BREAST IMPLANT SIZING 101
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Hood: Absolutely 550 ccs, Style 20 would be a perfect size for you! You should have had this style to begin with! You will probably be closer to a D cup....and I think you will be very happy with this size. I do not like to make a projection regarding cup size, but I have followed your expansion, your exchange and I have seen your photos with your current implant sizing.
I am so thrilled you are going to do this and that you have your PS finally heading in the right direction with your reconstruction goals!
Deborah
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Thank you so much Deborah! Your opinion means so much to me!!!
I am so HAPPY HAPPY, JOY JOY!!!!!
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Hello Deborah-Thanks so much for this thread. I just found it. Maybe you can gie me a little advice. Up till now I have been trusting my PS to take care of everything. I have TEs in currently under what is left of previous flap reconstruction. He is trying to get me symmetrical. He plans to overfill me ansd also I will require my left fold to be lowered. My question for you is if I am 5'6 1/2 and weigh 138 to 140 and under my TEs measures 29.5. What do you think would give me a nice c or small d cup? I also really need some cleavage. I will see my surgeon next week and I will find out what TEs are in now. Thanks for what you do. This is so complicated!
Ruthy
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Ruthy: You are going to need to email me photos, so that I can see what your flap reconstruction adds to your mound with the TEs in place. Depending on what your flaps lend to the mix, it could be from 475 ccs to 550 ccs in a high profile smooth round silicone implant. Also, I need you to provide the mfr, style and volume of the TEs, as I need to know the width. I know what width of implant would be right for your frame, but I want to make sure that the TEs correspond with that width accordingly. PM me and I will send you my email address.
Deborah
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I have question for you ladies, I am have a bi-lateral nipple sparing (tenitively) and am now a small B cup. I told the PS I wanted to go to a full B, or small C. I am 5'7" 130 and very athletic. I donot want to be too big but wanted fill out a little more because I lost some volume over the years. The question is the PS scheduler told me the PS order 400cc tissue expanders. I don't know what that means and now i'm worried they will be too big. Do the expanders have a lot to do with your final size. He didn't measure me chest, he just took photos of me,examined and and we talked about my size. Any suggestions and what should I ask him if call to confirm things?
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sweetie: The 400 cc volume tissue expander is not too large at all. It is probably the right size. What is your ribcage circumference? Measure around under the bra line.
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Hi Sweetie -- I'm a lurker but wanted to add that just because your capacity is 400 cc's doesn't mean you'll be filled to capacity.
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Hello Deborah,
I cannot figure out how to send you a PM. I went under private messages, then clicked on compose but there was no place to enter who I was trying to PM. I appreciate your reply. Actually my flaps are very small-a lot of the tissue was removed when I had my expanders placed. The left one has some extra tissue near my left underarm which will be lipoed at time of exchange. My right expander is filled to 495. My left is much less. He is planning on getting them evened up and said he would overfill them also. I will have to send you some pics when I figure out the PM process. Although I am 5'6 1/2, I am short waisted. Prior to my dx I wore a 34 c or small d. I now am more comfortable with a 36 band size. Thank you for your help. I don't know how you figured all of this out.
Ruthy
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Ruthy -- click on her name in this thread... it will take you to her profile page and then on the right hand side of THAT page you'll see an option to "send a private message"...
Cheers,
Lilah
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Thanks Lilah!
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whippetmom-my rib cage is around a 31-32. I wear a 36-B bra now,but don't fill it out completely, I have more fullness on the bottom and more muscle on the top. Is the Dr supposed to measure your rib cage? He said something about doing that during surgery. Just wondering because I tend to obsess about this things ahead of time and my friend and I were talking about not going to be big because she used to be my size until she gained weight and she is now a full C and doesn't like that. I'm so used to be in the B range I'm not sure I'd want to be much bigger.
Liliah-what's a good way to determine what size you want to me? is it just figure it out as you go?
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Hi Sweetie! I know Deborah is the expert here, if it's ok thought I'd try to help. I'm pretty close to your size, same height, ribcage, just weigh about 5 pounds more, (and I used to be athletic:) TE's were expanded to 500 ( I think they were a smaller number size), my final implants are 460 allergan high profile 45's, and I am a very full 36c. You can tell as you're expanded sort of how big you're going to be, if your PS overexpands TE's your final implants are smaller. So at one point I thought this is how large I want to be, let's fill some more.
Finally some gorgeous weather headed our way, hope you can get out and soak up some sun!
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I also want to add that with reconstruction a 36C looks more like a natural 36B. You don't have the tisuue or something that make it appear smaller. Deborah can give you the more technical terms. I just wanted to caution you not to go too small & regret it later because fully clothed it won't look as big as you used to be. My suggestion would be to aim a cup size larger, if you want to appear the same as you were before breast cancer. 0
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I posted this question in another thread but afer reading all this, I think this is much better.
My PS is recommending to get the 410 silicone filled implants that are still in clinincal study by FDA. He is one of the doctors participating in the study and says that the natural shape of the implant will look great on me.
