Are 450cc high profile breast implants too big for me and is mild pectus excavatum going to be a problem? (Photos)

Hi.  To appropriately discuss implant size and choice, you really need an in person evaluation by a plastic surgeon with good experience with breast augmentation.  Opinions and preferences will vary somewhat from one surgeon to another surgeon.  Personally I start with the base width of the patient as the starting point for the footprint of the future implant.  Tissue characteristics, and desired postoperative size, and patient anatomy all factor in to the proper selection of implant volume as well as profile.  I go over all of that all in detail with my patients at the time of their consultation.
I would recommend consulting with a board-certified plastic surgeon with good experience in this area.  He or she can thoroughly review the options with you so that you can make a good and well-informed mutual decision.
Good luck and take care, Dr. Howell

Depending on the individual anatomy and desired results, estimations and measurements should be made for each patient individually. The elements that form up the breast shape and size can be different in each person. Your pectus excavatum may also be improved with fat grafting. It is best to consult a board certified plastic surgeon who is experienced in cosmetic breast surgery in person and discuss your goals and options after a physical examination.Hope this helps,Ali Rıza Öreroğlu, MD FEBOPRASEuropean and Turkish Board Certified Aesthetic, Plastic and Reconstructive SurgeonIstanbul, Turkey

You need a formal evaluation by a licensed plastic surgeon and expert in breast augmentations to determine what is best for you and your goals.Proper breast enlargement is not a "cookie-cutter" procedure where the same technique is applied to every patient. Every woman who comes to my practice has unique needs and different goals for her breast augmentation. As a board-certified plastic surgeon, I always listen carefully to each woman's concerns and thoroughly discuss the key points of the procedure. I also take into account their overall height and weight, the size and shape of the underlying chest and ribcage, the tightness and elasticity of the skin, and the amount of natural breast tissue. Prior to the procedure, we discuss and make decisions regarding location of the incision, whether to place the implant under or over the chest muscle, and what type of implant to use (I offer multiple types of silicone gel breast implants, as well as saline implants).
My experience performing thousands of aesthetic breast surgeries in a wide anatomical range of patients enables me to achieve consistently beautiful and natural results that are customized to each patient’s body type and goals. These results are the product of extensive communication, meticulous planning, and skillfully executed surgery.
I suggest consulting with a board-certified plastic surgeon and expert in Breast Augmentation surgeries. - Dr. Cohen

In my practice patients choose their breast volume. In order for that size implant to conform to the dimensions of the patient's chest different profiles are available. In your particular case it looks as though a high profile implant would be necessary to give you the 450 mL volume without breaching the diameter of your breasts. High profile implants in my opinion do look somewhat artificial.

Hello and thank you for the question.  You should go back for another lengthy discussion with your plastic surgeon. Most plastic surgeons use many modalities including in-bra sizers and goal pictures to select the final implant. Your final result depends on lots of things including your chest wall anatomy, skin envelope, and degree of breast ptosis among others. My best advice is that you communicate your goals and aesthetic ideals with your surgeon as clearly as possible and trust your surgeon's skills and abilities to deliver what you are looking for. Best,

Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon

Hello and thank you for your question.    Based on your photographs alone, I think you would be an excellent candidate for a breast augmentation -- I do think, however, that a 450cc implant may be large for your anatomy.   The proper implant selection involves a number of different issues.  I would first have a detailed discussion with you to clearly define your desired breast outcome goals – this would include not just the size you would like to achieve, but also your ideal breast shape.  I would then select the best breast implant for you based on volume of the implant, projection of the implant, contents of the implant (saline vs silicone), shape of the implant (round or anatomic), surface of the implant (I only perform smooth), position of the implant (over or under the pectoralis muscle, skin stretch of your breast (more stretch would require a larger volume to fill, as in your breast), degree of breast sag (which would benefit more from a lift), breast diameter and overall chest circumference, native breast tissue volume, and any history of prior surgery or trauma to the breast.

The next step for you is to seek out a board certified plastic surgeon who specializes in aesthetic plastic surgery.  In your consultation, be sure your surgeon addresses all your concerns and discusses the surgery details including the position and size of the incision used, the type of breast implants available, the risks and benefits of the procedure, recovery time, and post-operative course.  Also, be sure to see plenty of before-and-after pictures in women who have a similar breast appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome. 

And lastly, I think the most important component of the consultation is to establish a good connection with your plastic surgeon.  It’s the connection that allows you to clearly define your desired breast outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.  

For more information on breast augmentation, please refer to my link below.

Good luck.  

Mark K Markarian, MD, MSPH, FACS

Harvard-trained Board Certified Aesthetic Plastic Surgeon

At size 32, each 100 cc of implant corresponds to 1 cup size change.  450 cc implants weigh 1 lb each and will take you up 4 ½ cup sizes.  Also, these implants will not fit retro-pectoral.  They will have to be placed pre-pectoral or dual plane and the implants will descend.  I recommend you reconsider the volume and go more conservative.  The only thing holding up your breast implants will be the skin envelope.Best Wishes,Gary Horndeski, M.D.

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. 
With regards to your specific question, in cases of pectus excavatum a high profile device often serves to hide the depression in the chest wall within your new cleavage. The narrower device is often better suited for the more limited planar surface of the chest wall.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
 
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Verified Member
Real Top 100
RealSelf Hall of Fame

sounds like a great size for you.  keep in mind that your pectus will still be visable.  good luck

Hello and thank you for your question. You are a great candidate for a breast augmentation.  450cc may be a large size for your chest wall diameter.  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.  

Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon