BREAST IMPLANT SIZING 101

Eee3 · June 2015

whippetmom: thank you so much for your input. Do you think that I need another fill before I do my exchange. I was thinking that I am still in a b cup status. I also don't feel like they project very much. They seem very wide and flat to me. Which implant do you think would offer the most projection? I would also like it to still look as natural as possible. Wow, I guess I want it all now. Thoughts?

whippetmom · June 2015

Eee3: Why did you stop filling? If you are not having TE troubles and your skin integrity is good, continue with fills. You should be fine now, if you stop, with Style 20, 500 ccs. You would want to continue with fills, perhaps, for the Inspira. Have no idea about anatomicals....you might not need much more, because your dimensions are likely close enough to those of the 410s. Your PS is the one who should know how much more is needed for any specific implant

whippetmom · June 2015

Mersk:
Based on your height, weight and ribcage dimensions, 12.7 cm does not seem wide at all. Do you want to send me photots? You could probably go to 425 ccs in a Mentor high profile smooth round, which is a bit narrower. The pockets need to be secured laterally, so that they do not continue to migrate in that direction

whippetmom · June 2015

badgergirl: If Memoryshape, definitely the higher volume mentioned. Personally I would prefer the Allergan Inspira, SRX or SSX, 415 gms.

http://www.bizjournals.com/losangeles/news/2015/02/27/fda-approves-allergans-natrelle-inspira-implants.html

Badgergirl · June 2015

Thank you Whippetmom!

Mersk · June 2015

I am probably overly conscious because these TEs are so much bigger than I was previously. I am still a couple of months away from my exchange surgery. I'll let you know how discussions with the PS go. Thank you so much

patriciahurtado · June 2015

Lady's surgery is over!!! My hubby said the gummies description is 620cc I was wondering is that a lot? I see them small? He did fat graphing from my stomach and thighs I'm don't have fat from my thighs where did get it from. But I'm happy I want see them but I can't. My ladies what should I expect? They don't look big like the expanders. What is 620cc in our world?

Eee3 · July 2015

thank you for all the information. I have an appointment next week to have another fill. I just misunderstood and wasn't sure if I needed more.

I will keep you posted on How things go!

greenae · July 2015

hi Whippetmom

I am having a left Recon with implant and a right reduction/ lift. I currently have an Allergan TE 133 MV 15, filled to 600cc

I am 5'6", 155 lbs and a 34G on the right, 700g of tissue was removed from left breast during mx.

I asked to "downsize" to C-D

My PS plans to use an Allergan silicone round implant.

Trying to figure out how he will size, especially since reduction/lift occurring at same time. Do you have an idea of implant for me?

Thank you for your help!

Arlene

whippetmom · July 2015

greenae:

Depends on amount of available skin. Even with the reduction/lift, you will have ptosis (droop) which needs to be replicated as best as possible by the choice of an implant on the MX side. A Natrelle Inspira might be a good choice - SSF or SRF 675 gms. The size and choice of style/profile all depends on what is achieved with your native breast. If you need more upper pole fullness on the MX side, a Sientra smooth round might be a good choice. I just think with your prior breast size and what might be remaining in terms of your skin envelope, anatomicals might be too risky - too much risk of rotation.

greenae · July 2015

thank you, Whippet

Prettysure my PS is using aN Allergan Natrelle round. He already nixed the highly cohesive and anatomical. I seem to have plenty of skin and ptosis.ugh. So worried about how he will achieve symmetry. I look pretty scary right now. Would posting a pic help? I am just wondering if I should be suggesting anything to him?

Thanks so much!

Arlene

whippetmom · July 2015

greenae: Then it could possiblybe Allergan Style 15, 575 ccs or 616 ccs, or Style 20, 750 ccs to 800 ccs.

greenae · July 2015

thank you, whippet!!

BoxerM · July 2015

Hello, I am new to the Forum, and hope you can help me. I have been trying to figure out what size implant will achieve my desired goal.

I had nipple/skin sparring BMX 4/20/15. Mentor med height 450cc TE's, currently filled to 400cc. I am 58 yrs old, 5ft 2in, 129 lbs, and 31in around my ribcage.

Before sx, I was a 34A and would like to be a full B. With my current fill, it appears to be the size I want, but would prefer more projection. I understand implants tend to have less projection than TE's. Is it posssible to get more projection without getting more fullness?

I am considering anatomicals, and my PS agrees (hear from his staff that he prefers anatomicals with his breast recon. pts). I want a more natural look.

