BREAST IMPLANT SIZING 101

pixiemuse

Hi whippetmom: any advice, direction and or assistance would be greatly appreciated.

To continue what I stated above,

I have Mentor 450 Tall Height expanders in place (I feel like they are way to tall but thats me)

5' 2" tall, after the lipo for fat transfer I should have approx. 32" to 33" rib cage

Prior to chemo I was a high side B, after chemo mid to low B cup. (dense tissue and lots of cysts)

Dr uses Mentor implants but which one and type has not been discussed as yet.

I wanted to go up a bit to a C but now I'm not certain. Due to the amount of skin and tissue that was removed my Dr inflated the expanders to a D so I would have skin coverage. I hate the D!! Now I'm afraid of what a C is since I didn't get the chance to live with a C for more than a week.

My pre-op appt is Oct 14th with implant surgery to be Oct 22nd.

Thank you so Much for your help,

P

kitkat3713

I was diagnosed with Stage 2A triple negative breast cancer last November (2014). I had a mastectomy on my right side in December, went through chemo January-May (2015), had first stage of reconstruction in July, and the second stage just over one week ago. The PS was very friendly and helpful. During the first stage, I had a lift and small implant on the left side. The right side used skin from my back and then had to have an expander put in. On the second stage, the expander was removed, anatomical implant put in with some fat from my mid-section. The day after my surgery, when taking off the bra and bandages, I could immediately tell that the right side was not big enough and noticeably smaller than the left side. I was very disappointed and very emotional. I wanted it to be my last surgery. I called the PS's office to schedule an appt to have the stitches removed, but I wanted to meet with the PS before that to discuss the size. He called me the next morning and his friendliness quickly changed. I was completely shocked at what he said and the tone he used with me. He asked me if I measured it, he said he did everything I asked him to do, and he said that I needed to be better educated on how to choose the correct implant. I had already been crying that morning and after he hung up on me, I started bawling. I couldn't believe his demeanor. I said in every appt that I wanted to be symmetrical. I told him that I thought the anatomical implant would be best since I still had a natural breast on the left side and he agreed. I never told him what size to put in and I trusted his judgement. I went a couple days ago to have my stitches taken out and I brought a friend with me for support. As soon as she saw me, she said she could see the difference in size. Other people have too. I cannot go without a bra and I certainly wouldn't look right in a swimsuit either. At the appt, he measured both sides and he said they were almost equal. I told him that I realize that one side may be slightly larger/smaller than the other, but it was very noticeable. He wouldn't listen to me or my friend and he kept interrupting us. He wouldn't look at me with my clothes on to see the difference. He told me that I had to figure out what needed to be done and how much more fat, etc. would be needed. Again, I was shocked. I'm not the professional that has been doing this for over 25 years.

I went home and put a 1/2 cup of rice in a small Ziploc bag and put it in my bra. That made the right side comparable to the left side. I looked online and saw that a 1/2 cup was equal to 120 cc. When I was with the PS, I asked him what size implant he put in and he told me. He showed me the size of the next larger one too. Well, the next larger size is 110 cc's more. That right there tells me that he put in the incorrect size. He is being so stubborn and doesn't want to hear that it's wrong. I have an appt to see him again in a couple weeks. I'm almost to scared and angry to. I've made a couple of consultations with other PS's to get their opinion, one though cannot get me in until November.

As someone posted earlier, the disappointment from the reconstruction has been my breaking point. I've been strong for most of this, but I just can't take it anymore and when I think about it, I start to cry.

Has anyone had the anatomical implants? Should I have the current implant removed and have the next larger one put in? I really think that is all that is needed. I will say that I don't want him to take anymore fat from my mid-section because I'm still very sore and bloated.

Any suggestions will be greatly appreciated.

LoriWNY

KitKat--Glad to meet you but sorry that we have to meet under these circumstances.

I would go to a different PS! Why put yourself through the anxiety of dealing with a doctor who doesn't understand that he needs to make you happy in order to do his job properly? There are plenty of women on this board who have, unfortunately, experienced dissatisfaction with their PS and have sought second/third/fourth/fifth opinions--and are thrilled that they did so, me included!

I saw a few second opinion plastic surgeons before I scheduled a revision surgery from round implants to anatomical implants in a different volume. I am so happy that I took the time to find a PS with whom I felt 100% comfortable. He even told me that he was "at my service" and that if I "was not happy with the outcome," he "didn't do my [his] job properly." He truly listened to my wishes; I had a great result with the revision and am very satisfied with my new PS.

It is almost the end of of September so November is not that far away. Take the time to get it right and you will be happier in the end.

