BREAST IMPLANT SIZING 101
Comments
-
Susug:
Yes, I know of Dr. Spiegel. I have seen her work. Very nice. The “internal bra” technique was first described by Deborah Bash, MD - a plastic surgeon at the Mayo Clinic in Scottsdale. I saw the results of that specific procedure and the results were amazing. For Dallas/Ft Worth, Louis Strock, MD does beautiful work
0 -
Morrigan: Your questions are fine. Specifically, the make, style and volume of the tissue expander is what I would need to help you further.
0 -
Tigereyes:
I would recommend Allergan Inspira, SRX 420 ccs or 445 ccs. Nothing smaller than 420 ccs. You will only achieve the projection to closely approximate that which you havewith your “extra projection” style TEs, if you have the SRX, SSX, SCX....Allergan Inspira.
0 -
salamander:
You either have a low height, medium height or tall height TE. There is a specific volume associated with your TE. Ask your surgeon’s office for that information!
0 -
Botgirl:
Because of your ptosis/droop on the right, I would suggest overfilling the left, and then exchanging to a Mentor moderate plus profile smooth silicone round. The volume would be 370 or 405 ccs. You can see the difference in the projection, as the tissue expander has a projection of 7.0 cm, while the implant has a projection of 4.1 or 4.4. This hopefully creates some ptosis on the reconstructed side, to gain some symmetry on the right. I just cannot say if this will be enough though, to match that native breast. I would consider the mastopexy, if better symmetry is desired.
0 -
I know cup size is regarded as irrelevant, and hard to really assign with our implants. But approximately what size will 400 or 420 cc implants be on a small framed petite lady?
Thanks in advance!
0 -
e99 - really it's truly impossible to say. IT depends on your height, weight, measurements, the kind of implants, the doctor that is placing them, whether they are over or under the pec muscles, how much tissue the doc has to take to get clear margins, etc. etc. etc.
Oh - and it also depends on the bra. Each company makes bras just a bit different. Each moves differently on your frame. And bras made in other countries are different again. Think going to Chicos and buying a size 1 which is really a 12 or 14 or some silly thing in the real world.
If you are happy with your expanders, then you need to discuss that with your PS. Just remember that implants won't have as much projection as expanders.
Edited to say, if you read the entire header of this thread, you will get a feeling for the complexity of the issue. If you post everything Whippetmom requests, she's pretty good at giving you a reasonable answer.
0 -
Hi whippetmom,
My journey with cancer started with screening mammogram before breast augmentation and I am hoping to close the circle.
I had my exchange surgery on 6/24 and I am kind of disappointed, so I wanted to ask for your opinion.
My PS went with 545 cc Natrelle Inspira SSX implants and fat transfer grafting. They do look good, but not the look I was going for. I want the upper pole fullness, round, cleavage ( push up bra look ), "fake" looking breasts. Any suggestions?
Stats: 5'4, 124, rc 32".
0 -
BgRose:
Well, you have the implants with excellent projection. They should be just right for your frame. It does depend on the tissue expanders though. Were they larger than the implants? It may be that the pockets are larger than the implants. Can you send me a photo via private message?
Deborah
0 -
e32: What Minus-Two said.....
Deborah
0 -
Hi I would like to get some input on implant sizing.
I have Allergan TE - REF 133S-FV-12-T 400cc
My PS uses/ recommended Allergan round smooth implants however if there are better options I could see if I can ask for them so please let me know.
I am 5'3" , 126 lb, ribcage circumference 34 inches
Before mastectomy I was fluctuating between 34B and small C.
My PS overfills the implants until the patient likes the size they see.
I hope to have a good projection and not flat pancake like foobs
Thank you
0 -
Hi Whippetmom,
Following up on my original question from June 22. I have additional information to inform your recommendation:
- Expander: Mentor CPX 4 - Smooth surface medium height cc vol 350 (cat # 350-9212)
- Current fill: 320cc, with another fill this week (July 17)
- Will require radiation, but awaiting decision on chemo first. No date scheduled for either yet.
Putting my original information below for reference:
On June 4th, I had a right-side, skin-sparing mastectomy, with immediate tissue expander reconstruction.. The plan is to exchange the TE for a Mentor silicone implant on the right side, with a lift and implant for symmetry on the left side.
