BREAST IMPLANT SIZING 101
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yarimi888
I am not familiar with the reverse technique you describe. Sounds interesting though. I think that you will want to be in the 400 cc range with implants - in a high profile style. I have heard of the Ideal implant - have heard good things. I am not familiar with the others.
Deborah
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Brandywine:
If your PS uses Mentor only, it would be Mentor’s smooth, round high profile silicone implants - 550 ccs. The Xtra Smooth version might be larger than you would like. How do you like the size you are currently? If your PS has access to Allergan Inspira, there are some nice selections in that line. But no need to size you with Allergan if he is sold on Mentor.
Deborah
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Hi whippetmom! Here's some info on the "reverse" technique (article title, since I can't post links):
Lim, GH. "Novel Approach for Risk-Reducing Mastectomy: First-Stage Implant Placement and Subsequent Second-Stage Mastectomy"
I don't know much about the Ideal, except that it looks interesting (I have no objection to silicone over saline). 400 cc sounds like a lot, but maybe it isn't?Thank you so much for sharing your knowledge with us.
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I believe that unless someone tells me "you are going to die if don't do this immediately," there is NO reason to be rushed or feel rushed.
Long after the Surgeons, Oncologists, Nurses, and so on leave your journey, you are left with the results.
Get what YOU want. If you want bigger, go for it.
This is your life and your choices.
Coach Vicky
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One of our members posted this link on another thread & I perked up because I'm in Houston. Whippetmom said she'd seen reports from Mayo Clinic/Scottdale
https://www.tmc.edu/news/2019/11/a-new-way-to-reco...
It sounds to me like this would allow the implant to be placed over the muscle, with this "internal dermal brassiere" to be placed between the implant and the skin. I did click on the product link, but couldn't tell for sure. I'll follow the member who's investigating this procedure and report back what she learns.
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Hi MinusTwo,
This sounds like they are describing pre pectoral (over the muscle) reconstruction. They use acellular dermal matrix to create a scaffold to hold the implant above the muscle, under the skin. I have had this reconstruction and there is at least one thread here people can look at if interested! I have to look, but I think there is one that is “TE/Implant Over The Pectoral. Can Exercise....”
Thanks for posting the article. Super interesting!
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whippetmom / Deborah - thanks for the info! It's so hard for me to tell if I like this expander size because of how strangely they sit on me, but I think they're ok, I'd maybe want just a little bigger. I'm going for a small C cup look.
My PS said he likes to use the Mentor Xtra gummy implants, so would 550cc still be your suggestion?
He said he can also use Allergan implants, so which Allergan implants/size would you recommend?
Thanks again!
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Brandywine:
The Mentor Xtra is a fine choice. You would be at 595 ccs or650 ccs in the Xtra Smooth High Profile in that style.
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INFORMATION WE NEED:
1. Your height, weight, ribcage circumferece (measuring under the bra line or under the tissue expanders with a measuring tape). 28 in
2. If you DO have tissue expanders already, we need to know the exact style of TE (Mentor, Allergan, Sientra, SSP) AND the volume - the mfr's recommended volume, NOT your current fill volume. So if you have Mentor TEs, they would be LOW HEIGHT, MEDIUM HEIGHT or TALL HEIGHT. If you do not have the "height" information, you might have a style "number", If they are ALLERGAN TEs, they would be one of six styles, with letters such as "MX" or "MV" or "SX" or "SV" or "FX" or "FV". They might have the number 133-V followed by a number like "13" or "14". TO SAVE TIME (FOR MOI) YOU COULD LOOK UP THE DIMENSIONS OF YOUR TISSUE EXPANDERS.... Mentor Arturo high profile 225 cc
3. Also, please advise if your PS has told you that he/she uses one brand or style of implant exclusively so that we can save time in our research. Yes Mentor round
4. Your pre-mastectomy breast size is also important, because it does have some bearing on expansion, tissue expander volume and the need for good tissue coverage over your future implant. I'm not sure really. VS put me in a 32 D, but I'm pretty sure that wasn't correct.
