BREAST IMPLANT SIZING 101

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  • Ceci-246
    Ceci-246 Member Posts: 50
    edited February 2018

    Hi Vicky,


    I would be happy to start a new forum or topic so that this thread can go back to the topic of sizing and the excellent advice from whippetmom.


    Btw, he may not have said exactly those words about patients caring about the brand - I think he was saying that he considered it his call and didn’t think to ask. While we were waiting for the OR, he looked up the sizes closest to the 500 I asked for, and asked me to choose between 485 and 520. That would have been a perfect opportunity to say “I’m thinking of using Inspira and their sizes are 485 and 520.” He acknowledged that his thinking and hospital processes need revision and thanked me for bringing this issue to his attention. He is the director of breast reconstruction so it’s his job to change the processes. He said he was always more focused on the hospital consent documents and thought the patient brochures were boilerplate FDA mandated language. He asked me to review the Inspira brochure and compare it with Mentor - if I felt so inclined. I am glad my PS realized how clueless he was and will implement new procedures.


    I agree with you completely that these are our breasts and we should be given as much info as possible. My friends think that most women probably don’t ask and just trust their doctor, but I haven’t seen much evidence of that. Instead, I have seen very informed questions and highly educated considerations like your insistence on getting the implants that you want for yourself. Again, I’m so very grateful for the amazing women here.
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  • Amya90
    Amya90 Member Posts: 2
    edited February 2018

    I was told about 800cc being the largest silicone implant but I was still no where near comfortable at 800cc so I chose to continue filling, even if it means getting saline. Next Tuesday I'll be up to 950cc and the last Monday of February I'll be done at 1000cc... And to be honest, I feel so incredibly ignorant about the different kinds of implants. I feel so out of the loop about things.

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  • Rozzydozzy
    Rozzydozzy Member Posts: 3
    edited February 2018

    Whippetmom,

    I’m noticing a decrease in size with the swelling coming down. They are medium height, high profile, memory shape (mentor). I saw my PS this week and he mentioned my left side may shrink after radiation and I may need a revision after that.

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  • b001528
    b001528 Member Posts: 9
    edited February 2018

    Hi, this is my first time posting. I had BMX on 2-2 with TEs. Diagnosed in 2009 with chemo, rads, lumpectomy, seroma emergency surgery and lymph dissection. Thanks for sharing! The TEs are soooooooo painful. I was filled to 240 after surgery but hoping to be smaller at exchange.

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited February 2018

    b001528 - please read the header for this thread so you can provide all the info Whippetmom needs to answer your questions- items 1 through 4. I agree - TEs were very painful. I called them turtle shells

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  • b001528
    b001528 Member Posts: 9
    edited February 2018

    I sent whippitmom a PM, which I included below with her recommendation-

    The cancer breast was 600cc (per PS) and the regular was 1300 cc. The expanders are long and filled to 220cc after surgery. They already look really big and I want small breasts now. II now have Allergan 133MV, 600cc. I am 5'3", 170lbs, 36 waist. What are your thoughts?

    Answer-

    I think you need around 575 ccs in a moderate plus profile (Style 15 Allergan) . Also, Allergan Inspira would be a good choice for you - also in the same size range. You need to discuss this with your PS. You need a width of at least 14.5 cm to 15 cm. This is considered a small implant for your size. So discuss all of this with your PS.



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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited February 2018

    Good oh. Glad you got her recommendation.

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  • Randi64
    Randi64 Member Posts: 177
    edited February 2018

