Choosing between 275cc and 300cc...

Question

I'm 5'5", 125lb currently a 32A. I am very concerned with my body image and want a fuller chest, but I want the most natural look possible. I don't want the implants to make me look heavy or overweight, and I don't want them to look obviously fake to strangers. I'm not sure I trust my surgeon's judgement. He's recommending 300ccs, but originally recommended 325/250cc which looked overwhelming to me. Will 300ccs be too much? Or should I stay at 275cc.. I'm nervous about regretting either decision

Joe Gryskiewicz, MD, FACS · Answer

Hi Lauren,First and foremost the implant should fit the dimensions
of your breast and tissue cover.  Here are a few tips
for you because this is perhaps the hardest decision for a patient to make, as
well as the surgeon. But you should be able to pick your own size and it sounds like your PS is open to revisiting this.  Also see the video
attached to my answer. Balancing the implant to your over-all body shape
and tissue cover is essential.The main thing is to have the diameter of the implant fit
the diameter of your breast "foot print".  The average size chosen over our last 7,000 breast implants was
“350cc”. BUT, 90% of our patients tell us they wish they were
bigger a year after BA. (We will see you
every year for routine checks at no charge.)  It’s like your mind incorporates
the "new you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients
that they will experience an increase of approximately one cup size per 200 cc.
You can try on implants in the office by
placing them into a special bra.The implant is also flattened somewhat when under
the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for
flattening of the implant in the partial sub-muscular pocket. Once you decide on a size you like, then add
on 25cc, because in real life the implant will be flattened slightly by your
tissues.Multiple measurements need to
be taken to fit an implant to your exact anatomy.  Have your surgeon's
office show you the charts of the implant dimensions for the various profiles
of silicone and saline from the manufacturer.  Then you and your surgeon
can piece together the puzzle by matching your measurements, with your wishes,
versus your tissue cover and the available implants to arrive at
a surgical plan.Keep in mind
larger implants tend to have more problems over the years. Since silicone implants wrinkle less than
saline implants, they might be your best bet.You can
also approximate this at home by measuring out an equivalent amount of rice
placed into a cutoff foot of old panty-hose, and put this in your bra.Wear this around the house for a while, and
see what you think.Implant size must
square with assessments of tissue cover, breast diameter, and chest wall width.
Multiple measurements of your chest wall
are taken (seven in total). Implant size
selection has been an issue of much discussion. Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape. A photo album of patient
pictures is maintained to assist them. These photos ultimately help in determining
where the implants will be placed, since they can be shifted inside (to provide
more cleavage), to the outside, up or superiorly, and down or inferiorly during
surgery. In determining the final size
selection, I always place the highest priority on the preoperative measurements
and potential tissue cover.Finally,
your verbal requests are factored into the analysis. We use
the quick-recovery approach, so click on the web reference link below to have
this explained and you can see the list of Quick-Recovery (Flash-Recovery or
Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery
journals.It is a surgical procedure that uses
special instruments and techniques to minimize tissue damage and avoid touching
the ribs. It causes far less trauma to surrounding tissue than traditional
approaches, and it dramatically reduces pain and recovery time. In published studies
of BA patients, 95-percent of women interviewed after the procedure returned to
normal daily activities within 24-hours. Quick-recovery BA is not a
“gimmick.”These specialized techniques,
which actually speed recovery and get you back to your daily routine, kids and
work, are published in our plastic surgery journals.Because these PS journals are “peer-reviewed”
and edited, they are the gold-standard in our field as being valid science.
Therefore, these are sound techniques, not marketing hype.Be sure
to see only a board certified plastic surgeon (by ABPS - The American Board of
Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic
Plastic Surgery) and or a member of ASPS (The American Society of Plastic
Surgeons). Also, ask if the PS has an
established, high volume breast augmentation practice, performing several
hundred breast augmentations each year. Be sure the PS has been in practice for a
while, about 20-years might be a good gauge.Does the PS offer all three incisions?Discuss the implant type (gel or saline), shaped "gummy bear"
or non-shaped, smooth or textured, implant pocket (over or under the muscle)
and the "quick-recovery approach."Ask to see their before and after photos if you didn’t see any on their
website.  If they are experienced, they should have several 100 breast
implant patients for you to view.  I would also recommend that your doctor
offer you the chance to talk to past patients who would be happy to discuss
their experience with you.  You need to feel comfortable, so make sure the
environment is safe as in an accredited surgery center. Also, ask a prospective surgeon if he or she
has ever published journal articles in professional peer-reviewed journals,
which they can provide you.See Dr. Wallach's point below.All the
best, “Dr. Joe”

Jose M. Soler-Baillo, MD, MS · Answer

Thank you for your question.  You should ask to "try on" the different implants to see how the sizes look on you.  Keep in mind, the difference between 275 and 300 cc's is very small.  You do want to ensure that BEFORE the surgery you have a good idea of what you will be getting.  Finally, if your surgeon is board certified in plastic surgery and an expert in performing the breast augmentation using implants, then you should trust his judgment.All the best,Dr. ResultsMiami, FL

Sheila S. Nazarian, MD · Answer

If you want to try it out, fill a ziplock bag with 300 cc of rice or water.  Put the bags in your bra and walk around with them for a day.  Adjust volume as needed!

