200cc good for me? (Photo)

From photos alone, your question cannot be answered precisely, nor should it be. An in person evaluation by an experienced board certified plastic surgeon whose aesthetics seem to align with your own is your best advice. The degree of breast asymmetry you possess is certainly within normal limits, with one breast showing a bit more skin than the other, making the nipple/areola slightly lower. This may or may not end up corrected with teh same size implants. From your photos it does not appear that a mastopexy would be required to correct asymmetry, with the possible exception of a small superior crescent mastopexy above the lower nipple.

The actual size implant is best determined by your plastic surgeon based on photos YOU select of your "ideal" outcome. In my practice I always come to surgery with more than one size and I routinely use sizers to see how close we can match your breasts to to your "wish" photos. This algorithm rarely leads us astray. The most common reason for patients to be disappointed after breast augmentation relate to size and position. Either too big or too small or too high. In your case I recommend a subfascial (above the muscle) placement for your implants.

Do you research, and be sure you are confident that your surgeon understands your wishes and that he or she can help you achieve your desired goals. Best o luck to you.

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing. Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look."
With regards to your specific question, 2ml does not sound unreasonable if you are seeking a very conservative upsize. For smaller framed individuals, a HP device is recommended.
Communication is key as you and your surgeon create your custom surgical plan.
As always, discuss your concerns with a board certified plastic surgeon.

Dear kitkat107,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient.
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.


Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery