Do 35 ccs really make a difference?

Question

Hello there! I'm currently stuck in the middle of the classic argument of choosing between 35 CCs. 415 CCs vs 450 CCs (high profile, round silicon gel in both). I am a deflated 34 B. Will the extra 35 CCS be helpful or hurtful to someone with a minimal amount of sag and total loss of upper pole fullness? I'm trying to weigh the pros and the cons of the extra CCs. I will definitely avoid the larger implant if the concensus is to. Thank you Doctors!

Michael Orseck, MD · Answer

35 cc is less than a 10% difference in your case.  It really wont amount to much at all.  Close communication with your PS can help you decide on which is right for you

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  In general with the implant sizes that you are comparing 35cc's will not make much of a material difference in your end results as it is less than a 10% increase in volume spread over the entire dimension of the implant.  Assuming both implants have been cleared by your surgeon as appropriate for your frame I would advise selecting the one that you feel looks best on your frame.  Hope this helps.

Daniel Barrett, MD · Answer

Hi GeorgiaGirl89,
  
Breast implant type and size selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion of the pros and cons of the various types and sizes. 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 your 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

Lawrence Iteld, MD · Answer

This is one of the most commonly asked questions during consults and sizing.... how much of a difference does going up or down make?
The bottom line is that the difference between 415 and 440cc is actually quite small- one ounce- or about the volume of a shot of vodka/whiskey/tequila.
Let's think about this a different way... think about adding an extra shot of espresso to your morning grande latte.... Is the cup that much fuller? Sure, you may get a little extra buzz, but I doubt that you are going to notice the difference in amount of coffee that you drank
For most women, the decision between two implants is a major one, but in reality, the difference between 20, 30, or 40 cc is usually very small.  Like the extra shot of espresso, it may make you feel better but is not likely to change the aesthetic result.

David R. Alfonso, MD, FACS · Answer

Usually an amount like 35cc will not make much of a difference in terms of long term outcome. You may be happier knowing that you chose the bigger implants so you dont regret going smaller

Christian Subbio, MD · Answer

Usually 35 cc would not make a huge difference.  If you have a B cup now, you may have 500 cc worth of breast already.  If you add another 400, that is a total of 900 cc.  At that point, 35 cc only represents about 4% difference.  So, you see it is not a huge difference.Best of luck!
Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

David J. Wages, MD · Answer

Thank you for your question.  Thirty-five cc's in a 415 cc implant is not much difference.  35 cc'c in a 125 cc implant is more of a difference.  It is all relative to the total size.  As one chooses a larger implant there are trade offs of extra weight that may contribute to sagging in the future.  Discuss this with your surgeon as well.  Good luck.

Donovan Rosas, MD · Answer

Patients often think in terms of cup size when considering
augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of
volume. This can lead to some confusion when sizing. Additionally, it is
important to remember that cup size itself is not standardized with variations
from one manufacturer to another. Unfortunately, as many women can attest their
cup size in an industry leader such as VS is not necessarily transferable to
another brand.
Another point which is often under appreciated is that of
anatomy and starting point. Any implant will add volume to the volume which is
already present. The implant is additive. A particular volume will not
necessarily confer the same cup size to different patients (often times it will
not even confer the same cup size to different breasts in the same
individual...remember they are "sisters" not
"twins"). 
A general rule of thumb is that 125cc can represent somewhere
between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc)
are typically less consequential representing a volume change of less than
a shot glass. However, I have found these numbers, at least anecdotally, to be
of little help. Patients often present with notions/goals which do not
correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools
including:
-3D imaging (has the added benefit of offering a volumetric
analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look
rather than a cup size. Once a patient settles on a look that pleases them the
overall cup size increase becomes less relevant.With regards to your specific question, 35 cc represents a subtle difference of less than the volume of a shot glass. Patients will often struggle with the decisions, but in actuality most will be unable to tell the difference between +/- 35 cc. I will usually tell patients that until the difference exceeds 50-100 cc implants are nearly indistinguishable. In my practice, I have patients agree to a range of implants with which they would be happy and based upon their overall leanings (subtle vs. dramatic), I will make an intra-operative selection from this pre-selected range.As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Michael J. Weinberg, MD · Answer

Thanks for this question.Sizing for breast augmentation is the most difficult and time consumibg aspect. In general, I don't t think that 35cc is actually a large or significant amount. Having said that it may be a significant psychological amount in that if you wake up and wish you had gone larger, then it will bother you that you didn't add those 35cc. One more factor to consider, against adding 35 cc, is that you are already getting a relatively large implant of 415cc that is High Profile which will significantly stretch your breasts. Finally, I have found that most patients find it difficult to see a difference of 50cc and can generally only see the difference between 75 and 100cc.

Tiffany McCormack, MD · Answer

35 cc's is not a huge difference from a volume perspective but with respect to the implant measurements matching your measurements there could be a difference.  I like to use the width of the breast to help determine what size and profile best fits a patient within a range of what the patient is looking for.  In other words if your breast width is 14 cm, choosing a 16 cm implant may not look great.  Conversely, if your breast width is 16 cm and a 12 cm breast implant is chosen that may leave you with a bit of a gap and not look right.  Your surgeon may or may not use similar measurements but this may help guide your decision.  That being said, the base width between those two sizes may only be a cm and both may fit your chest just fine in which case I recommend the slightly larger one so that you don't feel like you short changed yourself.

Do 35 ccs really make a difference?

Answers (15)

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