- Height: 5'8"
- Weight: 155lbs
- Ribcage: 32"
- Bra size prior to nipple sparing mastectomy: 36 small C
- Age: 47 (not aiming for super 'perky' at this point)
- Would consider going up a size (full C or D)
The PS will use Mentor smooth round silicone implants (exact implant type TBD). Of the available Mentor silicone implants, which type and fill volume would you recommend for the right side?
Thank you very much in advance!
0 -
Hi Whippetmom,
I am resubmitting my post. I didn’t see a reply to it, hopefully I didn’t miss it.
“I would like to get some input on implant sizing.
I have Allergan TE - REF 133S-FV-12-T 400cc
My PS uses/ recommended Allergan round smooth implants however if there are better options I could see if I can ask for them so please let me know.
I am 5'3" , 126 lb, ribcage circumference 32 inches
Before mastectomy I was fluctuating between 34B
My PS overfills the implants until the patient likes the size they see.
I hope to have a good projection and not flat pancake like foobs
Any recommendations for a plastic surgeon in IL who is expected with prepectotal implants In case I want to explore that option? My expanders are giving me so much discomfort and I have a lot of animation so I can only imagine how bad will it be with the implants
Thank you
0 -
Emily12: I would suggest Allergan Inspira, smooth round silicone implants, SSX or SRX - 445 ccs, or SSF or SRF 450 ccs. Your TEs have a projection of 5.3 cm and so the “X” version might make for a pretty tight closure at the time of exchange. Talk about these style options with your PS.
Deborah
0 -
Salamander1
I would suggest Mentor Xtra Smooth high profile smooth round silicone implant, 450 ccs, or the original smooth round high profile implant, 350 ccs. The sizing is all entirely predicated upon symmetry with the native breast. Deciding factors are: How much ptosis (droop) you have with the native breast, andthe amount of projection that can be achieved with the mastopexy and augmentation of that breast. Even though your TEs hav a projection of 6.4 cm, your PS will likely need a lower projection style implant in order to match the natural droop of the native breast. Again, it all depends on what your PS will achieve with a lift and implant on the left.
0 -
Hi Whippetmom,
I am so grateful for this group and your help. All the decisions that go into Breast reconstruction is just so confusing, so this is much appreciated. I would love your advise. My info...
1. Height 5’7”
2. Weight 132lbs, currently, but usually in the 126-128 range. I have put on some weight during and after chemo, and trying to keep the weight on so I’ll have some options for fat grafting.
3. Ribcage circumference- 28.5 in
4. My Tissue expanders are in. They are the Mentor Artoura high profile smooth. 475c. Style # (R) 9351510-31 (L) 9433627-038 Ref# SMXP 130RH
They are currently filled with 410cc saline.
5. My PS says he uses Allergan Natrelle- smooth round gummy bear. That’s all the info he gave me. Are the gummy bear ones safe? I’m confused.
6. My pre- mastectomy size was a 32- DDD/E in the Freya bras. My breasts were a lot fuller when in my 20’s and appeared larger, but my bra size has always been anywhere from a D to an E depending on the bra. I would love to stay around the same size without compromising the natural look of them. I worry that going to a D will make them look unnatural.
Thanks again for your help. I look forward to your response and advise!
Nadine
0 -
Whippentmom,
Thank you. A follow up question: what does it mean to have a tight closure and why does it matter. I am completely new to all this.
0 -
Hi Whippetmom,
I am resubmitting my post. I didn't get a response. Hopefully I didn't miss it. Thanks!
Hi Whippetmom,
I am so grateful for this group and your help. All the decisions that go into Breast reconstruction is just so confusing, so this is much appreciated. I would love your advise. My info...
1. Height 5'7"
2. Weight 132lbs, currently, but usually in the 126-128 range. I have put on some weight during and after chemo, and trying to keep the weight on so I'll have some options for fat grafting.
3. Ribcage circumference- 28.5 in
4. My Tissue expanders are in. They are the Mentor Artoura high profile smooth. 475c. Style # (R) 9351510-31 (L)9433627038 ref# SMXP 130RH
They are currently filled with 410cc saline.
5. My PS says he uses Allergan Natrelle- smooth round gummy bear. That's all the info he gave me. Are the gummy bear ones safe? I'm confused.
6. My pre- mastectomy size was a 32- DDD/E in the Freya bras. My breasts were a lot fuller when in my 20's and appeared larger, but my bra size has always been anywhere from a D to an E depending on the bra. I would love to stay around the same size without compromising the natural look of them. I worry that going to a D will make them look unnatural.
