Currently 450cc, planning to go 650-700cc - is 50cc's a really big difference?

Question

I have had 450cc mentor under the muscle high placement for nearly 5 years. I’m planning to go bigger, either 650 or 700cc. My Dr is ok with 650, but is pushing back on 700, even though he commented on how well my current augmentation has healed and held up over the years. How much of a difference in risk is there for 700cc than 650 cc? I’m 5’6”, about 145lb currently (was 135 lbs with my first augmentation), underbust of 30, bust 36, waist 29, hips 41. I realize 450 to 650 is a pretty big difference, but trying to understand why he is so against 700 instead of 650cc.

Mehmet Ozdemir, MD · Answer

While 50cc might sound like a small amount&mdash;essentially a couple of tablespoons of volume&mdash;the jump from 650cc to 700cc is often where we hit a "tipping point" regarding the physical limits of your breast tissue and skin envelope. Your surgeon’s pushback likely isn't about the volume itself, but rather the increased diameter and weight of a 700cc implant on a 30-inch underbust; at that size, every extra gram significantly increases the risk of "bottoming out," thinning of your natural tissue (atrophy), and palpable rippling. In the world of high-volume augmentation, we often see that 650cc provides that "wow" factor while still allowing the tissues to support the weight long-term, whereas 700cc can cross into a territory where the risk of the implants shifting or causing chronic back and shoulder strain rises exponentially. Essentially, your doctor is likely trying to protect the "shelf life" of your results, ensuring you don't end up needing a complex corrective lift just a few years down the road because the skin gave way under the extra weight.

Frank Agullo, MD · Answer

Going from 450 to 700 is a real jump in volume, almost 60% more implant, and your existing pocket has to stretch to accept it. You will absolutely notice that part. Whether you pick 650 or 700 within the range matters far less. 50cc inside a 5+ year stretched pocket reads as a quarter cup to nobody.

The bigger considerations on a major upsize: tissue thinning, capsular contracture risk going up with a bigger pocket, possible bottoming out if your IMF is not surgically reset, and visible rippling if you are thin. High pocket placement also means an upsize tends to look fuller on top, which some women love and some don't.

Your operating surgeon should size you with implant sizers in a bra and walk through profile (moderate plus vs high) since that changes width and projection at the same volume.

#StayBeautiful,

@RealDrWorldWide

Carlos Alberto Ríos García, MD · Answer

A 50cc difference by itself is actually not dramatic visually. Most patients would not see an enormous difference between 650cc and 700cc alone.
The bigger issue is usually not the extra 50cc &mdash; it is crossing into a size range where tissue stress begins increasing more significantly over time.
Your surgeon is probably thinking less about:
* “Can 700cc physically fit?” and more about:* long-term tissue effects* implant weight* bottoming out* stretching* rippling* thinning tissues* and future revision risk
Especially since you already have:
* a relatively small underbust (30)* larger hip proportions* and implants that have apparently held up well for 5 years
he may be trying to protect the quality of your tissues long term rather than simply refusing size.
Going from 450cc to 650cc is already a major volume increase. At that point, many surgeons begin evaluating:
* soft tissue support* skin elasticity* pocket dimensions* nipple position* and implant width
very carefully.
Sometimes surgeons become resistant at certain implant thresholds because they know complications tend to rise disproportionately once implants become too heavy for the patient’s anatomy &mdash; even if the patient initially looks great.
Another important detail is that larger implants can continue changing the breast over time, especially with:
* aging* weight fluctuations* pregnancy* or gradual tissue stretching
So your surgeon may simply feel that 650cc keeps you within a safer structural range while 700cc begins pushing those limits.
In practical everyday appearance, the difference between:
* a well-supported 650cc result vs* an over-stressed 700cc result
may become much more noticeable years later than immediately after surgery.

Daniel Barrett, MD · Answer

Dear Graceful601882,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. 
When it comes to sizing, 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 it is 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, every one of them has 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.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Yily De Los Santos, MD · Answer

Even though 50cc sounds like a small difference, breast augmentation is not just about volume. Implant width, additional weight on the tissues, and how the size fits your anatomy long term all play a major role.

When a surgeon pushes back against a certain size, it’s often not because the immediate result would look bad, but because they are thinking about how the tissues will hold up over time: skin stretching, tissue thinning, sagging, or implant displacement.

With a smaller frame like yours, going from 450cc to 650cc is already a significant increase. The extra 50cc between 650 and 700 may not create a dramatic visual difference, but it can increase tension on the skin and tissues, especially over the years.

It’s also important to understand that two implants with the same cc can look very different depending on base width and projection. Sometimes the desired look is achieved better through profile selection rather than simply increasing volume.

Currently 450cc, planning to go 650-700cc - is 50cc's a really big difference?

Answers (5)

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