BREAST IMPLANT SIZING 101

Leslienva · November 2015

Has anyone had the Inspira implants?

trailrose · November 2015

Leslienva,

I had Inspira implants put in for my revision surgery and love the look.

Frill · November 2015

Hi, everyone. I am so happy I found this thread. I'm so worried about making the wrong decision. I've looked at so many pictures, read about so many women being unhappy with their reconstruction afterwards. My "girls" are the only thing I like about myself, and now one has to go. I decided I should probably go BMX because there would never be a good match for the first one. I thought implants would be the way to go. PS said I was a great candidate and I could go larger if I wanted. I asked her if I should ask other questions and she said no, now I see there are a BILLION questions for her to answer the day before freaking surgery.

I can't remember if the surgeon (aka Lucy Lawless) said I had to have radiation if I had MX or if it depended on MRI results. Would that I would have taken the advice given and recorded the conversation. My sister went with me and all she said was, "I thought they did that to everyone." Thanks.

Surgeon (not PS) talked about fat grafting from my stomach, but I believe that was with lumpectomy. (I'm a huge help) She talked about the tissue expanders for sure though.

So for the deets. I'm 46. The girls don't know it. My mom, at 69, still had the same boobs all her life. I wear a 36C (professionally sized). I'm 5'8 1/2" from the frequent hospital visits. I weigh 192, a very heavy weight for me, about 40 pounds about normal, although with the sort of cancer diet - back to normal diet - OMG freaking out I have cancer diet, I've dropped 5. I just checked my under boob measurement - 36".

Help.......I'm usually the calm advice giver and I'm just a nut case. Well, until someone comes home. Then I put the mask back on.

TallnTerrific · November 2015

Whippet mom, I completed my bilateral surgery this week and had tissue expanders put in. My PS was going to fill them to 400-500 during surgery, but when he got in there he discovered very deep and broad pectoral muscles. He decided to only fill 250, but will higher if I like. He said the heavier musculature will cause pain in stretching but that he could go bigger. Do you recommend waiting until swelling and bruising has subsided to make that choice? They are kind of odd shaped and high in a way that looks a little abnormal. How does a person decide?

Leslienva · November 2015

I had my surgery on Thursday. It got delayed several hours due to a backup in the OR and I didn't get out of the recovery room until 7:30 pm. My surgeon had left by then so I'm not even sure which implants I got! I guess I'll find out on Monday when I go in to get my bandages changed. Meanwhile, I have a drain on the left (radiated side), which is really painful, but no pain on the right side.

whippetmom · November 2015

Frill:

You are a hoot! I am sure you will do just fine. It sounds as though tissue expanders and then implants are the recommendation. I think you will be in the 700 cc range with implants. It depends on your weight fluxuation though, since 40 pounds can make a difference, as the implants do not change as you gain or lose weight. I think you need to talk to your PS well before the surgery date, to see what size tissue expanders she plans to use. The day prior to surgery might be too late to make changes.

whippetmom · November 2015

Tallnterrific: Wait two weeks between fills and yes, I think you should continue with fills, as tolerated

KSChadd · November 2015

Hello,

I just have a general question about swelling after swapping out implants, went a bit taller and more full. He went through a different incision site than before so it's more painful than I was anticipating but I am glad we didn't add more scar tissue on the old incision site which already pulls my nips to the outside.

So my question about swelling it just about how much for how long, also about compression bras...I didn't wear one last time but this time I am supposed to wear it until my follow up next week and it's Very tight and Very uncomfortable. I went from MX to FX with Natrelle Style 410, 550ccs to 770ccs.

Thanks!

Katie

whippetmom · November 2015

Katie

Call your plastic surgeon tomorrow and ask if youn could wear a sports bra, instead of the compression bra. Duration of post-op swelling after surgery is somewhat subjective and always depends on the type of revision work that was done as well as swapping out the implants,. Coupled with our own individual response to the healing process. However, one week to 10 days is about the standard.

