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What Size Implants Should I Get? Want Large D Cup Boobs, or DD. 5'8, 143 Lbs, Sillicone Implants!

I know I should not focus on the cup size but more on what I want it to look like, I want them to be large, I am 5'8 and a little bit and weigh 143 lbs and am athletically built, I want them to be the Playboy look-- large, but not so large that they can cause complications.My Dr. recommended the 450-500 range but when I tried those on at the office they all seemed so small. What would you do?

Doctor Answers (13)

What implants will give the Playboy look?

+2

First of all, thank you for being honest in what your goals are--all too many women are shy about expressing their true wishes (until after surgery, when they aren't hesitant to tell their surgeon he did not fulfill their [unspoken] goals). Also, you should absolutely trust your own assessment if you feel that the 450-500cc implants are insufficient to meet your goals. By my method of estimation, I believe it takes about 250cc to equal one cup size. Thus, 450-500cc implants will add 2 cup sizes to your present size (which I don't believe is a C-cup)! So I agree with you here!

Larger may in fact be better, as it will help to fill your skin brassiere better, not to mention diminishing the percentage of asymmetry between your breasts. A quick example to illustrate:

Let's say your right breast is 90cc naturally and your left 100cc. (I'm not saying they are, just using these numbers as an easy mathematical example). This is a 10% difference.

Now, let's add 400cc to each side. You will have 490cc on the right, and 500cc on the left, a 2% difference.

If you add 700cc to each, you have 790cc and 800cc, or a 1.25% difference. So, larger size improves symmetry, all other things being equal.

However, your grade 2 to borderline grade 3 ptosis and relatively short nipple-IMC (inframammary crease) distance does increase the technical difficulty in avoiding a double bubble, as Dr. Minniti has correctly commented on. Other colleagues have included helpful observations as well; I'm sure you will read all of them.

Your breast base dimensions are a critical part of choosing the right profile implant once the size is zeroed in on, and if I saw you in consultation, I would tell you that while every effort would be made to achieve both your size and appearance goals, your anatomy is not "ideal" for an "easy" implant placement and a "slam-dunk" great result. You will need to give your implants time to drop into position behind your breast tissue to adequately fill-out your skin brassiere and to hopefully minimize double bubble formation. Secondary surgery to reposition the implants (if not achieved properly at the initial procedure and over time) may be necessary, and even that would not be a big deal if it yielded the great result you hope for.

But I would also tell you that there is a chance that you might need some sort of full or modified lift procedure to reshape your skin brassiere if a double bubble or other unsatisfactory aesthetic result is seen, despite everyone's best efforts and your best compliance with post-op instructions. I do the secondary lift procedure for the DIFFERENCE in the cost between augmentation alone and augmentation plus full lift, so as to take the financial issue out of the discussion, and with full knowlege that this IS a second operation, with full recovery, another set of (minimal) risks, etc. But with this anatomy, that is the reality, and simply slapping-in a set of implants is precisely what you DO NOT need!

Thoughtful consideration of the anatomic challenges and specific measurements here are critical to achieving the highest likelihood for success! Best wishes!


Minneapolis Plastic Surgeon
5.0 out of 5 stars 144 reviews

Understanding Breast Implant Options

+2

Hi there-

Questions about which implant size is best are so incredibly common that I think I write just about the same thing at least 3 times per day.

Please read the following for a good understanding of why picking the implants before surgery is probably not the best way to go:

 

Hi there-

 

It's amazing how often people ask this question... Understanding the answer requires a bit of background:

 

Let's first agree that the implant is not going to be sitting in space (as it would be outside of your skin and under a loose bra). Rather, the implant is going to be under your skin, your breast tissue, and maybe even under your chest muscle (depending on your choices).

 

It is critical to understand that all of these layers (your skin, your breast tissue, and your muscle) are going to affect how any particular implant looks inside of you, by applying a counterforce to the projecting force of the implant. 

 

Furthermore, your individual skin characteristics, as well as those of your breast tissue and your muscle, are different than these characteristics in any other woman- you are an individual. 

 

Finally, elasticity and compliance of these tissues is very difficult to predict accurately before surgery.

 

So, to summarize, your appearance with any particular implant is ALWAYS going to be affected by where the implant is placed, and by the qualities of your tissues and how much resistance these tissues provide- and these variables are nearly impossible to accurately predict before surgery.

 

Therefore, it is my opinion that committing to an implant size before understanding how that implant will look inside of you is a mistake, and is a big part of the reason that so many women have a second operation within one year of their breast augmentation in the United States.

 

My best advice to you would be to find a surgeon you like and trust (someone Certified By The American Board of Plastic Surgery) and who's work you admire. Have a nice talk about what you want to look like- and then let them make the decisions necessary to achieve the look you described.

