160 lbs, Moderate profile 5'6, 31. I'm a 32B and would like to be a full D, are 405cc to small for me? (photos)

Hi mistymink,

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.

Implant profile is one of the important considerations to make. Many patients wrongly assume that the higher the profile the better. The truth is, the more profile (or projection/height) and implant has, the narrower its base has to become. This is associated with several problematic consequences.

The first issue is that the patient loses width and therefore cleavage of the breast. The second is the breast becomes more narrow and pendulous, often falling lateral and onto the side of the chest, and third, high profile implants have a higher risk of bottoming out because they exert more pressure on the inframammary fold than moderate profile implants.

High profile implants do have a role in symmastia repair (when I need to narrow the base width) but otherwise I try to avoid them.

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, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.  See the below link on some suggestions on finding the most qualified Plastic Surgeon for you.  Always insist on a board certified plastic surgeon.

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I do this with my patients, we then look at pictures of women with similar measurements with different size breast implants. My patients tell me that this process is very helpful in determining what size breast implant is right for them.
Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author

hello thank you for your quesiton and provided information as well..based on the photos shown, the ideal in your case is that you go to consult in person with a certified plastic surgeon who will see and evaluate you and see what amount of cc for your case were ideal to get the result you expect.

mistymink.   I appreciate your concern because Size does matter and photos of you would help.  I try to tailor each breast augmentation operation to my patient's desires and body type.    I ask my patients to bring in photos of breasts the size they desire, because there can otherwise be confusion because B or C cup can vary greatly by brassiere manufactures! I also utilize the implant in the bra technique, with several different implant sizes with a tighter fitting T-shirt to get an idea of what you will look like. Be sure to consult with a board certified plastic surgeon and go to your consult with all your questions written down so you don't forget to ask something.

You need to see an expert plastic surgeon who does a lot of breast augmentation. Try on the implants you want with a tight bra. See a Vectra 3 Dimensional image with the size implant considered. See before and after photos from your board certified plastic surgeon that are acceptable to your result. Good luck...

Hello, it sounds like you've almost decided on your final implant size but aren't completely sure.  Your surgeon will be best able to answer your questions about the gap between your breasts because they will compare your implant with versus your breast dimensions.  

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.   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.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Dear mistymink,

Thank you for your question. I generally try to keep my patients below 350cc, as when you go larger it increases the chances of the skin sagging and needing a revision as you get older. That being said, you will need 400+ to achieve the look you want. Your plastic surgeon should be able to give you an idea about volume either with in office sizers, photos or with virtual imaging. 
Remember, the photos you see posted on Instagram are usually around 6-8 weeks and rarely 1-2 years out. It's good to have volume, but also discuss the long term effects of higher volume implants, you deserve to know. Good luck!

Without photos or an exam it's difficult to make a specific implant recommendation. If you are unsure about the implant you've chosen I encourage you to return to your surgeon for further discussion. Many have sample implants available you can "try on" to get an idea of how you may look after surgery. In addition I use sizers during surgery to help my patients achieve the look they are wanting.