5. GRAMS VS CUBIC CENTIMETERS: Essentially interchangeable. A gram is a measure ofmass/weight and ccs a measure of volume. It is the dimensions of the implant that matters more than the discrepancy between the "size" of an implant designated in "grams" as opposed to one designated in "ccs".
6. OVERFILLING OF TISSUE EXPANDERS: There is no hard and fast rule regarding overfilling of tissue expanders. Some plastic surgeons overfill, merely because they always do for every patient. Some never or rarely overfill (my plastic surgeon was in that camp.) She felt that if the right tissue expander was selected, there was no reason to fill beyond that which the manufacturer recommended. In cases where the patient's skin envelope is very tight, and a larger implant is desired, overfilling would have some benefit. In the case of a unilateral breast reconstruction, where the future implant needs to mirror a native breast which has some ptosis (droop), overfilling can help achieve that needed symmetry.
7. "DROP AND FLUFF": Drop and fluff" is a term created long ago by the breast augmentation crowd....to reflect how the implants can settle and take on a different appearance and more natural appearance. Doctors do not use this term and I do not use it, because this is not breast augmentation. In breast augmentation, since women are going larger and the breast envelope is smaller, the implants often sit up and ride quite high on the chest wall, and appear very taut and/or flattened in appearance. With augmentation, it takes a while for the native skin and tissue to adjust to the implants and so those galls do experience what they call dropping and sort of filling out or not being so compressed and gaining projection.
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.
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Suzie - I see this is your first post. I'm not sure why you re-copied the header of this thread. Did you have a question?
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Hi! I was diagnosed with Stage 1 triple positive invasive ductal carcinoma about 8 months ago. I completed 6 rounds of TCHP and had a double nipple sparing mastectomy with tissue expanders. My expanders were Mentor Arturo high profile 225 cc.
I’m 5’2”, weigh 123 lbs, and my rib cage measures 28”. Before my mastectomy I was wearing a 32C bra from VS (I was really more like a B in my opinion). I had my exchange surgery a few days ago, and my results are not what I was expecting. I knew that my implants would be on the smaller side, judging my the sizes I hear other women get. I got 240 cc Mentor Memory Gel Xtra Moderate Plus profile, but I still thought that they would appear bigger on my small frame.
I do really like how soft and natural they feel, but I don’t like how flat they appear. Will this change any over time? Should I have gotten bigger implants?
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Suzie - Whippetmom will be along and address the size.
But in the mean time, you should not judge how you look for at least 6 weeks to 6 months after your exchange surgery. Everything will be healing inside for that long. The best thing to do is step away from the mirror. I know it's hard, but truly - you just can't tell how they'll look after a few days or even a few weeks. It's best not to dwell on it now. Implants will not have as much projection - but you can't possibly know now how they will turn out.
Edited to say, you can look up the 'exchange' thread to see what others go through at this point.
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Thank you for suggesting the other thread! I’ll definitely take a look at it.
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Susie: Your implants are a bit smaller than I might have suggested for your frame. Something 350 ccs to 425 ccs would be a consideration down the road. High profile, not moderate plus profile As MinusTwo stated, you need to give it time anyway, because you would want to wait several months before undergoing an exchange to anything larger. Give the body time to recover from general anesthesia, and give the skin envelope time to relax and expand a little.
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Hello! Like others, I'm having trouble judging the size/look of my breasts with the tissue expanders in (side boob is a real thing currently).
I'm 5'4 1/12" and about 135 lbs with a 31" rib cage. My TEs are Sientra AlloX2 Full height - dimensions 12cm width x 11 cm height x 5.3-6.0cm projection. Volume 270-330ccs.
I'm sorry I don't recall the type of implant my PS uses, and her website is down right now. I wore a 34B in a victoria's secret bra before mastectomy. Some would gape, some would squish.
