BREAST IMPLANT SIZING 101
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Hello, Kren. I’m no expert on sizing and expander size vs. implant size, so I can’t speak to that. Although how large your breasts will be compared to your expanders depends on the size of actual implants being used. My expanders were 350 volume, filled to 360, and my implants (Mentor Xtra) are 465, making me probably a 32C (I’m only 4 weeks out from exchange surgery and still healing). I have some posts on this thread starting on Page 512 where you will find my stats and other info. Regarding the Mentor Xtras, they do have a nice feel to them, but still feel nothing like my pre-op breasts (which were implanted with Mentor’s original silicone implants). My old boobs,, even with implants, felt natural because of the breast tissue. While my reconstructed boobs have a soft feel and nice give to them, they feel artificial. Hopefully fat transfer will help with that. Good luck to you
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Kren - Whippetmom IS the expert & will be along in time. But for her to be able to answer your questions, you need to read the header and post all your body specifications requested.
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Hi Whippetmom,
After spending a lot of time researching and still unsure of sizing I am thrilled to find this sight. I am grateful for your insight and time!
My expanders are 133s-mc-11-T, 250cc, medium height.
My rib cage under bra is 31 1/2Height 561/2
Weight 131
My expander have now been filled with 280cc. I am looking to feel in proportion. My bra size before was 34 A I am wanting to to go bigger and staying balanced. I am athletic and I also like feeling feminine. I have another appointment for another expansion next week. My thought is going just slightly bigger. But I am so unsure of how the results will be . Any insight is valued!
Thank you!
Skylark4
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Deborah - hope you are OK.
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I have a question about the amount of fill in a tissue expander compared to the size of the implant.
I had 300 cc fill total (my choice) but my implant is 770 cc, according to the Device identification Card that I was given after the implant surgery. The implant size seems too big to me, given the amount of fill. I asked my plastic surgeon about that during the post-op appointment, and he said he thought I had more than 300 cc fill. This is not the case, according to my memory and my own notes. He also said something about wrinkling, which I did not quite understand. In any case, I will talk to him about all this again, but first I want to understand better how this all works.
My implant is Allergan Natrelle Inspira SCF-770. At this point, I don't know what the tissue expander was, although I can/will ask my surgeon.
In the first post in this thread, I see that Allergan Natrelle Inspria implants have a higher fill ratio. What does that mean? Could it explain why I had 300 cc of fills total, but my implant is 770 cc? Is there any other explanation for the difference in the amount of fill and the size of the implant?
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P.S. I first asked about this in another sub-forum, The Itty Bitty Titty Committee, but although I appreciate the feedback I got there, I am following up here because this sub-forum seems a more logical place for my questions. I hope that is okay.0 -
Naya - I hope Whippetmom is OK. She hasn't posted since October..
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Hi, Minus Two. I didn't realize that. I hope she is okay too!
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Dhenslee1
So you will need to be in the 800 cc range with implants. Either Mentor Xtra Smooth high profile or extra full/ Extra high profile Inspira,0 -
skylark45
You will want to be in the 400 cc 425 cc range with a high profile smooth round silicone - Inspira implants.
A question…are you happy with the volume and appearance of your TEs now, or do you feel they are too small? I do agree with your PS that you can go wider - 12.0 cm to 13.0 cm in width would be better.
Deborah
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Well, so I have been incognito. I am so sorry for missing so many posts. If those of you who posted back in November and December still need help, I can do so.
I have been recovering from a few difficult personal issues. They took me into a deep valley. Part of it was getting a new standard poodle puppy in November, and then receiving a diagnosis that our 14.5 year old whippet has dementia. So it is like having a 95 year old man with Alzheimer's and a toddler with ADHD. And the toddler is trying to knock the elderly man off his feet whenever he gets the chance. The puppy came after suddenly losing our dog of 3 years to a horrible illness. So I had expectations for the puppy that were unrealistic. I felt overwhelmed and I was still grieving the loss of Joe, and I just really fell apart. The valley is not so deep now, because I have been clawing my way back to the top. I'm getting back in the saddle again.
This just pales in comparison to what many of you are going through in your breast cancer journeys. But it is astounding to me that God cares about every single hair on our heads. Some people might be thinking.."huh?…a dog"?" She has been absent because of a DOG?" But it goes to show that He meets us where we are….with the trivial and the sublime. He cares about every single last bit of it.
