BREAST IMPLANT SIZING 101
Comments
-
bnita: I don't know why he needs to extend the incision....unless your incision is unusually short. But let's see photos. I'll PM you my email address.... or post them on the pic forum. Also, why don't you ask this question on Exchange City - about your PS going through the IMF for the exchange....
Deborah
0 -
Whippetmom, I finally have some information to see if I am on the right track....before my BMX I was a 36DD and a tad smaller is fine but I feel a bigger upper half balances out my wider bottom half. I am 5'7", 160# and my ribcage below my breasts is 32". My PS put in Natrelle 133MV-15 expanders and he added 300cc at the onset. I go back to see him tomorrow and he may give me my first post-mx fill. What are your thoughts on his choice of expanders for me?
Kelly
0 -
Kelly: I would recommend 750 ccs in a high profile, smooth round silicone implant. You would need 750 ccs in Style 20 [using Allergan since you have Allergan TEs] in order to match the width of your TEs. Your PS used TEs with this width because this was the base width of your native breasts. One important question is referable to how much skin you have overlying the TEs. If you have pretty sufficient skin flaps [due to your DD cup size pre-BMX] you might not need to expand fully and in most cases, I see patients overexpanded more than necessary, thereby imposing too much droop or "ptosis" at the time of exchange. So you might want to email me photos once you have another 100 to 150 ccs...so that we can determine how much further you need to go.
Deborah
0 -
Thank you Deborah, I will get some pictures to you as soon as I get a few more fills. I do have quite a bit of excess skin waiting to be filled up...it looks strange at this point to say the least but I am grateful that they use as much of what you had originally to reconstruct the new ones. I see my PS this afternoon and frankly I am excited about this process.
Thanks again for your help Deborah!
Kelly
0 -
Thanks so much for the well wishes. I'm a week out, and got the tape off, drains out today. Still stiff & sore from all the pocket work, but only taking anti-inflammatories. They look beautiful. They don't project as much as the TEs did, and I asked the PS why he didn't go larger, as we had discussed sizes of 375-425. He said that the 400 didn't look right, and they wouldn't be able to achieve the drop of a natural look being too large. I'm swollen on top now, have a little hamburger bun thing going, but not much. Was told to wear a bra, like a soft sports bra, 24/7, not to break a sweat or let heart rate go beyond 90 for the next three weeks, & no exercise for three weeks, then start out slowly, gently. And of course, keep sleeping on my back. I have devised a cheat by propping pillows such that the breast can hang free while I am on my side, but am good about staying mostly on my back. Don't want to messed it up, having come this far!
They look really beautiful, yet after drop and fluff & nipps/areolas will look pretty real. I love his style of making it look natural. Am in awe. Will let you know when pics are up on Tim Tam site. Best wishes and happy holidays to you all! xoxo Melissa
0 -
Mellissa: Congratulations and getting such natural results. Can't wait to see!!! What a great Christmas present for you.
0 -
This is exactly the kind of feedback and information I have been searching for and hope you will be able to give me some advice.
I am four weeks past a BMX where my 9 year old moderate profile saline implants were left in place. (I think the implants helped me find my 7mm tumor because my breast tissue was pushed against the flat surface of the implant.) I had breast augmentation 15 years ago with textured 300cc saline implants. Those implants were placed very high and looked like I was always wearing a push up bra, but I loved them anyway because I finally had some boobies. I had them redone 9 years ago by a wonderful PS who lowered my natural crease and replaced the implants with Mentor 350cc smooth saline (silicone was not available during that time). They were perfect and most people wouldn't suspect they were augmented. They fit nicely into a 34D bra without looking too Pam Anderson busty. I must have large pockets because they move freely...can be pushed up, squished together, have droop and fall to the sides when laying flat.
Now I need to attempt to put Humpty Dumpty back together again. After the BMX they look odd because they are full and round across my chest but have little projection like the often described hamburger bun. I am 5'3", 124 lbs with 28" ribcage but have really wide shoulders. I have been looking into silicone implant specs and need advice. My current implants are described as being 13.3cm diameter with 3.9 cm projection. I like the cleavage and "side boob" look of my current implants. I don't know if I should be looking at high profile or moderate plus profile. To get the same diameter with a high profile silicone implant I would need 500cc which would give me a 5.3 cm projection. Is this too big for me and is it even possible to increase this much in size without TEs? Will my current pockets need to be revised if I decide on a smaller implant?
My other question is how long after surgery do I need to wait before I can swap out implants?
0 -
Kelly: Update me after you meet with your PS, but please ask him about this excess skin, letting him know that you do not want excessive droop and therefore you might not require full expansion in order to get a nice snug fit in those pockets.
0 -
Melissa: I am thrilled that you are so happy with your results. We just cannot wait to see photos!
0 -
Darla: You will need to wait at least two months and preferably three, after your BMX. I think that you have a few options. You could also exchange out for moderate plus profile implants - using Allergan as a model, a Style 15 MPP, 397 ccs - 13.1 cm width by 4.2 cm projection - or 421 ccs, 13.3 cm width by 4.3 cm projection - could probably be placed without further expansion.
As far as a high profile implant goes, yes, it would take a 500 cc high profile implant to match the width you have presently. It is likely though that you would require expansion in order to exchange to this volume of implant. An option would be to have your PS use the Mentor Spectrum expandable saline implant. He could use a higher profile model and this type of implant, which is unique in that it can gradually be expanded over a six month period of time, giving your skin the ability to expand gradually. Once you are happy with the size, the tubing can be disconnected and the implants are then permanent. So you have some options.
But I certainly would not have thought a PS would reinsert nine-year old implants....whatever for? I would switch them out most certainly. Discuss this further with your PS and let me know what transpires.
Deborah
0 -
Thank you so much Deborah for your reply.
My PS was away on vacation during the time I was diagnosed and had surgery. It happened very fast. From discovery of lump to BMX was a matter of a couple of weeks. My BS was very pleased to be able to leave my current implants in place so that I could proceed with surgery without a PS available.
Without a consult with my PS prior to BMX I am left to imagine what is the next step until a consultation in February is scheduled. I am torn between keeping the implants I have loved for all these years and proceeding with reconstruction. I know my old salines need to be replaced but am afraid I will not like the new and improved any better. I like my current diameter but would likely need expanders to exchange to the current diameter and add projection.
Do you think 500cc Mentor high profile is too large for my frame? I wish there were more implant size options available.
0 -
Your questions/answers are helpful. I'm looking for as much info as I can find before my exchanges are done. I had my final fill Nov. 30th. I'm at 900cc...my PS wants to use 800cc silicone implants...but I'm not totally convinced. I think the base of my TEs are much too wide and high. I feel the edges in my armpits and just below my collar bone. I am being expanded in places that boobs should never be...lol Am concerned the exchanges will be the same size base. Am looking for some comfort....and projection! I'm slightly full figured and have read that although 800cc would be large for a petite woman...they might actually look round and nearly flat on me so have been considering saline with some overfill(if needed). Just not sure how comfortable they would feel. Anyone use saline instead of silicone? I would like as much projection as possible with a smaller base than my TEs. My next appt. with my PS is Jan. 4, 2011 and I would like to go armed with knowledge. I need visuals but do not have access to the photo site. Any help/suggestions would be appreciated. After going through the process, I would like to have a successful outcome...thanks!
Dee
0 -
P.S.
I had incision necrosis and had to have them revised...nearly lost them the second time, too...so the scars are large. I am expanded in the center of my incisions, but on the ends am not???? They are wrinkled skin flaps...anyone else have/had those? I asked my PS if he was going to revise them during the exchange and he said no...that he would wait and see when he did the nipples. Maybe that's procedure...I don't know....but what if I don't do nipples? Just a lot of things in this process that seem 'odd'(for lack of a better word) to me...
0 -
Darla: I would almost wager that your pockets are sufficient, without the need for further expansion, for smooth round silicone implants, MPP's, 397 ccs - Allergan or 400 ccs Mentor. It is only 50 ccs we are talking about here. You would have your same width and greater projection. I think they would look much better. We never see moderate projection implants in breast reconstruction patients. They are just ridiculously pancake-like on the chest wall. This would be the easiest fix. I think you might require tissue expansion in order to exchange out to implants with a volume of 500 ccs.
0 -
Dee: Find out the style of your TEs for me. You might have a little plastic card with this info - or the nurse will have this documented in your chart. Also, I need your height, weight, ribcage circumference, measuring below the TE or bra line.
0 -
I just saw the PS again Today and he said we can't fill any more cause the skin is too tigh. He said that the TE breast is a little bigger then the natural side and that he could put 100 cc round in the natural side. Hi is planning for a 450-495 gram gummy in the MX side. He is planning on a full height, X projection.
here are my stats again: I have an Allergan 133MV TE with a 300cc fill volume. Right now it is filled to 400cc. I am 5' 1" and 112 pounds and ribcage is 29. My natural side is a barely B cup size.
Does the 450-495 size sound right for me? Any other advice for this? I just filled out all the paperwork for the Gummybear study while I was there today. There are some loopy questions; especially the ones about how you feel about your breasts.
0 -
Namaste!
