Breast Augmentation Advice for Size and Placement

I'm booked for breast augmentation next week, but I'm still unsure what size I want. I'm 5'11" and a 36B currently. I'd like to be a D cup, but not the fake look. The surgeon said 325cc round silicone implants over the muscle. Should I opt for slightly bigger? My friend who is only 5'5" got 380cc and they don't look that big. Also, she got hers put under the muscle and was told that's how they look the most natural. Is this true?

Doctor Answers 6

Tough to know without an exam or a photo

Picking the right implant for each patient requires good communication between the surgeon and the patient, and a thorough discussion of the advantages and disadvantages of several options, including:

type of implant (saline or silicone)

profile of implant (denotes the shape of the implant and how much projection it has)

size of implant

implant pocket (subglandular (in front of the muscle) or subpectoral (behind the muscle)

Every woman has different goals, different anatomy, and as surgeons we all have slightly different tools and styles to determine which implant will not just look the best for each patient, but more importantly, will meet their individual goals. Let me give you a few tips that may help you decide what you want done for your procedure:

In general, I think silicone implants for most women look the most natural, especially if you are very thin. Now, some surgeons would disagree with this, but I think that if you're planning on placing the implant above the muscle, you should strongly consider silicone implants, because salines will look very unnatural and you will likely see the rippling of the implant over time.

I will often place the implant behind the muscle, unless the patient is very, very active, has a little bit of droop to their breasts, or has a strong preference for this placement. I think the muscle hides the implant a bit more and prevents visualization of the edge of the implant, in particular along the cleavage line.

Picking the right size can be difficult, and I will usually use a temporary sizer during the procedure, so that I can pick the proper implant for my patients. This adds a few minutes, but I think it goes a long way toward achieving the size, look, and symmetry that my patients are looking for.

I hope this helps-- the key is to have a detailed discussion with your surgeon during your consultation so that he understands what it is you want and gets you those results on the day of surgery.

Good luck!

Dr. Salemy

Seattle Plastic Surgeon
4.9 out of 5 stars 149 reviews

Breast implant size and placement advice

Yes breast implants placed under the muscle tend to look more natural (see my realself articles). However there are consequences. See video below. IF you are set on a D cup breast I would go with a larger implant.. Try sizers on.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 82 reviews

You will need a bigger implant

I have many patients in the 5'11" to 6' plus range and on this frame, a 325 implant will give you a full B or small C result. Most of these patients need an implant in the 400-450 range to get a reasonable size for their heights and frames. The base diameter of the implant should match the base width behind your breast and this dictates the volume that is best for you.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Meals on wheels


Things are apparently done differently in England. Actually, there is some practice variation here in the states as well. Most plastic surgeons in the U.S. use a technique known as biodimensional planning, in which measurements are taken of your breasts and chest and coupled with your height, weight and personal goals to give a narrow range of implant sizes. I will have 3 (an extra one, just in case) of each of the implants in that range available for the surgery. During the surgery, while you are anesthetized, you are placed in a sitting upright position with a temporary breast sizer inserted under your breast. The sizer is then inflated to a size that fits your personal goals (D cup) and the final implant volume is chosen based on that process. Perhaps your surgeon has a similar practice, but on the surface, you are exactly right. A 325cc implant does not sound right for your D cup expectation. Good luck!

Kenneth R. Francis, MD, FACS
Manhattan Plastic Surgeon
4.6 out of 5 stars 47 reviews

In my experience at least 375-400 cc is required to produce a D cup in a Victoria Secret

Bra sizes vary by manufacturer. For most average women with B cup breasts I have found that 350 cc implants usually crreate a C cup and 400 cc is required for a D cup using the Victoria Secret Bra cup sizes.

I am also talking about round low profile or moderate profile gel implants. I have not found that submuscular versis subglandular implant location makes much difference with regard to final size.

You are not ready for breast augmentation....

You are clearly unprepared for your surgery if you do not know the exact plan and your surgery is next week. No surgeon on a forum is able to tell you what size implant and where to have it placed without examining you.

A 350cc implant looks very different on a lady who weighs 100lbs at 5 feet tall versus a 6 foot tall lady who ways 180lbs.

You need to see your doctor and have a long discussion explaining your goals and asking your questions. Why are you going above the muscle vs under the muscle?

Did the surgeon explain why or just say "do it this way." You can't just show up on the day of surgery and hope it goes well. The #1 reason in the United States that women have revision surgery is for a size change. Thus, you need to know you goals beforehand.

Call your surgeon on Monday and find out how they size people.

  • Do they have sizers to try on?
  • Do they do digital imaging?

If you wait until after surgery to ask questions it will be too late...

Evan Sorokin, MD
Cherry Hill Plastic Surgeon
4.8 out of 5 stars 77 reviews

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.