BREAST IMPLANT SIZING 101
Comments
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CTrunningmom:
I think that I would have recommended smooth silicone rounds. As far as anything else is concerned, that would all depend on what you were hoping to achieve. I personally think that your implants might be on the smaller side than I would have suggested, but then you might have communicated that you wanted to be on the smaller side to your PS. So, after the fact it sort of is a moot point. If you are happy with your results, that is all that really matters!
Deborah
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lmcmorrow:
I think that you will want to at least be around 400 ccs to 450 ccs with your implants. You could use some additional width - 12.0- cm width, vs 11.0 cm width. So that translates to something in the 400 cc range. I like Inspira, high profile or extra high profile in terms of style - smooth round silicone.
Deborah
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Hello whippetmom,
I glad that I found this website, and have been reading some of your posts recently days. I am in awe of your generosity with your time, expertise and suggestions on this site.
I would like to have your opinion for my question. Thank you very much in advance.
I am 5'5"tall, my weight usually around 115lbs to 120lbs, with 27.5"chest circumference.
Pre-mastectomy bra size is 32 AA or 34 AA, i am very tinny.
TE: Allergan naturelle 133S MX-11-T 300cc
My target aid for a full B, or at least small B. I really don't want to be a pancake any more. I just wondering that is my TE 300cc will be too small for full B? But I don't have opportunity to exchange the TE volume size any more at this point. I remember you mentioned that it always not by CUP SIZES, but I mentioned full B, just generally estimated it as a usually size that we can understand.
- Is is possible to aid for a full B with TE: MX-11-T 300cc?
- How much can MX-11-T be overfilled to aid for a full B.
- What implant size you will suggest for me?
By the way, My PS suggest Pre-pectoral breast reconstruction, better than Sub-pectoral before the surgery.
I wish I was able to find you before decided the TE volume.
Thank you so much for being such a valuable resource and goodsuggestions.
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Hello whippetmom,
I glad that I found this website, and have been reading some of your posts recently days. I am in awe of your generosity with your time, expertise and suggestions on this site.
I would like to have your opinion for my question. Thank you very much in advance.
I am 5'5"tall, my weight usually around 115lbs to 120lbs, with 27.5"chest circumference.
Pre-mastectomy bra size is 32 AA or 34 AA, i am very tinny.
TE: Allergan naturelle 133S MX-11-T 300cc
My target aid for a full B, or at least small B. I really don't want to be a pancake any more. I just wondering that is my TE 300cc will be too small for full B? But I don't have opportunity to exchange the TE volume size any more at this point. I remember you mentioned that it always not by CUP SIZES, but I mentioned full B, just generally estimated it as a usually size that we can understand.
- Is is possible to aid for a full B with TE: MX-11-T 300cc?
- How much can MX-11-T be overfilled to aid for a full B.
- What implant size you will suggest for me?
By the way, My PS suggest Pre-pectoral breast reconstruction, better than Sub-pectoral before the surgery.
I wish I was able to find you before decided the TE volume.
Thank you so much for being such a valuable resource and goodsuggestions.
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hi whippetmom getting to that point, have a discussion with PS scheduled for Friday to talk about/schedule my exchange (planning on doing it in July).
Height: 5'5"
Weight: 165
Ribcage: 34.5"
Currently have Mentor Artoura High Profile SMXP130RG 475cc
We overfilled to 520cc, I was a full 36D before surgery and, would like to be close with the implants. I do like my current size with TE, would be OK slightly bigger but, not going smaller.
My PS says he generally Allergan but, will use something else if i have a preference.
I have time to make a decision, if I get the PS' suggestion before you have time to reply I'll post them so we can compare.
Thanks
ETA: my PS didn't give a specific model but, he said he will use Allergan, Smooth Round, extra full, ultra high implants and we're going to go a little bigger than the 520cc I have now.
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Thank you! I won't be able to switch to a 12 at this point so am hoping they can overfill to achieve the size I desire.
