BREAST IMPLANT SIZING 101

lbarbados

Psal70 and lago, thanks for the encouraging words! 

MBJ

Deborah:  So sorry to hear about your shingles!  I hear it's incredibly painful-Would taking an antiinflamatory help?  I know I mentioned that I take Wobenzyme-5 pills with 1000 mg of Vit C 3 x a day to you before but just wondering if this would help.  Gentle hugs to you and a speedy recovery.  I was out of town but I am back now and happy to help with the picture forum.

ameece0016

CAN MY AUNT WITH NO INSURENCE GET FREE IMPLANT IF THEY TAKE HER BREAST OFF

MBJ

ameece:  Is Medicare paying for her surgeries?  All MX's requiring recon jshould be covered.

TinaT

OK, had my exchange on Wednesday (2 days ago).  I ended up with Natrelle Style 15 in 533cc.  They said that both the appropriate diameters in Style 20 and 45 looked huge on me.  Of course, the nipples dictate a lot.  I wanted a nice slope, no coconut shells (my PS calls them grapefruit halves), and ptosis without too much skin-skin contact.  I liked the overall size with my 600cc TEs filled to 450cc, but the projection seemed to accentuate my bony sternum.  They said the 20s and 45s just looked too drastic on me and they didn't think I'd be happy.  I had given them my wish list and I was never stuck on any bra or cup size and I trusted them to get as close as possible to what I was hoping for.  I'm witholding all judgement (good or bad) until things settle in.  PS and PA seem very happy with the results so far!

I'm supposed to wear the surgical bra until further notice, but I was told I can wear other bras as well long as there are no underwires and they are supportive.  The size M feel uncomforably tight around the band, but seems to hold things together better.  It was so uncomfortable right after surgery that they finally put me in a Large.  If whippetmom or anyone else has a chance to check out the picture forum - does the Medium seem supportive enough or should I look for something with more lateral support?  I'll have to check my old PMs because I think there was a brand that was recommended to me a while back.

Whew!

TinaT

OK, I don't know if I'm ready to be overwhelmed by the bra thread yet.  Just wondering if there's something better for me to wear than the surgical bra I was given.  Want to be sure there's good lateral support, right?  Whippetmom suggested an "Elements of Bliss" bra when I had my TEs, but don't know if that's appropriate here, plus there seems to be different styles.  Help!

ALittleBitBritish

To the Suffering Shingle Sisters, 

I hope you are all pain-free..sending healing thoughts!!

  Alison 

lago

My PS didn't put me in a surgical bra. Just had me wear this band initially all the time but now just a few hours a day. I'm still bra-less except for the sports bra when I exercise. He did want me to wear one of those when "bouncing" around. He actually told me not to spend too much money on bras right now because they are still changing.

The nurse said he changes back and forth regarding the surgical support bra. Right now she said he feels the compression can constrict the blood flow which is not good for healing. 

So far the boobie prizes are not migrating to my arm pits so I guess I'm doing the right thing.

whippetmom

Tina:  Wow!  You are going to be one happy girl!  I just saw your photos!!!  More comments on your thread.

Elements of Bliss would still be great at this point.  Look for a 36 band size - C cup. Macy's, Kohl's have them. Oh, also Wacoal Awareness.  Dillards and Nordstrom's carries Wacoal - not sure who else. Don't spend too much right now - buy one or two.  The post-sx bras look okay for now - but try to get into something more encapsulating next week.

whippetmom

Thanks Alison!    Cannot WAIT until that moniker dies out!  Feeling better but the nerve pain is a killer.  Makes you want to cut off the affected limb for relief!

TinaT

Thanks, Deborah, I definitely need something with adjustable straps so will check those out ASAP!

TinaT

lago:  Isn't it odd how they all have their different recommendations?  Glad you're doing well!

lago

TinaT Yes although it seems more PS have people in surgical bras. I'm not sure if I have run into anyone yet here other than me who wasn't in one. So how long to folks have to wear those things anyway?

annettek

I had to go eight weeks-24/7. I think it helped with the shaping, location, etc a lot.

islandmom

lago:  My PS does not believe in surgical bras.  I did not get one and he told not to wear a bra at all in the beginning.  I wore a regular underwire bra anyway, after the first few days.  It did not bother me, even though I had stitches, even heavy duty staples in my IMF on my lifted/augmented side (I am a uni).  I would say I feel the most comfort when I do not wear a bra although I wear one most of the time.  

The one thing my PS did insist was that I massage everyday, he said that would help them drop.  It has been almost 12 weeks and they both have dropped, which makes me happy because they were way too puffy on top.  

