Which implant size would help me achieve a natural result? Stuck between 300 and 320 CC (photos)

Question

I am 100 lbs, 5'2" with little/no breast tissue. My BWD is around 12.5-12.75 cm. My surgery is Jan 30th and my surgeon is recommending Sientra Smooth Round Low Plus Projection implants placed submuscular via the inframammary folds. I want this to look natural and not too large but I'm worried about going too small with 300cc. I also heard that when placed under the muscle the implant will look a little smaller so I'm wondering if I should go 320 cc to not have any regrets?

Albert Ko, MD · Answer

Thank you for your question and photos! A 20cc difference is not much at all. Looking at your photos, you would carry a 300cc implant and have a noticeable difference. You should express your concerns to your provider prior to surgery so you are both on the same page. Best of luck!

Brian K. Reedy, MD · Answer

Thanks for your question!
In my experience, patients usually wish they had chosen the bigger implant. There is not a big difference between 300cc and 320cc. Perhaps you should try on implants again so you can make a definitive decision. Best wishes!

Carlos Marciales, MD · Answer

For sure you need under the muscle implants, and 320 will be good, it’s not to big, it will be look natural, and yes under the muscle look smaller

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Daniel Barrett, MD · Answer

Dear LilGhostie,
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

Derek Fletcher, MD · Answer

Accurately predicting the exact implant volume that will achieve your goals is difficult. Your goal photos are very helpful. Implant selection starts with your specific breast measurements (thank you for including them). Your implant must respect the natural boundaries of your breast. I usually select 8 different implant sizes in 2 profiles depending on my patient's goals and goal photos. During surgery, I place implant sizers in the patients body to assess shape and volume prior to committing to the permanent implant. Permanent implant selection is based on which implant sizer most closely recreates the desired breast shape and volume depicted in that specific patient's goal photos (which are displayed on a large, high resolution screen). I usually know which implant is most likely to provide the best fit before surgery. But I never commit to a specific implant until I have tested it with the corresponding sizer.

Connie Hiers, MD, FACS · Answer

I think both would look nice, but 20 cc's is actually a small increase. Go with 320 cc's. I do not suggest going larger for you. Even 250 cc's would do well for you.

Camille Cash, MD · Answer

The difference in volume between the two implants you are considering (20cc) is just over a tablespoon of volume.  The difference will be hardly noticeable, and may not even be noticeable at all once the implants are in the body.  Your surgeon has examined you and discussed your goals with you.  I encourage to heed her/his recommendation.

Mark A. Schusterman, MD, FACS · Answer

Thank you for your question.  There is very little difference between 300 and 320 cc's.  The general rule of thumb is to go with the larger implant when in question.  Most people wish they had gone larger after a BA.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.

Generally speaking breast implants in the 250 cc to 300 cc range can provide a natural looking result.  For a natural looking result smaller is better.

Of course your surgeon will help you make this decision and you should be able to look at before and after photographs of patients who have had breast augmentation.

Which implant size would help me achieve a natural result? Stuck between 300 and 320 CC (photos)

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