BREAST IMPLANT SIZING 101

whippetmom · July 2015

cpn70

Yikes! I am so sorry! My email notification was inadvertently turned off for a day. You are not too large. My question for you is: are you happy with your size now? I agree with your PS, but I would suggest only a high profile or extra full profile. I think you might be unhappy with the projection of a MPP implant. In a Mentor HP, 700 ccs or 750 ccs, and in an ultra full projection, 800 ccs.

Your ribcage circumference is measured with the measuring taunder the tissue expanders. Could you verify this measurement for me?

mysunshine48 · July 2015

Dddd

wildmountains · July 2015

Hi Whippetmom –

Thank you so much for getting back to me. I have met with my PS this week and we did my final fill bringing me to full 800 cc in each breast.

To answer some of your questions: Are you happy with your size now?Yes, I really liked the size I had with my expanders filled to 720 cc, before the final fill. I definitely would not mind a little more. I am shooting for a very full C. Right now being at 800 cc they are big and wide and uncomfortable ( and into my armpits more on rt side then left) but I know it is only temporary so keeping mind realistic and know that I will be losing some projection.

My PS said no MPP for me since it will not be enough. So he is thinking Mentor High Profile for me. He also told me that he will moving my rt breast pocket in toward my sternum to make them more even and then adding some stitching on rt side by armpit to minimze any side boob from happening. Since he only uses Mentor , he said he typically brings in 3 diff implants into surgery( 700cc, 750cc and 800 cc) to see which one will look the best. I told him to please focus on 750 cc or 800 cc since I am worried that I will too small with 700, since I know how I looked in 720 cc.I will definitely ask him about Ultra High Profile in the 800 cc as well, thanks!

We also talked about FG and PS said only it is was necessary since he thinks that I will have enough skin along with the high profile for upper pole fullness. If I need it after they settle then it will be done at next reconstruction along with nipple.

You had asked me to re-mesure my ribcage, I put my bra strap size in error. Sorry about that. I re-measured and I have a 34" circumference.

Thank you again for all your help, your time and your valuable insight!

Christi

cheddiecat · July 2015

Hi Whippetmom!

I'm new to all this, but see that you've been at this for a while, and would appreciate your guidance and experience. Here's the required info:

1) 5'3", variable weight (unfortunately) between 150-160#, 33-1/2" ribcage

2) TEs are Mentor CPX4 Tall Height, 14.6 cm diameter, 750mL. They feel uncomfortably wide and poke out into my arms!

3) No mention of manufacturer preference (but would it HAVE to be Mentor?)

4) Previously wore 38C bra

Originally wanted to be same size as before but perkier and PS expected to fill TEs to 700-750 ccs to allow for good projection (currently at 400 and still look sort of flat). However, at this point in my life (60 yrs) I would like to get serious about losing more weight and reduce to 135# and wonder how that would impact sizing since my body would shrink but implants would not and then clothes would not fit. Years ago, at 135#, I wore a size 34C bra. Should I shoot for something in between? Or wouldn't it matter? Thanks!

MinusTwo · July 2015

cheddiecat - interesting. After reading BCO for a bunch of years, you're one of the few who has considered our age & how that affects what weight we might like to be as we continue to age. I had implants when I had just turned 67 & was around 165 lbs. They were a bit bigger than I wanted but sure wasn't going to start over. Forward 1-1/2 years and a recurrence, I had serious diarrhea with chemo that caused me to loose 60 lbs. You can imagine how the implants looked at 106 lbs if they were big at 165 lbs. I've gained much of the weight back but trying to stay no more than 145. If I had to consider implants now, I would go several sizes smaller for sure.

whippetmom · July 2015

Sounds good Christi! Keep me posted!

whippetmom · July 2015

cheddiecat

No, your Mentor tissue expanders will easily translate to Allergan or Sientra. The primary reason some plastic surgeons exclusively use one manufacturer another, is that they have developed a relationship with the breast implant sales representative. 😱

Yes, if you are 5 foot three and weigh 135 pounds you probably would be fine with implants in the 600 cc to 700 cc range. I personally think that this would be an incentive for you to lose the weight. Every 10 pounds you lose, the implants will appear larger on the chest wall. I don't know why you would need to fill all the way to 750 ccs, if the implants are going to be considerably smaller. It is better to go smaller, because it is easier to go to larger implants later, than it would be to downsize. I would recommend Mentor high-profile 650 ccs or Allergan Natrelle Inspira, 695 gms. These are all smooth, silicone round implants. I am afraid that anatomical implants, which are dictated by the dimensions of the tissue expander, would be too tall and appear too flat on your chest wall. I personally find that sometimes tend to look quite oval in appearance, especially on petite gals.

