BREAST IMPLANT SIZING 101

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  • TrmTab
    TrmTab Member Posts: 832
    edited December 2018

    Had my exchange today and am resting in a hotel overnight as my home is 1.5 hrs away and didn't want the bumpy ride and the 83 y.o. mother who now lives with us and would be having a cow over my condition and not let me rest!

    I am good.  They only used a high strength Tylenol during surgery (plus anesthesia of course) and I am just taking Tylenol now. I do have the hard stuff, but if I can do okay with Tylenol (which I did at MX and first exchange) so much the better.

    I am supposed to see the PS in two weeks...but that is New Year's Eve, so don't see her until Jan 2, Yikes!  I do have emergency contact and my PCP at home knows I may reach out to her...but have all good thoughts so far!

    Only walked 6K, so far, but that seems okay given the procedure...walking up and down the hotel hallway, and was okay enough to go into supermarket with DH on way home from hospital so we could have some food supplies used the cart like a walker as needed, good to stretch my legs...the room has a living area with wet bar so I am good with the lite fare we were able to get.

    Take care all, TT 

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  • JennieKeaton
    JennieKeaton Member Posts: 80
    edited December 2018

    Hi Whippetmom - here's my information:

    5'4", 120 lbs, 30" ribcage.

    I have aerexpanders with a volume of 400 cc.

    Pre-mastectomy, I was a small B cup.

    I am thinking I want teardrop shape, moderate plus. Gummy bear? Smooth silicone natural width.

    Does this make sense for me? I want to be a full Bish. Want to have a natural teardrop shape - not too rounded and not too high.

    Thanks for all you do!

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  • Gloriana1952
    Gloriana1952 Member Posts: 4
    edited December 2018

    Hi! I've been reading these forums for a couple of months, but this is my first question.

    I had a BMX on Sept. 28, 2018. I had tissue expanders put in at that time. Sorry I don't know more specifics, but my PS uses Mentor products, and I believe they are 800cc expanders. They're pre-pectoral, which is what my PS prefers.

    I am 5'4", 230 lbs., and preoperatively I wore a 44B-C bra. My chest measurement is 42". I've finished with the TE fills now; they are filled to 960cc. I now fill out a 44D bra quite fully.

    My exchange is scheduled for Feb. 13. I had the choice of a 800cc Mentor round smooth high profile silicone implant, or a Mentor saline implant which could overfilled. At my last meeting with my PS, I expressed a desire for silicone, because it's softer. PS asked, "That will be somewhat smaller than what you have right now, is that okay?" I said that I thought it would be.

    However, I like the way my chest looks in my clothes right now; I feel much more like a "figure 8" than like a "pear". So I'm still conflicted. I like the idea of the softness of silicone, but I also like the look of large breasts. With your experience, can you give me any thoughts about how the 800cc silicones would look on a woman of my size? Or how the saline implants look/feel after 6-12 months of "wearing in"?

    I'm hoping to make a good decision, so I can use all the tips I can get.

    Also, whippetmom, do you currently have whippets? I love them. I work with greyhound adoption and have one living with me now (I did have two). Woof!

    Thank you,

    Gloriana


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  • Imkopy2
    Imkopy2 Member Posts: 265
    edited December 2018

    JennieK please read the full header up top for Whippetmom to give you an accurate evaluation. If you’re not sure of some information please contact your PS office. Whippetmom os not as active on this board as she used to be hopefully you get the info posted before she pops up next. She is truly amazing with sizing if she has all of the info requested.

    Hugs,

    Michelle

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  • VegGal
    VegGal Member Posts: 507
    edited December 2018

    I've heard that larger silicone implants can be custom made. That way you could get your silicone and the size you want, too. 


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  • Gloriana1952
    Gloriana1952 Member Posts: 4
    edited December 2018

    Unfortunately custom implants are not a possibility for me. I can only choose one of the two offered (both Mentor). I hope someone will be able to offer some perspective for me. Thanks

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

    Gloriana - When she checks in, Whippetmom will still need the model # of your TEs as stated in the header. You should have gotten a card from your doc, but you can call the nurse to get that info.

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

    Julia81:


    I think that an extra full projection style smooth round Allergan Inspira would be a good style, with a size range of 550 ccs to 620 ccs.. I would not advise going braless. What is holding up the implants? Skin, primarily. Like a rock in a very thin sock.
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  • whippetmom
    whippetmom Member Posts: 6,920
    edited December 2018

    munmunmary

    What did you end up with? Hopefully more than 300 ccs.....

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

    borogirl

    You want the implant, in most cases, to be larger than the tissue expander. Every plastic surgeon has a different view regarding sizing. There is no hard and fast rule. A 450 cc implant will be smaller than a 450 cc TE. I am referring to a 450 cc TE, not a 450 cc TE overfilled to 600 ccs. You have to look at the dimensions of the implant and dimensions of the TE.

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

    TRMTAB

    Yes, as Coach Vicky said, so beautiful! Thank you so much for the reminder about gratitude!❤️❤️ I look forward to hearing about your results!

