Transaxillary Breast Augmentation- Is 375cc Too Big?

I am 67", 123lbs, 28/yo and currently a 34AA... my PS took measurements, decided that a transaxillary would be a good decision because of the lack of breast tissue and visible scars... i initially selected a 325cc but went back today and i really like the look of the 375cc, is this going to be too big for me?

Doctor Answers (13)

Implant Selection Process

+1

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


Houston Plastic Surgeon
5.0 out of 5 stars 35 reviews

Size too big?

+1

Given your height and photos, I believe the size range you're discussing is within the typical range in my experience.  It's hard to comment, however, not knowing exactly what you described to your surgeon. 'Too big for me' is a personal judgement and, for some patients this would be too big and for others too small.  If you elaborate on what you're looking for I think we can advise you better.
 

Scott E. Newman, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 25 reviews

Use Silicone!

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For most of my patients who are very lean like you and with little breast tissue, I prefer silicone implants.   These implants can be placed throught the areola with equally good scars.  I would not pick a saline implant over a silicone just because you prefer one scar over the other.   I never pick a specific implant before surgery.  I ask my patients to bring in pictures and together we decide on a reasonable overall shape and fullness using pictures.  Stuffing your bra with implants is inaccurate.  During surgery I use a disposable sizer to costumize the perfect volume of implant to give the desired look for my patient and match the pictures they bring in.  90% of the time if you pick the implant before surgery, you wish you had gone bigger.  Anything between 350 to 450 can look very nice on you depending on your goals and the style of implant used.  Best of luck.

Daniel Yamini, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 14 reviews

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400cc implants!

+1

I usually recommend that my patients go a little lager than what  they think is just right - three months after surgery, most wish that had gone larger!  I assume that you are talking about gel implants and an axillary approach.  Is so, the larger the implant, the more difficult it is to insert by way of the axilla.  Consult with your PS for his recommendation.  Good luck!

Joseph N. Togba, MD
Oakland Plastic Surgeon
4.5 out of 5 stars 11 reviews

Transaxillary augmentation--325cc vs 375cc?

+1

To answer your question directly, a 50cc difference is barely visible, if at all. Remember that 50cc equals 3 tablespoons plus 1 teaspoon of volume--over an entire breast this corresponds to about 1/5th cup size. So, when in doubt, choose the larger size, since the vast majority of patients either like their size or wish they had gone larger. Virtually no one feels they are "too large."

Another concern, however, is that you did not say if you are considering saline vs. silicone. You are quite slim with very little breast tissue of your own, and a very thin subcutaneous fat layer to conceal implant edges and/or ripples. You should seriously consider submuscular (actually dual-plane) silicone gel (cohesive 5th generation by either manufacturer) implants. Axillary placement leaves a scar in the armpit (sometimes visible in swimsuit, sleeveless tops, and nude), dissection crosses the path of the lateral 4th intercostal nerve (sensation to the nipple), and not only is correct implant position harder to achieve with this incision choice (more high-nipple, bottomed-out results), but this is a warm, wet, bacteria-rich area (where do you think armpit smell comes from?) with a higher risk of capsular contracture from biofilm and/or bleeding.

Oh, BTW, if you need re-operation for ANY reason, it will usually need to be via an inframammary incision.

So why not choose it in the first place? Stitched together precisely with under-the-skin dissolving suture technique, this incision choice heals with a nearly imperceptible hidden-in-the-crease scar that allows the best access for proper inferomedial pectoralis muscle fiber release, best control of bleeders, and most accurate inframammary crease position. Just check out how many questions are asked about crease position, double bubble, and cleavage problems. Look at the before and after photos on my website's photogallery and see if you can see any scars. Not saying axillary is "wrong," just that there are pros and cons with each choice, and re-operation risks need to be factored into this equation!

