BREAST IMPLANT SIZING 101
Comments
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Tina: I responded to your message back in August, but coming here now, I see it never posted.?? My response was that the Inspira implants would be ideal for you. Now that you have exchanged, I can say that the creases are likely where the implant is dropping and settling into the pocket. Check back in a month to let us know if this is the case.
Deborah
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DaughterofBarb:
You have sufficient projection with your TEs to exchange out to an extra full profile Inspira or a full profile Xtra Smooth Mentor. I would get a second opinion though. You want to get it right as much as possible the first time around. Do not exchange until you are clearly satisfied. I agree that the method of leaving the flaps without a TE or implants was a bit unconventional. You had some nice pockets which had been molded by the augmentation. What was the need to not perform immediate reconstruction?
Deborah
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Hi Whippetmom,
I just had a Bilateral Nipple Sparing Mastectomy, with TE's over the muscle on 9/20. I know I'm not even a week out but I am starting to think about future fills. I came here looking for implant sizing and looked at my TE card and it says 275cc. I think that's not going to be close to the size I want to be at all. On top of the constant pain from the expanders, now I have to worry about this. Maybe you can help me. I would like to be a small D cup. What should I do?
5'8, 140lbs, ribcage is 32.
Tissue Expanders: Mentor CPX4 with Suture tabs, Medium height, smooth, 275cc, 10.7x9.3x6.2cm
My natural breast size is a 32B.
TE's filled to 100cc at time of surgery.
Very worried, and scared, Thank you
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Thank you @Whippetmom / Deborah. I’m back with an update. I had one virtual second opinion and although that PS wouldn’t see me for a consult until I am a year out from my exchange surgery, they did take a lot of time with me reviewing my info and are actually in agreement with my current PS’s plan.
But I did finally had some good dialogue with my PS and his surgical scheduler. Apparently I was mistaken in my assumption that Inspira implants are an option as he no longer uses them, so I’m limited to Mentor. Despite his repeatedly saying “450cc” at my last appointment, he assured me that he understands my concerns and will do everything in his power to get me close to my pre-MX size without compromising nipple placement and his surgical scheduler provided me with the various styles and sizes he has on order for my exchange surgery. They are Mentor Mod Plus Profile Xtra (SMPX) in sizes from 405 to 525 and Mentor High Profile Xtra (SHPX) in sizes 415 to 490. I don’t love all the sub-450cc options he’s ordered and will be very disappointed if I end up with anything that small. Even 450cc seems like a disappointingsize for me given where I was. I’m hoping that HP Xtra 490cc, which you also recommended above, will work since those seem to be close to my original dimensions without being too flat (and will hopefully get me in the full C/small D range). I’m concerned about the Mod Plus Profile Xtra lacking projection. My original implants were from 2000 back when there was only one profile and it was very low (my 400ccs were 14.5 x 3.2, I believe), so I’d prefer a bump in projection and a bit less width. He doesn’t generally use Ultra High Profile, but if you think there are any options in Mentor’s Ultra High Profile line that could work for me, I’m happy to make the request of him.
The pockets for my original implants were under the muscle and my PS only does pre-pectoral for reconstruction. I did have some distortion from pec flexing with my original implants, which I’m certain would have been more evident after MX, so I am completely on board with going over the muscle despite the extra “work”. As to why he didn’t do immediate reconstruction with TE placed at the time of MX, it didn't have anything to do with me specifically. That is his general procedure as he feels he gets better results with fewer complications by waiting at least a week after MX to place implants or expanders. I was only able to find info from one other PS (out of NY if I recall correctly, but I can’t find the link) who does this, so I guess it’s not super common.
Thank you so much for taking the time to help!Kaycee
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Kren: I responded privately to you about this, since I read it in my private messages before coming here. If you have any further questions, let me know!
Debora
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DaughterofBarb:
Tell the PS you absolutely will not be in agreement with Moderate Plus Profile. It is Mentor Xtra HP….No other styles to consider. I hardly hear of any plastic surgeons using the MP style any longer. It is HP or Extra Full projection. Projection is hard to achieve with breast reconstruction, and so what will a MP style do for you?
Deborah
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Whippetmom, I hope I'm posting in the right thread and would love your advice! I had my exchange surgery in July, 215 cc mentor memory gel smooth round moderate classic profile. I'm 5'3" and 123 lbs. 32C. The implant size is fine. Fat grafting was done along with the exchange surgery, things look quite good and I feel very fortunate. The only thing that bothers me are ripples when I move/bend, which I know is very common in thinner people with prepectoral reconstruction. I saw the surgeon and he said that we can do any or all of these: 1. more fat grafting, 2. put in a more cohesive implant, 3. put in a larger implant. I don't want to be larger, so that's off the table. I'm definitely sold on doing more fat grafting. The question is, do I want to swap the implants at this point? It's so difficult to know the right decision to make! I think I'd do well with more cohesive silicone, but if I can get results that are just as good with fat grafting I'd prefer to do that. He did say that the more cohesive silicone might look less natural than what I have now. Any advice? How many rounds of fat grafting do people usually do for rippling?
