Should I go bigger than 300c moderate under the muscle silicone round implants? To achieve the results I love (Photo)

Hello and thank you for your question. You are a great candidate
for a breast augmentation.  300cc or slightly larger may be realistic for you to achieve your goals.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  This entire surgery
can be performed with a small incision technique.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Achieving the perfect size can't be determined via online questions.  This would need to be determined and a lengthy and thoughtful consultation, showing pictures, trying on sizers, etc.  Everyone holds the volume differentlyBest of luck!
Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

First, from photos alone and without a clinical exam, it is really hard to know which size is going to help you achieve your goals.  From the photo that you provided, I would say that 300 cc is not going to allow you to establish this much of a volume increase.  Also, I would discourage you from the moderates since they tend to be wider and, in my opinion, give much less lift and shaping for my younger patients.  In my practice, we employ a formalized plan that helps our patients achieve their desired size and shape which includes the following:In-person consultationBreast measurementsDiscussion of goals Pre-operative meeting to review photos (2-3 that you bring in demonstrating a volume relationship that you find attractive) and choose a style of implant and size rangeUse of implant sizers in surgery to actually see what specific volumes accomplish with your specific tissueI have found that this approach generally allows us to be very specific in terms of identifying what it is that you want and what we can actually accomplish with various implant styles and sizes.Above all, make sure and meet with a Board Certified Plastic Surgeon who specializes in breast enhancement.  Who you choose for your initial surgery makes all the difference in terms of outcome not only for your first surgery but also potentially for any additional revisions down the road.I hope that helps and wish you the very best!-Gregory A Buford MD FACSBoard Certified Plastic Surgeon and Author

Dear babesbabes,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, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

An in person consultation would be necessary to perform a breast implant sizing evaluation to determine if 300 cc fits your muscle pocket.  Most patients think in terms of cup sizes; where breast implants are measured in volume.  The average breast implant in the US is 350 cc.  Typically you will not notice a significant different between breast implant sizes unless they increase by 100 cc's. Try on a profile bra with sample silicone implants under a tailored blouse, tight sweater, swimsuit, and other garments you typically wear so that you have the best idea of whether the garments fit as desired with the implant selected.  I would recommend that you go with the size that boosts your self-esteem, and fits your anatomy.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

I appreciate your question!

After performing hundreds of breast augmentations, I have found that the size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision. Bringing photos as well can help us to finalize, but please understand that these are of other people’s bodies and your results will probably be different.

Silicone will give you fullness at the top (upper pole fullness). Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured.

Anatomic gummy bear implants might be a good choice to give you a more natural look. These highly sought after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, is a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.

We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast.

The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon 

#RealSelf100Surgeon

#RealSelfCORESurgeon

Hi there. Thank you for the post. It is really impossible to predict from photos alone whether 300cc is the right size for you - that is something best determined during a consultation based on your measurements and a trial of implant sizers. Having said that, 300cc is an average implant size and therefore is likely to be close to the mark. Good luck!

and use unlined bras to 'see' what you will look like.  Adding 10% to the sizer volume to choose your implants help achieve the look you saw so does a 300 cc sizer give you the look you want?  Most in my practice, unless very petite, choose implants much larger.  And I only overrule when they start looking ridiculous with their desires.  And if torn between two adjacent sizes, always go with the larger one as the most common complaint in my practice is 'I wish I went larger'....

Implant volumes do not correlate with cup size too well. You can do a baggy test and fill it up so that it fills the bra you want to wear.  This will give you a rough idea of what volume will be reasonable.

There are 4 basic questions that need to be answered before breast implant surgery:
Location of scar (incision)Above or below the muscleType of implant (saline/silicone, round, anatomic, high profile)Size of implantThe hardest decision to make, BY FAR, is the size of the implants.  Please see a board certified plastic surgeon who performs breast implants frequently to help with your decisions.
Based on the photographs submitted:
The right breast is larger in size than the leftThe right nipple sits lower on the chest wall than the leftThere is mammary ptosis present on both breastsThe diameter of the right areola is larger than the leftThe base of each breast is wideThe cleavage area is wideThe left inframammary crease is slightly higher than the rightI believe you are on the right track with your implant size and selection, maybe a bit larger in size would be appropriate if going under the muscle.  When implants are placed under the muscle they tend to flatten out more and look smaller than anticipated.  A basic rule of thumb is 200 cc for each cup size, so if you are currently a B cup and want to go up to a D cup, then a 400 cc implant might be a better choice.
Good Luck!