MinusTwo

KitKat - it can take up to 6 months for the swelling to go down & everything to settle. Most docs I've heard about will not do revision surgery before then. That will give you plenty of time to meet someone in November. I agree with Lori - find someone you can talk to who's on your side. I ended up crying every time with my PS until my grown son went with me one day & glared. After that he couldn't have been nicer. I have anatomicals and I LOVE them. You might want to read posts on Exchange City where everyone discusses pros/cons/etc of their procedures.

pixiemuse

kitkat - very nice to meet you. What you are going thru is exactly my fear!! I'm sorry you are going thru this, I think we all have been through enough to have to just deal with whatever is dished to us at the end. Maybe I'm incorrect for feeling this way but the Doctors are the experts and should listen and educate their patients. This is not like buying a dress or a new outfit that you can try on and really see the fit. My husband noticed that my Dr. listens to me but forgets things she has told me what would be fixed each time we are there. For me it's been helpful to have a second set of ears in my appointments that makes lists and reminds her of what I have asked for and what she has promised to do. My pre-op for final implants is a few short weeks away, this site has helped me make more lists of questions to ask. I agree with the other responses to you. find someone you can talk with and takes the time with you.

Hopefully this will make you laugh....... I met with two male docs both made me uncomfy and were not pleasant with all my questions. In the last appt. my mother who was with me for both had enough and looked him squarely in the eye and told him he would most likely have more sympathy and more questions than I had if he was about to have his penis removed and had to have a new one rebuilt. I decided on a female Dr.!! (not saying a male PS is bad, just was not for me)

kitkat3713

I realize there is swelling, but if it looks too small swollen, what will it look like in six months? :-)

That's funny about the male PSs. I found the opposite when I found out I had endometriosis years ago. My female doctor was not sympathetic and as soon as I went to a male doctor, he told me what my options were, etc. and was very nice. I'll have to see if there are any female PSs on my insurance.

whippetmom

Suzy1067:

With memory shape implants, I would suggest nothing smaller than 495 ccs medium height high profile. In Mentor ultra rounds, the size would be 590 ccs.

whippetmom

pixiemuse: ....390 or 440 ccs, Mentor memory shape medium height, high profile. I would suggest Mentor high profile smooth rounds 475 ccs or 500 ccs, because I think you might be happier with the shape and feel, in light of the degree of skin dissection at the time of BMX.

whippetmom

kitkat: I agree with the suggestion that you find a new PS.

pixiemuse

whippetmom - Thank you so very much for the information.

pixiemuse

Suzy1067

Thank you so much for the information - that is in line with the PS's recommendations as well.  Nice to have a "2nd" opinion

OceanSky

Whippetmom & All who are facing a mastectomy,

Stella McCartney (the designer) is offering an exquisitely beautiful post mastectomy bra FREE to breast cancer patients right now. The bra is called Louise Whispering Bra

Stella McCartney's mother died of breast cancer & she created this bra as a result to assist women with breast cancer. Right now she is offering it FREE!

I've been in contact with Stella McCartney's Customer Care department and asked their permission to post this information on BC.org. They gave the go ahead.

I wish I'd had something this beautiful after my mastectomy rather than the hideous uncomfortable surgical bra the hospital charged my insurance for.

To all those facing your mastectomy, I hope you get this bra in time!

Bright Blessings,

OceanSky

Rebecca54

Whippetmom and all of you knowledgeable ladies on here....question that a friend asked me that I'm embarassed I never asked PS. Saline vs silicone...I felt both and like silicone so chose that but now I'm 2nd guessing myself. I have a friend with saline implants and she believes they are safer. What do you ladies think???

Chrisrenee77

Rebeeca- I have silicone implants and I love them. My PS does not like saline implants he says you can see the ripples from saline implants. Also, saline implants are not as comfortable as silicone. As far as the safety of silicone implants, they have a thicker shell than what they did in the 80's/90's. I would recommend you ask your PS what they prefer, and ask to see pictures of patients that have used silicone and saline implants. See which ones you like better based on pictures. Just my opinion.

Stix

has anyone with implants had their pectoral nerve cut for reconstructive purposes? How was your physical activity afterwards? I am very active. Thank you.

Rebecca54

Thanks Chris, I am sure that my PS prefers silicone as his PA showed me about 10 different silicone and one saline. I just never asked the question. It's such a basic question and when my friend asked I didn't have the answer. Seems like most use silicone these days...

whippetmom

Rebecca....they are safe enough.

Edwmel

Hello, this is my first post and I am not sure if I am posting on the right place but I need help determining the size implants to get and this seemed like the best place to ask. I had a DM 6/23/15 and have TEs now and will be having my exchange surgery on 10/20/15. I am 5'-4" and 110 lbs and am 28" at the ribcage. My TEs are Natrelle Style 133MV-11-T Allergan filled to 250 ccs at surgery. I have since been filled to 425cc and I met with my PS yesterday to select implants. He helped me choose a 445 cc but I do not know any other details regarding these implants.

