Size Determination for Breast Reconstruction?

Question

I had a double mastectomy on March 27, 2013 and have had by 2nd expansion. My plastic surgeon explained to me that cup sizes are different than those having breast augmentation. That being understood, I'm just trying to get an idea of how 600 - 700 cc gel implants look on a woman that has had a mastectomy. I am a 47 year old, 5'7" and weigh approximately 160. Is there a site I can go to for just generalized information?

Stefan Mark Szczerba, MD · Answer

Unfortunately I don't know of a website that outlines that.  However I don't think a website is the best way to work this issue out.  The way that I do this in my practice is to know what the gram total was when the specimen was taken out and sent to pathology and keep that in my records for reference.   Another point of reference with the new generation of implants is to keep meticulous measurements of width and height of your breasts.  I then use a reasonable size of my expander to reconstruct your breast volume.

For an average size patient after mastectomy, you will not likely be on the map in terms of volume  until approximately 300cc are in you expanders.  I recommend filling 60-120cc into each breast every 7-10 days until you are happy with your size in a shirt.  A good rule of thumb is that every 200cc is one cup size.  At 5'7" 600cc is not an unreasonable volume.  Best Wishes!

James N. Romanelli, MD, FACS · Answer

Probably the best way to determine how large your final implants should be is to see what size you are most comfortable with during the expansion process. I don’t think any site will really help you because of differences in body shape, even when 2 individuals are the same height and weight. My breast reconstruction patients undergoing tissue expansion are encouraged to think about size between fills. Generally, we want to overfill the expanders before the implants go in. Unfortunately, your final shape will be different with implants, but using expanders as a guide is still the most reliable method I know to help with this decision. Women who have breast reconstruction with implants are often shocked by a size of 600 or 700 cc. But the look achieved in reconstruction is not at all as large as the same implants used for augmentation. Best of luck with your decision.

Lisa Cassileth, MD, FACS · Answer

Suddenly, you have to change your language from cup sizes to cc's! The best information is how the tissue expanders look - the final silicone size in cc look like the tissue expanders filled to that cc. Most surgeons inflate the tissue expanders a little more than you want the final breasts to look, so the pocket for the implant is a little loose. To get a ballpark now, get your pathology report from your mastectomy. It will have the weight of your resected breast tissue on it, and this roughly corresponds to implant size needed to achieve the same volume (within 50cc or so). A quick warning: tissue expanders, because they are so stiff, will look more prominent than the final implant. So if you like the anterior projection of your breasts, make sure you mention it to your plastic surgeon.

Steven Wallach, MD · Answer

A good way to figure out how 600-700 cc's would look is by having your expanders gradually filled to this number and see how they look in a blouse.

Tracy Kayan, MD · Answer

Congratulations on getting through the first part of your reconstruction. For my reconstruction patients, I usually try to get a good idea about whether they ultimately want to have larger or smaller breasts than before their mastectomy. I try not to get too fixated on the actual volume in the expanders (although I keep careful track of this to make implant ordering easier), but rather on how they feel and look in clothing as we go through the expansion process. The tissue expanders will never fit into a bra the same as a natural breast, but you can get a ballpark idea about what cup size you will be when you are at a particular volume. You can always ask if your plastic surgeon has sample implants that you can touch/see and you may discover that you are surprised how big or small a certain implant is. Ultimately, you should continue with your expansions until you are at a size you feel comfortable with. 

	     As far as resources for good before and after photos for breast reconstruction, I have not found any in particular, believe it or not. This site seems to be the most comprehensive. I hope these answers have been helpful.

Size Determination for Breast Reconstruction?

Answers (5)

Answer: 600-700 cc implants after expansion

Answer: 600-700 cc implants after expansion

Answer: Sizing for Breast Reconstruction

Answer: Sizing for Breast Reconstruction

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Everything you need to know about Breast Reconstruction

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Size Determination for Breast Reconstruction?

Answers (5)

Answer: 600-700 cc implants after expansion

Answer: 600-700 cc implants after expansion

Answer: Sizing for Breast Reconstruction

Answer: Sizing for Breast Reconstruction

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Recommended reading

Everything you need to know about Breast Reconstruction

Our mission is to create a world where every investment in modern beauty is Worth It.