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Zoe:
I do not think that your tissue expanders are too small. I would suggest 345 ccs or 400ccs in Allergan Inspira - either the SSX or SRX styles. When you give me a cup size, that really never fully translates with breast reconstruction. I might wear a D cup in a Victoria's Secret bra (although I have not bought one in twelve years) - and a DD cup in a European bra. Bras like Natori,Freya and Chantelle are much preferred for post breast reconstruction clients. And far prettier, IMHO. So I just recommend what I interpret you want to look like in a bra....It is not exacting science. But the most important thing you can do now is communicate this suggestion to your PS. As long as your skin integrity is good, you can certainly handle 400 ccs.
Deborah
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Morrigan:
Based on your comments, I would suggest 580 ccs or 615 ccs. Allergan Inspira, Style SSX or SRX. Your TEs should get you there.Deborah
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@whippetmom thanks! I'll email him the rec and ask what he was planning!
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I'm so sad I didn't see this post until after my reconstruction. I really wish this was distributed and discussed in all with all reconstruction Md's
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I'm so sad I didn't see this post until after my reconstruction. I really wish this was distributed and discussed in all with all reconstruction Md's
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Hello whippetmom - I did not find this community until after my reconstruction was done. In reading through the posts, your advice is so thoughtful and helpful that I thought I would ask you about my situation. I had a BMX in March 2020 with tissue expanders put in at the same time. In Sept 2020, the tissue expanders were exchanged for implants and I had fat grafting done as well. At the end of December 2020, I had another fat graft done along with some revisions to tighten up some excess skin. I am 5'5", 148 lbs, and rib cage is 33.25". The expanders were TE Sientra Opus AlloX2 Full Height. The left fill was 460 cc and right fill was 540 cc, and exchanged for Sientra Smooth HSC+ Moderate Plus 650 cc. Before the surgery I wore 36C/D bras.
At this point, I have full range of motion but still have a decent amount of pain and pulling, and the implants still feel uncomfortable and foreign. I was told that it can take a very long time for healing, but I'm starting to wonder if I should have gotten smaller implants. Is it possible that they hurt because they're too big? If I decided to get smaller implants, what size might you recommend? Or does the size not really have anything to do with the pain and maybe I just need to be patient and give them longer to heal? I appreciate any input you might have and thank you for your time and assistance. This community is just wonderful!
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Goldengirl:
Your pain and discomfort are not related to the size of your implants. What you are describing is Post-Mastectomy Pain Syndrome. There actually is a forum with this name here on bc.org. Doctors rarely, if ever, tell patients about PMPS, even though it occurs in over 50% of breast cancer patients. The omission is likely due to the fact that it is the breast surgeon who accidentally damages the peripheral nerves during the mastectomy. I'll find some links for you. There are simple procedures to help reduce the discomfort.
The most important thing you can do is ask for a referral to a physical therapist who performs myofascial release...and there are PTs who work nearly exclusively with breast cancer patients. You have to be the squeaky wheel now....and obtain the services you needHere you go: Read the full transcript.
https://www.breastcancer.org/community/podcasts/postmastectomy-pain-20181005
This is the PMPS forumhttps://community.breastcancer.org/forum/136/topics/747016?page=60#idx_1779
Deborah
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Thank you very much for your feedback and the very helpful links! You and this forum are a wonderful resource!
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Hi Whippetmom, I am checking in after a long break from this forum. I hope you and your family are all doing well. I am so impressed and happy to see that you are still active here, helping more and more women to make informed surgical decisions. I checked in quite a while back and read that the picture forum was shuttered.
I am hoping that you will give me a few words of your wisdom. I saw my P.S. Gabriel Kind in San Francisco last year about a week before the shutdown. Now starting over again and heading back for another pre-surgical appointment. I have capsular contracture with no real pain, but I have tightness and distortion and two occasions of my right implant partially flipping (?) which required manual manipulation to reseat.
Height: 5'8" / Weight: 143# / Rib circumference: 33.5"
I originally had Natrelle Style 15 implants (533cc with 4.7cm projection) under muscle which looked very natural on my body. You actually commented on the picture forum that you were surprised that you liked the Style 15 on me. I liked the ptosis, but I had a lot of rippling. We swapped out in 2013 to Natrelle Style 20 (550cc with 5.6cm projection) to get more upper pole fullness. I still have some rippling on the left, but it is much improved.
The right implant "catches" a lot and I fear that one day it will not be manipulated back into place. It has also pushed up on my chest so things are no longer level or even. I have little flesh/fat on my upper chest so these implants have too much projection for my liking. Dr. Kind likes Natrelle, and I am hoping that the new-since-my-last-surgery Inspira Soft Touch implants will be a good compromise between the two styles I have already had. Dr. Kind initially didn't feel he could do enough fat grafting to help with the rippling, but at last year's appointment he mentioned it so that could be on the horizon.
Sorry for the wordy post, just wanted to give you as much info as possible and let you know what my hopes are.
Thank you so much!
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Hi Tina! So nice to hear from you!
Yes, the Soft Touch version of the Inspira would be my choice. It sounds as though you are still in good hands with Dr. Kind. Let us know how you like the results. It is a journey, to be sure.
Best to you!
Deborah
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Hi, Deborah!!!
Yep, I'm back... new primary: papillary carcinoma with microinvasion. Next month would have been ten years...
The good news: currently, no radiation recommended; just Tamoxifen.
The "new" girls still look as great as they did when you suggested them ten years ago. I will be forever grateful to you.
xoxoxoxo
(PM me if you like!)
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Oh Blessing - sorry to see you back.
I'm 10 years from original implants that Deborah so perfectly recommended. And 8 years out after my recurrence. Fortunately they were able to do ALND surgery w/o harming the implant on that side. So the R side - with the 2nd surgery & radiation - looks just great. The left side at 10 years is pretty saggy. My PS said he could fix that side, but since I have the Allergan 410s (with no problems) I'm just riding it out.
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Hi, MinusTwo!
I'm so sorry you had a recurrence... how are you doing now?
My MO was concerned about the effect of rads on my implants... she wants me to meet with the RO so I have all the info.
(I was looking forward to having the perkiest boobs in the nursing home... when I get there, that is...)
Good to know yours are doing well.
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Blessings - The skin & muscle changes on my radiated side keep the implant sitting high and tight. Which is fine with me. If you end up with radiation, I hope it doesn't cause you any problems. Deborah likely has more knowledge about this.
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I think it is safe to assume that all of us will have the perkiest breasts in the nursing home. 😂
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Oh my goodness, I've been away from these forums for quite a few years. As I sit down to write this I see recent posts from Blessings2011 and MinusTwo. I'm so sorry you both had to deal with recurrences, but it's still a comfort to see your familiar names here. I think we all started our surgical journeys in 2011 and found help and amazing advice on these discussion boards.
Whippetmom, I had my revision surgery in San Francisco on Aug. 24 to remove my Natrelle Style 20 implants due to capsular contracture. As I wrote a few weeks ago, Dr. Kind told me that he now usually uses the Natrelle Inspira Cohesive implants because most reconstruction patients ask for projection. But, after giving him my wish list of wanting softer implants of about the same size with some ptosis and a nice slope he offered to use the Natrelle Inspira SoftTouch implants instead and to do an initial round of fat grafting for the inevitable rippling he predicted on my frame. I'm still wrapped up and I don't go for post-op and drain removal until next week.. But, my paperwork tells me that he used the SoftTouch Full Profile SSF-560. The statistics are almost identical to the Style 20 implants he removed.
Fingers crossed !!!
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Hello to all you BC experts. This is my first post, but I have been lurking, reading and learning from all the info on this site and forum since my diagnosis in May. Such a wealth of great information and helpful people! I feel I've made it through the worst parts of my BC so far and am looking forward to the light at the end of the tunnel, which is my exchange surgery in November. Sadly, I've run into some issues and was hoping for some guidance.
A little background: I have a strong family history of cancer, breast and otherwise, so I have been getting regular screenings starting around 35 (I just turned 47). I had a breast augmentation in 2000, with Mentor 400cc smooth round silicone implants placed under the muscle as part of Mentor's clinical trial for FDA approval of re-introduction of silicone implants for augmentation. Never a single problem with those implants in 21 years. Size was around the 32DD/34D range depending on the bra, no ptosis. Due to my implants and dense breast tissue, my annual screenings have always included ultrasounds, which is a godsend since my cancer was not detectible by mammogram, it was the ultrasound that found it (common with ILC, I have learned).
I had NSBMX in may performed by a BS that is highly regarded in my area. Initially I wanted direct to implant surgery, but I was not able to find a PS in my area who perform direct to implant. The PS I selected, who came highly recommended, explained that he feels he gets a "better result" by allowing the flaps to heal for about a week after MX surgery without tension before inserting implants. So I was originally scheduled for a second surgery to insert implants 8 days after my MX surgery. Unfortunately, my right NAC (cancer side) had some delayed healing, so the surgery was pushed to 17 days after my MX surgery. The morning of surgery, my PS said everything looked really good and I had only a minimal chance (10% to be exact) of waking up with TEs if my flaps had tacked down too much in the time since my MX surgery, etc. Needless to say, I was very disappointed when I woke up with TE. I had told my PS from day 1 that I just wanted to be around the same size as pre-MX (32DD/34D) and he stated that I would need 500-600cc implants (smooth round, he prefers Mentor but uses other brands including Natrelle, prepectoral placement). He never winced, batted an eye or suggested that wouldn't be possible. I was a bit taken aback when I learned he only placed 350cc expanders, but his PAs assured me he could overfill, etc. I saw his PAs and nurses a lot more than I ever saw him post-op. At my most recent appointment (where I thought I would be getting another fill), I was SHOCKED when my PS stated that he wouldn't fill me anymore and the largest implant he can use is 450cc (high profile, so 12.8 x 5.1 I believe)! I was devastated. Crushed. In tears. Never once did he mention that achieving my prior size (or close to it) wouldn't be possible! While I completely understand how skin integrity and nipple placement w/nipple sparing and are integral in determining the implant size/profile, I estimate that had around 550cc between implants and tissue pre-MX and my nipples weren't malpositioned, so I am not understanding how I don't have the skin or how the nipple placement is an issue for me. Most frustrating is that my PS never mentioned anything about this along the way. I feel like the victim of a bait and switch by a shady salesperson.
Stats:
5'3", 125lbs (pear/thinner up top), 29-29.5" ribcage
Natural Breast Size: 32B
Augmented, Pre-MX Breast Size (submuscular w/Mentor 400cc rounds @ 14.5 x 3.2): 32DD/34D
Breast Tissue Removed (pathology doesn't show weight):
L: 13.5 x 11 x 3.5
R: 15 x 14 x 1.5
TE: Mentor Medium Height 350cc capacity filled to 360cc (11.7 x 10 x 6.6, I believe) NOTE: These seem like a B, maybe small C cup at best and I am not happy with the size. Will 450cc implants appear much larger at all? Since my previous implants were 14.5 and the breast tissue removed ranged from 13.5-15, I feel like these TEs might be too narrow to for my ribcage and to achieve my pre-MX size?
I realize in the grand scheme of things I am very fortunate. My cancer was diagnosed early, clear margins with no lymph node involvement, so no chemo or rads, I was able to save my nipples, etc. I try not to lose sight of that. But this entire time I was led to believe I would end up with around the same breast size, so I am really struggling with accepting that 450ccs is all I can get. Any experts want to chime in on how 450cc will be as compared to what I had pre-MX? I was going to see if I could convince my PS to try Natrelle Inspira Full Profile 485cc (13 x 5.4). Should I try to get a second opinion (if so, would love some PS recommendations preferably in FL)? Should I just accept the 450cc for now and expect to have a revision to hopefully larger in a few months? Sorry for the long rant. I appreciate any and all insight and opinions.
