Hi. I am 42, mother of 3 (breastfed), 5'3", 31" ribcage, BWD 14cm. Have recently lost 65# & would really like to look & feel proportional. Would rather err on the side of too small than too big. What do you think would be a good size/cc range for me? Thanks!
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Doctor Answers 14
Choosing an Ideal Implant
Even for us as surgeons, there is subjectivity, individual preferences.
Your preferences are most important: your sense of balance and proportion, your desires for shaping and fullness.
Having said that:
- you start with breasts of excellent size and shape: your results can be quite excellent
low profile implants will be the most "stealth," providing a shape of a mature woman's breast
- volume range ~225cc
- about one cup size increase
many women in my practice prefer the slightly more upper pole fullness provided by a medium profile implant
- volume range ~325cc
- about 1-1/2 to 2 cup size change
Of course, these are estimates, and are not a substitute for a thorough consultation and examination.
Breast Augmentation Suggestions
Thank you for the helpful photo. I'm happy to hear you say that you'd rather err on the small side, rather than the big side. Choosing the smallest implants that will meet your goals will likely save you headaches later on.
I would choose gel implants, round, smooth, under the muscle. The 14 cm basewidth you report seems very wide for you--your surgeon will re-measure, as I would really be surprised if that measurement is correct for you. If you were in my office, once I measured your base-width, I would choose a range of implant sizes that would fit your width. You would be able to literally try them on in a bra to choose which one you prefer.
Just guessing, I think you'd end up somewhere in the low-to-mid 300 range. But we'd know for sure after a consultation, which is the best way for you to now proceed.
Implant recommendations for ideal breast anatomy
Excellent photo. Your breast anatomy is nearly ideal, and you should expect an excellent result with breast augmentation. Your intuition to get a small implant is a good one: smaller implants will likely last longer and stretch your breast tissues less. Also, a small implant will preserve the nice shape of your natural breast and not add any 'fake' looking contours. Based on your appearance in the photo, and your breast width, I would favor an Allergan style 15 339 cc implant in the sub-muscular position using an infra-mammary incision. The diameter of this implant will fit well within your relatively wide breast base width- which is essential for a natural result.
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Choosing a breast implant size.
The picture helps, but it would be better to see a front view. With that said, in your mind you have an idea of what you would like. get a measuring cup and some zip-lock bags (sandwich size) fill two 250cc another set to 300cc ant the third set 350cc. wear a light sports bra (not too tight) and place the closed bags in the bra. Try the 250cc first, and work your way up. This technique will give you a pretty good idea of what the volume will look like. You can try on shirts and dresses to see how they will look. If undecided between two sizes,always pick the bigger one.
Your augmented breasts will be very similar to your breasts now, just bigger. Nipple position, breast fold position etc. will not change. When you look at before and after pictures of breast augmentation patients, pay attention to the nipple position etc. before the surgery , and notice how it is the same after surgery. What changes is the size.
As far as technique, the transaxillary approach leaves no scars on the breast. Using the Keller funnel I can place gel implants through the armpit, and the y look and feel great. Second choice would be the periareolar approach with the keller funnel. Both behind the muscle with smooth gel implants
I hope this helps.
Recommending Breast Implants
The details of the procedure I might recommend for you would depend greatly on things we could not understand without a consultation...
I'm afraid that it has become too common and easy to believe that breast augmentation is a simple procedure and that plastic surgeons are simply technicians... You decide what you want then find a surgeon willing to do it for you for the lowest price possible....
This is a backwards approach and is clearly part of why there are so many women having revisions of their breast augmentations...
Breast augmentation is actually a fairly subtle procedure. The best way to go about this is to first contemplate your goals. Not in terms of bra size or the volume of the implant you know a friend has... but in terms of what you want to LOOK like...
Once you are clear on the appearance you would like to achieve, then spend some time and energy identifying a quality, experienced and Board Certified Plastic Surgeon (you can read about how to go about this by following the link below). Visit them for a consultation, communicate carefully your goals, and then (after an examination) let them use their training, experience, and skill to advise you on the details of the technique they would recommend to achieve your goals for you.
Breast augmentation sizing
Thank you for posting your photos and your breast information. Implant sizing takes into account the measurements of the breast combined with your tissue quality. 14cm seems wide for you but if accurate you have a lot of options in regards to implant sizes. You look to be a small B cup or thereabouts now. To increase to a full C or small D, an implant in the range of 275-325cc would likely suffice. Placement could be either subglandular for a smaller implant or submuscular for a larger implant. My preference would be a smooth, round, moderate plus profile silicone gel device. A smaller implant is a good choice as the implant is going to affect the breast less in the long run.
Sizing breast implants for natural/predictable outcome
I would agree with other answers that it looks like you're between an A and a B cup and quite suitable for breast augmentation. I would recommend that you have your breast width remeasured with you upright and arms down. The average width breast for patients seeking breast augmentation with a 34" chest is 13 cm and you apparently have a narrow chest. A breast width of 14 cm would be unusually wide.
Based on the rechecked width of your breast, the diameter of the implant that fits will be 3/4 to 1cm less than this width. With a round implant of that diameter you can be sure the implant will fit and look natural. If you choose the lowest profile implant in saline (Allergan) or silicone gel (either brand) you can look up the cc's of volume and expect that your breasts will look about a cup size larger which would be a B/C size. If you choose a medium profile (Mentor or Allergan) in saline or a middle profile silicone gel implant (Mentor or Allergan) you can also look up how many cc's that would be and you can expect to look 1 1/2 cup sizes larger or a mid C cup. A high profile implant (saline - Allergan) or gel (either) would increase you by two cup sizes and would probably look too big and more artificial.
This assumes the implant is placed properly in the subpectoral position, ideally with an inframammary crease incision, and is filled properly (if saline) and then gets healed properly. But regarding size of the implant, start with your measurements and the effect of the different profiles and then figure the cc's of volume. Don't start from the cc's first.
Use the rule of thumb that every 200cc added to your breast will result in one cup size increase
From the photo you appear to be at present between an A and B cup. If I understand you correctly you have recently lost some 65lbs. Did this weight loss lead to an unwanted decrease in your breast size that you are trying to correct with implant surgery? To restore your previous size use the rule of thumb that every 200cc you add will increase your breast size by a cup. For example, if you were hoping to become a C cup again you will have to go up a cup and 1/2 and this would require a 300cc implant. Once you have made this calculation then double check your choice by trying on this implant to visualize if it is producing the desired result. Make adjustments as necessary if the calculation does not measure up to your needs. There is no really good system for predetermining the correct implant size but doing what I described will give your surgeon an excellent reference point to work with in the operating room. Ultimately, the surgeon has to make the final decision for you based on this preoperative choice and his or her sense of proportion and understanding of your goal.
Finding your perfect size
There are several considerations but given this format I will cut to the chase and state that I believe a moderate plus silicone gel filled implant in the range of 275-300cc would provide you with a solid cup and a half increase if placed in the submuscular position. I think if you are looking for a solid 2 cup increase or more, your anatomy could manage up to a 500cc high profile silicone implant but this would be a decision made after a consultation
See my website link below for a fun little tool or the video for a breast sizing device..
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.