Considering 420cc xtra high profile - is that too big for my frame? (photos)

Question

Hi, I’m 5’5” tall and 120lbs. Pre kids I was around a 30c bra size. I went in to my first appointment with my surgeon and he measured my BWD at 10cm, my NF at 5/6 and ptosis at 4. My goal is to be much larger than I was pre kids. I tried on sizers in the 400cc range and was happy with that look. My surgeon on the other hand comes from a more “natural” look perspective so he seems uncomfortable with my implant size choices. I’m looking in the 420cc range with sientra xtra high. Is this too big?

Brian K. Reedy, MD · Answer

Thanks for your question! As surgeons, we do sometimes limit patients if we can't get them the best result with the size they have chosen. It may not be an aesthetic preference but rather a surgical one. I would suggest chatting further about why that is his recommendation. You can always seek a second opinion. Good luck!

Zoran Potparic, MD · Answer

This is ages old question. Based on your narrow frame I would say that 400 ml plus implant is too large and would look fake rather than natural on you. If you like a fake look, that will work. Smaller implant and high profile should be considered. It is best to select series of breast models that you like and  discuss volume/size with a surgeon. Good luck.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Warren Schutte, MD · Answer

Thank you for the question. I appreciate the approach of the consultation that you had. In my clinic, I always take breast measurements and allow patients to try on sizers. Feeling comfortable with the sizer is the most important part of breast augmentation and your future satisfaction. You have to live with the volume, thus you should be the most integral part of the sizing decision. If you liked the 400 range sizers and the 420 xtra fits your measurments, go for it! Good luck on your breast aug journey.

Ram Kalus, MD, FACS · Answer

“Too big” is subjective and depends mostly on your aesthetics. For your frame and breasts the 420 cc high profile implant is likely to potentially result in an “augmented” or artificial appearance. If this is not a serious concern for you then the implants you are considering may be ok.

One particularly useful maneuver is to share with your plastic surgeon some “wish”
Photos of women’s breasts you find attractive. This can help your plastic surgeon make a more precise implant selection for you. Best of luck to you.

Daniel Barrett, MD · Answer

Dear citronvdh,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Eleonore Zetrenne, MD · Answer

First off if you got that big, it will really stretch out to your skinNumber two a high profile implant on someone of your frame will look unnatural. Do you want to go with moderate plus implants, because that much projection does not look natural. The biggest size you should go should be 375, 350.Listen to your surgeon, because they know from experience that you will eventually become unhappy with the appearance, especially with the weight causing sagging of the skin. You will eventually need a breast lift with this is preventable if you do not go to heavy. As a woman, clothing will become more difficult because of the breast projection and your narrow frame

Camille Cash, MD · Answer

The implant size you are considering will on your frame give you a result that is more obvious, round, and "fake".  When selecting a surgeon you want to be sure that you are on the same page when discussing your surgical goals.  It is important you feel comfortable and confident in your surgeon and surgical plan.

Connie Hiers, MD, FACS · Answer

With that size, you will have a more round and fake look than a more natural look with a smaller size. I would suggest not going any larger.

Daniel Urias, MD · Answer

With a 10cm BWD you will be limited to a much smaller implant than you desire. The implant should not be wider than your breast pocket or you may run into issues with malposition, unnatural look, implants that sit more later or cause synmastia. One solution is to perform fat grafting to the breast for the extra volume.

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