Thanks again for your help. I look forward to your response and advise!
Nadine
0 -
Nadine: Whippetmom is not on BCO every week. It's possible she's currently on vacation. I expect she will check back in before the end of the month. Hope that gives you time to make your decisions.
0 -
Mwgirlintx:
Your TE’s are 13.0 cm wide and have a final fill projection of 6.8 cm. The corresponding Natrelle Inspira implant would be the SSX, SRX or SCX, 540 ccs (13.0 cm wide x 6.2 cm projection) or 560 ccs (13.25 cm wide x 6.3 cm projection). On your frame, this should give you a DD cup or DDD/E cup in a bra such as a Freya or Chantelle. Any other bra, I have no clue. But you will not have the same appearance as you did with your native breasts. It just is the way it is. But the size will be just fine for your frame.
Deborah
0 -
Hi Whippetmom,
I appreciate your help. I am 48 yo, 5 feet 4 inches and was 154 lbs a month ago before my b/l mastectomy. Bra size was 34C and would like to be about that again. 33.5 inches around the ribs. Current expanders: Natrelle 133S FX max 550 cc... info I found in an online Natrelle catalog: full ht/extra projection 13 cm width, 13.5 cm height, 6.7 cm projection.
I'm not sure about overfilling or if my PS exclusively uses Natrelle implants, although when first talking implant options he recommended the gummy bear type. I think I would want the mid-level "gummier" soft touch type.
Is there anything else I should ask him? I am only at 210 cc and don't yet understand how much "fill" will take me to approximately my original size.
thank you for any suggestions!
Amanda
0 -
Hi Whippetmom,
Looking for some advice. Status post bilateral nipple sparing prophylactic mastectomy on 8/18 for BRCA1+NF1 gene mutations. Here are my specs:
1. Height: 5’ 7” Weight: 130-135 lb Ribcage Circumference: 30 in2. Tissue Expanders: Natrelle 133S-MV-12-T 300 cc. She does overfill if needed. Currently filled to 230 cc
3. Planning for Natrelle Inspra Smooth Round Gel Implants.
4. Pre-Mastectomy Size: Mostly 34B. Mastectomy specimen weights were 170 g on left, 180 g on right if that helps at all.
I am currently filled to 230 cc which she said gives me a “projection” around 4 cm and max projection for my expanders is 5.2 I believe. I am currently happy with the size/projection of my TE’s and would like my implants to match this. My concern is that she says we are “in-between” sizes for the implants right now. If I stay at my current fill size, the matching implant she said would be the 250 cc low plus profile in order to stay at width of 12 cm. She said the implant would likely not have the same projection and would sit flatter. When I look up the projection of this 250 cc implant it’s only 3.1 cm. She said the next size up would be another fill to aim for implant of 310 cc moderate profile which has a projection of 4 cm which she believes is where I’m at currently. I like the way my expanders currently look and am worried about the implant looking smaller if I go with the 250. Do you think to keep the same projection that I should do another fill to aim for the 310 cc implant?
Thanks,
Danielle
0 -
MandySkier:
I would recommend the Allergan Inspira. SSX (the midrange “soft touch” version), 560 ccs. Let your PS fill to 500 cc to 550 ccs, or to toleration. This should get you to where you want to be. If the skin is lax and the PS had additional room, you could even go to 580 ccs.
Deborah
0 -
Danielle:
Keep filling to 300 ccs and a bit more, to skin stretching toleration. Don’t stop now, just because you like the size of the tissue expanders. This will equate to exchanging out to too small implants. With a bit of overfill, you could likely get to 385 ccs - tweaking the dimensions to 12.25 cm and 5.0 cm projection. Certainly to 365 ccs - 12.0 cm width and 4.9 cm projection. You could easily handle the 12.25 width.
Deborah
0 -
Hi! I am 7 weeks post my prophylactic double mastectomy (BRCA+). During surgery, I was filled 200cc and 90cc since (3 fills - 30ccs per fill) - so 290cc total.
height: 5'1
weight: 120 lbs
ribcage: 30in
TE: Allergan - 133S SV (250cc volume, 12.0 width, 8.4 height, 5.3 projection)
pre-mastectomy size: 32C
At my most recent fill, my surgeon said we were probably done fill-wise. Now that I'm home I'm realizing I'm bigger than I was before - I was hoping to be slightly smaller - and am wishing I didn't go through with this last fill since it put me larger than where I'd hoped to be. The odd shape of the TE was making it so tricky to compare to my previous size so this larger size sort of creeped up on me. So I guess what I'm wondering is…
- How do I know what amount of ccs make sense for me/would most match my previous size?
