375cc high profile silicone smooth round - Is this as big as I could of/should of gone? (Photos)

Question

I am 5’4” anf my weight has fluctuated since my augumentation in October 2024. I was a 34B before my surgery. I was scared to do 400cc and ended up going with 375cc high profile silicone smooth round. All i wanted was big C/small D very round breasts. I am fully healed and am dissapointed.. they are not nearly as big and definitely not round. Im told that going over 400 would be more risky and the two sizes were perfect for my frame. Should I or could I of gone bigger or are they suppose to look this not rounded? They also didnt turn out anywhere near my crisalix photos.

Daniel Barrett, MD · Answer

Dear lilyb1,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. 
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

William Andrade, MD · Answer

Hello, based on your postop photos there is only a narrow space between your breasts, so choosing larger implants with a wider base width would risk synmastia (an abnormal web between the space).  If you have high profile implants, an option would be to choose extra high (extra full) profile implants, which would have more projection yet the same base width.  Choosing larger implants comes with increased risks such as rippling, palpability, numbness, etc.  Your own surgeon would have the best understanding of your tissue thickness and elasticity, and could give a better opinion whether going bigger is a reasonable option.   I should also mention that breast implants simply create a bigger version of your own breasts.  If your breast are round to start, they will be large and round.  If they have a conical, pointy shape, they will be larger and have that same conical, pointy shape.  If you check out before-and-after photos of people who had breast implants inserted you can see that this is true (see link provided).

Zoran Potparic, MD · Answer

Looking at your postoperative photo I would say that you have very symmetric, full breasts, that fit your torso. However, it is always a question of individual preference and you should do what you want. Good luck.

Gary M. Horndeski, MD · Answer

At this time, I recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Donovan Rosas, MD · Answer

The choice of implant size/volume is a decision which is best made in concert with your board certified plastic surgeons. There are a number of factors which play into the decision including patient desire and chest measurements. Ultimately, your surgeon, based upon his/her exam will be able to guide a prospective patient toward reasonable options.
There are a number of tools available to help a patient make decisions with range offered by their surgeon including sizers, goal photos and 3D imaging. However, it is important to realize that these are "guides" and not "guarantees." They are meant to offer a patient a reasonable estimate on which to make decisions.
3D imaging has become an effective tool for discussing options for patients and narrowing down choices. However, it is important to remember that the imaging is only a simulation. There is no substitute for the experience of a board certified plastic surgeon. 
With regards to your specific question, small variations in volume are unlikely to make or break a result. If 375 cc feels small you will likely have to consider something in the rang of nearly 500 cc. Your result seems reasonable, however, marrying expectations to results is something that all surgeons struggle with. It is vitally important to spend time discussing the results of your imaging consultation with your surgeon. As this will help clarify your goals/expectations and guide your surgeon in adjusting those expectations as needed.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Guray Yesiladali, MD, FEBOPRAS · Answer

Thank you for sharing your experience &mdash; what you're feeling is completely valid, and it's not uncommon to have these concerns after augmentation.

Tuan A Truong, MD, FACS · Answer

Thank you for your question. Congratulations on healing well after surgery. I am sorry about your disappointment, as it looks like the results are quite good. The postop photos show a narrow cleavage and they certainly look rounder than pre-op. Unfortunately, even with the variety of tools at our disposal, no guarantee can be made about the size or shape of the breasts after surgery. Simulation models are just that - a computer-guided model of the human body, which does not take into account the various factors your surgeon has. A thorough discussion with your surgeon about your disappointment may help alleviate your concerns. Good luck on your journey!

Camille Cash, MD · Answer

I'm sorry you are disappointed in your result.  The difference of 25cc in the two implants you were considering would not have made a significant change to your look.  The look you have is a nice result that appears to fit your frame, however if you are wanting more volume you can consider an exchange for larger implants.

John Samas, MD, FACS · Answer

Based on the photos you provided, it seems to me like you are a small D-cup. As to whether you could have / should have gone bigger, that's completely a subjective choice. Of course you could have gone bigger, but it all depends on the conversation between you and your surgeon (which I can't speak to). In regards to Crisalix, having used it at one of my practices, I can tell you that in my experience, it does not always give an accurate representation of what the result will look like.The most important thing here would be your satisfaction (or lack there of). Forget the "what if", the bottom line is you are not satisfied. You need to have an open and honest dialogue with your surgeon, and together, try to find a way to leave you feeling satisfied.

Darryl J. Blinski, MD · Answer

Great question it should be understood. The computer imaging is no guarantee that’s gonna be your outcome and this should’ve been discussed with you at your surgeons consultation. Now you can do an exchange with the understanding you need to go up at least 100 cc to see any kind of significant difference so I would recommend at least a 440 to 450 cc high profile implant. Best virtual consult with. Expect fees to arrange from $8000-$12,000.

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