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Topic: BREAST IMPLANT SIZING 101

Forum: Breast Reconstruction — Is it right for you? Discuss timing and various procedures and techniques.

Posted on: Jan 7, 2010 10:01PM - edited Oct 31, 2017 03:13PM by whippetmom

whippetmom wrote:


DISCLAIMER! I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon.

PLEASE DISCUSS WITH YOUR PLASTIC SURGEON THE DIFFERENCE BETWEEN SMOOTH AND TEXTURED IMPLANTS (WHICH INCLUDES THE "GUMMY BEAR" ANATOMICAL IMPLANT) AND RISKS PERTAINING THERETO: NEW FDA FINDINGS

http://www.breastcancer.org/research-news/fda-upda...

https://www.medscape.com/viewarticle/887654

This thread is where we discuss implant-based reconstruction and where we endeavor to help you with some idea of the implant style and sizing that might best work for you.

INFORMATION WE NEED:

1. Your height, weight, ribcage circumferece (measuring under the bra line or under the tissue expanders with a measuring tape).

2. If you DO have tissue expanders already, we need to know the exact style of TE (Mentor, Allergan, Sientra, SSP) AND the volume - the mfr's recommended volume, NOT your current fill volume. So if you have Mentor TEs, they would be LOW HEIGHT, MEDIUM HEIGHT or TALL HEIGHT. If you do not have the "height" information, you might have a style "number", i.e., 354-6311 or 354-7114...etc. If they are ALLERGAN TEs, they would be one of six styles, with letters such as "MX" or "MV" or "SX" or "SV" or "FX" or "FV". They might have the number 133-V followed by a number like "13" or "14". TO SAVE TIME (FOR MOI) YOU COULD LOOK UP THE DIMENSIONS OF YOUR TISSUE EXPANDERS....

3. Also, please advise if your PS has told you that he/she uses one brand or style of implant exclusively so that we can save time in our research.

4. Your pre-mastectomy breast size is also important, because it does have some bearing on expansion, tissue expander volume and the need for good tissue coverage over your future implant.

5. GRAMS VS CUBIC CENTIMETERS: Essentially interchangeable. A gram is a measure ofmass/weight and ccs a measure of volume. It is the dimensions of the implant that matters more than the discrepancy between the "size" of an implant designated in "grams" as opposed to one designated in "ccs".

6. OVERFILLING OF TISSUE EXPANDERS: There is no hard and fast rule regarding overfilling of tissue expanders. Some plastic surgeons overfill, merely because they always do for every patient. Some never or rarely overfill (my plastic surgeon was in that camp.) She felt that if the right tissue expander was selected, there was no reason to fill beyond that which the manufacturer recommended. In cases where the patient's skin envelope is very tight, and a larger implant is desired, overfilling would have some benefit. In the case of a unilateral breast reconstruction, where the future implant needs to mirror a native breast which has some ptosis (droop), overfilling can help achieve that needed symmetry.

7. "DROP AND FLUFF": Drop and fluff" is a term created long ago by the breast augmentation crowd....to reflect how the implants can settle and take on a different appearance and more natural appearance. Doctors do not use this term and I do not use it, because this is not breast augmentation. In breast augmentation, since women are going larger and the breast envelope is smaller, the implants often sit up and ride quite high on the chest wall, and appear very taut and/or flattened in appearance. With augmentation, it takes a while for the native skin and tissue to adjust to the implants and so those galls do experience what they call dropping and sort of filling out or not being so compressed and gaining projection.

8. CUP SIZES: There is no predictable way to tell you what cup size you will be with a specific volume of implant. Maybe with breast augmentation it is done, but it is all entirely different with breast reconstruction. Plastic surgeons cannot guarantee or predict cup sizes! Cup sizing is tricky, because you might be now wearing the wrong size bra. So you might tell me you wear a 36B, and you really could instead fit better in a 34C. Also, after reconstruction, there are only sports bras and European bras that we recommend as the best option for reconstruction patients. So you might tell me you want to be a "C" and end up in a European bra, like a "Freya" or "Chantelle" (my favorites.). So you might wear a D cup! But you will LOOK like a C cup or even a B cup. It is confusing, I know but you will see what I mean when you are on the other side of this.

SILICONE IMPLANT LINE UP:

MENTOR: www.mentorwwllc.com/global-us/...

