BREAST IMPLANT SIZING 101

kwilcockson

Hi whippetmom...I want to start by thanking you for all the help you are giving everyone on this subject, it's so confusing! My question...my TEs are 300ccs, my ribcage measurement is 31", 125lbs. 5'4". I am aiming for a large b, small c. About the same as before. I feel like the TEs are kinda smaller than I thought, but it's hard to tell since they are wide and oddly shaped. Are implants usually the same size as TEs? I just don't want to downsize after all this hassle. Also, what size implant would you recommend?

whippetmom

kwilcockson: Without knowing your style or mfr of tissue expander, I cannot comment fully on what implant would be best. But I think you want to be in the 425/450 cc range with implants, if smooth silicone rounds. It is very common, with your TE volume, to exchange out to implants at least 100 ccs greater than your TEs. This is because we look at the dimensions of the TEs as compared to implants, and it most often, with silicone rounds, requires larger implants to match the dimensions of the pocket created by the tissue expanders. I do not know about anatomicals for you, because it all depends on the style and mfr of your TEs. Your PS might prefer Mentor over Allergan. So once you obtain this information, we can revisit this and revise the suggestions accordingly.

kwilcockson

whoops..they Are allergen 410. 300cc

whippetmom

Kwilcockson...

Please scroll to the top of this thread and read the header - specifically #2. Allergan 410s are anatomical implants, not tissue expanders.

SanFranKitty

I just had my implants exchanged for my tissue expanders on Tuesday. I'm 5'6 and 117 lbs and we went with natrelle saline 68hp, which is a round high profile. One at 360 and one at 370 The measurement under my rib cage is only 29 so I don't think they would have been able to get much volume in otherwise. There maybe someone here with a similar build so as soon as the swelling goes down I will let you know what I think about them.

p.s. Some fat was added from my belly and looks like the above hip area judging my my bruises.

kwilcockson

sorry. 133fv-11. I looked at the wrong page

grandma3X

SanFranKitty- I'm 5'7" 120 lbs with a 29.5" rib cage. My TEs are 275cc Mentor but we only filled to 260. The PS was worried about my skin. I would be interested in hearing more about your implants and how you feel about the size. I was a small B before surgery and hoping for something a bit fuller after my exchange at the end of Oct.

herstrong

Whippetmom, thanks for your thoughts! So let me get this straight - my expanders hold 350, they're overfilled to 400, and you're suggesting implants in the 450 - 475 range? From your post above to kwilcockson, it sounds like you don't have to expand all the way up to the insert size. I'm feeling like I don't need to go larger, but if that's what I need to do to achieve my desired outcome, I'm all for it. It would be nice to get access to the picture forum, but apparently I was denied. It's hard to make decisions when you don't really know what you're going to look like after surgery. I'm hoping to have some cleavage in the end. But for now when I'm in the expanders, I do feel like they're tall a sort of mountain-shaped. So maybe I wouldn't feel as big with an insert where the shape is more smooth and round. I'll discuss this with my PS Monday and follow up with you.

Thanks,

Julie

Anonymous

herstrong,

Not to replace whippetmom, but rather to help, from what I have read here a 400 cc expander and a 400 cc implant will not look the same. An expander has a hard back and implant does not. So to achieve the same look, an implant needs to have more volume. Also, if you sent a pm to someone about the picture forum, it can take some time for them to get back to you. They need to make sure you are legit to protect the privacy of those in the forum, so give it time.

SanFranKitty

Hi Grandma3x! We are really close in size. I was a large A, sometimes small B. With tissue the expanders I expanded to a good C size. That is what is cool about the expansion process, you can experiment a little with size. I liked the projection I got with the expanders. I will let you know for sure when the swelling goes down. Glad I added some fat. Right now I look six months pregnant even with a binder! Also my chest is pretty swollen. I'm going to have to get creative with clothing so that I can leave the house.

herstrong

Wildtulip, I requested access more than two weeks ago. Someone posted that they just received access but I have not been approved. So we will see.

kwilcockson

how do you request access to the photo forum??

Anonymous

kwilcockson, Go to the reconstruction forum and look for the topic, "Before requesting access for the picture forum" and read the info at the beginning of the topic. It gives instructions on who to send a message to, etc.

AZ85048

Ladies: Below is the link explaining access to The Picture Forum. Please keep in mind that it is NOT part of BCO and just two women run the whole operation voluntarily. Please be patient as it takes some time to vet each member who requests access. Fumi and Lilah do the very best they can to keep it a safe haven for those of us with pictures and personal stories up there. I'm sure you can understand that they have to be very careful allowing admission. After all, this is the internet... .

https://community.breastcancer.org/forum/44/topics...

As an example for you, I had TEs with the capacity of 450ccs. I now have two Mentor high profile silicone round implants, one is 650ccs and the other is 550ccs.(size difference because I have an uneven chest wall) - and they look the same. So in reality I went 200ccs past the volume of my TEs on one side; and believe me, they are in no way large in appearance. Hope that helps!

(Hi, Deborah! Here's a puppy for you to drool over...)

kwilcockson

Thanks AZ, that does answer my question about the expanders.

JessieJake

Hi again Whippetmom,

I posted way back in April but things changed slightly since then. I'm scheduled for exchange on 9/7. Getting nervous!

Originally you suggested possibly "high profile style anatomical, such as a MF style 255 gms or possibly....might be stretching it...a. MX style 255 gms."