Frill · November 2015

Thanks, whippetmom! I'm a chimom! I vascillate between it will be ok, and frankenboobs. I've been writing down questions, though, that's helpful , staying proactive is good.

If I'm skinny, my big boobs will just look better and bigger, won't they?! Cancer already stole my secret second wish career as a titty dancer, at least I could have the boobs for it. Tee hee!

KSChadd · November 2015

Thanks, I did and he said a sports bra is just fine, whew!

So much more comfy, hopefully the rest of the swelling go down soon and the rest of the tenderness will be good as well.

:-)

whippetmom · November 2015

FRILL: A 500 cc tissue expander would be the minimum size for you...

pch · November 2015

Whippetmom, hello! I'm so happy you exist!

I just had a bilateral mastectomy with TEs and a 250cc fill last week.

I'm 5' 2", 110-115 weight range (happy around 111/112), and was a 36C/34D depending on the bra pre-op. I have hated having such big breasts for my height all my life, but was very proportionate (36-27/8-36). I even like my tissue expanders better than my previous hourglass shape. (Sad, I know.) That said, I haven't the vaguest idea what to do next. I'd like enough projection to balance my hips/belly straight on and in silhouette, but I only want to go as big as necessary to look balanced. On the plus side, looking straight at me, I'm very broad shouldered and have a wide ribcage (+/-30") for my height. (I'm like a box with a waist.) I will find out the brand of TEs I have at my PS appointment today, but am looking for advice on how big to go fill-wise and the type of implant that would give me a nice natural anatomically normal breast with good cleavage (I've always had flat sort of crap cleavage due to kind of saggy boobs). What are my dream implants?

I'm so grateful for this thread.

pch

rozzy62 · November 2015

whippet mom, we are all so fortunate that you are so knowledgeable and so generous. I am nervous about depending on my ps to determine the size of the implants. I am concerned he will "oversize" me. Currently, I have TE, and I would much rather err on the side of "small" implants. I am a shade under 5'1" and about 109 lbs. Athletic body, exercise a lot, but kind of "straight", not curvy, always had small breasts, 34 A/smallB. Broad shoulders. Ribcage is 30-31-ish inches. Girls got bigger after menopause. I just turned 66, was dx with ILC and had a bilateral mx end of September. Am Stage 2A, no nodes, and because of oncoscore, will not have chemo. TEs are Allergan133 MX-0-T. SN left is 20456208 and 20510689 right. Filled at surgery with 150 ml saline. Two expansions of 100 ccs each have been done post-op. So, total of 350 ccs. I think this is enough. Ps is ok with tissue and does not feel that there is any "skin redundancy". (who knew that term?) Left looks larger to me than right, at this point, but I know that will be adjusted. (left was "affected" side) and right side was done prophylactically. Today I discussed with ps the type and size of implant. We have settled on silicone. We talked about Natrelle as being a good choice. Any assistance from you is very much appreciated.

reallywow · November 2015

Hi everyone -- Hoping to get some of your insights and recommendations on implant size. In answer to the questions above:

1. I'm 5ft. 1in, 135 lbs with a 31in. ribcage circumference. I'm almost 49 and have started going through 'the change' so my weight has been fluctuating. aaargh... fortunately tamoxifen hasn't really been hitting me with any side effects including weight gain, but I'd like to get back down to 115 at least.

2. I have the Natrelle 133SV-14 tissue expanders 'installed'. These are short, variable projection. I have the 375cc size.

3. I am not sure if my PS uses one type of implant exclusively, but during the pre-op consult he brought along with him the Natrelle 410 anatomical and I believe the Natrelle round silicone. I want to go silicone.

4. I used to wear anything from a 34C to a 36B, but I would like to be a full C.

My concern is that there will not be enough projection for a full C as the final size. I had a skin sparing bilateral mastectomy, but I also have an area above my left breast, where the cancer was, that looks and feels hollowed out because the breast surgeon was probably more aggressive with removing breast tissue there than the other side which was prophylactic. My PS assured me that they would fix that, probably with lipo and a fat injection.