ALLERGAN:

Page 33 breastimplantadvice.com/wp-com

ALLERGAN NATRELLE INSPIRA

Newest generation of silicone "cohesive gel" implants. "With regards to silicone implants, they are prefilled, and it turns out that the traditional Allergan Natrelle implants are only about 86-87% filled with silicone gel, whereas the Mentor MemoryGel implants are 91-92% filled. Hence, the enhanced upper breast fullness that many patients liked better with Mentor implants.

Now, the Natrelle INSPIRA™ implants are available from Allergan, giving patients and cosmetic surgeons an additional option. The INSPIRA silicone gel implant is an "over-filled" or "fully-filled" silicone implant – 96-97%. Hence, a moderate-plus profile INSPIRA implant can give patients who need a moderate-plus profile implant, the high-profile look they desire from Mentor. The advantages of silicone implants include a decrease in the risk of capsular contracture, an enhanced warranty, a more natural feel, and less palpable rippling. And now patients can avoid the risk of their breast feeling too hard from an overfilled saline implant!"

9. NATRELLE "INSPIRA" - NEWEST FDA APPROVED ROUND IMPLANTS FROM ALLERGAN:

A Beverly Hills plastic surgeon succinctly explains the benefits of this new implant.

"The new Natrelle INSPIRA™ implant is a silicone gel, smooth round implant. The smooth round implants are the more classic implant style as compared to modern anatomically shaped implants that mimic the natural distribution of breast volume. However, the new implant differs from other round implant options with its higher fill ratio.

The Benefits of Higher Fill Ratio

Higher fill ratio means that there is slightly more silicone gel filler per unit of volume. In the case of the INSPIRA™ implants, a more highly cohesive gel filler is also used. In my experience, I've noticed a slight difference in feel and lower wrinkle susceptibility in implants with a higher fill ratio. The denser volume of gel filler in the implant can result in a decreased chance of rippling and longer shell longevity.

ANATOMICAL IMPLANT INFORMATION:

IF YOU PREVIOUSLY HAD BREAST AUGMENTATION (prior to MX) Please read further:

This is from Grant Stevens, MD, PRINCIPAL clinical trials investigator for the Allergan 410 and Mentor CPG anatomical implants.

"The shaped form-stable gummy bear implants, such as the 410 and the CPG, are not ideal implants for women who have had previous breast surgery and have already pockets for those previous implants. Those women have pockets which are generally too large to safely accommodate the shaped form-stable implants. However, the Sientra form-stable silicone gel breast implants, which are round, can be safely placed in these patients." Quote is in this article:

http://www.cosmeticsurgery.com/articles/archive/an~283/

And in Dr. Stevens' interview article re: cohesive implants...

http://www.marinaplasticsurgery.com/wp-content/themes/marinaplasticsurgery_com/news/articles/gel-implants.pdf

BEFORE THE MASTECTOMY...READ AND DISCUSS WITH YOUR SURGEON!!!

http://www.forbes.com/sites/elaineschattner/2017/0...

https://www.sciencedaily.com/releases/2016/07/1607...

https://www.practicalpainmanagement.com/patient/co...



DISCLAIMER! Please read my biography under my personal profile. I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jun 22, 2020 11:20AM salamander136 wrote:

Hi Wippetmom,

I'm so glad to have found this group, and your help. On June 4th, I had a right-side, skin-sparing mastectomy, with immediate tissue expander reconstruction until pathology determines what additional treatment I'll need (still waiting to find out if I will be radiated). The plan is to exchange the TE for a Mentor silicone implant on the right side, with a lift and implant for symmetry on the left side.

  • Height: 5'8"
  • Weight: 155lbs
  • Ribcage: 32"
  • Bra size prior to nipple sparing mastectomy: 36 small C
  • Age: 47 (not aiming for super 'perky' at this point)
  • Would consider going up a size (full C or D)
  • Current expander: Mentor CPX 4 - Smooth Surface (not sure which height or volume) - not filled yet

The PS will use Mentor smooth round silicone implants (exact implant type TBD). Of the available Mentor silicone implants, which type and fill volume would you recommend for the right side?

Thank you very much in advance!

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Jun 24, 2020 11:58AM Botgirl wrote:

Hi! Thank you so much for doing this! I really appreciate your help. I've done a some research on implants and am meeting my PS next week. I am hoping to have my exchange surgery in August.