Does anyone had these implants? if they are so good why the FDA has not approved them for everybody to use.
I was thinking to do silicon implants any way, but this seems to be a new option.
Hugs and all best wishes to everyone.
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There has to be a trial period for new implants. The 410 implants (called gummy bears) are a little harder than the regular congealed silicone implants and some people think they are too hard. But some people love them. As to feel the implants to see the difference between and 410 and a style 20 for example. JUDY
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Sweetie: I think that implants with a volume of around 500 ccs in a high profile smooth silicone round is where you are going to want to be - somewhere around Katey's volume. Certainly the high profile style in Allergan [Style 20] or Mentor would be a safe recommendation for you - based on your comment regarding having an athletic build. The 400 cc TE your PS plans to use would be the smallest I would want to go. Your PS might want to overfill or overexpand that TE by 20% to get you into a 500 cc implant. In most cases, going from a 400 cc TE to a 500 cc implant is possible without additional expansion. It depends on how nicely your skin stretches during expansion. What Hood says about the deception of bra size, volume and how to achieve it after mastectomy is true. It is a connundrum, but you have to look at it as entirely different than the natural breast or breast augmentation. The lack of connective tissue and fat in that breast leaves only the implant to form the mound. It takes more than you think to get where you want to be...
Sandy: In additon to what JUDY said...I just responded to your post on the Exchange City thread. ...
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sweetie: Would you further describe what you mean by your natural breasts having "more fullness on the bottom and muscle on the top." All of this will be changed with a bilateral MX, but I just want to know about any chest wall issues you might have.....
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Katey and Hood1980- good advice, so you think with 400cc I should be around a full B-small C? that sounds about right since that is what I told him in the office. I think I'll double check with him and call the office to ask again.
Whippetmom-now I think I better call to get futher details on what is doing! DO you think a 400 is too small for a full B cup? I know he says he doesn't like to overextend too much because he thinks they fit better and don't move around as much, plus we are going with silicone and possibly tear drop gummie bears What I mean by fuller on the bottom is breasts are small and not sagging alot, but the fullest portion is the bottom, the top is more muscle. So I'm more like a tear drop shape as apposed to round and full all the way. My body would be more like a vollyball player on top (not quite like a female bodybuilder but you know how they get more muscular in the chest and lose the breast fat) (i'm not that musclar!) Do you think a tear drop shape wouldn't be as good for me becaue I want more fullness back towards the top. I was debating that against the round but I guess it's hard to tell until I see and I know your right everything is going to be sooo different. Maybe you can help me,what should I ask my PS when I call him back?
Katey- I agree! i'm off for my walk now, was getting sick of that rain!
Sandy3170-my doctor is able to offer the "gummie bears" I talked to a woman who has them and she loves them,very natural and they have a tear drop shape. The quality is different because if they break they don't leak like the old silicone implants, you can research it online and it explains what they are. I'm not sure what I will go with until I get there. Let us know what you decide on. BTW if you PM I can send you the name of the woman who had them, she is also on this website.
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Sweetie: If you go with the gummy bears, the tissue expander selection process is key, as the pocket needs to be created specifically for the anatomical shape of the Allergan 410. So I would talk to your PS and discuss...letting him know you would like to end up in the 475 to 500 cc range with implants....and he can map out the TE choice accordingly.0
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Whippetom,
great advice. Is the 475-500cc range a full B small C? Is the allergan 410 tear drop or round or does it matter? I'm not sure if I want tear drop or round yet. I am thinking teardrop but I may like the round once I see how the expanders look.
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Sweetie: Implant volume does not have any relation to cup size. 475 ccs on one woman might be an "A" cup, on another a "C" cup, on another a "E" cup!
It all depends on your body habitus, what happens during expansion, how your skin and chest wall respond to expansion, if you have a thin, bony chest wall or some extra padding and adipose tissue. But if all things are perfect - yes - around a B/leaning towards C cup.
I am just telling you that this size will get you where you want to be, within the parameters dictated by which TE the PS uses - the volume of that TE and your plastic surgeon's willingness to work with you on the numbers. If your PS has the 400 cc in mind, we are limited in many ways by virtue of the size of that TE. However, the TE is chosen based on your inframammary fold width, your ribcage and the amount of skin flaps the PS will have to work with after the mastectomy. He will likely use the largest TE he can SAFELY use for you, and based on information you provided, a 400 cc or 500 cc would be the only two sizes I think would work for you. There are different styles which can be chosen, but essentially, your PS is probably looking at a TE with a width of around + or - 13.0 cm. But he knows better than I do which TE will fit in the pocket which will be created at the time of MX and he might take in two sizers and see which one will work best. Sometimes NONE of this is fully known by the PS until they have you under the knife in the OR....
