BREAST IMPLANT SIZING 101

LoriWNY

Zen--For me, symmetry was the goal in my breast reconstruction. I would think it would be very difficult to achieve symmetry in your case without replacing your current left implant with something that will more closely match your right implant. However, I will defer to Deborah who is the expert here! The pro side of the argument here is that both implants can be done now during one surgery/one anesthesia which will probably result in less and/or shorter surgeries later on.

Think about it this way--you are making a cake to match the cake you made last week. If you had only made a double batch of cake last week, both cakes would match but because you were unable to make a double batch, you now must try to replicate the cake you made last week with the cake you make this week. The cake you make this week does not match closely enough to the cake you made last week so you have to keep tweaking and adjusting the cake you made this week. By the time you are done, you have really worked twice as hard on the cake you made this week so that it would match last week's cake!

Since your PS has experience in this area and he is already telling you that he foresees issues with symmetry, he is probably a pretty good judge of what will match and what will not match. If I were in your shoes, I would tell him that symmetry is my goal and give him permission to exchange the left implant so that both sides are symmetrical.

ZenIt

Thank you, Lori! I agree. In my mind I do "know" he is right, and I will give him my permission to make that call. In my case there is not much tissue on my MX side, just thin skin, so he does have challenges to overcome as it is, no need to be stubborn and add to that, I guess.

Love your cake example! Now I need it

Nigelsmom

Greetings Whippetmom:


I have been trolling this thread for some time now and this is my very first post! I will have to go back and update my specifics in my signature.


First, thank you on behalf of everyone who's ever written & asked a question & for those who just trolled like me. Your time, effort & info are priceless.


So, I had a lumpectomy in March 2015 on the left breast with 2 sentinol node removal (benign) After Chemo (April thru June) I decided to have a bilateral mastectomy on 8/18/15 due to my Triple Negative diagnosis. I have not had radiation.


On 8/18/15 I had bi lat mx with immediate reconstruction. Implants are: right and left Allergen MX-16 TE's with 850ML capacity.


A 6x16 cm Alloderm sling was used on both left & right sides. Mastectomy specimen weights were approx 1200 grams. A significant skin trimming was performed because of excess breast skin and pre op ptosis. Prior to surgery my right breast was 36F and left was 36DDD


I am 5 feet 9 inches, 180 pds and have measured my rib cage (using metal one I wrapped under my breast and it measured 32inches). I know....bad girl...probably a tad smaller.


I was filled at time of surgery to 450. Slow inflation in left TE compared to the Right. Lost plastic surgeon and found a another one who will do the transfer. Long Story. But lucky to find qualified surgeon & view his work live with women who are his patients. (Whew)In the interim a PS stepped in to provide fills only on left side to provide symmetry.


I am now at approx 700cc and happy with size. Fullness & no real major rippling. Currently I am wearing a Warner's 36D bra and fill it out nicely. I like being smaller and like the fullness I have now. I can send you pictures.


I am scheduled for my exchange surgery on 11/10. Should I be looking to stick with rounds (I'm not trying to go for the implant showgirl look) more natural. Any suggestions. Thanks in advance😊

whippetmom

CatsRus: You would want to be in the 650 cc or 700 cc range with implants. You need to explain your desire to go larger so that your PS can use an adequately sized tissue expander. I feel that the TE should be a minimum of 14.0 cm in width. Keep me posted once you talk to your PS.

whippetmom

Zenlt: Lori is right....symmetry trumps size. Ask your PS to bring in Mentor ultra full projection rounds, as well as anatomicals, at the time of exchange. I think silicone rounds are much more forgiving when you have pocket discrepancy, but you need to discuss this with him.

whippetmom

Nigelsmom: I am wary about anatomicals, because of your skin laxity. Despite the trimming/excising, the laxity remains. It has much to do with age also. I cannot see where I would have been a candidate for anatomicals - 58 at time of dx and some ptosis and my skin really stretches! If anatomicals, the only one would be the Allergan 410 MX-685 gms. I would recommend Allergan Style 45, 800 ccs or Natrelle Inspira, SSX (the soft touch style) 745 gms. You will want to wear a bra every day....and there are plenty of great bras. I wear them all day and wear a bralette to sleep in. I want to avoid droop and most importantly, bottoming out. Support the girls! Let me know what your PS has to say....

whippetmom

Lharry: Yes, those or the Inspiras I mentioned.

whippetmom

I have been really preoccupied with a project I am working on and I apologize for not having the time to check here recently. Things are settling down and I have a trip to Texas planned next week, during which time I will check emails at night.

Deborah

Soancika

Hi,


I am new here and planning on bmx next year. Have 2 appointments wih 2 different plastic surgeons in a couple of weeks. Trying to learn as much as I can before I go in. Profile, implants and cc's confuse me so much. I am 5'6 and 145 lbs. My current size is 36B, but don't really fill it out. Would like to be a full C or a small D. How many cc's would that be? Like the mentor memory shape from the pictures that I saw. Are they silicone? I read that they are softest to the touch. Any recommendations would be greatly appreciated.

whippetmom

Soancika:

I would say implants in the high profile, 550 cc to 600 cc range would get you where you want to be. I don't predict bra sizes though. The shape of an anatomical is a bit of eye trickery...it could look essentially the same as a round inside your pockets after BMX. The style of implant is not a one-size-fits-all decision and your PS should select the best implant on an individual basis. I have never read that Mentor memory shape implants are softest to the touch. I doubt they could make that claim. I honestly do not know any implant manufacturer who could make such a claim. Let's see what your PS has to say about sizing when you have an apt, and then come back here to discuss.

