Are 650cc Saline Implants Too Large Under the Muscle For a 34A?

650 cc implants are quite large. It would be very helpful to see pictures of your chest or get an idea of what the base diameter of your breasts in centimeters is. Each sized implant has a given diameter (this depends on its volume and profile). For instance, a 350 cc moderate profile implant has a diameter of around 13.5 centimeters. A 650 will be much wider. If you breass base diameter is very wide, then you can tolerate the larger implant. If you are more narrow (i.e 12-14 cm)then the implants will be too large for your frame, despite your weight or hip size. Please also remember that, "the bigger they are, the harder they will fall." I recommend going in to talk to your plastic surgeon again and looking at other pictures of implant patients with your same heihgt, weight and chest diameter to get an idea of how such large implants might look on you.

Regards,

Daniel Medalie, MD

From your description, it sounds as though you are good candidate for 650cc implants.  They are large and will give you much larger breasts, but if that's the look that you like than your request seems reasonable.  Going underneath the muscle will help to "hide" the implants and give you a more natural look than if you went over the muscle.  Good luck!  Dr. Schreiber

I would consider an implant over 600cc as very large.  In most patients this can carry an increased long term risk.  Without photos and and examination it is difficult to say if that is too large for you.  However, based on your height and weight, I would think that 650cc implant might work.  A thoughful and skilled surgeon should never put an implant that is too large, simply to satisfy the patients size.
 

It is impossible to answer without knowing your dimensions and the compliance of your skin envelope.  More important than implant volume are implant dimensions, the diameter, and projection, and how they align with your anatomy.  Trying implants on in the surgeons office helps, as does pre surgical 3D simulation, such as the Axis Three device.  If you have a broad chest, relaxed skin (e.g. post partum), and want to go up two or more cup sizes, 650cc probably not too large.  Realize that most of the volume is in the width, not the projection.  If you need a lift of the nipple areola complex, larger implants facilitate this.

Generally speaking,larger implants increase the risk of complications such as implant malposition, which can be very difficult to correct longterm.  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