Is 650cc pushing it if I am 5'11, 155 lbs and a small B cup? (Photo)

Question

Right now I am a small B. At both my consultations I chose 550 then 650. This is an ideal size. I don't want small boobs but I'm also nervous about sagging

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello and thank you for your question.    A 650cc may be too large or just fine for you, but this question, and any other question about your breast augmentation would be best answered during an in-person consultation because proper implant selection involves a number of different issues.  I would first have a detailed discussion with you to clearly define your desired breast outcome goals – this would include not just the size you would like to achieve, but your ideal breast shape.  I would then select the best breast implant for you based on volume of the implant, projection of the implant, contents of the implant (saline vs silicone), shape of the implant (round or anatomic), surface of the implant (I only perform smooth), position of the implant (over or under the pectoralis muscle, skin stretch of your breast (more stretch would require a larger volume to fill, as in your breast), degree of breast sag (which would benefit more from a lift), breast diameter and overall chest circumference, native breast tissue volume, and any history of prior surgery or trauma to the breast.
  
The next step for you is to seek out a board certified plastic surgeon who specializes in aesthetic plastic surgery.  In your consultation, be sure your surgeon addresses all your concerns and discusses the surgery details including the position and size of the incision used, the type of breast implants available, the risks and benefits of the procedure, recovery time, and post-operative course.  Also, be sure to see plenty of before-and-after pictures in women who have a similar breast appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome. 
  
And lastly, I think the most important component of the consultation is to establish a good connection with your plastic surgeon.  It’s the connection that allows you to clearly define your desired breast outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.  
  
For more information on breast augmentation, please refer to my link below.
  
Good luck.  
  
Mark K Markarian, MD, MSPH, FACS 
  
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Keith Hodge, MD · Answer

In general, taller women can usually accommodate a larger implant unless they have a very petite frame. You don't want to choose an implant that is wider than your natural breast. This will increase your risk of permanent nipple numbness. There are also other breast measurements and dimensions that come into play when determining the ideal size for your frame. So I would listen to your plastic surgeon. They do this for a living! Good luck!

Kenneth Hughes, MD · Answer

Without an exam it is impossible to say whether the larger implants would be right for you.  Larger implants tend to be more reasonable in taller patients, wider patients, and transgender patients.These larger implants will create more tissue thinning over time, have more potential for rippling, more potential for bottoming out, greater likelihood of breast lift revisions, etc. I would recommend that you go with the size that boosts your self-esteem, and fits your anatomy.  Try on a profile bra with 550 and 650 cc saline and silicone sizers under a tailored blouse, tank top, bikini, workout clothes, and other garments you typically wear so that you have the best idea of whether the garments fit as desired with the implant selected. Choosing an implant based on an aesthetic goal that exceeds your anatomic capacity may lead to complications and possibly revision. Selecting a board certified plastic surgeon is imperative to achieving the best results possible without a high chance of complications occurring.

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would recommend seeing additional ASPS board certified plastic surgeons to ensure that the implants you decide upon are the right ones to meet your expectations.  It sounds as if it may be wise for you to "try on" several of the implants so that you can have a better visual representation as to what they would look like.  Best wishes!

William Andrade, MD · Answer

Hello, typically larger implants are associated with an increased risk of problems like postoperative sagging, numbness, rippling and other issues.  However, proper implant sizing depends on each person's unique anatomy.  If a person has ample pre-existing tissue to cover large implants, this choice could be appropriate.  Your surgeon(s) will be the best source of advice whether larger implants are reasonable for you, and discussing their potential risks and benefits.

Gary M. Horndeski, MD · Answer

Unfortunately, you have not told us your bra size just your cup size.  650 cc implants weigh over 1 lb each, will result in descent of your breasts and possible revisions.  Implants are not lifetime devices.  I recommend you consider much smaller implants if you want to have long term stability.  Best Wishes,Gary Horndeski, M.D.

Donovan Rosas, MD · Answer

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. 
With regards to your specific question, I would caution against excessively large implants. 650 cc is large on most frames.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Top 100
RealSelf Hall of Fame

Robert Cohen, MD · Answer

You need a formal evaluation by a licensed plastic surgeon and expert in breast augmentations to determine what is best for you and your goals.Proper breast enlargement is not a "cookie-cutter" procedure where the same technique is applied to every patient. Every woman who comes to my practice has unique needs and different goals for her breast augmentation. As a board-certified plastic surgeon, I always listen carefully to each woman's concerns and thoroughly discuss the key points of the procedure. I also take into account their overall height and weight, the size and shape of the underlying chest and ribcage, the tightness and elasticity of the skin, and the amount of natural breast tissue. Prior to the procedure, we discuss and make decisions regarding location of the incision, whether to place the implant under or over the chest muscle, and what type of implant to use (I offer multiple types of silicone gel breast implants, as well as saline implants).
My experience performing thousands of aesthetic breast surgeries in a wide anatomical range of patients enables me to achieve consistently beautiful and natural results that are customized to each patient’s body type and goals. These results are the product of extensive communication, meticulous planning, and skillfully executed surgery.
I suggest consulting with a board-certified plastic surgeon and expert in Breast Augmentation surgeries. - Dr. Cohen

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  650cc may be a large 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.   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.   
 
 Best wishes and good luck.

Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon

Pejman Aflaki, MD · Answer

Hello and thank you for the question.  The best advice you can get is by direct consultation with a qualified plastic surgeon. Many factors including patient's desired breast size, skin envelope (both quality and quantity) and breast width diameter among others are important in selecting the implant size. Choosing the right implant should be a shared decision between you and your plastic surgeon. In a typical consultation, you try a variety of in-bra sizers and in combination with several other measurements that your surgeon will do, the final implant volume is selected. Keep in mind that extremely large implants can lead to skin stretching and sagging/bottoming out in the long run.
Best,
  
Pejman Aflaki, M.D.
  
Johns Hopkins-trained double board-certified plastic surgeon

Is 650cc pushing it if I am 5'11, 155 lbs and a small B cup? (Photo)

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