I would like to be a 34 B/C after double mastectomy. Can I get a smaller implant?

Question

I was diagnosed DCIS. On August 6, 2018 I had a nipple sparing double mastectomy with expanders placed. I am 5’2 120 lbs .The Dr filled me to 475cc in one visit. I would like to be a 34 B/C. Can I get a smaller implant?  What size is recommended?

Anthony A. Admire, MD, FACS · Answer

Thanks for your questions regarding implant sizing. Overfilling expanders to a larger size than what will be planned for the final implants is commonly done. Hopefully you have discussed with your plastic surgeon about implant sizing, shape, etc. As far as a recommended size, it should fit your breast width, chest width, desired shape, etc.

Christine Fisher, MD, FACS · Answer

Good question! The size of your breasts after reconstruction is ultimately up to you. I encourage you to share your aesthetic goals with your plastic surgeon so that adjustments can be made to your expanders to ensure you get the results you want. Keep in mind there are many factors that determine the best implant size for you, including chest width and the amount of projection you desire. Your surgeon can help you weigh those factors to achieve an outcome that is both proportionate and natural. Good luck to you!

David Parizh, DO · Answer

If you want smaller implants the skin envelope just needs to be addressed. A reconstruction where the nipples are appropriately positioned to accommodate the smaller implants is a very reasonable option. A good plastic surgeon should go over incision placement and reconstructive goals. What you are asking for is very reasonable and doable. Hope that helps. Good luck!

Frank Agullo, MD · Answer

One of the advantages of having expanders is that you can see the results as you're getting expanded. If you have 475 mL in the expanders right now, that is close to what it's gonna look like and the size with a 475 mL implant. Your surgeon can add or remove fluid until you're satisfied with the size.#StayBeautiful #RealDrWorldWide

Daniel Barrett, MD · Answer

Dear azgirl1014,breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

David Light, MD · Answer

The most important factor in deciding breast size is the patient's preference. For a woman that is 5'2" and 120 pounds, a B to C cup sounds reasonable. With a 475 cc fill, you are likely already in the C cup range. My personal preference is not to overfill patients (filling the expander to a size larger than the planned implant). I actually prefer to underfill so that the implant fits securely into the pocket. I find that this helps to prevent rippling and implant flipping, especially with pre-pectoral reconstructions. If you want to be smaller than what your current size I would recommend discussing your goals and preferences with your plastic surgeon so that you are confident you are on the same page. I hope this helps.

Alex Senchenkov, MD, FACS · Answer

You should choose the size and volume of implants that is right for you. The volume will depend on the width of your chest, desired projection, and volume. You will make this choice. 34 is your chest circumstance in inches. Aside from your body weight, it is not a subject to change or choice as it is the way you are built. 
I hope this helps. Best of luck to you.

Asaf Yalif, MD, FACS · Answer

You can have whatever implant size you would like. In general we decide by taking  measurements - a 475 cc on a very small frame may be a "D" while it may only be a "B" on a larger frame. With the expanders in place fluid can be added or removed until you are satisfied with the appearance. Then a final implant can be selected.

Joseph Franklin, MD · Answer

It is absolutely possible to have smaller implants than the volume that was placed into your tissue expanders.  We all over expand initially to give the skin time to stretch.  Your surgeon can take out some fluid if you desire to give a better idea of your desired size.  Implants are sized based on your chest width.  Suggesting an implant size without breast measurements is not possible.

I would like to be a 34 B/C after double mastectomy. Can I get a smaller implant?

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