BREAST IMPLANT SIZING 101
Comments
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SMH:
I would not have pegged you with your build and especially your ribcage, for implants as wide as you have currently. I would have said 425 ccs in a high profile smooth round silicone implant. I would not have recommended textured round implants for you but I would not recommend textured round implants for anyone, quite frankly. But that said, it hinges also on what style and width of TEs your PS used for expansion. Perhaps it was a 13.0 cm wide TE..which is why he did not use a HP implant. But in that case, I would have preferred Allergan Style 15, 397 ccs - which is 13.1 cm in width. Do you recall the style and volume of your TEs? Your current implants are 14.0 cm in width.
Hate to throw a monkey wrench in here...I just think the style of implant has as much, if not more, to do with your feeling of the implants being too large, than does the overall volume. Do you want to email me photos? PM me if so. You say that your implants look good and I think you are trying to decide whether you want to go through another surgery. I can understand your angst about this....it is a weighty decision. I think you need to get fitted properly for a bra and see if you are happier with the size. You are not a 34 band - and so get thee to Nordstroms in Phoenix for a fitting. I have to say that I have far more women wishing they had larger implants, than smaller implants. Going from an A to a D is a bit of an adjustment. I wish you would post photos on the pictures forum and you would have a bevy of women weighing in to give you their thoughts regarding size as well.
Let me know if you have any further questions.
Deborah
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DebinKansas:
Let's try to determine why you feel your TEs are so wide, because they are 13.0 cm which would not be too wide for your frame. Is it that they are too far apart - widely spaced? Have they migrated laterally? You are desirous of more projection, and your TEs have a maximum projection of 7.4 cm, which cannot be replicated by any implant on the market. You should see a more projection when you are fully expanded. Is your skin pretty loose in the TEs? Or is the skin very tight? If you want ptosis after the exchange, you might need to overfill the TEs to around 600 ccs, perhaps even 650 ccs. So now on to implant selection. If you have a long torso, and since you like projection, you could be a candidate for the ultra full projection Allergan Style 45 smooth round silicone implant in 600 ccs or 650 ccs. If you go with a high profile smooth round silicone implant, I would vote for 600 ccs in that style, 550 ccs at the minimum - Mentor or Allergan, does not matter. The ultra full projection only is available by Allergan - Style 45. But I do want to know about your complaints about width. It would be helpful if I could see photos also, which you could either email to me or post on the pictures forum. What Estepp said above regarding sizing - that it takes more volume than we realize to "make a mound" - is absolutely correct. But we can refine the implant selection after I see pictures or get a better idea re: what is going on with the width of your TEs.
Deborah
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Laura: What would I do without you to keep me humble?????
I was so happy you found my sunglasses....
oh....and my shoes....0 -
Deborah... I will be having a NSM BMX w/ TE's on 11/30/10. I plan on taking pictures before, during the time of "fills" and after. I plan on coming back to this thread to ask your advice!
Does seeing pics before the BMX help you determine what would be good for my frame? Should I make sure I take side shots too? I'm probably a wannabe "B" right now and am not sure if I want to go "bigger" or not. I'm thinking I probably do considering pretty much ALL of my bras are "padded" in some way or another. Should I take pics of me with my padded bras that I like on too? The waiting is so hard. I am so curious as to how this will all look afterwards! ... I've seen pics.. but even looking at the NSM BMX pics... everyone's TE pics look so different depending on what size they were prior to surgery. Just wondering what would be helpful to make sure I do BEFORE surgery. Thank you so much for your time in helping all these women! 0 -
Whippetmom - thanks for your reply. I did not have any TEs. I had my nipple-sparring DMX and my implants put in all on the same operation. My implants are also placed in a pocket/hammick or bra made out of Alloderm; not just an Alloderm sling, which is why my PS says she always uses textured implants with this procedure. In other words, the Alloderm goes from the top of the implants to the bottom of the implants (armpit level to fold level). Because my pictorial muscles were not cut or used, the width of these muscles are not an issue. I am also under the impression that this a fairly new procedure,..I have not talked with anyone else yet who has had this done. My PS has only been doing this for 2 years now. You are right about your statement about me being worried about another surgery and I'm wondering if the size change will make me happier. I do realize that my current implants are 14.1 in diameter. If I replace with 354cc, style 115, they would be 13.0 cm in diameter. From your experience, would 1 cm in diameter make that much of a difference, not to mention the reduction in cc?
