Breast Implants - 400cc Too Big for Small D?

I recently had breast augmentation and asked the PS for small D full C. I am 5'2, 105lbs and I was given 400cc. I feel like this amount was too big too achieve this look as I started off with a 32C. I have many friends who are taller than me and wider than me and they were given the same amount or even less to go from an A cup to a D cup. I have not D&F yet but thinking in the end I am probably going to be more like a DD or E. Am I being anxious or am I calculating this whole cc's thing wrong?

Doctor Answers 19

Implant CC and cup size

It is very difficult to say whether or not a 400cc implant is too big for your frame without conducting a physical exam.  The appearance of a 400cc implant is highly dependent upon the patient's body frame, weight, height and amount of breast tissue that they currently have and it is important to note that a specific volume or cc will look very different on two patients, even on sisters of a similar body type!  Since it will take roughly 3-6 months to see where your implants settle out and for most of the post-operative swelling to dissipate, I would recommend waiting until you have reached this benchmark to make any final conclusions about size.  In the interim, I would also recommend following up with your operating surgeon to discuss your expectations and goals, as the surgeon might better put your mind at ease during this waiting game.  I hope this helps and best of luck!

Wait to drop and fluff

Bra size is an inaccurate way to measure breast size. Bra cups aren't standardized and so a D by one brand could actually be a C or E in another. It's very unreliable. Therefore, what your surgeon thought was a D, as you requested, could have been true to them. I would suggest you wait until you've actually dropped and fluffed first then consider whether you got the results you wanted.

Also, it's best not to ask what your friends have gotten because their body type is different from yours.

Ronald Levine, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 23 reviews

Breast implant size

The look of 400cc implants depends on your frame, height, body weight, and amount of soft tissue. I would suggest waiting for your post-operative swelling to decrease and for your implants to drop before drawing any final conclusions about sizing. This can take up to six months. Be sure to have a dialogue with your surgeon about your goals and expectations. Best of luck.

Lara Devgan, MD, MPH
New York Plastic Surgeon
4.9 out of 5 stars 16 reviews

Cc's and cup size

Dear Miami4877,

It appears that you are very early in the post op period.  Please, keep in mind that there is swelling that needs to subside and the implants will drop over the next 3-4 months to give you a smaller more natural breasts and look.

400cc implants look different in different people. Considering that you started off a 32C, it is likely very difficult to impossible to keep you a C cup or even a small D. Based on your examination there is a certain volume which best fits your body. Given that you are 5'2" and 105, 400ccs seems a bit large, but I can not tell you for sure as pre-op measurements, photos and exam are all essential in determining the range of implants that would have best fit you. 

Cup size is a ratio of breast volume to chest circumference it is tough to estimate exact post-operative bra sizes. Another confounding factor is that there is no standardization of this ratio by bra manufacturers.
However, a loose rule of thumb is that it takes about 150-200cc to make a change in cup size in a 34 circumference chest. Therefore if you are already a 34C, adding 400 will likely increase you a bit more than 2 cup sizes, likely (but not for sure) making you a DD or even more depending of how full of an C you were to begin with. If you buy 36 size bras you will find that the cup size would be smaller, so you may be 36C or D. Keep in mind, this is a very rough estimate and the goal should be the look and not a bra size. 

My best advise is that you discuss your concerns with your plastic surgeon candidly. Best wishes. 


Too early to tell, be patient

You still have dressings and a "shiny" look which suggests that you are still very early. It takes at least 2 months for settling or "Dropping and Fluffing" to use a popular internet term amongst women in the BA community.

At 5'2" and 105 lbs you are quite petite and especially if you were already a C to start, you may well end up in the very full D or DD range. As to your ultimate satisfaction with your result, it would be best to give it more time.   

David J. Levens, MD
Coral Springs Plastic Surgeon
5.0 out of 5 stars 71 reviews

D Cup after breast implants

I avoid using cup size when discussing breast augmenbtation results with patients. I ude biodimensional planning to give them a rangle of sizes that will look natural and ideal for their body type. Before and after photos can be an excellent way to communicate what you are look for from surgery.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 115 reviews

Implant size

It looks as if you are very early out. It is very hard to tell this early out what your breast size will be. You are very swollen and your implants are riding high. Once everything is settled and the swelling has subsided, then I would judge the size... the process can take up to 6 months.
As for the 400cc, everyone starts out with different breast size and shapes, so to compare with your other friends isn't a fair comparison.
My advise is to wait it out... for atleast 6 months, if you're still feeling like they're too big, then consult with your PS and see what your options are at that point.

