460cc or 500cc Silicone?

Question

Im having surgery on fri. I still haven't decided between 460cc or 500cc in high profile. I am also having a lift. I am 124 lbs and 5'1. I wear a 36b tho I am actually smaller. I don't want to look ridiculous but of course want to be fuller. I've been doing so much research and it's all confusing. I would like to be a full c. It's a one shot deal so I want to get it right. Help????

Gerald Minniti, MD, FACS · Answer

Hello,

	While some of the other surgeons have actually tried to answer your question, and some gave you a hint of caution, I am here to give you a serious reality check.

	If this is going to be a 'one shot deal', then you may want to rethink having breast implant surgery at all right now, especially given your choice of very large, HP implants on a small frame/small breasts.  Your risks of complications are higher than a breast augmentation without a lift, by virtue of the fact that a breast lift creates more potential problems.  In addition to that, using HP implants has it's own higher complication rate over its less projecting counterparts (intermediate profile implants).  If you scan this site for other women's posts who have a variety of post operative complications needing reoperation, you'll see most have either inappropriately large, or HP implants, or both.

	Please read your consent form for the complications, as well as financial responsibility for re-operation.  Although most are unlikely, like hematoma, DVT/PE, or death, many have a fairly high rate of occurrence, like rippling, capsular contracture, and asymmetry.  If you have a complication that you can't live with, what are you going to do?  It wont be for free.

	Sometimes the cheapest way to go is not so obvious.  Choosing a surgeon who will size you appropriately and not allow you to pick your implant size or profile, who performs meticulous work (especially needed when performing the more difficult augmentation mastopexy), with proper credentials (Certified by ASPS, Member of ASAPS), and is a specialist in all forms of cosmetic breast surgery, will decrease your risk for re-operation, and save you the most money, even if he was expensive (more than likely).

	I hope I've given you pause to think about you and your future.  I know this is an exciting time, and you may have been waiting for this day, but you need to know the reality of what you are undertaking.  I wish you the best of luck.

Gary M. Horndeski, MD · Answer

At size 36 B each 200 cc's of implant corresponds to 1 cup size change.  500 cc's would take you up 2 1/2 cup sizes, which would be approximately a size D or DD.  I doubt you could accommodate an implant of this size in the retro-pectoral position.  If you attempt to place a 500 cc implant it will extrude inferiorly and laterally and will require revision.  Your focusing on implant size but the lift is more important.  There is a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to place the implant, reshape your breast tissue to increase upper pole fullness, elevate them higher on the chest wall and more medial to increase cleavage.  Aligning the areola, breast tissue and implant over the bony prominence of the chest wall will achieve maximum anterior projection with a minimal size implant. 

	Best Wishes,

	Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

It depends on what you think a full C is. I think that either size will make you a D cup. Look at pictures on the Internet to get an idea of what you want to look like and show them to your surgeon. Whether you go with a 460 or 500 cc implants doesn't matter that much. It's less than a ten percent difference in size.

Christopher V. Pelletiere, MD · Answer

Without examining you, it is hard to say what the appropriate size would be for you. The difference between the two implants is pretty small - essentially four tablespoons. However, in someone who is 5'1, either one of those implants is going to be a fair amount of volume. I would check with your surgeon and see what direction they feel is best for you.

Sacha Obaid, MD · Answer

I strongly recommend that you try on the implant sizes that you are considering in your surgeon's office.  That way you will know exactly what to expect post-op.   Good luck.

Paul Gill, MD · Answer

Thank you for your question. It is much better to accurately discuss implant volume and projection with an in office exam and detailed measurements. In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements/characteristics. I use these measurements to help me during the sizing process to guide you to a safe result for your chest wall and just as important, one that meets your end desires.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 during the sizing process. In addition, review of photos and use of rice bags can be very helpful to the patient and surgeon in achieving a safe and happy result. Close intereaction and involvement from your surgeon during this process can help alleviate the anxiety and fears of choosing the right size. I wish you a safe recovery and fantastic result.Dr. Gill

Adam David Lowenstein, MD, FACS · Answer

Mandy- firstly, remember that the difference between the implants that you are deciding between is relatively minimal. If you had one of each placed, you would likely be hard pressed to tell the difference without very detailed examination. I would recommend letting your plastic surgeon decide during the operation which one will best fit the pocket that is made. In my practice I utilize sizers during the procedure and work toward achieving the shape that the patient wants, rather than perseverating on a specific volume in cc's. Utilizing this technique I have never had to re-operate on a patient to change their size.

Steven Wallach, MD · Answer

A 40 cc difference in implants is not a lot. If you are unsure of the final volume, then do a baggy test to see what you look like.

Jeffrey Zwiren, MD · Answer

There is not much difference between a 460 and 500 cc implant. This should not be a deciding factor in your surgery. As long as the implant is appropriately sized for your breast dimensions you should get a nice result.

Todd B. Koch, MD · Answer

If you are undecided, I would recommend returning to your surgeons office and trying on the different sizes again. You can also leave it to your surgeon to decide. I like to use sizer in many cases to help select the best size for my patients at the time of surgery.

460cc or 500cc Silicone?

Answers (16)

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