Chose 375cc and my doctor wants to up the size to 475cc?

Question

I recently has my sizing appointment and ended up choosing a 375cc HP silicone implant, i'm 5'1 150 lbs. My Doctor is wanting to up the size by 100cc for the actual implant to compensate for squish and tissue removal with the lift. is this normal? I'm very scared of having breasts too big, even the 375cc felt a little bit big to me but he didn't want me to go smaller. I'm trying to trust what he is saying but I have friends that have received similar or even smaller implants and look huge to me.

Richard H. Tholen, MD, FACS · Answer

Are you having a full breast lift, or a modified one? How much tissue does your surgeon typically remove with this type of lift? These questions need to be answered to see if 100cc "more" than your chosen size is indeed correct, or  too much.With a full breast lift, I typically remove no more than 30-45 grams of tissue per breast. To compensate for submuscular compression, I typically add 10-15% to the chosen sizer volume to achieve the goal size.So with a chosen sizer of 375cc, I would use (anatomy allowing) 400-460cc. To add back the volume of skin removed, that would make it 430-500cc. 475cc is pretty much right in the middle of that, and therefor not "out of line" whatsoever. The key phrase, however, is "ANATOMY ALLOWING!"After a breast lift, too-large implants can compromise circulation, and dead skin or nipples are not considered desirable cosmetic outcomes! Care must be taken to not enlarge too much when skin is being tightened and you want thin, soft, barely-visible scars. Not to mention good healing without wound breakdown!Discuss this with your surgeon. It may be that this is already considered and your surgeon's plan right on target. Or not, as the case might be. So ask, and be prepared to review his reasoning and choices in detail. It's your body, your goal, your dollars spent, and your complication(s) to endure if your gut is steering you in the right direction. But it's certainly a good question, especially if he seems to be "pushing" the bigger implants. Your surgeon should ultimately "want" what YOU want, if safely achievable. Best wishes! Dr. Tholen

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.   I would recommend that you trust your instincts with the 375cc.  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.   
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Tom J. Pousti, MD · Answer

My best advice: more communication.
It is definitely worth spending more time (prior to the date of surgery) with your plastic surgeon to discuss further.  As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.
Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) 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 are 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. For example, I have found that the use of words such as “natural” or "C or D cup” 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. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
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, after the use of temporary intraoperative sizers.
I hope this helps. Best wishes for an outcome that you will be very pleased with.

Victor M. Perez, MD, FACS · Answer

As you can see from previous responses, there are too many variables involved, you need to talk to your surgeon in regards to your concerns, he should be able to explain his thinking.The most important factor in obtaining a good result from your cosmetic surgery is the surgeon you elect to perform it,  after your surgery is done it will be more difficult to find a solution if you are no happy with the results.If you do not feel comfortable with your surgeon explanations, then you should consider a second opinion, an honest opinion can only be obtained after an in person consultation.Be sure your surgeon is a board certified plastic surgeon, preferably a member of the American Society for Aesthetic Plastic Surgery

Terrence Murphy, MD · Answer

It sounds like you and your surgeon are not on the same page. Although we commonly use an implant a little larger than the sizer chosen to accommodate for "squish" as you say. 100 cc is a fair amount. Maybe you aren't understanding what he is trying to say. I would discuss it further with them or look elsewhere.

Chose 375cc and my doctor wants to up the size to 475cc?

Answers (5)

Answer: Many variables

Answer: Many variables

Answer: Breast implant size.

Answer: Breast implant size.

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Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.

Chose 375cc and my doctor wants to up the size to 475cc?

Answers (5)

Answer: Many variables

Answer: Many variables

Answer: Breast implant size.

Answer: Breast implant size.

Browse related questions

Recommended reading

Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.