BREAST IMPLANT SIZING 101

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  • Dnice
    Dnice Member Posts: 158
    edited April 2015

    Hi dogsneverlie. I just read your post and thought I would see if you have looked into Brava and AFT. I Have been researching and consulting for a year. I decided to save that for the future if my revision surgery isn't ok. I had a capsulorraphy and larger implants put in to correct rippling 4 weeks ago. I had a great deal of radiation for a different Cancer when I was in my 20's. It seems to make reconstruction a bit of a challenge. BUT things are changing. Stem cell FG seems to significantly improve rad damage for some patients. Just thought you may want to know that. There's a great bit of info from other women on fatgraftpatients.com. that opted to try Brava and microfatgrafting. I'm waiting for my swelling to go away before I can assess where I'm at. Whatever you decide is right for you, I wish you luck. I'm still hopeful that I can end up feeling confident in my appearance with all the new techniques that are available. Many others have had success stories. Wishing you all good things.

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  • Dogsneverlie
    Dogsneverlie Member Posts: 278
    edited April 2015

    Thank you Dnice!  I would really like FG to the radiated breast - originally that is all I wanted but the PS examined me and said I needed so much tissue he recommended implants first to try and equal out the volume.  I need to be patient, I know....I want to give myself several months before I do anything else just to see what I look like.

    I know what you mean - I just want to feel good about myself.  I feel MUCH better in a bra so I am happy about that but man.....it still looks like the bottom half of my breast was cut off  :(

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited April 2015

    jojo:

    Your PS used a pretty large TE for your frame, although I like the benefits of the SX style TE. It is a short height tissue expander and does not expand the upper pole, thereby also not putting undo stress upon the pectoral musculature. However, from there is the strange twist to the plan your PS had for anatomicals. He used the opposite extreme in style, and used a full height implant. The dimensions are quite a bit off. He might have allowed for the underfilling dimensions, but the height of the TE is probably too much for the pocket.

    Here are the dimensions of your TEs:

    15.0 cm wide, 13.0 cm height and 7.6 cm projection.

    Your implants:

    14.0 cm width 14.5 cm height and 5.8 cm projection

    The anatomical that would have more closely corresponded with your underfilled 650 cc TE, would be:

    Allergan LX: 515 gms

    14.5 cm wide, 12.2 cm height and 6.7 cm projection.

    I am wondering if the one implant which has intruded laterally has rotated. I would definitely seek a second opinion.

    Incidentally, your implants are NOT larger than your TEs. You cannot go by the fill level, because your TEs have a volume of 650 gms, and they have the "footprint" of that size of TE. It is the style of anatomical which is causing this distortion. Again, another PS should be able to help you further. I would recommend smooth silicone rounds, or the new Allergan Inspira implants. Your pockets are too stretched now for smaller anatomicals and too much pocket work would need to be done.

    Let us know what you learn when you have that second opinion

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited April 2015

    Additionally jojo.....Most of us have implants larger than the recommended volume of our TEs. For instance, my TEs had a volume of 400 ccs and I was filled to 400 ccs. My implants have a volume of 550 ccs. It is a matter of dimensions.....

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited April 2015

    Dogsneverlie: Fat graft transfer can change it all for you. I am pretty ticked that you cannot get it approved. That is crazy.....it must be the type of insurance you have in NH....and I would think seriously about traveling to Boston and seeing if you could get it approved. It is all in how the request for approval is submitted by the plastic surgeon. Fat grafting is a piece of cake to obtain approval forin many areas of the U.S.

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  • jojo9999
    jojo9999 Member Posts: 202
    edited April 2015

    Whippetmom, I think I am beginning to understand. Did you mean to say that the Implants were too tall for the pocket since I had short TE's (from above: "...but the height of the TE is probably too much for the pocket.")? This is all great information, and also explains my discomfort.

    I also want to understand the play between dimensions and the appearance. The model/size that you suggest has a bigger projection, but will it make me look larger? That is, would the model that you suggest project 0.9 cm further out than what I have now? I guess it all depends on the 3 dimensions put together.