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

    JennieKeaton

    I do not have access to the AirExpander sizing right now. In a reconstructed breast envelope, you would see very little difference between an anatomical implant and a round implant. If you go with an anatomical, I would advise only a high profile or extra full profile. A moderate would be fairly flat in terms of projection.

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

    I will provide more answers tomorrow.

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

    JennieKeaton:

    Okay, I have the sizing info now for your AirEx's. 12.5 cm width and 8.0 cm projection. There is no anatomical implant which matches the dimensions of your TEs. That is the caveat with anatomicals. The implant needs to match the pocket dimensions, or the implant is at risk of rotating or distorting the pocket. Look at the Allergan Inspira implants - SCF or SRF - (you might like the SRF better) - I will check the sizing and edit this response.

    You have several options. SRXbis the smooth responsive gel, extra high profile style implant. In this style, I would suggest 470 ccs or 495 ccs. You would be closer to a C cup with this style. The other option is SRF, the full profile style version. With this style, 415 ccs is my reccomendation.

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

    Gloriana:

    Yes, I had two whippets but we are down to one now. I love greys also.

    I think that, unless you planned to lose 50 pounds, you had better go with the Mentor saline implant that overfills to 960 ccs. Many of us lost weight after breast reconstruction, and our bra size increased. The largest silicone will be the Inspira SCX or SRX, 800 ccs. The width is 15.5 cm and the projection is 6.7 cm. Perhaps the Inspira would be an option, if fat graft transfer could add some volume. That is a pretty good sized implant.

    One thing to consider is that it is easier to go larger at some point, but not so easy to go smaller. Pocket revision would have to be done to reduce the size for smaller implants, and the pocket narrowing does not always "hold".

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

    Gloriana: Wait - just read your response to VegGal. Why only Mentor? Where are you that your PS would not have access to Allergan?

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  • Gloriana1952
    Gloriana1952 Member Posts: 4
    edited December 2018

    Whippetmom, thank you for your advice. I’m in the Ozark area. My PS has stated that she only uses Mentor - I don’t know if that’s a professional preference, or if there’s another reason. But I won’t be switching doctors at this point. I had thought that saline would be more comfortable, since the TEs feel kind of like rocks at this point. Do the actual saline implants have any more “give” to them? Thanks again

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  • Ebronson19
    Ebronson19 Member Posts: 17
    edited December 2018

    Dear whippetmom,

    I'm hoping you can give me some food for thought on implant sizes to discuss with my PS before I schedule the exchange surgery. I had a double nipple/skin sparring mastectomy in June 2018, and just completed chemo, I will not need radiation. I told my PS that I would like to be the same size or a little bigger/fuller so that made me a good candidate for the nipple/skin sparring (combined with my cancer location/margins). Here's my info:

    5' 6.5" 125-130lbs, pre-surgery I had a 28" rib, and currently I have a 29" rib. I carry most of my weight in my hips, and have a 'bony' chest/shoulders.

    Pre-surgery I wore 30D or 32D bras mostly. I always wore push-up bras too because my breasts were full on the bottom but there wasn't much in the top half.

    My TEs are Mentor 300cc TEXP110RH, and measure 11cm diameter with a 6cm projection. I had a 10.5cm base width pre-surgery measured by PS.

    I am currently overfilled to 350cc, and PS told me he would like to stop at 400cc. He prefers to overfill.

    My implants (and TEs currently) will also be placed over the muscle with alloderm, and PS plans to do fat grafting. I'm ok with over-the-muscle implants, not sure about the fat grafting yet.

    My PS doesn't have a preferred brand for implants, he will get whatever I request. I did tell him I was leaning toward smooth round implants though.

    I think I covered everything, whew! I would also be willing to send photos if needed, my TEs look especially strange, since as I said I am rather thin on top and you can see all the tabs on my TEs😲. But overall, I want to maintain my semi-curvy proportions that I had pre-surgery.

    Thank you in advance!

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  • MACTAZ
    MACTAZ Member Posts: 597
    edited December 2018

    Hi Whippetmom - was hoping to get some feedback on my PS selection of TE and just some thoughts on his comments for a implant. I am having a UMX of right breast and probably breast reduction and lift on left breast.

    First, my measurements are as follows: Height: 5' 4 1/2" Weight: 132 but that is low due to chemo. I am hoping to retain weight around 135. Rib cage circum: 31" Current bra size, I know this isn't much help, is 34 DD. My right breast, which will have the mastectomy, is larger. I'm hoping to go down to a C or small D.

    My PS uses Allergan for both the TE and the implant. TE: He said he would be using Allergan TE 133FX, tall, extra projection. Implant: Allergan gelfilled smooth cohesive silicone round. He will select size based on where we end up with the fills in the TE and will bring in several shapes and sizes of implants to best match the left breast.

    Let me know if you need anything further, thanks so much.

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  • JennieKeaton
    JennieKeaton Member Posts: 80
    edited January 2019

    Hi Whippetmom -

    Update - my PS uses Mentor implants. We are looking at the textured. I know it comes with some risk, but it's the only way to get the teardrop look I want with my body size/shape. Would you keep the same cc's in that?

