I am planning to go under an exchange surgery from expander to implants. I am 5'1", 105lbs., whose chest width (arm pit to arm pit) is 12 inches. In order for me to achieve a natural yet perky-looking medium B cup size, which between high profile silicon implants or moderate plus implants is recommended? If so, how many CCs?
Medium Plus Profile or High Profile Implants for Breast Reconstruction?
Doctor Answers 15
Achieving a "perky" look in implant breast reconstruction
To achieve the "perky" look after post mastectomy reconstruction, I generally recommend either high profile (Allergan style 20) or ultra high profile (Allergan Style 45) silicone implants. The choice of the implant will depend on your surgeon's assessment of your base width and desired implant height. In addition, your surgeon will also likely reference the volume currently in your tissue expander implants.
Which profile-type implant for breast reconstruction
AS you alluded to, there are different projection types for breast prosthetic implants. There are low, moderate, moderate-plus, high, and extra-high. In addition, to this, other factors to consider are saline vs. silicone, textured vs. smooth, as well as round vs. shaped. All of these factors should be considered during your evaluation in order to assist you in determining which implant would be best for you for reconstruction of your breasts.
Breast width is, in my opinion, the most important determinant for breast implant size. I also typically use a high, sometimes extra-high, projection implant as I believe that the projection is necessary post-mastectomy, since the breast tissue has been removed and the reconstruction is now completely dependent upon the implant itself. This also gives a desired "perky" and "lifted" breast mound appearance.
Giving you recommendations for volume is difficult without an examination. However, as stated, measurement of your breast width (from sternum to lateral breast) is important to fit the breast pocket that will be created. If you have had a tissue expander placed, exchange of an implant for a similar size volume during your second stage, once you and your surgeon have determined that you have been adequately expanded, may also give you an idea of which size/profile-type is best for you. Hope that this helps! I hope for an excellent result for you!
Choosing the right implant
This is probably one of the most difficult parts of breast reconstruction. I use the dimension approach to determine base diameter and projection and then see what is available. I always make sure there are an assortment of sizes and projections for me to use as well as the sizers for trial during the surgery. This is usually left to your surgeon at the time of surgery after discussion as to size and shape with you. Your plastic surgeon may suggest doing something to the opposite breast to acheive the best symmetry such as a lift or augmentation.
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To choose high profile breast implants... or not
The decision for implant projection depends on the width of the expander (which is based on the width of your natural breast) and the volume that you feel comfortable with.
Choosing an implant for reconstruction differs significantly from a cosmetic procedure because there is no longer overlying breast tissue.
The goal is not to augment what is there, but to replace what isn't. For this reason, most women seem to choose high profile implants because they feel more comfortable with larger implants.
That being said, if the high profile device for your breast width is a much higher volume than what you feel comfortable with (as determined by the volume in your expander), then the moderate plus is the better option for you.
This can be confusing, but here is an example of implant sizes:
- High Profile Silicone Implant: A 12cm diameter implant has 375cc of volume resulting in 4.8cm of projection
- Moderate Plus Profile Implant: A 12cm diameter implant has 300cc of volume resulting in 3.6cm of projection
The high profile simply puts more volume in (and thus more projection) the same diameter (base width) implant. The base width is given by your unique anatomy and the volume by your comfort level.
Hope this helps you with your decision.
Measurements determine the best implant for you after breast reconstruction
I assume you are having both breasts reconstructed. If just one side, the remaining breast has to be considered so there is a good match. Basically, we use measurements to determine what implant is best for you.
The base width of the expander and its projection are all important as is the fill volume. If you are having reconstruction with the style 410 silicone implants, the measurements are very important. In general, we try to match the implant to the pocket dimensions in terms of width.
For volume, we usually remove volume from the expander in the office until we reach the volume you like.
For projection, it depends on the elasticity of the skin, the optimal width of the implant and the volume desired.
You can have a pretty result with either a high profile or a moderate plus implant. Your plastic surgeon should work with you so you understand the selection and feel comfortable with the choice.
Choosing between medium plus and high profile breast implants
In my practice, I limit my breast implant choices to medium plus and high profile implants in most cases. This provides excellent projection of the breasts and limits lateral fullness of the chest wall.
In your particular case, both medium plus and high profile implants would be suitable. The dimensions of the breast that you desire in terms of breast height vs. width dimensions is a matter of personal taste and must be addressed with your surgeon. Your base diameter is an important determinant, as well as your breast proportions. These should be measured and recorded by your surgeon.
Choosing the right implant for breast reconstruction
Naomi - Thanks for the question. It is a challenging one.
The reason it is so hard to answer is there are many unanswered questions -
What was the size and shape of the tissue expander? How much was it over inflated?
What is the shape and position of your other breast?
Are you planning on surgery on the other breast?
What is your normal breast diameter?
It would be simply a wild guess to provide you numbers without an examination.
Sorry we can't provide more information.
To get the best results your expanders have to have done their job!
Implant choice for breast reconstruction in my practice done with shaped devices. The projection is chosen based on the expander choice and the tissue response from expansion.
Breast Implants after Tissue Expander Breast Reconstruction
Generally most patients who undergo implant based breast reconstruction where tissue expanders are placed and expanded until the appropriate size is reached benefit from high profile implants. Often I will also use extra high profile implants in patients wanting a perkier fuller look. To learn more visit our site below.