BREAST IMPLANT SIZING 101

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  • Tunik
    Tunik Member Posts: 21
    edited April 2020

    Hello ladies,

    Hoping to get some guidance on implants. I had my BMX 6 weeks ago with TEs: SMXP120RH Mentor Artoura. I'm currently filled to 300cc. I'm 5'5, 125 pounds, rib cage 30''. I lost 10-15 pounds during chemo and before surgery used to wear 34B bras. I would like to end up about the same size as I was prior to surgery. Also, I will need to have radiation. As I understand to account for shrinkage the radiated breast is typically overfilled. By how much?

    I've been asking my PS about my options and the only answer I've got, "we'll keep expanding till you are happy with the size". But it's so hard to judge the size with the expanders! Thank you for your help!

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited April 2020

    ijl: What did you discuss during your appointment last Tuesday? Did you find out what brand of implants your PS uses? Allergan or Mentor?

    An implant alone will probably not look the same as your DIEP side. It can have symmetry though. I have no idea what size of implant you will need, because I have no idea of the dimensions of your DIEP side. That is what will be the determining factor in choice of implant. The width and projection of your DIEP breast will dictate the width and projection of the implant.

    Debora

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited April 2020

    Tunik:

    The implant that I would recommend is the Mentor Xtra Smooth Round High Profile implant. The volume would be 450 ccs to 465 ccs. Your PS will know how much overfill you might need to compensate for irradiation. However, I would also recommend that you discuss fat graft transfer to the breast after radiation, at the time of your exchange to implants. Fat grafting will help ameliorate the deleterious effects of radiation. Once you fill to 375 ccs, you should have a better sense of the size. Let me know how you feel about the size once you reach that fill level. Also, Allergan has implants in the Inspira line, which I feel would work well for you also. But ask your PS if he will use Allergan. If he will, let me know and we can work on some sizing options with that brand as well.

    Deborah

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  • ijl
    ijl Member Posts: 897
    edited April 2020

    Hi whippetmom,

    My PS said he has access to any implant manufacturer. He suggested Allergan round smooth silicon cohesive for me. He did say that my size is not too large so it made me feel better.

    I know that my breast with implant will not look as good as my DIEP one but as long ast they look ok in a bra I will be happy. He said that we can also do fat grafting to enhance the look. I am feeling much better after spending 45 minutes talking to him.

    Are Allergan and Mentor round smooth implants pretty similar ? or one of them is 'better'

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  • Tunik
    Tunik Member Posts: 21
    edited April 2020

    Thank you, Whippetmom. Really appreciate your guidance. Does it mean that I will be expanded to 450 ccs? Or is it 375ccs and then the implants will be slightly larger?


    I will check with ny PS about Allergan. Is Allergan preferred to Mentor? Or does it come down to doctor preferences?

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited April 2020

    Ijl.

    I would go with Allergan Inspira - the cohesive line your PS mentioned. Wider range of sizes.

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited April 2020

    Tunik: The dimensions of your TEs, filled to 375 ccs, match the dimensions of the implants I mentioned. Your PS may or may not need to overfill. Since you will have radiation to one side, perhaps that side will need some additional fill. It's up to him.

    Allergan Inspira has more size options

    Deborah

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  • e32
    e32 Member Posts: 55
    edited April 2020

    Hi Whippetmom! I have no idea what I'm doing. How can I find out what kind of TE I have? I am currently in TE with no fills yet due to COVID-19. I am just researching implant info and thinking about sizing. Can I still get sizing guidance without knowing some of the info you asked for?

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited April 2020

    emmaj99

    Call your plastic surgeon’s office and ask the nurse to look in the chart. Your tissue expander data must appear in your chart. Also, I need your height, weight, ribcage info

    Deborah

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  • Tunik
    Tunik Member Posts: 21
    edited May 2020

    Hi Whippetmom,

    So, I got my fill to 375 cc this week. I think I'm ok with this size. Maybe slightly larger would be OK but I don't think I want any smaller than this. I have one more fill to overfill the side to be radiated. So, does it mean that I still would be able to get 450 to 465 cc in Mentor Xtra Smooth Round High Profile implant? This is the brand my PS is using. Thank you! This is all so confusing.

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited May 2020

    Tunik: Shoot for the 465 cc volume. Did you discuss fat graft transfer with him? I think that you will need to wait at least three months after radiation. Right? You will know by then if there is a need for fat graft transfer. I wager you will.

    Deborah

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited May 2020

    Tunik: Shoot for the 465 cc volume. Did you discuss fat graft transfer with him? I think that you will need to wait at least three months after radiation. Right? You will know by then if there is a need for fat graft transfer. I wager you will.

