BREAST IMPLANT SIZING 101

whippetmom · February 2016

grandma3X

You have a couple of options, if your plastic surgeon is using Mentor implants. Your tissue expanders have the following dimensions: 10.7 cm width, 9.3 cm height and 6.2 cm projection. If he used the Mentor Memoryshape anatomicals, I would recommend the medium height high-profile style, 345 ccs. The dimensions are: 11.5 cm width, 10.8 cm height and 5.8 cm projection. The other option would be Mentor Memory round implants, and I would recommend 430 ccs in a medium height Ultra high profile style, which has the following dimensions: 10.9 cm width and 5.6 cm projection. I also feel that the high profile style would be good - one of the most commonly utilized styles - at least 375 ccs: 12.0 cm width and 4.8 cm projection. It is all going to depend upon the expansion of both skin flaps… the availability of skin that the plastic surgeon has to adequately provide coverage over the implant. Since you are a long way from the exchange to implants, I would suggest that you come back here after your PMX, after expansion of that TE, and let's see where you are at that time.

whippetmom · February 2016

eulabt:

Good to hear from you!

Your plastic surgeon is talking about using the Allergan Inspira implants, which I think would be a very good choice for you. I agree wholeheartedly with his sizing plan and I think you will be happy with your results!

whippetmom · February 2016

SeattleBound:

I'm sorry that you had to wait so long for answers, however I am so glad Minus-Two and Phyllis jumped in to give you some reassurance. I envision that you probably will need to be approximately the same size as Phyllis is-around 450 ccs to 500 ccs. Please read #2 in the thread header above, as you did not provide all of the information I need to be a bit more accurate with my suggestions. As far as round implants are concerned, I think your PS has made the best choice for you.

whippetmom · February 2016

mdepaul:

The Artoura high-profile tissue expander (finally) has a better footprint for anatomicals than the predecessor. Your TEs are: 13.0 wide, 13.0 tall and 6.8 projection. The corresponding anatomical would be either a Memory Shape medium height high profile - 555 ccs: 13.5 cm wide, 12.7 cm height and 6.7 cm projection, or same style, 620 ccs:,14.0 cm width, 13.2 cm height and 6.9 cm projection. Providing that you have sufficient skin flaps, both sizes would likely mirror (or exceed) what you have currently with your tissue expanders. Your option for silicone rounds would be 650 ccs - 12.9 cm wide and 6.4 cm projection, medium height ultra full profile implant.

eulabt · February 2016

Thank you Whippetmom! You have done such a great job helping this community! I really appreciate it!

mdepaul · February 2016

Hi,

Thanks so much for your input. Those measurements for my tissue expanders, do you know if they are taken with the manufacturer recommended amount of saline 475cc in each or with being overexpanded? I now have 690cc on the right and 640cc on the left (at my appt yesterday the plastic surgeon was a little worried about this little hole in the incision on the left which seemed to lead to a small tunnel under the skin so he did not want to do a full 100cc expansion but interestingly the left side looked larger than the right anyway so now it looks symmetric which is odd, they only began to look uneven in the last few fills).

I am so hoping he can use the 620cc implant size you mentioned on both sides. I was assymetric before, actually, and only sort of noticed but not much, and it was different by about 40cc so having implants of two sizes would not be that bad I guess... But I don't want 550cc on the left and 620cc on the right. That seems like too much of a size difference right?

Anyway thanks again so much for your help. Scheduled the exchange for April 1.

MinusTwo · February 2016

We love our Whippetmom!!!!!!!

AZ85048 · February 2016

mdepaul - "But I don't want 550cc on the left and 620cc on the right. That seems like too much of a size difference right?" Not really.

As whippetmom herself will tell you, 70 ccs really isn't that big of a difference. I ended up with a 550 cc implant on the left and a 650 cc on the right - and they look way more like twins than the originals did! My PS said the difference in size was because of the shape of my chest wall. He used whatever it took to make them look even - and it worked! So I guess we're not all made symmetrically. (LOL!) Anyway, welcome to BCO! (And you're in excellent hands with Deborah - we don't call her "The Breast Whisperer" for nothing!)

