelle
    VaLaMichelle Member Posts: 1

    Hi!

    I was had a left-side, nipple-sparing mastectomy in Sept, 2017, with a tissue expander. In Dec, 2017, I had the expander replaced with an implant and a small implant was used on the right for symmetry. I was very adamant about not wanting to be any larger than my pre-surgery size, but my PS explained that symmetry would be impossible without an implant on the right, a lift in which she would remove skin in a circle around the areola and below, or both an implant and a lift. Because I love to be active, I was concerned about extensive surgery and opted to have the implant on the right, but not the lift. I was not pleased with the results. The reconstructed breast is smaller than the augmented one. Both implants are sub-pec and the reconstructed breast is compressed by my muscle giving it a weird shape -- flat on the top and the nipple points upward. The augmented breast is fuller and the nipple points downward. If I place my hands against my rib cage and move them under my breasts, it is obvious that the base of my augmented breast is lower than the other. In short, the augmented one is obviously larger and fitted clothes enhance this. Regardless, I am feeling VERY fortunate to be cancer-free and back to my normal, active life at 50 y.o. The idea of any surgery again really bums me out. However, I have the textured Allergan implants that have been recalled. My oncologists has suggested that given that I am unhappy with reconstruction results and that I have these particular implants, I should consider another reconstructive surgery. I have visited a new PS who has said that he will need to put an even larger implant in the augmented breast! I was really hoping to be smaller, not larger!! He is suggesting over the muscle, and implants that "fit my skin". I am thin and active and think this will look and feel ridiculous. Symmetry and not having them in the way during activity is important to me. I am willing to have a lift to remove skin, but the PS said that nipple placement wold be an issue if I removed skin on the right. Advice? Thanks!!

    Height: 5'7"

    Weight: 122 lbs

    Rib cage circumference: 28.5"

    Bra size before sugery: 34B (I have the same bra-size, but they are "fuller" on the top

    Current implants:

    Left: 410 MF Natrelle 410 highly cohesive anatomically shaped silicone-filled 255cc

    Right: 410 ML Natrelle 410 highly cohesive anatomially shaped silicone-filled 125cc

  • moderators
    moderators Posts: 8,633

    Dear VaLaMichelle,

    Welcome to the BCO community. We are glad that you reached out here. We are sure that Whippetmom will be along to respond to your question. In the meantime here is a link to articles about implants on our main site. Keep us posted and send us a private message if you need additional assistance or help navigating your way around.

    The Mods

  • whippetmom
    whippetmom Member Posts: 6,028

    Lorraine:

    I think you could go with either the 560 or 595 cc volume in the Mentor Xtra Smooth high profile silicone implant. You can take a look at that style and see how the dimensions compare very favorably to those of your tissue expanders

    Deborah

  • whippetmom
    whippetmom Member Posts: 6,028

    VaLaMichelle:

    Based on what your new PS is describing, it sounds as though your pocket/skin envelope on the mastectomy side is larger than your implant, hence the inference that the implants should “fit the skin”. And now you have an implant on the native side, without having had a lift, so that skin is probably fairly lax. Do you have some droop on the native side? It sounds to me as if the anatomical on the MX side has rotated in the pocket somewhat, or has displaced a bit. If you are going to go through this, make sure the plastic surgeon is extremely qualified in the field of revisions - not just implant exchanging. In order to achieve the results you describe as desirous, you should probably be in the 300 cc to 350 cc range with implants - smooth silicone rounds This may mean you all have some pocket revisions and perhaps even that lift on the native side which you were trying to avoid. Unilaterals are tricky - no two ways about it. As I stated to a recent poster, symmetry is really a challenge and so maybe even seek consultation with yet another PS, just to make sure you are on the right track.

    You can always private message me and send a photo

    Deborah

  • Islander89
    Islander89 Member Posts: 7

    Hi Whippetmom! New to the forum. I had my BMX in December. I'm done with my fills and happy with my size,I currently fill out my 34C premx size. My question is,what size/cc should I tell my ps I want to be to keep them at this size? I'm afraid I'll be smaller after my exchange. My exchange isn't until Feb.25th,so ready,these expanders are sooo uncomfortable! Lol!