Soancika

Thank you! Really appreciate your input. I meant ti say that silicone is softest to the touch. Or is it? If I like the rounds wich brand do you recommend? Sientra, Mentor?

whippetmom

Mentor, only because you can get greater projection than you can with Sientra.

TallnTerrific

I am 5'8 220 lbs and wear a 42DD but it is not well sized. I am probably DDD. My chest size is 42" and my bust size is 49". I am going in for bilateral MX on Nov 10 but tomorrow I meet with the PS. I would like to move down to a small C cup after reconstruction. My goal is to not have to wear a bra. I am 56yr old and bras have caused me lots of skin tags, moles/warts, back problems etc. is this feasible? I don't have much information about the TE preference of my PS. I know he wants to use the silicone and showed me a type of implant that does not really leak. It is a more like a solid gel that is round. Any recommendations on TEs or size of the expansion. I will be having chemo and radiation and the TEs will be put in at the time of Masectomy under the pectoral muscles. My PS said they will be much higher on my chest than my sagging breasts are now. Any help you provide is appreciated.

PS. After meeting with my PS he told me he uses Mentor TEs and silicone implants. He said we would fill the TE's about 500cc to Keep space for the implants

SummerAngel

Soancika, just wanted to chime in because you sound like you're measurements are similar to mine. I'm 5'6", 138 lbs, and before surgery wore a 36B. Turns out I was wearing the wrong band size, I should have been wearing a 34, but anyway. My PS used Allergan 45 high-profile implants (recommended by Whippetmom ), 500ccs, and I'm now wearing a 34D. I'm very pleased with the outcome.

Enerva

hi ladies I just wanted to stop by and thank you all for all the wonderful advise you all give in this tread. Whippetmom you helped me so much. I am facing a bit of issues with the rad breast and well ps wants to leave it and wait another year to see if it gets worse if not then to leave it alone.

No much to do

I wish this coming year maybe new research and new better options ll be available for all the new sister here.

Love you and again thanks you for everything you dooo

whippetmom

Enerva: Have you talked with him about fat graft transfer to your rads breast

Enerva

hi yes I mentioned and he still said let's give it another year and see if it gets worse. Whippetmom I live where it take things to be really bad in order for the ps to do something about it right now I have no balance and the right nipple is turning toward the right pointing to the right if it continues to pull it ll be close to my under arm. So the skin on the middle of the chest is streaching to make room for the implant wile the nipple makes a move due to the skin on the right side of the breast is shrinking. Hard to explain . But at least he agrees he see what is happening he just has no interest on fixing it now. I fear they are waiting for the damage to be so bad they will then Say hum maybe we should remove the skin and nipples you had to fight so hard to keep in 2013 .

Never mind I am OK I have no energy to fight now Whippetmom I have now lots going on so no energy to push the ps.

I will in a year . I will keep watching here for all that may be new for when I go back in the ring

Love you all and sending you hugs

Nigelsmom

Thanks for your reply Whippetmom. My PS is thinking of using Inspiras. He mentioned that I might not have a lot of sag, but I beg to differ with such large implants. He says to stay away from textured. I like being smaller as compared to my natural breast size but. PS says he will not be using drains! Should I be concerned & what should I be on the lookout for because of no drain usage.

800 cc's?? I'm thinking of asking him to order Inspiras from 700 to 800 and hopefully he will find one that looks best. PS says I have plenty of skin and the placement of TE's look really good. All this PS has to do is "bring it home"

Again....thanks for the input. I've gotta find bras now. Lol

wildmountains

Hi Whippetmom -

Sorry about the delay in updating you back. I just wanted to say a huge thank you to you for all your wonderful insight and helpful recommendations !! I had such concerns about my exchange surgery and what I was going to look like afterwards. But your information and words put me at ease and I went into the surgery looking forward to it. Thank you thank you thank you !! After talks with my PS he decided to go with the Mentor smooth round 800 cc HP. My exchange surgery on 7/28th went very well and glad to be done with those horrible TE's. I only ended up being out for 10 days and then returned back to work (work from home). My PS and his nurse say that they look very natural and I am very pleased with the results and the way they look now few months later.

Since he moved the pockets closer (since I had a larger gap prior with my implants) it turns out the right side pocket still has too much room and he needs to go back in to tighten the pocket along with fat grafting/nipple reconstruction which is scheduled for this week.

Thank you for all your help, time and valuable insight !!

Cpn70 -Christi

CatsRus

Whippetmom, thanks for your input. My PS said the same thing as you! Apparently I have a wide boob base with not a lot of projection. She measured my boob base at 14 cm width. We talked for over an hour and she seemed to get exactly what I am looking to achieve. I was very comfortable with her. She uses mostly Mentor implants. My PMX and TEs surgery will be at the end of January. I have another appt with the PS in early January so will gather more questions for her then.


