How large of an implant size "cc" can you go up to with a breast width of 12cm?

Question

I've been seen by two PS; both measured me at 12cm bwd. One recommended 355cc Sientra HSC Smooth Round Moderate Plus Silicone and the other one recommended 325cc/350cc Mentor MemoryGel Smooth Round Moderate Plus Silicone. When it comes to sizing, I have a hard time picking the ones I want. Can I go up in a larger implant size "cc" if I decided to go with Sientra?

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello Miss Luck, thank you for your question regarding implant selection with your current breast width. 
You asked if you can go larger than the 325-355cc range with a breast width of 12cm...Short answer:  Yes.Long answer:   With a slight variation of a half to a full cm in breast width, which can be easily created surgically, we can place an implant with a larger volume.  However, you stated that you have a hard time picking the right breast implant.  Picking the right implant can be complex, as breast augmentation involves a
number of different issues...  I would first have a detailed
discussion with you to clearly define
your desired breast outcome goals – this would include not just the size you would
like to achieve, but your ideal breast shape.  I would then select the best
breast implant for you based on: (1)   Volume of the implant – actual implant sizers that you
try on during your consultation can help with this

(2)   Contents of the implant – saline vs silicone, saline
tends to be a little stiffer, rounder and can cause rippling of the skin
(3)   Shape of the implant – round or anatomic
(4)   Position of the implant – if it is over or under the
pectoralis muscle; each location would provide a different shape and projection
(5)   Skin stretch of your breast – younger patients tend to
have more taught skin with more… SHOW
MORE resilience, and respond well
to an implant; compared to an older breast with more stretch marks, which would
typically requiring a larger volume to fill the breast 
(6)   Degree of breast ptosis (sagging) – a significant sag
would benefit from a breast lift
(7)   Breast diameter and overall chest circumference
(8)   Native breast tissue volume – the amount and distribution
of the natural breast tissue. 
(9)   Any history of prior surgery or trauma to the breast
The next step for you is
to find the right aesthetic plastic surgeon.  In your consultation, be
sure your surgeon addresses all your concerns and discusses the surgery details
including the position and size of the incision used (with actual photographs and not just digital animations),
the type of breast implants available, the risks and benefits of the procedure,
recovery time, and post-operative course.  Also, be sure to see plenty of
before-and-after pictures in women who have a similar breast appearance to
yours, and preferably at different time frames (3 weeks out, 3 months out, etc)
to more accurately predict your own surgical outcome.And lastly, I think the most
important component of the consultation is to establish a good connection with
your plastic surgeon.  It’s the connection that allows you to clearly define your desired breast outcome
goals, the first step of this whole process. If you don’t feel you have a
good connection with your plastic surgeon after your consultation, he/she may
not be the best surgeon for you.Good luck.Mark K Markarian, MD, MSPH
Harvard-trained Aesthetic Plastic Surgeon

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question!
  
After performing hundreds of breast augmentations, I have found that 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. Bringing photos as well can help us to finalize, but please understand that these are of other people’s bodies and your results will probably be different.
  
Silicone will give you 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 softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured.
  
Anatomic gummy bear implants might be a good choice to give you a more natural look. These highly sought after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, is 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. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.
  
We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast.
  
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

Jeffrey M. Darrow, MD · Answer

The measured width of your breast helps your PS get a rough idea of what width implant will fit you.  If you match the implant width to your breast width, a proportional increase is likely.  You can modify the volume of implants that have a specific width by choosing a low, moderate, moderate plus or high projection implant.  If you've seen the charts of the width of implants, you will note that the width of the implants increases in very small increments, approximately 2 or 3 mm, with each size increase.  This small difference can easily and safely be placed so that if you have a measured breast width of 12 cm, you can still accomodate a 12.5 or even a 13 cm implant.  Discuss this with your plastic surgeon.  Have a 3-D scan of your breasts and a simulation of the appearance of what different implant sizes would look like in your breasts can be very educational.  This has helped my patients get a very close idea of what their results may look like.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  With a 12cm base width, you will have several options of implants.  Base width serves as a rough guide for implant sizing, but there are many other factors which also contribute.  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.   
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Steven J. Rottman, MD, FACS · Answer

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.

Aldo Guerra, MD · Answer

Hello Missluck.I believe with a 12 cm diameter you would max out around 375 cc in high profile Mentor breast implants. However, there's no way to recommend this size without seeing you in person. Good communication with your plastic surgeon is the most important factor to achieve a good outcome. Best wishes, Dr. ALDO :)

Reza Momeni, MD, FACS · Answer

Cup sizes are not standard across bra makers, and implant sizing is NOT based on height, weight, BMI, or capsize.  This is something you will need to do IN PERSON with an experienced surgeon to determine what works well for you, and to get advice about if what you like is possible and what to expect with regards to results.  Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search.

Steven Wallach, MD · Answer

IN order to adequately size you, you would have to be seen in person. Changing the profile is one way to work around a narrow chest and someone who wants larger volumes.

David A. Sieber, MD, FACS · Answer

Thanks for the great question. Finding the right size implant can be a challenging process during your consultation. The maximum sized implant is determined both by your base width (12cm in your case) and the amount of soft tissue stretch in your breast tissue. Implants come in different projections meaning the base width stays the same but the vertical heigh of the implant increases. This allows patients to have larger implants which still fit your breast base width dimensions. If you wanted larger implants that 350, you might need to use a high profile implant. This will give you a little more of an augmented look, but many women are still very happy with the high profile implants. Another option is 3D imaging. Many practices utilize 3D imaging exactly for this purpose. Ask the doctors you've seen if they are able to do 3D imaging to help you find a size you're happy with. Best of luck!~Dr. Sieber

Tom J. Pousti, MD · Answer

Thank you for the question.  There are no hard and fast rules when it comes to diameter of breast implant versus diameter of breast (band width). In other words, these measurements are useful but are only one of the many factors come into play when it comes to selection of appropriate breast implant size/profile.
Ultimately, careful selection of plastic surgeon and 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 know words such as “natural” or "C or D” 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/video, dedicated to breast augmentation surgery sizing concerns) helps. Best wishes for an outcome that you will be very pleased with.

How large of an implant size "cc" can you go up to with a breast width of 12cm?

Answers (11)

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