    Thank you in advance for any feedback you can provide to me! I am almost 7 years out from original exchange from TE’s to 500 cc Naturelle implants with alloderm and fat grafting . I’m 5’4 120 pounds. I previously had very large breasts which I enjoyed having. I had asked for the largest that I could get. I’ve never been happy. My fat grafting got reabsorbed pretty quickly. I only had about 30cc’s around each breast imjected. I have what looks like a very flat upper pole area then 2 round circles which unfortunately are very close together not allowing a bigger sized implant which would be wider and maybe lead to symastia. . My new PS is advising me to exchange for the textured gummy bear 410. She said I will not have that flat look at the top and I will get more projection at the bottom. She says that I have to stay with 500 cc’s which is disappointing. I’m afraid I won’t look that different . She will also try fat grating again to add more fullness. I asked her about rotation and she said I have a small pocket and she will make sure they go in snug . She also said something about releasing my scar which I don’t reskky understand. I’m really disappointed about not being able to go bigger bit , does this seem true about looking more natural and that I will have a bit more projection? Will these feel hard inside me? Right now I don’t feel my implants and I never want to!
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  • b001528
    b001528 Member Posts: 9
    edited February 2018

    Has anyone had problems with infected TEs? The cancer side is starting to look red after two weeks. Just a little and no fever. Does an affection come on immediately or is it a gradual process? Thanks

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  • LoveCanada
    LoveCanada Member Posts: 96
    edited February 2018

    I haven’t had an infection but my PS said she thinks I may have extra fluid and it may be fine but to watch it to be sure it doesn’t turn red... which makes me think it could be gradual.

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  • Jadalulu
    Jadalulu Member Posts: 57
    edited February 2018

    Hi Whippetmom, I am trying to decide if I need one additional fill to be at the size I would like to be at. I have been seeing the physician assistant for the last two fills and I feel like she is telling me conflicting information. Here is my info:

    Height 5'1" Weight 145lb (would like to lose about 10 additional) Rib cage 32.5-33 inch TE Allergen 133MX-15-T 700CC's (currently filled to 480cc's) My PS uses Natrelle inspira and classic implants.

    My size before surgery was a 34 EE (Freya bra) I absolutely want to go smaller, but I don't want to go too small for my body style as I have always been curvy. My thought is that I would like to go no larger than a D cup, I know that they are not measured in cup sizes so maybe this is where the miscommunication is happening. The PA told me on Friday that she thought that I would be a C or D cup right now. She asked that I go and try on a few bras in the sizes that I would like to be in, but that was a bust as my expanders are so wide they do not fit properly in the bras at all. She scheduled me for a pre op appointment with the PS on 3/6 which at that time I could have an additional 60cc's on each side to total 540cc's bilaterally.

    What size do you think I should ultimately go to, that would help with knowing if I should have another fill or not.

    Thank you so much,

    Jada

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  • Lalala1
    Lalala1 Member Posts: 20
    edited February 2018

    Hi Whippetmom,

    Just wondering if you know about the Mentor memory gel Xtra round smooth high profile implants? They seem to be new (at least in australia) and have higher fill ratios. They sound similar to the inspira cohesive high fill ratio round implants.

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  • LisaK12
    LisaK12 Member Posts: 107
    edited February 2018

    Hi,

    I was recently diagnosed with DCIS at age 51, and after two excisions with unclear margins am planning to have a double mastectomy in April. Skin-sparing on the left, nipple-sparing and skin-sparing on the right. (DCIS is directly under left nipple so that one has to go). Mine will be immediate, direct-to-implant reconstruction, no tissue expanders, and I do not plan to have nipple or areola reconstruction, just 3-D tattooing. My implants will be placed on top of the muscle rather than underneath (I am physically active with a strong upper body). I am considering anatomical/teardrop shape gummies because I would like to avoid rippling and prefer a natural upper pole with more projection at the bottom vs "hamburger buns." PS says I could get good results with either but seems to have preference for smooth round silicone due to slight risks associated with textured gummies. She does not have a preferred brand of implant and will go with whatever I choose.

    I am 5'2", 155 lbs., and ribcage circumference is 35 inches. Bra size is 34 DDD in Chantelle but varies by brand -- 36 D in most brands. I am comfortable going smaller (have lost 20 pounds over past year) and was happy at 34 B/C back in the day. Advice/suggestions would be most appreciated.

