How to choose between implant sizing options?

Question

Deciding on replacement implant size, I currently measure a 12 on my right breast and 13 on my left, that 1 having a capsular contraction. I have 15 year old moderate saline 360 filled to 365. I am at a toss up between a 445 SCX that has a 12 width and 6.1 projection and a 415 SCF that has a 5.1 projection and 12.5 width

Wess Cohen, MD · Answer

It can often be difficult to know the exact size that would fit you appropriately when performing a revision. Especially when the breasts are uneven with capsular contracture. I find it helpful to go to the operating room with a few different sizes and “try them on” to see what looks best. This requires a full understanding and trust between patient and surgeon that you are on the same page. Lastly, do not get too hung up on a 30 mL difference between implant sizes as that is approximately 2 tablespoons of actual volume- a drop on the bucket for 400+ cc implants.

Daniel Barrett, MD · Answer

Dear Independent484891,
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
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

The difference is about one tablespoon in size between the two sizes. I would suggest trying on both and seeing if you can even tell the difference.

How to choose between implant sizing options?

Answers (3)

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