    On my first consult with PS I told him that if anything good were to come of my cancer I could now have the small breasts I always wanted. I know cup sizes are not very exact, but I proceed to tell him that I would like to be a B cup (I was a 36D). Should this preference of mine figured into his selection of a TE size, or do medical standards dictate that the TE size depend on my physical measurements? (He took no measurements of me, although he might have done so during surgery. I feel like he eyeballed everything).

    I have the photos ready to send to you - sent a PM to you to verify email. Being overly cautious about not sending them to the wrong place!

    Thank you

    jojo

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited April 2015

    dogs - you were unable to have fat grafting previously due to insurance denial when you were trying to correct lumpectomy defects, correct?  Now that you have had implant(s) placed fat grafting becomes a revision, so your insurance may now cover it.  I would think it is still wise to wait a bit, as you will most likely experience a change in how things look over a period of time.

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  • Stix
    Stix Member Posts: 723
    edited April 2015

    how are things going special K?

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited April 2015

    No change as of yet, but I have a consult with a new PS next Friday.

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  • Dnice
    Dnice Member Posts: 158
    edited April 2015

    dogsneverlie- If you need the name of a PS in Boston, you can PM me on here. I've had all my surgeries performed there. I live in CT. Not sure how far away you are from Boston. It has definitely been worth the commute for me.

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited April 2015

    jojo: Yes, implants too tall for the pocket created by the TEs. Your skin flaps might have come into play here as well, since you had ample flaps with your pre-BMX breast size. You have to do something with all of that skin....either excise it away or fill it up with implant. I think that you would be a better candidate for a round implant. Once I see your photos, I will tell you which ones might work.

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  • mysunshine48
    mysunshine48 Member Posts: 1,480
    edited April 2015

    Jilly 59,

    I am trying to decide about expanders or direct to implant.....by tomorrow! I meet with my PL tomorrow and my BMX is Friday. I am leaning toward expanders. Are expanders different sizes? What questions do I need to ask tomorrow?

    You say you are smaller that you wanted. What size direct to implant - implants (that sounds funny) did you have? Did you tell your PL what size you wanted beforehand?

    This is all toooooo scary!

    Lynn

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited April 2015

    mysunshine - read the expander info in the header of this thread - it has some suggestions for things to ask your plastic surgeon.  Expanders are different sizes (height, width and volume), shapes and manufacturers.  Your surgeon should decide which expander to use based on your size/measurements, etc. The reason some have indicated that their implants look smaller than expanders is that the expander has a firm back and stretches outward and projects more as saline is added during fills - that is the purpose of it so that a pocket is created for the implant.  The implant is soft all over so some lose projection since there is not a hard back to the implant, although many notice more fullness the farther out they get from exchange surgery.  Since you already have implants from augmentation you should indicate your aesthetic wishes and ask your surgeon if he can place an implant directly that will give you the look you want - otherwise, you could go with expanders so that you get implants large enough to obtain the volume you added with your aug, plus what you lose with mastectomy.

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited April 2015

    Thank you Special K

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited April 2015

    whippetmom - I was hoping you were off enjoying Easter, so I was happy to help!

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  • farmerjo
    farmerjo Member Posts: 518
    edited April 2015

    MySunshine...sorry I did not see your post earlier. My Sientra anatomicals are 450's. I am 4' 11" and weigh 114. I appear to have a B cup. I have pics posted in the picture forum (under same name). Apparently the small size allows for direct-to-implant.

    I will check-in again later tonight!

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  • Chrisrenee77
    Chrisrenee77 Member Posts: 1,032
    edited April 2015

    I am 10 days away from my revision surgery and I can't wait. Now that I've had implants I know what to expect . The only thing I have to ask my PS is "will the new incisions affect my tattoos. Out of everything that could possibly go wrong, my tattoos are what I'm concerned a about. Lol

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  • Stix
    Stix Member Posts: 723
    edited April 2015

    you have already had the nipple tattoos?

