Longview Breast Implants doctors

Essentially the question is that of: How do I choose the correct implant to get the look I am wanting? This is the most important question when it comes to breast augmentation. In order to better address this question, we need to establish 2 main points:

First: Implants do not come in "cup" sizes. They either come prefilled (in case of silicone gel implants) with certain volume or unfilled (in case of saline implants) with a range of fill capacity. In either case, the fluid volume is measured in terms of cc's (very much like a can of soda has 355 cc's or ml of fluid). This is important as many patients request for a certain "cup" size. For example, "I am currently a B cup but would like to be full C cup." So what implant should be used to achieve this? Before we answer this question, let us consider another important fact: most women are fully aware of the fact that bra cup sizes vary by the manufacturer, so with one manufacturer, one may fit into a B bra but may require a C bra with a different company make. In other words, there is variability even within "cup" sizes which makes using "cup" size as a measurement even more frought with potential errors.

Second: For most women, they are more interested in achieving a certain "look" rather than a certain "cup" size which I applaud. After all, as long as the new size "looks" good to you - do you really care whether you require a certain cup sized bra? I think most women would agree with this statement. With this in mind, the real conversion that needs to be take place is: once you've identified the "look" you desire, how do you and your surgeon go about picking the right implant to achieve that "look?"

There are many different ways to get a glimpse of the "look" that you are after. Many offices use gel sizers, others use rice bags, etc. They will all work. So once you've decided on a look that you are seeking, we need to choose the implant to give you that look. Now, because the sizer or the rice bag was placed ON TOP OF YOUR BREASTS, as opposed to under the muscle, I think it makes sense to think a LARGER implant than the sizer is needed to achieve the comparable look - after all, the implant needs to expand the muscle and at times, it needs to "fill out" the extra skin envelope of the breast (as is true for most women after pregnancies) before it starts to expand the breast. So the real question is: what is the conversion factor? If you liked the look of a 300cc gel sizer, then depending on how much extra skin you have, I personally add at least 30cc's to saline implants, and 50 cc's to silicone gel implants, thereby filling saline implants to a total volume of 330-340cc or choosing silicone gel implants of 350cc. At times, if you had chosen a sizer of 400cc, then I would fill saline implants up to 450cc or choose 475cc silicone gel implants - meaning the larger the desired look, greater the conversion factor. By the above discussion, you have already noted that silicone gel implants "fit" smaller than saline counterparts and give lesser projection.

I have been very pleased with the above conversion method - more importantly, my patients have been pleased with their outcomes, as they got the look they were seeking. It's not perfect, but comes pretty close.

Hopefully this helps.

Choosing the right implant size is one of the most important elements of breast augmentation surgery. It is a process involving both the patient and the surgeon.

In my practice, the following steps are taken:

1. Patient expresses their desired size - often in terms of "cup" sizes.
2. I examine the patient and make breast measurements (breast width, sternum to nipple distance, nipple to inframammary fold distance, etc).
3. I then have patients do sizers with various bras. I have a home kit that allows patients do the size trials at the comfort of their home. I want patients to take their time with this process. I encourage patients to try on various clothing (swimwear, intimate wear, sweater, etc) until they find the size they feel most content with.
4. And then I reconciliate, i.e. - I determine whether the size chosen by the patient can be placed based on the anatomic measurements and breast tissue/skin compliance.

For the most part, I try to minimize my input for the size determination, as I truly feel this is a personal decision, and ultimately, patients have to feel content with the size chosen. However, if I feel that the size chosen is not compatible or may compromise the outcome (too tight looking, etc), then I will discuss my concerns with the patient to convey the pertinent anatomic considerations.

It is important to remember that an implant in itself is just one component that determines the size outcome. Obviously, it is in addition to the native breast tissue. Also, the very same implant placed in 3 different women of different height, weight, and physique will produce dramatically different size outcomes. This is the reason why I discourage patients from choosing the size based on photos or friends telling them what size will be "perfect" for them. Size has to be placed within the context of the specific patient's body/breast to have true relevance.

Lastly, although, we discuss breast sizes in terms of "cup" sizes, implants come in "cc" filling volumes - i.e. - how many cc's are prefilled (in case of silicone implants) or desired filling (in case of saline implants). So ultimately, most plastic surgeons do not guarantee a certain "cup" size, although unfortunately, it is the only "language" that we have for commmunication. In my practice, I try to focus on the "look" rather than the "cup" size. My home kit is based on the appearance in front of a mirror, while the patient is "blind" to the actual volume. This allows patients to choose the size mostly based on "what they see" and not on "what they think they need."

Ultimately, there are many ways to determine the right size. My method is just one way that works for me and my patients. Be sure to discuss with your surgeon their preferred method, and see if it makes sense to you.

Be actively involved with your size - after all, it's your breast/body, and you have to be happy with it.