Surgeon Says I Can't Get More Than 236cc. Should I Trust my Surgeon?

Hi I am 21 years old... very tiny. 5 feet, 95 pounds, currently a small A cup. I am having a breast augmentation in the next few months. I was planning on 300cc... but unfortunatly he told me the most he could do is 236cc or else I will look fake and it will cause complications. But that just sounds soooo small to me... it broke my heart. Will these even make a difference? I wanted to achieve a full B, small C cup. I am really tiny... should I just trust him? he is a good surgeon with a high rep

Doctor Answers (19)

Using Newer Shaped Breast Implants

+2

Hello Danni: I believe that you can have larger implants and still have a natural look. Ask your plastic surgeon about the newer shaped breast implants that come in 3 different profiles (moderate, moderate plus, and high profile) to better fit women's bodies. Judging from your photograph, you are petite and have a narrower A cup chest.

Your Plastic Surgeon can select the Moderate Plus or High Profile implants that are narrower than the traditional moderate implants, but stick out or project more from the chest. Therefore, you can, most likely, have the 300cc implants, with one of the newer implants that will give you the cc size that you really desire and still look natural. Best of Luck.


New York Plastic Surgeon
5.0 out of 5 stars 4 reviews

Thinking volume of implants instead of dimensions

+2

The problem here is thinking in terms of volumes and particularly specific volumes instead of knowing what dimension or size of implant will fit and what effect it will give and then looking up the cc's of volume. It's sort of like being sure that you want a size 4 dress but you really don't know if that's your size. It's better to measure your breast width and find what width (and height for a round implant) will fit your breast and then choose the forward profile to add to the volume that will affect cup size. 

Unfortunately it's not possible to easily measure the volume of the breast and it's not helpful, in spite of those that rely on it, to tell anything from stuffing a bra externally. If your breast width is measured upright with arms down and the implant diameter is about 3/4 cm less (to allow for the skin and underlying tissue) then the implant will fit you and look right. The choice is the forward profile. If it's a low profile implant it will increase your breast size by about one cup. If it's a medium profile it will increase by about 1 1/2 cup sizes, and if it's a high profile (saline - Allergan, not Mentor, gel - either brand) it will increase your breast size by two cup sizes. If you're a mid A cup then that would be a mid C-cup. The cc's of volume are based on this sizing, not by starting with the volume. In other words, you have to know the dimensions of the 236 cc implant in order to know if it will fit and what effect it will have. Don't get hung up on the cc's alone. It's possible the plastic surgeon you're dealing with understands this but isn't explaining it well. If he or she is going on pure volume judgment, I would get another opinion. 

The patient should get to choose the type of implant (saline or gel-filled) and the forward profile of the implant to choose what size she would end up with, but the surgeon has to make sure the width (and height) of the implant fits and get it positioned properly and then healed there. The tissues will accommodate any implant currently available done this way. 

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

How to choose breast implant size

+2

When considering  plastic surgery of any kind, it is always a good idea to consult with at least two board-certified plastic surgeons.  As far as implant size is concerned, the 236cc size may look very nice, but you could possibly go just a little bit larger if you wanted to.  I don't think I would recommend anything larger than 300cc because of your petite frame.  In my office, I allow my patients to select their size (with my guidance) by placing a variety of different sized implants in a bra at the time of the preoperative visit.  This way I am able to get a good idea of what will be satisfactory to my patient, since she will be asleep for the actual surgery and I don't want to have to guess what will make her happy.

Pamela B. Rosen, MD
Coral Springs Plastic Surgeon
1.0 out of 5 stars 1 review

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Implant Size Selection at the time of your consultation.

+1

You should trust your plastic surgeon prior to your surgery!  If you are unsure, get another opinion. 

Plastic surgeons select implants sizes and shapes based upon chest measurements, skin laxity, and tissue thickness... 

The consequence of going too small is an unhappy patient. 

The consequences of going too big in a small breast includes a multitude of unwanted problems (symmastia, visible implants, rippling, and other shape problems, and others). 

Your surgeon must exercise judgement to keep you out of harm's way. If he (or she) can not meet your size expectations, it may be better not to have the surgery.  It may be a good idea to wait until you can have textured silicone gel implants (if Canada is like the USA and has a 22 y.o. age requirement for these implants).

I have seen a few patients in the past, who could not accept safe implant sizes for their augmentations. Their results (done elsewhere with larger implants), were sometimes quite troubling and not easily surgically correctable.

Best Regards,

Douglas J. Raskin, MD, DMD
Colorado Springs Plastic Surgeon
5.0 out of 5 stars 23 reviews

Implant sizing

+1

It is very difficult to predict what cup size you will be after your procedure.  Cup sizes are not standardized.  So a D cup in one designer could be a C cup or B cup in another designer.   This is the approach I use to help guide my patients with their implant size selection:

I consider two factors when selecting implants for my patients:

1.Dimensional planning
2.Gel Implant Sizing system

Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.

Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look.  If you have decided on saline implants, then based on the gel sizer you select, we can guide you to the saline implant that achieves a similar look.
Hope this helps.
Dr. Basu
Houston, TX

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 117 reviews

Implant Selection

+1

Unfortunately, there is not a general rule of thumb or objective criteria to implant selection to replace an in office exam and good communication with a board certified plastic surgeon.  I typically recommend visiting with 3 board certified plastic surgeons to educate yourself fully and make the best decision.    In your case, if you are uncomfortable with your surgeon's recommendation, I would encourage you to get more than 1 opinion.

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 35 reviews

Implant size and cost

+1

Yes you can go bigger. You should be able to go with 300-325 without difficulty, depending on the width of your natural breast. You may have to go to a higher profile to get the diameter small enough to fit behind your breast.

As far as how natural they will look, it is all determined by how much natural breast tissue you have. With minimal natural tissue, then it is more likely to look less natural as the implants get larger.

Gregory Sexton, MD
Columbia Plastic Surgeon
5.0 out of 5 stars 27 reviews

Will A 236cc Implant Give Me A Small C?

+1

Dear Danni, Your request for a big B/small C implant is very reasonable.  The base diameter of an appropriate implant is determined by the size of your chest/breast.  An Allergan high profile implant, at 230ccs, has a base diameter of 10.0 cm, and at 300ccs, has a base diameter 10.9 cm.  It is my personal feeling that the .9 cm will neither overwhelm your chest, nor will it look fake and cause complications.  

I am sure your plastic surgeon is a good person with a great reputation, but your requested size is not unreasonable, and I feel a second, or even third consultation, would be appropriate at this time with a Canadian Board Certified plastic surgeon. 

S. Larry Schlesinger, MD, FACS
Honolulu Plastic Surgeon
5.0 out of 5 stars 200 reviews

Implant selection and technique- both influence the shape and appearance of the breast

+1

Dani,

      It is difficult to say what is right for you without an exam, but I would think a natural look could be achieved with upto at least 325 maybe more depending on thelook that you are after.  Many surgeons think that they have to place very narrow implants in patients like you.  I have a different perspective in that I use implants that are wider than what most people choose and use a technique that I call 'cold-subfascial placement' to shape the implant distributing the volume differentially ver the breast creating a tear-drop shape.  The breast then takes up a larger, higher footprint allowing the volume to be distributed in a natural appearance.  It is not a bad thing to find another surgeon you trust for a second consultation as we all have our biases.  I hope this helps!

 

All the best,

 

Rian A. Maercks M.D.

Rian A. Maercks, MD
Miami Plastic Surgeon
5.0 out of 5 stars 31 reviews

Breast implant size

+1

It is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the press implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 715 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.