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited February 2018

    coachvicky: I am sure your PS can now say, "you had me at "are you freakin' nuts?" I remember hearing a lot of plastic surgeons say they preferred "a more mature droop for the older patients." Why don't they ask what their OLDER patients would prefer

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited February 2018

    OCDAmy:


    Before you go through a flap surgery, I would prefer very much that your PS perform fat graft transfer to the radiated breast. Yes, with TEs in place. Fat grafting WILL improve the integrity of the skin. Perhaps two - maybe three sessions will be needed- but they are not "invasive" procedures and your lat muscle can be spared. It depends on the skill of the PS - in determining how many surgeries will be required.

    It works and this is why cutting edge plastic surgeons are doing this. If your PS cannot/will not, find someone who can. Trust me - this is much easier than an autologous flap surgery with the attendant recovery/rehabilitation requirements. There is a thread you should find here on bc.org entitled "Fat Graft Transfer and the Radiated Breast." In my next post I will also include some links to further information about FGT.
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  • whippetmom
    whippetmom Member Posts: 6,920
    edited February 2018

    OCDAmy:

    This is not a new and novel part of breast reconstruction. It has been ten years or more in the refining, to the extent that if you google "fat grafting radiated breast", you will see a bevy of plastic surgeons who perform this procedure and know it works.

    https://www.plasticsurgery.org/news/press-releases/technique-provides-new-option-for-breast-reconstruction-after-radiation-therapy

    https://link.springer.com/article/10.1007/s00266-009-9367-3

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited February 2018

    RozzyDozzy:

    Again, fat graft transfer can address this defect, if it occurs after rads. Please see the links I provided for OCDAmy.

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited February 2018

    Randi64:


    You will need to send me photos. Please private message me and attach photos. The reason for the concern about going much larger, is the medial disruption which has led to a partial symmastia. This can be corrected, with the implants moved laterally and capsulorrhaphies performed to secure the medial space. However, a much larger implant would put pressure on that revision/correction and it might fail.

    But please send me photos and let me see what is going on. I personally think you should go to a PS who specializes in complex surgical revisions.

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited February 2018

    b0001528:


    It is most likely a very benign issue -- the reddened skin on one side. It is called "Red Breast Syndrome" and it is felt to be related somehow to Alloderm or another acellular dermal matrix. It is like either an "allergic" response to the Alloderm, or it is a sterility issue. It is rarely, and I mean RARELY anything more than a reddening of the skin which self-resolves in a few weeks to a month. There is a lot of discussion about this on the net. Alloderm now is available in a much more sterile version, which they feel should reduce a number of complications - seromas, cellulitis - and red breast syndrome.

    https://www.medscape.com/medline/abstract/25695440


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  • whippetmom
    whippetmom Member Posts: 6,920
    edited February 2018


    Jada:

    I think you want to be, for example, at 745 ccs in a smooth round full profile Inspira implant. If you go with the new cohesive version, I am sure the sizing would be approximately the same. Your TEs are 15.0 cm in width and you need an implant with that same width, plus or minus a few millimeters. So if you need another fill to achieve this end, then have another fill. But tell your PS where you want to be. The SRF style is linked afor reference:

    image

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited February 2018

    http://simplybreastimplants.com/breast_implant_sizes/natrelle_breast_implants_ca_eu.html

    Lalala: Do you mean the Mentor Memory Gel round extra full profile/projection style? Extra full, not extra round? If so, that style has been available for many years in the U.S. However, if you mean the Inspira implants, which indeed are overfilled, I thought they were already available in AU. Link is above



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  • Moderators
    Moderators Member Posts: 25,912
    edited February 2018

    Dear LisaK12,

    Welcome to the community. We are glad that you reached out here. You have come to the right place for information and support. We are sure that you will get the help that you need and some answers to your questions. PM us if there is anything we can do to help you navigate your way around. The Mods

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited February 2018

    LisaK.....Oh my goodness....I am so sorry to have missed your post. Thanks to the Mods for giving me a heads up about your post!


