380 Filled to 400 (12.5width) OR 450 Filled for 475 (13 Width)?

I am stuck! Im getting Breast Aug in about 2 weeks! My doctor says that I have 2 choices: 380 filled to 400 OR 450 filled to 475! I am 5'2 and 140 lbs. I have a breast base of 12.5 on the left and 13 on the right. My nipple to base fold is 5 on the left and 6 on the right. My goal is to be a very large C or VERY small D. I need to make the decision soon but keep going back an forth. SO the 400 or 475? Keeping in mind that I dont want to be in the D's. I'm going with a smooth, round saline. HELP!

Doctor Answers (11)

You Have to Decide, Finally

+2

A major purpose of consultation is to help you sort through options and advise you how to best meet your goals.

This concept should be contributing to your choice of surgeon, rather than resorting to the opinions of Internet sources, though expert, who have not listened to your ideas and examined you.

In breast augmentation, there is not a uniformity nor precision that can accurately predict a specific woman's post-op 1/2-cup size.


Denver Plastic Surgeon
4.0 out of 5 stars 14 reviews

Breast implant sizing

+1

Much of the final “look” achieved after breast augmentation surgery  depends on several factors:
1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.
3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 792 reviews

MEasurements and the best implant selection

+1

It is very easy to be confused by this measuring system. Cup sizes are only used as estimates for clothing. Although the measuring technique for determining cup size is precise, the results of these measurements are not. Let me give you an example; weight is a very accurate measurement. However two patients that weigh 120 lbs are not likely to look alike. The same is true with two patients that have C cup breasts. This is why physicians tend to use volume (cubic centimeters or cc) as a more accurate measurement. Note: If you are trying to figure out what breast implant size you want to obtain, you can try the szing tool available through b4bra.com or read the articles about measuring there.

Size is a complex decision that is not only based upon your height, weight and current cup/bra size but ALSO on also on your breast diameter, waist, shoulder, and skin envelope measurements. These can only be assessed in person during a consultation. A good place to start is using my "Find your perfect size" tool listed in the left hand column of my bodysculptor.com home page. Another good place to look is the searchable database section of the physicians' photos on implantinfo.com. Best of luck.

Please see our website for a description of the procedure: bodysculptor.com You can view some of Dr. Placik's patients or many other patients by visiting the website:photo gallery

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

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Choosing the Right Implant for You

+1

hi there-

I could not possibly agree more than I do with Dr. Peter Johnson below-- the only reason I can think of for an experienced surgeon asking you to commit to an implant before surgery is so that after surgery if you are less than pleased he can say you chose the implant....

It is important to understand that a critical variable in determining how any particular implant will look in any individual patient is the elasticity (the stretchiness) and thickness of the tissues that will be covering the implant. This is not something that (it my opinion) can be positively predicted or measured preoperatively. An experienced plastic surgeon can ESTIMATE this, but even after many hundreds of implant operations, I find myself placing an implant that is different than the one I thought I would need preop to achieve the patient's goals.

The very best advice I could give you (as Dr. Johnson does) is to communicate your goal for APPEARANCE carefully to your surgeon, then let them use their skill and experience to choose the correct implant.

Here's a bit more on this:

Armando Soto, MD, FACS
Orlando Plastic Surgeon
5.0 out of 5 stars 113 reviews

Breast implant size choices

+1

In addition to the issue of knowing what size breast you are starting with, we also don't know the profile of the implants. I also find it quite unusual to have breasts that are close to the same size and having different widths. Further, I can't think of a reason to be told you can only have one of two sizes of implants. 

The correct answer is to double check the width of the breasts upright with arms down. The implant width should be 3/4 to 1 cm less than this width. Next choose a profile for the implant that will increase you from what your are to what you would like to be. The lowest profile implants will increase you by one cup size and the high profile implant (scaled to the width) will increase you by about two cup sizes. Medium profile implants would be in between. Look up the width of the implant (based on your breast width) under the profile you are choosing and find what the rated volume is. In saline-filled implants you can add up to 10% volume above the rated volume to maximize the volume or offset the volume from one side to the other. It doesn't sound like the surgeon you've chosen understands this but may be going on experience and guesswork or sizers. Most patients usually prefer to be better assured that the result will look natural and the size increase is what they're expecting (and is realistic). 

Scott L. Replogle, MD
Denver Plastic Surgeon
4.0 out of 5 stars 1 review

What is your breast size now?

+1

EAFB,

One thing missing in all of your fancy measurements is your current breast size.  It is essential to know the present volume of your breasts before commenting on what size implant you would need to get to a large C or small D.  Also, I don't quite understand why you only have two choices.  You should have many choices within a range of implant volumes and styles.  Perhaps, a second opinion might help your decision.  Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 32 reviews

Your surgeon should decide the implant for the look you want

+1

It seems the surgeon you have selected is asking you, with no experience, how a particular implant will look and perform. After looking at breast augmentation questions on this site concerning implant styles, position, shape concerns, predicted cup size, not to mention complications or misadventures, breast augmentation is not a 'simple' procedure. If your surgeon understands the look you want, why should the burden be on you to select an implant? What if your guess is wrong? Stop guessing and find a surgeon who will take charge and give you the look you are after.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 31 reviews

380 Filled to 400 (12.5width) OR 450 Filled for 475 (13 Width)

+1

Again NO PHOTOS!!! Very hard to give accurate advise. My guess from your excellent posting is to go inbetween 400 to 450. Like 425 range HP's as my choice. But if really DO NOT want a D-cup than stay in the 400 cc range. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

How to pick breast implants.

+1

1) This is the most common type of question on RealSelf.

2) It is the surgeon's job to pick the right breast implants, not the patient's. Implant selection is really pretty technical.

3) Make sure your surgeon REALLY understands the look you want. Mentioning a cup size is not enough. Show your surgeon pictures of breasts you like.

4) Then your surgeon has to tell you if your chosen look is realistic for your anatomy. The most common mistake is to go too big.

5) I recommend that the surgeon NOT make a final implant choice in advance, because this is just an educated guess.

6) The surgeon should have a large inventory of different size and shape implants available in the operating room.

7) Then the surgeon can put sterile disposable implant SIZERS in your breasts during surgery, to see what a particular implant really looks like inside you. This is how to make the best choice. A sizer costs only $45, and takes all the guess work out.

8) Finally, the sizer is discarded, and the correct breast implants (based on what you want and on your anatomy) are opened from the operating roon inventory, and put in your breasts to complete the operation.
 

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Sometimes you need to make the decision at the time of surgery.

+1

Whilke it is nice to make a definitive choice, sometimes it is necessary to go into surgery with 2 options.  It sounds to me like you are using high profile implants.  You have opted for saline instead of silicone.  The larger you go with saline the greater the risk of rippling. The implants sound like they are Allergan implants.  The usual fill is 30 cc above the recommended minimum fill and they should be filled that way to decrease the risk of rippling.  A lot will also depend on the condition of your tissue and the amount of breast tissue you currently have. I do think the larger implant will give you a very full C if not a small D.  If that is what you want then go with the larger implant.  Good luck.

Steven Schuster, MD
Boca Raton Plastic Surgeon
4.5 out of 5 stars 3 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.