BREAST IMPLANT SIZING 101

Hi Whippetmom,

5'4" 108 lbs. 28" ribcage circumference

Mentor 8200 Med 450 cc

PS only uses Mentor or Allergan round silicone (no textured or anatomical)

Prior to BMX I was a 34 DD. I had both nipples removed, and a lot of skin removed. When I was fully expanded to I believe approximately 400-450 ccs my skin was VERY stretched and thin-looking. The expanded breasts were too large, but the PS did reduce them prior to chemo. Realizing cup size is unpredictable, I prefer to be much smaller than my natural breasts--a full B or at the most a small C.

My right TE has migrated towards my under arm and has a "football" shape with excess skin on the lower inner portion of my breast.

I have ink on the margin of my chest wall (DCIS not invasive) and the BS I used at the most "prestigious" cancer research hospital in NC did NOT remove the fascia covering my pectoral muscle even though I had approximately 10 cm of LCIS and DCIS, so now I must also have radiation to the chest wall. RO said had the fascia been removed I could have avoided radiation. They also lost one of the biopsy clips during surgery.

My new BS will be removing both axillary tails that were not removed during BMX. I apologize that this is off topic. I hope it helps someone else...had no idea to question one of the most "experienced" BSs and MOs, who have graced the cover of Time magazine, in the state. I have since switched to the "highest ranked" cancer center in NC and have received excellent care. Everyone in the center has been amazing!

I have a new PS who will do the IE at the same time as completing my mastectomy. He recommends IE first then radiation. He will also be doing lipofilling. My next appointment with him is Monday, so I will find out if this will be done during or after IE.

Any advice on size, style, and the implications of radiation is welcomed. I sincerely appreciate your time and dedication to helping us.

Whippetmom,

Thank you for the information and kind words! I will keep you posted along the way.

Whippetmom,

Thanks for all the time you have spent on this site. You and the other ladies have truly helped me out. I posted this before but I think I was on the wrong site.

I had a BMX in Sept of 2015. I waited until Aoril of 2016 to start reconstruction due to a pinched nerve in back.

The PS used Allergan TE 133LV-11-T the card I have shows 150cc. I am 5' 8" and weigh 155. I wore a 36 C bra before surgery. I would like to be close to the same size. I am currently filled to 190. He put in 80cc's at the time of surgery.The PS thinks I should be filled to a little over 500cc to get to my pre-op size. I think he plans on using the "gummy Bear" implants. I feel like I should have asked more questions. What is your suggestion? I've had 2 fills the first one 60cc's and the second one 50cc's. Both fills were painful for a couple of days even with muscle relaxers.

I have been reading the posts and need some advice. I meet with my PS again tomorrow. I'm 5' 7.5", weigh 138 pounds, and rib cage 30". I was a full 36 C. I had breast cancer about 20 years ago with a mastectomy and reconstruction with permanent implant at time of surgery. My natural breast has always been larger than the implant. When I spoke to the PS I said I would like to be a little bigger than I am on the left side (natural breast) but didn't want to be huge. I wanted a natural look. He got out breast cups and said I could do a 600cc on the left and 570 to 590 cc on the right to replace old saline implant with silicone. Second meeting the same sizes were discussed again. He asked if I would be happy with that. Looking at the size of the cups, I said yes or maybe slightly larger if possible. He said he could probably not do more than 570cc on the right side but 30cc would not be a noticeable difference. I have a TE in the left side that he is currently filling. It is already larger than the right side permanent implant. When he took the bandages off I asked if he had changed his mind and put a TE on the right side too. He said no. I said it's looks much smaller than what you showed me in your office. He said I told him I wanted to be slightly bigger so he replaced the old 375cc on the right side with a 400cc. Oh course that is not what we discussed. I have two questions. 1) What size implant would be appropriate for me to achieve a full C or a D cup? 2) Is it possible to put a larger implant in the right side now that the PS has already done it with a much smaller one than we had discussed? Thank you so much the advice! I meant to add my old saline implant was under the muscle. The new silicone implant and TE are over the muscle

Thanks so much. I will be meeting with him later today. I think it wasn't necessarily what he thought was best. I think somehow the sizes we had agreed on got lost between my last appointment with him and surgery. As I was leaving his office I heard the PS ask his assistant "what this other patient info doing in her file?" The assistance reply "That's not good." I'm just hoping it can be corrected!

I just had surgery last Wednesday. My PS replaced a saline implant under the muscle with a silicone implant over the muscle from a mx 20 years ago and placed a TE on the other side after a second mx last week.

Best wishes for a speedy recovery! I hate it when Drs tell me such and such happens to 1 out of 10,000. They never mention that I'm 9,999. Good luch

Hi to all!