My question is, what implant will work for me considering the TE that was placed? Do I have any hope of a C? He said there was no problem overfilling the expander. Right now I'm only on my 2nd fill and up to 410cc. I feel a little sore but my skin doesn't feel tight or stretched, so I could probably do a couple more. The original surgery I was filled to 270cc then 80cc then 60cc. I'm really not into the man pecs with side boob thing I have going on. I would like to project FORWARD instead of SIDEWAYS.

Leslienva · November 2015

I had my implant exchange last week. I was at 460 ccs on both sides with my tissue expanders, but my implants are 360 ccs. Is it normal to be so much smaller than I expected? I had some trouble with my radiated side earlier on, but it was doing fine with the tissue expander at 460. I see her again tomorrow to get the drain removed and will ask questions then, but I'm guessing she erred on the side of being careful. Still, it's disappointing...

katcar0001 · November 2015

Hi Whippetmom,

I had my exchange surgery yesterday and went with the Motiva 300cc round on the left and smaller one on my native side (forget the size). Motiva is a gorgeous, state-of-the-art implant. It will be approved by the FDA soon. I am so fortunate it was available to me in Mexico. I did the research and selected it over Mentor rounds. I am so happy with my choice. My only regret is that I would have liked a little bit bigger, but my surgeon had to do significant scar revision, and my skin was already stretched to the max at 295cc. I also must say that I have had the most excellent surgeons and care in Mexico--just the most compassionate, talented, well-trained, experienced and approachable PEOPLE. I have zero regrets about having my recon done here instead of the states, as my insurance covered me either way.

Cheers and thank you for sharing your wealth of knowledge!

~Kat

harusis · November 2015

Hello Everyone,

Just wanted to give you a brief update as to where things are at with me.

I had my expander exchange surgery on 11/17/2015, the implants that doctor used were

325cc MemoryGel® Breast Implants Smooth Round Moderate Plus by Mentor.

The exchange surgery is much easier than a mastectomy, and I'm very happy with my final result.

I am 5'4", 100 lbs.
Ribcage measures 29 inches.

I had Bilateral Nipple Sparing Mastectomies and Bilateral Sentinel Lymph Nodes
Breast Reconstruction-Breast Expander (Mentor CPX4 with suture tabs tall height, reference #3549312 (volume 350cc)) with Alloderm on 05/20/2015.

During the surgery I had 50cc in the expander, and had 1st 50cc fill on 06/24/ 2015

2nd 50cc fill on 07/15/2015, 3rd 50cc fill on 08/05/2015, Final 50cc fill on 8/26/2015.

Thanks again to "whippetmom" for creating this thread.

Best wishes to you all....

whippetmom · November 2015

Haitang: Going a bit larger and wider should not be a problem. I would not go narrower than the tissue expander

whippetmom · November 2015

pch: Tell me about your tissue expanders when you get that information

whippetmom · November 2015

rozzy62: I think there may be a typo here. "TEs are Allergan133 MX-0-T" Something else should come after the MX, such as a number: 11, 12, 13, for example, or a volume, like 250, 300, 400. Please recheck

whippetmom · November 2015

reallywow: With your style of tissue expander, you can exchange to a quite larger implant - I would suggest even Allergan Natrelle Inspira, SRX or SSX - a high profile smooth round implant, 570 gms. Otherwise, the always reliable Allergan Style 20, 600 ccs. I think that the style of anatomical - short height - which corresponds to your TEs, might be somewhat low profile to your liking.

whippetmom · November 2015

reallywow:.....also want to add that the SV and SX styles of TEs can tend to look somewhat shelf-like, and often migrate laterally. They are good TEs though....and your PS can correct any defects with fat graft transfer, as he mentioned.

whippetmom · November 2015

Kat, I am so encouraged to hear about your positive results and enthusiasm about the Motiva implants. I do look forward to fda approval here in the States. How interesting that your insurance company approved your having surgery either here or in Mexico. That is the first I have heard of this. But congratulations! Keep us posted on your end results!

whippetmom · November 2015

harusis: Thank you for sharing your good results. Implants are not a one size fits all venture and the moderate plus implant often renders great results for certain body types. You are tiny and the width gave you a bit more of a natural shape and gave you a little more width than your tissue expandres. So glad it all worked out

reallywow · November 2015

Thank you, whippetmom! I truly appreciate your input and I'm glad to hear that I have some options. When you say the anatomical implants that correspond with my TE's are you talking about the Natrelle 410s?

