Is 500cc saline implants okay for my size?

Dear jmolina202511,Breast implant type and size selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion of the pros and cons of the various types and sizes. But the decision will always start and end with the patient. 
Determining the ideal breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient. 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 its 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, everyone of them have 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.
Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery 
Member, Am. Society of Plastic Surgery

It is very difficult without assessing you in person to know what implant size will be a good size for you. Keep in mind that implant size selection not only depends on your personal preference, but it also depends on your unique measurements. There are various types of implants that can help you attain the look you are going for. Sagging depends on your body and your tissue quality. A thorough consultation with a board certified plastic surgeon will allow you to communicate what your desired result is and will inform you as to what is possible to achieve your goals. We have a device called the Vectra 3D imaging system that shows you what you will look like with any implant. Our patients are very happy with the choice of implant they make when using this system. To learn more about breast augmentation, you can read “A Comprehensive Guide to Breast Augmentation.”

I appreciate your question!

After performing hundreds of breast augmentations, I have found that the size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision. Bringing photos as well can help us to finalize, but please understand that these are of other people’s bodies and your results will probably be different.

Silicone will give you fullness at the top (upper pole fullness). Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured.

Anatomic gummy bear implants might be a good choice to give you a more natural look. These highly sought after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, is a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.

We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast.

The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon 

#RealSelf100Surgeon

#RealSelfCORESurgeon

It is important to discuss size and shape of a breast implant with your plastic surgeon as it pertains to you and your chest. A breast implant will not lift the breast and a larger breast implant will not correct sagging but only cause more sagging. In a breast that has good shape and is deflated, a breast implant should help though the degree of skin stretch is vital in determining longevity. Saline and silicone breast implants look the same but silicone definitely feels more natural and lasts longer. 3D imaging may give you an idea of what you will look like with implants.

As many have already told you, it is hard to answer this question without more information. My guy reaction is 500cc is too big for someone of your height. You didn't exactly say this, but are you using that big of implant because you have extra breast skin from your weight loss? If this is the case, 500cc implants might avoid the need for a breast lift for now, but will inevitably lead to large, sagging breasts in several years. It is best to get a second opinion in a situation such as this. Best of luck!BH

Please consult with breast implant specialists in your area to make best recommendations for your body frame, base diameter, and tissue quality for sizing of implants 

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  500cc is a large implant.  I prefer to use silicone over saline for my patients.  Most patients feel that silicone has a more natural look and feel than saline.  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.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Thanks for your question. During the exam, measurements are taken to assess the breast and to allow comparison b/w the right and left side. One of the most important measurements is the base diameter. This is how wide the breast is and is an indicator of which implants will "fit" on your chest. The laxity of the breast envelope is also important in sizing. In your case it is hard for me to imagine that a 500CC implant will not be too wide. I also would not recommend using a saline implant. Silicone is a far better choice in that it looks and feels more natural and is associated with less need for reoperation. Best of Luck!

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Thank you for your question!  Of course without seeing you in person and/or seeing photos I cannot make a specific recommendation.  However, plastic surgeons take many factors into consideration when helping women choose the breast implant size that best suits their proportions and matches their goals.  Height and weight will be part of the consideration but so is your breast anatomy.  I would recommend meeting with a board certified plastic surgeon who has many years of experience with breast augmentation surgery.  They will help you choose a size that’s best for you and hopefully you will be able to try on the implants so you can visualize yourself with that size implant.  Best of luck with your breast surgery!