BREAST IMPLANT SIZING 101
Comments
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tory: It all sounds good to me.....the implant sizes. I think you tell your PS to use the volume which looks best and fits best in the pockets. Looking forward to the day when we can see the final results!!
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Thanks for all your help, Deborah!
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whippetmom,
Just saw my ps and was 'armed' with info from you! Thank you. We decided he will bring 325's and 350's into the OR and see which one looks/works best. He knows I truly don't want to be any bigger (smaller if possible) than I am now. He had wanted to do a small fill but when I almost started to cry (ugh) he changed his mind. I was serious about the size thing! He's really a very sweet man. His scheduler will call me with a date and we'll go from there. I cannot wait!!!!! I did ask about fat grafting and he felt it wouldn't really help me at this point. He may 'tighten' up the skin when he gets in there. I'm feeling like I just need to trust him at this point. I just wish I could have my old breasts back. I really don't want any of this. sigh
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Whippetmom; Dr.B plans to use the spectrum only as an expander and remove it after all the fills are done, and put the same implant in as I have on the other side.He would also at that time cut the muscle and bring most of it back to it's original position in the back, leaving just the tip of it on the breast, since I just need a small amount, so at that point, the size difference would be minimal.I am excited about his knowledge and expertise and I do have a surgery date of January 10th/2011,since that is the soonest he has open since it would have to be done in a hospital, and not at his surgical center.If my HMO does not approve him, I already have a plan in place to change to a PPO insurance after November 15th where I could go to him.Thanks for all your help and lightning fast responses.
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LADIES.... I have posted the rest of my pictures on the picture forum...... I keep this part of my life PRIVATE.. and do NOT talk about it here.... but you can look at pictures there.... it is PRIVATE
Rads girls..... my thread is a good thread for you to look through.....I am in the WELL BURNT area......
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I see you talking about different kinds of implants and profiles. You recommended 400-425ccs for me, which I'll stick in a baggie and look at later to see if it looks right. But if I'm 42 what "profile" should I be looking for. This is what I had written 2 pages ago:
"5'7", 118 lbs. I used to be a B before I nursed my 3 kids. Then went down to an AA. ribcage 30". I'd like to be a B again. The problem for me is due to a nerve problem in my back, I can't wear a bra, so they have to look natural without a bra, and not hurt my back. My PBM is scheduled for Nov 2 with immediate reconstruction, expanders, then probably silicone. My husband thinks I should go a little bigger than what I was originally because "someday your butt will get big and you'll want it to be balanced" but I'd be satisfied with what I had. Any advice?"
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kjbrown: I am so sorry...I thought I responded to your post...but I was in Vegas on my Blackberry and so I suppose it did not go through....
Okay, so how about if I map out your entire tissue expander to implants scenario for you? I hope your PS is receptive...I think it will be worth taking to your PS or emailing to him next week - so that there is plenty of time to discuss this prior to your surgery on 11/2.
Tissue expanders:
Short height or low height in either Mentor or Allergan:
Here are the options:
Allergan: 133 SV - 250 ccs - 12.0 cm width
Allergan: 133 SX - 350 ccs - 12.0 cm width
Mentor Contour Low-Height = 250 ccs...11.7 cm width
I believe that the 250 cc TE would probably be best...either Mentor or Allergan. I just threw the 350 in there as an option....
Exchange to:
Allergan or Mentor:
High profile [Style 20 in Allergan - just high profile in Mentor] smooth round silicone implants with a volume of 375 ccs to 425 ccs.
There are a number of great articles supporting the value of using the low/short height TEs - which I can provide for you if necessary. I have discussed this many times over the past two years.
Are you on the pictures forum? I want you to go take a look at Val61's photos. She had the Mentor 250 cc low height TEs and her implants are 425 cc - high profile Mentor smooth silicone rounds. She has nearly identical statistics to yours. Go take a look...
Let me know if you have any other questions.
