How Many CC's Should I Go with a Breast Augmentation?

There are many factors that go into deciding on the size of implant to use in a breast augmentation.  Unfortunately, it is not as simple as basing it on your height and weight.  All women have very different breast shapes and sizes even for similar heights and weights.  It is what makes breast surgery challenging but very interesting as well.  Several anatomic factors go into choosing breast size such as width of your breast, any asymmetry between the two breasts (which is present > 95% of the time), the shape of your chest wall, the quality of your skin and soft tissue, etc.  Then, patient wishes on what their goal in breast augmentation have to be considered.  Are you looking for an "augmented" or "natural" look?  Do you want to be very large?  Are you trying to get a lift?  So, without performing a proper exam and discussing what you want from surgery, giving a recommendation is very difficult.  I highly recommend seeking out a plastic surgeon board-certified by the American Board of Plastic Surgery to help you make the best decision for you.  Good luck!

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.

You have already visualized your end result in your mind.  Your doctor should provide a way for you to visually "see" your result so that you can help determine what size implant is best for you.  Ultimately you need to be the one to choose your breast implant size, but you need to listen to the guidance of your surgeon.  Ultimately that is what you pay for is their expert guidance and counsel.

You are tall and weigh only 135, therefore your BMI is 18.8. This means you don't have a lot of fat under your skin. If you choose an implant that is wider than your breast, the border of the implant will show, because there is not enough subcutaneous tissue to create a smooth transition. In patients like yourself the breast base diameter is very important. The skin and soft tissue characteristics are also important. A silicone gel implant would be more appropriate than a saline implant when there is less tissue to cover the implant. I hope making you aware of  these general principles will help you choose the write implant size. Good luck.

I would recommend going whatever size you want to look like. Everyone has a different idea of what is proportional to their body. If I like D cups does that mean you should be a D cup? No, not unless that is what you wanted. The implant should fit properly on your rib cage, so there is that to consider and also what type of look you are going for, more round or more natural etc. But because you are tall you will need more cc's to get to the cup size you want than a smaller person. But without seeing you in person and actually knowing what cup size you wanted to be there is really no way to recommend a cc amount to you.

In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.
Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
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.
I wish you a safe recovery and fantastic result.
Dr. Gill

 The more breast surgery I do the more I realize that there is no correlation between the size of implant and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saiine/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size. 

Much of the final “look” achieved after breast augmentation surgery  depends on several factors:
1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.
3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  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 “C cup” or "fake looking" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.

First, it is impossible for you to have any experience with choosing an appropriate breast implant. Skill and judgment are what you are paying for when you select a surgeon. So what about size? The best advise is to do your homework and know inside what you wish to look like. Out of 'tons' of pictures something should click. There are plenty of others who can tell you how you should look, and dress, but the best judge is you.

Best of luck,

peterejohnsonmd

This is always an anxiety provoking question.  The best answer that I give my patients is be honest with yourself and your doctor with regard to the appearance that you want to achieve.  Once your doctor understands what you want, it is easier for him/her to reccomend an implant size. Do you want to be big? Do you want to be natural?  Do want to eliminate the droop?   Your doctor will evaluate the amount of breast tissue you have, the skin strech which is present, the width and shape of your breast and your chest in addition to other factors and recommend a size.  Question that recommendation.  Try to understand what it is that makes a doctor say that he wouldn't go bigger than 400CC.  Try on the implants again. Bring a friend with you.  Buy a couple of bras, C cup, D cup. DD cup and stuff them and try on your clothes with them.  Look at pictures  and determine what you like and don't like about them. Try to understand that the breast of a woman who has not had children looks and acts differently from the breast of a woman who had had children and may have nursed. Bring all of this information to the consultation so the doctor will have a better understanding of what you want and more importantly, whether or not your natural shape will allow him to acheive that. 

Choosing the correct size of breast implants is very important in achieving a very good and natural result. Factors that go into choosing the correct size include a patient's height and weight as well as breast dimensions. A narrow base of the breast limits the size. Of couse the size that the patient desires based upon photos needs to be strongly considered. But the experience of the plastic surgeon is very important in both determining the size as well as creating the mound. Ultimately the result should be one that is very narural. You don't want to create "watermelons"