    Stats:

    5'1,138 pounds

    34" ribcage,also my ribcage I've been told are extra wide..I look like a muscle guy with pecs😆

    Mentor artoura HP,smooth SN#9356058-055,375cc

    I'm currently at my last fill with 375cc,no overfill

    Prebra size,34C or 36 B

    Thanks so much!

  • Islander89
    Islander89 Member Posts: 7

    Hi Whippetmom! New to the forum. I had my BMX in December. I'm done with my fills and happy with my size,I currently fill out my 34C premx size. My question is,what size/cc should I tell my ps I want to be to keep them at this size? I'm afraid I'll be smaller after my exchange. My exchange isn't until Feb.25th,so ready,these expanders are sooo uncomfortable! Lol!

    Stats:

    5'1,138 pounds

    34" ribcage,also my ribcage I've been told are extra wide..I look like a muscle guy with pecs😆

    Mentor artoura HP,smooth SN#9356058-055,375cc

    I'm currently at my last fill with 375cc,no overfill

    Prebra size,34C or 36 B

    Thanks so much!

  • whippetmom
    whippetmom Member Posts: 6,028

    Islander89

    Mentor Xtra Smooth HP rounds 485 ccs, or Mentor Ultra High Profile smooth rounds, 535 ccs. The former will have a width of 12.0 cm and 5 8 cm projection. The latter will be 12.0 cm wide and 6 1 cm projection. Your TEs: 12.0 cm wide and 6.4 cm projection Focus on the dimensions, not the volume difference.

    Another option would be to go to a different brand - Allergan Inspira, SRX, 465 ccs 12 0 cm wide and 6 0 cm projection The Inspira is overfilled (like the Mentor Xtra Smooth) and so therein lies the difference between this and the Ultra High Profile version in Mentor

    Deborah

  • Islander89
    Islander89 Member Posts: 7

    Thank you Deborah for your reply,

    Should I ask for another fill then? What if my PS says he won’t be able to put the size implants you mentioned? Also, in your opinion and from what you’ve seen,what “size” am I? I’m sorry for the questions,lol but it’s so hard to get a “visual”..the expanders just have a different look to a normal chest with breasts...and I do want to be around 34 full C cup. I do recall my PS saying my TE’s can go to 420cc but he didn’t offer that with my last visit so hence,my last fill.


  • whippetmom
    whippetmom Member Posts: 6,028

    Islander:

    Show your PS the implant suggestions I mentioned and he will let you know whether you need overfills. As I state in my thread header:

    8. CUP SIZES: There is no predictable way to tell you what cup size you will be with a specific volume of implant. Maybe with breast augmentation it is done, but it is all entirely different with breast reconstruction. Plastic surgeons cannot guarantee or predict cup sizes! Cup sizing is tricky, because you might be now wearing the wrong size bra. So you might tell me you wear a 36B, and you really could instead fit better in a 34C. Also, after reconstruction, there are only sports bras and European bras that we recommend as the best option for reconstruction patients. So you might tell me you want to be a "C" and end up in a European bra, like a "Freya" or "Chantelle" (my favorites.). So you might wear a D cup! But you will LOOK like a C cup or even a B cup. It is confusing, I know but you will see what I mean when you are on the other side of this.

  • simonerc
    simonerc Member Posts: 155

    To whippetmom’s point... I now wear Natori 30DDD. I do not look anywhere near a DDD cup!!! I just did a bra fitting at Nordstrom with a post mastectomy fitter and that size is spot on!


  • simonerc
    simonerc Member Posts: 155

    And also bought Simone Perele bra as well as Natori. That one was 30E (DD) not F or DDD. Again, to whippetmom’s point, I look like a C cup.


  • Islander89
    Islander89 Member Posts: 7

    thanks again for your replies!

  • Gucci311
    Gucci311 Member Posts: 1

    Hi. I'm in the process of getting expanded and I'm getting nervous because I only have 1 fill left and have my radiation simulation the same day so I won't really have time to come home and try on clothes to make sure it's the size I want. They are rushing me because they want me to start radiation ASAP!

