600 or 800 Cc's over or Under the Muscle? Will These Achieve my Goal? Thank You (photo)

Dear Jennifer,

Simply stated your implants will be too big and your goal look is a bit over the top. Over time the implants will stretch the skin and produce saggy breasts.

Dr. ES

It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size and weather above or below your mucsle to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 600 cc implant to make her go from a “C” cup to a “DD” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos like you provided are useful if simply provided to the surgeon. I would also consider using the new FDA released IDEAL saline implant which has silicone like feel yet saline. See the below link.

    600 cc implants may be a better choice, because 800 cc implants very rarely fit anyone.  This may produce more of an abnormal look.

I would suggest putting the implant under the muscle.  I also would not necessarily focus on cc's but rather on BWD and profile.  I would suggest you use an Allergan style 45 gel implant. This will give you a full round look.  If you go to a saline implant  to get more cc's you will get more distortion than you want.

It sounds like being made too large is not going to be a problem.  I don't use implants that large but it sounds like you want to go with the larger size, and I say, God bless you, go with the 800!

It's good you clarified that you want a "full round porn-star" look, rather than a natural look, since they are two very different looks. It's also good you show pictures of your desired look, because the breasts in those photos are larger than a DD cup.  Saline implants in the 600-800 cc range will accomplish your goal in terms of size, but I would caution you against it. Generally speaking, the larger the implants, the larger the problems. In addition to the usual risks of capsular contracture and implant rupture or leak, 800 cc implants will place a lot of stretch on your skin, and you can get stretch marks on the breasts, along with premature drooping. They will also put pressure on what breast tissue you have, and distort your natural inframammary fold, because the volume has to go somewhere, and there is only so much room to go up and in (before you get uni-boob). Obviously we all have different preferences, and you can always find a surgeon who will do this for you. I recommend only having this type of surgery done by a board certified plastic surgeon. Just know what you're getting yourself into before you start, and plan your budget for the possibility of additional surgery.

In terms of picking the right implants to achieve your goals, generally speaking, I consider two
factors when selecting implants for my patients:1. Dimensional planning2. Gel Implant Sizing systemDimensional
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. However, there
are some limitations of what size we can recommend. For instance, some
implants may just be too big for a narrow chest wall. Your surgeon can
review this with you during the consultation.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. Hope this helps.Dr.BasuHouston, TX

I would caution against the larger implants, as they can cause lifelong problems due to implant malposition.  The larger the implant, the higher the risk of complications.  In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

Thank you for the question and pictures.
 As you can imagine, despite your good description of body type and goals, it is not possible to give you precise  advice online.
The best online advice I can give to ladies who are considering breast augmentation surgery is:


1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.



2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals. 
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 “very full DD” etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.



3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.

Generally speaking, I would suggest the use of the sub muscular (dual plane) position for the breast augmentation procedure.  You will find the pros/cons associated with the different breast implant positioning  listed on the attached link.




I hope this (and the attached link) helps.

I am not sure I concur with the choice of size or the use of saline for implants that large. Hopefully you have had the chance to try on implants of about those sizes to get an idea of the size that you might attain. Be aware that huge implants have a higher risk of needing secondary surgeries in the future. Best wishes.