  • Surgery: 2/28/20 right side skin sparing mastectomy with TE
  • Height: 5'10.25"
  • Weight: 143 lbs
  • Ribcage: approx. 31.5"
  • Bra size previously: 38B, but wearing Jockey XL crop top microfiber seamfree without cup inserts* for years
  • Age: 65
  • TE: Mentor Cpx4 Med (Smooth Suture Tabs 9200), 450 cc, Model 35093213, 12.7 cm W, 10.8 cm H,7.0 cm Proj
  • Expansion: 60 cc in March, then 60,100,and 90 cc at 3 visits in June and am currently at 350 cc. I have 1 more expansion planned before meeting PS.
My PS uses both Mentor and Allergan and does overfill up to 50cc. My left breast was bigger than my right and droops. A 38 B was always too big for my right breast. I don't know if this expansion will allow my right breast to be equal in size to my left. My PS did suggest possible reduction and/or lift for left breast when we first met. I would prefer not to have any surgery on my left breast but don't know if I can do this with the goal to have a moderately symmetrical look. Ok if my breasts don't are exactly the same and I end up with a smaller (A?) bra size. I also don't need a lot of projection. My biggest problem in the past was finding a bra with long enough straps that didn't hike up that isn't too tight since I have a long torso, which is why I went to a sports-like bra*. I assume after all this I might need custom or adjusted bras in the future since I seem hard to fit and don't like to have any padding.
Dx 11/2016, Right, 1cm, ER-/PR- Surgery 1/5/2017 Lumpectomy: Right Dx 1/9/2020, DCIS, Right, 5cm, Stage 0, 0/1 nodes, ER+/PR- Surgery 2/26/2020 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Tissue expander placement Surgery 2/27/2020 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Tissue expander placement
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Jun 25, 2020 03:50PM - edited Jun 25, 2020 03:51PM by morrigan_2575

Going for my 1st post op visit with the PS tomorrow morning. I had a BMX with Over the Muscle TEs placed on 6/19.

I know I'm a long way from needing this advice but, are there any specific questions I should ask tomorrow?

I have these in my notebook

  1. What Makes/Model of TEs are in place?
  2. Does he overfill? If so, how much?


I asked about what implants he uses during my first consultation. IIRC he said he generally uases Mentor but, will use Allergan if I prefer.

I know we're going for round silicone gummy implants but, that's all we settled on.

Dx 1/20/2020, DCIS/IDC, Right, 4cm, Stage IIA, Grade 2, ER+/PR+, HER2+ (IHC) Chemotherapy 2/5/2020 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 2/5/2020 Herceptin (trastuzumab) Targeted Therapy 2/5/2020 Perjeta (pertuzumab) Dx 6/19/2020, DCIS/IDC, Right, <1cm, Stage IA, Grade 2, 1/3 nodes, ER+/PR+, HER2+ Surgery 6/19/2020 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Targeted Therapy 7/6/2020 Kadcyla (T-DM1, ado-trastuzumab) Radiation Therapy 8/10/2020 Whole-breast: Breast, Lymph nodes, Chest wall
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Jun 26, 2020 01:54AM whippetmom wrote:

Susug:

Yes, I know of Dr. Spiegel. I have seen her work. Very nice. The “internal bra” technique was first described by Deborah Bash, MD - a plastic surgeon at the Mayo Clinic in Scottsdale. I saw the results of that specific procedure and the results were amazing. For Dallas/Ft Worth, Louis Strock, MD does beautiful work

DISCLAIMER! Please read my biography under my personal profile. I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jun 26, 2020 01:55AM whippetmom wrote:

Morrigan: Your questions are fine. Specifically, the make, style and volume of the tissue expander is what I would need to help you further.

DISCLAIMER! Please read my biography under my personal profile. I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jun 26, 2020 02:06AM whippetmom wrote:

Tigereyes:

I would recommend Allergan Inspira, SRX 420 ccs or 445 ccs. Nothing smaller than 420 ccs. You will only achieve the projection to closely approximate that which you havewith your “extra projection” style TEs, if you have the SRX, SSX, SCX....Allergan Inspira.

DISCLAIMER! Please read my biography under my personal profile. I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jun 26, 2020 02:11AM whippetmom wrote:

salamander:

You either have a low height, medium height or tall height TE. There is a specific volume associated with your TE. Ask your surgeon’s office for that information!


