Is 450cc too big for me? (photos)

Question

I went for a second visit, and tried on more sizers. I really like how 450cc moderate plus looks, but I am afraid they will turn out much bigger than I am wanting. I am currently a very small 34B and want to be a full C/small D. I know there is no correlation between cc's and cup sizes, I just don't want to be top heavy. I am 5'2 140lbs. Is there really a big difference in 450 and 400cc?? Thank you!!

Gary M. Horndeski, MD · Answer

At size 34 B each 100 cc’s of implant corresponds to 1 cup
size change.  To achieve a D would
require 200 cc implants.  I always
recommend small round textured silicone gel implants placed retro-pectoral
since they look and feel more natural, are more stable, less likely to ripple
or have complications needing revision. 
Implant profile is irrelevant in the retro-pectoral position since the
muscle compresses it.  Putting sizers in
a bra does not correspond to the appearance after internally placement of
implants.  22% of women who undergo
breast augmentation alone require revision within 2 years because they are
dissatisfied with the result.  A frequent
cause of dissatisfaction is over implantation. 
450 cc implants will not fit retro-pectoral, will extrude inferiorly and
laterally requiring revision. Best Wishes,Gary Horndeski, M.D.

Asif Pirani, MD, FRCS(C) · Answer

There is no way to guarantee a particular bra size. Bra sizing varies greatly between bra manufacturers and a C in one bra will be a D in another. What matters more than the assigned bra size is the way the implant looks on you. The best option for your body and aesthetic goals can be determined in a thorough implant sizing session.Implant sizing depends on several factors. One of the most important factors is your breast width. Generally, your surgeon will measure your breast width, and then provide you with a range of implant sizes appropriate for your native breast size. There are more nuances to it than just what I've described, but this approach works for most women.I usually have my patients bring in a large bra and a tight t-shirt to do sizing. I'll then choose 3-4 implants that I feel are appropriate, and have my patients place them in the bra under the tight t-shirt. My patients can then look in the mirror and get a good sense of what they will look like with the provided implant sizes. My patients like this approach and get a great idea of how they will look.By using this technique, your surgeon can outline a range of appropriate implant sizes that will be aesthetically pleasing, and you make the final decision.I hope this helps. Good luck!

Luis Macias, MD, FACS · Answer

There isn't a huge difference between 400 and 450cc's.  It takes about 50cc to make a perceptible difference in size, so you will notice it being a bit larger, but barely. As far as how many cc's are best for you, a physical examination to obtain measurements of your chest wall and breast width would help to answer your question more accurately. Since cup size is a ratio of breast volume to chest circumference it is tough to estimate exact post-operative bra sizes. Another confounding factor is that there is no standardization of this ratio by bra manufacturers.However, a loose rule of thumb is that it takes about 150-200cc to make a change in cup size in a 34 bra size. Therefore if you are a 34B, adding 450 will likely increase you more than 2-3 cup sizes, likely (but not for sure) making you a full D-DD or larger depending on how full of an B you are now. Keep in mind, this is a very rough estimate and the goal is not a specific bra size but a look you are trying to achieve.One tool I find helpful is Vectra 3D imaging, where I can virtually implant the different sizes and styles of implants. The 3D image of your chest morphs into a pretty accurate representation of your final result with some limitations of course.Good luck on your consultation and in making your final decision.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your pictures. If you like a 400 to 450 mL Sizer is best to increase the actual size of the implant at least 50 mL. You must realize if you're being sized the sizes or on top of your skin and not being influenced by the muscle and the skin.  You will have swelling that will make your breast size seem larger  but your breast size will decrease somewhat as the swelling resolves. Bottom-line go with an implant  just slightly bigger than you like.Earl Stephenson, JR, M.D., DDS, FACS

John Sampson, MD (license obligations) · Answer

There is a lot of energy and apprehension associated with implant sizing. But the basic question is pretty straightforward. How will I look with clothes on?.Because bra sizes are not scientific, the patient must be given the opportunity to convert her wishes to a volume or language we all can speak. So preop sizing with implants provides a crude but effective and cheap way to see what you look like before surgery. It is a lot harde to change the implant after surgery.  I have found this technique a simple, crude but elegant way to have my patients decide. Sure there are limits but all that is discussed preop with each patient. It is each patients responsibility to come to a decision she can live with. I find very few are unhappy postop.

Jaime Campos Leon, MD · Answer

Thank you for the picture.I would need to see pictures of the breast with out any clothing in order to determine which would be best for your case.Dr. Campos

Grady B. Core, MD · Answer

For a person 5'2" tall 450cc is quite large, even if you have very little of your own tissue. For patients in this height range, even with a larger frame and very little of their own tissue I would usually be in the 300 to 400 range even for those who want a fuller size. Since it appears you are choosing gel then you can go with a larger implant since gel is lighter per unit volume. For saline I try to keep all implants at 400 and lower to avoid late implant descent and pocket deformation. The saline advantages are that you can put them in without an incision on the breat endoscopically and in the smaller volumes they do fine if you already have some breast tissue to camouflage the implant. Gel can also be placed endoscopically up to around 350cc. Above that volume it should be placed through an incision under the breast fold. The advantage to gel is that is is softer but the capsular contracture rate is higher. As far as final sizing I have tried it all from sizers and so on ,and have found the best way for me to make people happy is to have them send me example photos of how they want to look. Having done this for almost 20 years I can just look at their pre-op photos and the ones they sent and that tells me their implant size as well as the type of implant and approach to use. Unfortunately I feel too many surgeons today put too much of the decision making process for surgical and technical issues on the patient when what we should be doing is just trying to learn what the patients wants and then use our expertise to give them that as much as possible in a safe manner.Other than the sizing issues just be sure to understand that you tend to get what you pay for in plastic surgery just like everything else. Good luck.

Robert Whitfield, MD · Answer

Some where between 350 and 450 will be the choice most likely.In breast augmentation I have chosen to spend time reviewing
photographs with patients to fully understand their expectation of size and
shape.  Many times this simply raises
more questions.  I will make measurements
and use the implant guides to allow the patient to understand exactly the sizes
that are reasonable for their body type and measurements.

Please find an experienced Board Certified Plastic Surgeon
and member of the Aesthetic Society using the Smart Beauty Guide.  These Plastic Surgeons can guide you on all
aspects of facial surgery, breast augmentation and body procedures including
tummy tucks or mommy makeovers!

Vincent P. Marin, MD, FACS · Answer

A shot glass is approximately 45 cc - so there is not much difference between 400 and 450 cc. The key to success is not you picking the right implant, but communicating with your surgeon and having him pick the right implant to get you to your ultimate goal. Have this discussion with your doctor to ensure you are both on the same page and bring in photos to better describe your ultimate result.Best of luck,
Vincent Marin, MDSan Diego Plastic SurgeonMarinAesthetics.com

C. Bob Basu, MD, MPH, FACS · Answer

Its difficult to determine cup sizes because cup sizes are not standardized.  They vary significantly by designer. So a C cup to you could be a B or even a D cup to someone else.   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.Best wishes,Dr. Basu Houston, TX

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