Gregory C. Gaines, MD
Gainesville Plastic Surgeon
5.0 out of 5 stars 26 reviews

How To Choose The Perfect Implant Without Doubting Your Choice

I'm sorry you are experiencing this anxiety. If you read patient stories about their experience post-op, you’ll see similar stories to yours and things like:

“If you’re happy with the size immediately after the surgery, you may be unhappy when the implants drop, because they will be smaller.”

“At this stage in recovery, some patients feel regret and wish they went bigger.”

Behind these statements is an idea that a patient’s thoughts and feelings about their decision change as they recover, and that this is normal.

I believe this is an out-of-date way of thinking about breast augmentation. Sure, people may have alternating feelings about this big life decision, but regret should NEVER be a part of it.

On RealSelf, you see so many patients tormented with uncertainty about whether they chose the right implant size or shape; they are anxious all throughout the recovery process, waiting at least 3 months to see the final result. This is a very unpleasant experience no patient should go through.

A patient needs to be educated the right way, they need to have all the right expectations set up front. When this is done right, you should be happy about your breast augmentation and implant choice, from beginning to end. It’s what I expect from all my patients, that they come out of surgery happy, and they stay happy.

HOW TO CHOSE THE PERFECT IMPLANT WITHOUT SECOND-GUESSING YOUR CHOICE

Forget about the “right size” or “best shape”.

I have better news: there is a PERFECT implant size for your goals, and a definite way to go about choosing it.

The perfect implant will look natural and beautiful, whether you go “conservative” or max out on size, and whether you choose round or teardrop shaped implants.

For you to choose the right implant size and shape, there are a few things that you need to understand first.

HOW IMPLANT SIZES ARE CHOSEN

Imagine lying on your back and drawing a circle around your breast. If you draw a line across that circle, it will be a given length. (The length of a circle is called a “diameter”.) This is a measurement that your plastic surgeon will take. The length of this area of your chest is called the “base width diameter” (BWD).

For women, the base width diameter ranges from 9.5 cm to 16.5 cm (3.75 inches to 6.5 inches). As you can see, there is a very wide range.

A smooth breast implant is circular, and has the same measurement as your BWD. So if your BWD is 12 cm, that tells us that your implant cannot be more than 12 cm. It won’t fit. So the BWD determines the max size of the implant, length-wise.

Then the question becomes, how much volume will this implant have? We’ve measured its length, now let’s measure how far out it will project. That projection is the Profile, which comes in low, moderate, full (high), extra full (extra high).

A moderate profile will fit into most women. For the implants with more volume, high and extra high, whether they will fit depends on how much your skin can stretch. The stretchiness of the skin is based on genetic factors, weight, age, and whether you have had children. A woman who has breastfed will have looser skin. That means it can be stretched further and have room for a high profile, if that is what she wants.

For the most part, the implant size and volume is limited by these two measurements: your base width diameter and how loose your skin is. It tells you how much you can max out on. As long as the breast implant is kept within these measurements, you will have a beautiful, natural look, even if you max out.

The “fake,” “top heavy” or “stripper” look happens when the patient wants an implant that is bigger than her measurements. If it does not fit her body, it will look unnatural. So as long as you stay within your measurements, you do not have to worry about looking fake.

DO NOT GET CONFUSED WITH TALK OF CCs

When you are doing research online, looking at other women, the volume of an implant, the cc’s, cannot guide you in breast size. Here’s why . . .

Think about just how wide a range you see in women’s body types, shapes, and frames. That’s why the base width diameter in women can range from 9.5 cm to 16.5 cm.

A smaller implant gets filled up with less volume. It’s common sense. If your BWD is 11 cm, the high profile implant will have 265 cc’s. If your BWD is 14 cm, the high profile implant will have 605 cc’s.


In other words, 265 cc’s and 605 cc’s will have the similar cup size for a difference in BWD. The cc is relative to BWD.

MY SIMPLE PROCESS FOR CHOOSING THE RIGHT SHAPE AND SIZE

Here's my promise to you . . .

There's a simple process to help you select the right shaped implant. Whether you go with round or teardrop, you will be thrilled with your results because we followed this process.  

(FYI: “Teardrop,” “anatomic,” and “gummy bear implants” are all synonymous, they mean the same thing.)

This is how it works.