    Before my double mastectomy I was a 34B. I would like to be a full C..I think. I am 47 years old and I'm 5ft 4 inches tall. 140lbs ( but usually 135lbs. And I just measured myself and still 34" around under my expanders.

    I'm currently filled at 510 ml. By looking I think I definetely want a little bit more. But not sure. What do you think?

    I will probably be getting saline implants at my exchange because I have prolonge QT syndrome and have a defribulator so I can never get an MRI and I have heard it is the only way to see if the implants are ruptured. So even the I prefer silicone I cannot get.

    I have always wanted bigger breasts so I figured if I have to go thru all of this I might as well get what I want. But I don't want to look ridiculous and I can't really tell for sure cause my expanders are oddly shaped and I'm almost positive the implantable will look a lot different. Plus I have always been very indecisive. So your opinion and advice will be greatly appreciated.

    Thanks

    Lisa

  • whippetmom
    whippetmom Member Posts: 6,028

    Simone: That is EXACTLY why I do not predict “cup” sizes for women Winking

    Look that the DDD cup size and you do NOT look like a DDD cup. So when women say, “I want to be a “C” cup, I say be careful what you wish for, because you might look like an “A” cup. It’s crazy. Thank you for the great example. ThumbsUp

  • whippetmom
    whippetmom Member Posts: 6,028

    Lisa:

    Based on your height, weight, ribcage, I can tell you will want to be in the 650 cc range with implants. But you will need to give me all of the details on the tissue expanders - as outlined in the thread header.

  • MCbeach
    MCbeach Member Posts: 43

    Hi Whippetmom-

    It’s been quite a while since I’ve been here. I will be having my 410s exchanged in a few weeks. I am wondering if it is possible to go a bit smaller w the swap or do I need to stay about the same size?

  • tinat
    tinat Member Posts: 2,235

    Hi Deborah, I've been MIA here for a long time. I just posted a rather long message with some questions, but so far it hasn't shown up. I will wait a bit before retyping the whole thing if I can even remember :)

    Meanwhile, the Allergan link in the header doesn't seem to be working. I am trying to get some info about SCF and SCX implants, but having no luck online finding any specs regarding dimensions and volumes.

    Also, wanted to say that I'm happy and applaud you for still being here to help out those who are trying to navigate and have some control over the reconstruction process.

    Thank you!!!

  • tinat
    tinat Member Posts: 2,235

    Hi Deborah (and everyone else)!

    I've been off the discussion boards for quite a long time while dealing with overwhelming family matters. I am happy to see that you are still here helping women to navigate the often difficult and confusing reconstruction process.

    I am trying to made some decisions about my capsular contracture. I am 5'8", 140 lbs, ribcage 31.5". My nipple-sparing bilateral surgery and reconstruction was in 2011 and I initially had Natrelle Style 15 implants (approx. 500-530cc). I recall you saying that these were rarely used, but in my case really worked well (I was on the Picture Forum). I was very pleased with the natural look, but not with the ripples. At that time my PS didn't believe that fat grafting would be sufficient so he suggested switching to Natelle Style 20 - 550cc to help fill out the upper poles. I still have these implants and I still have minor rippling on one upper pole area despite the higher profile and slightly higher volume. But, the rippling is much better.

    I haven't had the time or energy to deal with the capsular contracture which has been worsening for the past few years. But. I recently had an episode where one implant got "caught" or twisted (don't know how else to describe it) and required massage to manipulate it back into place. It's getting tight and uncomfortable enough that I finally saw my PS today. He uses Allergan implants and my dilemma is that he is recommending Style SCF or SCX implants. I want to strike a balance between natural-looking and the least possible rippling. He feels that the denser, more cohesive gel will help with the rippling, but I am concerned about having too much projection, especially in the upper poles. He initially said that he could do fat grafting at the time of surgery, but also offered the option of waiting to see how the upper poles look (step-off and/or ripples) before jumping into that. In fact, he seemed to prefer the latter.