SuebeeBC

Mine wanted me in a sugical bra for 2 weeks but took me out at one week because my breasts looked a little too close.  I wore a sports bra or regular bra in the day after that and nothing at night.  Now I am at 11 weeks and am in wired bras and feel great.

lago

islandmom how long do you do the massage. I do it everyday but maybe not enough. My surgery was June 24th and I'm not sure if they have dropped yet. I did finally purchase a bra today at Marshalls just to have one. No underwire though. I don't want to spend money on bras because my PS told me not to spend to much because they will continue to change for up to 6 months. I see him next week. Are you wearing a surgical band. I try to wear mine at least 1 hour a day. I think that helps them drop too.

islandmom

lago:   He wanted me to massage at least 3 times per day or more.  In the beginning I did it all the time but I have gotten lazy now.  He mentioned that he wanted the implant to make a new memory. I know it sounds funny, but that is how he described it.  On the first visit after E-day he actually took a marker and made lines on my skin to show me how far to squeeze the implant.  I do not know what a surgical band is.

I think you would be safe buying a few bras.  Yes they will change but I doubt that they will change enough for you to need a different size.  My foobs are smaller now but my bra size has not changed. I got fitted about 4 weeks after E-day.  

islandmom

Lago: You asked how long?  Maybe 5 to 10 minutes, I do not think I ever timed it.

lago

Thanks islandmom.

hillck I'm really not in any rush to wear a bra. I do have a few shirts that are too sheer to wear braless. My pink tee slightly shows my scars so I wouldn't wear it out of the house. Now I can wear it with my new bra.

jbennett38

Wow! I'm new to this board and am so impressed with everyone's knowledge.  Obviously, I came to the site because I have questions about implant size.  I had a BMX July 14 and have TEs in place.  I do not know what type I have, but will ask when I go to my PS on Tuesday.  I only have 280cc in my left side and 220cc in the right so I still have a long way to go.  I just feel so confused all the time and thought I would be further along with my fills by now.  After coming to this site, I am even more confused with all the choices.  I had no idea there were so many types of implants.  I am going to pull the information from the top of the page and come back to see what is recommended for me.  I would also like to get permission to look at the pictures forum.  I took pictures before my MX but haven't taken any since.  

 Thank you all so much for your posts.  It's so helpful to know others feel the same as me.   

tlc40

Jbennett- Sorry to welcome you here but so glad you found this place. These ladies have so much information to share. You are right, there are so many choices you may feel confused by it all at first. I was the same way. But the things I learned here really helped me decide what would work best for the result I wanted. Along the way I changed my final implant from what at first I thought I wanted to what I will be getting on my exchange coming up this month. You are lucky you found this early on in the fills so you still have plenty of time to decide.

The picture site is a separate private site & after you post for a while here you can send a private message to MBJ or Lilah to gain access...the pictures really helped me see how the different style implants looked on real women to see what would look best on my body. And it also helped ease my fears to see so many great results!

merovingian

whippetmom wrote on July 15:

The Style 20 - 325 ccs - will not be too wide for a 28 inch ribcage. Trust me.

The anatomical implants are trickier - because the volume and the style will be predicated upon the choice of the tissue expander. The TE is chosen with the future implants in mind. There are other parameters involved - the torso length - the sternal notch to nipple distance - whether the inframammary fold sits low or high on the chest wall. With Allergan, it might be that a 133MX implant - 300 ccs - would be better - overfilled [it is almost the standard to overfill the Allergan TE in prep for the anatomical] and then think of perhaps a 255 gram or 290 gram 410-MX style implant.

I just wanted to give some feedback, now that my wife and I have seen 3 PSs. All three want to use Allergan anatomicals, and all three were talking sizes in the range of 250 - 300 grams. So your sizing advice was right on the money.

Things are obviously a little bit different in this part of the world, but all three recommended LD-flap-plus-implant reconstruction rather than straight implant reconstruction on the basis that it would produce a superior result in terms of the cosmetics but also in terms of longevity. Indeed one of the three made it clear that he refuses to do implant-only reconstructions. Furthermore, all three were generally negative about round implants.

Anyway, it's not that I necessarily agree with what these guys had to say, but I think it's interesting that the consensus over here is quite different to what I perceive the consensus to be in the US. Incidentally, due to how slim she is, my wife is not a candidate for any flap procedure other than LD flap. 

We picked a PS and booked the BMX/recon for Dec 8. We have another consult before then. I will post TE and implant details when I know them.