At that time I had only 140cc in my TEs but I ended up with 200cc in each. At my pre-op today we did indeed decide on the anatomical. I think I was a little tired as I didn't get the specific name or model. She did say it was high profile. When I asked how big she was thinking for the implant she said possibly 250cc-300cc. I told her assistant after my PS left that I really hope she'll use 300. I don't want to lose size (but I sure want a better look than what I have with these TEs now!). My PS did say something about going bigger than my TEs to make up for port, etc.. on the TEs.

I am 5'7 1/2", 111 lbs, ribcage is 28" under bra line. My TEs are Allergan model 13mx-11-T, 300cc capacity filled to 200cc. over the muscle

Thoughts on that? I think I'm going to follow up to make sure my preference is clear.

Thanks!

Journey2014

Hello,

I have pre op appointment for September 26, 2016 for latissimus dorsi surgery for both sides. Can I ask my PS questions on TE details/information already? Or do I wait until my pre op exchange of TE to implants?

MinusTwo

Journey - if you'll scroll up and read all the headers, you can post your information now. IMHO, it's good to have some idea ahead of time what you're getting into.

Journey2014

Thank you MinusTwo for your advice

Hello Whippetmom, here are my information.

Pre-mastectomy: I wore 34 inches, cup A

Height: 5' 0"

Weight: 140 lbs.

Rib cage circumference: 35 inches

My PS uses offers mentor memory silicone gel and shaped textured memory shape for breast implants.

Please advise. Thank you.

whippetmom

Sorry for the delay in getting back to all of these new inquiries. I will begin answering this evening.

whippetmom

That is one itty bitty whippet pup, AZ.....

whippetmom

JessieJake:

The actual corresponding Allergan 410 anatomical would be a MX-290 gms or 320 gms. But I gave sizing suggestionsfor the MF style, because I was not sure if you would get enough projection since you were underfilling. So IF your PS can use the MX style, that would be great. Anatomical with a width of 11.5 to 12.5....so there is a range and your PS might take in two or three sizes to try out in the OR.

whippetmom

Journey: It depends on how much volume is created by your lat flaps. You might only need implants in the 250to 350 cc range. It also depends on how tight your skin envelope is and the size of tissue expander your PS is able to utilize. Sorry I am unable to give you more information at this time. Your PS might not even know this yet....and it is because of your small breast size that I am wavering.

Are you having lat flaps to gain volume or is it because you are having radiation? If it is the latter, then this factors greatly in the ability to determine final size.

whippetmom

Journey: I would like to also note that your original question was whether you could ask your PS about tissue expanders and implants at this early juncture, and I would say absolutely. Let your PS know you care very much about the ultimate results and share what you hope to achieve with reconstruction.

Journey2014

whippetmom - thank you for your advice, I am having a lat flap due to radiated skin on my left cancer side. This is my second attempt of tissue expander reconstruction, my first was on January 2016 but the irradiated left cancer side split opened and I had cellulitis on my right, that they end up taking them out.

I was expanded up to 330 cc but the skin did not fuse together and split opened.

whippetmom

---

Journey: Having previously had radiation plays a huge role in the choice of tissue expander. I am glad I asked. It will depend on how the flap takes and how that changes the integrity of the skin envelope. I would definitely discuss fat graft transfer at some point. It is not anything new.....has been well known for years that stem-cell rich fat can improve the integrity and texture of previously irradiated skin. You can google this and find information over the Internet.

http://www.plasticsurgery.org/news/2012/technique-...

http://www.plasticsurgery.org/news/plastic-surgery...

Major cancer centers like Johns Hopkins use fat graft transfer for breast reconstruction. So please discuss this option with your PS

Reckless

Hi whippetmom,

I actually already had my EX, but do not feel comfortable, the implants seem too big (size and appearance OK, but too close to my armpits, especially the left one). PSordered implants in a number of sizes, but selected the largest ones during the surgery. Can you please advise if a different implant would be better in case I decide to do a revision? The details are below. Many thanks!

Height 4'11"

Weight 116 lbs

Rib circumference 30"

Base diameter 13 cm (measured by PS; although she put in 13-13.5 on the implant order form)

TE: Mentor Artoura High Profile 500 cc, filled to 530 cc

Implants: Mentor Memory Gel Smooth round ultra high 650 cc silicone

Bra size pre-mastectomy: 36 DD

Current bra size: 34 D or 36 C

Yaniza

To grandma3X , I am 5'7' and about the same weight. I have tissue expanders in now. I am curious to know how much your expanders were filled. I am at 200 CC each now.

grandma3X

Yaniza - I'm filled to 260 ccs. My expanders are 275 but the PS said I'm done.

whippetmom

Reckless:

You will need to talk to your PS about narrowing the pockets and bringing the implants more medially. It is possible that the pockets are larger than the implants, and if so, the implants always will migrate laterally. In any case, you will need what is called a lateral capsulorrhaphy, and this would be performed bilaterally. It is a securing of the skin envelope laterally, and if necessary, opening up the medial area just slightly - never ever too much or you will end up with symmastia, which is very difficult to correct. But honestly, for your frame, you need to keep the implants fairly narrow. So it is a pocket revision essentially, utilizing the same implants. I would honestly get another opinion before going for a revision. Just to get a differing viewpoint on correction. Also, you need to be wearing a bra with good lateral support and this will help keep the implants from migrating into the armpits. Hope you are wearing a bra - with the weight of your implants and pre-MX breast size.