Will 450 cc silicone high profile implants fit my build? What size do you think I'll end up being? (photos)

Good afternoon!Sounds awesome to me- should put you in a nice mid-D range! Under the muscle, through a crease or nipple incision!

A 450 cc implant will result in a variety of cup sizes based on existing breast tissue, width of your breast, rib cage shape and a number of other factors. 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 450 cc implant to make her go from a “A” cup to a “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 a bit.
Additional critical decisions will also be made by your plastic surgeon such as: whether your implants will be above or below your pectoralis muscle. These choices are recommended to you based on the look you desire, the amount of sagging you may have, and other deciding factors. For more than 25 years, I have tried just about every method to best understand and achieve the patient’s optimal goal. The following is what I have found to be most accurate: To start with, I have found it most helpful for patients to bring in photos from my or other plastic surgeons’ websites to illustrate what they would like to look like. This gives me detailed standardized views and information both qualitative (shape, perkiness) and qualitative (size) and allows me to discuss with my patients how I can best achieve their objectives as well as realistic expectations. For example, though I always tell my patients that I cannot make them exactly the same as a photo because everyone has different anatomical constraints. However, these ”ideal” breast photos are brought to the operating room for reference during surgery so that I have the advantage of “seeing through my patient’s eyes” to best achieve their wishes. Even if the photo does not match their height or weight, I and most plastic surgeons are very good at translating the proportionality of the photo to your features.
I personally order more than one set of implant sizes and use sterile implant “sizers” (temporary implants) placed in the created implant pocket during surgery to know in advance exactly which implant would work best for you in both a sitting and lying down position. This also allows me the opportunity to modify the pocket to meet some of the more subtle shape features desired. This enables me to use my full artistic potential to achieve your desired goals.
Larry S. Nichter, MD, MS, FACS

Hi Pita, I think you are on the right track.  See the answer before mine, also.  I haven't examined you, but I probably wouldn't go any bigger than a 450.  The revision rates over the years goes up as the implants increase in size.  See below, but you will go up approximately 2 plus cup sizes, roughly.  Here are a few tips for you because this is perhaps the hardest decision for a patient to make, as well as the surgeon.  Also see the video attached to my answer.  We spend up to two hours for our BA consults to be sure there is careful communication. We do a full exam in front of a full-length mirror taking six exact measurements.    We put your photos on a large computer screen for imaging, and go over your “ideal-size” photos. We then save this information to your password protected “web account.”     
     First and foremost the implant should fit the dimensions of your breast and tissue cover.  Balancing the implant to your over-all body shape and tissue cover is essential.    The average size chosen over our last 7,000 breast implants was “350cc”.  BUT, >span >90% of our patients tell us they wish they were bigger a year after BA.  (We will see you every year for routine checks at no charge.) It’s like your mind incorporates the "new you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients that they will experience an increase of approximately one cup size per 200 cc.  You can try on implants in the office by placing them into a special bra.  The implant is also flattened somewhat when under the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for flattening of the implant in the partial sub-muscular pocket.  Once you decide on a size you like, then add on 25cc, because in real life the implant will be flattened slightly by your tissues.  Multiple measurements need to be taken to fit an implant to your exact anatomy.  Have your surgeon's office show you the charts of the implant dimensions for the various profiles of silicone and saline from the manufacturer.  Then you and your surgeon can piece together the puzzle by matching your measurements, with your wishes, versus your tissue cover and the available implants to arrive at a surgical plan.  Keep in mind larger implants tend to have more problems over the years.  Since silicone implants wrinkle less than saline implants, they might be your best bet.

     You can also approximate this at home by measuring out an equivalent amount of rice placed into a cutoff foot of old panty-hose, and put this in your bra.  Wear this around the house for a while, and see what you think.  Implant size must square with assessments of tissue cover, breast diameter, and chest wall width.  Multiple measurements of your chest wall are taken (seven in total).  Implant size selection has been an issue of much discussion.

     Therefore, I use a wide variety of methods, but the implant size is always established preoperatively.  Also, patients are advised to bring reference photos demonstrating their ideal size and shape.  A photo album of patient pictures is maintained to assist them.  These photos ultimately help in determining where the implants will be placed, since they can be shifted inside (to provide more cleavage), to the outside, up or superiorly, and down or inferiorly during surgery.  In determining the final size selection, I always place the highest priority on the preoperative measurements and potential tissue cover.  Finally, your verbal requests are factored into the analysis.