- Can a surgeon go with a smaller sized implant during the exchange surgery? If yes, how much smaller? Does the overly stretched skin just adjust to a smaller size?
- When you exchange from TE to implant does it drastically change the shape? The TE are just so wide and projected, I'm worried with an implant when they drop/slope a bit more naturally they'll look even bigger cause of the widened skin?
Hope these questions make sense! So hard to find the words to describe this haha. Thanks so so much for any info/advice you have!
0 -
Hello Whippetmom,
Lots to think about & read! Right now I’m 8+ years out from a partial mastectomy from Triple Negative BC. It was mostly DCIS but had micro invasion. I just had full breast radiation no chemo. I have a BRCA 2 variant that doesn’t seem to cause cancer. I get checked twice a year at Hopkins. One with Mammogram & then 6 months later with MRI. Last week something lit up in my MRI. I’m scheduled for a biopsy October 6th. I have already decided that if the beast is back I will be getting a double Mastectomy. I don’t believe I can have DIEP surgery as I’ve had 6 abdominal surgeries. So implants it is. When I was measured for mastectomy bras I was measured at a 42 AA. I wish I had been sized many years ago. I mostly wear coobie bras or that style for the last 8 years. I’m 4’9” & weigh too much. It’s been hard to loose weight since I had Thyroid cancer 2 1/2+ years ago. I also fell at work & hurt my back 3 1/2 years ago. I keep going as best I can. I have no idea what to do with a size. When I nursed my babies I was a 36 D but I know now I was the wrong size. All & all I’m just plain lost about all this!
0 -
Abbstah
1. I would suggest you look at Allergan Inspira, style SSF or SRF, 335 ccs or 345 ccs. This would be tweaking the width a bit, so the 335 cc would be 11.50 cm and 4.7 cm projection. The 345 cc would be 11.75 cm width and 4.8 cm projection. You would be smaller than you are with your tissue expanders. You look at dimensions, not volume.
2. If you went with a smaller volume implant, you would be as flat as a pancake, in order to stay close to your current TE width. You would need to go with the lowest profile implant available in order to get close to 290 ccs. It just does not work that way.
3. The implants will look much better than the TEs.
Deborah
0 -
julz4
Well, you will probably want to be in the 600 cc to 700:cc range with implants. I envision tissue expanders around 600 ccs.Deborah
0 -
Hi Wippetmom! Thank you so so much for your quick response - I really appreciate it!!! Just a few follow up questions if not too much trouble. So what you're saying is if my surgeon goes with a low profile implant, matches it to my current TE volume of 290ccs but goes with a smaller implant dimension wise, my size will be smaller than it is currently? Is there any way to know how much smaller they will look compared to how they look currently?
Alternatively, my surgeon has offered to take out some ccs from the TE if I feel the last fill was too much. I guess what I am trying to figure out is how many ccs in the TE is the right amount to help me be about a small C. I feel like currently I'm a medium-large C but again the odd shape of the TE is making it tricky to tell. Does the exchange from TE to implant always result in a smaller size and if yes about how much smaller? Is it possible that if my surgeon removes some ccs from the TE, we get back down to the size I hope to ultimately be, and when we exchange to the implant it's approx the same size look wise as the TE?
Sorry if these are tricky questions. I know this sizing thing is pretty nuanced because of personal body dimensions, etc. I really appreciate your help/thoughts. Thank you thank you!
0 -
Thank you for this post. Hopefully you are still taking questions. I just had a nipple sparing double mastectomy on 10/21 with Nartelle Expanders put in. I'm not sure which style. My ps filled them to 300 cc during surgery.
He says I can probably only go to 550 cc's in my expander and maybe put in 600 cc's implant when we do the reconstruction. I have always been big chested. Before surgery I was 36 D/DD.
I am 5'4 / 155lbs. My rib cage is 35". My ps only uses Nartelle implants. I am fixing to start menopause so I'm worried about gaining weight.
If I could choose, I would like to be a full D cup. My ps says my end result will be smaller than my natural breast size prior to my mastectomy.
Any recommendations would be appreciated. Thank you!
0