Let me know what you feel about the size at 600 ccs. Talk to your PS at your next appointment about your desires to lose weight and to go with smaller implants. Discuss with him the fact that you do not want the pockets to be too large and query whether underfilling will ensure a nice snug fit with allowance for good skin closure over the implant. Some plastic surgeons are under the impression that if we are 60 years old, we must want a lot of "maternal droop" and so we need to let them know that we want them nice and perky.

sas-schatzi · July 2015

Hi Deb, just a drop in hello and hugs.sassy

SummerAngel · July 2015

Thanks, Whippetmom! It's good to know that the expanders are part of the reason for the flattening. I'm ok with that for this part of the process, actually, because my lower pole area has been pretty angry about the expansions and my ribs hurt!

loriekg · July 2015

Hi Whippetmom! I am so excited to get your suggestions!

I am 5'-2", 120 pounds, and ribcage circumference is 30.5" and I am 51 years old. I have Mentor Siltex medium height contour profile tissue expanders (reference #354-8211) which are currently filled at 300cc.

I asked my PS nurse and she said they usually use Mentor implants. I was happy to hear on the picture forum that my PS was one of the two you had recommended in the Dallas/Fort Worth area. (I'm seeing Dr Heistein.)

Pre-surgery my size was 36C although I was not symmetrical, my left breast being smaller and not filling out the c-cup.

I am one of the rare ladies that actually likes their tissue expanders! If only I could lay on my stomach with these things…I'd be good to go! I think now, at 300cc's, I like the way they look, size and projection wise. I don't want to get much larger if I can avoid ptosis –maybe that's not the word. (I don't want the droop that I had before!) After having these TE's I'd rather go with a firmer implant, not so concerned with squishiness.

My skin is quite thin, so I am concerned about the rippling I hear about. What type implant would you recommend and how much more do you think I should fill to keep the size and projection I have now?

Thank you so much for all you do! --Lorie

Mersk · July 2015

My PS suggested shaped anatomicals for me but I am concerned about them being too firm and keeping the tear drop shape even when I am lying down. My PS said that is a common complaint with the Allergan ones but the Sientras are not as firm and a bit more natural feeling. Any thoughts/experience on Sientras being less firm? Thanks

farmerjo · July 2015

Mersk - I have the Sientra anatomicals and do not like them! They are way too firm for me. When you press in, they don't spring back like a normal breast.

LoriWNY · July 2015

Mersk--I currently have Allergan 410 FF silicone anatomical implants and previously had Mentor Cohesive I Memory Gel (silicone) moderate plus profile smooth round implants. I would say that my 410's are only slightly more firm than my Mentor implants were. Both types of implants would spring back when I pressed in on them--however, I think this really depends on the thickness of skin left after the mastectomy.

whippetmom · July 2015

Lorie:

The longed for sleeping on your stomach days are over. Trust me, it causes cleavage wrinkling, is bad for your face, and bad for your back. Also, you can displace your implants, as I did, after a year of face-planting nightly after the exchange. So I no longer sleep on my stomach. It will take a year to get used to back and side sleeping. For you; Mentor Memory shape 345 ccs, medium height, high profile or Mentor smooth silicone rounds, preferably 400 ccs, if you like the way you look at 300 ccs. Doubt you would need to fill further, but talk about these sizes with Dr. Heistein.

wildmountains · July 2015

Whippetmom –

One last question for you. I really liked the shape/size I was getting in the 720 cc TE and I would not mind a little more. So will the 750cc Mentor High Profile Smooth Round OR will the 800 cc Mentor Ultra High Profile Smooth bring me the closest to that size or larger?