Deborah
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Thank you so much. I see the plastic surgeon on 10/22. I'll bring all the info. with me. I'm still waiting for access to the picture forum. As soon as I get it, I'll look at Val61's photos. This is SO helpful!
Kathy
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I still have not gained access to the pic forum and I am looking for some encouragment when it comes to the matter of delayed recon. I won't have my recon until after chemo and the photos I have seen haven't been the best work. I tried to email the picture guy but it wont let me put in a name in the recipient box. Any suggestions or anyone have successful, beautiful delayed construction photos that they would share with me. I am not interested in the flap procedures just the TE and then the implant. Thanks so much:)
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KCmomx3: Thank GOODNESS we do not have a picture GUY! Holy moly!!!! I'll try sending you the link to PM Timtam, who is a female and a member here on BCO. Did you ever contact Estepp on Exchange City? She lives in your same town and state. Check your private messages...
Deborah
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I guess I misunderstood:) Thanks so much.
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Whippetmom
Question - 400 cc te's. You have seen my pics. Right side slightly smaller than the left. I made an appt for one more fill on 10/18. I don't want to go much bigger, but do want to try and even myself out. How much realistically do 400 cc's te's hold? I am at 405 cc's now.
Per previous notes, I think I will be aiming for the style 15 457 implants at exchange in Dec.
Thanks!
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STL: Oh, I have observed that they can handle significant overfilling. I recall seeing some literature - Mentor or Allergan, with mfr recommendation or admonition regarding overfilling, but it would certainly be more than the range you are in currently. And the mfr warnings are probably for liability/warranty purposes. More importantly, the rule is to not expand more than the skin will safely permit, and so that infers to me that 10 ccs or 50 ccs or 100 ccs might be too much overfill in some cases...so it is up to the PS to ensure that the patient can handle the overfill. In your case, it does not sound like a concern. So even them up!
Deborah
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Will do - thanks!!!
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Whippetmom-
My PS uses textured implants instead of smooth. What's your take on this? Is it a big difference? He is going to use Allergan in 600cc or 650cc high profile. I'm not sure which style. I have my tissue expander pictures on the pic forum titled TE 60cc-exchange scheduled 10/12/10 if you wish to look.
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It was recommended on this board I get about 450cc implants for my size to make me a large C. The PS ended up putting in 636cc's and it looks like I'm a large A cup, VERY small. I am very unhappy with the outcome. I started out a DD and wanted to go smaller but not THIS small. I'm happy the cancer is gone so I can't complain but am looking forward to revision surgery. I did not have TE's.
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buyo - I posted on the picture forum and referred you to whippetmom. You're TE's are gorgeous. Never seen any that look as good as yours.
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buyo: I cannot ever recommend textured round implants for breast reconstruction. They promote traction rippling and they do not feel natural to women who have had them. The few women who have had textured rounds have had them replaced with smooth silicone rounds.
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Robyn: I recall that your PS was recommending he use the same size implants you had previously - 350 ccs, and I said they would be too small and that you needed 450 ccs or 475 ccs at the minimum. I am really perplexed about your sizing issues with 636 ccs. What type of implants did you get, with a volume of 636 ccs? There are no silicone implants with that volume...
Do you want to send me photos so that I can see what is going on?
Deborah
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Robyn: I feel for you girl! I was DD also and now with TE's about a B cup. Because of radiation I may not be able to get filled to 700cc's (am at 550 cc's now) before my exchange surgery. I can't imagine being an A! I can understand you wanting to have another surgery to fix.
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i was a D cup with TE and am definatly a D if not a DD now and my implants were smaller. I am still a little swollen. Is the difference more to do with body size etc? I am a tiny little woman..?? seems like eveyone feels they are smaller. I think mine are the same even though exchange was to smaller CC implant
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I'm almost finished with expander fill-ups, one more and total will be 450cc's. I am 5'5" and 142 lbs. I measure 31" around ribs. The expanders are Mentor moderate height. My ps is trying to convince me to go larger. I would rather be smaller than larger...and will be furious if I wake up and my breasts are too large!