One other thing to know: If you like the "look" of a 375cc implant in a bra and stretchy top, this will require a 400-475cc implant in your body to give you the same "look" as when you sized. Trust me on this. If your surgeon uses the exact size you chose, you will be too small, or think he used the "wrong ones." Good luck and best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 118 reviews

Not too big, not too small, just the right size is a personal choice

+1

A 325cc, 350cc or a 375cc would look very good on you but the final choice is yours.  If you liked the look of a 325cc stuffed in a bra then it is wise to choose a slightly larger implant since placing an implant under the muscle does contain the implant differently than a bra.  Best wishes.

Louise Ferland, MD
Richmond Plastic Surgeon
4.5 out of 5 stars 7 reviews

Focus on your breast size goal and not the implant size

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While it's very difficult for patient's not to get caught up in selecting a particular size or range of breast implant sizes, there are numerous factors that going into selecting what might be considered an ideal patient. Selecting an arbitrary size restricts your surgeon from providing you with the best possible aesthetic result offered from other size implants. By communicating your aesthetic goals, your surgeon will indicate what range can possibly achieve that goal. Be mindful that your breast width, breast fold measurements, your height and weight, soft tissue thickness, implant location, and  previous surgical history and incisions all play vital roles in deciding your implant size, not just your arbitrary goal. Surgeons will often feel pressured or feel like they're letting down their patients if they don't place the "minimal" number that would satisfy a patient. However, too large an implant can lead to asymmetries, malpositioned implants, over dissection with longer recovery period, higher risk of revisional surgery, stretched tissues, enlarged scars and areolars, etc.

Jeffrey D. Hoefflin, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 9 reviews

When in doubt, go bigger

+1

Speak with yoru surgeon, but my philosophy is "when in doubt, go bigger". This is because it is true that mmost people wish they went bigger. You need to check with your surgeon to make sure that the bigger implant is not too big based on your breast measurements. Also, you should try them on to make sure you like the way they look, but keep in mind that implants looks slightly smallers when placed inside.

Matthew Schulman, MD
New York Plastic Surgeon
5.0 out of 5 stars 162 reviews

Breast implant size

+1

It is common for patients to wish they had picked bigger implant size after their augmentation.  If you liked how 375cc looked - I think you should go with that size.  Good luck!

Bivik Rajnikant Shah, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 8 reviews

What size is good for you

+1

What size you are looking for is sometimes difficult for you to measure.  Different companies sizes vary in bras.  A Warner's B is a Victoria secrets C which is a Frederick's D.  One data point would be to try on different sizes, and stuff the bra with something, and try on all the clothes in your wardrobe to get a philosophic idea.  Another way is to look on line at before and afters.  Look at sites that have the patients height and weight, how much breast tissue they had before the surgery, and the size and style implant they had put in.  All of those variables including the shape of your chest wall will come into play with the "total volume" of your breast.

It appears from your pictures that you have about 80-100 cc of your own breast tissue but you have a bit of pectus carinatum (which means that your breasts  foundation is somewhat going to the sides).  My average in Southern California is about 420 cc.  But most of the girls here wish to go to a middle to big C and some to D.  That is just So Cal for you.  My Anesthetist is from Shreveport and tells me that there women would rather be a touch more conservative and be small C. 

As a General rule, for a women that is 5 feet 6 inches tall and weighs 120 pounds, total volume of 520 cc is a middle C in Warner's bra.  So if you have 100 of your own, and you put in a 375 cc implant that would be a total of 470 cc, which is a small C in Warner's, or a big C in Victoria Secret bra.  For calculations, I use a total of 600 for a D bra and 450 for a B-C. 

Trans axillary approach looks to be a very good choice for you--it is my favorite way of doing breast augmentation.  Good luck to you!  You will get a great result.  Just make sure that you go to a Board Certified Plastic Surgeon, and hopefully one that does more cosmetic work like one that is a member of the American Society for Aesthetic Plastic Surgery.

Dan Mills, MD
Orange County Plastic Surgeon
4.5 out of 5 stars 16 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.