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SMH it sort of sounds like the Alloderm one-step process (which does not use TEs either).
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I had no idea that the muscles aren't used when you have Alloderm. It's only available as a trial here but that method sounds like it has a lot of advantages.
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Susan: Sure...we can map out now what might work for you. It gives you something to discuss with your PS at the time of your preop - so that he uses the best style and volume of TE to get you where you want to be. You can email me photos...but I also need your height, weight, ribcage circumference. PM me for my email address. Since you are having a NAC sparing, we do have some limitations with size, because we want your NAC to end up in the right place on the mound.
Deborah
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SMC: Yes, 100 ccs will make a significant difference as will even a 1 centimeter reduction in width.
I apologize for not thoroughly reading your initial post. I am also very perplexed about the above-the-muscle placement of the implants. Did your oncologist have an opinion about this placement? I would be concerned about the ability to detect a recurrence which might appear close to the upper chest wall, if the implants are over the muscle.
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Mantra: There are very few instances in implant-based breast reconstruction with the use of Alloderm - even in one-step procedures, where the implants are not placed under the pectoral musculature. SMC is describing a new procedure...
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SMH: You could talk to your PS about using Style 120 instead - still a textured round - but high profile, which would give you more projection but would be narrower on your chest wall. This would require some lateral revisions to narrow the pockets, but 400 ccs in this style would be nice on your frame.
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Hi,
Struggling here...looking for the page on this discussion board that has instructions on how to attach photos to a private email. Help?
Deb
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SMH - Hopefully I don't sound like a pervert, but you should consider posting pictures on the picture forum. The procedure you had sounds very interesting and I'm sure there would be others that would like to see too. How do you feel your implants look compared to those done with a more traditional method?
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Thank you whippetmom! That is what I will plan on then.
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SMH: I agree with Tory in that the picture site would give you perspective on how your recon looks compared to what others have gone through, which is the whole point of the picture forum: support from others who have been there. It isn't for everyone, but it so relieved my fears and concerns and gave me high expectations as to what is possible in plastic surgery. It is incredible what they can do and also what can be fixed! Best to you, whatever you decide. I started out by giving my private pictures only to whippetmom as it took me awhile to build up the courage to share.
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Whippetmom - I'm so relieved to hear that the 1 cm reduction in width will make a difference. I'll have to revisit the hi profiles again with my PS. When I talked to her before about them she believed that the midrange would give me a more natural look. I was and am so new at this that I was more concerned about the NSM and her procedure than what size implants were going in. My PS is a female with implants herself, which gives me a lot of trust. I just need to figure out the size thing! You know, I never thought about asking my oncologist about her opinion. I see her in a couple of weeks, I'll ask her then. I know she too was very intrigued by my procedure, not to mention my gynecologist!
tory - I don't know if I could do the photo thing. I don't think its perverted, I just don't think I have the comfort level to do it. Sorry. I think they look just as good as others I have seen through photos. My skin feels a lot thicker where ever the Alloderm is. My PS does both over and under but the reason I was interested in trying this new procedure was: she and my GS/OS said the recovery time was much easier (I was washing my hair by myself 4 days after surgery); My PS thinks it looks more natural over the muscle; she showed me pictures of other patients she had performed this procedure on; and lastly, she said I could always have it redone with the implants under the muscle. So far I am very happy with everything other than the size. (I'm thrilled about keeping my own nipples also.) Hopefully I will feel the same 5 to 10 years from now since my PS only has a 2 year history with this procedure.
Tory, by the way, I was very moved by your Lynn Redgrave quote. Looks like you and I have the same diagnosis. Are you on tamoxifen also?
