Is a 450cc under the muscle, high profile, silcone right for me?

Question

I used to be a D and after breastfeeding children, I no longer even fill a B cup. I am 5 foot 11 inches, weigh 130lbs, and after trying sizers, I chose a 450cc silcone high profile under the muscle. I see so many pics and a 450cc looks so huge, but when I tried the sizers it didnt look near as large. I dont want them to look like balls under the chest, but I do want a good size. Will a 450cc look more natural since I am tall?

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!

Gary M. Horndeski, MD · Answer

Unfortunately,
you have not told us your bra size just your cup size.  If you are 32 or 34 each 100 cc’s of implant
corresponds to 1 cup size change.  If you
are 36 or 38 each 200 cc’s of implant corresponds to 1 cup size change.  From this, you can compute the volume
required to achieve your desired goal. 
450 cc implants are large, will extrude inferiorly and laterally
requiring revision.  Since you have
breast fed, you may benefit from a simultaneous lift.  I recommend a new technique called Breast
Augmentation with Mini Ultimate Breast LiftTM.  Using only a circumareola incision it is
possible to reshape your breast tissue creating upper pole fullness, elevate
them higher on the chest wall and more medial to increase your cleavage.  Through the same incision, implants can be
placed.  Aligning the areola, breast
tissue and implant over the bony prominence of the chest wall maximizes
anterior projection with a minimal size implant.  Small round textured silicone gel implants
placed retro-pectoral 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.  22% of women who undergo breast augmentation
alone require revision within 2 years because they are dissatisfied with the
result.  Frequent causes of
dissatisfaction are over implantation and not performing a simultaneous lift
when needed. Best Wishes,Gary Horndeski, M.D.

Charles Cope, MD · Answer

Hi. To answer this question I would need to see photos of your
chest/breasts including breast width measurements. Different people can achieve
different results and cup size with the same implants - it depends on your
chest wall size, breast size/position before the surgery as to what cup size
and whether you get true cleavage with a particular implant. If you were happy with the sizers in your bra go with this size, especially as you are tall. 
The best things is to ask your surgeon to show you photos with similar body
frame and similar size implants to the ones you are thinking of to get a
realisitic idea of what to expect.

Try to find someone with a Vectra 3D imaging machine in your area to simulate
your breast augmenation result (see the link below) - in a recent article (Oct
2013) of Plastic& Reconstructive Surgery Journal (Plast. Reconstr. Surg.132:
810, 2013.), the main Plastic Surgery Journal worldwide, the 3D imaging VECTRA
machine was found to be beneficial for patients considering breast augmentation
surgery.

The article concluded that patients prefer a center that offers
three-dimensional imaging technology; they feel that the simulation is very
accurate and helps them greatly in choosing the implant; and that if they could
go back in time, they would choose the same implant again.

All the best with your decision. Regards Dr Charles Cope

Angela Champion, MD · Answer

Unfortunately, there is no way for me to tell you if that is the right implant size for you.  Being that you are tall and wore a size D prior to kids, I would say that it is a good size for you.  You are really the best judge for what is good for you and not good for you.  You did say that you tried on sizers in the office and you were happy with that size when you looked at yourself in the mirror and that is what is important.  Try not to get fixated on the cc's because the same cc's in one person can look very different in another person.  Focus on the overall look, whether you are happy with that size when you look in the mirror.  If need be, go try them on again! ac

Tom J. Pousti, MD · Answer

Thank you for the question. However, despite good intentions, online consultants will not be able to provide you with  meaningful specific advice.  Ultimately, in person consultation with well experienced board-certified plastic surgeons will be necessary. Careful measurements, dimensional planning, and careful communication will be key.
Generally speaking, the best online advice I can give to ladies who are considering  breast augmentation surgery ( regarding breast implant size/profile selection) 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 which operation and/or 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 "C or D cup" etc 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.  The use of computer imaging may be very helpful during this communication phase.
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, helps.

Jaime Campos Leon, MD · Answer

Thank you for the question.To best help you, a physical 
examination or picture evaluation is required in order to determine 
which procedure or technique would be best for your case.Dr. Campos

Gaurav Bharti, MD, FACS · Answer

This question is very difficult to answer without an examination or photos.  Breast implant size choice is determine by two main factors:  the patient's desired look and the patient's physical exam to identify what size implants can be accommodated safely.  Your surgeon will use these two factors to make the decision on what size to likely utilize.  Furthermore, many surgeons including myself will use temporary sizers in the operating room to make the the final decision for implant choice.  Good Luck in your journey!Gaurav Bharti

Steven M. Camp, MD · Answer

Thanks for sharing your questionMuch depends on your actual body type and breast tissue thickness.  You are a tall woman and relative to your frame a 450 cc implant is certainly a good possible implant choice if your chest width and tissue can support this.  A detailed consult and exam with a board certified plastic surgeon can help you understand if these will be a good choice for you.Best of Luck

Peter Klainer, MD, FACS (account suspended) · Answer

The best way to answer this important question is make sure you have confidence in your surgeon. He or she will guide you through the process either through the use of pictures, sizers, or both. To get an opinion here would require looking at your photos and knowing your chest and breast dimensions.Good luck with your surgery.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  Your best option is to follow the advice of your plastic surgeon after an in person consultation and breast implant sizing system exam.You may also try the Rice test at home.  In addition you may read about the Mentor Breast Implant Sizing System in the link below:

Is a 450cc under the muscle, high profile, silcone right for me?

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