210cc Silicone Implants, Under the Muscle, Mod Plus on a Petite 5'1 90lb Body?

The implant volumes you are considering are very low, even for a petite woman.  I almost never use an implant under 200 cc.  The problem is that the diameter is too small.  Most women like a V-shaped cleavage, not a U-shaped cleavage.  You are starting with basically no breast volume.  I suspect you would be happy with a 280 cc size, so definitely go with 230 if you are torn between 210 and 230.  You will not think you are too big later.  Look at K.A. and M.L. on my website and see what you think. 

Thank you for your question. The most important factor when sizing implants, is working closely with your surgeon, in person, to find the implant size that gives you the look that you desire. I would try on implants in a bra to find the size that you like. I find that most women know they have found the right size when their breasts come into balance with their shoulders, waist, hips and buttocks. Unfortunately, online recommendations will not be that helpful. 

At size 32 each 100 cc's of implant corresponds to 1 cup size change.  To go from a AA to a B would require approximately 200 cc implants.  However, you have not provided any photographs and there are other aspects to consider such as skin tone, nipple position, position of the breast on the chest wall and symmetry.  You may be a candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.  Through the same incision, an implant can be placed retro-pectoral.  Aligning the areola, breast tissue and implant over the bony prominence of the chest wall gives maximum anterior projection with a minimal size implant.  Smaller silicone implants are more stable long term, look and feel more natural, are less likely to ripple or have complications that need revision.  Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it.

Best Wishes,

Gary Horndeski, M.D.

If you think of five cc's being roughly a teaspoonful of fluid then you are talking about a very narrow range here.  I really don't think you can go wrong no matter which size you choose.  Two things to consider, however.  First, if you are going to err, I would suggest erring on the larger side.  This will be a change in your body image and your first impression when you see your result should be that you went too big.  After the implants have settled over the course of a few months, however, you will become accustomed to them, any swelling will have resolved, and the implants will have settled into position.  It is not unusual for patients at this point to wish that they had gone bigger.  I see a lot more patients who wish they had gone bigger over time than wish they had gone smaller.  Second, different doctors have different ways to determine which volume to use.  Some doctors hold up sizer implants or use bras, some make measurements of the breasts.  These are all nice, but the only way to truly see what an implant is going to look like in place is to put one in place and see what it looks like!  Unfortunately, you are asleep at this point and can't offer an opinion.  In my practice, I use disposable sizers that I use to help create the pocket for the final implant.  I can also fill these sizers up to the volume we expect to use and see what that volume will actually look like in place before we open an expensive implant.  If we need to adjust the volume up or down slightly, this is where we make that determination.  I always tell my patients that we might fine tune our final volume based on what we see with our sizer.  It might be that your doctor can do this as well.

Thank you for your question. There are many factors that go into the selection of the proper implant, and without an examination, a definitive answer cannot be given online. That being said, there are some considerations other than volume that may influence your choice.

The selection of a breast implant should be a 3 dimensional process. The width of the implant should match the base width of your breast and chest wall to avoid a large space between the implants or lateral overflow. The projection can then be chosen to match how full you wish to be. In your case, wanting to go from an A cup to a B, a moderate profile implant may be the best choice. These two dimensions with then lead you to the proper volume.

I would discuss this with your initial plastic surgeon. If you have further concerns, there are sizing systems that can be used to help you get a better idea of the final result. But in the end, make sure that the choice is based on more than just volume to get a natural appearing final result.

Best of luck with your breast augmentation.

Jeff Rockmore

Thank you for your question, while it is difficult to comment without at least pictures, the implant sizes you're discussing are small, however, it seems choices are sound based on your description. The differences between the implants are small and likely not visually noticeable. I think you would benefit from undergoing Vectra 3-D imaging to simulate your postoperative size using digital 3-D images as well as looking at before-and-after pictures of other patients that have had similar implant sizes with your body shape.  Best of luck. 

as the changes in the implant dimensions are miniscule.  I always like external sizers so patients can 'see' what they will be like.  Some doctors like to use the higher tech 3D photos.  The bottom line is that you need to visualize what the implant size will look like on you and when you do that, you can rest assured that you will be 'okay'.  If you don't upsize your chosen size, you will never be larger then what you saw with the sizer on your body.

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

I would go with the PS that examined you.

He/she is the only one that has measured you up. He/she will have tailored the implants to your physique.

Don't get confused by all of us online surgeons as we can give you guidance not definitive advise.

 

Good luck.

 

Implant selection really depend upon a number of factors.  I wil say that 20 cc differences in  implants is not a lot.