SeattleBound · February 2016

Oops, I am sorry, I forgot about the measuring. I measured 33 1/2 - 34 around, below the expanders. No problem about any delay in responding. You have to have a life, too

whippetmom · February 2016

mdepaul

The overfilling really is not something I take into consideration, OTHER than that this is what your PS will do to enable use of an implant substantially larger than your TEs. The width does not change much at all, and the overfilling generally adds to height but mostly projection. You need good implant coverage....and I am concerned about the opening in your incision. It is absolutely not worth pushing the envelope for sizing when you are at risk for a complication. No more fills! AZ is right about chest wall configuration - and other anatomical reasons could lead to a variable in implant volume on one side vs the other.

whippetmom · February 2016

I have felt like that puppy the past month!

whippetmom · February 2016

SeattleBound:

#2....I need more information regarding your TEs. 133V is not enough info.

grandma3X · February 2016

Thank you, Whippetmom! I'll come back this fall as I get closer to my exchange.

mdepaul · February 2016

Thanks so much whippletmom I am done with fills now and will hope and pray that stupid hole in my incision does not grow (the skin around it is lax actually, so I don't think the opening is from over expanding) and does not get infected - yikes!

I sort of want to do my exchange sooner but have to block my work schedule and I had it blocked for April 4-8 anyway so I am using that week and getting surgery April 1.

Anyway thanks so much for your help!

SeattleBound · February 2016

OK. I will request that info from the PS's office today. Thank you very much. At my f/u appt with my breast surgeon yesterday, he confirmed what I expected - that the left expander has shifted toward my armpit, at least toward the top).🤔 I hope this has little bearing on the final result

SeattleBound · February 2016

Hi Again!

My expanders are: Natrelle 133MX-11, max fill 300cc. Currently, I have 240cc in the left; 180 in the right. I measure 33 1/2 - 34"

Thank you for bearing with me. I have been so worried during this process with a big hematoma on the right that is still resolving. I want to look natural, but go a bit bigger than my pre-mastectomy. I don't wear low cut clothing, so I am more concerned about having some projection in my clothing, versus a cleavage. With these expanders, can a tear drop, versus a round be used if that would better achieve the result I am wanting? If possible, do you have any idea why my PS would not have offered that option?

Again, Thank you sooo much. I think you are an amazing person to have helped so many of us for so long

SeattleBound · February 2016

Hello!

Do you have the model # for your Natrelle implants? I looked at several Natrelle charts and notice there are quite a few types that are 500ccs. Since we are about the same size, I am very interested inyour thoughts and opinions!!

SeattleBound · February 2016

Hi Phyllis,

Do you have a model # for your implants? I checked several Natrelle charts and a number of implants can be 500cc. Since we are of a similar size, I am especially interested in your thoughts and opinion!

whippetmom · February 2016

SeattleBound:

Phyllis has Allergan Style 45 implants.

Honestly "tear drop" implants do not look any different (to my eye) than silicone rounds. You might have too much skin elasticity and a skin envelope which would not be suited to anatomicals. I certainly would not be a candidate for anatomical/tear drop implants.

Your PS should be able to get you into a Style 45 with your MX style TEs. I would advise holding off on fills, and watching and not doing anything to further compromise the tissue surrounding the TE that you say has a hematoma. That is a concern.

Deborah

Anniekay80 · February 2016

Thank you again Whippetmom (the breast implant whisperer)! I've been "uncomfortable" and not really up to posting since my last visit/fill with my PS. I am currently at 250 cc in my TEs and my B cup bras fit great now when I tried one on......with the inframammary incision they told me no bras so I've worn loose soft camis since surgery (they never gave me anything to wear after surgery) and I never asked if I could start wearing a bra.....don't really want to unless it would be beneficial somehow. So, I finally got to discuss implants with him and he swears he showed me implants and we discussed them at my first appt. I didn't argue with him.....he is the one who will be holding a scalpel in the OR after all. LOL

Anyway I asked about anatomical tear drops and he laughed and said of course that's what we need to use on you because you have a narrow chest and skin below the nipples that needs to be filled out. He showed me 2 Mentor textured gummy bear implants. He talked about how my TEs are 12 cm or so and the implants with be 13 cm wide providing a tight fit. He said maybe a 495......not sure if that is cc's or style #, but I know he is thinking something around 450 cc or more. When I asked about the chance of implants rotating, he said it was nothing to worry about because he is meticulous with the pocket work making sure it's a firm fit so it doesn't move.