DISCLAIMER! Please read my biography under my personal profile. I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jun 26, 2020 02:42AM whippetmom wrote:

Botgirl:

Because of your ptosis/droop on the right, I would suggest overfilling the left, and then exchanging to a Mentor moderate plus profile smooth silicone round. The volume would be 370 or 405 ccs. You can see the difference in the projection, as the tissue expander has a projection of 7.0 cm, while the implant has a projection of 4.1 or 4.4. This hopefully creates some ptosis on the reconstructed side, to gain some symmetry on the right. I just cannot say if this will be enough though, to match that native breast. I would consider the mastopexy, if better symmetry is desired.

DISCLAIMER! Please read my biography under my personal profile. I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jun 27, 2020 08:53PM e32 wrote:

I know cup size is regarded as irrelevant, and hard to really assign with our implants. But approximately what size will 400 or 420 cc implants be on a small framed petite lady?


Thanks in advance!

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Jun 28, 2020 06:09PM - edited Jun 28, 2020 06:11PM by MinusTwo

e99 - really it's truly impossible to say. IT depends on your height, weight, measurements, the kind of implants, the doctor that is placing them, whether they are over or under the pec muscles, how much tissue the doc has to take to get clear margins, etc. etc. etc.

Oh - and it also depends on the bra. Each company makes bras just a bit different. Each moves differently on your frame. And bras made in other countries are different again. Think going to Chicos and buying a size 1 which is really a 12 or 14 or some silly thing in the real world.

If you are happy with your expanders, then you need to discuss that with your PS. Just remember that implants won't have as much projection as expanders.

Edited to say, if you read the entire header of this thread, you will get a feeling for the complexity of the issue. If you post everything Whippetmom requests, she's pretty good at giving you a reasonable answer.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Jul 4, 2020 11:32AM BgRose wrote:

Hi whippetmom,

My journey with cancer started with screening mammogram before breast augmentation and I am hoping to close the circle.

I had my exchange surgery on 6/24 and I am kind of disappointed, so I wanted to ask for your opinion.

My PS went with 545 cc Natrelle Inspira SSX implants and fat transfer grafting. They do look good, but not the look I was going for. I want the upper pole fullness, round, cleavage ( push up bra look ), "fake" looking breasts. Any suggestions?

Stats: 5'4, 124, rc 32".


Dx 8/21/2019, DCIS, Right, <1cm, Stage 0, Grade 2, 0/1 nodes, ER+/PR+ Surgery 10/17/2019 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Jul 6, 2020 12:16PM whippetmom wrote:

BgRose:

Well, you have the implants with excellent projection. They should be just right for your frame. It does depend on the tissue expanders though. Were they larger than the implants? It may be that the pockets are larger than the implants. Can you send me a photo via private message?

Deborah

DISCLAIMER! Please read my biography under my personal profile. I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jul 6, 2020 12:19PM whippetmom wrote:

e32: What Minus-Two said.....

Deborah

DISCLAIMER! Please read my biography under my personal profile. I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jul 7, 2020 09:32PM - edited Jul 7, 2020 09:35PM by Emily12

Hi I would like to get some input on implant sizing.

I have Allergan TE - REF 133S-FV-12-T 400cc

My PS uses/ recommended Allergan round smooth implants however if there are better options I could see if I can ask for them so please let me know.

I am 5'3" , 126 lb, ribcage circumference 34 inches

Before mastectomy I was fluctuating between 34B and small C.

My PS overfills the implants until the patient likes the size they see.

I hope to have a good projection and not flat pancake like foobs

Thank you

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Jul 15, 2020 09:46PM salamander136 wrote:

Hi Whippetmom,

Following up on my original question from June 22. I have additional information to inform your recommendation:

  • Expander: Mentor CPX 4 - Smooth surface medium height cc vol 350 (cat # 350-9212)
  • Current fill: 320cc, with another fill this week (July 17)
  • Will require radiation, but awaiting decision on chemo first. No date scheduled for either yet.


Putting my original information below for reference:

On June 4th, I had a right-side, skin-sparing mastectomy, with immediate tissue expander reconstruction.. The plan is to exchange the TE for a Mentor silicone implant on the right side, with a lift and implant for symmetry on the left side.

  • Height: 5'8"
  • Weight: 155lbs
  • Ribcage: 32"
  • Bra size prior to nipple sparing mastectomy: 36 small C
  • Age: 47 (not aiming for super 'perky' at this point)
  • Would consider going up a size (full C or D)


The PS will use Mentor smooth round silicone implants (exact implant type TBD). Of the available Mentor silicone implants, which type and fill volume would you recommend for the right side?

Thank you very much in advance!