I was originally thinking of mod. profile anatomicals (PS prefers Mentor), but note that projection is much less than TE. Even the high profile projections of similar sizes are still less. Is my TE at this fill (400cc) already at max. projection? I am afraid of looking too full if I go with high profile. Also, does the implant tend to get squashed under the muscle, even though pocket created?

I would greatly appreciate your suggestions. I go back next week for possibly another and last fill. I know anatomicals need to fit pocket to prevent rotation, which I am concerned with.

whippetmom · July 2015

The best Mentor anatomical (and Mentor's anatomicals have dimensions that never come close to those of the tissue expanders) would be 495 ccs in a moderate height full projection style. Anything with less projection and it is going to be quite flat. If you are going for projection, instead ask for Mentor's smooth silicone round 590 ccs. Dimensions of your TEs. 12.7 width and 7.0 cm projection. Dimensions of the Mentor round ultra: 12.5 cm width and 6.3 cm projection. You will need to fill to 450 ccs... There is no way to get projection without fullness. Otherwise, they would be torpedos.

farmerjo · July 2015

"Torpedos"...LOL Whippetmom! That's exactly what my husband told me he wants! Shocked

krikbrand · July 2015

Hi! I am new to this site and looking for some advice. I am a 44 yo and had bilateral nipple/skin sparing mastectomies in June for DCIS of the right breast. No radiation/chemo. I currently have tissue expanders in place and feel they look very wide and kind of flat (a little matronly looking Winking ). They were kind of wide (14cm width each) preop and a little droopy but I was hoping with reconstruction they would look a little rounder and more youthful. Is there still hope? Can the implants look different from the tissue expanders? I don't want really large breasts and would like them perkier vs bigger and wider. Because they were wider previously, does that mean that is all they can do now? I was previously a large C/small D cup (wore a 36C vs 34D) and would like to be more of a B/C cup.

I am 5'4", weigh 132lbs, ribcage measures 32 inches.

This is the information I have from my surgery:

GRAFT/IMPLANT INFORMATION:

Catalog/Model #: 133MX-13-T, Implant Name: natrelle-expander mod tab 500cc, Manufacturer: Allergan, Inc., Implant

This is what was removed:

"right breast mastectomy nipple sparing" is 295 gram, 17.0 (M-L) x 3.4 (A-P) x 16.0 (S-I) cm

"left breast mastectomy nipple sparing" is 315 gram, 17.3 (M-L) x 3.5 (A-P) x 19.5 (S-I) cm

This was the preop description:

Breasts: Bilateral breasts, mild ptosis. Breast width is 14 cm bilaterally. Nipple to notch distance is 22.5 cm bilaterally.

This is the current fill:
Implant type: Allergan 133 MX-13-T - Current cc: Right breast: 500 cc.

CC instilled today: Right breast: 140 cc of air removed (filled with air during surgery), saline amount added today 170. Total cc: Right breast: 170 cc. (Left breast is the same)

(I think this means that there is only 170cc of saline in an implant that holds 500cc but they are already plenty big (and wide).

No idea what the PS uses for implants although he showed me a round silicone one in the office. I am currently seeing a PA for fills and post-op visits and won't see the plastic surgeon again until closer to the surgery but I have all of these questions. (Also if I can get rounder/fuller implants, should I have the expanders expanded more than current - I can tell them when to stop and I feel they are full enough already.)

Thanks for any help you can provide.

whippetmom · July 2015

krickbrand:

Your TEs are only 13.0 cm wide. Not too wide at all. Ofttimes they appear wide when they are underfilled, and then appear more proportioned as fills continue. I would recommend Allergan Style 20, 500 ccs, or Allergan Style 15, 371 or 397 ccs. Style 20 has more projection than Style 15. They will give you that round, full appearance. I would suggest that youcontinue with fills. The width will not change with fills. You will gain more projection and that additional expansion is needed for good skin closure over the implant.

BoxerM · July 2015

Thanks for your advice. My concern with round implants is that it may give too much upper pole fullness, which will not look as natural (especially since I was a small A to begin with). Also, I have a hollow spot one one side below my collar bone and just above my breast. My PS thinks the anatomical may help fill it out. Do you agree with that? It seems the anatomical may still sit below that hollow spot.

Another question I have is since implants are softer than TE's, will they tend to get flattened out under the muscle, and lose even more projection?

krikbrand · July 2015

Thank you so much for your response! A couple more questions. If I have them fill them more and they are larger than I want, is that a problem for when they put in the implant? What happens to the extra skin? Also they used alloderm with the surgery, would that be adding to the look of width? Does that remain with the implants or is the alloderm only used with the expanders? Also to clarify, I want rounder breasts then current but not the kind that look like they are obvious and just stuck on. Would your recommendation be the same? I really appreciate your advice. thank you

BoxerM · July 2015

Hi kirkbrand!

