Are 400 cc Implants Too Big for Someone with AA Cup? (photo)

I am a competitive cyclist, 54 y/o, 5'-9"-145 lbs. I have minimal breast tissue (AA) and my skin is firm but not tight. My ideal size is C to Full C. Recently I had my first (of 4) consultation with a Board Certified Plastic Surgeon. He suggested a sub muscular placement using a Moderate Profile Plus Silicone implant. After one measurement horizontally across the breast, he suggested using a 300 to 325cc implant. After bra gel sizers I looked too small. Could 400cc + work without looking "fake".

Doctor Answers 12

Natural appearing breasts in athletic women

Judging by your pictures, you could certainly tolerate bigger implants, but I would strongly suggest two things: 1.) Get true subfascial placement not submuscular and 2.) get low profile implants.


As a cyclist, any augmentation involving the muscle will be strange looking and feeling when you cycle or do anything involving arm movement.  I use  a unique technique called cold-subfascial augmentation that preserves complete fascial support without involving the muscle but there are other subfascial techniques that will serve you well.  Do not go with subglandular either as this technique will give your breasts a very low aesthetic lifespan.  I hope this helps!



All the best,


Rian A. Maercks M.D.

Miami Plastic Surgeon
5.0 out of 5 stars 46 reviews

4500 Biscayne Boulevard
Miami , FL 33137

Breast Implant Size

For your stated objective, then your surgeon's recommendation is sound.

The size of the implants are based on a combination of a patient's goals and objectives and her anatomy. In order to provide a natural looking augmentation, the surgeon needs to evaluate many factors including soft tissue coverage, skin laxity, chest wall width, breast imprint width, the shape of the breasts and relative level of constriction to ensure that the breast implants are appropriate for your body.

Consult in person with the other 3 experienced and expert board certified plastic surgeons to understand your options.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 25 reviews

1501 Forest Hill Boulevard
West Palm Beach, FL 33406

Implant Selection Process

If you are a competitive cyclist, it may be worthwhile to consider a subfascial/subglandular approach to your implant placement.  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 62 reviews

9200 Pinecroft
The Woodlands, TX 77380

Implant choices

Without a formal exam it is diffiuclt to say what would be best for you.  If your skin is a bit loose and the dimensions are appropriate, a 400 cc implant may be OK. Hard to say without the exam.  To get a rough idea in your mind, it may be beneficial to perform a "baggy test."

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

1049 Fifth Ave
New York, NY 10028

Implant sizing

Thanks for your question.  Thanks also for the excellent photos including your base width. I am concerned you do not have much skin or stretch.  400 cc may be hard to pull off even with a high profile device. Also, larger implants could interfere with your cycling. Good luck.

Vishnu Rumalla, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 129 reviews

1870 Keller Parkway
Keller, TX 76248

Implant size

Implant size is subjective as to which size is best for you.  I, however tend to agree with the recommendation of something in the low 300's.  They mat be a little smaller than you might ideally want, but given the fact that you are very thin and athletic, they will be less of a problem interfering with exercise  and wearing a sports bra. Try finding photos of other women similar to you on the internet where the size implant used is designated and you will become more comfortable making a size decision.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 17 reviews

9339 Genesse Avenue
San Diego, CA 92121-2119

What size breast implant is too big

A good plastic surgeon can grow skin on your breast to any size you want. Implants under the muscle need 50+ more cc's to look the same size as sizers in your bra. They will not look fake. The commonest reason for re-operation is going bigger. Don't let the doctor tell you what size you should have. Find a surgeon who'll give you what you want.  Dr Foster

Lawrence Foster, MD (retired)
Sacramento Plastic Surgeon
3.5 out of 5 stars 15 reviews

589 Tahoe Keys Blvd.
South Lake Tahoe, CA 96150

Bigger implants will look fake

Your question is a good one.  Generally, the larger the implant, especially in a woman with little native breast tissue, the more artificial the result will look. This has to do with too much upper fullness, as well as proportion with the rest of your body.

Michael Leff, MD
Bellevue Plastic Surgeon
5.0 out of 5 stars 7 reviews

1600 116th Ave. NE
Bellevue, WA 98004

Are 400 cc Implants Too Big for Someone with AA Cup?

Make sure you have shown the photos of the finished look you like to your surgeon. During surgery he should be able to try test sizers under the muscle until finding the volume that most looks like what you want. If he plans to go to the OR with just the one predetermined preop size you might want to try a different surgeon. It is the surgeon's job, not yours, to pick the volume that gives your preferred look. And you never really know what the look will be until you try that volume in place under the muscle.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 17 reviews

10201 SE Main
Portland, OR 97216

How to pick breast implants.

Hi.  I hope you find this article helpful.  Very large implants would look fake and also interfere with your competitive cycling.

1)  This is the most common type of question on RealSelf.

2)  It is the surgeon's job to pick the right breast implants, not the patient's. Implant selection is really pretty technical.

3)  Make sure your surgeon REALLY understands the look you want. Mentioning a cup size is not enough. Show your surgeon pictures of breasts you like.

4)  Then your surgeon has to tell you if your chosen look is realistic for your anatomy.  The most common mistake is to go too big.

5)  I recommend that  the surgeon NOT make a final implant choice in advance, because this is just an educated guess.

6)  The surgeon should have a large inventory of different size and shape implants available in the operating room.

7)  Then the surgeon can put sterile disposable implant SIZERS in your breasts during surgery, to see what a particular implant really looks like inside you. This is how to make the best choice. A sizer costs only $45, and takes all the guess work out.

8)  Finally, the sizer is discarded, and the correct breast implants (based on what you want and on your anatomy) are opened from the operating room inventory, and put in your breasts to complete the operation.


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

875 Park Ave at 78th Street
New York, NY 10075

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.