Jeffrey Rockmore, MD · Answer

Thank you for your question.  Picking the implant size is often one of the most stressful parts of the breast augmentation process.  There is not any right or wrong answer in your case based on your description, and it is likely that either size can provide a nice result.  There may be some limitation based on the width of your chest and breasts.  The width of the implant should match the width of your chest to avoid excessive space between the breasts.  If the implant is too small, and thus too narrow, it may lead to a wider space between the breasts than is desired.  Your surgeon should be able to help with this.It is important to remember that there is only a small difference between the 275 and 300cc implants, and it will likely be difficult to tell the difference between the two.  This is only a difference of 2 tablespoons, which is quite subtle in the overall scheme of things.  If you are concerned about being too large or noticeable, I would suggest the smaller size.  Best of luck with your breast augmentation.Jeff Rockmore

William Andrade, MD · Answer

Hello, many people have difficulty picking their final implant size.  Fortunately you have narrowed it down to two choices that are only about 10% different in volume, so the final outcome will be fairly similar regardless of your choice.  If you are still having concerns you could return to your PS for another assessment and to try on implant sizers.

Ram Kalus, MD, FACS · Answer

Thank you for your inquiry. Without a physical
examination, or at least photos, it is difficult to respond with accuracy, but the best way to
determine which breast implant size is best for you is by first finding out
your specific wishes not only with words or letters as in cup size or “not too
big” or “natural”, but also with a visual understanding of what you hope to
look like. This can be accomplished either with photographs of patients whose
breasts and body type look like yours, or ideally with photos of patients not
only whose breasts are similar to yours, but are also a similar height, weight,
and pre-operative breast size. In our own practice we have provided that unique
functionality on our website to accomplish exactly that.

Unfortunately the most common reason for a woman to be
unhappy after her augmentation is feeling as though she is either too big or
not big enough. Thankfully, in our practice this is rarely a problem because
implant size selection is what we spend most of our time discussing and determining.
I do not place the onus of selecting the actual breast implant size on my patients
since they are coming to me for my advice and expertise, but I do ask my
patients to be as specific as possible about their aesthetic goals and I then
advise them accordingly.

I would advise you to have this "visual" conversation with your plastic surgeon. If you are not confident that he or she is understanding your wishes, you should consider a second opinion and seek the advice of another  board certified
plastic surgeon experienced in breast enhancement surgery and make sure that
your own sense of aesthetics aligns with that of your plastic surgeon. Your
idea of “natural” or “pretty” or “proportionate” might be different from your
plastic surgeon’s and it is very important for you to feel confident that you
are both of like minds as far as the goals. Best of luck to you and I hope you
are successful in achieving the enhancement you are seeking.

Bryan G. Forley, MD · Answer

Dimension analysis of the base diameter and corresponding projection of the breast should be considerations apart from pure volume in selecting an implant. There are many styles of implants to choose from and this should be discussed in depth with your surgeon. If you are doubting the judgment of your surgeon, then I would seek a second opinion before proceeding.

Arnold S. Breitbart, MD, FACS · Answer

There is not much of a difference between a 275cc and 300cc implant.  It's most important to know what cup size you want to be.  In my own practice, I use sizing implants during the procedure.  In your case, for example, I would use sizing implants during the surgery to see exactly which size implant looks best to achieve the cup size you desire.

Brian Coan, MD, FACS · Answer

Hi, thank you for your question
on which implant size would be best for you. Right now it sounds like you’re considering 275cc and 300cc. Since there is no way to say definitively
over the internet which size would be optimal for you, take comfort in the fact
that the surgeon uses your unique measurements and is able to provide you with
a general range. In many cases the board
certified plastic surgeon can best be your guide as they’ve met with you in
person and heard your aesthetic goals. You may consider doing 3-D imaging;
however with nearly all the breast cases we’ve performed, we’ve found patients
enjoy doing a live “try on” session where they actually can “try on” the
implant in a non-padded bra in our office. This does not give an exact measurement of outcome, rather it gives a
nice idea of what to expect. For patients who desire a more natural look we
like to recommend the shaped implant. For patients who desire a more full, voluptuous look we recommend a
higher profile implant. And remember that all breasts have at least some amount
of asymmetry (we like to say they’re like sisters and not twins). My very best to you. - Dr. Brian Coan

Steven Wallach, MD · Answer

Since you are looking at implants in a similar range, you can try them on and see what you like. Baggy tests are simple and easy. A 25 cc difference is not a big deal.

Choosing between 275cc and 300cc...

Answers (13)

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