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Jul 18, 2020 01:56AM Emily12 wrote:

Hi Whippetmom,

I am resubmitting my post. I didn’t see a reply to it, hopefully I didn’t miss it.

“I would like to get some input on implant sizing.

I have Allergan TE - REF 133S-FV-12-T 400cc

My PS uses/ recommended Allergan round smooth implants however if there are better options I could see if I can ask for them so please let me know.

I am 5'3" , 126 lb, ribcage circumference 32 inches

Before mastectomy I was fluctuating between 34B

My PS overfills the implants until the patient likes the size they see.

I hope to have a good projection and not flat pancake like foobs

Any recommendations for a plastic surgeon in IL who is expected with prepectotal implants In case I want to explore that option? My expanders are giving me so much discomfort and I have a lot of animation so I can only imagine how bad will it be with the implants

Thank you

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Jul 21, 2020 05:32AM whippetmom wrote:

Emily12: I would suggest Allergan Inspira, smooth round silicone implants, SSX or SRX - 445 ccs, or SSF or SRF 450 ccs. Your TEs have a projection of 5.3 cm and so the “X” version might make for a pretty tight closure at the time of exchange. Talk about these style options with your PS.

Deborah

DISCLAIMER! Please read my biography under my personal profile. I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jul 21, 2020 05:59AM whippetmom wrote:

Salamander1

I would suggest Mentor Xtra Smooth high profile smooth round silicone implant, 450 ccs, or the original smooth round high profile implant, 350 ccs. The sizing is all entirely predicated upon symmetry with the native breast. Deciding factors are: How much ptosis (droop) you have with the native breast, andthe amount of projection that can be achieved with the mastopexy and augmentation of that breast. Even though your TEs hav a projection of 6.4 cm, your PS will likely need a lower projection style implant in order to match the natural droop of the native breast. Again, it all depends on what your PS will achieve with a lift and implant on the left.

DISCLAIMER! Please read my biography under my personal profile. I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jul 23, 2020 02:47PM Mwgirlintx wrote:

Hi Whippetmom,

I am so grateful for this group and your help. All the decisions that go into Breast reconstruction is just so confusing, so this is much appreciated. I would love your advise. My info...

1. Height 5’7”

2. Weight 132lbs, currently, but usually in the 126-128 range. I have put on some weight during and after chemo, and trying to keep the weight on so I’ll have some options for fat grafting.

3. Ribcage circumference- 28.5 in

4. My Tissue expanders are in. They are the Mentor Artoura high profile smooth. 475c. Style # (R) 9351510-31 (L) 9433627-038 Ref# SMXP 130RH

They are currently filled with 410cc saline.

5. My PS says he uses Allergan Natrelle- smooth round gummy bear. That’s all the info he gave me. Are the gummy bear ones safe? I’m confused.

6. My pre- mastectomy size was a 32- DDD/E in the Freya bras. My breasts were a lot fuller when in my 20’s and appeared larger, but my bra size has always been anywhere from a D to an E depending on the bra. I would love to stay around the same size without compromising the natural look of them. I worry that going to a D will make them look unnatural.

Thanks again for your help. I look forward to your response and advise!

Nadine





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Jul 25, 2020 05:40PM Emily12 wrote:

Whippentmom,

Thank you. A follow up question: what does it mean to have a tight closure and why does it matter. I am completely new to all this.

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Aug 3, 2020 08:47AM Mwgirlintx wrote:

Hi Whippetmom,

I am resubmitting my post. I didn't get a response. Hopefully I didn't miss it. Thanks!


Hi Whippetmom,

I am so grateful for this group and your help. All the decisions that go into Breast reconstruction is just so confusing, so this is much appreciated. I would love your advise. My info...

1. Height 5'7"

2. Weight 132lbs, currently, but usually in the 126-128 range. I have put on some weight during and after chemo, and trying to keep the weight on so I'll have some options for fat grafting.

3. Ribcage circumference- 28.5 in

4. My Tissue expanders are in. They are the Mentor Artoura high profile smooth. 475c. Style # (R) 9351510-31 (L)9433627038 ref# SMXP 130RH

They are currently filled with 410cc saline.

5. My PS says he uses Allergan Natrelle- smooth round gummy bear. That's all the info he gave me. Are the gummy bear ones safe? I'm confused.

6. My pre- mastectomy size was a 32- DDD/E in the Freya bras. My breasts were a lot fuller when in my 20's and appeared larger, but my bra size has always been anywhere from a D to an E depending on the bra. I would love to stay around the same size without compromising the natural look of them. I worry that going to a D will make them look unnatural.

