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Want to Go From C Cup to Full D/DD With Upper Pole Fullness

I'm scheduled for a donut lift w/ augmentation (silicone unders). I have one breast slightly larger than the other. I currently wear a 32C. I have been recommended for 300-325 (plus or minus 50 cc's). I have opted for him to use sizers in the OR in the range of 300-350. Should I go larger to accommodate for my large BWD? Say giving him a range of 325-400? Would 400 be huge on me? STATS- BWD:14cm Nipple to Nipple:18 cm R)Breast from Sternal Notch:23 (L)Breast from Sternal Notch:21

Doctor Answers (10)

Breast augmentation c or d cup

+3

It all depends on the look you are tryng to achieve. You already have a fairly large amount of breast tissue and the mid 300's range would give you a larger c result, which I believe would look natural. If you move into the 400 range your final result is closer to the D cup you are seeking. Without an exam and knowledge of your height and weight  it is hard to make a definitive recommendation.


Philadelphia Plastic Surgeon
5.0 out of 5 stars 26 reviews

Donut Mastopexy

+2

Without seeing you in person or being present for the surgical decision making, it is difficult to give you specific advice.  However, I agree that a donut mastopexy may not be enough to accommodate the ptotic skin of your breasts and correct the asymmetry that you have.  The implants will fill the volume, but I suspect that you will still need at least a vertical incision, if not also an anchor incision, to achieve the best results.

 

Good Luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 55 reviews

Breast augmentation

+2

It is hard to say which implant would be right for you without a full exam and a full discussion of yoru goals. 50 cc difference in implants usually does not offer more porjection but may increase the width a bit on the implant.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

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Breast augmentation by the numbers

+2

Cosmetic surgery is an art, and though it is tempting to list off breast dimensions, nipple to notch, diameter, nipple to fold, etc. it is difficult to match the correct breast implant. You haven't shown what you wish to look like, though a guess would be in the 350-400cc range to get you to a very full D. Augmentation by the numbers is like paint by the numbers with less than professional results. Also, just an opinion, the donut lift may be trouble. We would suggest just a vertical lift, slight, on the larger breast only to even the skin envelop.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 26 reviews

Breast implant sizing

+1

The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used 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. 
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 700 reviews

How big

+1

When i do a breast augmentation/mastopexy i will have several sizes of implants in the OR and will pick a size that will create symmetry and give nice cleavage and fullness without being overstuffed.The size should be proportional to your overall body size.

Robert Brueck, MD
Fort Myers Plastic Surgeon
5.0 out of 5 stars 14 reviews

Bumped Nose Tip After Rhinoplasty

+1

Based upon the photos and your written history and desires, I feel the implant size is toooo small for DD cup. Also the left breast may need a "lollipop" lift. Best to obtain additional in person opinions. Best of luck from MIAMI 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Make the correct diagnosis Pre-op & match the technique.

+1

Ms SandDollars: Your desire for D/DD with superior pole fullness should be matched with the correct implant size, implant profile, position of the implant (subpectoral/dual plane) as well as the breast lift technique.  From the photos attached you have a) breast asymmetry (nipple position as well as volume mismatch); b) relatively relaxed skin brassiere which may make a "donut Mastopexy" less than successful in balancing your breast volume, as well as nipple position.  If you are inflexible in the choice of a short scar lift, you may get a suboptimal result.  By contrast, the placement of your breasts is relatively "close", which ideally should provide acceptable "cleavage" or a close intermammary distance, afterwards.  Often the use of either a high profile or moderate plus profile implant will assist in producing the upper pole fullness you seek.  Instead of concentrating on cc's, ask your PS to match your base diameter with the footprint of the implant. 

An implant-lift is both technically challenging as well as potentially problematic for the surgeon, who needs to have a clear idea of your aesthetic ideal, before scheduling your case.  Get on the same page!  Good luck.

Lavinia Chong, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 36 reviews

400cc's wouldn't be too big

+1

A difference of 25cc's (your range of 300-325) is less than a tablespoon of fluid so it would be hard to notice a difference.  I think 400cc's would not be too big if you are looking for the D/DD range.  Good luck!

Bivik Rajnikant Shah, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 7 reviews

Breast Aug to a DD

+1

Cup size can be subjective.  When asking for a D/DD result, it is necessary to utilize a larger implant.  Don't be afraid of the 400CC implant, or larger if you really want that DD. You  have asymmetry which will  require a right mastopexy to improve.  You may also require different sized implants.

Beverly Friedlander, MD
Short Hills Plastic Surgeon
5.0 out of 5 stars 8 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.