My worry is that I will be disappointed that they are too small when I am finished. I would like a full C cup at least, but not too large. This seems so shallow of me at this point but I would hate to go through all this and not be happy with the results. Any thoughts and advise would be greatly appreciated as my surgery is just over two weeks away!

Girl53

Pixie: I am howling! Really needed a good laugh today. Did the doctor flinch? LOL!!!! Hope you're well.

whippetmom

Edwmel:

You are in the right place and the information you provided is sufficient, with the exception of the description of the choice of a "445 cc" implant. The only "445" I know of is the Alleregan 410 445 grams, and it is a MX style anatomical implant. If that is the one you are referring to, you will be large enough. But you ought to confirm the manufacturer and style of implant before the exchange. It might be a volume in a saline implant....I just don't have time to go through all of the styles and volumes in saline right now. Please find out and get back to me on this.

Deborah

Edwmel

Thank you so much! I wish I had read more of these great posts before I saw my PS for selection. I will be calling his office on Monday to get the specifics of my implants. It is such a comfort to listen to others that have been through this.

Melissa

Edwmel

Hello again! I spoke to my PS office today and they told me the implant he selected is the Natrelle Inspira Round Gel 445 cc. Hopefully, this is the information you need. If so, do you think this is a good selection for my size? Thank you again for your time.

Rebecca54

Edw, we've all been there. It's hard to pick a body part!

Edwmel

Thanks Rebecca54! I needed a laugh

whippetmom

Edwmel:

Let's verify which style of Inspira. With a volume of 445 gms, this could be a moderate profile implant (too flat) or a textured extra full profile, which is great in terms of profile, but I just do not know about a textured implant for a thin gal like you. I do not know enough about the textured Inspiras....if they have the same risk for traction rippling as do other silicone rounds.

I personally think either of these would be preferred....or rather....I feel YOU would prefer...

whippetmom

Edwmel: Actually, I should have circled the SRX version also. Either would be a good choice

sknitter

I had my double mastectomy August 28th with tissue expanders. I want to be a B size and I'm wondering how much they should fill my expanders. I keep reminding them that a small B is good for me. For the most part, it seems as if PS tend to want to go bigger. How many cc's should they put in? After surgery, the PS said she put in 240. Then I've had 2 60cc fills and 2 90cc fills. Thanks,

whippetmom

sknitter: Please read the thread header, number 1 and 2, and get that information in #2 from your PS if you do not have it. The TE info is recorded in your medical record.

kgirard411

Help... I am really unhappy with the size and shape of my new breasts (L breast done immediately during prophylactic mastectomy in January, Right Expander exchanged 5 weeks ago) .

I am 5'6" and 187 lbs (I gained about 20 lbs while on chemo). I am about 34.5" under my chest, 36 waist, 44 hips. Original bra size was 38 FF. Trying to lose that weight I gained, but have always been curvy hourglass and was happy at 165 lbs.

The PS used Mentor smooth round moderate plus profile gel 450 cc. now can't fill a B cup - stuffing the ends of the bra so they don't dent - is this normal? (they are flat like pancake - no protrusion). She only showed me round ones - I knew nothing about teardrop or gummies. I trusted her. I have spoken with her a couple of times about how I feel. She initially said "I've given reductions to lots of women and they are happy with them"... well I never asked for a reduction though if I did, it would be more like C or D I would request - I felt my larger breasts at least kept me balanced - more hourglass.

Question: If I lose weight, will I be happier with the size of these, or should I be trying to get a second opinion on sizing. She said that was the largest she could put in(?), but everyone else's I have seen are much larger, and have a much nicer shape. She also told me I didn't have enough fat for a flap surgery, however since then I have seen many who are much smaller than I am have DIEP surgery and much better results.

Does anyone know what sizing would be normally requested for my size?

I look in the mirror every day and tell myself I will get used to it, that they look "fine", try to push them up to get more cleavage/size, but I still don't like them. Does anyone else feel this way? So sad and frustrated. I should be happy - I am alive and NED.

whippetmom

kgirard411: I am sorry you have been short-changed with your plastic surgeon. Your implants are far too small for your frame. You need a high profile implant, at the very least. The volume should be somewhere around 600 ccs to 700 ccs. If you had FF cup breasts pre-mastectomy, you had sufficient flaps. You need a new plastic surgeon. I looked at your post on another site and this is who I would recommend you go see. Don't bother with your current PS from this point forward.

http://www.macleodtrailplasticsurgery.ca/about-us/our-surgeons/dr-whidden

Deborah