Would 475cc be too big for me? I’m currently a 32A and want to go up to a D. (Photos)

Question

I want to get 475cc Saline implants. The patient coordinator I talked to said they have saline implants with a silicone outer shell. I’m currently a 32A and want to go up to a D, or at least look for something like in my wish pic. I’m quite skinny..wold they be too big for my frame? Is it possible to get that look with saline implants. Just wanted more opinions on this

Justin Yovino, MD, FACS · Answer

Given your history, desires, and wish pic I think an implant between 400-500 cc is reasonable.  You should consider a high profile implant as well.  I have a feeling that your wish pic patient has had more than one breast augmentation.  She likely has increased her size with each surgery.  This allows for tissue expansion.

Gerald Minniti, MD, FACS · Answer

Hello,Implant selection is a very important process, and patients desires may not be appropriate. Your anatomic capacity (determined by ABPS certified/ASAPS member surgeons who specialize in breast surgery) will govern the maximum size implant you can accommodate without vastly increasing your risk for complications and reoperation.  Cup sizes are not helpful for your surgeon to determine your aesthetic goals, and there is no way for any surgeon to reliably deliver a given bra size.  Go to your surgeon and get sized, but be sure you don't exceed your anatomic capacity. Best of luck!

Urmen Desai, MD, MPH, FACS · Answer

The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. I think that if you are an A cup and want to go to a D cup, you are going to be looking at an implant probably in the 350-500 cc range, so I do not think a 475 cc implant is out of the question. However, the volume is not as important as your measurements and the measurements of the implant.You are likely going to need a high profile implant to achieve your goals and the width of the implant needs to fit your breast width, which may limit the volume you can have. I think your next step needs to be a consultation with a local plastic surgeon who is board certified by the American Board of Plastic Surgery. I would not be suggesting saline implants for you, so if your surgeon is suggesting that, I would question that recommendation and maybe consider a second opinion. Hope this helps!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You are a great candidate
for a breast augmentation.  It would be helpful to know your individual breast measurements in order to determine if 475cc is an appropriate size implant for you.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  This entire surgery
can be performed with a small incision technique.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Daniel Barrett, MD · Answer

Hi xcocobutter,
  
Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient.  
  
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements. 
  
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match. 
  
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
  
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals. 
  
Daniel Barrett, MD, MHA, MS
  
Certified, American Board of Plastic Surgery 
  
Member, Am. Society of Plastic Surgery

Robert M. Kachenmeister, MD · Answer

Thanks for reaching out and sharing photos. So many factors go into sizing. I would love to give you a perfect answer based off of photos, but at an in person consultation measurements will be done and a surgeon can suggest some implant sizing and profiles based on your end result goals. I would suggest you start by going on a few in person consultations with board certified surgeons and bring along some "wish" photos! Best of luck! Dr. Kachenmeister

Tim Sayed, MD, MBA, FACS · Answer

Thanks for the question and photos.The wish pic shows breasts that are closer together than your native breast shape and folds. While you may have that kind of close cleavage after augmentation when you are wearing supportive bras/bathing suits, you should not necessarily expect that when not in support. The volume range of 475 may very well be appropriate - it will depend also on the measurements of your breast diameter, nipple to fold distance, breast bone width, and other factors. We use Crisalix software to simulate in 3D your breasts and the potential results of augmentation with different size and style implants as this helps take the guesswork out for patients. On consultation in the office, typically we would ask you why you are expressing a preference for saline; most surgeons prefer silicone implants in the overwhelming majority of patients, although we can get nice appearing results with saline too. Silicone tends to feel softer to the touch. The saline implants do have an outer shell made of silicone.

Kiran Polavarapu, MD · Answer

It would be really pertinent to have a full consultation with breast measurements taken. Using this information, your plastic surgeon can help you chose the appropriate implants and the " look" you are going for and advise you on other adjunctive procedures to give you your desired look. Good Luck!

Robert H. Hunsaker, MD · Answer

The volume alone is not very useful information since the DIMENSIONS of the particular implant matter most. Therefore the proper profile also needs to be chosen. Your surgeon should be able to best advise you which implant is best for your individual goals based on your existing anatomy/dimensions.

Would 475cc be too big for me? I’m currently a 32A and want to go up to a D. (Photos)

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