Will 400cc high profile silicone implants look fake? (Photo)

Question

Hi, I'm 6'2", 193 lbs, athletic/curvy build and I went to my pre-op and my surgeon first suggested 350cc then said I should go bigger to 400cc. It doesn't look huge, but I'm afraid of my implants looking too fake. Will 400cc high profile implants give a fake look? I was thinking of changing from high profile to moderate plus...I'm still debating it. I have a few weeks until my surgery day.

Sheila S. Nazarian, MD · Answer

Given your height, I think you could go either way without them looking fake. If you haven't already, try out both sizes and see which look you prefer. Best, Dr. Nazarian

Justin Yovino, MD, FACS · Answer

The moderate to moderate plus profile implants are usually associated with a more natural augmented appearance. High profile implants will have more "pop" projection and possibly be more obvious.

Brian K. Reedy, MD · Answer

If you like what you see in the mirror when you try on implants, then chances are that you will like your end result. I typically use a moderate plus, but you should trust your physician. You picked him/her for that exact reason hopefully. Trust your gut and good luck!

Jerome Edelstein, MD · Answer

Hello,As others have said, What looks "natural" can be very subjective. Given your height and build, 400cc does not seem like an overly large volume. The best way to determine what fits you proportionately is for your Plastic Surgeon to measure and examine your breasts, then recommend implants which fit your base width and provide the shape you are after. When placed under the muscle, HP implants can look very natural. My patients find it helpful to try on the sizers in their clothing and choose from available sizes the volume and shape that they like the best. If you like the implants that your Plastic Surgeon has recommended you can proceed with confidence.All the best

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

The size of implant best for you  is dictated by your
chest wall measurements.  Once we determine that we can choose the profile
based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant
should be equal to or, more ideally, smaller than the width of your breast. The
breast width is a measurement of how wide your breast is at the base, which
should be measured at the level of the nipple. Choosing an implant that is
smaller in diameter than your breast width will avoid the "side
breast" fullness that is often associated with a more artificial
appearance.  Other than that, you should choose the implant based on
volume, not on the dimensions of the implant.

Silicone will give you a fullness at the
top (upper pole fullness).

Silicone implants come pre-filled with a
silicone gel and are the softest implant available. They feel more natural,
which makes them a good option for women with less natural breast tissue; but
they require a larger incision. It may be more difficult to realize if this
type of implant has ruptured, so it is important to monitor them with annual
follow-up visits. Additionally, because this implant contains a more liquid silicone
(less cross-linked), if this implant should rupture, it will leak only into the
scar capsule formed around the implant but may cause some discomfort or implant
distortion.

Anatomic gummy bear implants might be a
good choice to give you volume.

These highly-sought-after, anatomic
implants offer a look that more closely resembles the natural silhouette of a
breast, and, therefore, are a very attractive option for individuals seeking a
natural-looking, aesthetic primary breast augmentation. Additionally, these
implants are an especially excellent option for patients undergoing restorative
or corrective breast surgery because they provide more stability, shape, and
reduced incidence of capsular contracture. Compared to other types of silicone
gel implants, the silicone in the cohesive gel implant is more cross-linked;
therefore, should the implant shell “rupture,” it maintains its shape and
silicone does not leak.

During your breast augmentation
consultation, you should feel the different types of implants available, and
try on various implant sizers in front of a mirror to help you to get an idea
of how you will look following the surgery. You should also bring pictures of
the look you would like to achieve, as well as a favorite top to wear when
trying on implant sizers.

The best way to assess and give true
advice would be an in-person exam.

Please see a board-certified plastic
surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

David A. Bottger, MD · Answer

At 6'2" 193lbs a 400 cc implant is not an excessively large device. It does, of course, depend on how much breast tissue you are starting out with. The optimum implant profile is more dictated by your breast diameter measurements.Best of luck.

Tom J. Pousti, MD · Answer

Thank you for the question. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical.  Given that your surgery is coming up soon, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of know words such as “natural” or "C or D cup” or "fake look" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.

I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

C. Bob Basu, MD, MPH, FACS · Answer

Dear Deeds1991:In terms of picking the right implants to achieve your goals, generally speaking, I consider two  
factors when selecting implants for my patients:1. Dimensional planning2. Gel Implant Sizing systemDimensional
 planning – The measurements of your chest wall are taken. Also, the  
breast dimensions including the height, width, and current dimensions of
 each breast form the basis of dimensional planning. Based on these  
measurements, the implant size is recommended. This will give you a  
unique breast implant that is suited for your body frame. However, there
 are some limitations of what size we can recommend. For instance, some 
 implants may just be too big for a narrow chest wall. Your surgeon can 
 review this with you during the consultation.Gel Implant Sizing
  system – During the preliminary breast implant consultation, you will 
be provided with an option to “try on” a variety of implant shapes and  
sizes. You can also visualize the possible outcomes of your surgery  
which helps you to get that perfect size to give you the shape that you 
 longed for. This way your preferences are known and you can then pick a
  range of implants that will “fit” just right to give a soft natural  
fuller look. Hope this helps.Dr.BasuHouston, TX

Robert Singer, MD · Answer

The perception of what is a "natural looking breast" is very individual and varies greatly from patient to patient and from doctor to doctor.The best cosmetic result in any particular breast augmentation patient depends on a variety of factors, including: Your individual anatomy, desired outcome, realistic expectations, a thorough discussion with the plastic surgeon about the options, and an understanding of the pros and cons of any particular implant choice. Proper sizing is not just about the number of cc’s. The thickness of your tissue, breastdimensions which include the width, height, and projection, as well as chest wall width all need to be considered when choosing an implant. Trying on implant “sizers” of various shapes and volumes while wearing a tight t-shirt, bra, or bathing sit at a preoperative visit will help you and your surgeon choose the optimal implant.There are no manufacturers' standards for cup sizing in the bra industry. The cups of a 32 D and a 36 D are significantly different. Cup size varies from manufacturer to manufacturer and even within styles from any particular manufacturer. Nor is there a direct correlation between implant shape or size and cup size.Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest that your plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.Robert Singer, MD FACSLa Jolla, California

Wesley T. Myers, MD · Answer

Thank you for your question. Breast augmentation surgery is
individualized to each patient. Breast implants are manufactured in a variety
of shapes, sizes, and with either smooth or textured surfaces. The method of
implant selection and size, along with surgical approach for inserting and
positioning breast implants will depend on your preferences and your anatomy
and previous surgeries. The shape and size of your breasts prior to surgery
will influence both the recommended treatment and the final results. I tell all
of my patients “Dimensions and proportions are the determinants of a beautiful
breast; not volume.” I recommend that you make an appointment with a board
certified plastic surgeon to discuss your breast augmentation options based on
breast measurements and tissue dynamics.

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