Implant size? Going for a second consult in a few weeks. (photos)

Hi, I'm a 33 year old mom of three little ones. I nursed all three for a year and sadly, my previously small but full breasts have been replaced by these!!! I've been to two consultations and have surgery scheduled for Nov. 30th. I told my doctor that I want to be a large B and look very natural. Both doctors suggested a 400cc implant! I chose silicone and feel like this size will make me look enormous. My breast width is 12cm. I am a little over 5'7" and weigh 123 pounds.

Doctor Answers 22

Breast Implant Size

Each woman has unique physical findings and unique desires.  An experienced plastic surgeon who listens carefully to what you want and does a thorough evaluation of your breasts is likely to recommend the best type and size of implants.

For a woman with modest-volume breasts, the larger the implants that are placed, the more the final shape of the breasts will be defined by the implant rather than the natural breast tissue.  For instance, if she has 100 cc's of her own breast tissue and 400 cc implants are placed, the final total volume of 500 cc's is 80% made by the implants (400 out of 500 cc's).  While that may work okay when she is younger, in just a few years the tissues will thin out and the implants will become even more visible.  

Keeping with the example of this woman with modest-volume breasts, she may actually be a candidate for almost any type of breast implant.  This appears to be true in your case, judging by the photos you provided.  A round implant will likely provide a round result.  The larger the implant, the larger and more rounded the result is likely to be.  Some women are primarily concerned about volume and they want to be a C cup.  For those women, round, moderate-plus or high profile implants of 350+ cc's might create that result.  For women who are more concerned about shape and not necessarily exact bra size, a shaped silicone implant may work best, or at least is something at least worth investigating.  

At 5'7", your frame can probably carry larger volume implants than someone who is 5'2".  400 cc's may work just fine, but I suspect you may end up in a C cup (or maybe even a D cup in Victoria's Secret bras).  When I evaluate women for breast augmentation I listen for what kind of look they are seeking.  We focus on the look rather than the bra size.  Ultimately if you can wear the kind of clothing you want and look great,  then it may not matter as much exactly what bra size you end up wearing.  

Make sure you explain carefully to your surgeon what you are wanting.  We, the doctors answering questions on RealSelf, cannot tell you exactly what will work best for you because we haven't actually examined you.  A plastic surgeon who does a lot of cosmetic breast surgery and who has actually examined you is probably your best resource.  Judging by your pictures and your comments, I think 400 cc's may be a little large, but again it's hard to tell just from the photos.  



Fort Worth Plastic Surgeon
4.8 out of 5 stars 24 reviews

Which Size Implant Size is Right for Me? #breastaugmentation #breastimplants

  • I agree with your concern that 400 cc implants may be too large for you.  Of course, ultimately, you will have to make the decision of which size you like best. 
  • We do find that trying on implants in our office is an extremely helpful way for our patients to decide which implant size best suits their expectations. 
  •  We have our patients try on sizers at their initial consultation and at their pre-op appointment. 
  • Consider going with an implant in the low 300s or even high 200s next time you do sizing. 
  • Thanks for sharing!

Breast augmentation

Thank you for your question and photographs.

If you clearly expressed you cosmetic goals then your surgeon recommended the best implant type/sizes for your body based on your measurements and goals but in the end, you are the decision maker and if you feel 400ccs is just too large then choose something smaller. It is difficult for me to give my recommendations for implant size without examining you and knowing your measurements. A suggestion would be to allow the doctor to place sizers during your procedure and then give them permission to choose the implant size based on how they look on your body. Best of luck in your endeavors.
Sincerely,

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 68 reviews

Size

I would suggest going back to the surgeon you preferred and ask to try on a range of sizes, starting as low as 250 and going up. If 400 seems to large for you, don't settle for that size. Your surgeon can guide you to the range of sizes best suited for your frame and tissue. However, if you prefer to be a full B, go with the size that makes you feel most comfortable. A 400 cc implant will be much larger than a full B.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Best Breast Implant size?

Thank you for the question. 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.  Although I generally cannot provide patients with specific advice online, I would share your concerns that 400 cc breast implants will be too large given  your description of goals.



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, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.


 

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.



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 "large B 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.

I hope this (and the attached link, dedicated to "natural looking" breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with. 

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

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 Implant size? Going for a second consult in a few weeks.

Thank you for your question and photo.  He had excellent breast anatomy and should be able to achieve a very nice result with breast augmentation.

Considering the fact that you want to be a full B cup and look natural I would consider breast implants in 250-300 cc range to be more appropriate for your very fit thin body.  I agree the 400 cc seems too big. Seek another opinion and requested the implants be placed underneath the chest muscle.  To learn more about sizing please read the link below. You can try the Rice test at home to see what 400 cc will look like.

Breast Implant Sizing

Hello,

The purpose of sizing in front of the mirror is to determine the proper size implant necessary. You need to be happy with how you look in the mirror, then the surgeon will know what size to use. 

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Breast augmentation

Thank you for your question.  If you are concerned with the size implant that they recommend not being the one to help you achieve your overall goal, you may wish to request that your chosen surgeon allow you to try on some sizer implants so you may better visualize what that implant size will look like on you.  If they do not offer that option, you may wish to schedule a consultation with a different board certified plastic surgeon.  It is important for you to be comfortable with your choice and feel like your desires are being considered.


With kind regards,
Lane F. Smith, M.D., F.A.A.C.S., F.A.O.H.N.S., F.A.B.F.P.R.S.
Las Vegas Plastic Surgeon

Lane Smith, MD
Las Vegas Plastic Surgeon
4.5 out of 5 stars 84 reviews

Consider A Smaller Implant

The goal of an augmentation is to create an aesthetic breast with the size, shape, and projection that is desired by the patient. During a consultation, measurements of the breasts are used as a starting point to recommend a breast implant. The decision on size, shape, and position of these implants is based on your anatomy, the type and size of the implant, and your preferences. 

Based on your photos, a 400ml implant appears proportionate for your frame - however, it would likely enhance your breasts to a large C or small D cup. If your goal is a small C or large B cup then something in the 300ml neighborhood may be better suited to you.

See the link below for more info on breast augmentation. 

A detailed examination will help delineate the best surgical treatment. In office sizing and digital three-dimensional simulations can help guide your implant choices. A second opinion with a plastic surgeon certified by the American Board of Plastic Surgery would be the next best step.

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.