Currently barely an A cup and I want a full C size or a small D. Help me choose a size please! (Photos)

Question

I am a 39 y/o, 5'8.5, 127,5 lbs woman and scheduled a BA end of October. If I remember correctly my breast width is around 12cm. I am going for Motiva Ergonomix, 340cc/400cc dual plane. Currently barely an A size and I want a full C size or a small D. I keep on changing my mind about the size, would love to hear a professional opinion! I hear women usually would have gone bigger in hindsight. Any advice is highly appreciated!

Chet Mays, MD · Answer

Thank you for your inquiry!  We would love to meet with you to discuss your concerns.  I would suggest going in and trying on different size implant.  Take different styles of clothing that you wear and see how everything looks.  Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals!

Daniel Barrett, MD · Answer

Dear ReginaPhalange86,

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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Warren Schutte, MD · Answer

It is very important that you are the leading decision maker when it comes to implant size choice. I would recommend spending time again trying on breast implant sizers. I do believe that the range you are choosing between ais right on track for accomplishing your goals. If you are between 2 different sizes, it may be wise (if measurements fit correctly) to go with the larger of the two choices.

Donovan Rosas, MD · Answer

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing.  Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.  
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
Based on your photos/measures, your stated options sound reasonable. I would not struggle over small variations (44 ml is a shot glass) as this is unlikely to make or break a result.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." Communication is key as you and your surgeon create your custom surgical plan. 
As always, discuss your concerns with a board certified plastic surgeon.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Choosing the right size and profile breast implants for you. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast 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

Camille Cash, MD · Answer

From the photos submitted either implant you are considering should give you a nice result.  Many surgeons have sample implants available that you can "try on" to get an idea of how you may look after surgery.  I prefer to use sizers during augmentations surgeries to help my patients most closely achieve the look they are wanting.  I've included a video that I hope you find helpful.

Currently barely an A cup and I want a full C size or a small D. Help me choose a size please! (Photos)

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