Why Do my 375cc Silicone Implants Look Only Like a Small C Cup? (photo)

Question

Started apprx. 33A and wanted to achieve a very full C/small D cup (generally speaking since I realize the cup system is faulty, but that's what people not in the medical field know to go by). Two days ago I got 375cc silicone implants subglandular. I tried on a C cup bra that I used to wear when I was pregnant and I still had room! ahhh and I was told they would probably look a bit small after swelling goes down! (Although I keep ice packs going so I don't notice swelling). Is this normal??

Edwin C. Pound, III, MD · Answer

There are two basic problems with determining cup sizes after breast augmentation surgery. You mentioned the first one - the fact that bra manufacturers do not have standard cup sizes. The second problem is that there is no formula for translating implanted volume to cup size. Different doctors have different ways to determine the appropriate volume to use in order to get you into the cup size you want but it is more of an art than a science and, unfortunately, no one can guarantee you a cup size.

Naveen Setty, MD · Answer

Thanks for your question and pictures. It does look like you have a nice result so far after surgery. It is way too early to make any judgments about size and result so early after surgery. As the implants settle and the tissues stretch to accommodate the implants, the projection may increase. Wait at least 3 months and preferably 6 months before considering any revision surgery based on results. Good luck.

Robert F. Centeno, MD, FACS · Answer

You have an excellent result after breast augmentation that will only get better with a bit more healing. The amount of preop breast tissue you start with and implant size determine your final size. If you go much larger than your tissues allow, you increase your risk of implant wrinkling, palpability, capsular contracture, implant malposition and reoperation. It looks lik you and your surgeon made a wise choice.  Try to stop focusing on an arbitrary issue like cup size or a particular bra and focus on whether you attained the aesthetic outcome that you were desiring.  Bigger is not always better. Best wishes.

Brian C. Reuben, MD · Answer

Thank you for your question and photos. The final size cup size of breasts after augmentation is an area of great angst with patients. While it is nice to have a goal cup size that you relay to your plastic surgeon, it can be difficult to hit the exact size you have idealized. There are many methods employed to try to get as close as possible but none are perfect. In your case, that one bra may be loose but others may not be. In evaluating your photos, you have a very nice result and nice shape to the breasts. That in itself is very valuable. You are still very early in the post-operative period. As things settle over the next few months, your size and shape can change a bit. Give your body time to recover. You will likely be very pleased with the results and enjoy shopping for some new bras.

Luis Villar, MD, FACS · Answer

There is a limit to how big an implant can be inserted at the time of surgery. The breast enlarges symmetrically at first.  At a certain point the lower pole cannot stretch any further and the upper pole enlarges disproportionately until it looks unnatural, or the nipples point down.  Under the muscle placement limits medial movement of the implant and as the implant gets bigger, it moves down and out into the armpits.  We place saline under the muscle to hide the wrinkles, but silicone on top of the muscle to get better cleavage and smoother transition in the upper pole as a general rule, but every patient is different and a hands on examination has to be performed before definitive recommendations are made. You have a reasonable result for your anatomy and the surgery chosen.

	Best wishes.   Knowledge is power.  Luis F. Villar MD Best FACS

Laurence Weider, MD · Answer

It is really too early to determine your cup size. With time, the breast tissue and skin often relax which makes the breasts look larger and project forward better. I would give 3-6 months and maintain communication with your surgeon. Best of luck.

Randy Proffitt, MD · Answer

You are only 2 days out from your surgery so don't rush to judgement. As you said there is not a direct correlation between implant volume in cc's and cup size. Far too many women get hung up on cup size, when you should concentrate on what looks good to you. Your early result looks good. The implants are well positioned and symmetrical. Wait for the swelling to abate before jumping to conclusions. You shouldn't do anything for 3-6 months anyway. Also remember different bras fit differently. There is no uniformity from one bra company to another. Again concentrate on what looks good to you in the mirror and so far it looks good, and if that isn't enough look at your before photos. I always give a copy of the patient's before photos to them early after surgery so they don't forget what they used to look like.

Darryl J. Blinski, MD · Answer

Unfortunately the size choice was took small. At least a 450 cc ignorant is needed in my opinion. Sorry.

Joseph L. Grzeskiewicz, MD, FACS · Answer

For most women, I would expect that you are right in the ballpark as far as hitting your C cup goal with 375 cc implants. At 2 days it is very difficult to tell what your final size will be though. Believe it or not, I am often fooled this early on by the "optical illusion" created by swelling. The surrounding tissues swell, and this makes the breasts themselves look proportionally smaller and the bra fit differently. A few weeks later after swelling resolves, the surrounding tissues go down, but the breasts now appear FULLER relative to the rest of the area, which is what we want. I would be patient and allow things to soften and settle, and in the end, if it turns out you still want to be bigger, it's not the end of the world to change the implants to a slightly larger size. It's not what any of us wants to think about, but from time to time it happens, and it's not a huge deal. Having said that though, it is really not common, and it will probably not be the case with you either.

Quinton Chivers, MD, FRCS(C) · Answer

Im sorry to hear you are unhappy with your implants.  With your apparent frame and preoperative size dimensions, Im not sure you will reach a D size breast with your current implants you do however have a nice result.  Talk with your surgeon- often times they will want to make you happy as their primary goal and while many operative costs are fixed,  should you still be unhappy at 3-6 months ... he/she may be willing to waive any surgeons fee at least associated with larger ones.  Most plastic surgeons won't guarantee bra sizes as they can vary by manufacturer and patient dimensions.  Preoperative cup size, implant sizers and thorough consultations patients regarding their aesthetic desires are a surgeons best guide.

	Regards,

	Dr Quinton Chivers

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