What size should I choose? 415CC? 465CC? or 515? I am presently a 34/36A would like to be a DD or DDD.

Question

I am 5'5" approx. 150 pounds, I am presently a 34/36A would like to be a DD or DDD believe BW is 12.6 I have seen 2 PS and they both suggested over, crease incision and 1 PS suggest 415 the other 515 HP silicone (gummy bear) So would like some advice

Martin Jugenburg, MD · Answer

Choosing the breast implant size is the most nerve-wracking part for most patients.  Some surgeons simply make measurements and tell you what you need.  Others use computer programs to simulate the outcome to help you decide what works for you.  In our clinic we use actual breast implants to help you see what you would be getting and how it would look on you.  Because each person is very unique, online recommendations are not helpful.  You need an in person assessment and YOU need to decide what you like better.

Shim Ching, MD · Answer

Cup size, although everyone uses it to judge breast size, isn't a precise measurement.  Even based on the information you provide, it isn't possible to give you an idea of how large your breasts will be.  If you have voiced your desire to be a DD or DDD to your surgeon and this is the size he agrees would give you this look, you will have to trust him.  We find Vectra imaging to be a very useful tool to help patients decide on the size they would like.

C. Bob Basu, MD, MPH, FACS · Answer

There are several factors that plastic surgeons consider when recommending implant sizes. I consider two factors when selecting implants for my patients:1. Dimensional planning2. Gel Implant Sizing systemDimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look. Hope this helps.Dr. BasuHouston, TX

Curtis Wong, MD · Answer

in unlined bras to find out what will work best for you.  My patients all feel we get it right over 95% of the time using this technique.  But whatever size you like in the bra must be increased by 10% to produce the look you saw.  If you don't, you will be smaller than what you anticipated.  And the most common complaint in my career is the 'I wish I went bigger' comment.

Robert Singer, MD · Answer

The best cosmetic
result in any particular breast augmentation patient depends on a variety of
factors, including: your individual anatomy, realistic expectations, a thorough
discussion with the plastic surgeon about the options, and an understanding of
the pros and cons of any particular implant choice. Proper sizing is not just
about the number of cc’s. The thickness of your tissue, breast dimensions which
include the width, height, and projection, as well as chest wall width all need
to be considered when choosing an implant. Trying on implant “sizers” of
various shapes and volumes while wearing a tight t-shirt, bra, or bathing sit
at a preoperative visit will help you and your surgeon choose the optimal
implant.

There are no manufacturers' standards for cup sizing in the bra industry. The
cups of a 34-36 D or DD and a 38 D or DD are significantly different. Cup size varies from
manufacturer to manufacturer and even within styles from any particular
manufacturer.

Keep in mind that following the advice from a surgeon on this or any other
website who proposes to tell you exactly what to do without examining you,
physically feeling the tissue, assessing your desired outcome, taking a full
medical history, and discussing the pros and cons of each operative procedure
would not be in your best interest. I would suggest that your plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the
American Society for Aesthetic Plastic Surgery (ASAPS))
or the Canadian Society for Aesthetic Plastic Surgery (CSAPS)  that you trust and are
comfortable with. You should discuss your concerns with that surgeon in
person.

Robert Singer, MD FACS

La Jolla, California

Tom J. Pousti, MD · Answer

Thank you for the question.  There is no accurate/reliable/predictable correlation between size/profile breast implant utilized and cup size achieved. Make sure that you read about the pros/cons associated with the different options for breast implant positioning; this website is a good resource in this regard. Despite your good description of goals, 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, and computer imaging)  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. I have found that the use of words such as  “natural” or "D or DD 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, dedicated to larger breast  augmentation surgery concerns) helps.

R. Stephen Mulholland, MD (retired) · Answer

Dear Flygirl15,

From your clinical information that
has been submitted at 5’5” and 150 pounds and 34/36 A cup, your desire to be a
DD or larger may be anatomically possible. 
The difficulty with breast augmentation surgery is trying to visualize
the aesthetic outcome of the volume selection for your breast implant.  You will have saltwater or saline round or
teardrop or cohesive gel round or teardrop breast implant device options that
will in all likelihood be placed under the pectoralis major muscle through an
inframammary incision, if they are cohesive gel implants, or periareolar and
inframammary incisions if you select saline. 
To visualize and simulate the aesthetic outcome, I would highly
recommend you seek a plastic surgeon that has expertise using the VECTRA 3D® imaging station. The
VECTRA 3D® takes your photograph in
three dimensions and allows you to select various implant sizes to see a very
accurate representation of the three-dimensional changes that the selected
implant will provide following the augmentation. I have been performing
augmentation surgery for 20 years and I have deployed the VECTRA 3D® for the last five years. 
The use of pre-operative, simulated 
imaging has removed one of the greatest variables, which is uncertainty
about the aesthetic outcome of the actual breast implant selected.  As long as your anatomical measurements and
skin elasticity allow for the various sizes that you desire, breast imaging
will help you pinpoint which implant works best for your sense of figure, shape
and proportion.

The decision to do breast
augmentation surgery and change your figure, shape and form is a big one and I
believe it would be worthwhile for you to do breast imaging to help you confirm
the figure, shape and form and breast implant size, shape and volume that you
find most attractive. You
can certainly feel free to check out my website where, in the breast
augmentation section, there is a television video clip of the VECTRA 3D® in
action.

I hope this information has been of
some assistance and best of luck.

Sincerely,

R. Stephen Mulholland, MD

Certified Plastic Surgeon

Yorkville, Toronto

Scott L. Replogle, MD (retired) · Answer

Choosing a breast implant by cc's and making it work is like choosing a shoe size or a dress size by the size number and forcing it to fit. The proper way to make sure an implant fits and what effect it will have is to measure the width of your breast upright with arms down and subtract about 3/4 to 1cm to find out the proper width of the implant that will fit it. The choice is the profile of the implant which determines the forward volume of the implant and its apparent effect from a 1 to 1 1/2 to 2 cup size increase. This is the range that will fit and look natural if the implant is in a subpectoral (below the muscle) position. The best approach in my opinion is an inframammary crease incision, implant placed below the pectoralis muscle for the upper part of the breast, dual-plane release of the muscle out of the lower pole of the breast and using a round, smooth surface implant. I see no benefits of using a true gummy bear type implant in the usual cosmetic augmentation situation. Also, it is unrealistic to go from an A cup to a DD or DDD cup in one procedure as the tissues will not accommodate that much stretch at one time and you are a setup for needing a revision or putting up with a very poor looking result. Take the largest increase in one procedure with a high profile, round, smooth surface implant and later on consider increasing its side once your tissues have accommodated the original implant. Don't fall into the "Michael Jackson" problem and think you can have whatever result you want from whatever you're starting from.

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

Starting atan A cup breast it will be very difficult to achieve a double D or triple D sized breast.  As a general rule 200 cc of breast implant should increase you by 1 cup size therefore to go from an A cup to a double D cup is going to require more than 600 cc of breast implant.Your chances of complications go up significantly when you try to expand the breast so much especially over 500 cc.   The risk of capsular contracture and distortion of your breast is much greater when you place such a large implant under the breast instead of under the muscle.If you trust your plastic surgeons it is always best to follow their advice.  I would recommend you not focus on cup size but focus on the look that you want to achieve by using a breast implant sizing system evaluation.  During this exam implants of various sizes will be placed into a non-padded bra so you can see how you will look with each size.  For more information on choosing breast implant size please read the following link:

What size should I choose? 415CC? 465CC? or 515? I am presently a 34/36A would like to be a DD or DDD.

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