I Want More CC's, Why Won't My Doctor Go Bigger?

5'4 130lbs Bwd 13 I Am a Deflated 34b Cup. I am going with an excellent surgeon and was really upset when he told me he would only go up to 450cc's hp saline implants. I was hoping to look like a full d cup maybe dd. I don't want to spend all of my hard saved money for results that I do not want or like. My question is..Can I go up to at least 500cc's?? He just plain out refuses because he doesn't want me to have uniboob or sideboob. He is also using Natrelle 68hp do you think mentor mod+ would be better?Would luv cleavage

Doctor Answers 18

Wishing to be a DD

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50 cc will NOT make a visible difference. As a general rule;  200cc roughly equals 1 cup size. So, if he is suggesting 450cc implants that will roughly take you up to a full D cup. Now, if your surgeon is placing your implants behind the muscle then he can only put in as big as your muscle will allow. If he is suggesting placing your implants on top of the muscle, then he can fit a larger implant. But, beware, implants behind the muscle retain their place for longer periods of time. Implants over the muscle have only your skin envelope to hold them in place.  FYI- the larger the implant the heavier it is and the sooner it will stretch out muscle, skin and surrounding breast tissue. I hope this helps. Best wishes, Dr. H

Implant size

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I think it is too much responsibility for the patient to choose their implant size.  I normally ask patients to let me know what their goals are (usually through photos) and from there, I would discuss the options with the patient. I would want to see some photos of what you want to achieve before stating if 500cc was too big.

The volume of the implant is only part of the formula

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If you're seeing a experienced board-certified plastic surgeon (not a cosmetic surgeon who does plastic surgery), he is knowledgeable about the different factors involved in choosing the right size breast implant for you. From your photographs it looks like you have a wide sternum which limits the cleavage you would have if you're implants are placed under the muscle. If he is planning to go under the muscle, then he is limited on how far he can go immediately without developing a symmastia or "uniboob". If he goes with the silicone implant placed sub mammary, the implants can be placed more immediately to develop more cleavage. As some of the other physicians have stated in their reviews, 50 mL is not much of a difference (less than 10%).

I would discuss the use of silicone implants in the sub mammary position with your surgeon. He may be amenable to increasing the size and that situation.


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while you may like how 450 (or 500) cc augs look right now, implants of that size may not look so good 5 or 10 years from now. the bigger your breasts are (real or implants), the more they will sag over time. cautious conservatism with respect to size shows your surgeon is looking out for you and uses good judgement to protect his patients from poor decisions. 

Bruce K. Barach, MD
Schenectady Plastic Surgeon
4.6 out of 5 stars 13 reviews

Want to go bigger?

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Your plastic surgeon is being cautious, and with good reason. I don't know the exact dimensions of your breast, but, in a nutshell, you can only fit so much into the current skin and soft tissue envelope you have in the breast. Although it may be possible to go bigger than the size he recommends, he may be concerned that placing in implants that large may place you at an increased risk of complications in the future, or just may not look very good right now.

The reality of being a plastic surgeon in Texas is that, often times, patients want to go bigger then I recommend. I often times will place implants larger than my recommendation, but only after having a long conversation with the patient about the potential risks of doing so. The truth of the matter is that the difference in diameter between a 465 cc and 500 cc style 68 HP is only 4 mm (there is no 450 cc); if a 465 is okay, you could probably get away with a 500 as well.

Hope this helps - best of luck.

Limitations on implant size

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I usually recommend implants sizes based on 1) patients' anatomy: height, weight, chest/breat width, chest height, thickness of breast tissue and 2) patients' goal.  We want implants to be proportional to patients' body as well.  I think that your plastic surgeon is being safe and has a good intention.  With larger implants, you may have more complications in the future; you will also sag faster with larger implant.  Having said that, 50cc does not make too much difference. If you do not trust your surgeon, you may want to visit with other board-certified plastic surgeon for second opinion.

Larger Implant Wanted

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The ultimate goal of any reputable board certified plastic surgeon is to have a successful outcome. We do our best to listen to patient concerns regarding size. I am sure there is a very good reason why your surgeon will not place larger implants. You should have an honest and frank discussion with your surgeon. If you have done your research and your surgeon is one of the best in your area, take the advice. Best of luck.

500 cc Question?

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Do you trust your surgeon?  Do you like him? I agree there is very little difference between a 450 and a 5500 cc implant  but I also get  the impression that your surgeon is trying to give you the best result without complications. Larger implants weigh more and over time your skin may stretch. No one can say how your breast implants will look in ten years. Your skin appears thin and gel implants might be a better alternative. Do you want to get another opinion?

Richard Linderman, MD
Indianapolis Plastic Surgeon

Implant choice

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Choosing the right implant for you is really multifactorial in nature.  First it is based upon your natural anatomy and the elasticity of your tissues. Second the approximate size you want.  Volume doesn't always correlate to cup size.  These factors are all taken into consideration during the ocnsultation. But a 50 cc difference in volume is not a lot.  Choosing the dimensions of your implants really should be based upon your anatomy.

Implant Size for You

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Selection of your breast implant size is dependent partly on the dimensions of your chest wall. Your chest wall width and height will aide your surgeon with your implant size.   To maintain a full yet body proportionate look, there are indeed some limitations on implant sizes.

 I consider two factors when selecting implants for my patients:

1.Dimensional planning

2.Gel Implant Sizing system

Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. Even your fitness levels and other relevant criteria are taken into consideration. It is you who will decide what you are comfortable with.

Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for.

This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look.  So try these implants in the office to pick which look you like the best.

Best of luck


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.