    Debora

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  • Aftonfog
    Aftonfog Member Posts: 7
    edited May 2020

    Hello there!

    This thread has been a godsend!

    I am scheduled to have a BMX in June (waiting on official date because of the virus). Before I make my final decision, i wanted to reach out to you ladies.

    I spoke with my PS again yesterday to discuss reconstruction options. He really wanted to go for the direct to implant route for me, but I decided against it because “I will likely stay the same size or slightly bigger.” He then said tissue expanders are the only other way because I want to be smaller than I am now... Like small B. I’m not thrilled that I’ll be off my feet for longer and have second surgery, but it appears to be the only way to go smaller???

    I’m 5’6” 116 pounds with 29” underbust. If I measure across my bust, it’s 32.5-33” depending on the day (so maybe full C, small D). I really want to be smaller (B), and if he can’t make that happen, I’ll end up going with no reconstruction.

    Before my surgery, I will be able to consult with him again. I’m seeking advice on type of implant that could work best, cc amount range, or anything else helpful.

    Thanks!

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  • wulfgirl4
    wulfgirl4 Member Posts: 38
    edited May 2020

    Hello! I just had my second fill today so I'm up to about 165 ccs so far. I'm usually about 148 lbs... but chemo & steroids added more weight on... I don't plan to keep it on. Any advice you could give would be so much appreciated!

    1. Height= 5'5, weight= 162 , Ribcage circumference = 32

    2. Mentor Low Height (TE)

    3. Mentor Memorygel round smooth walled silicone implant will be used

    4. Pre mastectomy size = 34C

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  • Tunik
    Tunik Member Posts: 21
    edited May 2020

    Hi Whippetmom,

    So I saw my PS today. They were able to safely add 50 cc to my breast to be irradiated, so I'm up to 425 cc. The implant you recommended was 450-465cc. They noted that the skin was pretty stretched and if I wanted to add more, I needed to wait another 2 weeks. The question is do I delay radiation to get another fill in? The PS said they could try to expand after radiation as well but I've been reading here that it's complicated. They do fat grafting at the exchange surgery. Any advise?

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  • Sunshine39
    Sunshine39 Member Posts: 8
    edited May 2020

    Hi Wippetmom,

    Hope you are doing well during this crazy time. My exchange surgery was initially scheduled earlier this year but was postponed twice due to Covid. It's now rescheduled for this month. Though I still am uncomfortable (I'm located in NYC) to have the exchange, I really would like this to be over with. Below are my stats if you could kindly suggest a model and size for me. I'm currently filled at 420cc and I think it's too big.

    height - 5'4"

    Weight - 125

    Ribcage - 30

    Bra size prior to nipple sparing mastectomy - 34b And would like to be the same size

    Current expander - Allergan 133s Mx 12-T and i will not be radiated.

    The PS ordered Allergan ssf and ssm for each of the following volumes in cc (360/375/385/405). My concern is that they will still be too big for me.

    If helpful, I can pm you the pictures.

    Thank you very much in advance!

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited May 2020

    Aftonfog:

    Well, I think that your PS will need to reduce the skin flap somewhat, in order to achieve what you want in terms of size. If you go the TE route, you want to stay in the 200 cc or 250 cc range with tissue expanders and exchange out to something equivalent with implants.

    Deborah

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited May 2020

    wulfgirl:

    What is the volume of your tissue expanders? Not the current fill level, but the actual volume when final fill is achieved.?

    Deborah

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited May 2020

    Tunik: I am sorry, but I cannot answer that question. You say your PS feels your skin is “pretty stretched”, and so he is the only one who can tell you if it is possible to continue with fills.

    Deborah

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited May 2020

    Sunshine39:

    The sizes you listed do Include the SSM volume selections, which would be 310 or 330 ccs. I personally think 360 ccs in the SSF would be best, but if you want to minimize projection and have a flatter appearance, the SSM style would be the choice.

    Deborah

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  • Aftonfog
    Aftonfog Member Posts: 7
    edited May 2020

    whippetmom,

    Thank you for your feedback. I was hoping this was possible. He did say that the tissue expanders were my only option if I wanted to stay on the smaller side. However, my BS did suggest that another option would be to just do nipple reconstruction now and give myself time to think about TE surgery at a later date. I explained to her how hesitant I am to have implants in general.

    I have another consultation with the PS on Wednesday to discuss everything.

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  • sage
    sage Member Posts: 24
    edited June 2020

    I had a BMX on 3/13/20. This was prophylactic due to PALB2. My right breast (cancer 9 years ago with radiation) was filled to 120ml during BMX. My left was too but had a hematoma and they had to go back in one week after BMX and new TE was not filled. Then came COVID-19 and my State was shut down. Therefore, I went 2 months before my first expansion.