    I am looking for specifics about the Allergan implants, but the link in the header here doesn't seem to lead anywhere. Are you aware of any online info with dimensions, volumes, etc? The Allergan info I find includes anatomical and textured implants so I know that is outdated. I am able to find some info and I see that there are also SCM and SCL profiles. I am wondering if the SCM would work better for me.

    ***Edited - I found an Allergan/Natrelle brochure online with the dimensions and volumes I was searching for. It does include the textured anatomical implants that I believe have been recalled, but it also has data for smooth round implants. https://www.natrellesurgeon.com/Content/PDF/Matchup_Guide_FNL.pdf

    Any thoughts or suggestions from anyone are greatly appreciated. Sorry for the lengthy post, and thank you again for the time and effort you offer to all of us!!!

  • moochella
    moochella Member Posts: 1

    Hi Deborah,

    I would love to hear your advice regarding my expander and upcoming exchange surgery (estimated early to mid April 2020). Here are my details...

    I'm 53 y/o, Unilateral MX (nipple sparing) on right, 5'8 1/2 “, 130-135 pounds, rib cage circumference 31:5", normal bra size 34B or 36A

    TE - Mentor CPX4, smooth/moderate height, recommended fill 275, (my fill 1/15/2020 50cc, 1/30/2020 75cc, 2/6/2020 60cc = total 185cc to date)

    PS uses Mentor silicone implant (smooth memory gel)

    I'm not sure if this is important info - lumpectomy removed 15g and MX removed 237g of breast tissue for total of 252g

    I am planning to get a silicone implant and probably a mini implant + lift on unaffected breast for symmetry. The breast that was removed (R) was larger than my (L) breast.

    While the shape is different, the current TE (with 185cc) appears to be around the same size as my other breast and PS thinks I might not need any more expansion. I would like to be slightly bigger (e.g. cup size from large Asmall B to medium B at most).

    Please let me know if you have any thoughts, suggestions and/or questions that you would recommend I ask my PS. This is all very overwhelming and I appreciate any input you can provide. Thank you so much!

  • yarami888
    yarami888 Member Posts: 2

    Hi whippetmom!

    I'm doing a risk-reducing mastectomy not in the US. My surgeons want to do the implant first (they lift and correct too), and the mastectomy second. I'm thin and want to have smaller breasts (I've always had B cups, although I never have been quite sure if what I'm wearing actually fits), but I'm flexible.

    Height: 5'8

    Weight: between 130-135 (I've fluctuated a lot these last few months)

    Rib cage: 32.5 inches

    My surgeon uses Mentor, Ideal, Motiva, Nagor, and Eurosilicone. Thank you!

  • brandywine0220
    brandywine0220 Member Posts: 2

    Hi whippetmom! I'm 5'4", 145 lbs (but my normal weight is generally 130-135 lbs, which I hope to be back to soon), have a ribcage circumference of 31 inches, and have Mentor Artoura High 500 tissue expanders (already filled to 480 but my PS will overfill). My PS uses round, smooth implants only but I'm not sure what brand. My pre-mastectomy size (I had implants then as well) was a very full C cup, sometimes a small D cup depending on bra brand. I'd like to be a little smaller than this after my exchange surgery (a small C cup). What expander fill level and what size implants do you recommend for this? Thank you!

  • moderators
    moderators Posts: 8,633

    whippetmom is the best! We are so grateful for her! brandywine, welcome to our community and private message us if we can help.

    Warmly, The Mods

  • whippetmom
    whippetmom Member Posts: 6,028

    TinaT

    The SCX or SCF would be the two appropriate styles for you. But the SCX would be fine. I like the idea of this, as it is most cohesive style and may help prevent capsular contracture.

  • whippetmom
    whippetmom Member Posts: 6,028

    Moochelle:

    I can tell you where I think you should be (volume-wise) with an implant on the MX side, but not the specific volume or style. A high profile style, yes, and around 350 ccs minimally. Volume is out the door on a unilateral, because the goal is symmetry with the native, remaining breast. So your PS is going to use the volume and style implant that best matches the augmented native breast.

    Deborah

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