Lilah

Merovingian -- I'm sorry the doctors are insisting on the Flap procedure.  It was my understanding that is only necessary in the case of prior radiation (perhaps your wife has had radiation then?)... I have an anatomical (I'm a uni) -- an Allergan 410 -- with no flap and it is fine!

I'm not surprised that where you are (is it Australia?) they recommend the anatomicals over the rounds.  I think that is because (a) anatomical gummies have full approval outside of the US, so there is far more choice in the actual consistency of the gels themselves and (b) they are simply in far more widespread use there and have been for a decade.

I have to say I like my gummy just fine.  It is firm -- slightly firmer than my natural remaining breast --  but it doesn't move much because it is textured and adheres to the skin.  I have no ripples and it looks great.  The Allergan 410s also have very good projection (one reason I wanted it -- as it matches very closely the projection of my natural remaining breast).

Did the doctors say WHY they don't like to do implants without flaps? 

whippetmom

merovingian:  Is your wife having rads?  If not, I am perplexed about the doggedness of the PS to insist on a flap procedure in a patient like your wife. On a positive note, docs in Australia use a lot of Mentor CPG anatomicals....which I think are preferable to Allergan's 410s, if you have a choice.  Please keep me posted on how she is doing.  I hope she is getting through chemo okay.  I will be praying for her.

Deborah

Lilah

Deborah -- can you elaborate on why you think the Mentor CPGs are preferable to the Allergan 410s?

whippetmom

Lilah: Good question.  While gathering my past references I came upon a year old study comparing the two manufacturers of true cohesive gel implants and this might change my opinion considerably.

Initially, it seemed to be a general concensus that the major complaint about the Allergan 410 was that it was "too firm" and so Mentor endeavored to make the CPG competitor a bit softer than the Allergan 410.  This was according to Steven Teitlebaum, MD, who was one of the first principal investigators who had access to both the Allergan 410 and Mentor CPG implants. 

http://www.aboutplasticsurgery.com/breast-enhancement/breast-augmentation/the-mentor-cpg-contour-profile-gel-implant-632

Also, Mentor devised a formula for determining the future size of the implant, in accordance with the style and volume of tissue expander used at the time of surgery.  So there is more of an exacting science than you find with Allergan.  This is evidenced in their Two Stage Implant planning guide...

http://www.mentorwwllc.com/pdfs-global/breast/EN/literature/CPG-CPX-sizing.pdf

But in looking for the information, I did come across this study last year which shows a five-fold increase in rippling of the CPG over the 410.  This is pretty significant.  Apparently in an effort to make the anatomical CPG less firm, the trade off was the complication of post-op rippling.  So this alone might make me change my tune regarding the advantages of Mentor over Allergan in the true cohesive gel comparison. Rippling is a troublesome complication after breast reconstruction to begin with and we want to avoid this risk whenever possible.

http://aes.sagepub.com/content/30/1/51.abstract?rss=1

Deborah

[Thanks Lilah!]

Lilah

Fascinating Deborah!  I have been pretty happy with my Allergan 410... and if I could change anything I'd make it slightly softer -- though it has definitely gotten MUCH softer since exchange last year.  So maybe when it comes time to replace I'll go for the Mentor CPG.  I am pretty sure my PS has access to everything.  She even offered to get me that other brand you asked me to ask her about a while back, when I asked her about it (sorry I no longer remember the maker -- it was a company making larger silicone implants?  Does that ring a bell?) 

Anyway if I switch at some point I can be the test model for whether it matters, ripple wise.  I am increasingly of the opinion that if you get ripples it isn't so much the kind of implant as the nature of your body (thin skin, not much fat -- one or the other or both).   I think I have thick skin because I have no rippling... OR it's the 410... hmm.... we will never know unless I 'speriment

Edited to Add: actually it isn't that I would like it to be softer -- it is soft enough -- what bugs me is that it doesn't move much (not much jiggle unless I jiggle it myself).  Whereas my natural breast jiggles more.  But I think even women with smooth round traditional silicone report that sort of thing... so it, again, may not have a lot to do with the item implanted but rather the body into which it has been placed.

Psal70

Hi Lilah - I think that implants with no breast tissue don't jiggle but you or Deborah can correct me, I used to think because I had radiation it doesn't jiggle like my natural side - I was on vacation overseas and 2 of my cousins had implants (plastic surgery by choice) and they jiggle and look like natural ones

Lilah

PSal I bet you are right.

So I'll default to: thrilled with my 410   (Not just pretty happy LOL).

I think there are a lot of factors that contribute to one's satisfaction with implants and only part of it is the implant itself.  How well it is installed, as it were, is another big factor.  And then there is what god gave us -- which we can't really change.