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

First, a physical exam is really needed to make any meaningful
recommendations. Generally speaking, 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

Thanks for your question and photographs.  It is difficult to answer your question without an in-person exam.  Depending on your base width, you may be able to accommodate a 600cc high profile implant.  On your small frame, I believe this would deliver the "fake" look you desire.  You appear to be fairly thin, so a submuscular placement may be better for your to help minimize risk of visible wrinkling in the upper pole of the breast.  I would seek out a board certified plastic surgeon in your area for an in-person consultation to better answer your questions.   Good luck. 

 Thank you for the question and pictures. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. Generally speaking, I think that it is in most patients' best interest to have breast implants placed in the sub muscular (dual plane) position. You will find lots of information about the pros/cons associate with different breast implant positioning on this website.
Otherwise, unfortunately, online consultants will not be able to provide you with specific enough advice (regarding specific breast implant size/profile) to be truly helpful. Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant type/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. In bra sizers can be useful communication tools also.  For example, I have found that the use of words such as “natural” or "D or DD cup" or "fake look" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during the communication process.
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 for an outcome that you will be very pleased with.

You are  an excellent candidate for augmentation since you have perfect skin envelopes to receive implants.  Gel implants will be the best since they are soft, natural, and carry lifetime warranty.  Over the muscle is preferred: under the muscle isolates your own breast tissue from the implant volume which can lead to separation of components.  This will begin as a slight softness under the breast and can progress to full-blown double-bubble contour where the implant is held high on the chest by the muscle and the breast droops below.  Even when this doesn't occur there is the unnatural problem of the breast moving and distorting whenever the muscles are flexed.  All of this is avoided by staying on top of the muscle for the most natural and longest lasting result.To determine implant size we like to have our patients try on "bra-stuffers" in the office.  Once the volume has been determined we choose the implant design (shape, profile) that fits the patient's chest.Be sure to consult a surgeon certified by The American Board of Plastic Surgery.  Ask to review a comprehensive (ALL the photos) portfolio of pre- and post-op pictures so you can see the types of results that are reasonable to expect.