My PS only talked about the Mentor High Profile. I do not want to end up with a small C.

Thanks so much for all of your feedback, information and suggestions. They are all greatly appreciated!!

Thank you!!

Christi

harusis · July 2015

Hi Whippetmom,

I would love to have some advice on implant size & style.

I am 5'4", 100 lbs.
Ribcage measures 29 inches.
I had bilateral nipple / skin sparing mastectomy on 5/20/2015 and now have Mentor CPX4 with suture tabs tall height, reference #3549312 (volume 350cc).
I am now filled to 150 cc's.
Before surgery I was 32A.
My PS works with Mentor and Allergen, Sientra.

Thank you so much….

whippetmom · July 2015

Christi: These sizes would be fine. With the HP style, you have more width but less projection. You can see that with the HP, there really is not much difference between 750 ccs and 800 ccs. With the ultras, you have a slightly less width and more projection. I would ask your PS to bring in these three sizes and see what gives you the best appearance

Your TEs: 14.6 cm wide and 7.6 cm projection

Mentor HP:

750 ccs: 15.1 cm wide and 5.9 cm projection

800 ccs: 15.5 cm wide and 6.0 cm projection

Mentor Ultra HP

800 ccs: 14.1 cm wide and 6.7 cm projection

whippetmom · July 2015

harusis: Thank you for providing the dimensions of your TEs for me! I pretty much know Allergan TEs by heart, but it is because the widths are all even numbers.

So.....

Anatomicals: Mentor Memory Shape: 345 ccs - Medium Height High Profile: 11.5 x 10.8 x 5.8 ...or

Allergan 410 - 325 gms 12.0 x 11.1 x 5.7

Smooth silicone rounds: Mentor or Allergan: 350 ccs or 375 ccs (depending on how you feel about the size when expanded to 350 ccs) Sientra: 355 ccs. Allergan Natrelle: 290 gms if a HP and 370 gms if an ultra HP.

Sientra textured shape round base: 320 ccs

An important factor to consider, is which implant will render the best result and allow the nipples to end up in the proper location on the mound. So as you expand, it will become clear to your PS which style of implant and what volume in that style will be best for you.

You did not state your desires for an end result though. If you wish to remain an A cup, this all needs to be revised.

Deborah

wildmountains · July 2015

Whippetmom –

Ok great, thanks so much !! Will definitely let my PS know that these 3 choices to in with and I trust that he will pick the best one for me. He knows what size I am shooting for. Feeling more relaxed, prepared and excited for my exchange surgery now.

Thanks for all your help !!

Cpn70 - Christi

harusis · July 2015

Thank you so much!! Whippetmom

I feel very lucky to have you and this forum to help me through this difficult time.
Many thanks.

Badgergirl · July 2015

Help please ;-)

My exchange surgery has been scheduled for next Wednesday, and while I was settled with the decision to go with the Inspira (415 or 465) at 9 am, now at 10:00 pm, I'm second guessing myself all over the place. I could probably post this in exchange city too, but figured this might be a good place too. I was large before, a size E, and had ptosis. I was concerned about the anatomical for two reasons - first, rotation. I know it's a minimal risk, but I am very active and didn't want to worry. Second, because I had ptosis previously, I was worried about the slope at the upper pole. So we chose a round, but now I'm worried about a shelf. GAH! The PS is planning to do some fat grafting, but did caution there would not be much fat to grab (which I know, is a good problem to have...kind of).

Advice, comments, insight, suggestions are all welcomed! And thank you in advance - I'm grateful!

whippetmom · July 2015

Badgergirl

Send me photos. Private message them using the landscape icon next to the goggles icon in the task bar. I want to see why you think you will have a "shelf". If you were an E cup previously with ptosis, I highly doubt you will need to be concerned about a shelf

Badgergirl · July 2015

Whippetmom -

Pictures sent...thank you so much ;-)

katcar0001 · July 2015

Hi Whippetmom - I am going in for a tissue expander on my left side in less than 2 weeks. I did not have a skin sparing MX, and the skin is very tight, and I have an ugly scar that needs revision. The surgeon thinks he can expand me to 300cc but probably not much more. I am tall and long waisted but have a very tiny ribcage and no meat on me. I was probably a 34AA prior to all this and am now more like a 32AAA. He suggested the Mentor anatomical highly cohesive silicone implant for me and possibly an allograft for support. Any advice for me before I go in for the TE surgery? I don't have a clue about this process, and it seems like the more I read, the more confused I get.

