Will 235 cc or 255 cc emulate the look I want to achieve? (photos)

Hi Tasteful7907,
Thank you for an excellent question.  Implant size discussion and implant selection is one of the most important steps during your consultation with the plastic surgeon. The decision-making process depends on your desires as a patient, as well as breast and soft tissue dimensions of your chest.  In addition, to "trying on" implant sizers at the office, virtual 3D planning using Vectra can help as well.
The implant sizes in the 235-255cc range seem like a good fit for your petite frame, and the difference between the two sizes is minor.  I think you should have a very good result overall.  
Best regards, Dr. Karanetz

You need a formal evaluation by a licensed plastic surgeon and expert in breast augmentations to determine what is best for you and your goals.Proper breast enlargement is not a "cookie-cutter" procedure where the same technique is applied to every patient. Every woman who comes to my practice has unique needs and different goals for her breast augmentation. As a board-certified plastic surgeon, I always listen carefully to each woman's concerns and thoroughly discuss the key points of the procedure. I also take into account their overall height and weight, the size and shape of the underlying chest and ribcage, the tightness and elasticity of the skin, and the amount of natural breast tissue. Prior to the procedure, we discuss and make decisions regarding location of the incision, whether to place the implant under or over the chest muscle, and what type of implant to use (I offer multiple types of silicone gel breast implants, as well as saline implants).
My experience performing thousands of aesthetic breast surgeries in a wide anatomical range of patients enables me to achieve consistently beautiful and natural results that are customized to each patient’s body type and goals. These results are the product of extensive communication, meticulous planning, and skillfully executed surgery.
I suggest consulting with a board-certified plastic surgeon and expert in Breast Augmentation surgeries. - Dr. Cohen

Hello, thank you for your question. A board certified plastic surgeon will be able to guide you to the correct size implant measurements. and desires measurements of the chest wall and breast imprint width as well as knowledge of all breast implant sizes and profiles should make this process easy. Try on a profile bra with various saline and silicone cc sizers your PS recommends under a tailored blouse, tank top, bikini, workout clothes, and other garments you typically wear so that you have the best idea of whether the garments fit as desired with the implant selected. Schedule an email, Skype or in-person consultation for proper evaluation.

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.The key to obtaining a natural result is to stay within the parameters defined by your BWD. 
With regards to your specific question, I would not struggle over such small size differentials. 20 cc is 4 teaspoons of volume and will make a negligible difference in final outcome.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
 
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Verified MemberReal Top 100
RealSelf Hall of Fame

Hello there The best way to be sized if with a combination of trying sizers and 3D imaging with systems such as the Vectra 3D.Submuscular placement may initially be a little flattened by the overlying muscle .But in the long-term the implant behind the muscle may even look a little larger as placing the implant behind the gland can lead to some thinning of the gland . This is more common with larger implant sizes however .You are petite and both of those sizes are appropriately small to suit your frame . The difference in the two sizes is so minor that it would be difficult to recognize which was which .So all in all I think 3D imaging is most likely to help you .CheersTS

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.  

Best wishes and good luck.


Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon
 

Dear Tasteful7907,
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

Hello and thank you for your question and sharing your photos. You are right in that submuscular placement of the implants will make them look slightly smaller. But, there is no way to accurately estimate the exact 'volume loss'. My best advice is to communicate your goals with your surgeon as clearly as possible and trust your surgeon's skills and ability to deliver the results you are looking for. Best wishes and good luck. 
Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon

Dear Tasteful7907, 
Thank you for your questions and breast implant sizing is a very individualized process based upon each patients desires and their measurements. Cup sizes vary from each bra manufacturer so this also adds to confusion. It can be difficult to pick an exact size implant with sizers alone so it is more important that your surgeon understands the look you are hoping to achieve. Most surgeons like myself with private operating facilities stock implants in many different sizes and in varying profiles so that on the day of surgery when the sizer is placed in the patient a decision can be made which implant will best provide the patient her desired results. When you are talking about cc's in an implant know that 20cc's is four teaspoons so it is misleading to some and is really about the shape and size the patient starts with and their desired outcome. It sounds like you have had a very comprehensive discussion with your surgeon and as long as you are both on the same page you should have a very nice result. Best regards, Tarek V. Copty, MD., FACS

In my opinion, it is not possible to accurately determine how many ccs (if any) a patient would “lose” when undergoing sub muscular breast augmentation surgery. I suggest patients do not make decisions based on statement such as: “you will lose 25 or 50 cc of volume when breast implants are placed under the muscle”. These statements are simply not reliable enough to utilize clinically.
***Given that your surgery is coming up soon (and your ongoing concerns), I would suggest that you schedule additional time to spend with your plastic surgeon communicating your goals, preferably prior to the date of surgery. 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.
One question that might be helpful for you to consider: would you be more disappointed if you are slightly too big or slightly too small after the breast augmentation procedure?
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 "B or C 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.