❤️❤️
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Nayabean:
I would need to know the size and style of your tissue expanders. You might have had a 500 cc or 600 cc TE, for all we know, which was only filled to 300 ccs because you wanted to stop there. I know exactly what your PS meant by “wrinkling". It is likely that your skin envelope was large and so he needed a large implant to “fill it up". Otherwise, it is like putting a rock in a sock, and we know that would not be a pretty sight.Find out about the manufacturer,style and volume of your TEs.
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Whippetmom - of course we understand and feel your pain. Anything we love is not "just a....." Glad you're on the upward slope. Your knowledge and dedication is so valuable.
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Whippetmom - I'm very sorry to hear about what you've been going through. I can't imagine. My dogs are precious to me and have a profound effect on my life, everyday, all the time. That I do understand.
I don't know if you want us to repost - I wrote this back in November. I would still love to hear your recommendation, if you're willing. Thank you so much and God Bless.
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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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af2021
i would advise going the tissue expander route. It has been four months since your mastectomy. There has been skin retraction. That skin envelope might not be as “fresh" as it would have been with an immediate reconstruction. It has tightened up. So I fear you might wake up and the doctor would say, “oops…we could not get a 310 to fit and so you have 250 ccs". I think I would bite the bullet and ask for TEs. You don't want to have a one step surgery with general anesthesia and then, greatly disappointed, find you want to go back for tissue expanders . Minimize the number of surgeries. I can tell you that you will be happier with 400 ccs - 450 ccs. I like the Mentor Xtra Smooth high profile style implants. Ask your PS to use TEs which will get you from Point A to Point B.
Thank you for your kind words. They really mean a lot!
Deborah
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Whippetmom those of us who have been blessed with such a connection know that it isn't ever "Just a dog". I am sorry for your loss of Joe, and for the emotional difficulties around dementia in your older whippet. Sending you much needed hugs and understanding.
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Hi, whippetmom. I am so sorry about Joe. I know the loss of a dear pet can be devastating. They are pure love, your best friend, a member of the family. It hurts so much. I hope in time that you feel peace. And I hope the new puppy settles down and minds his manners around your older dog.
Thank you so much for replying to my post, where I asked about the amount of fill in my tissue expander (300cc) compared to the size of my implant (770cc).
You asked for the manufacturer, style and volume of my TE. I checked op notes from my mastectomy/TE insertion in MyChart, and found this (I am copying and pasting here): EXPANDER NATRELLE TE SMOOTH 133S-MX-15-T WITH FOURTE, ALLERGAN USA INC . (There is also a Serial # S24277029 and a LOG # 470929.) (If that is not enough information, let me know and I will contact my PS and ask him directly.)
I am not quite sure how to read the description in the op note, so I turned to Google. Looking at a couple links (here and here) from natrellesurgeon.com (an official Natrelle site?), it looks as if TE 133S-MX-15T has a volume of 700, and that it is for moderate height with extra projection, and is best paired with round implants. (I wish my surgeon and I had talked about this beforehand, because I would have said I don't want extra projection or round implants. I have a non-cancerous breast which was reduced during the reconstruction surgery, and I hoped the implant would be close to the same shape and size.)So . . . although your excellent rock-in-a-sock analogy makes me understand what the PS said about wrinkling (which I did not really understand when he said it), I am still confused. The first time we ever met, before the mastectomy, I told my PS that the size I was hoping for was a large B or small C, and asked how we would know when we were there. He told me that "what you see is what you get," meaning that after each fill I can decide if that is the size I want, and he would stop then. After the third and last fill (total at that point was 300 cc) he said that I was a "solid C." That was what I wanted, it looked good to me, and so we stopped there. I definitely did not want to look any larger than that after the implant, and that was super clear in our discussions.
But if the implant* is much larger (770 in my case) and is filled up (I am assuming it is filled up), doesn't that mean my implant is more than twice as large as I wanted, given that I had only 300cc of fill? Should my PS maybe have put in a smaller TE in the first place, to avoid having a too large skin envelope?
Thank you again for helping me understand this!_________________
*Implant: Allergan Natrelle Inspira SCF-770Edit to add this P.S. The difference in size between the implant and my other non-cancerous breast that was reduced (the implant being larger and higher) is not freaky. But my husband and daughter notice it. A stranger on the street probably would not. But I do, and it bothers me still. (The reconstruction surgery was 4.5 weeks ago.)
