Trying to decide between 350cc & 400cc. (Photo)

Question

I have surgery in 2 weeks and my pre-op apppintment is on Wednesday & I keep going back & forth between 350cc or 400cc. After reading reviews it seems most girls wish they went bigger but I don't want them to look ridiculous on my small frame.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.
  
The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  
  
Silicone will give you a fullness at the top (upper pole fullness).
  
Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.
  
Anatomic gummy bear implants might be a good choice to give you volume.
  
These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.
  
During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.
  
The best way to assess and give true advice would be an in-person exam.
  
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.
  
Best of luck!
  
Dr. Schwartz
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

John Diaz, MD · Answer

It is very difficult without seeing you in person to know if the implant sizes you mentioned are too big or too small for you. Keep in mind that there is only a small size difference between 350 cc and 400 cc. Also, implant size selection depends on your unique measurements, so what may be too small for one woman may be perfect for another. Lastly, the choice of implant size is also a matter of taste. What you think may be too small, another woman may think is too big. We have a device called the Vectra 3D imaging system that shows you what you will look like with any implant. Our patients are very happy with the choice of implant they make when using this system.

M. Scott Haydon, MD · Answer

Thanks for your question and the photo. Without an exam and measurements, it is hard to advise you on size choices. Normally we measure the base diameter of the breast so that we can tell how wide an implant to choose. The profile of the implant is chosen based on how "round" the patient wants the breast to look. I use the Vectra3D imaging to help patients with their decision by seeing various sizes and profiles. There's always 2nd guessing about "should I have gone bigger/smaller". In each case though changing sizes means changing dimensions and typically that means it would not "fit" as well on your chest. Best of Luck!

Ralph M. Rosato, MD · Answer

Remember the difference in the two implants you are considering is very small.  You have a small difference in the size of you breasts pre-op. I ask my patients to consider what would be a better result too big or too small.  If you choose too big than go with 400 if you choose too small then go with the 350 both sizes will give you a nice result.

Robert D. Wilcox, MD · Answer

Dear chloezoe,

At our office, we have found the most satisfactory way to determine implant size is to have you put the various sizers in a sizing bra that you are wearing, pull your shirt over it and see what look you prefer. You did not mention what height and weight you are, but that factors in to the decision as well.

I hope this has been helpful to you.

Robert D. Wilcox, MD

Tom J. Pousti, MD · Answer

Thank you for the question.  Based on your photograph, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. 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.
***Given that your surgery is coming up soon, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.
  
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 cup” or "look ridiculous" 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 (and the attached link, dedicated to breast augmentation surgery for petite patients) helps. Best wishes.

John P. Stratis, MD · Answer

You are expressing a common concern.First of all there is not much visual difference between 350 and 400 cc's. Have your Dr show you the actual volume difference(usually a bottle of Lidocaine).The difference tends to be psychological. After the procedure most patients will say that they could have gone with a bigger implant than the one they chose. If you choose the larger implant then you may still say that you could have gone larger but you won't say you should have gone larger.I have never had a patient that felt they went too big. I use the Mentor Implant Sizer system and Vectra 3D imaging. These are very useful.

Robert Whitfield, MD · Answer

You should be comfortable with your choice before surgery.  I use 3D imaging for all of my patients.  It helps them confirm their choice of implants.  It will give you more understanding of your potential outcome.

Jon A. Perlman, MD (retired) · Answer

Thanks for your question.  You appear to have a small frame and my inclination is to recommend the more conservative size.  However I think it's in your best interest to have your surgeon take responsibility for the final implant selection based on your goals, goal photos, and the actual appearance of your breasts during surgery when "sizers" or test implants are positioned with you asleep but in a semi-upright position.  I believe that seeing the actual results using different volumes gives your surgeon important aesthetic flexibility and accuracy in matching a patient's goals rather than placing the burden of decision on you based on stuffing a bra, etc....Good luck, enjoy the video above for more information and enjoy your results.
Jon A Perlman MD FACS 
  
Certified, American Board of Plastic Surgery 
  
Extreme Makeover Surgeon ABC TV 
  
Best of Los Angeles Award 2015, 2016 
  
Beverly Hills, Ca

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