    It sounds as though you are large breasted naturally, and so this leads me to pose some questions regarding your one-step procedure. Do your breasts droop? I am just concerned that you are going to have some nipple placement challenges if your skin flaps are large and if you are going smaller than you are currently. This is something to discuss at length with your PS. For that very reason - that you are larger breasted - I also agree with your PS about round implants. You risk rotation with anatomicals and they do not really look any different in a reconstructed breast than do rounds. I would opt for the Allergan Sientra implant, in an extra projection style, minimally around 600 ccs and up to 700 ccs. Your PS will bring several sizes into the OR during surgery to see what fits best. Find out also if she is going for to reduce the amount of the skin flap at the time of the BMX. That would have some bearing on the volume of implant which could be used.


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  • OCDAmy
    OCDAmy Member Posts: 873
    edited February 2018

    Whippet mom, thank you so much for this informatio! I am going to speak with my PS about this. I had never heard of this before

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  • Jadalulu
    Jadalulu Member Posts: 57
    edited February 2018

    whippetmom thank you so much for the info!!

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  • LisaK12
    LisaK12 Member Posts: 107
    edited February 2018

    Thanks whippetmom. At my ideal weight at age 25 I was a B cup, then with weight gain over the next 25 years I became first a C cup and then a D. Yes, they droop a bit but not too much. My breast tissue is extremely dense. I never had kids & never breast fed.

    My BS says they will spare as much skin as they can but will have to take some of the skin around the areola on the left, which is why she wanted to make sure that I'm ok with going smaller (and I am). She would remove some extra skin from the right side then as well, but spare the nipple and areola. I will talk to my PS about the nipple placement issue you raised and also about the Sientra. 600ccs or more sounds big to me but I value your expertise in this a great deal and do want to be in proportion with my lower body, which is also curvy. I do expect that I will continue to lose weight gradually over the next several years, as I have been steadily for the past 17 months due to living a healthier lifestyle overseas with eating better and increased physical activity -- so don't want to go "too big." (Although my understanding is that it is more common for patients to complain their results are too small.)

    My goal is "one and done" for now because we are overseas and I am returning to the states for the surgery and plan to be there for 6-8 weeks. My expectations are moderate/reasonable I think -- I'm preparing for the worst (by reading a lot here about others' experiences), but hoping for the best, and don't expect perfection. I know I am likely to need more surgeries down the road eventually. I also have a history of pulmonary embolism and deep vein thrombosis due to a genetic mutation, so am opting for the least complicated way forward that I can manage, with the least downtime possible. Hence the desire to avoid lengthier/additional procedures involving flaps, expanders, etc. I hope that makes sense...

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  • LoveCanada
    LoveCanada Member Posts: 96
    edited February 2018

    Hi whippetmom, I'm interested in your input on my ideal implant size. I'm 5'1", 118 lbs (usually range between 115 and 123), ribcage circumference is 29 in. My tissue expanders are Allergen 400cc and style # is 133MX-12-T (left 21719371, right 21778368). My pre-mastectomy size ranged from 34C to 36D, depending on the bra, but I don't wan't want large breasts. I had a lot of droop (as my surgeon so delicately put it) and now that they're higher, I'm happy to stay smaller. Right now they're filled to 300 and I don't know that I want to go much more, if at all, but I know they'll look different as implants so it's hard for me to tell. My PS said he doesn't overfill and the projection should stay the same since it's over the muscle. Any thoughts? Please let me know if you need any other info. Thanks so much!

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  • shelabela
    shelabela Member Posts: 584
    edited February 2018

    Hi whippetmom,

    When you get time please give me your input on what I should ask for. My PS actually told me to research the different implants.

    Before my BMX. I was a 36b, before kids i was a 36c (full C)

    I am 5'5 weigh 170. My ribcage is 33

    Currently i have Allegran 400CC 133mx-12-T.

    I would like to be back to where i was before kids. A very full 36 C.

    Thanks in advance.

    Shelabela

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  • LisaK12
    LisaK12 Member Posts: 107
    edited February 2018

    whippetmom -- You said "Allergan Sientra" extra projection -- did you mean something else? I think it can be either Allergan or Sientra but not both...

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  • Gemini_girl
    Gemini_girl Member Posts: 32
    edited February 2018

    Why are all posts so old???

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