Not sure of which size to get - is it best to go a bit bigger when going under the muscle? (Photo)

I had 300cc LP breast implants 10 years ago but need them replaced. The surgery at the time was simply to give a lift to my naturally large breasts - I am a 30F natural (or 32DDD) and am happy with that size. I had a recent weight loss and started into fitness - my breasts go smaller (32D)...

Doctor Answers 2

Larger Implant Can Help - But Consider Lift As Well

For women with moderate to severe breast sag, a breast lift (mastopexy) may be recommended to ensure the best result and longest lasting result. Failing to have a breast lift when necessary will only lead to a less than ideal result leaving the patient unhappy and needing a revision surgery. A larger breast implant can help lift the breast, but the low hanging breast tissue will still be present causing a disconnect between the implant and breast tissue located at the bottom of the breast. Therefore, if you are getting the revision for overall improvement, for lift, perkiness and size, then do not only consider the larger implant, but make sure to talk to your surgeon about the lift as well. Best of luck!

Orange County Plastic Surgeon
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Not sure of which size to get - is it best to go a bit bigger when going under the muscle?

Thank you for the question. No, in my opinion, it is not possible to accurately determine how many CCs the you would “lose” when undergoing sub muscular breast augmentation surgery. I would suggest that you do not make your decisions based on statement such as: “you will lose 25 or 50 cc of volume when breast implants are placed under the muscle”. These statements are simply not reliable enough to utilize clinically. 

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant size/profile selection) is: 1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work. Sometimes, it is necessary to seek several consultations before you feel comfortable about your choice.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "DD or E cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, best not to discuss your goals and/or judge the outcome of the procedure performed based on achieving a specific cup size. The use of computer imaging may be very helpful during the communication process. The use of in bra sizers may also be helpful. In other words, use as many “visual aids” as possible during the communication process. I encourage patients to meet with me as my times as necessary, to feel comfortable that we are both on the “same page”.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery. I generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.

I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes.

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.