32A/AA with 400cc Implants To Be a Large C, Small D Cup?

Question

Hi, I'm 5'4" about 105 pounds and i currently wear a 32a/aa size bra. I would like the final result to be a big C, small D. I want to get saline implants under the muscle...what amount of cc's would you recommend? Thank you.

Gerald Minniti, MD, FACS · Answer

Hello,

	I would like to clarify a few things for you to help make your experience a good one, and not filled with unhappiness or regret.

	No surgeon can guarantee a cup size for two main reasons. First, there is no standardization of bras.  In other words, any given cup, like 'C' for instance, can have a slightly different shape or size depending on the bra model or manufacturer, and this will influence how a woman feels the bra fits her. Another problem is using a 'formula' to calculate the required implant volume to change a woman's cup from her current size to her desired size.  Each woman's breast will accommodate a breast implant differently, some will expand and allow the implant to project to it's fullest extent, others will 'crush' the implant into a flatter profile, and this will have an effect on how a bra will fit.

	So, how will you know that you have successfully communicated your aesthetic goals to your doctor? There are a number of ways, some high tech, some low tech, all helpful. I prefer to have women bring in photographs of models/celebs whose 'proportions' they like, and also some that they definitely don't like too.  That gives me a good idea of your personal vision of how you would like your new breasts to appear relative to the rest of your body.  This technique alone is about 95% accurate.  Another technique I employ is the use of a special bra and 'sizers' that fit into the bra over your breasts.  Putting this on underneath your favorite tops while looking in the mirror will let both you and me know how you want to look.  Once that is established, an implant size range is chosen.  Finally, there are computer controlled photographic systems that can morph your breasts into any size you want based on a given implant size that is input into the program. Really cool and wiz bang, but you are missing the full visualization of how your entire body will look in clothing.  Combining any two techniques will get you as close as you can to giving the doctor an understanding of where you want to go.

	OK, now the bad news. It's a bummer when reality strikes, but there is no getting around it.  The problem is you are small breasted and thin, and you want to change your cup by 3-4 sizes up. It's not that it's impossible, it is possible, but people like you who want such a large change face the greatest risk of having either early or late term complications after your surgery.  The two most common problems you will face are rippling and capsular contracture.  Although rippling can be minimized by using silicone gel implants, it does not guarantee the prevention of rippling, and it typically gets worse with time as the implants continue to exert their force against your straining, over-stretched tissues.  Capsular contracture is considered an early complication, but your risk is increased not only early but also later too.

	I hope you visit a few surgeons who are qualified and very experienced too. Your discussion with them will help you make a decision about persuing your goal size or compromising to lower your risk of complications.

	Best of luck!

Kris M. Reddy, MD, FACS · Answer

Breast Implant Size is a combination of subjective and objective criteria.There is not a direct correlation between the cc's of a breast implant and the corresponding cup size, as cup size is an inexact measurement that varies considerably among companies and even within the same company. Online consultants will not be able to guide you as well as surgeons who perform in person consultation.The size of the implants are based on a combination of a patient's goals and objectives and her anatomy. In order to provide a natural looking augmentation, the surgeon needs to evaluate many factors including soft tissue coverage, skin laxity, chest wall width, breast imprint width, the shape of the breasts and relative level of constriction to ensure that the breast implants are appropriate for your body.Consult in person with 3 experienced and expert board certified plastic surgeons to understand your options.

Paul Gill, MD · Answer

In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.
	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

Curtis Wong, MD · Answer

The answer is it varies because cups vary accordingly to band size and manufacturers do not have a standard size they have to live by. One company seems to be upsizing their cups (you're really a B cup but they say your fit their C cup and you want to buy it since you're now a C cup). I find the most accurate way to determine what size you will be is to utilize sizers, either gel sizers in your doctors office or homemade rice sizers. Get a large cup bra and place the sizers in the cups and increase or decrease them until you find the volume that you like and can live with. Add 10% to this and you get the implant size that will be very close to what you saw with the sizer in your bra. Cup sizes cannot be guaranteed... you can only choose a size to give you a certain look. If you're truly an AA cup and go up to a D cup, you could develop stretch marks.

Tom J. Pousti, MD · Answer

Thank you for the question.

	In order to give you accurate advice, much more information is needed.  Most importantly, physical examination will determine your current situation;  a full discussion and communication regarding your desired goals will also be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.

	There is no specific correlation between use of certain size breast implant and achieving a certain bra cup size.

	In my practice, the use of photographs of &ldquo;goal&rdquo; pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as &ldquo;natural&rdquo;  or "D cup" etc 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 suggest that you choose your plastic surgeon carefully and then communicate your goals carefully.

	Best wishes.

32A/AA with 400cc Implants To Be a Large C, Small D Cup?

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