Here is the Allergan website where you can scroll down and look at photos of the actual Allergan 410 tissue expanders...
http://www.allergan.com/assets/pdf/natrelle_catalog.pdf
Deborah
ADDENDUM: Also, just want to note that if you do opt for nipple/areola sparing, your PS will take this into consideration with TE selection and future implant selection - because he needs to obtain the best symmetry possible on the breast mound he creates. So it depends on where your nipple/areola complex ends up on your skin flap....talk this over with your PS. You may need to go with a smaller implant in that case, in order to have the nipple show up in a fairly logical position on the breast mound.
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whippetmom-thank you!! great advice and questions for me to ask my doctor. I am so glad I found your thread before my surgery. I am going to call him before surgery to go over all of this. I am also not 100% sure about the nipple sparing because there are variables once they do the surgery, they have to make sure there is no cancer in that area. I think I need to ask him what happens to sizing in that case. This is hard to imagine because essentially the PS is recreating a breast and it's so hard to imagine what I will look like while at the same time adjusting to the loss of how I look now. I asked my husband if he remembered about the visit (the Dr went over so much!) he says he did say something about creating a pocket for the cohesive silicone, but now I'm not sure if he had a special style in mind, because I mentioned teardrop. Do you think a tear drop will look to droopy or more natural? I want a natural look, but as I mentioned I'm flatter at top now and would like to be rounder but not too round to the point it looks unnatural.
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Hi Ladies
I am just starting to investigate implants so forgive me if I ask a question already answered here.
First, does any one have A or small B implants? Can you tell me how many cc's that would be?
Thanks
Merilee
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I am kind of bummed out. I saw my PS yesterday and was tentatively set for exchange surgery on May 6th. Well, I had all my fills done locally and have not seen my PS for quite some time. When I saw him yesterday he said we can't do the exchange in May, instead we are going to do a bilateral breast mound revision with fat injections to try and plump up my radiated side. It is quite a bit smaller and is very tight. I had my heart set on getting rid of these dumb TEs. Has anyone had this surgery and how bad does it hurt? How long did you miss work? Now I have to wait three more months after this surgery before I can get my implants. That will just about put me to the two year mark since this whole ordeal started. It is so very frustrating. I know I want it to be right especialy with such a high failure rate for implants after radiation but I am just so bummed about this. Let me know your experience with this type of surgery. THANKS!
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Sweetie -- yeah it's Whippetmom who has all the answers
(I just posted a teeny little aside there)... I see she is already taking good care of you!Lilah
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Merilee: Read my original post at the top of this page. Also, read my comments to SWEETIE re: "cup size." Implants to not equate to cup size. I need the following...
Height, weight, ribcage measurement [measuring the circumference of your ribcage under your tissue expander(s) or under your bra line]. Also, if you have TEs [tissue expanders] - we need to know about them. The style - Mentor or Allergan most likely - and whether they are short height, moderate height, full height if Mentor and style number if Allergan. We also need the recommended fill volume of the TEs - the number of cc's.
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shortgirl: I think this is fabulous! I absolutely endorse the use of fat graft transfer to the radiated breast. I think this is a brilliant move by your PS, in an attempt to improve the texture, viability and appearance of your radiated tissue. I trust he knows how to do it and has done it previously. Do not be in a rush with reconstruction. You want the best outcome possible and the fat graft transfer to the radiated breast could also minimize your risk of capsular contracture in the future. You have to see this as a very positive addition to your reconstruction journey. You also will get your tummy liposuctioned in the process.
Deborah
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Well I am 5'3'', 125 lbs, rib measurement 34 inches. I will most likely go with moderate,but have no idea of maker or style as I have not seen any yet. Do not have tissue expanders yet. Just trying to gather the right info to take to the PS on Wednesday. And I would welcome a list of good questions to ask.
Thank you
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Merilee: The two most commonly used breast implant styles are the moderate plus [not "moderate" only, as the moderate style is far too wide and too flat for breast reconstruction. ] and high profile style smooth round silicone implants. Both Mentor and Allergan have their own version of these two implant styles. It all depends on your chest wall characteristics, the amount of skin flaps your PS calculates you will have after MX and the base width of your current breasts. Your PS will need to determine what style and volume of tissue expander he will be able to safely use after MX. So the future implant is in major part, predicated upon the aforementioned findings. Things to ask your PS:
1. What size tissue expander - manufacturer, style and volume, do you think you will be able to use for me?
At this point, tell him what you hope to achieve. If you want to maintain your current size, let him know. If you would like to be larger or smaller than your current breast size, let him know.
2. Ask him if he typically overfills the TE or just fills to capacity. Ask if he typically places his patients in implants which are smaller than the TEs or if he most often uses implants larger than the TEs.
Essentially, ask him to describe also what size implants he feels would work best for your frame. Plastic surgeons typically and should select the tissue expander with the future implant in mind. BEFORE your MX is the time to tell him what you hope to achieve, because this might enable him to adjust his plan and select a tissue expander which might help you better meet your goals for reconstruction.
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Thank you. I should have told you that my MX was a year and a half ago.
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