Are 450cc and 500cc Implants Too Big for D Cup Breasts?

Looking at your photo, it seems that you may also need a breast lift at the same time of your breast implant insertion. The sizes you list (400-500cc) are fairly large and may get you to the cup size you want however these implants may over time cause your nipple position to drop. This is difficult to determine without examining you in person, but you may want to consult with one or more board certified plastic surgeons in order to see what the best approach is for your particular anatomy.
Best wishes,
Dr. Bruno

Thank you for your question, and your photo.  Cup size can be a funny thing.  It's mostly based on projection.  It can also depend on how much breast tissue you had to begin with.  Figuring out the cc's is often based on your base width, (how wide your breast is).  Some Plastic Surgeons will uses sizers at time of surgery, but we are all different.  There used to be standardization, but that went away.  It can depend on what style of bra you wear.  They usually will get to their final position in 6 to 12 months.  One will usually drop faster than the other, and the shape may go through various changes.  Please let your Board Certified Plastic Surgeon know what your goals are.  Please follow their post op instructions. For example; we like message, but some surgeons will have you wait, or do it in a specific manner. Please let them know your thoughts and concerns.  
Jeffrey J. Roth, M.D., F.A.C.S.
Board Certified Plastic Surgeon
Las Vegas Plastic Surgery

Thank you for your question.  An examination will best determine the best size implant.  You may to consider a breast lift with implants for best results.  Consult with a Board Certified Plastic Surgeon.

You need to try on sizers to see if you like a particular volume.  You do not look like a D cup.  The sizes you mention look like they will fit you well.  You just need to see which you like best by trying on the sizers.

         Based on your
pictures, it appears that you have significant breast sag in the presence of
moderate breast volume. Without the ability to perform a physical exam, it’s
very difficult to make an accurate assessment of your situation.

 

         It would appear that
correction of your problem will require a breast lift. This breast lift will
result in your breasts appearing larger than they did when they were saggy. For
this reason alone, a 500CC implant might be too large for your body.

 

         It’s important to
understand that correction of this type of complex problem will require that
your surgeon be able to make decisions in the operating room. It’s important
that you discuss your aesthetic goals with your surgeon and it’s also important
that you realize that decisions will need to be made in the operating room that
will optimize your result.

The 10% difference you are debating is not worth the mental anguish. If 500 is too big for you, it is likely that 450 will be too big as well. Size is relatve. While you seek a D cup as desireable others would call it too big.

From your photo it appears that you will likely need a full lift. Placing those large implants and a full lift will be a difficult surgery with high risks. Also, you have plenty of breast tissue and adding another 500 cc to that will result in very large breasts.
You definitely require a mastopexy which will tighten the skin and adding a smaller implant will give you the upper pole fullness that is desired most often.
Good luck.

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

Looking at your photos, you have some sagging and you may benefit from a breast lift with your augmentation.  In terms of implant size selection, 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

When you meet with  well experienced board-certified plastic surgeons, you should delineate your goals clearly. For example you may want the nipple-areola  to sit higher on the breast mounds- this may require breast lifting surgery.

 In regards to breast size, the more breast surgery I do the more I realize that there is no correlation between the size of implant 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. 
If surgery is decided upon, it will be very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" 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 press 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.