Should I go with 280cc saline or 320cc saline? (Photo)

I know there's not much difference, but I am wondering if I should go with 280cc filled to approximately 300cc or if I should go with 320cc filled to approximately 350cc. My surgeon suggested I go with 280cc in our initial consultation but said I could go bigger if I pleased, we did agree on high profile. I am wondering if I should go bigger to achieve the look I want. I have an 11 centimeter breast diameter and a 29 centimeter chest width and am currently a small 32 A cup.

Doctor Answers 9

Breast Implant Sizing

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Congratulations on deciding to move forward with a breast augmentation. Now you are in the tough stage, sorting out what is right in terms of size, types of implants, placement, incision site, among other things.
In terms of implant size, you should know that is not as much about volume as it is your size and frame when it comes to your chest. Primarily we look at the width of your breasts and underlying chest to get the right diameter. Too small a breast implant will result a funny look (like a tennis ball under your breasts) and too big does not work (a basketball under your breast would be more on your back than your chest). Once the diameter range that is best for you is determined, then we start figuring out projection to give us the size of implant that look good for you and fits what your goals are. 

This is very important, especially with the new form stable or gummy bear implants. Very few surgeons are using saline anymore because of the rippling and their deflation rate. It used to be that be simply thought of volume bit as you can see it is much more complicated now. In fact, the implant companies, although they will replace your implants if you have a deflation, no longer fully warrantee them with money toward the surgery in first few years the way they do for the gummy bear implants. The only way to answer all of this is to get with your surgeon and do some more planning and strategizing.

I have added a video about the gummy bear implants that explains some of this for you.

I hope that helps.

Best regards.

Kirkland Plastic Surgeon
4.9 out of 5 stars 64 reviews

280cc Saline or 320cc Saline

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Factors which contribute to the outcome of Breast Augmentation are #size, #shape, and #profile.
The #profile is determined by the amount of #projection versus roundness that the you desire, as well as the #size of the implant and size of your chest. Also, the placement or incision location will also have an effect on profile.
This may also provide some insight. If a woman wears a size 36 AB bra and would like to be a C cup, which is the average size that women wear and the average size bra that is sold, she needs a volume of approximately 350 to 390 cc to make that change. This becomes less if she's wearing a 34 bra, because it has a smaller strap size and the cups have a smaller diameter. A smaller diameter implant would then be a volume of approximately 300 to 350 cc. In the same way if she was more petite, maybe a double zero or size one and wore a 32 AB bra, then to become a 32C cup she would only require about 250 to 300 cc. The profile is determined by the amount of projection versus roundness that the you desire, as well as the size of the implant and size of your chest. As much as it's important to know what size bra you currently wear, the strap size is important to know as well. It affects the diameter of the cup and subsequently the diameter of the #breast implant that you choose. In my practice, about 15-20% of the patients are good candidates for silicone #shapedimplants.
#Subpectoral or #submuscular implants refer to placement under the muscle which still remains the most common placement in the United States. #Submammary or #subglandular implants are the placement under the breast tissue in front of the muscle. This tends to more common in Europe and South America. General guidelines suggest that women with larger drooping (ptosis) breasts that do not want a breast lift often have the implant placed above the muscle, although another option, #DualPlane, has become more popular. In the Dual Plane method, the implant is placed under the pectoralis muscle but the breast tissue is also release, in part, from the muscle. Those patients with minimal breast tissue should usually have the implant placed beneath the pectoralis muscle for more soft tissue padding.
Your Plastic Surgeon will measure you to determine the best shape, size and placement of the #implants to be used. Lastly, another important element to a satisfying result of your #augmentation is realistic #expectations.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Should I go with 280cc saline or 320cc saline?

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Thank you for the question.
 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. Given that your surgery is coming up soon, I would suggest that you schedule additional time to spend with your plastic surgeon communicating your goals, 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. I have found that the use of words such as “natural” or "C or 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, dedicated to breast augmentation surgery concerns) helps. Best wishes.

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Saline breast augmentation and sizing

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In our practice, we use Crisalix for 3D sizing.  So a patient can "virtually" try on implants prior to surgery to see how she may look after surgery.  For a small difference in implant sizes, it is hard to see on Crisalix or any other 3D program.  I think it is easier to see changes beyond 50cc and higher.  It sounds like you are generally in the right ranges for your frame and many gals like you, go for the slightly bigger implant.

Good luck!

Implant Sizing?

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It is impossible to make any recommendations regarding implant volume without actually seeing you in person to assess multiple factors such as your height, amount of breast tissue, quality of your skin etc. The information you have provided does suggest that you are thin without much breast tissue. It sounds as if you might have chosen a high profile implant because of your relatively narrow base diameter, but high profile saline implants are usually not a good option for most patients because they can create an unnatural breast shape, so I would be cautious about that choice. Also, if you don't have much breast tissue, then you will certainly be able to feel a saline implant through your tissues, and if you are really thin, then you will likely see the outline of the implant through your tissues. These are some of the disadvantages of saline implants and you should be aware of these issues when choosing an implant. Because of these drawbacks many women will instead choose to have a new generation gel implant which will feel softer and look more natural. Also keep in mind that unless you look exactly like the person who's photos you provided (height, weight, shoulder width, waist size, amount of breast tissue, skin quality), then you should not expect to have a similar result because all of these factors have an impact on the outcome. You might want to consider doing another consultation or two before finally deciding on how to proceed.

Should I go with 280cc saline or 320cc saline?

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Unfortunately no one can give you worthwhile advice on implant size without an exam. I am wondering why you are choosing saline. The abnormal feel and the rippling are unacceptable now that the excellent quality silicone implants are on the market. In fact I see many patients each year that are converting from the saline to silicone. No one ever goes the other way.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Choosing a size is a matter of personal preference

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If you are worried about size already, you should probably go with your larger option.

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. 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. The experience of the surgeon and the degree to which they explain the options to you is of utmost importance. 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 implant. Don't let the doctor tell you what would look good on you. They cannot tell what you perceive to be the best size. That is up to you.

Implant size

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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 suit at a preoperative visit will help you and your surgeon choose the optimal implant.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you 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) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

What size should I choose?

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In general, most women return with the desire to have gone bigger.  300 versus 350 ml is not much difference as you noted.  Keep in mind, that the larger a high profile implant is, the less natural the look may be.

Todd C. Case, MD
Tucson Plastic Surgeon

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.