What Surgeon Should I Trust? (photo)

Ive been on 3 consultations for BA. I explained that I wish to have a natural look but I don't want to regret going too small. One surgeon suggested 375 cc's. One told me he would not go over 360 cc's and finally, One surgeon told me that I needed at least 550 cc's. I am very confused as to what I should do. My breast width is 13 on both sides. 5'7'', 170 pounds and losing. I also need help in deciding between moderate and moderate Plus profile. Silicone. No kids. Size and profile help please?

Doctor Answers (15)

Recommendations

+1

Unfortunately, you have not told us your bra size.  If you are a 32 or 34 each 100 cc’s of implant corresponds to 1 cup size change.  If you are a 36 or 38 each 200 cc’s of implant corresponds to 1 cup size change.  From this, you can compute the volume required to achieve your desired goal.  Since your breasts are asymmetrical you will need different size implants.  I recommend you get professionally measured to help you determine your actual cup size.  I always recommend the smallest size silicone gel implants placed retro-pectoral since they look and feel more natural, are more stable, less likely to ripple or have complications.  I recommend a circumareola approach because of the asymmetry of your areola can be corrected using this incision.  The profile of the implant is irrelevant when placed retro-pectoral since the muscle compresses it. 

 

Best Wishes,

 

Gary Horndeski, M.D.


Texas Plastic Surgeon
5.0 out of 5 stars 120 reviews

Sizing breast implants

+1

Unfortunately the patient cannot "try on" a breast implant like a shoe or dress and I disagree with the responses that indicate that anything useful can be gained from external sizers. 

Breast implants have to be fitted to what they are filling and know what effect that will have on the apparent size of the breast since there is no simple way to measure breast size before or after breast augmentation. Basically, in gel-filled implants there are three choices of forward volume (profile) implants that if properly fitted to the width of the breast, will make it look 1, 1 1/2, or 2 cup sizes larger. The proper way to measure breast width is upright with arms down. 13 cm is an average breast width and in middle profile implants would result in a volume somewhere in the 300's. The width of the implant should be about 3/4 - 1cm less than the measured width of the breast. 

So get a good opinion of what size your breast looks now and figure up 1-2 cup sizes depending on the choice of forward profile. Significant volume asymmetry is harder to deal with in silicone gel-filled implants as there is no way to vary the volume on one side without increasing the width on one side unless there is a whole half cup difference in volume. 

Moderate plus profile (the middle profile) is a reasonable choice for most women in silicone gel-filled implants. Have the plastic surgeon measure your breast width upright and subtract about 1 cm from that measurement. Look up that width (diameter) on the implant charts for medium (usually called moderate plus) profile gel implants and you can see what volume the implant should be it you want to be sure it will fit and look natural (assuming it's positioned properly) and make you look about 1 1/2 cup sizes larger. 

Scott L. Replogle, MD
Denver Plastic Surgeon
4.0 out of 5 stars 1 review

Breast implant size

+1

I prefer to use measurements and to try on implants in a sports bra.  You clearly have a lot of assymetry and will likely need two different sized implants.  I prefer the moderate plus profile implants in most cases as I like their amount of fill and base diameter.  Good luck!

Christopher J. Davidson, MD, FACS
Wellesley Plastic Surgeon
4.5 out of 5 stars 11 reviews

Asymmetry after surgery

+1

I'll try to give you an idea of implant sizes based on your pictures, but take it with a grain of salt as a picture will never replace a physical exam. I would recommend subpectoral moderate silicone implants. Your base width is too large for a high profile implant unless you want a DD+ cup. I would recommend around 400cc on the right and around 450 on the smaller left side for a "full C" result. Good luck.

Marcelo Ghersi, MD
Miami Plastic Surgeon
5.0 out of 5 stars 70 reviews

Best Breast Implant Size

+1

I understand your questions and confusion.  The best way to determine the ideal implant size for your body is to "try on" sizers in the presence of your surgeon and ask for feedback.

