BREAST IMPLANT SIZING 101

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  • Peace13
    Peace13 Member Posts: 6
    edited February 2017

    thank you Minustwo and Whippetmom! Yes that makes sense, so we are really starting from nothing after a mastectomy. It's true what someone else said before that its hard picking a body part! I feel much better going to next appointment now

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  • tinajens
    tinajens Member Posts: 2
    edited February 2017

    Thank you so much whippetmom! I will take a look at these and talk with my PS.

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  • Shoregirl
    Shoregirl Member Posts: 375
    edited February 2017

    Thank you for the style 20 HP chart Whippetmom. My TEs are 450cc, which are still smaller than 475cc. But my pa had said the ps would use a SMALLER implant than my TE are being filled to. They plan to overfill to 500cc and use 475 implants. I had said I am concerned because in your previous post to me you had said "you need at least 550 ccs in a smooth round HP style implant. I would even venture to state that the implant which best mirrors the dimensions of your tissue expanders would be Mentor ultra high profile implants, 650"

    Please excuse my confusion, but it does appear the chart you referenced in the 1st post was not the style 20, not sure the style, but as you said, the 650 on the 1st chart (catalog # 350-5650BC) does appear to have the closest match to the dimensions of the CPG-4 450cc TE. The 475cc in the Style 20 only has 5.5 projection, much less than the 7cm projection of my expanders, and the 650cc of the style 20 only has 5.9 projection, but a 14.2 diameter, which is wider than my expander. Was the chart referenced in the 1st post for Ultra high profile, and the style 20 is regular HP? Is it possible to get a 650cc implant in a pocket that had a 450 expander in it overfilled to 500? Is it possible to go with the Natrelle Inspira for more projection even though I have Mentor TEs? I obviously need to consult more with my ps, but any suggestions you can arm me with I do sincerely appreciate. This just doesn't make sense to me, maybe it's the brain fog. I did tell the ps I wanted to be as close to the pre surgery size I could be, and I don't think 475 is going to get me there!

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited February 2017

    Shoregirl:

    Sorry! My mistake. I forgot you said you have Mentor 450s. Forget the Allergan link. Yes, you can exchange to Inspira implants. If you feel you are not getting through to your PS, get a second opinion. You do not need to go through the exchange until you have an understanding of what is best for you and fits your desired outcome.


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  • Shoregirl
    Shoregirl Member Posts: 375
    edited February 2017

    Ok, thank you Whippetmom. I see the surgeon's assistant tomorrow, so your quick response was right on time! I am happy with my ps, he actually was my 2nd opinion doc. I just need to learn to ask more questions while I am there! I kind of just put myself in his hands and trust his judgement, but I now realize I need to be more vocal about my desired outcome. Thanks again, blessings to you!!

    Shoregirl

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  • BleuJay
    BleuJay Member Posts: 9
    edited March 2017

    I'm one day post exchange, and missing my tissue expanders. My PS used Allergan 410 MF 335. I was expanded to 300, because that was all I could take and my skin is very thin. It looks very natural but I'm not quite as big as I would have liked. I'm hoping that with time I will grow to like my new breast

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited March 2017

    Bleujay: Hang in there. 😉. Let us know how you feel in a coupleof weeks.

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  • Goldene
    Goldene Member Posts: 9
    edited March 2017

    Whippetmom, thank you so much!

    I know the key are dimensions...that's why I'm stressing over diferances about 3 mm in width and projection, and 5 mm in hight in implant sizes I'm considering...and I'm very worried will I have enough projection with smaler implant, and would new brests be to wide in ratio to projection (I'm going for high profil Mentor CPG implants) ...Dimensions of my TEs are width 11,3 cm, hight 11,8 cm, projection 6 cm, volime 350 cc. At a moment I'm filled to 350 cc and I don't like that size, seem to be little too wide. When I was filled to 290 cc, I loved that size on me and TEs didn't look wide at all. As I was undecided about size my PS give me small sizers of 50 cc and 75 cc to try over my TEs inside my surgical bra and I liked look with adition of 50cc...but sizer ad only projecton (as it's tiny), but TEs filld 60 cc more seems not just more projected, but wider. I'm also confused beacose my PS say size is same TEs and in implant, I'll only get better shape and position with implants. And I read everywhere (this boards included) TEs LOOK biger then implants, regardlles same volume. I was thinking Mentor CPG style 333 volume 330 cc (width 11 cm, hight 11,5 cm, projection 5,6 cm, but I'm frithend it will make me bigger/wider than my desired full B cup. My other option is Mentor CPG 290 cc (dimensions of that implant are width 10,5 cm, hight 10,9 cm, projection 5,3 cm). So I still can't decide wich size implant is right for me. I'm 167 cm tall, 47 kg, ribcage 71,5-72 cm. Oh, and I know You are not fan of tall hight implants...but my PS say that will give me more upper pole fullnes. I'm so undecided...

