Am 450cc Under Muscles Am Confused to Go for 650 or 700 Under Muscles For Bigger?

Question

An 164cm hight and 54 kg weight,,i did 450cc under the mascles 3years ago and i wasnt soooo happy about the result and i wishef to go bigger ,after i delieved my twins my breast get soft and not big as be4 , i am confused between 650 or 700 i want them big and silicone under mascles please advice

Ary Krau, MD, FACS · Answer

Hi alamirah2,

	     Choosing the "right' sized implant is always a bit of an adventure.  To start with, I urge you not to look at this as an exact science.  Rather, you should have a general idea of the size you are looking for.  Keep in mind that you yourself may  have different desires at different times of your life, or perhaps even on different days of the week, for that matter.   The difference between 650 cc's and 700 cc's is 50 cc's.  That is approximately 2 ounces.  Not a big difference. I don't think it is worth struggling to try to decide between these two sizes as there is a less than 10% difference between them.

	     To get a general idea of the look a patient is looking for,  I find that using pre operative sizers is a great tool.   I like to use Mentor's Volume Sizing System to help patients  decide on a size.  These sizers are tear drop shaped implants that patients put on  prior to surgery in their bras to mimic the look they would like surgery to achieve..  At the same time, the surgeon is able to visualize this and thus give him or her a clear goal to create  in the operating room.  I, personally, find this method to be the most helpful as a communications means for implant sizes.  I find them more helpful than looking at pictures or even using 3-D images.  Unlike a 3-D image, Sizers are actually a three dimensional  structure that the women can see as well as feel.  She can wear them under  particular clothing  to give her both a visual as well as a tactile sense for that volume.

	Good Luck,

	Ary Krau MD FACS

Kenneth Hughes, MD · Answer

The difference of 50 cc at that high of a volume will not make a great deal of difference and will be barely noticeable. The addition of 200 cc or 250 cc from your original size should increase you at least one cup size. Kenneth Hughes, MD Los Angeles, CA

Steven Wallach, MD · Answer

Without an exam it is impossible to say whether the larger implants would be right for you.  Remember the larger the implants, the greater risk of complications.

Tom J. Pousti, MD · Answer

Thank you for the question. 
	As you can imagine, despite your good description of body type and goals, it is not possible to give you precise  advice online. 
	The best online advice I can give to ladies who are considering breast re-augmentation surgery is:  

	1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.   

	2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals.  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 “bigger" etc means different things to different people and therefore prove unhelpful.  Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.    

	3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.

	 I hope this (and the attached link) help.

Sugene Kim, MD, FACS · Answer

Hi. Although I need to examine you in person to give you a recommendation, just based on your height and weight, 650-700cc implants seem to be too large for you. As you go up on implant size, there are higher risks for complication. If you are not happy with excess skin after pregnancy, breast lift may be an option. You should visit with a board-certified plastic surgeon who can examine you and give you a recommendation on the size.

Khalid Almutairi, MD · Answer

You need to see a board certified Plastic Surgeon with experience in Breast augmentation, correcting your breast problem should begin with assessing the degree of ptosis (breast droopiness) , and wether you would be a candidate for a breast lift . Sometimes the problem is better corrected with a mastopexy procedure to improve the shape and projection of your breast. Talk to your surgeon about the different techniques available. If the suggestion is made to replace the implants with larger ones alone inorder to address ptosis, I would recommend getting another opinion as most of the time when ptosis is corrected in revision of breast augmentation with larger implants, patients end up with a high risk for recurrent Ptosis and usually return back to their surgeons dissatisfied because this procedure usually does not address the real issue, which is increased skin laxity (loose skin and gravity effect).

Jourdan Gottlieb, MD · Answer

This is best answered by your surgeon in the consultation room. Without photos and measurements and a clear idea of your goals, I couldn't begin to pick an implant size for you on line. Doing a "rice test" may be helpful to you. Fill some stockings with raw rice and see how much volume you need to get to a nice size--use a stretchy sports bra. With that info your surgeon can help pick the right size. 

	All the best.

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