Is 421 Cc Enough Achieve D Cup?

Question

I am a 36 year old female and breast fed all three of my children.  I am a small A cup and want to be at least a small D cup. Would 421 cc of silicone breast implants be enough? Also, which is better moderate profile or high profile?

Ryan Neinstein, MD, FRCSC · Answer

420cc is a large implant, it all depends on what you are looking for. Without examining you I assume this implant will give you a large wow factor if that is what you are looking for

Lewis Albert Andres, MD · Answer

Hello!  Thank you for your question. In 
general, implant size does not 
correlate with bra cup size.  The cup size itself will vary from 
manufacturer to manufacturer as well as who is doing the actual 
measurements.  Thus, cup size is never a reliable indicator for your 
breast size.  I typically encourage my patients not to communicate her 
desires in cup size but more on the actual look and appearance. Given 
your desires, a breast augmentation, with an implant or fat grafting, 
would be an ideal procedure that would meet your expectations.  Breast 
augmentation is now the most popular procedure performed in plastic 
surgery today.  One tolerated very well by women with minimal downtime 
and high patient satisfaction.  Good 
communication between you and your surgeon of your expectations is 
warranted - choosing your surgeon wisely is the first step.   Discussion
 
of your wishes and having an honest and open dialog of your procedure is
 mandatory (e.g, implant type, incision, placement, etc). Your height, 
weight, breast width, and body habitus will make a difference for which 
implant style/projection to choose.  Implant 
profile will also make a difference on the projection, which will 
influence overall breast/cup size.    I have found
 
that photographs brought by the patient is helpful to get a 
visualization of the appearance you wish for in terms of size, shape, 
fullness, etc.   In addition, your surgeon's pre and postoperative 
photographs should demonstrate a realistic goal for you of results.  
Sizers are helpful during an in-office consultation.  Once this has 
been accomplished, allow your surgeon to utilize his/her best medical 
judgment during the procedure to finesse the best possible result for 
you after preoperative biodimensional planning and fitting the right 
implant for your breast width.  This is the most important determinant 
for the sizing of implants, which will provide the optimal result and 
most aesthetically-pleasing result for you.Consult with a 
board-certified plastic surgeon well-versed in breast procedures who 
will examine and discuss with you the various options and factors to 
consider and help you decide which one will be the right one for you.  
Hope me that this helps!   Best wishes for a wonderful result!

David E. Kim, MD · Answer

This would be a great question for your surgeon. If you don't have a surgeon yet go on a few consultations with board certified plastic surgeons and they should be able to help you decide on a size.

Otto Joseph Placik, MD · Answer

Size is a complex decision that is not only based upon your height, weight and current cup/bra size but ALSO on also on your breast diameter, waist, shoulder, and skin envelope measurements. These can only be assessed in person during a consultation.

Thomas Fiala, MD, FACS, FRCSC · Answer

When women come to me for breast augmentation, they often have been thinking about what they want - which is good.  But unfortunately, they get caught up in the details - like the number of cc's - which can certainly be confusing.

	Overall, it's more helpful to think about proportions, rather than implant volumes.

	At a consultation, we talk about the shape you want, and about how your body frame and proportions influences the selection of the implant.  A 421 cc implant will look very different on someone who is 5'0" and 95 lbs, compared to someone who is 5'8" and 170 lbs.  It's really about the proportion of the implant compared to you, more than the overall implant size.

	Then, based on a series of measurements, we can find a selection of choices that might work for you.  Next, trying them on in a sports bra & T-shirt and getting you to look in the mirror, although it sounds simple, really helps.  It's more important that you like what you see in the mirror, than what the implant fill number (421 cc) is.

	So, the answer isn't exactly simple.  But an in-person consultation can help sort this out for you.

