What size silicone gel implant?

I'm 5'8" tall and want to be a very full C or small D cup when all is settled post op. My surgery with silicone 415 cc netted very poor results so I'm having them redone. Would a better bet be to go with 475 or 500?

Doctor Answers 9

What size silicone gel implant?

Thank you for the question. Online consultants will not be able to provide you with specific enough advice to be truly helpful. 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.  



Generally speaking, patients undergoing revisionary breast surgery should understand that there may be many variables besides breast implant volume that come into play when determining optimal  breast implant selection during revisionary breast surgery.  For example, adjustment of the breast implant capsules may be necessary; this adjustment may be a factor when it comes to selection of appropriate breast implant size/profile.    Lots to factors to consider...



Generally speaking, the best online advice I can give to ladies who are considering revisionary 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. For example, 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.  Personally, I find it most beneficial to have a wide range of breast implant types, sizes, and profiles available.

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.  

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

I appreciate your question.

The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  

Silicone will give you a fullness at the top (upper pole fullness).

Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.

These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

#RealSelfCORESurgeon



Breast Augmentation - Size Selection

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Having them redone?

Thanks for sharing your experience. One rule of thumb I use in my practice is to always upsize by at least 100 cc and downsize by 200 cc when revision surgery is done for size dissatisfaction. I feel that changing implants for smaller than 100 cc will not make a difference for my patients that is significant. However, your situation may be different. On this online forum, there's really no way to tell you which size would be better for revision surgery. Since you are taller then most of my patients, I would be inclined to go for the bigger one as long as you don't feel it is overwhelming. Speak at great length with your plastic surgeon. Best wishes on your upcoming operation!

Dr. Guerra

Aldo Guerra, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 190 reviews

What size silicone gel implant?

I recommendation is to allow your plastic surgeon to make the final implant choice based on his understanding of your goals and review of photographs that you select as your target image and size and contour.  Once your sleep test implants can be used to determine which volume gives you literally the best size but natural and optimal shaping and contour.  Without seeing you in person is difficult to guess how much larger you should be made but under a 50 mL difference is going to be very subtle and probably less than you would like. Good luck and best wishes.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

Implant selection

Hello and thank you for your question.  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.  This entire surgery can be performed with a small incision technique.  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.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 77 reviews

What size?

Without photos of your starting situation the forum can not be too much help. A lot depends on what you look like now.

I have included FAQ for sizing below. I hope it is helpful to you. With implants already in you don't have the luxury of sizing with sample implant you the PS that examines you will have to make recommendations based upon your goals.

Best wishes.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 90 reviews

Choosing implant size

Choosing implant size  is a very important decision. It depends on what you are unhappy about with your original surgery.  If it is size, then I would recommend choosing the larger of the two implants.   Good luck 

John Paletta, MD
Savannah Plastic Surgeon
5.0 out of 5 stars 18 reviews

What size silicone gel implant?

Hi, Cameronmc

Without direct examination and seeing the pre and post-op photos, I cannot recommend the right implant size for you.  In addition, I would like to understand your desired look and understand why 415cc yielded a "very poor result."

Please visit with board-certified plastic surgeon and share your wish photos with him/her.  Please review before and after photo gallery and ask your plastic surgeon which size/profile implant would give you the desired outcome. After examining your and understanding your goal, your plastic surgeon should guide you to the right implant size/shape/profile.

Best wishes.

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.