Thanks everyone for sharing.

katykids

thank you again for your help. PS used mentor memory shape med. height high profile 620cc. I did ask about the ones suggested. They look smaller than I was before but I was okay with that.

Ref 334-1402 Sn 6908393-25

Leslienva

Hi ladies,

I met with my PS yesterday about my upcoming implant exchange. She says that she won't be going through the original incision, that she goes through underneath the breast to put in the implant. I haven't heard this before. I could understand if this were my radiated side, but this is the prophylactic side. I'm concerned because it means yet another scar. Is this common?

whippetmom

Leslienva:

Some go through the original scar and some take the inframammary approach. In most cases, you really have a hard time seeing that IMF scar.

ZenIt

How is everybody?

I called and left a message with my PC's practice manager about him bringing different rounds to surgery, as well as gummies, and generally giving him okay to work on both sides.

Going in on Tuesday. Can't believe it. I know it is not THE end of this road, but it getting scary close. I had some kind of expander in for the last 3 years and 3 month (want to be specific on this one , lol, to the month )

Will update after. He said I will have one drain, grrr. On the other hand - one? After LD I had 4 on one side, so this is nothing, I'll take care of little guy no problem.

Haitang2008

Whippetmom:

Hi. I had a bilateral mastectomy on Sep 17.

1. I am just 5'3", currently 140lbs, and ribcage circumference of 32".

2. Tissue expanders --MENTOR® Smooth Round SPeCtRUM® Saline Catalog # 350-1440

3. I do not know what kind of brand or style my PS to use

4. My pre-mastectomy breast size is 36B, I feel that I want to be a little larger this time.

5. My TEs were overfilled to 350 ccs now.

I'm currently trying to decide

1. whether I should fill the expanders more times(adds 50cc each times), or stop at 350cc.

2. The MAXIMUM FILL for my TE is 330 cc( I find this from WEB), is there a problem to over filled if to 450cc?

3. Any suggestions for the implant?

Any advice would be greatly appreciated.

Thank you,

leftduetostupidmods

If I would be allowed to say something re: implant size.

You must be aware that if you gain or lose weight, reconstructed breasts using an implant will not change the way natural breasts do. When I had the surgery, I weighed 157 lbs. At the time, I had told the PS I wanted pretty much the same size, so I ended up with 36 C, the same as my natural breasts were. I went up in weight during the hormonal therapy but didn't wear a bra all that time, the only thing I know is that my belly was way ahead of the breasts. I weigh 137 lbs now and went for a professional bra fitting and I am size 32 DD/32E depending on the bra model. As I intend to lose 12 or 17 more lbs, I do not know what I will end up with. So please take that into consideration too.

whippetmom

Haitang: You technically have expandable "implants" vs "tissue expanders". Some plastic surgeons use the Mentor Spectrum for tissue expansion, and some possibly use this style because it can be come a permanent implant, if the patient so desires. Once you are filled to maximum fill, the PS can just close off the port and you are done. I don't believe that this will make a large enough mound for you though. I believe that the Spectrum cannot be overfilled...perhaps a smidgen....but I think there are limits, as this is an implant, not a tissue expander. I think that for you, something like the Mentor ultra full projection, 390 ccs, or even 440 ccs, or possibly the Mentor Memoryshape, med height, full (or it might be "high") projection, 480 ccs preferably.

Stix

I am appealing to go out of network for a revision the appeals committee wants me to send them a pic...because they want to make sure that it is actually a medical necessity versus 'I don't like the reconstruction 'I have sent them two letters from my current ps saying I have thin skin from and implant bottoming out. I have had 3 failed surgeies...2 were revisions.i have had 3 plastic surgeons work on this without resolution to the problem. I told them I would send pic....but now thinking ... the pics don't give it justice of the protrusion assymetry..... and rippling. ...what does everyone think about...i will tell them that i will meet them in person and show them the reconstruction... I really would like to make them feel uncomfortable These people are not ever doctors ... I really feel uncomfortable with my pictures being in someone else's hands that works at 5he same facility as i. LASTLY they want to send my pictures to another dr.that is a sister hospital to the appeals committee hospital.doesn't this sound odd how they want to send my pictures around town in the mail ??? ANY COMMENTS PLEASE

owlwatcher

seachain you are correct weight loss can have a distinct look to how the foobs look.

Haitang2008

Whippetmom,

Thank you for your answer!

I checked the Product_Ref_Guide from MENTOR, the Mentor smooth rounds high profile 350 cc 11.7 cm is the only one has the almost same base Diam. (11.6 ) with my expandable "implants" kind of TE. I did not find the Mentor ultra full projection, 390 ccs, or even 440 ccs in the Product_Ref_Guide.

I like the silicone rounds. The Mentor smooth rounds high profile 400 cc has a Diam.12.2 cm, is the 0.6 cm bigger a problem?

Another closer one is the Mentor Smooth Round Ultra High 455 cc 11.2 cm, this one is the 0.4 cm smaller base Diam.

Thank you,