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  • ZukiCat
    ZukiCat Member Posts: 23
    edited April 2015

    Hi again ladies,

    Hope you're all doing well! I has my last fill yesterday and have reached a whopping 230cc ( which is 30 more cc's than the TEs are supposed to hold)! I am so massive. Not. Regardless, my last two fills have been brutal and yesterday's was the smallest. But boy is it sore and uncomfortable! Anyway, while at my PS's office I was told I would be getting anatomical implants ( and not for at least another 4 months.....) and I asked for the biggest projection. Will this look a little less strange once the TEs are removed? Also, do the anaromicals take the same kind of time to settle and " fluff" as the rounds, since they seem to already be "settled"?

    Thanks for any replies!


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  • trailrose
    trailrose Member Posts: 219
    edited April 2015

    Zukicat- Did you tell your PS you are a runner and will the anatomical implants be the best for you?

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  • CaliRN
    CaliRN Member Posts: 54
    edited April 2015

    Hi Zukicat,

    Congrats on being done with fill those are the worst! I had the 410's put in last week and I do not think they drop and fluff Like the rounds but they do take awhile before they take their shape. My pectoral muscles have been clamping down on them making them look flat and square and the surrounding swelling has also distorted them. They definitely do not have the projection of the TE's. My PS went up almost 100 cc in size. I think I will be happy with them but it's still early. I also had fat grafting at the time of exchange. Good luck!

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  • Dogsneverlie
    Dogsneverlie Member Posts: 278
    edited April 2015

    Thank you Whippetmom!  I had another follow up with PS yesterday - he said the BC side, especially the areola is very swollen.  He wants me to continue with the band for another month and to start massaging underneath the BC breast while holding down the top to see if that will ease some of the hard tissue but I don't think it will.  I will certainly do that just in case it helps but it feels the same as it did before the reconstruction so I just think it is the damaged tissue.  Then I see him on June 30 and if it is still the same, I will bring up FG.

    I feel so much better though in my bras and bathing suit!  For me, there is a big difference!  Here is one Bali sport bra sample photo and one of the bathing suits.

    image

    image

    After                                                            Before


     

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  • Dogsneverlie
    Dogsneverlie Member Posts: 278
    edited April 2015

    Hi Dnice and thank you!  Yes, I did all of my surgeries at the Lahey Peabody and Burlington locations but I had radiation in Dover NH as it was a closer commute for me and I knew people there (the same RO who did treatment for my dad's brain cancer also treated me and luckily for me, my lovely adoring SIL works in oncology).  I am only an hour commute from Boston on a good traffic day!  After June 30 if the radiated tissue is not softer and my PS can't do the FG, I may need to look elsewhere in Boston!

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  • CaliRN
    CaliRN Member Posts: 54
    edited April 2015

    dogsneverlie...you look fantastic!

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  • CaliRN
    CaliRN Member Posts: 54
    edited April 2015


    not sure how I deleted my last post but Dogsneverlie you look fantastic!

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  • Chrisrenee77
    Chrisrenee77 Member Posts: 1,032
    edited April 2015

    Stix- yes I already have my tattoos I spoke with my PS today and he said that he will try his hardest to not mess either my nips or tattoos up.  He said he will have to make a big enough incision to get an 800 cc implant into both breasts.  Next Thursday is my big day and I'm nervous as hell.  Who would be nervous after 4 surgeries? Geez, I'm an old pro at this by now. 

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  • LoriWNY
    LoriWNY Member Posts: 193
    edited April 2015

    Dogs--you look great.  Congratulations on such a great result!

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited April 2015

    Yes Dogsneverlie....what a transformation! Very happy for you!

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  • ZukiCat
    ZukiCat Member Posts: 23
    edited April 2015

    dogs - you look fantastic

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  • ZukiCat
    ZukiCat Member Posts: 23
    edited April 2015

    hi Trailrose - I did mention to the nurse that I was a runner and that I was concerned about rotation. As well, my PS knows I am active. But I will bring all of this up at my next appointment in July, and if he can tell me it will not pose a problem then I am all for the more natural look. Thanks for reminding me of that!


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