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited March 2017

    Goldene: You need CPG 380 ccs. The dimensions should be slightly larger with the anatomical, to avoid the risk of rotation. The 290 ccs is too small. You need to fill up that pocket or trust me, the anatomicals DO rotate.

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  • Goldene
    Goldene Member Posts: 9
    edited March 2017

    Thanks, Whippetmom, for your advaice AND your patience!

    Today I tryed some bras, several syles in size 32 B all unlined and they fit nicely, so you are right, slightly bigger implant will not just be safer in pocet, but will give me look I'm aiming for.

    Again, thank you very much!

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  • Ptorres60
    Ptorres60 Member Posts: 2
    edited March 2017

    Hi Wippetmom! Thank you so very much for this information. Would love your advice as this is all so confusing. I'm still in deciding mode as to round or anatomical implant. I am 5'6", 195 lbs, under TE is 38". As you can tell I'm on the heavy side. My bra size before DMX was 38DD. I have Mentor TE's, Style 9300, tall height, catalog #3549314, 550 fill. I don't want to be as big as I was before, but also want my implants to project nicely. My PS uses mainly Mentor implants.

    Thanks again, Pam.

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited March 2017

    Ptorres60:

    Mentor Memory Gel ultra full profile smooth silicone round implants, 700 ccs or 750 ccs. Yes, your TEs are sufficient to get you there.

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  • Harasl94
    Harasl94 Member Posts: 5
    edited April 2017

    Hi Whippetmom!

    Firstly, thank you so much for doing this!!!

    I have already had a mastectomy with a TE on my right side in early December 16. The TE is currently filled to max capacity (350cc). I am due to see my PS next week to discuss the details of the exchange. My PS has also advised that they generally don't overfill by more than 50cc.

    I'm 5'3", 125lbs and my ribcage circumference is 28" and pre-surgical bra size was 34B.

    The details of my TE are:

    Mentor 350cc, Style 8300, Textured, TALL HEIGHT, 11.3 x 11.8 x 6.0

    I did express prior to surgery that I would like an augmentation out it (D cup if possible) but did not specify how big - might be a little late for that too but would love to hear your thoughts and opinions.

    Thanking you!

    Sarah

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited March 2017

    Sarah: A few questions

    Is your PS on board with augmenting and also you are assured that he plans to place an implant on the native side as well?.

    Does your PS recommend anatomical implants or silicone rounds?

    What do you think about the size you are at present?

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  • Harasl94
    Harasl94 Member Posts: 5
    edited March 2017

    Whippetmom: Yes PS is on board with augmenting and has already stated that he will place an implant on the native side to achieve symmetry.

    I'm not too sure about the type of implant, I'll have to confirm and get back to you. What are the differences between the two?

    The current size is okay, I wouldn't like to be any smaller than this but I would like to go bigger if possible.. hah

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  • Krma
    Krma Member Posts: 16
    edited March 2017

    Hi and thank you for your help. I am 5'5" tall. I previously wore a 38C bra. I weigh 173 lbs. I already had a bilateral mastectomy direct to implants. My plastic surgeon used Allergan Natrelle silicone-filled breast implants. My PS used style 45. My left is a 500cc. My right is a 550cc. My breast cancer was on the right side and that breast was a little larger than the left prior to surgery. I guess that's why she used a larger size on that side. My question is where do you think I will end up size wise? Am I going to be large, small, I really can't tell yet. I'm only 2 weeks past surgery. Thank you

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited March 2017
    Krma

    Since you already have your implants, the question is: What do YOU think out the size of your implants? At two weeks out, you should be able to assess whether or not the implants are suitable for your frame. At two weeks out to you should going to Nordstrom's or finding a bra fitter to know what size bra are you wearing. So, you see, the size you are now is entirely subjective, because You might be happy on the smaller side. Or, you might be wishing you were larger. YOU are the one to assess whether the implants are too small or too large or just right. How do YOU feel about the size?
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  • whippetmom
    whippetmom Member Posts: 6,920
    edited March 2017

    Haras:

    I think you will want to be in the 400 cc to 475 cc range with implants, but this depends on a number of factors. A mastectomy plus augmentation would be easier with smooth silicone rounds than it would be with anatomicals. Anatomicalls are limited by the mere fact that they are designed to fit in the pocket created by the tissue expanders. So you would not be able to go much larger with an anatomical, because it is rigid and your PS will need good closure over the implant. You can fudge a bit more with a round silicone implant, which is softer and more pliable. That said, it all depends on symmetry when you are unilateral. So the size of implant the plastic surgeon uses will all depend on your skin integrity, degree of expansion, ability to achieve ptosis (droop) so that he can match the native breast.