Right now his plan is 1 or 2 more fills then exchange in April or May. I am thrilled he and I are on the same page. Going in informed gave me the opportunity to ask the right questions. So, thank you again, whippetmom, for explaining everything to me that is taken into consideration when choosing implants. It is so much easier to ask intelligent questions when you have some understanding of the topic at hand. I asked him how long he waits after the final fill and he told me it is all dependant on my healing from original surgery......he says my healing so far is great and I could go for exchange soon after last fill.

Right now I constantly feel like a baby elephant is sitting on my chest.....these pecs don't like being stretched so much, but I still currently have a little loose skin to fill. They offered to go an extra week before next fill, but I don't want to delay the exchange and I can tolerate this baby elephant on my chest all day.

I don't know about anybody else, but for me waking up in the morning after side sleeping all night is excruciating! .....and I cannot sleep on my back. It feels like all my chest muscles tightened up overnight and a full grown elephant is sitting on my chest when I wake up and move even a tiny bit. The good thing is that pain goes away within a few minutes of being upright standing and moving around. I have made sure to take everyone's advice and faithfully do my arm stretches throughout the day and I have kept my full range of motion in my arms and shoulders.

Didn't mean to run on and on, but I write like I talk......a LOT! In my defense, these boards have become my main source of conversation and socialization for the past 2 1/2 months. My husband and kids are all working all day, my sister lives in Florida and is really busy, and my best friend of 18 years who promised to "be there" for me and visit often has let me down (one visit and maybe 2 calls in all this time).....she lives 10 minutes away. But that is another story for another day...... One good thing about this BC is you find out who you can count on, and who you can't.

Praying for everyone on these boards and wishing you all comfort and health. I hope you all come away with more knowledge about this whole process we are all going through. I hope that knowledge brings you confidence and comfort like it did for me...... By sharing our burdens, may we lighten each others load.

Cyber hugs to all.....

SeattleBound · February 2016

Thank you, Whippetmom. In looking at pre-post pictures of round implants vs other types, I see what you mean. Is the size with expanders in place similar to the size when the TEs are replaced by implants with the same cc's? Is there any way to determine how many cc's will result in a C cup, for example? Also, my reconstruction breasts with TEs feel quite hard. Do silicone implants feel softer?

Thanks to everyone for sharing your info and experiences. It really helps!

Seattle Bound

Tina1969 · February 2016

Hi Seattle Bound,

Just hopping in on this conversaton to let you know that the silicone implants feel and look nothing like the TEs. I am one week post op from my exchange surgery and I can tell you the implants are softer. It's amazing how much more comfortable they are. I'll let Whippetmom answer your other questions.

Good luck to you!

Ringelle · March 2016

Whippetmom -

I had my tissue expanders placed on Feb 3. I found out today their exact specs. I confess I did not ask quite enough questions as to my PS plan of action to fully understand where he was headed. When I compared the TE specs with your original response to me, I was even more confused. I guess I just don't understand how all the factors come together. So you have all the info: I'm 5'8" and currently 195 lbs. My ribcage is 39.5". Prior to BMX I was 65 pounds heavier and I was about a 42DD. I'm not interested in being anywhere close to my original size. My PS placed the following TEs: Mentor CPX3 Med Ht Contour Style 7200, 450 cc. I'm curious of your opinion and if/how your recommendations would change from your original response to me: "Much of this depends on the amount of skin envelope you have (since you were large breasted prior to BMX) and that envelope needs to be filled up to some extent. So I think you need at least 600 ccs in a smooth, round Mentor moderate plus profile implant. This would give you the width you need and enough of a mound. You could go up to 800 ccs and still never be as large as you were prior to BMX.

Thank you for the additional information.

whippetmom · March 2016

Anniekay:

I like what your PS has to say about a snug fit with the anatomicals!! It all sounds good to me!

Many of us remember the iron/coconuts, aka tissue expanders. For me and for many, it is a very dim memory. I honestly cannot recall much about that time. hang in there, for it will be over soon. 😉

I am sorry your friend has not been there for you. Some people do not have the emotional ability to handle tragedy. It might be a fearful, dreaded thing to some - the deep, dark fear of not knowing what to say or how to cope with the unknown that a cancer diagnosis can mean for someone. So there is distance. I know that for me it was easy to turn here to this website - to find safety and solace. I think a lot of gals have felt the same way. But I hope you can share with your friend how much this has hurt you. It might be a reality check for her, and it might salvage the relationship. 😇

Deborah

whippetmom · March 2016

Ringelle:

I think my assessment would remain the same. You still likely have quite a large skin envelope, unless your PS greatly reduced the amount of skin during the BMX. 600 ccs would still be on the small side for you - but certainly reasonable. But most importantly, what does your PS say about sizing?

