Will 220 CCs in the Fifth Generation Cohesive Implants Being Tested Produce an Adequate Result in an AA? (photo)

I'm currently scheduled to participate in the Allergan 410 clinical trial, receiving 5th generation Cohesive Gel implants next month. I'm 25, a 5'4.5, 110 pound, slender woman with little breast tissue to start, a 34AA. Because of my breast diameter, I'm limited to a 220gms/FF implant. I'm concerned this will only bring me to a small or mod. B cup. I'd like to be closer to a small C. The first two photos are of me, the second two of what I'd like to be. How far off am I? Thanks for responses!

Doctor Answers 7

Breast Implant Sizing

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Hello Kells9,

I think you have done very well for yourself finding a doctor that participates in the 410 study and is also recommending the most appropriated sized and profiled implant for you.  Contrary to most women and many surgeons, breast augmentation is not about getting whatever the woman desires in cup size.  That thinking has led to the current abysmal statistics regarding national complication and reoperation rates: 25% of the 300,000 woman having breast augmentations performed every year will have a second, unplanned reoperation within 3 years.

BTW, the photo of the woman labeled 'ideal 1' has at least one complication that is apparent: She has asymmetry due to unilateral malpostition of one of her implants, specifically drop out. This is most likely due to the unpredictable tissue stretch that occured with these oversized (for her anatomy) implants.  I don't mean to sound paternizing, but this is not what you want.  I bet she notices and has complained to her surgeon.

Heed your doctors advice! No, you will not be a C cup, but you will have a nice enhancement with little risk of either early or late term complications.

Best of luck!

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

220 cc implants

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The only way to reasonably approximate the right implant for you is to perform a physical exam and discuss your goals with you.  What may look right for one person may not be right for another.  A consultation is key.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

220cc implants will not achieve your goal photos.

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Of course, your examining plastic surgeon has a significant advantage in having the opportunity to examine and measure your breasts and pertinent anatomy. So he or she can obtain information that all of us here can only estimate from your description and photographs.

That being said, a few generalizations may be useful to consider.

First of all, you are concerned for a reason. Try on 220cc implants in a bra and stretchy top and see if you like the look, or if the resultant size matches your goal photographs. Have you shared your goal photos with your surgeon? And has he or she responded with information that the size you are "limited to" will achieve this size? I'm not sure why you are "limited" to anything but your requests, your anatomy, and your surgeon's judgement!

Second, in general it takes about 250cc to equal about one cup size. So by this method of estimation, you will gain almost one cup size in addition to your present size. This means you will fall short by almost a cup or so.

I agree with Dr. Aldea that cup size is so variable among bra manufacturers, and patient "mental images" regarding cup size are equally variable, that this is a metric which is virtually worthless in helping women size for breast augmentation surgery.

Still, we have to start somewhere, and your pre-op photos and your goal photos do not show unrealistic expectations, or anatomic roadblocks to any of us who would strive to achieve your best result, rather than "limiting" you to a specific parameter based on a study protocol or specific surgeon's preconceptions.

Thus, your photos (and my own experience with thousands of women over 24 years of doing breast augmentation) tell me that you are right to be concerned. If you are paying for this surgery, you should be allowed to have input about your own goals, particularly if your anatomy and goals are reasonable and compatible. I believe they are, and would encourage caution with proceeding as planned. Perhaps more discussion and even an additional consult or two with ABPS-certified plastic surgeons that have extensive experience with breast surgery can provide a useful counterpoint to your present recommendation. Good luck and best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Trust your surgeon

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Hi there-

From the information provided, it sounds like you are in excellent hands.

The only points I would make are:

  • You are on the right track to realize that the appearance of your breasts is more important than the number on the implant. 
  • You are probably therefore better off giving your surgeon some leeway to alter the plan and use a different implant if necessary to achieve your goals if the implants you selected do not give the appearance you thought they would once placed at surgery.
  • The Cohesive Gel implants tend to be a bit stiff and firm in augmentation patients- especially thin women. 


What Size IMplants to Use

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Although you can get the look you want, I seriously doubt the 220cc implant will get you there. You may want to either accept what you can get if you stay in the study or get what you want by dropping from the study. At any rate make sure you have communicated your desires to your surgeon.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Breast Augmentation Results with 220 mL Breast Implants?

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Thank you for the question and pictures.

Unfortunately, there is no way of knowing exactly what the 220 mL breast implant will look like on your torso and what  cup size you will be wearing after surgery.  As you know,  cup sizes will vary depending on the bra manufacturer;  therefore, it is best not to base your satisfaction with the results of surgery based on an arbitrary letter.

I would suggest that you communicate your goals clearly with your plastic surgeon and ask him to do his best to achieve these goals,  while maintaining the priority of SAFETY  and avoidance of complications,  especially given your small frame.

Best wishes.

Projected Cup Size with Cohesive Gel Breast Implants

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I realize just how frustrating it must be to NOT be able to visualize your augmented breast size. But, due to the fact there is NO bra cup standardacross the industry and breast implant shells create differently shaped breast implants which, even with similar volumes, result in different breast shap, makes it ethically impossible to predict a cup size based on implant type.

That being said, the fact that your surgeon educated you to the fact that your AA breasts limits your implant choice to a specific size implant tells me you picked an ethical and experienced surgeon. The fact that he/she participates in the Allergan 410 clinical trials implies that he is BOTH experienced and nationally recognized.

Rather than aspiring for something that is not achievable without compromising the outcome rest assured you picked the right surgeon and will have the largest most attractive breasts achievable under your circumstances.

Peter A. Aldea, MD
Memphis Plastic Surgeon

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.