I am 27 y 1.54m 45kg
What Size of Implant I Need to Achieve the Picture Volume? (photo)
Doctor Answers 5
Proper evaluation and implant sizing system are the best option to achieve the look you are seeking
Thank you for your question and photograph. Fortunately you have very pretty, naturally shaped breasts and should have an excellent result from breast augmentation if it is done by an experienced board certified plastic surgeon.
I urge you to seek consultation with a plastic surgeon certified by the American Board of Plastic Surgeon who is very experienced and has a good reputation for cosmetic breast surgery.
The Dr. will take specific measurements of your chest and breast, and hopefully use a Breast Implant Sizing System to try different sizes of implants in your bra to give you an idea of how you will look.
Follow the advice of the plastic surgeon who examines you and not estimates based online.
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Proper Implant Selection
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.
There are several variables in determining implant size. When recommending implant size for my patients, I consider the followings: 1) patients' anatomy (height, weight, chest width, chest height, amount of breast tissue) and 2) patients' desired look/goal. Without knowing your chest measurement and breast tissue amount, I cannot give you any recommendation. You should visit with board-certified plastic surgeon who will examine you. Try implant sizers to get a rough estimate of the size you may want. As you know, bra/cup size will vary depending on the brand. Good luck with you.
Dr. Sugene Kim
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External sizers to determine the volume
then you can choose what style and type will work best for you. Then you have to choose what technique and implant position. As for the subfascial, it is an interesting concept but its closer to a subglandular type result as the fascia is never taken as a clean sheet off of the muscle, nor does it cover the upper portion of the implant well. If you encounter any surgeon that says their way is the best and only way to go, get it in writing and know what happens if it isn't the best.
The photo you provided shows an excellent result and breasts change with time - nothing is permanent. But to 'see' what you will look like, external sizers help considerably.
Achieving your desired result in Breast Augmentation is More Complex Than Just Size. Think Shape, Technique, Width
That is a slightly difficult question to answer. There is quite a bit more than size to consider. First of all lets start with the picture that you selected as a goal. Although this looks like a wonderful result of a dual-plane breast augmentation with a round moderate to high profile implant, it has the typical stigmata of dual-plane breast augmentation. The breasts are too low and too splayed apart widely separated low breasts with flatness at the top from muscular compression. This may not be obvious on first glance but if you look carefully, you will notice that the superior pole (top) of the breast is compressed and flattened by the muscle, the is a rather abrupt step off or ledge where the top of the implant begins projecting from the chest wall, and really the narrow and high projecting mass of the implant has fallen off the true breast real estate and towards the axilla. Also because of the technique and implant choice, what I call breast-pectoral dysjunction is amplified. What I mean by this is that there is a very descrete change in angle where the axillary fold and pectoralis muscle (modified by the surgery) meets the take off of the breast implant.
Keep in mind that although these findings appear subtle, the flash and softness of the photo disquise them a nit and this is the patient completely relaxed, with normal animation and muscular tone, all of this gets worse! Whith time all of this will be amplified and the implants will take a further "down and out" appearance because of the unopposed forces of the superior pectoralis major muscle.
I want to reitterate that this is a great result for a dual-plane augmentation with a narrow highly projecting implant, but it leaves me very dissatisfied and just does not appear natural at all.
I prefer to create breasts that are full and beautiful without all of this stigmata and future of further bottoming out (they are already way too bottomed out for me to tolerate in my practice). One of the keys to overcoming these shortcomings is a different philosophy in implant selection and a change in technique that allows appropriate selection. An implant wide enough to occupy the natural footprint of the breast is required for a more natural result. This is simply not possible if any bit of the implant is to be under the muscle (this pushes the implant away from midline). As you probably know subglandular implants have a reputation for fairing poorly and I would agree. So what is the solution?
Its subfascial breast augmentation- all of the advantages of the two former techniques without the negatives. I exclusively use a technique called the Cold-Subfascial Breast AugmentationTM that allows the shaping of breasts with a strong internal support bra made of your own native fascia. It also allows the breast to take shape just next to midline like a natural breast and allows projection beyond the chest wall to create a nice feminine curve and obliterate pectoral-breast dysjunction. I use exclusively anatomically shaped highly cohesive form stable implants because I believe they are of unparrallelled safety profile and aesthetic efficacy. Results of this technique are very disparate from dual-plane results in anyones hands.
Although there are many ways to achieve good results, you should not focus soley on size. You are on the right track- find results that you like in a surgeon you trust and let them guide you through the decisions that work best in their hands and experience. RThe size will depend largely on your chest wall dimensions and your surgeons technique and judgement. I hope this helps!
All the best,
Rian A. Maercks M.D.
In response to Dr. Curtis Wong's comment regarding subfascial breast augmentation I agree completely. With conventional techniques and without technical expertise and care most claimed "subfascial" breast augmentations are truly subglandular. This is exactly what led me to develop the Cold-Subfascial Breast AugmentatinTM. Thank you for your comment Dr. Wong.
In my practice I exclusively use highly cohesive form stable (gummy bear) anatomically shaped implants. I feel that from a safety and efficacy profile there is no other acceptable choice. These implants allow me to create full, even large breasts with volume distribution that delivers a natural looking and beautiful result. Part of the trick is the true subfascial plane that I use called the Cold-SubfascialTM plane in my practice. With the careful dissection of a complete fascial envelope I am able to further shape the implant to a perfect match for the imdividual patient's body.
To sum up, consider subfascial placement avoid dual plane. Avoid higher profile implants and look into anatomic shaped choices ie tear drop implants. I hope this helps!
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.