I just wanted to post an update. I am 2 months post exchange (exchange TE with teardrop implant after a mastectomy on left cancer side and direct to implant prophylactic nipple sparing mastectomy on the right). The bruising which had formed on the right has been absorbed. The scab that had formed around the nipple incisions, fell off the skin only a week ago. The right breast still looks a bit bigger than the left and it also looks more like a breast because the skin and nipple were spared. I can now sleep on my sides without feeling any discomfort, exactly the way I used to before reconstruction. I can move my hands and lift household weights and do my chores just as before (but I am still not overdoing it). I like the fact that the teardrop implants are firm and I have never felt them move around. The right breast feels harder when squeezed, whereas the left breast feels softer, probably because of the thinner skin and the lack of fat on the left. I even did the flashlight experiment. The left breast was bright and red, when lit, with small veins going through the skin, whereas the right breast could barely be lit by the flashlight and large veins were going through there.

As a conclusion, I suggest to everyone who is given the option, to have a skin & nipple sparing mastectomy. I love my right breast, it feels and looks as though I had a cosmetic surgery to it and not a mastectomy. My left breast which had to go through a modified radical mastectomy and then TE placement, is just OK. Maybe if I had fat grafting (which I did not) it would be better and it would look more like a natural breast.

Whippetmom, thank you so much for your advice! The sizes you mentioned are exactly what the PS originally said I should have. He is supposed to be one of the best PS's in the area specializing in breast reconstruction. I know for sure my file was mixed up with another patient's. I over heard them talking about it as I was leaving the office I'm my first visit after surgery When I asked about it he insisted it was just a minor mix up and that he put the size in I said I wanted. He opened my file to show me his notes. I saw two photos on a page before he quickly closed the file and left the room. When he came back he asked when I was going to see Dr...... and I said that's not my oncologist surgeon. He said "oh I thought it was" and left the room again. Something about the photos kept bothering me. It finally came to me a few days later. I don't think they were my photos. The woman in the photo had a right breast much larger than her left. I was the opposite of that before surgery. I have another appointment with him on June 1st. I don't know how to approach this. I'm sure they don't want to admit their error for fear I might sue. When I all want is to fix this! Do you think it's possible to get a 400cc implant replaced with a 570cc? Is it possible to have my 525cc TE exchanged with a 600cc silicone implant? Thank you again for all the time you so generously give to all of us who were lucky enough to find this site!

Whippetmom

Thank you again for your help and guidance. It is very much appreciated! I will post my info Re my two cancer diagnosis almost 20 years apart when I get the final report. Still waiting for my Her2 test. This has been such a helpful site. I have seen people post calling you an angel and you definitely are!!!

Hi All I was diagnosed May 10 with invasive ductal carcinoma. I am choosing a double mastectomy for sure -already have implants (D cup) so I'm deciding between expanders and just going direct to implant? I don't want my breast size to be any bigger it's just that I got 2 opinions from 2 different hospitals suggesting these options. I know a lot of women go with expanders but can someone offer advice or experiences on going direct to implant?

My PS told me the exact same thing yesterday whippetmom. I had previous reconstruction (lost 3/4 of left breast due to abcess) and he felt more comfortable doing the TEs and moving things around at time of exchange (if they were able to save my nipples). My first reconstruction was in 1985, I was told the at that time my implants would go under my breast tissue. I allowed my PS to manipulate my implants and I flex and relaxed my chest muscles until I was about to scream! He and my BS thought that 1985 would have been way to early for that type of procedure. When he was done squishing and squashing he said "I'll be damned, they are under the breast tissue!". We'll know for sure next Wednesday :-)

Thank you for all you do for us here!You rock whippetmom!

tsoebbin - I'm curious as to what whippetmom will recommend bet I wanted to chime in since I've sort of been where you are. I am 5'8" and I was 260lbs when I was diagnosed in May of last year. First of all, ask you PS his/her opinion. I was slowly losing weight but by the time I had my mastectomy I was not where I needed to be for reconstruction. My PS encouraged me to get to get my BMI to 30 before starting reconstruction. I'm sure if I had pushed he would have done the reconstruction sooner but he told me that my cosmetic results would be better and my risk of complication would significantly go down at that BMI. He also said I would have a difficult time continuing to lose weight once the expanders were placed. He was SO right! I gained weight with my surgery (do every time) and even 4 months later I have yet to lose those the last 10 pounds. I'm so glad I listened to my PS. I took the six months between my mastectomy and expander placement to lose weight (40 pounds more, 70 total), work out and get healthy. I've had issues with the normal pain and discomfort but no complications. I feel so much better about myself and my health and having some shape now has been rewarding. I'm looking forward to my exchange next month. I still have weight I'd like to lose but I don't feel like I have to guess about what size implants to get and even if I had complications, I know I would have done everything I could to avoid them. Goodness knows, we don't want to go through anything more than we have to!