But I will be going to another state to have this done I will have a physical consult with my PS he day before and have had many over phone etc but with out trying on sizes yet I am worried i will end up to small or way to big.I am very wide shouldered 39cm from armpit to arm pit arm not stretched.16cm from armpit to cleavage mark and 13cm for BDW.18cm from collar to nipple. I have been recommended HP 750 but when I do the rice test it is not even close I also have asymmetry I would like large
I Want to Make Sure I Get the Correct Size for Upcoming Lift and Implant, How Does One Decide?
Doctor Answers (9)
Breast implant sizing
Thank you for your question. It will be impossible to make any formal recommendations without a formal physical exam by your board certified plastic surgeon. I concur with my colleagues: communication is key to safely achieving your goals. In my practice, 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. Even your fitness levels and other relevant criteria are taken into consideration. It is you who will decide what you are comfortable with.
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. So try these implants in the office to pick which look you like the best.
Hope this helps. Best of luck.
Unfortunately, you have not provided any photographs. Certainly 750 cc implants are quite large. In my entire career of 25 years, I have nerver used implants that large in a retro-pectoral position on the primary augmentation. More important than implant size, is the type of lift you are going to require. I recommend you undergo a lift avoiding vertical incisions such as the boat anchor or lollipop. There is a new alternative technique that does not require vertical incisions and produces a signficant lift. The lift may give you the cosmetic appearance you desire with minimal augmentation. I would be very reluctant to put a 750 cc implant in someone who has already had hanging breasts. The additional load will make them droop even faster. You will need a more extensive consult prior to surgery to sort out all these matters.
Best of Luck,
Gary Horndeski, M.D.
Predicting size results in augmentation/mastopexy
I agree with Dr.'s Garramone, Minniti, and Stephenson. You are a set-up for problems ranging from minor to disaster by having a procedure done out of state with inadequate in person consultation and with a combined lift and augmentation with excessively large implants based on some misconception of sizing and results.
Breast implants do not lift the breast and larger ones do not lift it further. A properly done lift alone will make the breasts look larger which makes it doubly hard to judge the outcome in relation to size achieved. Because of the surgical alteration of the breast and the incisions required for a lift, the risks to the blood supply of the tissues and the effects of forward pressure from the implant work against successful control of the result and avoiding complications and the need for revisions.
In general, a breast implant placed at the time of a mastopexy should be a bit smaller than that placed with a breast augmentation alone and a high profile implant should be avoided completely. If you want the best result and control over the size while avoiding problems, I would do the mastopexy first (assuming you need it which is often not the case) and then consider the augmentation as with an augmentation alone. I would also consult in person with the surgeon at least twice before the surgery and not have it performed out of town without planning to stay in the area for at least a week and possibly more.
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A breast augmentation with a breast lift is a complicated procedure because the plastic surgeon is changing a number of things including the size and shape of the breast and the position and size of the nipple and areola. Only one of the choices is the implant size. It is important to understand that this combined operation is really two different operations performed at the same time that work against one another. Placing too large an implant will compromise the lift and completing the lift first will limit the size implant that can be placed. In my practice I do not commit to the size implant prior to this particular procedure and in general I use smaller implants than in my breast augmentation only patients. The implant you are considering is one of the largest, most projecting implants made.
You should also remember that problems increase with larger implants and with implants that project more. In my practice I see patients for this operation at least twice before the procedure. During these visits we spend a lot of time going over the procedure and the type and style and size implants that we will consider using. I would find it difficult to do that over the phone. You are making a big decision and you will have a relatively short time to discuss the choices and make decisions which will affect you for many years to come. You certainly do not want to make a decision that will lead you to more surgery in the future.
Thank you for your question and good luck.
Breast Augmentation/Lifting and Size Selection?
Thank you for the question.
Prior to proceeding with the surgery it will be very important to communicate your goals with your surgeon. In my practice I find the use of goal pictures to be very helpful. I have found that the use of words such as “large” or “DD cup” 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 breast 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.
Keep in mind also, that when undergoing breast lift surgery along with breast augmentation surgery, there may be limits as to what breast implants lies can be used safely.
I hope this helps.
Breast Implant Sizing
I don't know what you mean by 750 cc HP being 'not even close', but I can tell you based on your bwd of 13 cm, the proper starting volume is 325 cc. Depending on other measurements, this may go up by 30 to 90 cc, leaving you far away from 750.
This system is not based on what cup size you were hoping to be, or what you believe is proportionate for your height, weight, shoulder, hip, buttock, or thigh size. This is based on reproducible results that will limit your risk for early and unexpected complications, as well as late term complications too.
Just a quick word about extra large HP implants. Their long term effects on both your soft tissues and even your rib cage is best described as destructive. These are very heavy and very denxe (high profile equals narrow base) implants that will thin and stretch your soft tissues and flatten your rib cage were they sit on your chest. You are committing yourself to not only multiple revision surgeries long before you have to, but also risking problems that will never be corrected adequately by any surgery.
Best of luck!
750 cc implants are quite large. The best thing to do prior to your consult is to do the "baggy test" at home to see what approximate volume you like.
Choosing Correct Implant Size
Sometimes geographic distance makes it difficult to see plastic surgeons but seeing the plastic surgeon the day before the operation for the first time in my opinion is not the optimal situation. It appears that a 750 cc HP implant has been suggested but that would be too big in my opinion especially if a lift is to be performed at the same time. The most important measurement is the width of the chest which corresponds to the width of the implant.
Correct size is the look that is right for you
The implant number cannot be determined by trying the implant on in a bra like sizing clothing. The size and projection of the implant depends on the avilable skin envelope and the look that you want. Use photos to show your surgeon what you expect a good result will be. Unless the surgeon knows you as well as you do, the size to him is a best guess.
Best of luck, Peter Johnson, MD