I'm 5'1, 32C. Is 450cc going to give me a fake/pornstar look? I'll be getting a moderate profile (Photo)

Hello, well to start, your breasts are quite asymmetrical, both in size and shape, the nipple of the right breast is higher than that of the left breast, 450 cc would be more or less added to the size if you have a D or double cup d

Dear Resourceful463669,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

If you place a 450cc implant into your current breasts, you will have very large breasts. I would recommend a smaller implant and a breast lift. I would recommend seeing a surgeon certified by the American Board of Plastic Surgery. Ideally, a surgeon that has also completed a 1 year aesthetic fellowship accredited by The Aesthetic Society. I would also find one who has the ability to show you preoperative 3D imaging that can simulate different implant sizes.

Nobody knows what appearance of your breasts will make you happy, and looking at 'wish pics' is still a guessing game that leads to reoperation, even in the most experienced surgeons (this is for multiple reasons beyond the scope of this reply). Regardless, whether looking for fake or natural, what drives women back to the operating room is THEIR perception of THEIR proportions, i.e. the size of the implant, and not how their breasts may appear to another person. So, don't crowd source here. You need to find a surgeon who knows that there are only two validated methods of implant selection: 3D photo simulation software or the use of in-office sizers, my preference. Finally, how did you come up with moderate profile? That should be decided by the surgeon as part of the implant selection process.

At size 32, each 100 cc of implant corresponds to 1 cup size change. 450 cc implants weigh 1 lb each, cannot fit retro-pectoral and will descend down the chest wall. Your breasts are already low on the chest wall and this will make it even worse. I recommend a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

With a small frame and being 5'1" adding 450cc implants may give a "top heavy" appearance. Many surgeons have implants you can "try on" to help you get an idea of how you may look after surgery. A board certified plastic surgeon can help you select the right implant based on your frame and surgical goals.

Hello.450cc will be a moderately sized implant on your frame. I am surprised that a moderate profile is the best fit for your body habitus. At 450cc of volume, I would have guessed that you'd be fitting into a more projected implant. The most important factor is that you are comfortable and loved the 450cc sizer when you tried it on. It is very important that you choose the volume you want in an implant.

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Thank you for your question and photos. An examination in person would be required to properly evaluate you and make specific recommendations. That said, based on your photos and dimensions, the 450 is almost certainly going to give you an exaggerated unnatural look which you would like to avoid. You appear to have generous breasts and if you are looking for a rounder fuller look and Moderate (classic) or lower profile implant should suffice. Volume (300 versus 400), is far less significant than implant width and projection. Implant width is similar to shoe size. The implant literally needs to fit into your breast and chest. The 450 implant may well “fit” your breast, but the volume and projection are what will determine the “look” you want, similar to the style or type of shoe you would select. It is true that for a given volume a high profile implant will have a narrower diameter, and it is also true that a person such as you with a petite frame and full breasts should require a wider diameter implant to enhance fullness and roundness. Other considerations such as saline versus silicone are also important, as are "round" versus "anatomical" or "form stable" or "shaped", smooth surface versus textured, and softer versus firmer with the different levels of gel cohesivity.

The term “natural” can mean different things to different people and the profile of the implant does not necessarily determine that. You can certainly achieve a “natural” appearing result with a high profile implant if properly selected, but as a rule, the larger the implant and the higher the profile, and certainly if the implant is positioned too high, the greater the chances you will look “augmented” because of exaggerated upper pole fullness or convexity.

In my practice, besides a thorough interview process and physical examination with careful measurements, we use on lay sizers within an unpadded bra to help you understand what you are likely to look like in a bra, bathing suit, or T-shirt with a given size implant. In addition, and this is critical, we ask all of our patients to provide us with photos of their desired final look, with images of women’s breasts that most closely resemble the look they are trying to achieve. This serves as a visual guide that thankfully rarely leads us astray. The most common reason for patient disappointment after breast augmentation is size-too big or not big enough. This algorithm which we have been employing for over thirty years has proven to be very successful.

Because all of these factors can leave you quite confused, it is crucial that you select an experienced board certified plastic surgeon whose aesthetics align with your own, and with whom you feel comfortable. Don't be reluctant to seek a second or even third opinion if necessary to be sure and feel confident about moving forward with scheduling surgery. Expressing your desired cup size is notoriously inaccurate, and final breast size is the most common reason for patient disappointment after breast augmentation, either too big or not big enough.

Take your time, do your research. Best of luck to you.

Thanks for your question. I suggest that you try on sizers before having your procedure. It's difficult to say if 450cc implants will be too large for your frame, but your breasts will be significantly bigger after your breast augmentation. This is also something you should discuss with your plastic surgeon prior to your surgery.

Best of luck!
Port City Plastic Surgery