BREAST IMPLANT SIZING 101

Journey2014 · October 2016

Whippetmom,

In your own opinion, is it better to have the ideal weight prior the final exchange? Does your body weight or body size affect the size of the implants that the plastic surgeon will recommend for me to use or have?

whippetmom · October 2016

Journey: It would be good to lose weight (if you intend to do so anyway) while maintaining a good healthy diet. There is no rush to have the exchange surgery, unless you need to have it completed before the new year for insurance purposes. But you do not need to reach your "ideal" weight prior to the exchange. Don't make yourself crazy about this. It needs to be a realistic goal which you will maintain for a lifetime, so don't hasten to get to the finish line weight-wise.

Journey2014 · October 2016

Whippetmom,

That is my plan to lose weight before my exchange, right now I am 141 lbs. and I am only 5 foot. I am hoping to loose at least 20 lbs. I just had my lat dorsi surgery last week and still recuperating. Not being able tobw work out makes me feel more lousy and feels fat.

Just in case I am still kinda heavy by the time of my final exchange surgery and when I lose the weight does it means I will have loose skin around my chest area

whippetmom · October 2016

Journey...Yes, you might, but that is something the PS should take into consideration. It might mean a revision once you get to your goal weight.

Journey2014 · October 2016

whippetmom,

Thank you for your insight, I hope you don't mind my asking, did you had some loose skin after your final exchange and lost some weight? Did you had revisions

whippetmom · October 2016

No Journey. I have a narrow ribcage....always have. No fat at all there. I lost abdominal and thigh girth. I am 5'3" tall and 112 pounds now. I lost 18 pounds, mainly because I started eating healthy and stopped drinking alcohol.

Journey2014 · October 2016

Thanks for replying, now I really need to start eating clean and no more happy hour after work

whippetmom · October 2016

For me, it was sugar. I started eating no refined sugar and the weight just melted off. The three things you can avoid and start dropping weight: 1. Refined sugar. 2. Alcohol. 3. Wheat

Houston2016 · October 2016

Hello, I just had UMX on 10/5/16 and still following up with PS. I have TE in place. Tomorrow I see him to discuss about whether I do implant or DIEP but I'm leaning toward implant. So far I read some websites that implant has unfavourable results down the road. I don't want to believe that. I'd like to hear what pros and cons all you ladies have experienced. Also, I'd like to know if I do radiation and hormone treatment, can it be done after or beforeimplan.OK Thanks everybody for sharing.

whippetmom · October 2016

Houston:

Implant based reconstruction is a successful procedure for many, and not so successful for a few. The risk of "failure" of implants for patients who have had radiation is much higher, but with the advent/use of fat graft transfer, some of the complications have been greatly mitigated. Honestly though, if you are a unilateral, the primary goal is SYMMETRY, and it might be that a DIEP will afford the ability to more closely match the shape of the native breast. Or, a DIEP plus implant, depending on your height, weight, body habitus, preexisting native breast size. So it is something to discuss with your PS.

If you live in Houston, according to your screen name), you are in a Mecca for autologous microvascular/microsurgical breasts reconstruction specialists. It is often their preferred method of reconstruction and so you might also get a second opinion from someone who performs primarily implant-based reconstruction - just so that you are getting a fair representation of your options.

aussiemum71 · October 2016

Hello ladies and whippetmom,

Firstly, thankyou all for sharing your stories. This site is a wonderful source of information. I'm hoping I have signed up correctly in order to post and receive advice.

I am 5'5, weigh 110lbs, and my ribcage circumference is 27 inches. I currently have Mentor Tissue expanders in (tall height, size 350cc). I am currently filled to 350 in each side, and not putting anymore in. I liked the look/size at 300 (and I filled my old bras nicely). My pre-surgery bra size was a 10D (which would surprise people as I am quite slightly built).

My surgeon will be placing Mentor teardrop implants when I have my exchange in February. I'm hoping to end up a similar size to my original size but if anything would err on the side of smaller rather than larger (I fear I will look like I have fake breasts if they are too large!)

I'd love to hear what size you think may be right for me. Please let me know if I need to provide any further information.

