Will the 700cc look too big on me? (Photos)

Question

I’m 29 years old 5’11, 165lbs. My frame is more athletic/broad and I have wider hips after having kids. I tried on implants yesterday and loved how the bigger sizes looked. In the picture my left side is 700 and right is 650. I decided on the 700 but after going home and looking at pictures of 700cc implants they look so big. I tried on smaller sizes but I just didn’t see the difference I wanted.

Donald R. Revis Jr, MD · Answer

Good afternoon!It's not about the number- it's about the look. You tried on the sizers- I vote to go for it! The last thing you want is to be saying "I wish I had gone 700cc" six months from now!

Scott Farber, MD, FACS · Answer

Congratulations on your decision to undergo breast augmentation surgery. The most important factor when considering size and profile of a breast implant is to first ascertain the patient's chest width. Once the width is determined, an appropriate implant can be chosen that best corresponds to the patient's specific anatomy. In my practice, after a range of implant sizes is selected, the patient can utilize our sizing system to try on implants of various sizes to get a feel for what volume matches their aesthetic ideal. Moderate profile implants are wider but have less projection, whereas high profile implants are narrower but have more projection. Women who desire more upper pole fullness and cleavage may benefit from a wider moderate profile implant. Women who have a narrow chest width but desire larger implants may benefit from a high profile implant. Ultra high profile implants will give a more augmented appearance given the much greater projection. It is important to convey your aesthetic goals to your Board Certified Plastic Surgeon so that the appropriate implant can be chosen. Good luck !

Donovan Rosas, MD · Answer

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. 
700 cc is a huge implant irrespective of frame. 50 cc is unlikely to make a significant difference in outcome (slightly more than a shot glass). However, it is important to remember that complications rise with volume. The greater the implant volume...the greater the weight...the quicker the sagging.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Gary M. Horndeski, MD · Answer

700 cc implants weight over 1 ½ lbs each and will most likely cause neck, shoulder and back pain.  There are 2 parts to augmentation: one is cosmetic and the other is functional.  Large implants make the breasts look better but functionally they may not be practical for you.  Implants are not lifetime devices and half are removed by 9.5 years.  I strongly recommend you consider smaller size implants or combined with fat transfers.Best Wishes,Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Jkinto,
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

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  700cc is a large implant size.  The best advice you can receive is from an in-person consultation. It would be helpful to view pictures of your breasts and to know your individual breast measurements.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   
 
 Best wishes and good luck.

Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon

Gregory A. Buford, MD, FACS · Answer

From the photos you provided, either implant would look nice.  However, placing implants on top of your tissue really doesn't give you a good idea of how they will look beneath the muscle.  To help guide you, I would choose 2-3 photos of a proportionate volume look of breasts that you want to achieve and bring those photos in to your Plastic Surgeon.  From there, you can choose a range of sizes and then use sizers during surgery to help determine which volume (when placed beneath the muscle) actually helps you achieve that look.I hope that helps and wish you the very best!Warmest regards,-Gregory A Buford MD FACS PCEOBoard Certified Plastic Surgeon and Author

Douglas L. Gervais, MD · Answer

What implant size to choose is a personal decision. If you like how they look then go with the 700cc!! In my opinion the photos you posted looked great. Good luck. Dr Gervais.

Johnson C. Lee, MD · Answer

The ideal Implant size cannot be determined by height and weight alone. It is best to have an in-office evaluation so that careful measurements can be taken to determine the best size implant for your chest diameter, several upper body measurements, and current breast tissue. Once you have the measurements, they are all put together to determine the right implant from the right manufacturer. Breast implants of the same cc's can look and feel extremely different depending on the profile and material. In my office, I have the MENTOR breast implant sizing system where different size molds are used to simulate how you appear in your own clothes and help finalize your decision. Hope this helps!
Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.   
  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. Sometimes, it is necessary to seek several consultations before you feel comfortable about your choice.
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 "D or DD or DDD cup” etc may mean 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, best not to discuss your goals and/or judge the outcome of the procedure performed based on achieving a specific cup size. The use of computer imaging may be very helpful during the communication process. The use of in bra sizers may also be helpful. In other words, use as many “visual aids” as possible during the communication process. I encourage patients to meet with me as my times as necessary, to feel comfortable that we are both on the “same page”.
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. I generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.
 One question that might be helpful for you to consider: would you be more disappointed if you are slightly too big or slightly too small after the breast augmentation procedure?
I hope this helps. Best wishes for an outcome that you will be very pleased with.