400cc or 450cc HP Silicone Under the Muscle? (photo)

Question

I thought I had decided on the size of 400cc but now I am questioning my decision. I am a full A cup and a small B cup on a good week. I have a small shoulder frame, 63" and 112lbs, 36.5" hips, 28" waist, and 32" bust. My goal is to reach a very large C cup to a small D cup. Would 450cc be too much for my frame? Would that size increase my risks of complications such as capsular contracture or back pain later in life? I want to get the largest size that is safest for me.

David Stoker, MD · Answer

A 450cc implant will likely make you a D-cup.  A full C-cup would probably be closer to 350-375cc.You are fortunate in that you can look great in all of those sizes, so the choice is yours. Good luck.

Luis Villar, MD, FACS · Answer

You should not be deciding on cc's, that is your surgeon's job. Based on your anatomy, you and your surgeon should come to an agreement about silicone or saline, over the muscle or under the muscle.  You should come to an agreement about size. Modest, "classy but juicy", Big and fake.

	 An experienced surgeon will then place progressive sizers in the surgical pockets and serially enlarge the breasts.  The breast enlarges symmetrically at first. Then the lower pole cannot stretch any more and the upper pole starts to enlarge disproportionately. Eventually the upper pole gets full and unnatural or the nipple areola complex starts pointing downward.

	 If you want a "classy but juicy" full natural look, we drop back a size at the first sign of deformation.  If you like a zaftig look, increase the size to push the upper pole short of dropping the nipples.

	Remember your anatomy will determine what is possible, not your surgeon.  He should be skilled enough to do the best with what you have.If your surgeon is asking you to choose a size in cc's, seek some second opinions.

	Best wishes. Knowledge is power.  Luis F. Villar MD FACS

Paul Gill, MD · Answer

Generally speaking, larger implants lead to more risk of complications.  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

Jeffrey Zwiren, MD · Answer

I do not promise a patient a cup size because this is a ticket to disappointment. It is best to look for a shape or contour that you like. In our office we use the Vectra 3D imaging system. This allows the patient to visualize their result prior to surgery. In one year of use and over 100 breast augmentations I have had no patient complain of an implant size problem.

Steven Wallach, MD · Answer

Without an exam, it is difficult to say what would be best for you.  Measurements and a discussion of your goals is key.

Jourdan Gottlieb, MD · Answer

One guideline which may provide a limiting factor is the breast width. Most surgeons feel that if the implant is wider than the breast, the outcome is likely to be unsatisfactory. 

	There are no fixed defintions of cup size, so choosing an implant size by cup size is unreliable. I prefer having patients try on implants, and then using that info to  help pick an implant size. The difference between 400 and 450 is rather small, so it is unlikely that the larger of these two is more likely to cause more issues. 

	All the best.

400cc or 450cc HP Silicone Under the Muscle? (photo)

Answers (6)

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