How many cc of Silicone would I need in order to achieve DD from A sized breasts?

Question

I currently have HP Saline implants filled to 465cc. Before my initial breast augmentation I was (barely) a 34A and am now a 34D. I am going to redo my breast augmentation and would like to switch to silicone implants and also increase in side to 34DD. How many cc of silicone will be required to do so? Please advise.

Jed H. Horowitz, MD, FACS · Answer

you would most likely need at least 600 cc to make a difference in the cup size that you wanti would do a capsulectomy to allow the breast tissue to spread evenly over the new  implant

Christopher J. Davidson, MD, FACS · Answer

Thanks for the question - many patients come to the office requesting a specific cup size - and unfortunately cup sizes differ between bra manufacturers.  Yesterday I saw a patient who was wearing a D cup bra but in my book was not an ounce larger than an A cup...  But it is important to tell your doctor what general cup size you are seeking -since it gives him or a her a sense of approximately what size you are seeking.  The most important thing, however, is to try on implants in a bra and also to use computer simulation - where your doctor creates a digital model of you - we use Crisalix which I love...Anyway - more specifically - keep in mind that if you are looking for an implant that is significantly bigger than 465 cc - and you are a petite woman - a DD sized implant may simply not fit into/within your anatomy.  Definitely a very important discussion to have with your surgeon re what is the largest implant size that could be used given your anatomy.  Best of luck!

Martin Jugenburg, MD · Answer

Hello,Thank you for your question!It may be best to have an in person consultation to discuss sizing, if you are considering going to DD. An implant size on one person may look different on another personYou can learn more on our social media (Instagram and Snapchat): @realdrsix.
Regards,

Larry S. Nichter, MD, MS, FACS · Answer

Probably 100-150 cc's more should do it, however your concept of a DD maybe different than mine. Therefore this is my best helpful considerations: 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 350 cc implant to make her go from a “A” cup to a “C” 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 the link below.

Gerald Minniti, MD, FACS · Answer

Hello,Well, there you've heard it: we can't determine a cup size, either online or in person.  I know it's frustrating because cup size is the only way (seemingly) that one can talk about breast size.  The problem is using it to determine the implant volume. One issue is that variability of cup sizing is great, or in other words, not standardized.  Another problem is individual perception of how a bra fits is also variable. Finally, the shape of your breast can affect how your breast fits into a bra, regardless of its actual volume. The most important thing is not what bra size you're wearing, it's how you look in the mirror.  I tell my patients that they'll need to increase their implant volume by at least 20% to appreciate any perceptible change.  For you, that would be 93 cc above your current implant volume of 465 cc, or about 550 cc.  Whether that's right for you would need to be determined by either using sizers in the office or showing photographs of desired appearance.One final note off subject.  Although you've apparently done well with a considerably large saline implant, further enlargement, even with a silicone gel implant, might put you at risk for rippling, possibly worse than you have now.  Additionally, there might be other unforeseen issues that could happen due to using 'extra large' implants. Please give extra consideration on whether to proceed further; remember, very large implants pose a significant risk of long term complications that may require multiple surgeries. Also, problems can occur that are not entirely 'fixable'.  If you decide to proceed, please consider using a revision breast specialist to maximize your result and minimize the risk of complications.Best of luck!

Kenneth Hughes, MD · Answer

A very general estimate is that one cup size is 150 cc to 200 cc of volume. Kenneth Hughes, MDLos Angeles, CA

Paul Gill, MD · Answer

Thank you for your question. It is much better to accurately discuss implant volume and projection with an in office exam and detailed measurements. In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements/characteristics. I use these measurements to help me during the sizing process to guide you to a safe result for your chest wall and just as important, one that meets your end desires.The next step is to try on this range of implants in the office with your doctor. The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant. It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you during the sizing process. In addition, review of photos and use of rice bags can be very helpful to the patient and surgeon in achieving a safe and happy result. Close intereaction and involvement from your surgeon during this process can help alleviate the anxiety and fears of choosing the right size. I wish you a safe recovery and fantastic result.Dr. Gill

Steven Wallach, MD · Answer

A good thing for you to do is perform a baggy test to add the volume in your new bra to see what it takes to fill.  Simple but not always perfect answer.

John D. Smoot, MD · Answer

Thank you for your question and this is always a concern when someone wants such a dramatic change.  Your focus should be on what looks good and not on the number of CC's or cup size.  Your surgeon needs work with what is possible because what is wanted and possible are not always the same.  I would encourage you to speak to who has done a lot of these procedures and listen carefully to what they say.

Tom J. Pousti, MD · Answer

Thank you for the question and picture.  Generally speaking, the best online advice I can give to ladies who are considering  revisionary 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're looking for. Ask to see lots of examples of his/her work.
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 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.

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 hope this (and the attached link) help.

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