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  • willa216
    willa216 Member Posts: 165
    edited March 2017

    Hi Whippetmom:

    Wondering if I could ask your opinion - I do realize that you aren't a doctor :) but you've been so helpful in the past.

    I had a direct to implant MX, over the muscle in July. I had serious capsular contracture at just about a month or two out. About 6 weeks ago I had a capsulectomy and my PS exchanged the saline implant for silicone ( Apparently I had not only contracture but a seroma behind the implant that was larger than the implant itself).

    I'm a small framed person and my PS used Ilow profile Inspra 140cc. She said she would have 110-160 cc available in the OR. I need to be really small to match my native breast (a larger A ) The 140 cc implant seems way too big! I had asked her to go smaller rather than larger if she could since I certainly understand that with an MX a perfect match isn't possible. Maybe there are limitations as to how small the implants can be relative to the original pocket?

    Initially when she took out the drains the foob was very flat. Over the course of a few days it filled out and seemed nearly the perfect size and shape to match the other. Then after about a week the implant side kept getting larger relative to the other. At my post op three weeks ago she said everything looked great and all of this "extra" was just swelling. I haven't seen any decline in swelling at all in over three weeks and I don't feel swollen. Am I off my rocker to think that I should be seeing closer to the final result at 6 weeks out? It seems that with over the muscle implants there isn't much "dropping" going on. I don't want another surgery but I can't wear a bra or any of my normal clothes because of the difference in size. I'm probably more stressed than I should be but I really hope to avoid another capsular contracture and more surgery. I know people often end up doing many surgeries to reach their final result.

    I hope this doesn't come across as whiny. While my PS has a good reputation I'm having trouble communicating and am looking for some additional insight. I see her on Wed so I'm trying to get a grip as to how to best articulate my questions . Maybe the problem is my expectations.

    Thank you, as always. I appreciate you.



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  • whippetmom
    whippetmom Member Posts: 6,920
    edited March 2017
    willa:

    You are not coming across as whiny at all! I am concerned that there something else going on behind that implant again. Yes, the swelling should be resolving instead of staying the same. If you are not satisfied with your plastic surgeon's response to this concern, I would advise that you get a second opinion. In my experience, I don't see an implant looking just fine initially and then getting larger.
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  • Krma
    Krma Member Posts: 16
    edited March 2017

    Hi Whippetmom,

    I guess my point is I'm only 2 weeks past surgery. My PS says they will drop and change with time. I think I'm also swollen. I'm wondering if with a previous 38C, 5'5.5" and 175lbs, would you have recommended 500cc/ 550cc Allergen Natrelle S45 or something else? My doctor said my breasts were more cone shaped so I believe she was trying to add as much projection as possible. I know it's difficult to say bra sizes but do you think I will be a B or a C or something different? I cannot tell yet by looking at my breasts

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited March 2017

    Krma:You might have had tubular breasts, which is a condition which sometimes makes it limiting, and even challenging, in terms of the size and style of implant your plastic surgeon was able to use. I would need to have you send me photos, to even know whether you would be a candidate for larger implants. I guess you are asking for me if I would have recommended larger implants? Certainly nothing smaller than 500 ccs would be on my radar for you. But Style 45 is a very good style, if indeed your PS felt she needed to achieve as much projection as possible. You can always send me photos via private messaging.

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  • Shoregirl
    Shoregirl Member Posts: 375
    edited March 2017

    Hi Whippetmom,

    I had my last fill last Thursday. Had consult w/PS Monday, and he said no more fills. I am pre-pec, skin is really tight. He is concerned if we put anymore in my incisions could open (wise pattern). Even though I am only expanded to 475 in a Mentor cpg-4 450cc TE, they look huge to me. Definitely more projection than my nat breasts, but my nat breasts were wider and taller. So.....he is ordering a range of sizes of the Natrelle Inspira from 400 to 475cc. High profile. I asked for ultra high profile and he said he would try it as well. I know I will be a little smaller, just wondering how much if say he were able to get a 450 in there? Right now I am filling a 38D bra very nicely w/TEs.

    Thanks, Shoregirl

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  • willa216
    willa216 Member Posts: 165
    edited March 2017

    Hi Whippetmom: Thanks for your insight the other day. It was definitely helpful.