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Whippetmom,
I need your help. I had a reconstruction last year with Natrelle Inspira implants SSF-450. I have to have an implant exchange surgery due to capsular contraction and my PS is proposing to change my implants.
I am 5’3” , 128 lb, I am athletic and have wide shoulders for my height. My ribcage is 32”
The implants I have are UTM and they sit high the projection seems ok with loose clothes but with tight clothes or bathing suits look unnaturally high and forward. The other issue I have is I have a gap of 2 fingers/ around 2” between the breasts. No cleavage what’sso ever.
The PS is proposing to use moderate profile which will close the gap but I am afraid that I will end up having a pancake look. He suggested we go with SSM - 375.
please help me assess his proposal. Isn’t that too little projection? What are my options in order to close the gap and also still have some projection0 -
Hi Wippletmom - I'm considering a prophylactic SMX on my good breast. I plan to discuss with my breast surgeon when I see her later this year. I had broached the subject earlier and we decided to wait. When I get it done, I'm thinking of getting smaller implants. Do you know if anyone has had that done? What was their experience I'm petite and a 36G/H and would like to drop a couple of cup sizes.
I'm 5'1" 117 pounds. 31" rib. My implant is a Mentor Memory Shape650cc
Thanks.0 -
NSBrown - glad you found this site. Whippetmom doesn't post every day anymore, but she will weigh in. It will help if you read the header and provide answers to some of her questions - particularly 1 & 2 below, but also some of the other issues.
1. Your height, weight, ribcage circumferece (measuring under the bra line or under the tissue expanders with a measuring tape).
2. If you DO have tissue expanders already, we need to know the exact style of TE (more details requested)
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Thanks MinusTwo - I updated my post with updated info.
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perl5672:
I would go with fat graft transfer. It is far less invasive. Your PS is right about cohesive implants. Because of your small size, you probably would find them too rigid. Just so you know, the rippling does resolve something on its own over time.
Deborah
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Emily12: You need to send me photos via private message.
Deborah
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NsBrown54:
I am not sure why your PS used such large implants. Were you quite large breasted prior to the MX? I gather he did so to try to match the native breast? Yes, you can switch out of those Memory Shape implants for certain. But I need to know which style you have. Look for a registration card you might have received at the time of surgery. Or call your PS’ office and ask for that information. Get back to me with that info and we can determine where to go with sizing.
https://www.jnjmedicaldevices.com/en-US/product/mentor-memoryshape-teardrop-implants
Deborah
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Deborah, thank you! I've been second-guessing my decision about only doing the fat grafting, and your recommendation helps me to just relax and go with my gut, which was fat grafting. You're an angel to help so many women here. Thank you!!
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Hi whippletmom - They're Mentor Memory Shape Medium Height, Moderate Plus Profile. 650cc. I'm currently wearing a 38E bra. My PS was trying to match my remaining breast size. I've met with my breast surgeon and have scheduled a prophylactic mastectomy for next month. Have an appointment with my PS on Monday.
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whippetmom,
Thank you. I sent you photos in a private message. Just a bit more details: I have to stay UTM due to close chest margins. I have seen women get better cleavage with OTM implants but that is not in the cards for me. Also I had 133S - FV -12T-400 Expanders. The PS said he can release the pockets whatever that means to put a wider implant. As I said in my original post I am scared it will look flat if he puts moderate profile and goes down to 375 c
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Hi whippetmom,
Thanks so much for all your help, I’ve learned so much reading through this thread!
I just had a single mastectomy a few weeks ago and had a TE placed. I’m meeting with my surgeon tomorrow to discuss plans, but was hoping to get some advice from you.
Height: 6’
Weight: 155-160
Ribcage: 32” (note: I had bone cancer as child and they removed my 9/10/11th ribs so a little smaller than would normally be for my frame)
My expander is the Allergen Naturelle 133S MV (moderate height), 400 cc (I believe they started with 150 and I’ve had two fills so am around 280cc now)
My bra size was 34c/36b which I have since realized was probably not accurate, I’m probably more of a 34b.
Since I only had the cancer-side breast removed, the plan is to augment my remaining breast with an implant during the expander exchange. I do have to do radiation which I know is worst enemy of plastic surgeons bc of how it destroys the ski.
Any recommendations on implants would be much appreciated. In an ideal world, I would like to increase my size as much as possible while still being able to not wear a bra. I also have a fairly long chest wall and while expander is placed where my breast was, because its larger it almost looks like its in the middle of my torso - could that be fixed with a taller implant? Also would the fact that I am augmenting one impact the type of implant to use?Thanks in advance!
