BREAST IMPLANT SIZING 101

whippetmom · February 2014

Mommyathome: Height, weight, ribcage....??? Measure circumference of ribcage, UNDER the TEs with a measuring tape....

whippetmom · February 2014

Melissa: I like where your PS is going! For you....high profile smooth round silicone implants with a volume of 475 ccs or 500 ccs.

It sounds as though you are filled to capacity....so what do you think of your size and volume currently?

whippetmom · February 2014

softballaholic: Yes, as Dulci mentioned, I need to know the style and volume of your TEs...and your height, weight and ribcage circumference. It IS possible your PS used TEs which were smaller than you needed. I don't know why though....seems silly.

You can PM me privately if you like, and I would like for you to PM me with the name of your PS and your location in the US. I feel you need a second opinion before you go through with the exchange. There is a chance to get it right BEFORE you go through the exchange, so let's explore all avenues. There ARE larger implants. You can go up to 900 plus ccs with saline implants - 800 ccs in silicone. I have been on these boards for over five years and do not know anyone with custom implants.

Deborah

Galsal · February 2014

Thanks. It didn't seem like the thin FOTL cotton types at Walmart would be enough support so feedback is helpful. I do have some of the comfort ones which would do but they're nylon not cotton. Not the best option for healing. Will check again.

sandra4611 · February 2014

Tina,

I KNOW...it's infuriating that they all seem to have their own version of "you must do it this way." It's true for all phases of this journey, isn't it? After five months on this website and reading the experiences of a thousand women, I would be SHOCKED if two doctors EVER agreed on ANYTHING. Shocked

When you read about some of these differences (not something as minor as bras, but about treatments) it plants a seed of doubt which is NOT what we need at this time of our lives.

sweetandspecial · February 2014

My PS has no problem with me going braless for anything except workouts and running stuff. I only where one to bed if I forget to take it off after work and then forget to take it off before bed Smile . My implants are supported at the bottom by my pecs. I know this because 1) my PS released a bit more muscle under lefty at exchange so it would drop a bit to match righty and 2) when I flex my pecs I can feel the muscle with my hand both at the bottom of the implant as well as a bit below it.

Everyone's muscle structure, mass and layout is slightly different though. That may explain why some need the alloderm or stratice slings underneath for support and some don't?

littlecalico · February 2014

Hello girls!

I'm back :-) Thank you so much for your thoughtful answers and inspirational sentences regarding my dilemma. As it turns out, my PS and the medical team who are taking care of me have decided not to do the contralateral mastectomy before my 30th birthday (in a bit more than 3 years): they feel that the decision of "self-amputation" it too harsh, too heavy on my 26-year-old shoulders. Basically they've been saying all along that I was the one who had to decide (because there was no gene alteration, there was no scientific ground for the PMX), and in the end they told me they decided they would not do it before my 30th.

At first when my PS told me he was going to reconstruct me in early April but not do the PMX because of this collective medical discussion over my case, the first thing I felt was relief: finally, I didn't have to do this choice on my own: they made it for me by not considering it advisable before my 30th birthday. Their argument is: women with a gene alteration are not candidates for the prophylaxy before their 30th birthday (in France I guess?) so I should not be. That said, my PS said that in the end, he thought that surgeons were also there to bring comfort and stop anxiety from eating up their patients, and that if I really really insisted on the PMX now and if I couldn't wait, then he would be the first to support me.

So far I've not discussed it further. Since April is not far now, it looks like my reconstructive surgery is going to be about the right breast, and that the discussion about the healthy breast is postponed.

As I have said, I felt relieved...and now I'm starting to think I might do it anyway when I'm 30. Which is not in such a long time. I'm not sure how I feel about:

- keeping sensation for 3 extra years

- waiting

I feel like I'd want to have a little faith in life again. I feel like 3 extra years of sexual sensation in the breast is no luxury for my age. And I also know that the risk of getting cancer in the healthy breast increases with time, starting from a very low stat per anuum (0;7% chance per year), which is the reverse of the stats of recurrence in the breast that was ill (high chances in the couple of years to come, decreasing risk after). So I guess I'm getting what the doctors' sense of priority is all about (avoiding recurrence, not avoiding new, improbable cancer)

I just wonder what it will feel like: adjusting to a new physical body image now, and then change that again in 3 years' time.
I hear what they're saying about the stress I've been through with my disease at my age, and that it's good to take things one step at a time. The "non-violent" process of waiting a few more years to decide makes sense. I just hope that I won't feel "unfinished" when reconstruction of the breast starts in April and ends in the following months.

