36A, 5'8", 142lb - Will 425cc Make Me Look Top-Heavy?

I Am Having a Breast Augmentation in a Few Weeks. After Seeing my Surgeon He Suggested 425cc Silicone Submuscular Implants. I measured a 36 A, I am almost 5'8, 142lbs... I am so concerned about the size. I did the rice test and 425cc just seemed big! I know they will look smaller once implanted, but I am unsure. I do not want to look top heavy or have breasts that are too large. Thoughts?

Doctor Answers (6)

Size selection

+2

This forum is filled with repeated implant size questions.  You need to revisit your surgeon until you are totally certain that the size is what you want.  Try the implant sizer test in his office, take a friend/family to help you with the decision if you're not sure on your own.  Don't try to figure this out the day before , or even worse, the day of surgery.  That will not lead to a clear decision and you'll feel very rushed.

Best Wishes,


Dallas Plastic Surgeon
5.0 out of 5 stars 55 reviews

Implant Selection Process

+1

In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.
Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 38 reviews

Breast implant size

+1

The more breast surgery I do the more I realize that there is no correlation between the size of implant and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saiine/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size. 
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" or "top heavy" 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 756 reviews

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You should always be 100% happy with the implant size you choose.

+1

If you are not 100% satisfied with the recommendation, hold off on ordering your implants until you find one you are satisfied and confident with.  When the implant is placed under the muscle, you do tend to lose some of the volume. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Picking the size of the implants

+1

Here's what I do:  I try to match the width of the implants to the width of the patient's breast, in order to get a proportional look.  Next, we discuss which shape ("profile") you prefer, between low, medium and high profile.  They each give a different kind of result.  How much roundness and fullness do you like in the upper portion of the breast?

Between these two choices (width & shape), we usually have 3 or 4 implants that are "contenders", which I then have the patient try on in a sports bra & T-shirt.  While the system is not perfect, most women find the try on process to be very helpful.

If you are concerned that 425 cc might make you feel uncomfortably large, then see your surgeon again and discuss it.  Now is the time to get the size right - pre-operatively!

 

All the best,

Thomas Fiala, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 28 reviews

Implant choices

+1

I fyou felt 425 cc's was too large  by the rice test, then you should probably review this with your doctor and choose a smaller implant.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 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.