Thankyou very much, big hugs all the way from Australia

whippetmom · October 2016

aussiemum:

If Australia usesthe UK Mentor catalogue, the anatomical that best corresponds to your tissue expander would be the Mentor CPG tall height high profile implant, 380 ccs or 430 ccs - quite probably you would prefer 380 ccs - if you wish to err on the smaller side. However, I am wondering about your preexisting breast size and how much skin availability you have. You want the anatomical to be nice and snug, so that it does not rotate. So whichever fits nice and snug in the pockets - that is the size for you.

whippetmom · October 2016

I tried editing all of the letters running together in my prior post...about five edit attempts. It is maddening

aussiemum71 · October 2016

Hi whippetmom,

thanks so much for such a speedy response! I think my surgeon was leaning towards a 330 as he measured the width as being 11cm (so 380 would be the next one in that scale). Is there much of a difference between 330 and 380 (I know sounds like a silly question but visually it may not make too much of a difference). We will do final measurements and sizing etc in a few months closer to the exchange date. I'm not sure what you mean by "how much skin availability"? My skin currently feels pretty stretched and tight. Do you feel 330 may be too small? Thankyou again for your invaluable input, I really appreciate it

Houston2016 · October 2016

Hi whippetmom, what would be the conditions if I decided to delay reconstruction indefinitely? I'm currently have tissue expander. Another is if I decided not to save any skin after mastectomy, would the implant later more difficult? Thanks.

JessieJake · October 2016

Hi Whippetmom,

I have a follow up question that perhaps you might have an idea about. I have had my implants for something like 6 weeks now. Anatomicals - 410s, above muscle, with alloderm sling. On the bottom half of my right implant (between the IMF and nipple height), I have a bumpy ridge traveling across the implant. My incision is IMF. When I saw the PA at my one month post op, she spent a little bit of time looking at it and feeling it, but ultimately said it's scar tissue and not to worry about it. The left side does not appear to have this.

It's lumpy enough that there are a couple small spots where it's pressing out on my skin and is noticeable if you know to look for it.

While I like my overall look and size; this is bugging me. I do see my PS on 11/21 as I'm currently scheduled for 2nd fat grafting procedure (I am on the fence about this, though) and I plan to ask her at that appointment.

Any thoughts?

Thanks!

Andraxo · October 2016

Met with PS this past Monday for more time on the computer like the "Weird Science" 80's movie when they make the woman. Ha! We reviewed my 3D body images with different implants. Decided on low projection gummy bears (Allergan 410). I don't want cleavage or upper projection! I just want small natural shaped breasts. The only question is the implant height - medium or full - and that will be determined in the operating room (I have a very long torso so likely full height). Both height sizes have the same projection...just 3.8 cm. I'm 5'5" approx. 125#, muscular & athletic. It really helped to see the computer images of my body with different sizes, and it helped me feel better about moving forward with surgery since I've been stressed about choosing recon over staying flat. I'm on the schedule for Nov 9th for tissue expander & alloderm placement over my pecs. Fills would start 8 weeks later (early January) and they think I'd need at most 2 fills. Exchange for implants would likely be in late Feb or early March.

Thanks everyone for sharing stories and decision making. It helps! - xo

whippetmom · October 2016

aussiemum: If your TEs are 11.0 cm wide, I recommend the 11.5 cm width anatomical. Just so that it is nice and snug. But your PS is able to assess what is appropriate once he removes the tissue expanders. Why risk that implant rotating? Most plastic surgeons here go slightly larger (some quite a bit larger), depending on the skin envelope availability and also to insure that the implant is tight in the pocket.

aussiemum71 · October 2016

Thanks whippetmom - eek I dread the thought of an implant rotating!! I will definately talk to him about that next time I see him. Thankyou once again for your input. I really really appreciate you taking the time to give me some advice.

whippetmom · October 2016

JessieJake: Can you PM a picture to me? You can link it by using the landscape icon in the task bar (to the left of the arrow) above thisreply box...

purple16 · October 2016

@andraxo @whippetmom ...just read that you reviewed your 3D body image on computer to see how you would look in anatomicals etc. Wow.Granted, my PS provided all my options (diep, etc.) when I wanted implants he leaned toward round silicone (as did whippetmom) but at no time in any of our meetings did he show me a computer screen. In my consent appt. I asked the nurse where were the catalog/ samples...that got me one silicone implant to look at, and then the PS did show me what low/med/high profile would look like, and that he was thinking medium. When I showed the PS the suggested size/ccs that I recd from this forum, he said, "I haven't decided yet on what size" and also gave me no indication that he would swap a dozen in and out and lift my 5'11" 175lb frame up to show the room, either. It's been pretty much a "trust me you'll be fine" scenario. I just said I wanted to fill out my clothes...he did note that one side had too much skin or was not filling at the bottom, he was very brief, but said he'd fix it and if needed, would fix it again. He's the president of the plastics society in this area of the country so I know I'm in great hands.I just feel a little gypped now I didn't get the 3D look-see. I commented about how far apart the expanders were, would I have cleavage, and he said the muscle determines that but he would place them as close as possible. Did I read somewhere about fat grafting for cleavage or just upper pole? Swap out surgery Nov 1st.