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Nayabean
Okay…so it is always good to know if you have had a bilateral or unilateral mastectomy. Everything I said before can be disregarded. The size of the implant vs the tissue expander does not matter. Symmetry is the key…volume is not. You cannot be a “c” cup with an implant, if the native, reduced-in-size breast is a D cup. So I understand why the TE was larger - to approximate the width and height of your native breast. It does not matter that is is an extra full projection style TE…It is all about dimensions of that TE as it compares to the native breast width and height. If you still have some ptosis (droop) in that reduced native breast, the implant will need to be smaller than the pocket/skin envelope, as small as necessary to gain as much symmetry and natural droop as possible. What that volume might be is unknown by me. The PS may take various sizes into the OR and use the size and volume that creates as much symmetry as possible. You are not a candidate for an anatomically shaped implant, because it would rotate in the pocket very quickly. An anatomical implant requires that the implant be larger than the skin envelope, and it is only in very few cases where an anatomical implant would be appropriate for a unilateral reconstruction. One such case for a unilateral based recwould be in a woman with small breasts, no droop, who wants a very small anatomical implant, or to also have an augmentation of her native breast to gain symmetry.
I hope this clarifies some things for you. Please let me know if you have further questions!
Deborah
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Hi, Deborah.
"You cannot be a 'c' cup with an implant, if the native, reduced-in-size breast is a D cup." I am very sorry I did not make this clear, but the reduced-in-size breast is, I believe, a C cup, maybe a bit smaller. And the implant is definitely larger -- maybe a D cup? (Before the surgeries -- mastectomy and reconstruction -- my breasts were probably G cups, so it's hard for me to know what a C cup and a D cup look like.) But bottom line, the two sides do not look at all symmetrical to me; the implant side looks bigger than the native side.
I just measured both sides. They are similar in width (horizontal, across the widest part, which is the nipple area). The implant (left) side is 11.5 inches, and the native, reduced-size (right) breast is 11.0 inches. But the top to bottom measurements are different. The implant (left) side is 9.75 inches, while the the native, reduced-size (right) breast is only 7.5 inches. The difference, as far as I can tell, is that there is a very noticeable mound at the top of the implant (left) side. So again, as you said, symmetry is key, and my basic problem is that the two sides do not look symmetrical to me
Thank your for the explanation about anatomically shaped implants. I did not understand that at all, before!
And thank you so much for your patient answers to my questions!
Meredith
P.S. I would say there is ptosis in the reduced native breast, but it is not clear to me how I would measure that. In any case, there was a LOT of ptosis in the breasts before. I am 71 years old, and my breasts were quite large and extremely droopy before the mastectomy and reconstruction. Having said that, I would say that the two breasts, at this point, are similar as far as droop goes, and I have no complaint about how that aspect looks. It's that mound on the top of my implant side that looks weird to me, and makes that side look larger that the native, reduced side.
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navabean:
I am confused. Do you already have an implant on the MX side? You call it the “implant side". Do you actually mean the “tissue expander side"?
If it is a tissue expander, the mound at the top - the tissue expander - is a rigid and firm device that does not drop and settle into the pocket the way a silicone implant will. So you really cannot go by the wonky appearance of the TE. The implant will not look like that. Have you discussed all of your concerns with your PS? He should address this discrepancy (if it is a discrepancy that I cannot see) but one you are seeing. Ask all of these questions prior to the exchange - if, it is a TE we are discussing currently, and not an implant!
I also should not have even mentioned “cup sizes". It is too confusing. See my comment in the thread header about the unpredictability of “cup sizing".
You can always private message me with photos.
Deborah0 -
Rah2464….
Thank you for your kind words! They are so appreciated.Debora
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MT: Thank you for standing watch over posts in my absence. I really am touched with your caring concern for me!
Deborah0 -
Hi, Deborah.
Thanks for your patience with my questions. I feel as if I am not explaining any of this well and just generally not being clear. I apologize for that.
Yes, I already have an implant, which was put in a little over a month ago. In my initial post, on January 19, I said that my implant is Allergan Natrelle Inspira SCF-770. I gave you the information about the TE today because you asked about it, and of course it makes sense to have that information.
My bottom-line question is, if I had 300cc of fill in my TE -- an amount that I wanted, with no more -- does it make sense to have a (filled up?) implant that is 770cc, and which makes the implant side look bigger than the native reduced side? (That is not just my perception; my husband and daughter also see the difference.)Thanks again,
Meredith
P.S. I did speak with my PS about these concerns in my first post-op appointment after the reconstruction surgery, but we were not on the same page. The main thing he said was that he thought I had more than 300cc fill, which is absolutely not the case. (He had urged me a number of times to get one more 100cc fill, but I did not want that and it did not happen. Maybe he forgot that we did not do that?) In any case, I will bring it up again at our next appointment, which is in six weeks.
