Difficulty Choosing Implant Size - What's the Difference between 20CC?

Hi, I;m just wondering, in a professional opinion, is there a big difference between 20cc's in a silicone implant? I'm scheduled for a BA on August 5th and originally picked the 320cc round textured silicone implant over the muscle but am wondering whether I should go with the 300cc. Is there a big sizing difference (once inserted) of 20cc's? I'm 5"4, currently a 34B and about 125lbs. I'm hoping to be a small C-cup size.

Doctor Answers (16)

20cc difference in implant size is negligible

+2

As made clear by the uniform consensus of the other plastic surgeon respondents, 20cc difference in breast implant size should have a negligible effect on your appearance at the sizes that you are considering. In general, if there is any doubt, most women would rather be a little bigger then a little smaller.

Make sure that your plastic surgeon knows exactly the look that you are seeking. He/she should make the final choice of implant size based on your expressed wishes.


Scottsdale Plastic Surgeon
5.0 out of 5 stars 20 reviews

Determining cc's and size for implants

+2

20cc’s will not make a significant difference in size and appearance of the breasts. Clear communication with your plastic surgeon is important in achieving the desired goals of the patient.  I like to communicate with patients with “goal” pictures.  During surgery, I use temporary sizers to determine the size/profile that will give the patient the look she is looking for. Trying to predict the size of the implant preoperatively is not ideal.  I think it is too much responsibility for the patient to choose the size of the implant.  Ideally, the surgeon would make that determination once he/she is in the operating room with sizers in and examining the patient in the upright and supine position.  There are many variables that come into play when choosing the correct implant size (how much breast tissue the patient currently has, the shape of the chest wall (concave vs. convex), etc..  Some places have you put bags of rice or implants in your bra – that is normally not very accurate.

 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 779 reviews

Very small difference

+2

20cc's will not make a visible difference to your overall size or result.  I typically tell patients you will need to go up or down by 100cc's or more to see a real change.

Renato Saltz, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 13 reviews

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Volume of breast impants

+2

A cc is cubic centimeters which is the same measurement in volume as a ml. So- 20cc is 20ml.

 In the english system 20's  is about 2/3 of one ounce. I usually tell patients to think of 30cc's as 1 ounce

 

Either way you look at it the amount is negligable.  Go with the implant that best fits the base width of your breast.

Jack Peterson, MD
Topeka Plastic Surgeon
5.0 out of 5 stars 13 reviews

No difference between 20 cc's in breast implants

+2

A 20 cc difference between implants is not visible.  Don't worry about that at all.  I have photos of a patient of mine with adjustable salines that have volumes that start at 425 then 500 then 600 and there is hardly much difference so 20 is really nothing.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 51 reviews

20 cc Difference

+2

20cc's is not that much of a difference at all. It takes a full 150cc's + to go up a full cup size. The majority of patients wish they would have gone a little bit bigger. I wouldn't worry too much about 20cc's. I think either way you will accomplish a small C cup.

Leo Lapuerta, MD
Houston Plastic Surgeon
4.5 out of 5 stars 24 reviews

Not much of a difference

+1
20cc won't make a huge impact on your breast size. But just a note - most patients wish they had gone larger than smaller. 

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 69 reviews

20cc is not much

+1

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 124 reviews

Implant Selection Process

+1

20cc of size difference will be extremely difficult to notice in clothing.  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 39 reviews

Implant selection

+1

There is not much difference between a 300 and a 320 cc implant.  I would think that you have narrowed it down to a good size and you should be happy with either implant as long as it is a match to your breast dimensions.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 10 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.