Is 450 Cc Too Large - Will They End Up Droopy and Weird if I Go High Profile Silicone? (photo)

Hi - Am planning for implants and am starting to wonder if 450 are too large and will look fake or droopy. I also do a lot of sports so am not sure if they will drive me insane. Was thinking high profile silicone under the muscle but not sure if moderate plus would be better. Any thoughts based on the photo would be so appreciated. Height 5'7" Weight 135 Age 35

Doctor Answers 17

High profile is NOT recommended! 450cc is on the high side, but could be just fine at 5'7" tall!

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You have very pretty breasts with a natural teardrop shape, and submuscular silicone gel implants will give you a fabulous result because you look that way now. But high profile implants will look high, round, and with an unnaturally-wide cleavage ("Baywatch coconuts"), especially if you go slightly smaller than 450cc.

Based on your photograph alone, 450cc may be a bit on the big side of "best choice," especially since you are active in sports, but I would reserve that recommendation until an in-person examination was possible, and would even base my final decision on the actual skin and muscle tone found at the time of surgery.

Regardless of the final implant volume chosen in accordance with your pre-operative photographic goals, sizing with implants in a bra and stretchy top, and discussion with you, I would choose the widest, lowest-profile implants possible to give you the most natural look, normal (not wide) cleavage, and "fit" to your pocket base diameter. I suspect that will be moderate or perhaps moderate plus implants, but NOT high profile!

Lots of plastic surgeons seem to prefer HP implants for the upper pole fullness they provide, but the increased projection and narrower base give an unnaturally-projecting, round, and wide-cleavage look (with LESS upper pole fullness--HP implants are shorter vertically the same way they are narrower horizontally, since they are round!) that to me is decidedly "fake" looking. If that is what you prefer, then OK, go for it! But if you want soft, natural, and aesthetically-beautiful breasts that mirror your pre-operative breasts (only larger), then follow my recommendations above. Best wishes! Dr. Tholen

How to choose breast implant size? - make it fit your existing breasts and lifestyle

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450 implants weigh about 450g.  Get a ziplock bag and fill it with rice worth 450g.  put one bag into each bra cup.  Now jump around.  See how it feels.  If you really are a very physically active person this is certainly a factor you want to consider.  The other thing to consider is that higher profile = more fake look.
The best thing is to see a board certified plastic surgeon and try different implant sizes.  Discuss your goals with your surgeon and make sure you understand the reasoning why he/she will recommend a certain size and shape of breast implants.
In general, for a natural look, you want an implant that is about as wide as your existing breast.  Going too big will give you un-natural bubbles, while going too small will just look like small lumps on your chest.
Once you chose the right 'base diameter', you can adjust the volume by adjusting the projection.  An ultra-high profile implant will have most volume for a given implant width, but that will give you very fake looking protruding breasts.
Once again, the best thing is to go in and try out different implants.  Some surgeons offer 3D software that predicts what you would look like after the surgery but always remember it's just  a computer guessing at what you might look like, its not a 100% reliable prediction of your outcomes.  In our practice we have used these programs and stopped using them because the feedback we got from patients.
Martin Jugenburg, MD, FRCSC
Toronto Cosmetic Surgery Institute

Consider your ultimate goals

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450cc on your body type probably won't look over done if the treatment is performed correctly. However, you might want to consider moderate plus rather than high profile for a more natural looking change.

Larger implants tend to sag at a faster rate. If you are particularly concerned about that over the long run, and are physically active, you may want to go with a smaller implant. 

Implant Selection Process

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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

Paul S. Gill, MD
Houston Plastic Surgeon

Best Breast Implants For Me?

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Thank you for the question and picture.
 Although I think this is an excellent forum for patients to receive general advice regarding plastic surgical procedures, for more specific advice pertaining to your situation you will be best off communicating with your chosen plastic surgeon.  

I suggest that you choose your plastic surgeon based on appropriate  training, certification, and (most importantly)  the ability to demonstrate significant numbers of “results” that appear to be aesthetically pleasing to you. Ask to see lots of examples of his/her work ( preferably in person).

You will find that you will be bombarded with information online;  this information will be probably conflicting and/or confusing.

Communication with your plastic surgeon will be key to achieving the results you are looking for. Unfortunately, the use of words such as “fake or natural” means different things to different people. . 
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

In my practice I use goal pictures to communicate with patients.  With this technique patients are able to demonstrate what they are trying to achieve and what type of looks they do not like as well. 
I also 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 “I wish I was bigger”.

I hope this helps.

Is 450 Cc Too Large

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Thank you for your question in the attached photo. 

Without some additional information is not easy to answer questions. 450 cc probably be a rather large augmentation for you. A smaller size is more likely to appear natural.  In terms of profile, your surgeon we'll probably advise you to choose an implant that is no wider than your breast tissue. this is just a guess but I imagine a moderate plus implant the size will be wider than her native breast tissue,  and if so,  a high profile would be a better choice.

A consultation with a plastic surgeon will help you select what is best for you. Best wishes.


Jourdan Gottlieb, MD
Seattle Plastic Surgeon


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It is impossible to tell what would look good without a discussion and examination. I would suggest bringing in some "wish pictures" since this gives the best idea of what you think is attractive. I have patient who would be happy going from an A to a B and others that want to go from an A to a DD. It must be individualized to the patient.

Breast Enhancement

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I dont think the weight makes a difference because women with large implants never complain of them being heavy, I would suggest a smaller implant above the muscle for a quick recovery and less interference with your muscle especially since you are active

Best Breast Implant Size

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Thank you for your question and photograph. From your photograph you appear to have very naturally shaped normal appearing breasts. You should be able to achieve your desired shape and size with breast augmentation.

I concur with Dr. Pousti that your decision about the size of breast implants is best made after consulting with and choosing your plastic surgeon who will perform your operation.

There are many options available to help you make this important decision. If you visit the Mentor and Allergan breast implant manufacturer's websites you can see before and after pictures of patients who have had various sizes of breast implants placed and try to find ones with your pre surgery breast size. In addition Mentor makes a breast sizing system which allows for the placement of various sized properly shaped implants into your bra to give you an idea of what different sized breast implants will look like on you. In addition if you check the link to the article at the end of this answer it describes a home test called the Rice test which you can do privately in your own home.

You state that you are concerned that 450 may be too big and that you are very active in sports. It is always important to trust your instincts and generally speaking women who are very active in sports are often more more comfortable with implants below the 400 to 450cc range.

Most importantly consult a plastic surgeons who are certified by the American Board of Plastic Surgery, experienced in cosmetic breast surgery, and to have an excellent reputation in your local community.

Best of luck to you.

Implant Sizing

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I consider two factors when selecting implants for my patients:

1.Dimensional planning
2.Gel Implant Sizing system

Dimensional 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.  If you have decided on saline implants, then based on the gel sizer you select, we can guide you to the saline implant that achieves a similar look.
Hope this helps.
Dr. Basu
Houston, TX

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.