Armando Soto, MD, FACS · Answer

Hi there-
One of the things I find most interesting is the amount of misinformation the average patient must sift through when researching breast augmentation surgery. In particular, I think that many patients become overwhelmed with implant choices and the abundance of information about these options available on the Web.
This is complicated once they contact a surgeon or two for information about the implants, and which is most likely to give them the result they desire. Somewhere along the way, opinions expressed by a surgeon are perceived as fact by a prospective patient (because of the surgeon's reputation or the apparent strength of his/her opinion), who then becomes more confused when she hears a differing opinion.
This leads to ridiculously technical questions being posted on sites like RealSelf and others, such as:
"I am 5'5", 125 lbs, my measurements are 34, 22, 36. I have had 3 babies, all by C-section, and I breast fed two of them. My breasts sag a little, but not as much as some women I have seen. I want to have a full C-cup breast. Should I get 325 cc Allergan 410 style implants, or Mentor 350 cc Moderate profile implants. Projection is more important to me than a natural shape..."
Every time I get one of these over-thought questions, I always think the same thing... ???????
Let's take a big step back from the trees here and take a look at the forrest in front of us, shall we?
Fundamentally, the reason any woman seeks breast augmentation is because she wants to achieve a certain appearance, right? Let's repeat that- to achieve a certain appearance. NOT a certain bra size, or a certain implant volume, or even a certain implant type. When  you first stared to think you might want an augmentation, you didn't think, "I would like it if I could have 350cc implants"... You probably thought, "I would love to look like that (after admiring another woman's breasts)..."
So if we can agree that what you are really after is an appearance you would be happier with (as I always tell my patients), let's make the desired appearance the focus of our communications...Let us both ignore bra sizes (which are not standardized and the choice of which is very arbitrary) and implant types/sizes (for now)... Let's first understand what you want to look like. I think you would agree that if we are able to make you look the way you wanted to look, the letter on your bra and the number on your implant is lees important, right? Help me understand what you want to look like, and I can give you a very accurate recommendation of options for achieving that appearance -- provided a careful physical examination has also occurred.
Why is the exam so critical? After all, can't we just put small implants in women who want small breasts and larger implants into those who want larger ones?
The exam is critical, because for any one particular woman, there are only a few good choices of implants available, regardless of her goals, and these options are arrived at by taking careful stock of her breast tissue, skin, and frame. In other words, your anatomy will, to a large extent, help us understand the implant options that would make you look the best. This is the "One Right Result" concept. The taking of these measurements is so important, I do it myself every time, and based on these measurements and my patient's goals, then make recommendations regarding the implant options available to her (as these options would be different for different women).
While (as with any aesthetic procedure) no guarantee of outcome can be given, you are much more likely to achieve your desired outcome if you focus on communicating your desired appearance successfully with a skilled and experienced, Board Certified Plastic Surgeon than by over-researching the implants and micro-managing the details of the surgery. In fact, I can think of no better way for you to increase the odds of you ending up dissatisfied.
So don't over-think it. Think carefully about the appearance you want, communicate it carefully to your surgeon (using photos if possible), and make sure that the implant choice arrived at by the two of you together is based on both your anatomy and your goal. You'll be happier and the process will be less stressful!

Sam Jejurikar, MD · Answer

Hi,
Without examining you, taking measurements of your breasts and chest wall, and examining the quality of your breast skin and breast supporting ligaments, it's simply impossible to answer your question.  
The chest wall diameter, breast width and height are all important factors in selecting an appropriate implant. The breast skin envelope is only so large; selecting an implant that is too large invariably means that implant will sit too high, too low, or too lateral.  If a patient has a narrow frame and desires a really large enhancement, I am be more likely to recommend high profile implants.  The profile of an implant equates to the projection of that implant.  For a given volume, the higher the profile, the fatter and narrower an implant is.  As a result, higher profile implants tend to provide more fullness and a rounder appearance to the upper portions of the breast.  Higher profile implants tend to be really useful in women with relatively narrow breasts who want significant enlargement of the breasts; in these women, if a low or moderate profile implant were selected, to achieve the desired volume may entail the implant riding into the underarm region.  In contrast, a patient with a wider build or wider breasts may find that high profile implants may fail to adequately fill their entire breast; they often times benefit from implants with lesser projection.  
Your best bet is consultation with a board certified plastic surgeon.  Best of luck.

Richard Baxter, MD · Answer

If only it were that simple! The thing is, we are stuck with a cup size system that was developed as a way to determine bra size without directly measuring the breasts. So cup size depends as much on the size of the chest as much as the volume of the breasts. 
For these reasons, there is no magic number or implant type for a certain cup size. What we do here is have the patients try samples on in a bra of the size they want. Once we know the size, then we match the volume to the base diameter to determine the implant profile.

Sugene Kim, MD, FACS · Answer

There are several variables in determining implant size.  When recommending implant size for my patients, I consider the followings: 1) patients' anatomy (height, weight, chest width, chest height, amount of breast tissue) and 2) patients' desired look/goal.  Without knowing your chest measurement and breast tissue amount, I cannot give you any recommendation.  You should visit with board-certified plastic surgeon who will examine you.  Try implant sizers to get a rough estimate of the size you may want.  As you know, bra/cup size will vary depending on the brand.  Good luck with you.

	 Dr. Sugene Kim

C. Bob Basu, MD, MPH, FACS · Answer

It is very difficult to predict what cup size you will be after your procedure.  Cup sizes are not standardized.  So a D cup in one designer could be a C cup or B cup in another designer.   This is the approach I use to help guide my patients with their implant size selection:

	I consider two factors when selecting implants for my patients:

	1.Dimensional planning
	2.Gel Implant Sizing system

	Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.

	Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look.  If you have decided on saline implants, then based on the gel sizer you select, we can guide you to the saline implant that achieves a similar look.
	Hope this helps.
	Dr. Basu
	Houston, TX