Deborah

whippetmom · March 2016

SeattleBound

Typically, implants need to be approximately 100 ccs greater than the base volume (not the overfilled volume) of the implant, but this is not always the case. Dimensions are more of a factor (for me) than volume. There is no way to calculate fill level with cup size. I do not predict cup size because it is such a crazy, wide variable. Most implants are a lot softer than TEs, although anatomicals can be a bit more rigid than standard silicone rounds for sure me women. However, anatomicals can relax and become more natural over time, according to a number of women. It is pretty subjective, but nearly everyone will attest that it is a relief to have the exchange to implants. 😉
Deborah

SeattleBound · March 2016

Thank you, Whippetmom. On Monday, I tried to get information from my PS about the model # of the implants he will be using (such as Natrelle/Allergan 45). He said, "Oh no, we are past those, we use Inspira." But he would not be specific. It is very frustrating that he seems to react as if he is being criticized when I am only asking for info. After he left the room, his nurse confirmed that implants are much softer than TEs which other patients have told her feel like boulders on their chests! I agree - hard like rocks. His nurse did not know if he uses a "sling", matrix, etc. Can you shed any light on the pros/cons of those? that? and which Aspira round would you recommend? Currently, I am expanded to 300ccs on the left in my 300cc TE, 240ccs on my right where there is still some hematoma resolving, and the muscle is tacked down because he had trouble getting the TE covered by the pectoralis.

Thanks soooo much. Information feels empowering even if I can't get my PS to talk, My BS is great, though, and will see me any time if I have concerns, but leaves the PS specifics to my PD doc

SissiAngel · March 2016

Dear all!!!

I am in EU and I am new to this community, but not new to breast cancer. I was diagnosed on November 2012, at age 38 (1.7 cm, grade 1, ER+, PR+, HER2-, 1/3 lymph nodes), when I also had the mastectomy of my left breast. I had 8 chemotherapy sessions which ended on May 2013. Since then I have been taking one tamoxifen pill 20mg daily and will be taking it for 5 years.

After 3 years, I decided it was time to have my breast reconstructed using silicon gel implants. On November 2015, I had my first reconstruction surgery where my PS placed the tissue expander (Mentor, CPX2 Siltex Medium Height Style 6200, 650cc w.14.6cm x h.12.6cm x proj. 7.6cm). On February 2016 I had my last fill and I had it overfilled to 680cc.

In 3 weeks I will be having the exchange surgery, plus a prophylactic skin & nipple sparing mastectomy of my right breast with immediate one-step implant reconstruction. A few days earlier I am going to have my before-surgery-consultation with my PS. Taking under consideration my TE measurements, I am thinking of having the Mentor CPG 323 Cohesive III medium height high projection silicon gel implant measuring 685cc w.14.5cm x h.13.6 cm x proj. 7.1cm on both breasts. My PS said that for the right breast, where the skin will be preserved, a smaller implant might be needed in order to be symmetrical with the left breast.

I am 5'4'' (163cm), 159lb (72kilos) - I was 139lb (63kilos) but gained 20lb (9kilos) since chemos and tamoxifen pill - and my chest circumfirence is 33 inches (84cm). Before mastectomy, I was a full C, small D cup size depending on bra brand.

I would appreciate any piece of advice.

Best regards,

Sissi.

whippetmom · March 2016

SeattleBound:

Natrelle Inspiras are great! I would say 520 gms to 550 gms in the SRX or SSX style. (Please read #5 in the thread header about grams vs centimeters.)

http://www.simplybreastimplants.com/breast_implant_sizes/natrelle_inspira_srx-ssx.html

whippetmom · March 2016

Sissi:

Why was the skin not spared on your left breast at the time of mastectomy? It sounds as though you are not in the United States? If the left breast was not skin sparing, I cannot be certain how much expansion your PS has been able to achieve with the tissue expander. Your pocket might be pretty tight? It also depends on what size you were prior to mastectomy, as we consider how much skin flap you will have on the right. Because you are also having a nipple sparing of the right breast, where that nipple ends up on the mound is important. In your case, symmetry trumps size/volume of the implant. I hope your plastic surgeon plans on taking various sizes and styles into the operating room at the time of the exchange, to ensure every chance for a good, symmetrical result.

BREAST IMPLANT SIZING 101

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