Now I'm just trying to decide if the current fill (plus 20cc overfill) is what I want. Sometimes it feels too small, other times too big but the position and feel is so strange that it seems impossible to judge. Thank you!
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scoop:If Mentor, I would recommend the 450 ccs Xtra Smooth high profile rounds. Compare the dimensions.
If Allergan Inspira, 445 ccs SRX, approximately the same dimensions.
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Thank you whippetmom! It's really nice having someone with so much knowledge and experience! I really appreciate your help.
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Scoop just another opinion..I'm 5'6 120 lbs 29" ribcage, previously 34/36 B. I had my exchange surgery 2 months ago, 495 cc implants. I fit into a C/D bra depending on brand but feel much smaller! So hard to figure out the perfect size for us... I hope you find yours and are happy with results.
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LiveLoveLaugh, thank you for the info! Do you feel smaller than a C/D or smaller than you did before? It feels so permanent trying to figure this out. Like designing your own body...
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You're welcome. Yes, I feel smaller than a C/D. But the same size implants on different people/body shapes will be/look different. So I agree, so hard to figure out the "perfect" size for us. It's like you wish you could know some magical way before surgery! lol
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Whippetmom,
Thank you for the advice! I haven’t been able so see my PS since my one week post op due to COVID-19. I’m also noticing that my new boobs look fuller toward the center but kind of flat from a side profile view. My nipples point slightly outward. Any thoughts on why that could be?
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SuzieQ
You would need to PM me photos....
Deborah
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I'd like some guidance on implant sizing. I had a bilateral mastectomy on 3/26/20 with immediate TE placement. The tissue expanders are the following: 11.4x8.1cm 250cc Style 9100 Smooth Suture Tab Sterile Mentor Cpx4 P6.1cm - S7638211-042. At this point, each tissue expander is filled to 200 cc. I am very petite (5' 1", 90 lbs, 27" rib cage). Prior to the bilateral mastectomy, I wore a 32C bra and would like to achieve a similar silhouette. Any advice on implant sizing would be greatly appreciated.
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Hello!
I had bilateral mastectomy 3/20/20 (R/cancer, L/prophylatic). I started immediate-delayed reconstruction with tissue expanders. I was going to do delayed reconstruction because I didn't like the wait/time frame for having to wait to start immediate reconstruction, but literally, at the very last minute before going into to the OR, I consented to an immediate reconstruction since the PS schedule had opened up due to the COVID-19 cancellation of his non-essential procedures. So I did not have the pre-op appointment that I would have had if I had known I was going to do it all at once--maybe things would have been discussed more then/I would have given options, I don't know. Anyway, at my initial consultation with the PS, he said he wasn't going to talk cup size yet, we would just have to see what my skin would allow--he said likely it was going to end up looking like a had a lift. We only discussed saline vs silicone - he recommends silicone (no gummies since they can can move, I guess?). I'm 5'2" and 158 lbs, but I was trying to lose weight before my diagnosis and my goal weight is 125-130. I was a generally a 36B before surgery. I had my first in-office fill on 4/7 and my second fill today 4/14. I am going to have 8 rounds/5 months of chemo. Was planning to start chemo at the end of this month but now it's going to be early May (due to exchange for implants). I initially didn't think I was going to need radiation, but now that is a consideration due to my close surgical margin...my surgical margin was clear, but only by 0.5 mm at the superior margin and so now I may need radiation after chemo after all. (that's another thread's question).
