400cc Breast Implants with Lift to Achieve Full C-D Range?

I am 34 years old, 5'5" tall at 128lbs, with 36B breast size. I would like a full C-D range post breast lift and breast augmentation. It is really hard for me to decide what implant size to pick. With a moderate plus profile silicone gel would a 350cc or 400cc bring me to the size I want without being too big? My plastic surgeon said that I will lose some skin due to the lift; and with the implants under the muscle, it will also apprear smaller. I like the look of the 350cc sizer, so would choosing a 400cc make up for the loss of skin and appearance of a smaller implant under the muscle?

Doctor Answers 16

Selecting the best size of breast implants

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One of the most important considerations in breast augmentation surgery, with or without a lift, is the selection of an appropriate sized implant. While I always ask my patients what cup size they would like to be, I only do this as a way to help me understand what she is thinking. In reality, the actual cup size is not important as the appearance of the breast. For example, if you came in to my office and told me you wanted to purchase a size 13 shoe, I would respond "that would certainly be possible, but you may not like how it looks or feels on your foot!" So it is with breast implants. I have always felt that worrying about cup size or volume of a breast implant as an initial consideration is "putting the cart before the horse." The real important issue is: Do you wind up with breasts that look good for your body type and size, and do they make you look the way that you want to look.

I always offer my patients the opportunity to try on as many different sizes of implants that they wish so that they can feel comfortable with how they will look with a certain size of implant. That way, we really don't focus on cup size or implant volume. If a 400 cc implant looks best, that's what we use, and whatever cup size it winds up being so be it! You didn't pick your shoe size before you grew feet, so why would you pick your bra size before your actual breast size?

I would encourage you to ask your surgeon to try this exercise with you, and if he or she is not able to do that, consider a consultation with a surgeon who does this because it is a very accurate way to select implants. I rarely if ever have to return to the operating room simply to change implant sizes when we have helped patients select their implants in this way. This tells me that the vast majority of patients are happy with this method, the method is successful in helping them visualize their postoperative appearance, and the result is satisfactory.

I hope this helps with your concern. Best of luck in achieving your goals!

San Diego Plastic Surgeon

Breast sizer to implant conversion formula to predict final size of breast augmentation

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Given the measurements you have provided this sounds relatively accurate.

When an implant is placed under the muscle, you can assume that you will need to add 10-15% above the sizer to achieve a similar augmentation with an implant.

If you like the appearance of the 350 sizer, then doing the math 10-15% would mean the implant would have to be 35-53cc larger or 385-403cc final total volume to accomplish a comparable enlargement. This is only an estimate but it works relativley consistently.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast implant size and cup size.

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1) 400 cc's sounds too big. Very large implants stretch your tissues and age badly.

2) It is not fair or reasonable for you to pick breast implant size. This is a technical decision that is your surgeon's job. All you need to do is make sure your surgeon understands the look you want. And even your surgeon should not make the final decision in advance, because this is just an educated guess.

3) Your surgeon needs to put disposable implant SIZERS inside your breasts during surgery to see for sure which size is best for you. Only then are the permanent implants opened. So your surgeon needs to have an inventory of different size implants available in the operating room.

4) You may find the breast augmentation page on my web site useful.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Best Implant Size Following Lift

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It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 400 cc implant to make her go from a “B” cup to a “C-D” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below.

Finding the Right Amount of CCs to Achieve your Goal

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Breast augmentation performed in combination with breast lift surgery is one of the more challenging procedures performed in plastic surgery. This procedure is associated with a high rate of revisional surgery because of the large number of variables that must be addressed at the time of surgery. For this reason the selection of an appropriate breast implant is even more complicated than with breast augmentation alone.
It’s important to understand that lifting the breasts into normal position will often make them appear larger than when they were saggy. Furthermore, everyone defines cup size differently. For this reason, CCs aren’t easily translated into cup size. The removal of skin during breast lift procedures and the position of the implant relative to the muscle can also have minor effects on the perceived size of the breasts.
When larger implants are used during this procedure the potential for complications increases significantly. Large implants can compress the blood supply to the nipple areola complex and lead to tissue loss. Large implants can apply pressure to healing wounds and cause spread of breast scars. When selecting implants, safety should be everyone’s first priority. For this reason, the use of large implants during breast lift procedures may not be advisable.
Without pictures or a physical examination it’s virtually impossible to determine what sized implant would give you a C or D cup. It’s also difficult to know if a C or D cup can be obtained without significant compromises. These compromises include loss of natural look, increased potential, for complications, and the potential for unattractive scars.
Under these circumstances, it’s important to consult an experienced board certified plastic surgeon. Make sure this surgeon understands your goals and allow him the latitude to make intraoperative judgments that will help accomplish your goals.

Breast implant size

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You may find that an implant with a smaller base width to make your breasts project more forward from your chest wall and body can be sufficient, making a breast lift unnecessary. Consider the Allergan Inspira TruForm 2 implant and an areola reduction if necessary

Excellent thought process

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It is correct that you will lose some size based on the lift, and that the implants appear smaller under the muscle than the sizers look in the clinic.  It is reasonable to add some volume to your implant choice to compensate for these variables.


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When I perform a lift with an implant I do not spend much time on size with the patient, I do spend hours discussing goals and realities. I really believe a nice shape without too much volume is ideal and I achieve this with using sizers in the operating room and taking as much time as it requires to get a perfect technical result

Implant Selection Process

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You bring up an excellent point that a 400 cc implant will look very similar under the muscle and after a lift, in comparison to a 350cc in office sizer.   As you can see, the process can be rather complex.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection to replace an in office exam and good communication with a board certified plastic surgeon.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 95 reviews

Cup size and breast implants

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Thank you for your question.  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.

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.