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited January 2019

    Gloriana. Saline implants will feel much softer than your TEs

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited January 2019

    Ebronson:

    Yes..private message me photos. I think you could use the Allergan Inspira SRX or SCX, in the 450 cc to 500 cc range, but let’s look at photos.


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  • whippetmom
    whippetmom Member Posts: 6,920
    edited January 2019

    MACTAZ

    I would imagine your PS would use a TE - FX - 400 ccs or 500 ccs. It all depends on the width of your native remaining breast. The future implant size will be chosen based on the width of the TE and thesize of the reduced native breast.

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited January 2019

    Jennie:

    With breast reconstruction, you would not likely notice the difference between an anatomical and a round. But the anatomical would need to match the dimensions of the TE. As I stated, there is no compatible anatomical to compare to your TEs. The closest would be Allergan 410 MX, 410 ccs.

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  • MACTAZ
    MACTAZ Member Posts: 597
    edited January 2019

    Thank you Whippetmom.

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  • Avefenix268198
    Avefenix268198 Member Posts: 7
    edited January 2019

    Dear Whippetmom,

    Thank you for your input, was very useful, turns out that my PS switched from Mentor to Natrelle, and he used anatomic 360 ccs (he insisted on anathomic vs round), and the projection is just great 7 cm! Nobread buns anymore! Thank you!

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  • Gloriana1952
    Gloriana1952 Member Posts: 4
    edited January 2019

    Thank you so much. I’ve decided to go with saline implants, sized to about 960cc. Reading on this forum has really helped me. My exchange surgery is scheduled for Feb. 13.

    Gloriana

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  • SpankyG
    SpankyG Member Posts: 13
    edited January 2019

    Dear Whippetmom,

    I'm new to the forum but not to the world of breast cancer. I'm hoping you can give me some advice on this very complex subject regarding implant sizes in relation to body type when doing breast reconstruction.

    My History

    I'm a 54-year-old female living in Ontario Canada. I was diagnosed in October 2015 with Apocrine Breast cancer of the left breast (Grade 3/Stage 1). In November 2015 I had a lumpectomy of my left breast followed by Chemotherapy, Radiation & Herceptin treatment. I finished all of the treatments in April 2017.

    In October 2018, I was diagnosed with DCIS of the left breast. As a result in consultation with my surgeons I had a bilateral mastectomy of both breasts (right side was prophylactic measure) with latissimus dorsi flap surgery on the left side (due to the radiation) and expanders placed in both breasts for eventual silicone impants. The surgery was skin sparing, but not nipple sparing.

    My Measurements

    I am currently 5'7" tall, current weight 195lbs & current ribcage circumference 39 ½". I gained about 35lbs during the latter part of my first diagnosis while on chemo. It was due to stress eating and medication I was on for my emotional state. I intend to lose this weight & get myself back to where I was before all of this.

    I was a large breasted woman (36DD before cancer) and 38DD just before the bilateral masectomy. I'm hoping to get to a D cup after all of this is done.

    My Expanders

    My Expanders are Mentor 550cc Style 9300. As of today I am filled to 660cc (left) & 600 (right) after four fills. I have another fill scheduled in 2 weeks.

    From what I understand, my right expander is under the muscle and the left is over the muscle and under the latissimus dorsi flap.

    Implants

    My PS uses both Allergen & Mentor implants, depending on the needs and the patient's preference. He only uses smooth implants.

    From my internet sleuthing on the topic of breast reconstruction, I believe I probably need to go with the large 800cc implant to get anywhere near the D cup that I was hoping for. The profile options however are very confusing. I'm not sure what profile is right for my body type.

    My PS mentioned today that he may use the same size implants on both sides despite the latissimus dorsi flap giving me extra size on the left. He said that he considers this in many cases because the latissimus dorsi muscle eventually atrophies and reduces in size.

    Thank you so much for providing women with this help.

    F

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  • Macmom81
    Macmom81 Member Posts: 1
    edited January 2019

    Hi, Im new here. Just had my surgery on January 15th for the switch to implant. Im 5'5, 145lbs and ribcage 36. Dr put in 650cc Mentor smooth high profile xtra. What size would I probably be? Had my DMX on Sept 5th.

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  • concerned81
    concerned81 Member Posts: 3
    edited January 2019

    Hi! I just had my exchange on Jan 18th. I am wondering if the size and look of my implants will change over time. I’m having quite a bit of depression from seeing them yesterday for the first time because they look so small and flat.

    Prior to bilateral mastectomy, I was a small A cup. I had a skin sparing bilateral mastectomy and my plastic surgeon put in 300cc Allergan 133MX-11-T expanders. I was only filled to around 260cc and experienced a lot of bruising and increasing pain with each expansion. The plastic surgeon originally suggested that he would use 315cc final implants.

    I am 5’3, 110 pounds, with a 30 inch ribcage. After the exchange, I ended up with 255cc SCM Naturelle Inspira Cohesive implants. I’m concerned that they are too small for my body, but I’m not sure if it is because I got used to the projection from the tissue expanders. Also, it seems like most women get a lot larger implants. Is what I see in the mirror now the final look? Does the implant seem right for my body?

    Thanks



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