     We use the quick-recovery approach, so click on the web reference link below to have this explained and you can see the list of Quick-Recovery (Flash-Recovery or Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery journals.  It is a surgical procedure that uses special instruments and techniques to minimize tissue damage and avoid touching the ribs. It causes far less trauma to surrounding tissue than traditional approaches, and it dramatically reduces pain and recovery time. In published studies of BA patients, 95-percent of women interviewed after the procedure returned to normal daily activities within 24-hours. Quick-recovery BA is not a “gimmick.”  These specialized techniques, which actually speed recovery and get you back to your daily routine, kids and work, are published in our plastic surgery journals.  Because these PS journals are “peer-reviewed” and edited, they are the gold-standard in our field as being valid science. Therefore, these are sound techniques, not marketing hype. 

     Be sure to see only a board certified plastic surgeon (by ABPS - The American Board of Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic Plastic Surgery) and or a member of ASPS (The American Society of Plastic Surgeons).  Also, ask if the PS has an established, high volume breast augmentation practice, performing several hundred breast augmentations each year.  Be sure the PS has been in practice for a while, about 20-years might be a good gauge.  Does the PS offer all three incisions?  Discuss the implant type (gel or saline), shaped "gummy bear" or non-shaped, smooth or textured, implant pocket (over or under the muscle) and the "quick-recovery approach."  Ask to see their before and after photos if you didn’t see any on their website.  If they are experienced, they should have several 100 breast implant patients for you to view.  I would also recommend that your doctor offer you the chance to talk to past patients who would be happy to discuss their experience with you.  You need to feel comfortable, so make sure the environment is safe as in an accredited surgery center.  Also, ask a prospective surgeon if he or she has ever published journal articles in professional peer-reviewed journals, which they can provide you.      

All the best, “Dr. Joe”

Without exact measurements it is difficult to tell. However, I do think that your implant choice will get you to a solid D cup. I think it will look very nice on you.

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. This will ensure that you avoid the dreaded "fake" look. 
With regards to your specific question, it is difficult if not impossible to consistently predict cup size due to manufacturer variability. Whether or not this will "fit" your build is a function of opinion and BWD.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Lack of standardization within the bra manufacturing industry makes it impossible to predict cup sizes based upon breast implant volume measured in cubic centimeters.  The average implant size in the USA is 350 ccs. An ABPS board certified plastic surgeon will be able to guide you to the correct size implant for your measurements and desires.  Measurements of the chest wall and breast imprint width as well as knowledge of all breast implant sizes and profiles should make this process easy. Try on a profile bra with 450cc silicone high profile sizers under a tailored blouse, tight sweater, swimsuit, workout clothes, 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.  Choosing an implant based on an aesthetic goal that exceeds your anatomic capacity may lead to complications and possibly revision. Based upon his/her credentials, trust your surgeon to make the best decision in the OR when the implants are placed.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Dear Pita Lynn,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

based on your photos you appear to be a good candidate for a breast augmentation. The size is hard to determine from photos. 490 seems a bit large for your frame but as long as the width of the implant fits your chest dimensions it should be ok 

Hello and thank you for your question. You are a great candidate for a breast augmentation.  It would also be helpful to know your individual breast measurements in order to determine if 450cc is the right size for you.    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.  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.  

Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

 Thank you for your questions. Before you make your decision on procedure(s) size and shape of implants I would suggest that you meet with a Board Certified Plastic Surgeon again and go over your concerns and what you hope to accomplish.  Your surgeon should be able to explain to you why they are recommending the size and procedure they are according to your current breast tissue, measurements including your chest width and your desired outcome. Your Surgeon should be able to advise you thoroughly on your options.

We have all our Breast Surgery patients not only utilize our 3D imaging so they can get a real visual on what the implants will look like on them but also to actually try on the different size implants with a tight bra and t-shirt to see what they might expect. That way they have a good visual of what a 450cc implant will do as opposed to a 350cc implant for example. You want to make sure that you see a surgeon that will listen to you and your goals for the procedure and discuss in detail their recommendation for size and shape not only taking into consideration your desired outcome but also your breast measurements before the procedure including your chest dimensions. And then let you try the implants that they feel will give you the desired result so you are in agreement with the size. 

Most important is to pick a Board Certified Plastic Surgeon - Certified by the American Board of Plastic Surgery. It can be hard and confusing for consumers when a physician may tell you they are Board Certified. Make sure it is Board Certified in Plastic Surgery as many Physicians are certified but it is in another area such as Dermatology, Gynecology, ENT, or some other specialty that does not have the years of training and Certification in Plastic Surgery required to be a Board Certified Plastic Surgeon.