Is 425cc silicone implants too big for my size?

Question

I am getting my ba done on the 11th of july. I am a 34a pre op.I am just a bit concerned about the sizing. I am 5ft5, weighing 116 pounds. I was hoping for a small D (full C). I was looking at 365cc ones but they look too small to me. I wanted to get a size inbetween but my plastic surgeon doesn't offer one. I am really confused about the size now. Please help.

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

Director-Beverly
Hills Breast and Body Institute

#RealSelf100Surgeon

Jerome Edelstein, MD · Answer

Hello,Thank you for your question. My patients find it helpful to try on the implant sizers with a form-fitting t-shirt in the office. Everyone's idea of what a certain cup size or volume will look like is different. I suggest you choose from the sizes offered, which set you feel the most comfortable with, regardless of volume.All the best

William Andrade, MD · Answer

Hello, without a proper breast exam including measurements it is not possible to provide meaningful advice about your implant choice.  Depending on the person's body type, 425cc implants can have a very different outcome.  There should be implant sizes between the two volumes you are considering.

Robert Cohen, MD · Answer

For your height and weight, a 425cc implant is on the large end of what would likely work for you, but that is a significant oversimplification.  In reality, choosing a size is based on many variables such as base width diameter, tissue elasticity, proportion to the lower body, and aesthetic preference (more natural vs more augmented) to name a few.  If you have a narrower ribcage, you will probably need a high profile implant in the 425cc range so it will not be too wide, but this will give you a rounder, more projected breast, which you may not like.I think you need to spend more time with your surgeon discussing profiles as well as sizes, and I recommend trying on in-bra sizers to see more accurately what you will look like after surgery.  There is no perfect size, but you should feel fairly comfortable with your final selection by the time you head into surgery.  Good luck!

Milan Doshi, MS, MCh · Answer

In our practice we  give brest sizer to decide implant size.   one is asked to put implant on chest   and check in full size mirror to select the implant  larger the implant , long term outcome is poor.  Doctor can say what is optimum for you after taking various  breast and chest measurment. please discuss with your plastic surgeon for long term better outcome

Tom J. Pousti, MD · Answer

Thank you for the question. Online consultants will not be able to provide you with specific enough advice to be truly helpful.  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 know words such as “natural” or "full C, small 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 (and the attached link/video, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Brooke R. Seckel, MD, FACS (retired) · Answer

If you are concerned that 425 is too big it probably is too big.Sizes are available in 25cc increments eg 375,400 and 425. Seek a second opinion and make sure the surgeon has breast implant sizers to try on. Also do the Rice test at home as described in the link below:

Is 425cc silicone implants too big for my size?

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