    I saw my PS yesterday about the continued or increased swelling ( 6 weeks out) with the new implant. She says that it can take 3 months for swelling to subside and often 6 months - year for final result. She thinks that the reconstruction looks great (I agree it's the correct shape - just too big) and that I will be happy. She doesn't think it's bigger in the last few weeks, although I disagree. I should have measured. Haha. She said if I'm not happy then she'll replace the implant with a smaller size. I think I'll give it 6 more weeks with the swelling and if there's no improvement then I'll ask for the smaller implant and also get a second opinion. I don't want to wait 6 months - a year for resolution. After multiple surgeries, chemo an hormonal therapy I am embarrassed to say that this lopsidedness is further dampening my spirits and getting in the way of healing. . I wish I were more patient. I would think I would have learned that by now....

    Thanks again for your help. Hope you are well.

    Best wishes to all.


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  • whippetmom
    whippetmom Member Posts: 6,920
    edited March 2017
    Willa:

    Do not be embarrassed about your symmetry issues! You join a legion of unilateral mastectomy patients who have come before you and will come after you, who will experience this challenge. I would want the best symmetry possible also! So please know these feelings are normal and it DOES impact your mental and emotional ability to move on after breast cancer. My concern will always be your history of seroma. So even though it CAN take several months for swelling to resolve, you will see changes in swellings over that period of time. Because of that history of seroma, your PS should monitor you much more closely than other patients. You should take weekly photos so that you can visually determine if there are even subtle changes in size.

    Please keep me updated on how you are doing.
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  • Krisincali
    Krisincali Member Posts: 2
    edited March 2017

    My PS requested we begin the discussion of which implant by focusing on volume. I don't really understand how to do that... I am 5'8' at 145lbs and 48 years old. I was wearing a 32DDD bra and hated my post baby, saggy boobs that barely were contained in a bra at all! I'm looking forward to having cute perky ones again free from cancer! I want to be smaller, more compact, and ideally a full C cup. No more boob ooze into my armpit. From reading these posts, others have achieved a C cup with cc amounts ranging from 300cc to 800! I'm confused! Anyone have any ideas?

    I have an Alloderm graft, Allergan tissue expanders (not sure which size, but they feel like salad plates in there!) PS has filled it to 250 so far. (That was a nightmare - felt worse than amniocentesis!! How can they make that better? It HURT!) My ribcage measurement is 33 inches... From the pictures and the information on the Allergan site, I believe I want the shaped silicone models. I don't understand how to answer my doctors request to focus on volume...

    Any ideas?

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  • Harasl94
    Harasl94 Member Posts: 5
    edited March 2017

    Hi again Whippetmom,

    Thanks for the info. I saw my PS again on Wednesday and said that ideally I would like to go bigger than my current TE size. He has now decided to continue overfilling by another 100cc over the next few months to bring me up to 450cc I've also since been advised that textured anatomical silicone implants will most likely be used as this is standard across Australia - not sure how true this is? He has said that the implant will either be the same cc as the TE or 50cc smaller. He also said an augmentation will be done on the other non-MX side and to achieve symmetry a small implant of around 125cc will have to be inserted. I have noticed you have a preference for smooth round implants. What are your thoughts on this so far? Do you think this will be okay to achieve what I'm after?

    My details again for you - I'm 5'3", 125lbs and my ribcage circumference is 28" and pre-surgical bra size was 34B. The details of my TE are: Mentor 350cc, Style 8300, Textured, TALL HEIGHT, 11.3 x 11.8 x 6.0

    Thanks,

    Sarah

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited March 2017
    Krisincali:

    I would strongly advise against anatomical (shaped) implants with your prior history of very large, droopy breasts. Your skin is pretty elastic and anatomicals have to fit snug in the perfect pocket. I think your skin laxity might make it very difficult to contain an anatomical that will not rotate inside of a month. Frankly, I cannot tell the difference between an anatomical and a silicone round, once inside of a reconstructed breast. I think you will be in the 500 cc range with implants. There is the newer Inspira implant, which renders very nice results. I need further information regarding your TEs to refine the numbers. But you sound like you are in the ballpark with going to 450 ccs with fills.
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  • whippetmom
    whippetmom Member Posts: 6,920
    edited March 2017

    Haras:

    I do not know what the hard and fast rule in Australia is all about. This is not a one-size-fits-all style of implant. Experts here who are truly "in the know" about anatomicals, believe that there are better candidates than others for anatomicals and the rest are better off with rounds. I did battle this issue with another Austrailian gal about five years ago, so I feel your pain. My recommendations remain the same, as indicated in my prior message.

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  • Harasl94
    Harasl94 Member Posts: 5
    edited March 2017

    Thanks whippemom!

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