    Here's my stats: 5'4" 155lbs 36B

    My TE is the Mentor CPx4 650ml. Here are my fills to date (with breast totals after the =):

    5/13/20: L 200ml (0ml @ surgery) = 200ml, R 80ml (120ml @ surgery) = 200ml

    5/20/20: L 200ml = 400ml, R 200ml = 400ml

    5/27/20: L 150 ml = 550ml, R 150 ml = 550ml

    6/3/20: L 50ml = 600ml, R 50ml = 600ml

    6/10/20: L 80 ml = 680ml, R 80ml = 680ml

    My first 3 fills made the expanders feel much better. Last 2 have been tight but not unbearable. Skin looks good. My PS overfills and I did not have nipple/skin sparing so he would like room to work with and have nice clean scars.

    I have one more fill scheduled next week and then see where they are at if need one more. Does this seem like a reasonable schedule and do you feel at 650ml I will end up with breasts close to my original 36B? To be honest, I want to end up with nice perky sexy breasts. I mean I didn't go through all this $#%! to not be happy with the final product! But I don't want to be too big either! Please let me know your thoughts! Thanks.

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited June 2020

    Sage:

    I would suggest the Mentor High Profile Xtra Smooth Round Implant - 700 ccs. 650 ccs minimally. Ask you PS if he will also use Allergan implants. If so, I can give you sizes in that brand also

    Deborah

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  • beeline
    beeline Member Posts: 308
    edited June 2020

    Hi Deborah, thank you so much for doing this, it's amazing! Here are my details:

    Height - 5'3"

    Weight - 110lbs

    Braline - 28.25

    I previously wore a 34B, though was more like an A post kids. I would love to look like a full B or small C if my radiated side will stretch to accommodate it. I don't have TE's yet. Meeting with the PS on the 23rd. I will ask about brands then.

    In the meantime, can you tell me what you would recommend?

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  • sage
    sage Member Posts: 24
    edited June 2020

    Thanks Deborah. Just read about your suggestion and it seems like a good fit. If my PS works with Allergan, I will let you know. Stay safe!

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  • whippetmom
    whippetmom Member Posts: 6,920
    edited June 2020

    beeline:

    I think you will want to end up with high profile style, smooth round silicone implants in the 350 cc to 400 cc range. So whatever tissue expanders your PS will need to get you there is what you need to discuss with your PS.

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  • Susug
    Susug Member Posts: 193
    edited June 2020

    Hello,

    I was wondering if you have ever heard of FlexHd pliable Pre, an internal dermal brassiere created by Dr. Spiegel from Houston tx? I have a very good friend who is having surgery next week with her. I read her website and am very impressed with this procedure. Do you know about this? If so, do you know of any surgeons in Dallas tx that do this procedure? Thank you, Susan

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  • beeline
    beeline Member Posts: 308
    edited June 2020

    Thank you Deborah!

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  • Tigereyes
    Tigereyes Member Posts: 1
    edited June 2020

    Hi! I am so grateful to have found this discussion! Just reading the posts has given me a better vocabulary to use in discussing implants with my PS. I have my exchange surgery coming in August.

    I would appreciate your thoughts about sizing given my stats below. As one woman said, I want to make lemonade out of lemons and would like to be a little bigger than before my mastectomy. Maybe a small or full C? My desire is for my top half to be in better balance with my bottom half (hips and thighs) which is where I carry extra weight. Prior to surgery, I wore push-up bras to help give some projection. My current fill is 350 cc's which gives a nice projection for my frame. However, I am now wondering if the implants, which lie more naturally on the chest, will not give me the projection I would like at current fill. Will I have the same projection or should I go larger? My PS said he has ordered 3 sizes to try in surgery - 375 cc, 400 cc, and 425 cc. I am comfortable with him and his team making a "game-time" call with a range of implant sizes but I am now thinking I need to convey my desires for a nice projection - one in which you know I have breasts under my shirts!

    Here are my stats:

    Height - 5' 6"

    Weight - 135 pounds

    Ribcage circumference - 29.5 inches

    Current TE - Allergan 133S-MX-12-T, 400 cc

    Bra size prior to bilateral mastectomy - 32 B (a small B)

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  • wulfgirl4
    wulfgirl4 Member Posts: 38
    edited June 2020

    I asked the PA what the volume of my TE are and she was very vague... so I don't have an answer. :(. She told me to just try on one of my old bras to see if I'm where I want to be. I am at the size I WAS.... but want to be bigger, just not sure how much w/o looking fat or too big.

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