Whippetmom: I just sent you a PM this evening.
Karla
0 -
heebiejeebie: I had exactly this done--One on my non mx side to match the mx side, although I am quite tall (6') and thin (150) with a 30" rib cage. How long have you had your expanders in? Best results are when you wait at least 3-3 months or longer after getting expanded. Are you on the picture forum yet? Also, Whippetmom is amazing and will help you with the sizing.
0 -
heebie:
Well, 450 gms to 495 gms sounds large for your frame, not to mention, it is a leap from a fill volume of 300 ccs. The only issue I would take with the full height and extra full projection planned for the MX side, is that it might be taller and project more than your native breast - even with the augmentation of same. But your PS knows better than I what that native breast looks like and remember, symmetry is key. For a unilateral, it is not the size which is the focus, it is symmetry. So go over these issues with your PS. I just feel though that the size of anatomicals you mentioned would be too large for the pockets...especially if your skin is already compromised by tissue expansion.
Deborah
0 -
Whippetmom - - - The TE is a 300 cc capacity, but it is expanded to 400 cc now.
I thought 450-495 grams sounds big, but he said it will be about the same size as I am expanded to since my skin is really tight it can't be any bigger - just a more natural shape (teardrop) to match the natural side. And right now the TE side is only a little bigger then the natural side, it's just that weird bubble shape. He thinks he is going to get a close match in symmetry with these numbers and he does come highly recommended so I trust him. I will question him about the size when I see him next shortly before the surgery.
thanks.
0 -
heebie-jeebie: Sounds good to me then. Again, your PS can see you and examine you and I cannot and he knows what it will take to achieve symmetry. Keep us apprised...
0 -
Help me please on sizing. i have 600 cc expander sin right now. He filled me to 300 at the initial surgery and 150cc at my first fill. I am thinking another 150ccs is not going to be good enough. I am 5 ft10 in and weigh about 200 pounds with most of the weight around my middle. i told the ps that I wanted to be big on top. I figure if I have to do this, I wanted nice ones after, I was a 40 b/c before this. Is 600 going to be enough to fit my frmae???
0 -
Thank you whippetmom. I will get the info from the nurse. I'm nearly 5'8", weigh approx. 180lbs,(am in the proccess of losing weight...have lost 18lbs. so far).. My ribcage circumference is a little over 32''...maybe that will lessen as I lose weight? I know that my TE's were 650cc, but have been overfilled to 900cc. Will get brand/height/width at my next appt. Even at 900ccs I don't feel I'm particularly projected...just large round mounds... So I know if my PS uses the same width/height implants as my TE's, I will be even less projected with the 800cc silicone. Being large framed, I want as much projection as I can get. I will say that the more weight I lose the slightly more projected I look along with the high/wide round mound. Would also like your opinion on silicone vs. saline. I certainly would like some comfort, which I know I would get from silicone, but was wondering if saline was close to the comfort level of silicone? Thanks!
0 -
lovinmama: I agree....this is not going to be enough for you. I feel that you are one of those bodacious women who needs to go to saline implants with the maximum fill volume of 960 ccs, or you are just not going to be satisfied with the size. He will need to overfill you beyond the 600 ccs....but it depends on your skin flaps. Perhaps you have substantial skin flaps since you were a 40C previously, which means you might have sufficient skin for closure over the larger saline implants. You would definitely need the maximum volume if you stay with silicone implants - at least the high profile 800 cc implants - perhaps even what I recommended to nanadee below - the Style 45 800 cc implants. I believe this style would work well for you also.
nanadee: I do not know which style of TEs you have, but I would recommend the Style 45, extra full projection smooth round silicone implants in 800 ccs. This will give you the optimum amount of projection, and if your ribcage is indeed 32 inches in circumference, this would be an ideal style for you.
You gals present this discussion to your plastic surgeons and get back to me...
Deborah
0 -
Thanks Deborah...will definitely discuss with my PS.
Dee
0 -
Hi. a few women have asked me if a woman were to get a 410 implant (in the study) does she have an anatomical tear shaped tissue expander - or just a standard TE?
0 -
I had a standard TE and I have a 410 gummy.
0 -
flowerpetal: I see Lilah answered your question. There is no TE specifically made for the anatomical Allergan 410 or any other anatomical shaped implant. We all get essentially the same type, although there are TEs with different modes of expansion, made by other mfrs like PMT Corp and Silimed/Sientra.
0 -
Thanks for the info! I wanted to make sure that i was thinking straight!!!
0 -
I WANT TO WISH A VERY MERRY CHRISTMAS TO ALL OF MY BREAST FRIENDS!!!!
LOVE,
DEBORAH
0
