Tissue Expander to FInal Implant Questions

Hi, Frances,

I had a bilat mastectomy in June also and just had my exchange surgery 3 weeks ago (3 weeks ago tomorrow, actually). 

I am / was exactly the same size as you.  I was also a small A before the mastectomy.  And, I too had tissue expanders that were ultimately filled to 350 cc on one side & 320 cc on the other side.  My right side requires a nipple reconstruction b/c cancer was found in that nipple so it was taken off.  The PS uses skin for that reconstruction, which is why that one was filled more.

I know that my skin was stretched extraordinarily tight.  My PS actually showed me by turning off the overhead lights and shining a light through the skin, and it was practically transarent.  Anyway, he said that was definitely a sign that we were done with the filling.  Honestly, particularly at that time, at 350 cc, it was really bigger than the size I wanted anyway, but I knew he was overfilling the one side for the nipple reconstruction.

Ultimately, I told him I wanted to be about a Size B. I actually also told him I liked the size at about 320 cc.  Ultimately, I ended up with 300 cc implants.  I would have liked them to be maybe a little bit bigger than they are, but other days, I think if they were too big, I would need new clothes in some outfits, so all in all, I am good with it.  I know in my case, he placed several different sizes in during the surgery and his PA and the BS (who was there for the nipple removal) gave their input as well, based on the size I expressed to them I wanted to be and how they looked.  As he said, how they look is very dependent on the person's frame.  B/c I have a very small frame, the size he implanted look like very solid to large B on me, but would look small on others.

I know whipplemom on this site will also help you with trying to determine the best implant size for the look you are trying to achieve.

Good luck with the exchange!  It is a cake walk compared to the BMX. I was at home the same night and out and about the next day with absolutely no pain at all.

Amy

I too have little body fat...more now than before surgery unfortantely, but I digress.. My TEs were only 275cc and filled to 350cc.  My surgeon thought that was enough for my skin.  He had mentioned 370cc for exchange, I liked how my TEs looked and he said my implants would be close but a little smaller.  But in surgery he actually ended up using a 425cc Sientra Shaped implant.  I guess after he tried the others he decided he had some room so tried the bigger ones and the general consensus was the 425cc looked better. I too was an A on a good day before surger and now a C and sometimes a D depending on the bra.  But I look like a small C in clothes.  I think the implants look pretty close to the projection of my TEs...but look  and feel much better!

Are you wanting to go bigger than your TEs?  To get the projection close to your TEs your implant should be about 75-100cc bigger than your TE.  Since the implants are soft compared to the TEs the PS can usually go up at least 75cc bigger than your TE.  Now if you have had radiation this might not be true..I didn't have radiation so I don't know much about that.  Except the skin loses elasticity.

I wonder sometimes how women are filled to 800 cc's do it?  Does the muscle really stretch that much?  

Anyway...good luck and check out Breast Implants sizing 101..Whippetmom will know what you should be getting from  or asking your surgeon

well, my only suggestion is if you like the projection of your TEs and would like to be the same size after the exchange, to make sure your PS knows that.  ( from what I understand profile is the height of the implant, how high up the chest wall it goes and projection is how far it projects out.)   He will need to go up in CCs if you like where you are.  My 425cc look a lot like my TEs at 350ccs.  The implants are soft so they conform more to your chest wall than the hard TEs. I too had a side that was always tighter.  If you have 350cc expanders and get 350cc implants you will notice the difference in size.   

You can just post on the Breast Implant Sizing 101 thread and Whippetmom will get back to you with suggestions.  She is really good and knows her stuff.  Just start your post with her screen name.  She will need to know your height, weight, and TEs model and your measurement of rib cage under your TEs.  If you give her all that she will let you know what would be the best implants for your size  and shape.  

In the beginning of the thread there is a plethora of information on implants, if you haven't already checked it out, head over there and read through it all.  Lots of information.  Good luck! 

Ladies - I can't stress enough how helpful it has been to have our own "Implant Guru" as a member here on BCO. Her name is whippetmom, and the thread you want to visit is Breast Implant Sizing 101. Here's the link:

https://community.breastcancer.org/forum/44/topic/746448?page=405#post_4204319

Truthfully, sizing implants is both a science and an art. Using your former cup size, or deciding you want to become a certain cup size, kind of goes out the window with breast reconstruction. 

For the first time, your sizing will be determined by SO many factors. Please be sure to read the ENTIRE heading at the top of whippetmom's thread.... and then send her all the information she requests. 

The majority of us have received the exact same implants, in the exact same amount of ccs as she recommended.

For others, it was a good starting point for asking your PS the right questions. 

yea Frances, I see you posted to Whippetmom, good..she will lead you in the right direction.