I suppose my best hope is to find a picture of the ideal size (regardless of what size my ps thinks I should be). How do I get access to the photo forum?
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Cookie: You will need to post a bit more - newbies need to establish a presence on these forums and threads - before gaining entrance to the private pictures forum. You can go to the "members" link above, click and in the members box, type in the name Timtam. You can send her a private message requesting entrance and she will put your name on the list.
In response to your question about sizing...are you happy with the size you are currently with your TEs? Are they too big, too small or just right?
Deborah
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whippetmom,
My PS also says he uses the textured silicone implants for reconstruction. I am wondering why some PS do that. Have you heard of this much? Your suggestion is not to have the textured correct?
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Whippetmom: I had my mx 3 1/2 weeks ago. left side only - nipple sparing. It was after lumpectomy and re-excision so they had to follow that scar. My TE is Allergan 133 MV with a fill volume of 300cc. 150 cc was put in during the surgery. Now I am seeing your posts on short height rather then moderate and am concerned that I don't have the best size TE for me. I am 5 ft. 1, 110 pounds and my ribcage is 28.5. My first fill is on the 21st and he said he is planning on 100 CC. Then he thinks another 100cc will be all I need to equal the natural side. We discussed the possiblity of an enhancement of that side and he said that I can decide as we expand and see if the skin will be able to go larger. (natural side is a small
And my Dr. is in the "gummybear" study, so I am planning on those. I have 2 sets of photos so far, before the Mx and 2 weeks after. I was waiting till I had the first fill photos to post them on the picture forum. What are your thoughts about the TE size and in genearl about my size needs. thanks very much.0 -
HappyGirl: I actually have only heard of three cases where the textured round silicone implants were used in the past two years. One of the women was unhappy, but I don't recall if she did anything....but the other two I know for certain found new plastic surgeons and switched out their textureds for smooth rounds.
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heebie_jeebie:
Don't worry about your TE....it is fine. I had the 133MV style also. It is just that I think that the low height/short height TEs are preferable.
If you are going with anatomical gummies, the pocket must be created specifically for that implant. Your TE dimensions: 12.0 cm wide by 11.0 cm tall by 5.2 cm projection. The anatomical closest to those dimensions: 410MF - 295 gms..12.0 cm wide by 11.1 cm tall by 4.8 cm projection. It all depends on how much your PS overfills, if he does, and how much larger you want to be if you augment the native breast. You will be able to visualize all of this a little better once you get to maximum fill [300 ccs] with your TE...
Deborah
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FYI re: gummies and TEs.... it's my understanding that the PS has to overexpand for the gummy. Since it is not quite as squishy as regular silicone, and since it is anatomical in shape and therefore it MATTERS how it is placed (as opposed to a round which has no top or bottom), the surgeon needs more space to work with inside the pocket to properly place it -- so for example in my case my PS said she needed to expand me 100 - 150 cc's bigger than the final implant.
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Hi Whippet Mom - Bless you for doing this. I have a BMX w/TE scheduled for 10/18. Preop w/PS tomorrow. I'm 5ft 115lbs 29.5in ribcage. I currently have 325 cc HP allergan implants. My PS said I was at about 550cc total now (complete guess) when we met before. I'd like to at least a cup size larger than now. I was thinking HP TE but after reading this forum, am questioning that. Recommendations would be greatly appreciated!
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Dear Deborah,
My PS does like to overfill. I would like to have a final implant size of 550 cc. I believe the PS will want to overfill until at least 650 cc , if not more.
From what I understand, if it is overfilled it is easier for the PS to close up.
The rads side is holding up very well. I think I am loooky to have very "flexible " skin. Never had stretch marks during the pregancy etc.
I will post pictures so you can see.
Right now Timtam has given me access to the picture forum, but when I clicked on the link, I still cannot open it.
I think I will email Timtam again.
Thank you for your help.
Donna
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