I also absolutely agree that talking about cup size is confusing, but that is pretty much how my PS always talked about size. As to why we did not talk about this before the implant was put in -- well, that is a very good question and I have a lot I could say about it. But I think that is a separate topic, to an extent, that would derail my questions here. Suffice it to say, the PS never once -- not once -- brought up the subject of the implant, other than to mention when I asked once that it was silicone, not saline. I should have asked a lot more questions about both the TE and the implant especially, and while I can talk about why I didn't, I guess in some sense there is no good excuse. I regret deeply not bringing it up when the surgeon did not.
For what it's worth, in many ways this PE is wonderful. He is mentioned on these forums (including this sub-forum) by name several times, and always gets very high praise. I don't really know why this one area -- talking about the TE size and the implant size and how to get the two breast sides to be symmetrical -- fell through the cracks from his end. Again, I do take responsibility for not bringing it up myself. But I am also so puzzled as to why it was not a routine thing for him to take the intiavtive and the time to bring it up himself and go into it in some detail.0 -
@Whippetmom, I just wanted to express my condolences on your loss and the difficult time you’ve been going through. We lost our sweet Maggie to canine dementia in November, days before my exchange surgery. Such a tragic illness. We also lost Norton, our other senior dog, days before my MX surgery in July, and a senior cat early last February. It was all very overwhelming. Our pups and kitties are family to us, not “just dogs” or “just cats”, regardless of what we are going through. Sending you virtual hugs.
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Deborah, Thank you so much for your help. God bless our puppies.
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A picture is worth a thousand words…or something like that. So you could send me a photo and I could then comment further and help you figure out what to do to correct this. I will look again at the SCF implant width, but if it is 15.0 cm in width like the TE, even if the 700 cc tissue expander was only filled to 300 ccs, the width remains the same. The projection and height changes with fills, but the width generally is what it is.
I want to try to help you figure out where to go next with this. If you are open to a revision, I can help you communicate to your PS what you would like to achieve. If it requires pocket narrowing, it is a tenuous revision, in that you have to be very guarded about not disrupting the sutures and once again opening up the envelope/pocket. It is essentially a lateral capsulorrhaphy, to keep the implants from moving laterally towards the armpits. But the only next step I can help you with is the visual, which you can private message to me.
Deborah
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Me again Deborah. I'm going to be seeing my PS on the 17th of next month to discuss, again, what our plan is. By that time it will have been 8 months since my mastectomy, so I'm guessing you'd think skin retraction is even more of a possibility. I'm going to check in with you after my appointment and see what you think of whatever I come away with after that appointment. I'm definitely going to the consult with TE as the next step. I'll let you know which TE they use and the implants we pick to double check that you think it sounds like a good fit.. Thank you so very much. See you next month!
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Hi Deborah -
I am so sorry for the loss of your beloved dog. Hugs.
I had posted a note to you about a year ago (copied below), and as I am preparing for surgery in about a month, I was hoping I could ask just a couple brief questions as a follow-up to the advice you had given me. I've copied my original post below for reference as well. In advance I am very thankful to you for your advice!I saw my PS yesterday, and he informed me that the measurement for each implant across is around 11cm. I had asked him for 350-375 ccs per your guidance, and he said that to achieve that, I'd be at high profile or ultra high profile given how much room he has to work with on my chest. Wondering if you have a perspective on one versus then other (he uses mentor). I'd like a nice, full but still natural look. Based on then chart online, to me it looks like my best option is the Mentor Smooth Round High Profile Xtra 355 cc which is 11cm across, based on my chest width and desired implant size, but maybe I'm missing something.
Second question: I noticed that mentor has several options - Memory Gel Boost and Memory Gel Xtra, in addition to the traditional Memory Gel. Do you happen to know whether either can be used for reconstruction and if they give a superior result? I also could not find a sizing guide online for the Memory Gel Boost - maybe it's too new? Should I be asking about these?
Next question: I have alloderm currently for the 275cc implants that were placed a few months after my mastectomy nearly 3 years ago. It wasn't stitched in place and the implants have really gravitated towards my sides. Hence the revision. My PS mentioned that there is a newer synthetic material that is now used to create the pocket that will hold better (like a demi bra inside my chest) and that will be stitched to my ribs - keeping my breasts up and closer to the center of my chest. Is this common and the best plan?
Final question: He does fat grafting (liposuction) to help pad the area, last time he liposuctioned my abdomen area. I have asked him to graft from my thighs this time (liposuction) as this is where I carry my weight. Is fat grafting really essential, or can many people get away without it? I'm a bit torn as to whether or not to have it. I am extremely bony on my chest area so I can see why it would be fairly essential for me, but the recovery last time from the liposuction was a little more intense than I'd expected. I'm willing to go through it for a better long-term result - this is the hopefully final surgery to get the breasts "right" so I can get my nipple tattoos this summer!
