Expander Size to Get C Cup after Mastactomy

Question

How many CC should be added in the expander during the breast reconstruction after the mastactomy, to get size "C" with selicon implant ?

David Greenspun, MD, MSc · Answer

Since every woman's breast and chest anatomy are different (different chest width, different chest height, different chest shape, etc.) and since implants come in a variety of shapes and sizes, there is not a specific volume of expansion for a "C cup" breast. Since you are undergoing tissue expansion, you will be able to work with your plastic surgeon to determine what volume of breast size fells and looks best for you. When you get to a point in the expansion process that you are satisfied, let your surgeon know. They will then, most likely, "overexpand your tissue expander and then plan on exchanging it for an implant in the range of volume that satisfied you.

Raj S. Ambay, MD · Answer

Cup sizes are not scientifically measured. Every bra fits different.  An expander can be inflated until you are happy with the size then an implant of that volume can replace the expander

Steven Wallach, MD · Answer

This is sometimes very difficult to determine.But an easy thing to do for you is as you fill up the expander see at what volume you are happy. Then an implant can be chosen to match that volume.

C. Bob Basu, MD, MPH, FACS · Answer

If you have a tissue expander implant for your first stage of implant based reconstruction, you will have a say in your final volume during your expansion process. You will get a good idea of your breast size during the expansion process. Everyone's anatomy (chest wall width) is different so it is difficult to nail down the cc's to achieve the look you want.

Paul Gill, MD · Answer

I typically begin by asking the patient to let me know once we reach a tissue expander volume that allows them to look and feel normal in clothes.  This is very important, as many bra designs have differing cup volumes, but how one looks and feels in clothes will not change.  

	A typical rule of thumb is that 150-200cc of fluld are necessary to increase a cup size.   Therefore, starting from a mastectomy, approximately 450-600cc would be necessary.   This will also depend on your chest wall width, body size, and breast skin envelope characteristics.   I typically will overinflate the expander by 10% once I reach the target goal of my patient to ensure i have enough skin to create a natural result.  I will then bring a variety of implants to the exchange procedure to try on during surgery to ensure the best shape and size based on the patient's goals.   

	I hope this helps and I wish you a safe recovery.

	Paul S. GIll, M.D.

	Gill Plastic Surgery

	Houston Double Board Certified Plastic Surgeon

Samer W. Cabbabe, MD · Answer

You will need to be over-expanded, larger than the final anticipated cup size.  An estimate would be at least 400 cc.

George J. Beraka, MD (retired) · Answer

Hi.

	1)  This is just an estimate.  A C cup in a small woman and a C cup in a large woman have very different volumes.

	2)  Explain to your surgeon the look you want.  Tell him or her if you want to remain the same size or if you want to be bigger.  The important thing is to use a tissue expander with a large enough capacity at the time of surgery.  Then you can fill it to any desired size in the next several weeks.

	3)  The expander is temporarily overfilled to stretch the tissues.  So if you wanted 400cc permanent implants, we would expand you to at least 500 cc's.

	4)  You need to trust and communicate well with your surgeon.

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