Your surgeon should comment whether the size you pick is appropriate for the amount of breast tissue you have and skin type.  It is a mistake to place an implant that exceeds the breast's ability to accommodate it, and if you desire a natural look this must be avoided. 

John LoMonaco, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 160 reviews

Breast implant sizing considerations for a 'natural' look

+1

Your breast width is the determinant of implant volume, if you are looking for a 'natural' augmentation result. Avoiding large diameter, high volume implants would be important, in your case.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.5 out of 5 stars 32 reviews

Breast Size

+1

It truly is difficult to determine what size a patient would like and it tales good communication between you and your surgeon to determine what size implant to use.                                                                                                                                               The picture you posted shows a lot of asymmetry and this can be improved with the proper selection of implants. If silicone you would need different sizes and if saline different fill volumes.

Walter D. Gracia, MD
Arlington Plastic Surgeon
5.0 out of 5 stars 2 reviews

I think you need more advice!

+1

Without personal consultation, it's truly hard to make an accurate assessment, but with your 5'7" height, 170 pound weight (keep up the good work!), and the photo you have included, I would doubt your breast base width is really13cm. Since breasts do not have a "sharp" begin and end to accurately and reproducibly measure, each surgeon will obtain their own measurement. To use the number you provide as a basis for recommendation could subsequently be ALL WRONG!

I think that the surgeons recommending implants in the 300s are certainly playing it "safe" and would indeed give you larger breasts. You might even be happy with the results. But your photo appears to show asymmetry, and I would recommend at least 2 implant size differences (60cc) between your chosen implants to achieve better symmetry. 360cc will add about 1 1/2 cup sizes to what you presently "bring to the party." Is that enough? If not, then the surgeon suggesting 550cc may be closer to the mark. (I personally am leaning that way, despite my learned colleagues' conservatism in their answers).

The thing is--it takes much more back-and-forth between you and your surgeon(s) so that you end up with the volume increase you desire. Your size and chest make you the kind of patient that implants seem to be "swallowed up" into, and many patients with your anatomy regret their choice (or their surgeon's conservatism) and end up requesting larger implants (and another operation, and more $$). This, IMHO, is avoidable!

Once you have the size decided upon, then choose the profile that most closely approzimates your pocket diameter, not your present breast base size. This will give you the most natural cleavage and natural look. I suspect that unless you end up with large(r) implants you would be best served with moderate profile implants. (I think 13cm is off by at least 2-3cm). But that's why personal examination and good decision-making during surgery (and having ALL implant sizes and profiles available on-site) trumps any online opinion here!

Take a look at the photo gallery of our augmentation patients in the web reference link below. Since I uploaded the data myself from actual patient charts, I know the implant information is accurate, as is height and weight. You might be surprised to see how large(r) implants don't always make patients look "too big." Then get more advice and additional opinions if needed to make your decision. Do it right the first time! Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 109 reviews

Breast Augment

+1

Go with the surgeon you feel most comfortable with. Have a frank discussion about the financial ramifications of a size change after surgery. Make sure the surgeon uses an implant that stays within the boundaries of your breast width

GOOD LUCK

Ryan Neinstein, MD, FRCSC
New York Plastic Surgeon
5.0 out of 5 stars 35 reviews

Implant sizing

+1

Using your chest wall measurements as a guide is the best approach in my opinion. The difference in projection of a moderate and moderate plus implants in the size range that would fit your chest are minimal. I use 3D imaging, and contoured sizers in my office to assist patients in understanding why the best fit for them is the best fit. I would recommend implants in the mid-300 range. You do have some asymmetry, so different sizes will most likely need to be used. I do not believe you could obtain a natural result on your frame with implants as large as 550 ccs.

Patti A. Flint, MD
Scottsdale Plastic Surgeon
4.5 out of 5 stars 25 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.