To answer your questions: Smaarty: yes I have had (and I continue to have) appointments with psychotherapists. It helps me greatly.

Stix: yes, I would/will?? have a nipple sparing mastectomy of the healthy breast.

Tina: good to read you :-) And thank you again for your kind and helpful thoughts. I am not a candidate for DIEP as I have no fat that can be used. I do not wish to use my back muscle either. So it will be implants for me. I say implants in the plural because even though the prophylactic is postponed, the contralateral breast will get an implant in April to match the new reconstructed - and slightly augmented breast -

Friendships; thank you so much for your thoughtful answer, and for taking the time to share your story with me. It has helped me immensly.

This is where I am at: getting ready for a reconstruction which, as it turns out, is not programmed to be bilateral. Feeling happy to be reconstructed, unsure what to feel regarding the other breast: relief, yes I felt it. Scared? I'm less and less scared of my healthy breast, getting more used to it, rediscovering sensation of an organ I could not even bare to touch for the last months, because the fear of finding a lump again gave me cold sweats. Today I'm more aware of my risk of recurrence in the same breast...which makes me switch perspectives as to where the risks really are and how to deal with the following years.

I don't have anything specific to ask yet, but if my story strikes a cord in you, if you think there is something you'd like to say, please, I'll be happy to get, again, your good advice and support.

:-) There, I wrote a whole novel again. :-o

littlecalico · February 2014

As to the difference between doctors, don't even get me started on this! I think the most confusing is seeing doctors advising some chemically-based vitamine D supplements and, when you ask, discovering that they, for themselves, take the natural-based version of it. Hello, coherence!!

whippetmom · February 2014

Mommyathome: You will likely need around 700 ccs, minimally, in a smooth, round silicone implant - Style 20 in Allergan. You also might be a candidate for Style 45, 800 ccs. Mention these sizes to your PS.

Mommyathome · February 2014

Whippetmom,

What is the difference between the two of those? Is one a better choice over the other to look like a natural breast? I plan to do nipple tattooing at the end of all this, can that be done with either of these? Are they both round? What are the benefits/disadvantages of round implants?

whippetmom · February 2014

The Style 45 has more projection. The Style 20 would have a more natural appearance. Depends on what you hope to achieve with reconstruction. No disadvantages to round implants. Benefit of round implants over anatomically shaped implants is that there is no risk of them rotating in the pockets.

Mommyathome · February 2014

Thank you. I am hoping to ask the plastic surgeon to see pictures of others who've had this done to be able to visually see how they each look. This is not something that has to be decided until I'm at the end of the fills right? Or do we need to have this discussion now and know which implant we will use at the exchange. She guesstimated that my exchange would be in about 6 months; is that typical?

Mommyathome · February 2014

Whippettmom,

I also have 2 "divots" on the left side where the cancer was. One near my arm pit but in a little and the other where my nipple would be. How will that fill it to look natural, round and smooth? Right now it actually looks like it was stitched, bit it wasn't....

Melissa_M · February 2014

Thanks Whippetmom for your suggestion! I am a couple fills away from the final fill. My plastic surgeon said he will stop filling me at 400 cc if I want 450cc implant, 450 cc if I want 500 implant etc. He says the expanders themselves cover 70 cc. I am currently at 300 cc and look like a full A cup/small B. I wonder if there will be a dramatic difference when I hit 400 cc. Before my surgery, I was an A cup so anything bigger will be nice. I just pray everything goes well. Thanks again for your help and advice! Can't wait for the exchange surgery hopefully sometime in late April.

Enerva · February 2014

Sandra hope you are feeling better.

i will PM you

sandra4611 · February 2014

Whippetmom,

This one's for you.

aviva5675 · February 2014

whippet good!!!

janhart · February 2014

Picture says it all....perfect! Love it!

babs6287 · February 2014

too funny!

