Will 420cc Implants Make Me Very Big?

Question

I am scheduled for surgery in 4 days and now I am second guessing the size of implants. (pre surg nerves and size obsession) I am 5ft 115lbs, currently 34C breast diam 15cm, w/level 2 ptosis. I would like to have very large full breasts approx 34DD.I was advised implant sizes 330cc-500cc would work for me. My PS recommended 420cc moderate pr, saline under muscle. I have worn sizers in both 400&475. I love big, but dont want crazy big. Will 420cc give desired 34DD or do I need bigger implant size?

Richard J. Bruneteau, MD · Answer

It’s virtually impossible to answer
this question without a consultation and physical examination for a variety of
reasons. When choosing breast implants
for breast augmentation, we aren’t interested in implant size, but instead,
we’re interested in the appropriate implant fit. We want to achieve harmony, balance and
proportion with the surrounding anatomic structures. It’s obvious that 500 cc implants
would have a more dramatic effect in someone who’s 5’ tall than someone who’s
6’ tall. Also, your starting breast size
would ultimately impact your final breast size and final result.In addition, it’s important to remember that
50 cc is only 4 tablespoons. Terminology
is also important.I find that not
everyone’s idea of a D-cup is the same. This potentially leads to confusion as
well.The best approach to resolve this
issue is consultation with a board certified plastic surgeon with experience in
this area.In an effort to minimize
confusion, we utilize both external implant sizers and the 3D Vectra Computer
Imaging System.These two systems help
the surgeon understand the patient’s aesthetic goals.They also significantly alleviate the anxiety
that many patients experience regarding breast implant size.

Michael Horn, MD · Answer

It is so important that the size you pick is one that you like.We tend not to talk about cup sizes because they are so variable by brand and band width. The rough rule is that 200cc is a cup size, but it may not come out that way.I like to use 3D imaging to visualize the implant shapes and sizes in you.That way you know what you will get.

Lewis Albert Andres, MD · Answer

Hello!  Thank you for your question. In 
general, implant size does not 
correlate with bra cup size.  The cup size itself will vary from 
manufacturer to manufacturer as well as who is doing the actual 
measurements.  Thus, cup size is never a reliable indicator for your 
breast size.  I typically encourage my patients not to communicate her 
desires in cup size but more on the actual look and appearance. Given 
your desires, a breast augmentation, with an implant or fat grafting, 
would be an ideal procedure that would meet your expectations.  Breast 
augmentation is now the most popular procedure performed in plastic 
surgery today.  One tolerated very well by women with minimal downtime 
and high patient satisfaction.  Good 
communication between you and your surgeon of your expectations is 
warranted - choosing your surgeon wisely is the first step.   Discussion
 
of your wishes and having an honest and open dialog of your procedure is
 mandatory (e.g, implant type, incision, placement, etc). Your height, 
weight, breast width, and body habitus will make a difference for which 
implant style/projection to choose.  Implant 
profile will also make a difference on the projection, which will 
influence overall breast/cup size.    I have found
 
that photographs brought by the patient is helpful to get a 
visualization of the appearance you wish for in terms of size, shape, 
fullness, etc.   In addition, your surgeon's pre and postoperative 
photographs should demonstrate a realistic goal for you of results.  
Sizers are helpful during an in-office consultation.  Once this has 
been accomplished, allow your surgeon to utilize his/her best medical 
judgment during the procedure to finesse the best possible result for 
you after preoperative biodimensional planning and fitting the right 
implant for your breast width.  This is the most important determinant 
for the sizing of implants, which will provide the optimal result and 
most aesthetically-pleasing result for you.Consult with a 
board-certified plastic surgeon well-versed in breast procedures who 
will examine and discuss with you the various options and factors to 
consider and help you decide which one will be the right one for you.  
Hope me that this helps!   Best wishes for a wonderful result!

Otto Joseph Placik, MD · Answer

Whichever implant size you felt the most comfortable with is the ones you should go with. Make sure the size you are choosing is the one you really want. You should call the office asap and let the office know your concerns rather than on the day of your surgery.

Hayley Brown, MD, FACS · Answer

It sounds like 420 cc would be a very attractive, natural D to DD size. Don't get caught up in the #s, you can drive yourself crazy worrying about 30 cc which in reality is 6 teaspoons, and spread over a big surface area such as the breast doesn't amount to much. Most patients do wish they would have gone bigger. However, you are also petite, so you want to see an pretty shape, with some proportionality without being over-the-top. I would trust your doctor. You also have to realize that larger implants have more risks for complications such as surrounding tissue thinning, rippling, and sagging issues over time.

David Shafer, MD, FACS · Answer

Without pictures or examining you it is hard to give specific advice. The sizing need to be determined between you and your surgeon. Factors include your anatomy, your skin thickness and your expectations. Good luck with your procedure.

Paul Gill, MD · Answer

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

Tom J. Pousti, MD · Answer

The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size.  Much of the final &ldquo;look&rdquo; achieved after breast augmentation surgery  depends on several factors: 
	1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation &ldquo;look&rdquo; will be optimal.
	 2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.
	 3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result. On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants. Other differences involve how the breast implants are filled. Saline implants are filled after they&rsquo;re implanted, so saline implants require a smaller incision than prefilled silicone breast implants. On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers&rsquo; saline-filled breast implants are considered investigational. As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
	 4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  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 &ldquo;C cup&rdquo; or "fake looking" or "top heavy" or "crazy big" 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 use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible. By the way, the most common regret after this operation, is &ldquo;I wish I was bigger&rdquo;.
	 I hope this helps.

Peter A. Aldea, MD · Answer

Regarding: "Will 420cc Implants Make Me Very Big?
	I am scheduled for surgery in 4 days and now I am second guessing the size of implants. (pre surg nerves and size obsession) I am 5ft 115lbs, currently 34C breast diam 15cm, w/level 2 ptosis. I would like to have very large full breasts approx 34DD.I was advised implant sizes 330cc-500cc would work for me. My PS recommended 420cc moderate pr, saline under muscle. I have worn sizers in both 400&475. I love big, but dont want crazy big. Will 420cc give desired 34DD or do I need bigger implant size?"

	THE KEY to an attractive augmented breast is picking an implant which is fully covered by YOUR current breast tissue and does not slide sideways off your chest. Your surgeon can easily tell you if your breast width matches that of the 420 or 475 cc implant. Choosing a larger implant will expose the ripples of the implant along the side and bottom of the breast.

	The key to a long lasting perky breast is using the smallest implant you can put up with. You ALREADY have grade 2 sagging of the breast with your natural 34C breasts and yet you did not mention any plans to lift your breasts and correct the sagging during this surgery. Adding 420 or 475 grams to each sagging breast will increase the rate of breast sagging. Something to consider.

	I would talk to your surgeon and ask him which breast implant offers the best compromise of full coverage and weight to try and get the best result.

	Good Luck.

	Dr. Peter Aldea

Darryl J. Blinski, MD · Answer

If you like the 500 cc sizers than go for it. Otherwise you are setting yourself up for disappointment and the most common post operative compliant of, "I wish I would have gone bigger!"

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