460cc or 500cc Silicone?

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.

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.

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.