5’5”, 125lb, active mom, bw 12.5. Implant size and profile recommendations? (Photos)

Question

I have gone to a few different surgeons for consults and my most recent one (the one I’m booking with) is suggesting the largest of them all. I tried on a 300cc sizer (he said that’s approx what a 345cc mod profile would look like on me placed under the muscle and it felt so large and like they stuck out too much. With my BW of 12.5 he said my next option below that drops to low plus profile of 285 (which would look more like a 225 placed under the muscle). I’m leaning towards this as I really don’t want breastthat project outward a lot and look like two round balls I am wanting a nice slope and also want them to look nice in a hoodie/baggy clothes. I am fairly petite and when I tried a hoodie on with a larger implant I felt huge as they made like a “tent” Anyways.. will I be disappointed with 285cc low-plus profile like he says I will? Or is he just used to patients who want larger breasts?? I really wish I could do like a 300 moderate profile implant but he said they don’t have any that fit my BW I currentlt have barely any tissue (after breastfeeding 3 children) but I was so happy with my breastfeeding breast and kind of want that look but slightly larger. (I’m attach my breastfeeding breast photo)

Luis A. Mejia, MD · Answer

Thank for your question, No, you likely won't be disappointed; your surgeon is simply accustomed to patients who prefer a larger, high-projection look. Since you are petite with minimal tissue and want a natural slope that sits comfortably under a hoodie without creating a "tent" effect, trusting your instinct and going with the 285cc low-plus profile is the best way to achieve the understated, breastfed inspired shape you actually want.
Dr. Luis Mejia Let's make it better

Tyler Frew, MD · Answer

Hi there,
Trust your instincts here. If 300cc in a sizer felt too big and too projecting, a 285cc low-plus is a very reasonable choice for the natural slope you're describing, especially on a petite frame with a 12.5cm base width.
Here's why your surgeon's suggestion and your goal aren't really in conflict:
- Your base width sets the limit. A bigger implant at the same width can only go one way, which is forward. That's the "two round balls" and hoodie "tent" look you're trying to avoid.- With very thin tissue after breastfeeding three kids, more projection also means more stretch on the skin over time. A lower-profile implant that fits your width is usually kinder to thin tissue long term.- Your surgeon is right that under-sizing is a real regret for some people. The fix is to test it properly. Try the sizers on again in a sports bra and a fitted shirt, and then in a hoodie. 3D imaging such as Crisalix can also help you compare 285 vs a slightly bigger option side by side.- Wanting to look like your breastfeeding breasts, just a bit fuller, is a great and realistic goal to bring to that sizing visit.
If you try them on and 285 still looks right, go with what you love seeing in the mirror, not what other patients usually pick. An in-person exam is needed for personal advice, so finalize it with your surgeon at your pre-op sizing visit.
All the best!

Mats Hagstrom, MD (license on probation) · Answer

Each plastic surgeon will have their own way of guiding patients through the implant selection process.
Some plastic surgeons will make the decision based on input the patient other plastic surgeons will ask the patient to make the final decision. Putting implants in a bra is not representative of what it breast or feels like when it’s placed under the pectoralis muscle.
When you put an implant in front of the breast is going to project likecrazy.
After all the implant is in front of the breast now.
Personally, I’ve always used before and after pictures to get an understanding of what the patient is hoping to achieve.
Once I know the look, patient wants when I use that to make the implant selection.
I use temporary sizers during surgery to determine what size implant will give thedesired outcome. I ask patients to give me before and after pictures of outcomes that they like. I bring those pictures with me to surgery.
I have complete selection of implants at my disposal during surgery. Doing this requires either having an implant inventory or sending back all the implants that weren’t .
 This is not convenient, but in my opinion, it’s the best way to get an outcome consistent with the patient’s desire.
No method is perfect,but I have found that working with images is the best way to communicate what someone is hoping to achieve. If you show before and afterpictures, the patient will usually be able to tell you that looks too big, too small or just right.
It is true that many patients regret not having gone bigger initially.
When patients say they don’t want to be big they usually mean it.When patients are just a little gun shy it’s probably OK to go a bit bigger.
If you don’t want really big breast, then you should tell your surgeon that.
I’m not saying that my method of selecting implant size is the way to go, but in my practice, it worked the best.
The profile of the implant generally has to do with how big the implant is in a relationship to the breast diameter. If a patient wants really big implants and their breast diameter is small than you have to go with a high profile implant.
If the patient wants a modest augmentation, then a lower profile implant is going to work better.
The relationship between the breast diameter and the implant diameter is not absolute.
There’s quite a bit of wiggle room, but generally, it should be fairly good fit though the two diameters are not necessarily the same.The difference between 285 mL and 300 mL isn’t very much.
They’re almost the same implants.
The difference in volume is only 5%.
From the information you included somewhere around 300 mL should be about right for you for a modest augmentation. That looks really nice.
I recommend you have your surgeon show you a lot of before and after pictures of previous patients who had similar breast characteristics.
Bring pictures of yourself to as a reference.
Ask your surgeon to show you before and after pictures of other patients who look just like you do.
 Then ask yourself to do augmentations look too big or too small in your opinion?
You should then tell your surgeon which outcomes you think look just right.
Like I said, I make the final decision during surgery but other surgeons like to make the decision before they go to the operating room so they have to carry a bunch of implants back-and-forth.
If you chose your surgeon, well then you chills have a good experience, with a good outcome and a small chance of having problems and needing revision surgery.
Good luck,
Mats Hagstrom MD

5’5”, 125lb, active mom, bw 12.5. Implant size and profile recommendations? (Photos)

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