Allow your plastic surgeon choose the exact size implant that is most appropriate

Allow your plastic surgeon choose the exact size implant that is most appropriate to give you the desired look you hope to achieve. I prefer to have my patients give me an idea of what size they hope to achieve and then based on this factor, plus their current breast volume, their body and breast dimensions and tissue/skin characteristics will determine which implant size will be best for them. I also prefer to bring several sizes of implants to surgery and use temporary sizers to determine which implants will give my patients the best results that I can achieve.

The difference between 325 and 350cc. is less than10%. However, in general, size of implant is determined less by cc's and more by dimensions. Patients have a hard time understanding this and often get fixated on the cc's. The volume is the result of dimensional analysis, not vice versa. In fact, the volume tells nothing about the implants since a 350cc implant can have different dimensions (i.e. base diameter and projection) and thus produce different-looking breasts. The best way to choose size is to look at the base diameter of the natural breast and see what implants will give you the most natural look. This is usually the flattest or least projecting implant with the base width about the same as the breast so that the implant will be predominantly covered by the natural breast. You and your surgeon can then determine if this will give you the look you want (i.e. shape, cleavage, width, etc.). To up size, you can increase width or increase projection, or both, until you get outside your target look. There will usually be a few implants that will give you close to what you desire. I then ask a patient if she would be more unhappy being too large or being too small and vary my implant choice depending on her answer.

I have found that, in general, patients who are a little too small, wished they could go bigger but are less unhappy than women who are too big. The former still look good and more natural and can upsize with specific bras while the latter canot hide their excess size. Usually, in the long run, the smaller the implant, the less complications and side effects but speak frankly and specifically with your surgeon.

Going under the muscle does blunt the effects of the implants compared to on top of the muscle for the same implant but it is the relative, not absolute, size and dimensions of the implant that will determine how that implant will act differently in the two different locations.

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Hello,

Implants tend to look more natural and have fewer problems over the long term when placed under the muscles though. Just have a good discusion with your surgeon about where you'd like to end up so he/she can do that which is possible to get you there.

Best Regards,

John Di Saia MD

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Selecting the perfect size implant for an augmentation is extremely challenging.

300-325 cc should bring you to a C cup from a B cup. A 350 cc implant should work very nicely for you.

It is true that the implant tends to look a little smaller under the muscle. This is because the muscle flattens it a little bit. It's not that the volume is going anywhere, it's just that the implant is covered a little more. The difference is minimal.

The important thing to remember is not to focus on any one number. What matters is what your breasts look like after. As long as you're within the range you described (300-350), you should look good.

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