Andraxo · October 2016

purlpe16 - getting to view your own body images with different implant simulations is pretty rare. My surgeon is the only one the state (NM) with that technology and he said not many surgeons in the country have it. I know I am very fortunate to have had that experience. It's not exact, and doesn't take into account any skin anomalies etc, but it certainly helped me decide to move forward with recon instead of staying flat. It also helped with the sizing in terms of the footprint (width and height that would work on my body dimensions) and then we looked at projection and chose two sizes (same projection but different height) to try in the OR when it is time for exchange and he will choose which looks best at the upper slope. I'm still worried they will be too large in footprint and projection (one is 285cc medium height, the other is 320cc full height - same projection for both, and also 13cm wide) . Aside form working in healthcare and with surgeons, I also did a lot of research for everything (chemo, rads, recon) and I've watched a lot of shows on surgery. Yeah...they do prop you up to see how the implants appear while upright - it's is important for symmetry/positioning etc. I've never heard at fat grafting for cleavage, only for the upper pole, but I could be wrong on that. So sorry things are not going as smoothly as you wanted. I hope everything goes well for your exchange on Nov 1st. I get expanders placed on Nov 9th.

purple16 · October 2016

Andraxo:

Thank you for your detailed (and encouraging) response. Wishing you well on the next phase of your journey. Be well!

myToyStory2 · October 2016

Hi Whippetmom - Just following up after my exchange surgery earlier this week. TE's expanded to 500ccs, but woke up with 650cc Mentor MemoryGel Smooth Round High Profiles - just as you had suggested on p. 465 of this thread. PS was able to do implants on both sides, which had been a concern following my bouts with pseudomonas and reduced skin availability on the right side. What a relief! Thanks for offering your thoughts on sizing - glad to have that second opinion to lean on as you and PS seemed to be on the same page!

Enerva · October 2016

HI I saw a good video and just wanted to share

whippetmom · October 2016

myToyStory2: So glad it all worked out!

whippetmom · October 2016

Enerva: Thank you! Great video!

Bird-of-light · November 2016

Whippetmom, Help! When I went to talk to the PS about your recommendations, she responded as if I were an idiot. She was shocked that I would say I was happy with 420-480 cc in my TEs, but suggest a 540 or up in implant size (see your recommend). She said that tissue expander size correlates to implant size closely and getting the preferred volume now was the goal, not implant choice or size. I'm now at at 480 and do not want to go bigger. Maybe even 20 cc lighter. Who knows. My worry is looking smaller when we exchange because of the difference between TEs and implant. Is there not much difference? She told me that she will choose an implant after we decide on TE volume and wait 3 months to heal. She also said she always revises the pockets to make things snug. I left discouraged because I don't know how to move forward and she didn't reassure me. She seemed irritated I came with suggestions.
Bird

purple16 · November 2016

Whippetmom : yesterday I went in for my implant exchange surgery. I don't know if you're able to find my original post, but this is what I got: Allergan style 20, 650cc. Plastic surgeon noticed during expansion that one side was not dropping, and sure enough he had to chip away at scar tissue. I did not have radiation, so he couldn't explain it, but that textured tissue expander really took hold (and that attached upper arm muscle hurt for several weeks, I went to PT to stretch it). That arm is in way better shape now, after the exchange. So on the road to recovery.

Soccermom67 · November 2016

Whippetmom

I need your help! I had my exchange surgery on 6/27 with mentor memory gel smooth round high profile 450cc reference number 350-4504BC. I had a nipple sparring mastectomy on 10/11/15 with TE reconstruction. The TE were filled to 450cc .

I absolutely hate them! I think they have bottomed out. I have no upper pole fullness and my PS is recommending Natrelle 410. I am very uncertain about this POA. I have 3 other consults with PS set up over the next 2 months. I also have a lot of rippling. They look more saggy than my real boobs. LOL. I was hoping for at least perky boobies!

Numbers:

Height: 5 31/2 inches tall Weight: 126 pounds

Rib circumference: 30 inches

Cup size before surgery was a 34 C.

Let me know if you need any further info.

Thanks

BREAST IMPLANT SIZING 101

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