Thank you so much!
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Original Post:
Hello Deborah!
In advance, thank you for any guidance you can share!
Height 5'7"
Weight 125 lbs
Ribcage 29"
Age 44
I have already had my exchange surgery following my double mastectomy and I have pre-pectoral silicone implants, 275cc. I know my PS uses Allergan and Mentor, and mine are round, medium profile, I believe (I am sorry I don't have all the stats).
I plan to have surgery to modify the right implant, which has slipped over towards my right side. Since I feel there's a need for surgery anyway, I am planning to go slightly larger for both implants, getting my breasts exactly how I want them before I add nipples, which I do not yet have. I plan to again have pre-pectoral implants placed over the muscle.
I feel like I'm completely guessing on what size I need - would "a bit fuller" be 300 CCs? Something else? The ones I have are modest, easy, and extremely close to my normal breast size before the mastectomy, which was a B cup. I like to be active so don't want anything too large. I am wondering what you would recommend for something slightly fuller based on my frame - I am happy with a B+ to C- cup, in the "somewhere between the size of an orange and the size of a grapefruit" family. When I had the TEs, I did have him fill them to around a D cup, and I recall that I didn't love them when they reached that size, which is why we went with something closer to my natural breasts - which they are, but I'm looking for just a bit more fullness. My PS was very conservative with me on size based on my frame, and cautioned going too large.I prefer perky, which mine are currently, and I am also pear-shaped with a 26" waist and 37" hips, so I have wondered if a bit fuller breasts would be more proportional.
I hope I've provided enough info for you to guide me. Thank you so much! One of my 2021 goals is to finally finish the reconstruction I started in 2019.
Thank you,Kate
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I'd love some feedback from anyone who has swapped out implants due to how hard they are. I'm not sure if what I'm feeling is normal, but this forum has always been the best resource so it's definitely the best place to start.
I had a BMX and reconstructive surgery in 2017. My implants are Allergan Naturelle Inspira cohesive 210cc (I'm just over 5 ft and about 103 pounds so the size has been fine). They look ok, but are just so firm! Always a hugger, I now find myself leaning in with my shoulders because I'm so self-conscious someone will feel them (happened with a friend's young teen daughter 🥲). I also haven't slept on my stomach ever since, and getting a massage or seeing a chiropractor (laying on my stomach) is so uncomfortable.
A friend had surgery recently and her doctor used the Mentor memory gel implants. The difference between us is remarkable. Hers feel so much more like natural breasts. Softer, and just with more movement.
I've read about contracture and I'm not sure that's what I have as it's not totally uncomfortable day to day. Is it just these implants? Has anyone had the same experience? I thought the mentor are cohesive as well, but can cohesive be that much softer?
Thanks in advance for the help!
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Noodles I have definitely experienced this. After my first surgery, I had a lot of scar tissue, cording, you name it. My foobs felt like cement blocks on my chest. Very firm and very little movement due to the scar tissue. It was painful and uncomfortable. I finally followed my PS's advice about 2 1/2 yrs in and had a revision surgery. She removed all the scar tissue (tested it of course all benign) and put in a softer type of implant. I could sense the relief as soon as I awoke. I am a year plus out from that surgery now and it is still so much better than before. A little of the scar tissue has come back but nothing like it was. These softer implants do show the rippling more however just a warning if you are pre pec.
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Katepeony:
Answers to your questions:
1. Mentor Smooth Round High Profile Xtra 355 ccs sounds good to me.I certainly would not go any smaller. And it would be a negligible difference between 355 ccs and 375 ccs. I think high profile vs extra high profile would be better, since implants are over the muscle. Without that pectoral overage, sometimes there is a bit more of a step off (a shelf like appearance in the upper pole) if the implant has too much projection.
2. I don't know anything about the “Memory Gel Boost", but I would wager it was created to rival the Allergan Inspira's most “cohesive" version of the three styles. I would NOT go too “cohesive", because this portends a more rigid implant, and I think you need something with more “give" .
3. Yes, go with the new synthetic material. It does create a support for the implant. The PS will be performing a lateral capsulorrhaphy to address the lateral migration of the implant towards your armpits. The synthetic matrix should help in this regard also.
4. Have the fat graft transfer! Yes…especially if you have a bony chest. Also, there is sufficient documentation out now to support that fat graft transfer can ameliorate if not eradicate problems with pain and tautness after mastectomy. I had two fat graft transfer procedures and I am thankful that I did. If fat graft transfer is offered…do it
Deborah
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