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Go for the second opinion. It seems to me that delaying implant placement with no expander in place to maintain the flap size may have caused the issue. I have never heard of a doc letting the skin flaps go empty before implant placement.
I would not proceed with the current plan with the thought of going larger later. Any surgery has risks and causes scar tissue formation. The fewer of those risks the better
For reference, my rib cage size is comparable to yours, altho I am 5’ 10”. I have 600 cc Inspira SCX and I am 34 DDD.
Good luck
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Daughter - you definitely need to get a second opinion with a different PS. Whippetmom should be able to recommend some FL docs. There's also a semi-active Florida group.
I too have never heard of leaving skin flaps "empty". Expanders with no filling, but not empty. Hope everything works out.
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Thank you @MinusTwo and @VegGal (BTW, any chance you are vegetarian or vegan? I'm a long time vegetarian is why I ask). I sent a message to @Wippetmom and called a few other local PSs. Most won't see me since I am under the care of my current PS, but I found one that can get me in on Friday and am waiting for a return call from another once he reviews my records. So fingers crossed I will have some other opinions soon. If they all say 450cc is all I can take, then it is what it is, although I still won't understand how given I was larger pre-op and didn't lose any skin or nipple, no rads, etc. I appreciate your feedback.
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Hi DaughterOfBarb,
Yes, I am also a long time vegetarian. About 10 years now.
I remember my first appointment with the PS. His nurse was giving a quick orientation, and specifically explained that the pocket would shrink back quickly, and needed to have the expanders in to maintain the skin while it healed. Of course I am thinking of women who have a lot of skin removed and have to really stretch the skin. It seems the same could be done for you. I hope so.
Sorry you are having difficulty being seen by a new doc. I went through a botched cataract surgery in June, and it seems there is a “magic window" of 3 months where no one else will touch the first surgeon's work. Luckily I just passed the end of that 3 months last week and am proceeding with the “fixing" part. Maybe the same thing is true with PS's.
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Good evening, I'm hoping someone can refresh my memory about the healing time right after implants are placed. Due to capsular contracture I had my Natrelle Style 20 550cc silicone implants (placed in 2013) replaced three weeks ago along with capsulectomy and fat grafting (history of rippling). With my PS blessing I opted for the Natrelle Inspira Soft Touch implants (medium cohesiveness) rather than the Inspira Cohesive implants he typically uses for reconstruction (which he uses because most patients request the projection that the more cohesive gel offers). I wanted a more natural and softer look than my previous implants. I ended up with 560cc - SSF implants. My PS also tightened up the pockets.
So far I am really pleased with how things look and feel. However, in the past few days I have noticed multiple horizontal "ridges" across the lower poles on both sides. No verticlal ripples on top like I had before, just these weird "stripes" across the lower areas. I thought at first it had something to do with the sports bra I have been wearing, but the ridges don't really match the bra.
I'm hoping this is a temporary part of the healing and settling in process, but I don't remember this from my other implants. Any thoughts? Thanks!
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That's awesome, @VegGal! I've been meat free since 1995. I have a very strong family history of all types of BC, including my mother who also had ILC (genetic testing is negative thus far, but I believe that's simply because they haven't discovered the gene yet), so I always joked that my boobs were doomed, but my GI and colon were safe due to being meat free LOL.
Sorry to hear about your botched cataract surgery. Hopefully the fix isn't too complicated. My guess is you are correct in that no one will touch me until well after I proceed with the exchange with my current PS. At a minimum, I hope I can in for a couple second opinions now just to see if they concur with what my current PS is saying even if they won't take me on until after my scheduled exchange surgery. After all the cutting, I was really hoping to avoid an immediate Surgery 4 for revision.
Best of luck with your cataract surgery.
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Daughter - when I was in the middle of the "fill" process, I had two 2nd opinions. I wasn't necessarily planning on changing docs, but I sure wanted another view of what he was doing & recommending. Houston has several major hospitals so it wasn't a problem to see a different PS for a consultation only.
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