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400cc Breast Implants with Lift to Achieve Full C-D Range?

I am 34 years old, 5'5" tall at 128lbs, with 36B breast size. I would like a full C-D range post breast lift and breast augmentation. It is really hard for me to decide what implant size to pick. With a moderate plus profile silicone gel would a 350cc or 400cc bring me to the size I want without being too big? My plastic surgeon said that I will lose some skin due to the lift; and with the implants under the muscle, it will also apprear smaller. I like the look of the 350cc sizer, so would choosing a 400cc make up for the loss of skin and appearance of a smaller implant under the muscle?

Doctor Answers (13)

Selecting the best size of breast implants

+4

One of the most important considerations in breast augmentation surgery, with or without a lift, is the selection of an appropriate sized implant. While I always ask my patients what cup size they would like to be, I only do this as a way to help me understand what she is thinking. In reality, the actual cup size is not important as the appearance of the breast. For example, if you came in to my office and told me you wanted to purchase a size 13 shoe, I would respond "that would certainly be possible, but you may not like how it looks or feels on your foot!" So it is with breast implants. I have always felt that worrying about cup size or volume of a breast implant as an initial consideration is "putting the cart before the horse." The real important issue is: Do you wind up with breasts that look good for your body type and size, and do they make you look the way that you want to look.

I always offer my patients the opportunity to try on as many different sizes of implants that they wish so that they can feel comfortable with how they will look with a certain size of implant. That way, we really don't focus on cup size or implant volume. If a 400 cc implant looks best, that's what we use, and whatever cup size it winds up being so be it! You didn't pick your shoe size before you grew feet, so why would you pick your bra size before your actual breast size?

I would encourage you to ask your surgeon to try this exercise with you, and if he or she is not able to do that, consider a consultation with a surgeon who does this because it is a very accurate way to select implants. I rarely if ever have to return to the operating room simply to change implant sizes when we have helped patients select their implants in this way. This tells me that the vast majority of patients are happy with this method, the method is successful in helping them visualize their postoperative appearance, and the result is satisfactory.

I hope this helps with your concern. Best of luck in achieving your goals!


San Diego Plastic Surgeon
5.0 out of 5 stars 17 reviews

Breast implant size and cup size.

+3

Hi!

1) 400 cc's sounds too big. Very large implants stretch your tissues and age badly.

2) It is not fair or reasonable for you to pick breast implant size. This is a technical decision that is your surgeon's job. All you need to do is make sure your surgeon understands the look you want. And even your surgeon should not make the final decision in advance, because this is just an educated guess.

3) Your surgeon needs to put disposable implant SIZERS inside your breasts during surgery to see for sure which size is best for you. Only then are the permanent implants opened. So your surgeon needs to have an inventory of different size implants available in the operating room.

4) You may find the breast augmentation page on my web site useful.

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

Breast sizer to implant conversion formula to predict final size of breast augmentation

+2

Given the measurements you have provided this sounds relatively accurate.

When an implant is placed under the muscle, you can assume that you will need to add 10-15% above the sizer to achieve a similar augmentation with an implant.

If you like the appearance of the 350 sizer, then doing the math 10-15% would mean the implant would have to be 35-53cc larger or 385-403cc final total volume to accomplish a comparable enlargement. This is only an estimate but it works relativley consistently.

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

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Excellent thought process

+1
It is correct that you will lose some size based on the lift, and that the implants appear smaller under the muscle than the sizers look in the clinic.  It is reasonable to add some volume to your implant choice to compensate for these variables.

Gary Lawton, MD
San Antonio Plastic Surgeon
4.5 out of 5 stars 11 reviews

Options

+1
When I perform a lift with an implant I do not spend much time on size with the patient, I do spend hours discussing goals and realities. I really believe a nice shape without too much volume is ideal and I achieve this with using sizers in the operating room and taking as much time as it requires to get a perfect technical result

Ryan Neinstein, MD, FRCSC
New York Plastic Surgeon
5.0 out of 5 stars 39 reviews

Implant Selection Process

+1

You bring up an excellent point that a 400 cc implant will look very similar under the muscle and after a lift, in comparison to a 350cc in office sizer.   As you can see, the process can be rather complex.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection to replace an in office exam and good communication with a board certified plastic surgeon.

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 37 reviews

Cup size and breast implants

+1

Thank you for your question.  There are several variables in determining implant size.  When recommending implant size for my patients, I consider the followings: 1) patients' anatomy (height, weight, chest width, chest height, amount of breast tissue) and 2) patients' desired look/goal.  Without knowing your chest measurement and breast tissue amount, I cannot give you any recommendation.  You should visit with board-certified plastic surgeon who will examine you.  Try implant sizers to get a rough estimate of the size you may want.  As you know, bra/cup size will vary depending on the brand.  Good luck with you.

Sugene Kim, MD
Houston Plastic Surgeon
4.5 out of 5 stars 39 reviews

Cup size goals and breast implants

+1

It is very difficult to predict what cup size you will be after your procedure.  Cup sizes are not standardized.  So a D cup in one designer could be a C cup or B cup in another designer.   This is the approach I use to help guide my patients with their implant size selection:

I consider two factors when selecting implants for my patients:

1.Dimensional planning
2.Gel Implant Sizing system

Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.

Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look.  If you have decided on saline implants, then based on the gel sizer you select, we can guide you to the saline implant that achieves a similar look.
Hope this helps.
Dr. Basu
Houston, TX

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 123 reviews

Breast implant sizing

+1

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 press 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 751 reviews

Breast augmentation and implant size

+1

It is very difficult to suggest ther ight size to you without fully examining you, and reviewing the desired shape and size that you want.  I usually discuss volume with patient and not so much cup size.  Cup size is hard to pin down.

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.