450-600cc Silicone Impants? (Photo)

Question

I'm asking this question again but this time with more details. Im very flat chested (photos inserted) and I want to be somewhere between a full D or DD. I'm wanting HP, Silicone, Under the muscle. I'm 5'0, 127 pounds. I've been looking at implants between the sizes of 450-600cc an I want to get a professional's advice on what size would give me the boobs I desire (photos inserted) Keep in mind the "wish boobs" photos I've inserted is the look I want to achieve without a push up bra.

Emmanuel Mallol Cotes, MD · Answer

Thanks for the question, I recommend you a personal evaluation with a board certified surgeon to determinate better what volume you should get. a physical evaluation is the best way for best results, because we need to evaluated some parameters such chest diameter to give you a more precise advice. I recommend you to find a board certified surgeon with experience in breast surgery. Kind regards

Christian Subbio, MD · Answer

This can really be determined only with a long discussion in person and doing a physical exam. Different size implants will sit differently on different body types.  I would recommend making some appointments with board-certified plastic surgeons and trying on sizers.Best of luck!
Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Nelson Castillo, MD · Answer

Thank you for sharing your question.  The best advice on size can only be made after measuring key breast parameters in order to ensure that the selected implant "fits" into your natural chest anatomy.  I would recommend visiting a series of ASPS board certified plastic surgeons to try on the various sizers to get the best visual representation of an outcome.  Hope this helps.

Donald R. Revis Jr, MD · Answer

Good afternoon!
Of course we would do 
measurements, review photos and have you try on the implant 
sizers here in the office, but my initial thoughts based on your photos 
and goal size of D/DD is that you will need High Profile silicone gel implants
 in the 600cc (DD) range. Sounds awesome to me!I have attached a link to my Breast Augmentation photo gallery for your review which shows dozens of patients who chose 600cc- hope it helps!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  450cc may be able to achieve your goal of a D or DD cup.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Donovan Rosas, MD · Answer

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. This will ensure that you avoid the dreaded "fake" look. 
With regards to your "wish pics," you appear to be seeking a dramatic, less subtle change. It is important to understand where each of these individuals started and how your pre-op anatomy can limit your options. If you are seeking high volume this may not be achievable in a single procedure. A 600 cc device is very large and may exceed your BWD. The best advice is to seek in-person consultation and choose an implant that fits your size. If the volume is inadequate an HP device is suggested. If even that is not sufficient you may need to expand before up-sizing further.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

William Rahal, MD · Answer

To answer your question about 450-600cc, you need to take into account what's known as your base width diameter.
Imagine lying on your back and drawing a circle around your breast. If you were to draw a line across that circle, it will be a given length. Your plastic surgeon will measure this length, which is called ‘’base width diameter’’ or BWD for short. 
 
For women, the base width diameter can go from 9.5 cm to 16.5 cm, or 3.75 to 6.5 inches. As you can see, there is a very wide range. 
500 cc on a woman with a BWD of 10 cm is very different than 500 cc for a woman with a BWD of 15 cm. On one it may be too much volume in too little space, and for the other it may be even less than the max she can safely go. 
Regarding sagging, whether you have implants or not, aging, pregnancy and breastfeeding will do things to your body. When you’re pregnant, your body releases more hormones. You’ll gain weight. Your skin will be stretched by the pregnancy weight and lose some elasticity.  And after childbirth and breastfeeding, your breast will deflate and your skin will be looser. 
Now, there are two major unpredictable factors surrounding these changes I just mentioned. First, the DEGREE that these changes will occur is unpredictable. We don't know and can't know ahead of time, how much your breasts will deflate or how much looser your skin will become.
 
And second, it is unpredictable whether these changes will warrant a procedure. Maybe the deflation will be mild and not warrant a breast lift. 
 
So given these two unknowns, it is impossible to predict whether how much you will sag. But note that If you already have a breast augmentation, the implants will not affect those factors. 
I hope that answers your question the 500 cc volume and sagging. It’s great that you’re doing this research. I always say that the best patients are informed patients.
You might also want to research your options for breast implants. Choosing the right implant is the number one concern among women considering breast augmentation. Did you know, there’s actually a way to select a implant shape, size, and profile that is perfect for you?
A term that I use with my patients for the perfect implant is the “Pony Implant”.
So what do I mean by “perfect”? Well, a Pony Implant has three qualities to it. First, the implant meets your beauty goals. For example, you want to your breasts to look fuller while still appearing natural.
Second, when you chose your Pony Implant, you walk out of your consultation 100% confident that you’ve chosen the right shape and size for you. In other words, you won’t be second guessing your decision, and you won’t be afraid of having gone too big or too small.
And third, after your procedure, you are thrilled with your results, and say, "I’m so happy. This is exactly what I wanted!"
That’s the Pony Implant. And the great news is that there is a simple process to go about finding yours.
This issue of selecting the right implant is so important when it comes to patient satisfaction or dissatisfaction that, again, I really encourage you to learn more about it.
Thank you for reading and best of luck on your journey!

Melinda Haws, MD, FACS · Answer

I am unclear, are these pictures your wish looks?  If so, I would be shocked if you needed even a 450 to attain these looks.  But without a picture of you, or more importantly, an in person exam, it is hard to say.  These pictures illustrate the difficulty in requesting a cup size.  Cup size varies tremendoulsy from band size to band size (a 36B equals a 32D) and from manufacturer to manufacturer.  In addition, I find it extremely difficult to place a 600 cc implant at a primarybaugmentation unless the patient is quite large and loose 
please get an in person consultation with board certified plastic surgeons.  Best of luck!

M. Jude LaBarbera, MD · Answer

To get the look you desire, I would estimate about a 500 - 550cc implant. 
I recently performed a breast augmentation on an A cup woman who wanted 525cc. Her she has plenty before and after pictures that you can view under my reviews. She has also documented how far out from surgery she is in each set of pictures which is nice in seeing how the implants settle over the weeks. Good luck!

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