Flat Chested Woman Going To a C Cup With Silicone Gel Implants. What Size/cc's Should I Go With?

this is a common question.

what is your chest size?

36   a to c      375 -400 cc

34    a to c      325-350

32  a  to c        250- 300

these are general ranges  but most women dont wear the correct size bra

Hello! Thank you for your question. In
general, implant size does not
correlate with bra cup size. The cup size itself will vary from
manufacturer to manufacturer as well as who is doing the actual
measurements. Thus, cup size is never a reliable indicator for your
breast size. I typically encourage my patients not to communicate her
desires in cup size but more on the actual look and appearance. Given
your desires, a breast augmentation, with an implant or fat grafting,
would be an ideal procedure that would meet your expectations. Breast
augmentation is now the most popular procedure performed in plastic
surgery today. One tolerated very well by women with minimal downtime
and high patient satisfaction. Good
communication between you and your surgeon of your expectations is
warranted - choosing your surgeon wisely is the first step. Discussion

of your wishes and having an honest and open dialog of your procedure is
mandatory (e.g, implant type, incision, placement, etc). Your height,
weight, breast width, and body habitus will make a difference for which
implant style/projection to choose. Implant
profile will also make a difference on the projection, which will
influence overall breast/cup size. I have found

that photographs brought by the patient is helpful to get a
visualization of the appearance you wish for in terms of size, shape,
fullness, etc. In addition, your surgeon's pre and postoperative
photographs should demonstrate a realistic goal for you of results.
Sizers are helpful during an in-office consultation. Once this has
been accomplished, allow your surgeon to utilize his/her best medical
judgment during the procedure to finesse the best possible result for
you after preoperative biodimensional planning and fitting the right
implant for your breast width. This is the most important determinant
for the sizing of implants, which will provide the optimal result and
most aesthetically-pleasing result for you.Consult with a
board-certified plastic surgeon well-versed in breast procedures who
will examine and discuss with you the various options and factors to
consider and help you decide which one will be the right one for you.
Hope me that this helps! Best wishes for a wonderful result!

Moderate profile gel implants up to about 397 (Allergan) will fit a base width of 13.0 cm.  397 cc usually gives a nice, full C cup for a 34 A woman.  339 (Allergan) or 350 (Mentor) is also usually a C cup but more smaller or more conservative.  

Since many women say that they wish they would have gone a little larger, and since an implant that does not exceed your base width does not increase your risk of problems, the final choice would be completely subjective and based on your own preferences.

In our office, we would have a patient try on a 34 A bra, for example, and all the implants up to her base width to see which ones she likes.   If all were too small, we would try the high profile implants because up to 500 cc still fits in a 13 cm breast width.  Then the patient would decide if she liked the high profile or moderate profile implants and make her own decision. If she did not like the high profile, then the largest suitable size would be 397 or less for this example.

If you have very little breast volume now, and want to be a full C, my recommendation would be a high profile submuscular implant.  Mid-range profile will get you to a full B-small C in most bras.  Doctors prefer smaller implants because we avoid problems such as rippling/wrinkling, nipple numbness, implant visibility/palpability, skin stretching, PLUS, breasts augmented with smaller implants appear more natural and proportionate to your body.  The MOST natural, after all, is what you have now.  Many women however, really want some additional fullness, even knowing about the above potential issues.  My advice:  try high profile in the office, compare to mid range profile, and decide which YOU feel most comfortable with.

the most important decision in breast augmentation is choosing the right breast implant size. cosidering that the most common complaint after breast augmentation is not going big enough, I suggest that you always choose the larger size. It is alo important to consider your body frame in order to pick an implant that fits your figure. It is not how big or what cup size, but more importantly if it goes with the rest of your figure. Finally, I suggest that you try on different size breast implants in a bra on your self, and check things out in front of a mirror!

The best implants for you are the ones that give you the "look" you wish for. Unless you gave me more information about yourself (that's what a consultation, personal examination, and complete surgical measurements are for!), a base diameter (did each of your doctors measure the same way I do?), present cup size ("not even an A cup . . . completely flat with some loose skin"), and stated goal ("a nice 'C' size") are all very helpful but incomplete. You have done a great job getting 2 opinions, and hopefully I can give you some more help without the direct examination an in-person consultation would offer.