Babs

AZ85048 · February 2014

VERY nice, Sandra! ThumbsUp

Estel · February 2014

Galsal - Marena bras are good bras to wear post-surgery. The link is here:

http://www.makemeheal.com/mmh/product/compression_…

Here is a link to some others that some of us have worn:

http://www.walmart.com/ip/16898012?wmlspartner=wlp...

http://www.sears.com/hanes-zip-front-sports-bra/p-...

Jmd222 · February 2014

Hi, I had my exchange on 12/10/2014. I do not know what size my TE were before the exchange. I do know my old bras bathing suits etc. were to small. Before my Mastectomy's I was a 32 D. I feel like I was a small C when I stopped expansion. We decided to go just a little bigger to try and get a full C. My PS used Mentor Ultra high profile 590cc implants. I am huge!! Much bigger than before. I hated being a D and hate being a DD even more. I am 5'5 and weigh 118 pounds my measurement around the rib age is 31. Last week The PS said this is pretty much what it's going to be ( I was praying he would say I still had a ton more swelling to go down). I guess my question is does that sound like a reasonable implant for someone my size? Maybe I just need to vent to someone else other than my husband. I have been threatening for the last 9 years after my son was born that I was going to get a reduction ( didn't want to do it this way) now I end up even bigger.

Galsal · February 2014

Thanks Dawne and others too!

AZ85048 · February 2014

Jmd222 - Hi and welcome! That does seem large for a girl your size, but whippetmom is the expert around here. She'll be along soon... she's really smart and helpful! Nerdy Good luck to you!

whippetmom · February 2014

Thank you Sandra! And how true!

whippetmom · February 2014

Jmd222: That is the largest Mentor ultra full projection style implant. I don't know why he used that style. Did you discuss sizing prior to the exchange? One of the benefits of his using that style, is that it will be much easier to downsize you to a high profile style implant, because the Mentor Ultra is so narrow. That might not make much sense to your at this point, but in my book, it is the best case scenario if one needs to go to a smaller implant. But you will need to wait at least two months for the revision/reexchange. So you would need a Mentor HP 450 ccs or an Allergan Style 20, 475 ccs.

Deborah

Enerva · February 2014

Hi, whippetmom, so we can have a revision in two months? i ll see my new PS this Feb23, exactly 2 months past my exchange , i hope he is able to fix my problem. things didnt improve in this 2 months. i am glad i saw this info.

Jmd222 · February 2014

Thank you, Whippetmom for the reply. I did discuss sizing and the 450 was what we originally had planned. I called the office to ask them if I could go a little bigger than what I was with the expanders. (I was under the impression the 450 would give me the same size as the expander). I was told they would check and call me back. I didn't hear back for awhile so I called them back. The woman that does the ordering responded with " I told him". I told her that I was expecting someone to call me back to discuss it because I wanted to be clear on what size I wanted. I was told again that he knew. On my visit last week he said we could do an exchange. After many discussions with my husband we settled on waiting until fall to see how I feel. In the meantime I have reconstruction scheduled for the nipple and some fat transfer to fill in the top of the breast a little. Wondering if I should wait? Will that make things more difficult in the fall if I go for the exchange?

Thanks for listening,

JJMD

Anonymous · February 2014

JJMD,

My first exchange resulted in a much larger look than I was comfortable with. I waited 8 months before deciding to revise to smaller. My revision was in October. I am very happy that I did it, but it was such a hard decision. I wanted to be DONE and did not want more surgery. I also delayed my nipple recon til all was healed from the revision. I wanted to be very sure that the nipples would end up in the right place. It was hard to delay that next step...but I just got my nipples last week and having them level and even and in the right spot made it worth the extra 4 months.

Best wishes to you!!!!

DiveCat · February 2014

Yikes, I am sorry Jmd222! I am similar in size to you (5'4", 115-118 lbs, 29.5" ribcage) with natural 32DD's. No way do I want to be any bigger than I am (and have discussed being a little smaller with my PS). I can understand why you are upset, especially as now it seems like something that could have been avoided if that pre-surgery discussion had happened as you wanted!

I would recommend delaying the nipple reconstruction until you are happy with the size (either with what you have now, or with an exchange), as you want to make sure that you have proper placement. Going smaller after reconstruction might result in your nipples being where you don't want them to be.

BREAST IMPLANT SIZING 101

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