 

This will require a leap of faith- but maximizes the chances of you ending up happy.

 

I hope that helps you.

Armando Soto, MD, FACS
Orlando Plastic Surgeon
5.0 out of 5 stars 113 reviews

Implant Selection Process

+1

The larger the implant, the higher the risk of complications.  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 42 reviews

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Choosing larger implants.

+1

Choosing the correct size implants is a combination of evaluating your natural anatomy and matching it to your goals. Implant sizing requires a formal evaluation, although from your goals, it sounds as though 500cc would be the minimum size for your end result. Given your anatomy, this would likely require higher profile implants though to keep them from falling underneath your arms or violating the midline.  

You mention avoiding complications. For larger implants (those above 400cc), you are bound to have complications related to the size and weight of the implants as the years go by. Implant malposition, tissue thinning, double bubble (either immediate from fold undermining or progressive from implants dropping), and synmastia are all concerns. Also, the bigger the implants, the less your breasts look like natural breasts. Many women choose to decrease the size of the implants as the years go by because of these effects.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 12 reviews

Breast implants should go above the muscle to correct sagging.

+1

How to pick breast implant sizes
Article by George J. Beraka, MD
Manhattan Plastic Surgeon

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

How to pick the right size implant

+1

Sometimes it's hard to figure out the right size implant that works best.  A lot of it depends on your goals and taste. Your photo shows a fair amount of asymmetry with your right breast being a bit smaller and facing more outwrd (lateral). Also your nipple-areolas are a bit different. That being said I suspect you wouldn't have any problem going as large as 450. I think 500 might be pushing it. I generally recommend going to one of the breast augmentation websites, such as implantinfo.com. You will be able to search the database amoung thousands of women. There's a trick though to make it work: First search for height and weight. Next find women who have breasts that look like yours. Next, from this group find results that you like. Print out about six. I bet that the implant sizes used are within 25-50cc of each other. I have found this to be very helpful in helping to predict your result. If you don't like what you see in women who get 500cc, you might be heading in the wrng direction. Give it a try and take the photos to your surgeon to discuss. Good luck.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 30 reviews

Determining implant size

+1

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.. 

On this site, I do my best to give advice without a physical examination but I want you to know that a physical examination by a board certified physician is always the best way to get the most accurate information.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 791 reviews

Choose the look you want for breast augmentation

+1

It is very difficult to pick and implant by number, or try one on in the bra and know what your result will be like. We suggest choosing a look you wish and finding a surgeon who can recommend and work with your tissue to give you a result as close as you can be to your goal. Keep in mind you do face limits on the what your breast will cover safely, though show your surgeon the Playboy look if that is your goal.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 31 reviews

Breast Implant Sizing

+1

Hello Jennifer1164,

I respectfully disagree with the other responders to your question.  Your anatomy is a set up for a serious post operative complication called a double bubble.  You have a 'high riding' inframammary crease, which in essence makes your nipple and a sizable amount of your breast mound hang off your chest wall.  Placing a large implant in the correct position (at or slightly below your current inframammary crease) will make that implant way too high for the hanging breast.  In a futile attempt to make the breast look better, the surgeon must then lower the position of the implant, thereby lifting the natural inframammary fold off of the chest wall and creating a crease that runs diagonally along the bottom of the breast mound.

Unfortunately, you can not just pick out your desired breast size or bra size like a new pair of shoes in a store.  There are real anatomic considerations to be made and the reality is there are limitations to how big a given individual can go based on her dimensions and anatomy.  I can not tell you without direct examination how large of an implant would be appropriate for you from an anatomic standpoint.  Further, based on your photographs, your breast results would be vastly improved with a breast lift in addition to placement of implants.

I would consult with a few doctors who have an excellent reputation as breast specialists, and who are, of course, also certified by the American Board of Plastic Surgery and members of the American Society for Aesthetic Plastic Surgery.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 35 reviews

Implant size and breast augmentation

+1

In my hands in a patient your size and weight of 500 mL implant would create a large C or a small D. In order to create a D cup I would consider a 600 or 650 mL implant.

Large implants have consequences. The larger the implant the heavier the weight and the more the skin will be stretched over time. This means that a smaller implant in 10 or 15 years may look better than a larger implant at that time because the skin will become stretched and the breast will go down. Stretch marks can also occur with larger implants. Another problem that can happen with large implants is a drop of the inframammary fold.

Another consideration must make is that when you try the implants are the bra preoperatively it looks larger than the implantable look after surgery inside your body. So my patient likes to look on the 500 mL implant I will usually put in a 525 mL or 550 mL implant.

There are a lot of things to consider when you choose implant size.

Wendell Perry, MD
Miami Plastic Surgeon
4.5 out of 5 stars 173 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.