Thanks for including photos--you look great and appear to have little bruising, one sign of careful surgery (and good patient compliance with activity restrictions)! 450cc submuscular silicone gel implants seem to be a good choice for someone with your frame and pre-op breast anatomy, and your results thus far show what will certainly be D-cup breasts for some bra manufacturers. But, if you were to try on brassieres from other manufacturers and find that a C-cup bra fit better and looked nicer on you, would you be distressed? I certainly hope not, as you must understand that it's all about the "look," not the letter on the bra label!My sizing guideline (determined over 27 years and thousands of patients) is that it takes about 250cc to equal one bra cup size. This would put you nearly two cup sizes larger than what you started with. Since you didn't include pre-op photos, it's impossible to see if you were a "barely B-cup" or a "nearly C-cup" 34B, just as different bra manufacturers will fit your anatomy differently now, and in a few months when healing is further down the road.The actual answer to your question can be determined only by you, since expectations are a product of both your personal goals, and your surgeon's pre-operative teaching. Perhaps a better question would be:"How much will my breasts change in appearance as swelling goes down, skin and breast tissues stretch, and implant position drops over time?"The answer to that question is related to individual anatomic factors such as pre-operative muscle tone, skin elasticity, and healing/scar formation over the 6-12 months it takes to reach "final" appearance (as well as whether or not you gain or lose weight during that time). It also depends heavily on the quality of your surgery--if your surgeon used precise and careful technique, meticulous hemostasis (control of bleeding capillaries), performed antibiotic or Betadine irrigation of the submuscular pockets, avoided bacterial and other microscopic contamination of your implants (Keller Funnel no-touch technique?), etc., then you have the least tissue damage, the least swelling, and the fastest and easiest recovery. Not to mention the least likelihood of avoiding capsular contracture.Though many surgeons utilize periareolar incisions and produce fabulous results (as it appears your surgeon has), this route of implant insertion does expose your implants to a somewhat higher potential for contamination of the implants with intraductal bacteria, since the implants are inserted through the breast tissue. Axillary incisions avoid the breast ducts (and their bacteria) but the armpit is full of bacteria-filled sweat glands, so that too has a somewhat higher chance of bacterial contamination that could lead to capsular contracture and changes in your appearance. Inframammary crease incisions avoid armpit and intraductal bacteria, and therefore are the best from a bacterial standpoint, but some surgeons and patients prefer the appearance of the other scars and are willing to accept those (minimally) increased risks. And to be factually fair, individual surgical differences (see the paragraph before this one) are significantly more important than the slight differences in well-performed surgery via any of the incisional choices. (Also, to be complete, I did not include umbilical incisions, since only saline implants can be inserted via that incision.)So I'd say you have a splendid result thus far, appear to have had careful technique (as evidenced by your lack of bruising or significant swelling), and can therefore expect that size and volume of your breasts will change only by a minimal amount. Your implants will likely drop somewhat, and as your tissues and scars mature and stretch you will achieve a more teardrop (natural) and possibly more projecting appearance. Your breasts will also gradually feel more soft and natural. Whatever supportive and/or attractive brassieres you choose will be entirely up to you, as will be how they fit your beautiful new breasts. (And the letter on the label should be the LEAST concern!) Cheers for the holiday season! Best wishes! Dr. Tholen