So, originally I thought I was going to have the TEs in place for months with fills over that time period. I've read about people waiting for the exchange of TEs for implants for several months after the "final" fill. Well, last week (ie., 1st in office fill), the PS talked about doing my exchange before I start chemo. I thought, well what was the point of doing immediate reconstruction if the TEs are in place for only a few weeks? Anyway, I saw him again today. I questioned about the short time frame. He assured me it would be okay. He said I could leave the TEs in until after chemo but I would have to wait a month after chemo ended, so I would be looking at having the TEs for 6 more months. He discussed how the TEs are more uncomfortable than the implants and a lot of women feel better going ahead and having the implants in place before chemo. So now I will see him again next week for maybe another partial fill/final fill which should be full (I found out today they are 500 cc expanders). And surgery for exchange is now scheduled for 4/29.
So, all that info to get to my question - has anyone else had their process occur that fast? It just is a lot faster than I expected and from what I have read about other people's experiences online. I don't have any reason to not trust him. And will 550 cc give me a nice size? ( It would be great to be a little larger than pre-op but definitely not smaller ). Everything seems to be going okay so far. When I asked around before surgery, generally everyone loves him, one person said you just have to make sure to be your own advocate without elaborating. So I guess I'm just wondering if I need to be advocating something for myself here...Thanks in advance for taking the time to read my long story and for any comments!
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As78:
I am giving you dimensions for Mentor implants. Ask your PS (or his nurse) if he also orders from Allergan. If so, I will give you sizing for that brand also.
Mentor Xtra Smooth Round High Profile silicone: You can see how you need this much to match the dimensions of your tissue expanders. You still will not have the projection, but you are so, so petite, and I am reluctant to recommend an extra full projection style. See if your PS can obtain Allergan products, because there are more options with Allergan.
325 cc
11.4 cm width
4.6 cm projection
350 cc
11.7 cm width
4.8 cm projection
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Whippetmom:
Thank you so much. I'll speak with my plastic surgeon about Allergan implants as well.
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Whippetmom
I had DIEP 12 years ago on my left breast and now I have to say goodbye to my right one.
I am leaning toward implants but was reading that larger breasts may not do well.
I am 36/38 D. I am not too concerned about exact match as long as it looks good in a bra .
I have an appointment in Tuesday with my PS. Previously we only discussed TUG reconstruction so I will get more information on the implants. Do you have any suggestions for the manufacturer for my size?
I am 5'8" 160 pounds.
My questions probably sound naive , I never considered implants before just flaps. I just feel so much stress trying to decide
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Hello ladies,
Hoping to get some guidance on implants. I had my BMX 6 weeks ago with TEs: SMXP120RH Mentor Artoura. I'm currently filled to 300cc. I'm 5'5, 125 pounds, rib cage 30''. I lost 10-15 pounds during chemo and before surgery used to wear 34B bras. I would like to end up about the same size as I was prior to surgery. Also, I will need to have radiation. As I understand to account for shrinkage the radiated breast is typically overfilled. By how much?
I've been asking my PS about my options and the only answer I've got, "we'll keep expanding till you are happy with the size". But it's so hard to judge the size with the expanders! Thank you for your help!
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ijl: What did you discuss during your appointment last Tuesday? Did you find out what brand of implants your PS uses? Allergan or Mentor?
An implant alone will probably not look the same as your DIEP side. It can have symmetry though. I have no idea what size of implant you will need, because I have no idea of the dimensions of your DIEP side. That is what will be the determining factor in choice of implant. The width and projection of your DIEP breast will dictate the width and projection of the implant.
Debora
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Tunik:
The implant that I would recommend is the Mentor Xtra Smooth Round High Profile implant. The volume would be 450 ccs to 465 ccs. Your PS will know how much overfill you might need to compensate for irradiation. However, I would also recommend that you discuss fat graft transfer to the breast after radiation, at the time of your exchange to implants. Fat grafting will help ameliorate the deleterious effects of radiation. Once you fill to 375 ccs, you should have a better sense of the size. Let me know how you feel about the size once you reach that fill level. Also, Allergan has implants in the Inspira line, which I feel would work well for you also. But ask your PS if he will use Allergan. If he will, let me know and we can work on some sizing options with that brand as well.
Deborah
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