Can my body fit 600cc High Profile silicone? And should it be under or over the muscle? (Photo)

You may be able to get 600 cc implants.  Under the muscle would be my recommendation.Kenneth Hughes, MDLos Angeles, CA

There are many advantages to sub
muscular dual plane placement and very many disadvantages to sub glandular
placement. I would see no indication to do anything but sub muscular.
However, the shape of your breast would require a surgeon that is specifically
experienced in the treatment of ptosis with implants. This can be best
accomplished with the armpit approach. The most sophisticated approach to
breast augmentation is through the armpit with a surgical camera (transaxillary
endoscopic). Using this modern approach the space can be crafted under direct
vision, with virtually no bleeding and no postoperative bruising. Most
importantly, the shape of the breast is meticulously created. The other, older
methods of insertion are technologically less advanced. Both silicone and
saline implants can be placed through the armpit by a surgeon with skill and
experience using this approach. The incision in the crease is the oldest method
of placing the implants and puts a scar directly on the breast.



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. There is no maximum. That is up to
you.If you like 600 cc, that is the right size for you.

It is impossible to give you a yes or no answer about whether your body can accommodate a 600 cc high profile implant without an examination.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 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. There is also no
direct correlation between an implant size or shape and resultant cup
size.

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 you find a plastic surgeon
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