Lauren
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whippetmom,
Thank you. I sent you photos in a private message. Just a bit more details: I have to stay UTM due to close chest margins. I have seen women get better cleavage with OTM implants but that is not in the cards for me. Also I had 133S - FV -12T-400 Expanders. The PS said he can release the pockets whatever that means to put a wider implant. As I said in my original post I am scared it will look flat if he puts moderate profile and goes down to 375 c
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emily12: I responded to your private message. I am not sure why your plastic surgeon would be thinking about going down to the 300 range. I don't know what implant he is referring to, because that would only mean a narrower implant, rather than a wider implant. This is the range you need to stay in in a SSM - M meaning moderate - to get the extra width.
Deborah
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1. Height 6ft, weight 195lbs. Rib cage 39 inches
2. Tissue expanders are Natrelle 133S-FX-14T. Although these are 14 inches, my PS did say I would probably be ok going a tad wider
Prior breast size- 38C
Let me know if I missed any info needed! Thanks!!
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Thank you in advance.
34B or 36A pre surgery. Rib cage measures 33.5 inches. I weigh 118 pounds, am 5'3" tall. (Breasts were 280 ml and 310 ml when removed.)
Weight fluctuates up 5 lbs, this is my lowest weight in a while. I went to PS appt not knowing if I wanted reconstruction and because of my lack of preparation, we ended up focusing on just "being what I was" prior to mastectomy. He recommends (and I think only uses Mentor) SMHX310.
He said this will be prepectoral, without the need for AlloDerm. I had my mastectomy 4 months ago and the PS is going to do the 310 without expanders. I believe if I want to go any larger than that I'll have to do expanders.
Now my train of thought is, if I'm doing this I want to be AT LEAST what I was, no question, yes maybe even a little bigger, but the right look for my frame. I have another appointment with my PS and I'd like to have my thoughts in more order this time. I don't know if going the TE route to be a little bigger is worth it, but on the other hand, I don't want to be disappointed just because I didn't take an additional step in the process.
Looking for and appreciating all advice. Thank you much.
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I’m having a bilateral mastectomy in two days on Dec 7. I met with the plastic surgeon on Friday. He explained about the TEs and the process to eventual implants. I asked if the TEs were different sizes and he said that will all be based on my body measurements. We didn’t really discuss my desires for the look of my future implants as he said all he needed to know in this meeting was that I did want the reconstruction and he would place the TEs. After finding this forum, my question is this- does he need to know anything else from me before he chooses the TEs? I have seen pictures of some reconstructions I like more than others- mostly just the ones that sit a little lower. Is this the type of implant or did the tissue expander have anything to do with this outcome? I’m not sure what the different “heights” in TEs mean. Is this purely based on body measurements?
I am a moderate C cup and I did mention to him I’d like to be the same at least, but preferably a little bigger. I’m 5’4”, 140 lbs with a 31” circumference at top of rib cage. Ive read a few posts here with questions on whether the fill capacity of the TEs that were placed in them were too small, so I’d rather address this now with my PS before my surgery... if there’s anything I need to address. I don’t even know what the correct fill capacity would be.
I didn’t know there’s so much I don’t know until I found this forum! Any advice would be helpful. Thank you!0 -
I had an appointment with my plastic surgeon today and while I am happy with the size we decided on, I am constantly second guessing myself on the type. I chose Allergan Inspira Cohesives over the soft touch, due to the less risk of rippling, but now I am a little worried that they will feel TOO firm, even though honestly I couldn't tell much of a difference feeling them in my hand in the office. Anyone with either of these? Happy or unhappy? Thank you in advance!
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I have Inspira SCX. They are firm, but having had ripples with my previous implants…I just don’t care! The ripples REALLY bothered me.
Good luck
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Hi VegGal,
When you say firm, how firm do they feel? All I have to go on are these tissue expanders, which are super tight. Do they just sit like rocks on your chest? Are they soft at all?
Thank you,
Lstagg
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No, they are not like rocks at all. They are also not like TE’s. When I first got them, I compared them to an 18 year old’s breasts.
Fat grafting, which I have had, does increase surface softness. The firm underneath, of course, is unchanged.
Will you be prepectoral reconstruction or subpectoral?
Hope this helps
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VegGal,
It does help, thank you! I will have prepectoral placement. I hate the thought of ripples but I also hate the thought of everything always feeling so unnatural forever, but if it wont be like the TEs that is a relief. They will be doing fat grafting at the same time.
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Istagg - whatever you decide, it could never be even close to the horribly hard turtle shells that are those darn TEs.
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Hi, I currently have tissue expanders, OTM filled to 340cc. I am due for my last fill on Friday which will take me to 400cc. My question is, will the implants have the same size and projection as the TE's? I have read if you are UTM there is a decrease in projection but what about OTM. I am pretty happy with my current fill size as my ribcage is pretty narrow. Also, does anyone have any experience with the Mentor Xtra line of implants? I am considering these for my exchange. Thank you
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