Dogsneverlie · July 2015

Hello everyone! I have been gone for so long and I am catching up. Revision to fix the implant that moved up almost near my collar bone was done on June 24. He put the same size in because he was only replacing the one and not both. I feel and believe this is my fault for not being happy with my size. He said he did not dare go any larger due to the radiation damage and I have to move on and believe in him. I am disappointed but it is still better than it was. I am hoping this will be it and no further surgeries.

Now, time for me to read, read, read!!!!!!

whippetmom · July 2015

Katcar:

You know, a tissue expander around 300 ccs sounds like a good size range for you, based on your description of your anatomy, absent skin sparing, and current bra size. The key will be to sufficiently expand that tissue envelope in order to gain enough of a pocket for approximately a 250 cc/gm implant, give or take 25 ccs. You are a unilateral, and so the focus is using a tissue expander close to the width of your native breast, and the goal is to create an envelope sufficient to give you symmetry. I believe that a dermal matrix, such as AlloDerm, would be a good plan, if possible.

whippetmom · July 2015

Dogs...it all sounds good and I am glad that you are moving on. Fat graft transfer is always a viable option for that radiated breast down the road. Please keep in touch

katcar0001 · July 2015

Whippetmom--I am grateful to have received your reply just prior to turning in for the night. I have been worrying this subject to the point that it's interfering with my sleep, so maybe I'll get a decent night's sleep. You have confirmed that the doctor knows what he's doing based on my physique ;-). And yes, he is planning to use allograft. And this is in line with some suggestions from SpecialK A big hearty Thank You!

cheddiecat · July 2015

Whippetmom: Thanks for your response and advice. Just now checking the site and original post is on p.437 for ref. The reason fills were originally estimated to 750 cc is that discussion with PS occurred prior to my inspiration to lose weight and it was what he believed would get me to approx. same size as I was. Am up to 500 ccs with fills and still have some saggy skin that hasn't moved up and around the TEs, which I assume is what's going to happen with it. Not pretty. And I seem to remember leaning toward the anatomical implants.

Now, based on your input, have more questions . . . it was my understanding that the rounds didn't provide as much projection (~C cup) as the gummies. Is that true? And would rounds result in a "shelf" requiring fat grafting (which I would not object to since there's plenty of donor material!). Have been reading some on the Exchange City site and the fact that the gummies essentially don't move and people say are a bit "harder" than rounds is also making me rethink. Really want to learn as much as I can because this is a semi-permanent decision and would like to get it right the first time and be happy with the results.

Thanks again!

mazy123 · July 2015

Hi Whippetmom,

I would love to have your suggestions. I think it is amazing that you do this for everyone. Can't believe how much you know!

I had bilateral mastectomy on May 21st and had tissue expanders put in at that time.

Tissue expanders are Natrelle 133sx-14 (500cc capacity)

I am 5'8" and weigh 160 lbs. My pre surgery breast size was 36A. My ribcage is 33 inches. My previous breasts were a little saggy due to breastfeeding three children, but were still relatively small breasts.

I finished my fills today at 550ccs. I am happy with fullness and size seems to be right. A little bigger than before which is what I wanted, but still pretty natural looking (as natural as TE can ever be) On my surgery report it looks like they took about 420 grams of tissue from both breasts.

My exchange date is set for August 20th. My surgeon seems to think the anatomicals are the right solution for me. I think he uses the 410s. I think my skin is fairly thin and that I don't have much of the tissue expander going past the fold. Don't know if he thinks rounds would sit too high up on my chest. Maybe.

My concerns with the 410s are probably like everyone else's concerns-firmness, rotation risk

My previous breasts were pretty firm because they were so dense so maybe it wouldn't be as noticeable for me.

Open to your suggestions and very appreciative.

Thanks,

Mary

BREAST IMPLANT SIZING 101

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