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SMH - I totally understand about the pictures. I haven't posted any either, partly because I don't feel I have anything that isn't already there and partly because I'm not totally comfortable with it. My plan is to post some pictures after I have my exchange, which won't be until January. I don't like the way the TEs feel underneath the muscle, nor the way it makes me feel weird to do certain things (using a 3-hole punch at work, who'd have thought?), and my suspicion is that what you have probably looks and feels better, especially with arm movement.
I didn't notice your diagnosis, but you're right! Yes, I am on tamoxifen, since May. Have you been to the "bottle o' tamoxifen" thread?
I love that Lynn Redgrave quote. It just says what I feel so perfectly. If you have not seen the photos that her daughter took, they are moving too. http://www.nytimes.com/slideshow/2004/04/15/magazine/20040418_REDGRAVE_1.html
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Tory - No, I didn't know about the "bottle o' tamoxifen" thread. I'll have to check it out. Thanks for the link about Lynn Redgrave. It's very moving. Thanks!
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Thanks for sharing the photos, tory.
I look at her and say, "What a brave woman."
Wait a minute! We all went through that. What brave women we are!
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LOL Claire -- so true!
Thanks Tory -- loved those pictures. Looks like she chose not to reconstruct, which always fascinates me. What's brave is not just that she went through it but that she had her daughter document it.
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We ARE brave women. I agree, her particular courage was in letting her daughter document it. As a celebrity I can't imagine how hard that must be. I got the feeling that she was especially comfortable in her own skin though, and somehow that was really reassuring. She died about a month after I had my first mastectomy - without reconstruction - and I was really moved by that set of pictures and the little things she wrote with the pictures. Knowing other people go through the same things isn't quite the same as seeing it and the timing could not have been better for me. Despite the fact that she had just died, I found great strength from her.0
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Whitppetmom,
Thank you so much for your reply. Your description of the breasts being flat and wide was right on. You certainly make me feel a little better. I am trying not to look at them too much.
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Christina....Let's see how they are looking in a week to ten days. Let me know, okay? You can email me photos if you need some affirmation regarding size...PM me if you need my email address...
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SMH - just read your post - so your implants are on top of the muscle? I had nipple/skin sparing surgery, but no one ever mentioned putting the implants on top of the muscle. Very interesting, you really must post pictures!! Do you see any ripples since there is just thin skin there?
Whippetmom - I just got back from PS, and really he is so pleased with himself and thinks they are the "perfect" size. And again I have to say thanks to you for your help with that. I told him about this site and he thinks it is very interesting - I think I am the only one that asks so many questions when I see him. He wants to wait a few more weeks for the "after" pictures - so I don't know if I should wait and take my then to post on the forum - will they change much in a month?
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Valerie: Post them now and then post them a month from now. This way you can journal the changes in photos.
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I'm not sure what's happening with my implants but have posted updated photos on my thread called TE to gummies (Fore). If anyone has time to look at the photos, I'd really appreciate it your opinion. I've now put the old photos and the new photos at the end of the thread for better comparison.
It does not feel the implants themselves are moving. They seem to be exactly where they wrere on day one. But I didn't think that gummies have that drastic of a drop and fluff. And because of this, are these implants now too wide for my frame?
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I looked Mantra. Is it possible you were standing up straighter in the first set of photos?
I am surprised if it's really a shift because gummies DON'T drop and fluff as far as I know (well mine hasn't).
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Over the next several months, the doctor will periodically inject saline solution to gradually fill the expander. This gentle stretching of the skin creates the space in which a permanent saline implant will be placed during a subsequent operation. Some patients find the gentle stretching involves a small degree of temporary discomfort.....
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Fred seems to be using the board to advertise Viagara for Men. He just joined today. Time to report a post.
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Lilah, I was trying to stand straight and pushed my shoulders back just to see if the picture could look like the first one. Clearly . . . it didn't happen
The implants do not seem as if they have moved and appear to be in the same place since day one. I just didn't think that gummies drop and fluff. Now I'm wondering if they look too wide for my frame.
I will print out and take the photos with me to my appointment. It's still three weeks away but even if I sent them to her today, nothings going to happen that quickly. I'm just so shocked at how big a difference there is in such a short time frame. I'm thinking either perhaps the second pictures look more natural . . . or perhaps they look too wide for my frame. I honestly can't tell.
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