My TE's are almost the same width as yours (mine are Mentor, 12.7 cm), but I'm sl. Smaller than you on top. My TE's do not look too wide, so yours should be ok.

You do get fuller with each fill, and a lot rounder. You still only have a sm. amount of fill; that's why they don't seem too full. I am currently at 400cc with a 450 cc TE, and I am pretty full;but I want a more natural look and don't care too much for upper pole fullness, so I was considering anatomicals. It seems it's hard to get better projection w/o getting too much fullness.

Alloderm is used to form the bottom pocket where the TE and eventually the implant will sit. It is attached to the lower border of the pec's muscle (which forms the upper pocket), and is permanent. I don't think it adds to the width; it is also used to form the lower lateral border of the pocket though.

krikbrand · July 2015

Thank you, BoxerM. I feel like they already seem big so am kind ofafraid to add more but I guess it can't hurt to do another till and see how that changes things.

whippetmom · July 2015

BoxerM: You do lose projection to some extent, but it depends on the style and volume of the implant in relation to your TEs. The anatomical in Mentor, for you, would be, as I mentioned, 495 ccs, moderate height, full projection. I do not see you losing too much in terms of projection, but it all depends on the individual body type, how implants appear on the chest wall and there can be so many variables. This is why I would hope your PS would ALSO bring silicone rouunds into the OR, to see what looks best.

MsVeryDenseBreasts · July 2015

Hi there. Advice needed. Looking at PMBX options. I'm 5'6", 105 lbs and 28 inches around the rib cage under the bra line. I had been a 34C but have lost some upper fullness as menopause approaches. Would like to remain same size and if possible restore the upper fullness a bit. I have a breast surgeon but not a PS yet so I don't have a preference that's been dictated to me. I'd be very interested in your recommendation for the best restored natural look for my size before I meet with a PS so I have some frame of reference. My natural breast are more of a teardrop shape, which I'd like to retain if at all possible. Thanks much. So appreciative you are here.

Falconmarks · July 2015

Hello Whippetmom

I am new here. I got my double Mast 5/13 with TEs put in with first fill of 250 cc. I was given a little card that have the information on it so I hope I am giving the right stuff to you. The TEs are MENTOR breast implant size : 350cc-420cc. This is what it says on the card but I am tight filled right now at 430ccs.

My bra size before surgery was 38 C. I am 5'7" tall 130 pounds. I would like to keep my large breast size but if this is as big as I can go with these TEs then fine with me because I'm done with the pain anyway. My rib cage measurement that the PS did was 36". I think I heard my dr say he likes using the Mentor but I am not 100% sure. I would like to get some projection but not obnoxious, it seems like the TEs are pretty flat and go under my arm and spread out like pancakes even though they are fitting in a bra now, sorta, lol

Thank you for ANY help or suggestions you may have, I am overwhelmed.

FalconMarks - Teri

Stix · July 2015

Has anyone started a new job and went on a leave of absence before the 12 month federal guidelines. I may have a job offer coming up and I know I have to have another surgery.

What are your experiences.

SpecialK · July 2015

stix - FMLA provides job protection, so if you go out prior to eligibility I don't think your employer is bound by law to hold your position. Would your medical insurance be through this employer? If so, without FMLA they are also not required to continue your employer sponsored health insurance.

raleighgirl · July 2015

hi whippetmom!

I had allergen 133fv-11 300cc TEs placed two weeks ago. I am 5'5 and 105lbs, 31" rib cage. I just want to be the same size I was before surgery(or actually before kids) which was a 32b. The ps filled them to 120ccs during surgery. What volume do you think I need to be a 32b and what would be a good size silicone implant? I had mentioned to the ps I want to look as natural as possible, and he recommended a tear drop shape.

Stix · July 2015

Hi SpecialK.

Yes, I know the federal law. But, I was curious if anyone actually did go on a leave b4 the year and what their experience was? It will be at a big corporation that i would work. Waiting to hear back after my interview...

marketingmama · July 2015

Stix,

I went out on leave prior to my one year anniversary (I was about 5-6 months in) and was covered by short term disability. I took 6 weeks. My employer was very supportive and I didn't have to worry about job security. I think this sort of thing depends very much on the type of company in which you work, the actual job you do and the sensitivity of management around health issues. I am fortunate in that my employer is very focused on employee well being; however, it really seems heartless to imagine that any firm or manager wouldn't hold your job, especially if you have experience and expertise that are difficult or time consuming to replace.

Best of luck...

BREAST IMPLANT SIZING 101

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