Thanks again for your help. I look forward to your response and advise!

Nadine

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Aug 3, 2020 01:14PM MinusTwo wrote:

Nadine: Whippetmom is not on BCO every week. It's possible she's currently on vacation. I expect she will check back in before the end of the month. Hope that gives you time to make your decisions.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Aug 21, 2020 11:17AM whippetmom wrote:

Mwgirlintx:

Your TE’s are 13.0 cm wide and have a final fill projection of 6.8 cm. The corresponding Natrelle Inspira implant would be the SSX, SRX or SCX, 540 ccs (13.0 cm wide x 6.2 cm projection) or 560 ccs (13.25 cm wide x 6.3 cm projection). On your frame, this should give you a DD cup or DDD/E cup in a bra such as a Freya or Chantelle. Any other bra, I have no clue. But you will not have the same appearance as you did with your native breasts. It just is the way it is. But the size will be just fine for your frame.

Deborah

DISCLAIMER! Please read my biography under my personal profile. I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Sep 6, 2020 03:49PM MandaSkier wrote:

Hi Whippetmom,

I appreciate your help. I am 48 yo, 5 feet 4 inches and was 154 lbs a month ago before my b/l mastectomy. Bra size was 34C and would like to be about that again. 33.5 inches around the ribs. Current expanders: Natrelle 133S FX max 550 cc... info I found in an online Natrelle catalog: full ht/extra projection 13 cm width, 13.5 cm height, 6.7 cm projection.

I'm not sure about overfilling or if my PS exclusively uses Natrelle implants, although when first talking implant options he recommended the gummy bear type. I think I would want the mid-level "gummier" soft touch type.

Is there anything else I should ask him? I am only at 210 cc and don't yet understand how much "fill" will take me to approximately my original size.

thank you for any suggestions!

Amanda

Dx 6/9/2020, DCIS, Right, 1cm, Stage 0, Grade 3, 0/4 nodes Surgery 8/9/2020 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Sep 9, 2020 03:51PM gooddd05 wrote:

Hi Whippetmom,


Looking for some advice. Status post bilateral nipple sparing prophylactic mastectomy on 8/18 for BRCA1+NF1 gene mutations. Here are my specs:


1. Height: 5’ 7” Weight: 130-135 lb Ribcage Circumference: 30 in

2. Tissue Expanders: Natrelle 133S-MV-12-T 300 cc. She does overfill if needed. Currently filled to 230 cc

3. Planning for Natrelle Inspra Smooth Round Gel Implants.

4. Pre-Mastectomy Size: Mostly 34B. Mastectomy specimen weights were 170 g on left, 180 g on right if that helps at all.

I am currently filled to 230 cc which she said gives me a “projection” around 4 cm and max projection for my expanders is 5.2 I believe. I am currently happy with the size/projection of my TE’s and would like my implants to match this. My concern is that she says we are “in-between” sizes for the implants right now. If I stay at my current fill size, the matching implant she said would be the 250 cc low plus profile in order to stay at width of 12 cm. She said the implant would likely not have the same projection and would sit flatter. When I look up the projection of this 250 cc implant it’s only 3.1 cm. She said the next size up would be another fill to aim for implant of 310 cc moderate profile which has a projection of 4 cm which she believes is where I’m at currently. I like the way my expanders currently look and am worried about the implant looking smaller if I go with the 250. Do you think to keep the same projection that I should do another fill to aim for the 310 cc implant?


Thanks,

Danielle

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16 hours ago whippetmom wrote:

MandySkier:

I would recommend the Allergan Inspira. SSX (the midrange “soft touch” version), 560 ccs. Let your PS fill to 500 cc to 550 ccs, or to toleration. This should get you to where you want to be. If the skin is lax and the PS had additional room, you could even go to 580 ccs.

Deborah

DISCLAIMER! Please read my biography under my personal profile. I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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16 hours ago whippetmom wrote:

Danielle:

Keep filling to 300 ccs and a bit more, to skin stretching toleration. Don’t stop now, just because you like the size of the tissue expanders. This will equate to exchanging out to too small implants. With a bit of overfill, you could likely get to 385 ccs - tweaking the dimensions to 12.25 cm and 5.0 cm projection. Certainly to 365 ccs - 12.0 cm width and 4.9 cm projection. You could easily handle the 12.25 width.

Deborah

DISCLAIMER! Please read my biography under my personal profile. I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-

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