500 Cc's Implants Already a 36dd is 500 Too Big?

I am 5'9 170 lbs with broad shoulders and very wide breasts. I am having a BA with scar revision. My current bra size is a 36DD. I want upper pole fullness. I have already had an anchor lift and I have no upper pole. My PS says to get the upper pole I need no less than 450 cc's and probably 500 with a wide implant. I'm just wanting to get some other opinions. Thanks.

Doctor Answers 11

Breast Augmentation Size

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I have never understood the desire on the part of patients or physicians (especially physicians) to create unnaturally large breasts. I see 'before and after' photos at plastic surgery meetings and I almost always find myself asking the question: What's the `big' idea?

I view breast augmentation as more than a breast enhancement surgery. It is a total body contouring surgery, and the breast profile that one creates with implants should match a patient's overall figure. It should appear completely plausible that the breasts have not been surgically enhanced. I want for my patient's appearance to make others think "Wow - what a great figure", not "I wonder who her plastic surgeon is".

Over and over I hear patients remark, after reviewing some of our `before and after' photos, that they had no idea that a breast augmentation could look so natural. It can, and in my opinion it should. Having practiced plastic surgery in the 'breast augmentation capital of the world' (Los Angeles), and having performed hundreds of breast augmentations in North Carolina for patients who are seeking a breast enhancement that looks like it actually is a natural part of their body, I have developed some fairly strong opinions about this operation.

When considering breast augmentation surgery, I believe that the most important question for a prospective patient to ask themselves is this: Am I seeking a natural-appearing result? If the answer is yes, then seek out a surgeon who has the same aesthetic sensibility that you have (and appropriate training and experience). And insist on seeing `before and after' photos. A lot of them.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Breast tissue everywhere, except upper, and all those scars

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It sounds like you have enough tissue already, but it is in the wrong place!  I have found this to be the typical problem with the various types of "anchor" lifts.  All those scars and everything is as the bottom (and often the sides) with no upper fullness.  Often looks like an exaggerated tear drop!  The term "perky" has to be deleted from your vocabulary.  This is why I gave up on "anchor" lifts in the early 90's, even trying an earlier technique from S. America in the late 80's.  Internal shaping and suspension with the vertical technique has allowed this change because the technique doesn't rely on a segment of tissue bringing in enough circulation to keep the nipple alive. I have re-done many women over the years that had "anchors" that were fine with their size but not the shape, as well as those that didn't like the size, either.  I have found it safe.....and effective....to do the vertical technique with reshaping the tissue to get the upper fullness.  No nipples have been lost in this reshaping.  It has been interesting to notice that these re-do's usually do not require moving the nipple further up.  But this reshaping of the tissues can make you look like you had a lift, even though the nipple hasn't moved!

If you don't like your present size at DD when you are supported by a bra, then an implant may be necessary.....besides all the other techniques mentioned.  Just putting an implant in will just give you a bigger version of what you have.

Myles Goldflies, MD
Seattle Plastic Surgeon


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Photographs would be very helpful here. I generally use much smaller volumes for breast enhancement with a lift

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

500 mL implants may be too big.

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It is difficult to give you a precise opinion without examining you; however, I agree that 500 cc implants will give you at least a 2 cup size increase. I would highly recommend trying temporary sizer implants on in a bra to give you an idea of what that extra volume will feel like.

John Squires, MD
Denver Plastic Surgeon
4.9 out of 5 stars 82 reviews

Going with large implants

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Switching to larger implants may give you more upper pole fullness but only for a short period of time.  They will gradually drop just like your current ones did and you will end up in the same situation you have now.  To fully answer your question please send photos.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 31 reviews

Achieving Upper Pole Fullness

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Without at least the aid of pictures it is difficult to give advice. However it sounds as though you would benefit from a revision of your mastopexy (breast lift). I would caution you that this size implant will more than likely give you an approximately 2 cup size increase.

My recommendation would be to return to your plastic surgeon to discuss your concerns with them. If afterwards you still do not feel comfortable with the plan offered, then consider getting a second opinion, preferably in person. Good luck

Implants and upper pole fullness

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Without an exam it is difficult to comment. You may need a revision of your lift as well to give upper p[ole fullness. The implant will definitely add volume.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Upper pole fullness

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Implants will only add to your volume.  If you are already a DD cup then I doubt you really want to do that, especially with such large implants.  Some of my happiest patients are the ones who have breast reductions to lose some of that weight that is pulling through their neck and shoulders.  It sounds like you simply might need a revision of your breast lift procedure in order to redistribute the volume that you already have rather than simply adding to it.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 26 reviews

500 cc Implants for Upper Pole Fullness after Anchor Lift

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    In general, I typically place smaller implants if the only goal is upper pole fullness (maybe 275 cc to 325 cc moderate profile).  This tends to fill the area well without creating too much projection.  Also, I am trying to protect my patients from back, neck, and shoulder problems with such large breasts.  However, I do create a very tight skin envelope, perhaps tighter than many, with the breast lift.  You would have to be examined or pictures would have to be viewed to give a better answer.  Kenneth Hughes, MD Los Angeles, CA

500 Cc's Implants Already a 36dd is 500 Too Big?

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They sound pretty big--perhaps an increase of two cup sizes. Without photos it is hard to comment. Consider posting some and asking your question again. The best way for getting a useful second opinion is in person in a surgeons office. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.