STEP 1: See your options

During a consultation, I take out five breast implants and put them on a table. Before your eyes are low profile, moderate profile, high profile, extra high profile, anatomic, and saline implants.

Take a moment to examine each shape and size. Notice that the difference between some of the implants are subtle.

I will also measure your base width diameter and ee how much your skin can be stretched. This tells us what room we have to work with. Your implant will be that size or smaller, but no bigger.

STEP 2: Tell me your beauty goals

What is your goal? What look would you like to achieve?

Do you want to go "conservative" with a "natural and proportionate" look? Or would you like to go "as full as possible while staying natural"?

Your answer to this will determine the implant shape that appeals to you.

STEP 3: See how this implant looks on your body

Have you ever had a $41,000 picture taken of you?

When I opened my private practice, the first thing I did was invest in a $41,000 device called the Vectra 3D. It is a must-have tool for getting patients ideal results.

The Vectra takes a 3D photograph of your torso and breasts. Then, the 3D photo appears on a computer screen. On the screen, we can create accurate simulations of what your breasts will look like with different implant shapes and sizes. This will give you a realistic image of what you’ll look like after breast augmentation surgery.

You can experiment with the different implant options until you find the one you are happy with. Being able to see the results with your own eyes, beforehand, is the best way to communicate your desired look with your doctor. It takes out so much guesswork, especially about breast implant shapes and volume (cc).

Now here’s a fact about describing your goals: words can only take us so far. Very often, what a patient thinks, says, and truly wants are all different. You need to SEE what your implant will look like, on your unique body, to confidently say, “This is the perfect implant for me!”

That’s the beauty of the Vectra. It is a visual tool that creates accurate expectations and ensures the best communication. It will cast away your doubts and fears about choosing the right implant.

That’s why the Vectra is a critical investment for any practice. It is so important for giving patients results they are happy with and why, post-op, I often hear patients say, “They’re perfect. This is exactly what I wanted.”

STEP 4: Select your implant shape and size

On the Vectra, when we pull up simulations of your breasts with different implants, you will either like the result, or want to see a different one.

There are two ways you may get caught up. For example you may be caught up between two different profiles or two sizes within the same profile. You’re not sure whether to go medium or high. Or your mind is set on high profile, but you are stuck between two sizes, 345 cc or 365 cc.

If a patient is worried about 345 cc or 365 cc, I tell them that a shot glass has 40 cc. This is a good way of explaining that there really is not much of a difference. On the Vectra, you see that the differences are very subtle, nowhere near as drastic as you imagined.

Finally, you point at the option on the screen and say, “That’s the one I want.” Congratulations, you have chosen the ideal breast implant for you.

After the procedure, your breasts look very much like the way you saw them modeled.

You are thrilled, and like many of my patients, you tell me “I’m so happy with my results. They are perfect, exactly what I wanted. I wish I did this sooner.”

Note: there is an exception to this process. In the rare case that a patient has a long chest wall or "constrictive breast deformity", I would suggest considering an anatomic implant from the start. That shape will look better on this type of patient.

3 DIFFERENT EXAMPLES OF THIS PROCESS

Let me cover a few examples of what going through this process can look like.

Example One: The Patient Whose Taste Is Truly Conservative

This patient tells me that she wants the implant to look natural and proportionate. She does not want to have a dramatic increase in cup size.

Given this desired result, she will like either the round moderate profile or anatomic implant. We will then model both implants on the Vectra 3D imaging software and see which one she chooses.

In this case, it turns out she really likes the anatomic look. I explain that there's about a 1% chance of a complication in which the implant can rotate and require revision.

If she is ok with this, she'll go with the teardrop implant. If not, the moderate profile will meet her beauty goals.

Example Two: The Patient Who Is Afraid Of Looking “Fake”, But Ends up Wanting More Volume

This patient says something very similar to the first example. She wants to look natural and proportionate. She does not want a "top heavy", "fake" or "playboy look".

She does, however, want an increase of "about 1 or 2 cup sizes".

We model the moderate profile or the teardrop. But, it turns out, she wants more volume. At this point, I have explained to her that as long as we stay within her measurements she will have a beautiful, natural look. (A patient’s measurements are explained in more detail in an article about breast implant sizes.)

Because of its shape, there is a limit to how much volume can be added to the teardrop, so, she definitely will be going with a round implant.

She ends up going with a high profile implant, close to maxing out on size. She sees on the Vectra that it looks natural, but that it also has the size and fullness that really appeals to her. She's going to love them!

