Why do some larger implants (550-600cc) look so small, and some small implants (250-300cc) look so large?

Question

I'm 5'4" 160 lbs and scheduled for a tummy tuck, breast lift and implants. I have a small rib cage (32") and very small waist, with a large bottom. When I tried on different sizes of implants I ended up deciding on 390cc, but after looking at a million pics I'm worried I'm going too small. Any regrets not going with a bigger implant?

Ryan Hoffman, MD · Answer

You have an excellent question. Patients can look on the internet and get quite scared prior to surgery.  Implant size choice is one of the issues commonly brought up to me by my patients prior to surgery. Even looking at pictures of people with the same height and weight on the internet make choosing implant size difficult. I use a sizing system in the office and I think that gives patients a good starting point. In the OR, I take the patient's wishes into account and choose the size that looks best based on our preop conversations.Talk to your board certified plastic surgeon prior to surgery and feel confident that you picked a good size prior to the operating room.

Michael A. Epstein, MD, FACS · Answer

Thank you for your question.Yes, the same implant can look quite different in two people, and this is usually based on the beginning breast and chest shape.  Also, absolute cc's in different implants don't give the same shape (you can have a flatter/wider implant and a narrower/taller implant with the same cc's, and the shape given to the breast will be different).The important thing is to pick the implant that is best for you given the results you desire.  The selection begins with your surgeon measuring your breast dimensions and giving you a range of implants that will fit your breast.  Trying on implants is helpful.  We also use the Vectra imaging system to simulate the breast implants in your body to help guide the implant selection decision.In the end, the only way to know if you should have gone bigger is to put in the implants you felt would be the best, and see.  If you desire a larger implant, you can usually switch them out for a larger size (but it does require another operation).Best of luck!

Vincent N. Zubowicz, MD · Answer

An implant of a given size will certainly look much larger on a 5 foot individual as opposed to a 6 foot. Also the native breast volume is a participant in the final overall appearance.

Josh Olson, MD · Answer

Patients
seeking advice regarding implant sizes online will find only general advice
that may or may not be applicable to their case. My recommendations would be to
focus on choosing your surgeon carefully. Find a surgeon with results similar
to your goals. Online reviews can be helpful if you don’t have anyone close to
recommend a surgeon. These days anyone with a medical license can perform
cosmetic surgery so finding a surgeon certified by the American Board of
Plastic Surgery confirms they had appropriate training and experience.

I
prefer to use a sizing system to help decide volume (cc) and then using
patient’s measurements decide the final implant. High profile implants often
are used with larger implants as long as the breast width isn’t too wide. Using
a wider implant than the breast width is often avoided but can sometimes give
the patient the look and breast shape they are going for. There are 3D imaging
options such as Crisalix or Vectra which can also be helpful. The most
important aspect is an open discussion between you and your surgeon. General
terms such as “natural look” or “not too big” can mean completely different
things to any given patient so often photos of what you like or are hoping for
can be very helpful.Discuss your concerns with your surgeon and they can give you better direction with your examination. Try and look for 'before' photos that resemble your current body shape because 390cc on you may look completely different on someone else. Good luckJosh Olson MD

Manish H. Shah, MD, FACS · Answer

Hello tbenson80,Thanks for your question.The relative size of an implant on the body frame is simply a matter of proportion.  Most plastic surgeons try to size implants off the width of the individual implant pocket.  A 390cc implant, if it fits the width of the pocket, is the appropriate size for that patient.  You can adjust implant projection for the same width and this increases the volume of the individual implant.Preop sizing is a great way to get an idea of the best size for you.  That being said, some estimate revision surgery for size alone to be about 50%.  In other words, half of all patients eventually feel that they should have gone bigger.  With this in mind, I would allow your surgeon some leeway in picking a slightly larger size if they think it looks good on you.  This might alleviate some doubt you have currently.I hope this was helpful.Good luck,Dr. Shah

Jane M. Rowley, MD · Answer

How an implant will look depends on the patients preop breast size, and frame.  My best advice is to see an experienced board certified plastic surgeon.  In my experience, managing your expectations preop is more important and time consuming than the actual procedure.  You should be able to try on implants and look at lots of results and discuss what you do and do not like with your surgeon.  Then your surgeon will be able to help select the best implant for you.  Jane

Tom J. Pousti, MD · Answer

You are absolutely correct in that the same breast implants may achieve a very different outcome for different patients. Much will depend on each individual patient starting point. For example, patients may start off with a different volume of breast tissue natively, different chest wall contour ( concave versus convex)  and more or less breast skin elasticity.The best online advice I can give to ladies who are considering breast augmentation surgery is:  1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.   2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural”  or “C or D cup” etc means different things to different people and therefore prove unhelpful.  Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.    3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery. I hope this (and the attached link) help.

Robert H. Hunsaker, MD · Answer

Patients come in all sizes - tall, short, chubby, thin, wide chest, narrow chest, larger breasts, smaller breasts. All of this influence the dimension of the implant needed to achieve similar proportions in these patients. This is why it is best to allow your surgeon to choose the best implant for meeting your goals.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for your question and size is an individual decision based on measurements and sizing with various sized implants.  That said the same implant in different women will look bigger or smaller so photos can be deceiving.  Of course the amount of breast you start with will influence the post op result.Dr. Corbin

John Squires, MD (retired) · Answer

Multiple factors go into picking the appropriate implant size
and shape to get you the results you want. There is no one implant that is
right for everyone. People vary widely in their chest dimensions and amount of
breast tissue they have to start with. These factors greatly affect how a given
implant will look in you vs. other people. Dimensional planning is done with
chest and breast measurements which will show you a range of implants that will
fit your body. This is refined by having you select post operative photos you
like. We also try implant sizers on in a bra to get an idea what the implants
feel like and look like in your clothes. I have done computerized imaging in
the past but do not find it that helpful. Trying implants on in a bra gives you
a much better idea of the weight of the implants and how it will look in your
clothes. Seek a plastic surgeon who is certified by the American Board of
Plastic Surgery who specializes in cosmetic plastic surgery, as evidenced by
membership in The American Society for Aesthetic Plastic Surgery. Ask to see
many pre and post op photos and speak with previous patients.

Why do some larger implants (550-600cc) look so small, and some small implants (250-300cc) look so large?

Answers (10)

More Mommy Makeover Questions

What is a realistic price for a mommy makeover in the CT/NY Area? What is the total time that I need to take from work?

Could I have popped a stitch after vomiting?

Does grade 3 ptosis make for a more difficult lift and augmentation?

What is the percentage for skin necrosis for past smokers?

How soon should I be walking around after mommy makeover?

How soon can someone have a mommy makeover after miscarriage?

WE SEND PRETTY
EMAILS