BREAST IMPLANT SIZING 101

whippetmom,

Thank you for all of that information.

I told PS before he started that I am pleased with the volume, but would like more projection. I also want the implants away from my armpits. Left TE feels that it has moved towards my armpit and sit ticks out a little bit from the side. When I move my left arm, I feel I'm brushing against my breast. It is also poking me in the middle of my breast. PS said he could see it just a little bit, and it would be corrected at exchange. He also had the nurse take pictures of my breasts from the sides.

He said all of that (volume, projection, armpit) is good to know. I'm under the impression that we'll talk more before exchange.

He said he always overfills from the desired volume so that the pocket will be big enough. Today was my first fill since surgery. He added 60 ml, so now I'm at 480.

The nurse showed me Natrelle anatomicals at the end of the visit. I don't know what the size is, or what are his preferences and options. I have so many more questions for next visit.

Thank you for all your help

Hi Whippetmom,

You are amazing, your fame and selflessness in advising people extends to Australia! I'd love some advice as I am desperate to maintain my pre-mastectomy cup size after exchange. I am having a prophylactic bmx after BRCA1 mutation identified (unfortunately I have had radiation for a small cancer in 2013. I know this will make things more difficult, I'm not sure if this makes a difference to what size implant I should have - if it is a tighter pec muscle, I might need a bigger implant as it will squash it back towards the rib...?)

I'm 5 feet 4 inches, 138 pounds, 30 inches around ribcage.

I will have Sientra 450 medium height TEs

I am a 34D cup before bmx

I was told that I'd probably need to have the TEs expanded to 600 and that would be my size and then overexpanded by 100 more to help with some hang/fold. I'm just not sure this is going to be enough to get the size and projection I have as a 34D.

He uses Sientra implants with silicon. I've said I would like round as it seems to be the teardrop shape have even less projection.

Any advice would be really appreciated.

Best,

Sarahss

mshel, yes, that does sound correct.

If you don't have expanders then your Dr is probably doing a direct to implant procedure. This is where you have the mastectomy and insertion of the implant (with strattise or alloderm sling ) in the same procedure. I had this procedure done about 10 weeks ago but it doesn't seem the norm for some Dr's to do as they need to be skilled in microsurgery. I think that in the US it seems that women usually have the 2 step procedure surgery which involves an expander, to stretch the skin and muscle, then a second operation to facilitate the exchange to implant. Women will generally need 2 Dr's for this, a Plastic surgeon and a Breast surgeon.

I was able to have the direct to implant because I didn't really want a major increase in my bust. Generally speaking the DTI is used if you have either a/ a small bust or b/don't want much of an increase if at all.

When you see your Dr next then clarify whether they are using expanders or direct to implant, the Dr can also give you information on the type of implant they will use and the size of the implants they will take into surgery with them. Most surgeons take in more than a couple of implants and use surgical sizers to decide what size best suit the goal you want. My surgeon took in 300cc, 325cc, 350cc and 400cc implants into theatre with her and I ended up with 325cc implants.

Hi Whippetmom,

Wow that was really fast. OK, so I found out that yes, they are Silimed!

Best,

Sarahss

Hi, Whippetmom-I've been reading along for about a week, and finally decided to post. I just found out today that my exchange will be on Jan. 19. This is much earlier than I had thought, but I know it has to do with the glitches I've had with the TE's. Here's the lowdown: I completed 4 rounds of chemo on Oct. 26 and had BMX with TE's on Dec. 1. The TE's are Natrelle 133 MV-11-T and 250cc. was written below that on the info sheet. The PS filled each with 200cc during surgery. About 10 days later, I had my first fill of 100cc. each, and by the time I got home I was in excruciating pain. Turns out the fill only stayed in the top pole because the TE's are "too tight" on the bottom. So at the moment, I look like I have upside-down boobs! The PS said he can fix all this during the exchange to implants.

I am in my late 60's, 61" tall, and weigh 115 lbs. My rib cage circumference is 30". Before surgery, I was roughly a 36/38C. I had been a 38D the year before, but I lost about 15 pounds. On the path report, I believe one breast was 285g. and the other 318. My PS seems to prefer Natrelle products, and he is leaning towards anatomical ("gummy bear") implants and once mentioned he thought that 400cc would look good on me. Also, does the fact that I worked out pre-diagnosis and have "strong" pecs impact the final decision? I was told by the PA that it probably impacted the fill.

My pre-op appointment with the PS is this Friday, 1/8. I know I won't hear from you by then, but whatever info you can give me as to appropriate implants would be helpful. I would like to be roughly the same size as before, or maybe between a c and D. I can always have another appointment.

Thanks for all you do,

edtherapist

Hello again, Whippetmom,

My information is about 18 and 20 posts above on this page 450.

I was able to get most of my questions answered at my PS appointment yesterday.

My implants will be Allergen 410 series silicone form stable ("gummi") anatomical implants. They have texture to adhere. PS mentioned MX high projection or full projection. I don't know what the size will be. I was happy with my fill volume of 420, and at 480 my breasts look just a little too big to me. In terms of width, I told my PS that my TE's feel too wide to me and are bothering me in the armpits. I am a flutist and I need full ROM for my arms. The nurse told me he orders a few sizes and brings them to the OR.

With all that, what size(s) implants do you recommend. You had mentioned the Allergan 410 LX, 625 gms would be too flat. Are we looking at Allergan 410 MX or Allergan 410 FX? My exchange is scheduled for 1/18/16.

Thank you for your help.

Are Mentor or Allergan implants best for reconstruction? Having a hard time deciding between the round or anatomical. I do want projection but do not want high sitting big round look! Any suggestions?

Thanks, Whippetmom, for your guidance and suggestions. Met with the PS today, and he also thought the Allergan style 20 round would be the probable implant. He is thinking between 425 and 475 cc. What he does during surgery is try a round, then an anatomical. Then he decides which shape works best. He brings 4 sizes of each type. He does fat grafting if necessary. Too bad I'll be asleep during all this and won't be part of the actual decision making. Surgery is 1/19, and I'll let you know how it goes.

I had my skin sparing BMX in August of last year and have been steadily losing weight before my reconstruction starts. I have been given the green light to begin and have a surgery date of Feb 3 to place my expanders. I'm 5'8" and currently 195 lbs (I only see myself loosing another 20-30 pounds after reconstruction if possible) My ribcage is 39.5". I have a large, muscular frame and broad shoulders. Prior to BMX I was 65 pounds heavier and I was about a 42DD. After 6 months of being flat (and I don't wear my prosthesis much) I really don't want to go back to my original size or anywhere close. I just want some shape back. My pre-op appointment is on Jan 22 and I'm figuring this is when we will talk about more specifics. Up to this point we've only talked about my weight and different surgery options. Anyway - I'm hoping to have better understanding of what we will be talking about and what my options are by my pre-op. I don't know what kind of implants or expanders my surgeon uses but I have a feeling from the posters on the walls that they lean towards Mentor. Just a hunch. I don't know if this helps but I have two sets of prosthesis. They aren't the same brand but one is a size 7 and the other is a size 4. When I wear them, I tend to wear the 4's. Any help or advice would be appreciated. Thank you!