I Chose 325cc. My Husband Suggests 350. Suggestions?

Question

I am getting my breasts done in two weeks. I am 28 years old, 5'5, 100 pounds, and a 32A (small A). I wanted to be a full B small C.I dont want to go too big (or make it so obvious I had them done) so I decided to go with 325cc although my husband thinks i should do 350 since "they're isn't much of a difference between them". He read a posting saying that within a year the breast wont be as full. What is your recommendation?

Frank Agullo, MD · Answer

It is often difficult for patients to choose the perfect implant size. A board certified plastic surgeon is very comfortable in guiding you to make a good decision. A combination of body measurements and you preferences are used. You should try the implants under a special bra as well. I like to use the Vectra 3D system so that you can visualize the results with different implants. In your particular case, keep in mind that 15cc is a tablespoon, therefore the difference between the two implants is almost negligible.

John E. Sherman, MD, FACS · Answer

Lisa: this is small potatoes. (No pun intended). The difference between the two size implants is negligible. The most important aspect of the implant is the base width, the projection and the vertical height of the implant. Accordingly, a 350 mL implant may actually have more projection than a 325 mL implant if the base widths are different. The real issue, is whether it is worth arguing with your spouse over this minuscule difference. My vote would be to give into the 350 mL, and just be sure of the base width of the implant is what you would like.

	If this is a real issue..(it should not be) your implants might be with you longer than your husband.

Jaime Perez, MD · Answer

In reality, there is little difference between a 325cc breast implant and a 350cc breast implant; 25cc is less than the volume of a shot glass and less than 2 tablespoons.  I doubt that you, or anyone else for that matter, will be able to tell the difference between a 325cc breast implant and a 350cc breast implant.

	I recommend that you leave the final decision up to your plastic surgeon.  During your breast implant surgery he/she will likely place "sizers" in your breast to get an idea of which breast implant looks the best and is most appropriate for your tissue characteristics.

	Jaime Perez, M.D.

	Breast Implant Specialist in Tampa, Florida

	Plastic Surgery Center of Tampa, Florida

Sugene Kim, MD, FACS · Answer

There is not much difference between a 325 and 350 cc implant.  There are several variables in determining implant size.  When recommending implant size for my patients, I consider the followings: 1) patients' anatomy (height, weight, chest width, chest height, amount of breast tissue) and 2) patients' desired look/goal.  Without knowing your chest measurement and breast tissue amount, I cannot give you any recommendation.  You should visit with board-certified plastic surgeon who will examine you.  Try implant sizers to get a rough estimate of the size you may want.  As you know, bra/cup size will vary depending on the brand.  Good luck with you.
	Dr. Sugene Kim

Tom J. Pousti, MD · Answer

The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used 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 (saline/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 &ldquo;look&rdquo; 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 &ldquo;look&rdquo; 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&rsquo;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&rsquo; 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 &ldquo;goal&rdquo; pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as &ldquo;natural&rdquo; or &ldquo;C cup&rdquo; or "fake looking" or "top heavy" 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 &ldquo;I wish I was bigger&rdquo;.
	 I hope this helps.

Alan M. Engler, MD, FACS (retired) · Answer

Hi Lisa O. in Santa Maria, CA,

	The difference is basically inconsequential.  If you - or your surgeon - chose one size and instead had the other size put in, neither one of you would ever know.  To put it in perspective, 25 cc is just about one ounce (30 cc); the average size shot glass in the US is 45 ounces.  It really doesn't matter.

	Furthermore, no matter what size you choose you may eventually wish you had gone "a little" larger.  That's just the what it often is.

	So, I would suggest that you give your surgeon the general idea of what you're looking for size-wise, and leave it to him or her to decide at the time of surgery.  There are no 100% guarantees regardless of what is decided pre-op, but leaving your surgeon a bit of wiggle-room is likely to be beneficial for all involved.

	I hope that this helps, and good luck,

	Dr. E

I Chose 325cc. My Husband Suggests 350. Suggestions?

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