Currently a 32A and Want to Be a Full C. Is 475 to 500cc Silicone Too Big for Me? (photo)

5'4, 127lbs. Petite frame with curvy hips. I have breastfed 4 children. I am currently a 32A and would like a very full C Cup. I consulted with 2 PS and both siad I should go with 475 or 500cc, high profile silicone, under the muscle. I am worried it is to big. I am thinking closer go 450cc? Any suggestions.

Doctor Answers (13)

Breast augmentation A cup to C cuo

+1

Most patients want to have the fullest breast profile that still looks natural on their body. The limiting factor for implant size is almost always the appearance of the upper pole. At some implant volume, the upper pole of the breast begins to look excessively rounded or convex, and that is a look that says "breast implants live here". 


Regardless of implant type, there is really only one ideal position for breast implants with respect to the pectoralis major muscle. Subpectoral placement provides additional coverage of the implants in the cleavage area, which results in both a more natural appearance and more natural feel. This is especially true for slender, small-breasted patients, as the pec major helps to flatten the upper pole of the implant and prevents the upper edge of the implant from being visually obvious. That excessively round appearance in the upper pole is to be avoided at all costs.

The actual size of a breast implant, measured in cc's, is really not very descriptive of what a breast augmentation will look like, or what the cup size will be. It is all relative to the size of the breast and the size of the patient preoperatively. A tall, broad-shouldered patient with small A-cup breasts may require 450cc implants to achieve a C-cup breast volume postoperatively, while a shorter patient with medium B-cup breasts may only need a 250cc implant to achieve a C-cup breast volume.
For any patient there is obviously a range of implant volumes that would be considered natural-appearing, and a volume at which the upper pole of the breast begins to look very unnatural. While one patient may seek an augmentation that is 'perfectly natural', another may be interested in a result that is more on 'the full side of natural', and many patients do ask that the largest implant volume be selected that does not produce an unnatural fullness in the upper pole. By using breast implant sizers intra-operatively to determine exactly what breast implant profile and volume produces the best breast appearance in the O.R., patients can be provided with the closest possible approximation of their preoperative goals, and can be assured of a natural-appearing result.
When considering breast augmentation surgery, I believe that the most important question for a prospective patient to ask themselves is this: Am I seeking a natural-appearing result? If the answer is yes, then seek out a surgeon who has the same aesthetic sensibility that you have (and appropriate training and experience). And insist on seeing `before and after' photos. A lot of them. The before and after photos should should dozens of patients each from three different perspectives straight on side view and oblique. The lighting, distance from the patient and cropping should also be consistent. Attention to detail in photographs may give you insight into a plastic surgeon's attention to detail in the OR.


Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 40 reviews

Proper Implant Selection

+1

Thank you for sharing your photos.  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 35 reviews

Breast implant sizing

+1

The sizes are done with the width of the chest wall. I think 450 will get you to where you want to be but there is not way to access your skin quality or measure your breast width to make an accurate assessment.

Raj S. Ambay, MD
Tampa Plastic Surgeon
4.0 out of 5 stars 14 reviews

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Implant size

+1

If you want to be a large C or small D, 450 cc's will definitely get you there.  Be aware that implant size intervals depend on the manufacturer  and style of the implant, such as moderate versus high profile.  Generally, they go in 50 cc intervals once you go over 400 cc's.  Either way the size difference is only slight and you would be fine either with 450 or 475.  

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 10 reviews

Choosing your implant Size

+1

Thank you for your question.

In regards to breast size, 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 (saline/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. 
If surgery is decided upon, it will be 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 718 reviews

What size breast implants? (photo)

+1

Difference between 450 and 500 just over 3 tablespoons, not much.  Dimensions more important than volume (implant width and projection).  Your starting size is small, but skin probably very compliant if you've breast fed four children.  Try the different suggested implants on (non-padded bra and tight shirt), choose between mid-range and high profile among implants that match your breast base width. 

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 38 reviews

Implant too big?

+1

From your pictures, it looks like those implants will be much too big for your frame.

Your surgeon should take a number of factors into account when advising you on your implant choices - your desires, the loose-ness of your skin, how much breast tissue is already there, and how much tissue you have to cover the implant.  A breast implant that is too large will mean more and earlier revisionary surgeries, and will be a dead giveaway to everyone you meet that you've had surgery.

Hope this helps,

Dr. Hall

Jason J. Hall, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 3 reviews

Implants too big?

+1

The size you chose is most likely too big for your frame and may lead to early problems including double bubbles, early descent to name a few.

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

Implants too big?

+1

In a word, yes.  These implants can certainly be placed in you, but you will appear over-blown and very full on top.

Michael Leff, MD
Bellevue Plastic Surgeon
5.0 out of 5 stars 6 reviews

How big is too big?

+1

From your photos - there is no way to tell you what cup size you will be after a breast augmentation. You shouldn't be terribly concerned with this either as cup size is NOT a scientific measurement. Every patient has different skin elasticity, skin laxity, muscle strength etc. You should do your best to communicate with photos as to what you might like in terms of the "look" of outcomes you prefer. Then trust your surgeon to choose the right implant to make that happen. The reason we use sizers in surgery is the fact that you cannot predict the outcome preoperatively. Being rigid in your volume choice before surgery significantly limits your options.

You should see a board certified plastic surgeon in your area to get a formal opinion through and in-person consultation.

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 26 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.