I'm happy with shape of the underside of my breast with the TE's but they just look so flat 'straight on' and don't project enough with clothing on. I hope the implants will fix this. If I do 570-600cc implants does that mean I will need to be expanded to even larger than that?

I'm sure this is a question for my PS, but say they do lipo on my abdomen for the fat injection for breast pole fullness, do they do a 'complete' liposuction on the abdomen or just take what they need?

You're so generous with your time and are truly kind for addressing our individual concerns over the years. Have a wonderful weekend!

whippetmom · November 2015

reallywow:

Yes, Allergan 410s. Fat graft transfer for breast reconstruction typically dictates taking a small amount of fat. However, some women have made arrangements with their plastic surgeons to perform more aggressive a liposuction procedure, paying out of pocket for an arranged, discounted sum of money. Not sure how plausible this is now with health coverage changes.

katykids · November 2015

really wow:

I just had this with my exchange and PS took 100cc from my stomach. I didn't notice any difference in my stomach. Two spots--one from my belly button and the other just riight in a stretch mark. I had a dissolvable stitch and steri strip.

Asante314 · November 2015

hi new to this thread. I am currently scheduled for bmx after the new year. Reading this thread has been very informative but has raised the question of how much I should have detailed with my PS before my first surgery. Plan is BMX to TE w later exchange. The first PS I met with but didn't like immediately jumped to naming the brand of implant he used. The new PS asked me what size I want to be and then we disc I hadn't given it much thought, as I had been small chested and now post nursing ptotic unless wearing my current favorite bra. 36B with lift. He said I will likely be a C after because he needs to increase the upper pole to balance the ptosis. BS mentioned she may do a small incision above the NAC to help the ptosis as well.

I am happy with this PS. Great reputation. Nice bedside manner and has worked and trained together with my BS. Additionally I know a few women who are very happy with this pair of docs.

Should I meet with PS again before the first procedure, or is this implant choice something we figure out later.

Thank you for all your thoughtful advice and time on this thread Interactions and feedback from so many is so helpful

Frill · November 2015

My surgery didn't happen as planned, full deets are in the November surgery thread, but short story, the only thing that got done was MX (sort of) and sentinel node removed. There was this whole BP went through the floor thing, became undetectable, so they stopped.

I'm posting because I think my PS has a gross overestimate of my breast size, lol. Maybe she's talking to me like my breasts are the size I am in my bra - a VS Bombsell bra! So we're talking about surgery, what type of implants, what size, TE, fills, etc. I ask how much bigger I can be than what I am now (I'm thinking my actual size). She says she can't go that much larger than what I am now. I'm thinking....why? I'm going down my list of questions and finally I get to the money question. "Okay, then. How many cc's are you willing to go?" (Feeling like I'm at settlement negotiations - Is she going to go low? Should I bid high?) "700." BAZINGA!!!!!! She says, "That's the first time I've seen you smile today." "You said the number I have written down right here." (The number whippetmom said, so it's got to be good.) Then I ask to see some sample implants.

PS: These are natural shaped implants. [Holds up some something or others.]

PS: These are more traditional, less natural implants, that have a more augmented look.

Me: I WANT THOSE!!!!!!!!! What size are those?

PS: [Making notes] Those aren't quite your size, they're 650 cc's.

Me: [Holding implant up to chest and mouthing to DBF] I'll be HUGE!

DBF: [Rolling eyes]

Lol, hopefully someone got a laugh out of this. I just try to find the light in this when I can.

BREAST IMPLANT SIZING 101

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