First of all, your goals are the most important factor in helping you achieve your desired result. If a 4'10" tall 90 lb. woman with no breast tissue of her own wants to be "Dolly Parton" in size, anatomy simply won't allow that. This is pretty obvious to most patients. Similarly, a 6'1" 145lb woman who has breast-fed 4 children and had DDD-cup breasts when breast feeding, now has deflation and droop, and wants only to be a "natural-looking B-C cup" may need a full breast lift and only small, moderate-profile (widest implant base diameter) implants to achieve her goals--many of these patients want only breast implants to accomplish that, and don't want the scars or cost a lift mandates. Here again, anatomy simply won't allow that.

So, the degree of loose skin you have, as well as nipple position, may have an impact here. It sounds as if you don't require a lift, but a physical examination and measurements would confirm that in a moment. Let's proceed as if this (no lift needed) is the case.

Your final breast volume depends not only on the implants you and your surgeon choose, but also what tissue you "bring to the party." Based on your description, let's also assume you're coming to your own party pretty much without a contribution other than the skin brassiere. Perhaps you have had one or more children and may have breast-fed; this would be a very common situation with your described anatomy. In other words, you have very little of your own breast tissue, and your final size will depend mostly on the implant volume. I'm not sure what your mind's eye thinks a "nice 'C' size" is, but photographs from the internet or adult magazine can quickly show what you like, and what your surgeon's goal for your should be.

In over 2 decades of doing breast augmentation, I have learned that it takes about 250cc to equal one cup size in volume, so I would START looking at implants in the 450-550cc size range--perhaps a bit less if you have a little more breast volume than you give yourself credit for. Try on implants in a bra and stretchy top and see what you like. Then understand your surgeon should add 50-100cc to the size you choose to best match the look of the implants in a bra and top, since the under-the-muscle position takes away from the apparent final volume a bit (around 10% or more). Don't even look at the numbers, or, for that matter, the cup size label on your new bras--they will differ depending on manufacturer, and it's a LOOK you are going for, not a letter on a label (or cc's volume of implant)!

The most common reason for re-operation is request for larger implants, so you CAN avoid this mistake and get the look you want IF you do the following:


Bring one or more photos of desired breast size (unclothed, no bra, upright).

Try on implants in a bra and stretchy top and try not to look at the numbers, since your surgeon SHOULD make an adjustment in the operating room based on your tissues and anatomic findings at surgery.

See a couple more ABPS-certified plastic surgeons, particularly ones with years of breast augmentation experience. I suspect that both of the choices offered to you thus far are too small and will not meet your expectations. Of course this depends on numbers 1 and 2 above first, but based on what you have told us, I believe both may be off by at least half a cup size.


Read my article on the About tab on my Profile page on this site titled: "What is the Right Breast Implant Size for You?" or click on the link below for more information. Look at our photo gallery of other patients and see what implant sizes gave them the look you see. Our site features EXACT implant information, but some sites may offer what the patient or doctor "recalled" rather than actually reviewing each patient's chart as I did on our site.

It may be better to delay surgery and do things right the first time, rather than simply letting momentum push you forward. There is a reason you sought additional information here--listen to your gut or intuition! Best wishes!

 

Without a phsyical exam , it is impossible to suggest what would be best for you.  Wider framed patients often do better with mod plus or moderate profile implants.

Hello,

In the end you will want a certain breast size and shape regardless of what your bra cup size says.  The size range that you have mentioned is consistent with going from an A to a C cup.  I recommend you try some implants under a sports bra or very tight T shirt that are the size and projection you are considering to get an idea of what you would like more.  One of the plastic surgeons you have consulted should be able to help you out with this.

All the best,

Dr Repta

There is a lot of  information to sort through when selecting an implant. There is not a magic implant size that creates a "c" cup.  The final cup size is based on your height, your weight, your natural breast size and shape as well as your chest width to name a few.  All bras are created differently so a "c" cup in one will fit differently than a "c" cup in another.  Both a 390CC and a 339CC implant can create a "c" cup in the right circumstances.  My best advise to you is ask to try on several different sizes and select the one you like best  and don't stress over the final cup size. Generally a 13 cm chest width requires a mid range profile not a hi or lo  profile, to create a natural look.  Good Luck.

It is great you are doing extensive research in preparation for your upcoming surgery. However, I would caution you to communicate your goals clearly with your surgeon (I like to use pictures as the clearest communication tool) and to allow your surgeon some discretion in the  operating room.

The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size. 
Much of the final “look” achieved after breast augmentation surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.

2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.

3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.

4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.