I am 5'5, 140 lbs, w/36A breasts & want a full C cup. 400CC silicone implants, moderate profile, submusclar. Natural look?

The best way
to determine the size that fits your personal perception of the perfect breast
is to try on sizers. This way you can see how they fit on you, how they add to
your current volume, and whether they fit your frame. Although the surgeon can
guide you, only you will be able to tell what is the right size. Try on sizers.
HP implants, which are a more modern shape than moderate profile
implants, fit most women better. They have a more appropriate base diameter for
the average women's chest. Mentor HP profile saline implants have base
diameters that range from 8.8 cm (very narrow) to 13.8 cm (moderately wide).
The majority of women in my practice have base diameters in the 11 to 13
cm range. The HP implants fit them well. The moderate implants have
much wider base diameters for the same volume (often in the 14 to 15.6 cm
range). These implants are too wide for most women that I treat. So
when the base diameter is measured and correlated with the diameter of the
implant, it is most often necessary to use HP implants to achieve the volume
the patient is requesting. At the volume selected, my patient's base
diameters are too small for moderate profile implants. Measuring a diameter and
then telling the patient what volume they can have (in high, moderate or
moderate plus implants) in my mind is backwards. The patients should be
allowed to choose the volume. Then the surgeon carefully considers the
base diameter, projection, profile, manufacturer, and fill material that will
achieve the patients goals of size as well as qualitative look (natural,
intermediate, or bold upper pole fullness or projection), all the while taking
into consideration the patient's anatomic features that will affect the
outcome. HP implants can be made to look very natural or very augmented,
depending on where in the range the implants are filled to achieve a particular
volume. At the low end of the fill range, HP implants do not have the upper
pole fullness that most people associate with the fake look. On the other hand,
a fake over-augmented look can be created with a moderate profile implant if it
is overfilled (a common practice for surgeons that commonly use moderate
profile implants). In addition, too wide an implant will put the volume past
the anterior axillary fold, which in my opinion, looks more fake than upper
pole fullness. So there are many factors that need to be considered.
The experience of the surgeon and the degree to which they explain the
options to you is of utmost importance. Obviously all of my patients look
at photographs and we evaluate the look they are desiring in great detail.
For me, high profile implants are the first choice. I rarely find an
indication to use moderate or moderate plus implants. This does not make me a
better surgeon, or a worse surgeon. Look at the outcomes and judge for
yourself. The outcomes should stand on their own. The subtlety in
the final outcome is not achieved by which profile implant is used, it is
determined by the skill in the creation of the pocket, the choice of volume,
and where in the range the implant is filled. Don't let the doctor tell
you what would look good on you. They cannot tell what you perceive to be
the best size.

It sounds like 400cc is good for you, but I could give you a better idea during an in-person consultation.  To get an idea of how you'll look after the surgery, I would give you different breast implant samples to put into your bra. This is what I do for all of my breast augmentation patients and then they feel very comfortable in choosing the right implant size for themselves.Thank you for your question!Dr. Schreiber, Baltimore plastic surgeon

Hello,
Thank you for your question.
It is difficult to make recommendations without
a full assessment and without your full measurements. At your consultation,
your Board Certified Plastic Surgeon will be able to provide you with
recommendations to help you achieve your goal.
Take care.

Based on what you are describing, a 400 cc implant SHOULD  give you an augmented look while still looking somewhat natural.  However, without pictures, or an exam, its difficult to know for sure. 

t is very difficult to determine the best implant you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implants:

Sounds about right. It's impossible to say much more though without a good exam. Choosing the right size implant depends on your goals, dimensions, and quality of skin/breast tissue. Good luck.

Hello!The best way to determine implant size for a goal is to try on implant sizers. The key is meeting the proper width for your chest, and from there, finding the best projection to get the fullness level you desire. Being as slim as you are, a 400cc moderate implant may be a bit wide for your body. You should have a very good idea of what you will look like with proper sizing.Best of luck!

Photos and physical exam are optimal because I try to tailor each breast augmentation operation to my patient's desires and body type. There are pros and cons regarding saline and silicone implants, and patient anatomy and preference play a role in selection. The same is true regarding implant projection. 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. Good Luck!

Greetings Louie! Going from a A to a C is a pretty common scenario in my practice! However, there's no way to give you specific answers on size of breast implant without seeing you in consultation and performing an examination. Measurements of your breasts will let a surgeon decide which size is the best option. If your A is small then 400 cc be better. Just to be more confident you should try on sizers again before your surgery. A key for me is using the Mentor Volume Sizing System of breast sizers to demonstrate how these different volumes will look on your bodyIt's really all about the measurements and what breast implant will look the best on your body. See my link below for additional information on sizing.

I appreciate your question.

The size of implant 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