Example Three: The Patient Who Wants To Max Out From the Start

This patient tells me she wants to go as big as possible (usually while still looking natural).

We choose a round implant with the maximum profile/volume that will fit her measurements.

She sees the results on the Vectra 3D. She is either happy, or wants to go even bigger.

If she's happy, great! We have found the perfect implant for her.

If she wants to go even bigger, I have to explain that we've already seen the max implant volume that will fit her, based on her measurements. Anything more would look unnatural, and, much more importantly, would not be safe.

If she is ok with that fact, we can proceed. If not, I explain to her that ethically, I cannot give her the size that she wants, so if she insists on it, she will have to see another surgeon who is willing to do that.

SUMMARY

There you have it. Following my simple process, you will choose the perfect implant that meets your goals.

Will you want your breast augmentation to look as natural and proportionate as possible? Or will it turn out that you are looking for a fuller look?

After we decide on this together, we will see what this implant looks like on your body with a Vectra 3D simulation. You will be either happy or want to see a what a different option would look like. At the end of this process, we will have found the perfect implant for you!

Therefore, both round and teardrop shaped implants are acceptable choices. What it will come down to is what you think LOOKS best on your body. And thanks to the Vectra, you will be able to see it for yourself and make a choice you feel 100% confident about.

The lesson here is to rely on what you SEE (in the simulation), not on what you "think" will look best, or rules of thumb. Cut out the guesswork. Verbal communication cannot be exact when it comes to your personal preference about a specific beauty look. Thanks to modern tools, and an understanding of how to give patients the results they truly want, there is no reason why you shouldn't be able to choose the perfect implant for your body.

Don't settle for anything less than ideal.

It's for this reason that patients tell me that their results are "flawless" and "exactly what I wanted." They are completely satisfied with their results because they had a very good idea of what they were going to look like beforehand.

Keep doing the research that you are doing. Getting your doubts addressed and your questions answered will help you come to a decision. The best patients are informed patients.

You should now have a thorough understanding of how to choose the ideal implant based on your measurements and beauty goals. You may also want to read up about the breast augmentation recovery period.

And be sure to go to many consultations. Doing so will actually save you time overall. A consultation is where you will get the best quality information directly from a plastic surgeon.

Good luck on your journey!

William Rahal, MD
Beverly Hills Physician
5.0 out of 5 stars 22 reviews

Breast Implants - 400cc Too Big for Small D

It is still quite early in your recovery. Your #healing will continue for 2-3 months for the early period. This includes some #swelling, bruising, malposition, color differences. It is certainly feasible to #downsize to smaller implants and also alter the positioning; if possible. However, decreasing is size may also require a Breast #Lift to #tighten loose skin, better optimize the end result. Any #revision has risks of unhappy outcome or other complications. Also, the right implant for the revision is contingent on shape of body and your desired outcome. Typically, it's best to wait 6  to 12 months depending on the reason for #revision.  Matters such as sagging or drooping  and size change will not improve with time. As with all cosmetic surgery, results will be rewarding if expectations are realistic.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 102 reviews

No surprises please!

Hello Miami4877, Every surgeon uses a different angle when working with patients to determine what size implants will give them the outcome they want. I am a fan of The Rice Test and "Wish For" photos from patients. These tell me exactly how much volume they are comfortable with and what they're picturing for themselves. I have no idea what was the method your surgeon used or what took place, but I can say it is too early to tell what your final outcome will be. Be patient and let your breasts heal and change to their final shape over the next few months. You may be pleasantly surprised.

Please don't be hard on yourself about your "calculating". Relating and utilizing the implant diameter, projection and size to the relation of a patient’s body measurements and current breast volume are part of the process for an experienced surgeon. Patients are never expected to make a determination on this detail at my practice. When you say you agreed on something as ambiguous as a "small D/full C", this can't be. This is arbitrary and not accurate when determining implant size. What is important is how much actual volume makes you happy. What I fear here is that you asked for what you got, but what you got was not what you were expecting in your head. I would recommend meeting with the doctor at your next follow up and voicing your concerns. 

Lastly, don't ever base your comparison on how it looks on a friend. Even though you and your friend may seem similar in terms of body size, there are other factors that must be considered. It’s natural to think “My girlfriend has 400 cc’s so I should get the same size because they look perfect on her.” But the important words are “…on her.”

William Aiello, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 38 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.