450cc implants when starting out small going to look huge and silly? (Photo)

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Thanks for your inquiry, but without measurements of your chest it is hard to advise.  Have your surgeon verify that the 450 cc fits well and safely on your chest.  As for as your concern if it will be "too much or look silly?", it is impossible to answer without having a more detailed conversation about your goals.  Good Luck.  

Given your photo and your concerns, I would likely choose a smaller implant to achieve a more natural result. Thin women who choose larger implants tend to have a higher rate of complications, such as rippling or implant visibility. Talk with your plastic surgeon about which implant best fits your dimensions, based on measurements and breast skin/tissue factors. I would imagine an implant under 400cc in volume may be more appropriate.Best wishes,Dr.Bruno

Hello and thank you for your question. You are a great candidate for a breast
augmentation.  The size 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.  This entire surgery can be performed with a
small incision technique.  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.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

It is very difficult to determine the best lift you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implants

I appreciate your question.



The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  

Silicone will give you a fullness at the top (upper pole fullness).



Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.



Anatomic gummy bear implants might be a good choice to give you volume.



These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.



During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.





The best way to assess and give true advice would be an in-person exam.



Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.





Best of luck!





Dr. Schwartz



Board Certified Plastic Surgeon



#RealSelf100Surgeon



#RealSelfCORESurgeon

hello and thank you for your question and photo. This question is best answered in the office, where you can be measured and examined. Generally, it is also best to have the opportunity to try on several sizers to see how the implants fit your frame. 

I would suggest doing the rice test at home. Take a pair of nylons, fill each with dry rice ( 1 ounce = approx 30 cc ) and wear that inside your bra for a day. It will give you a good idea of how much added volume will make you feel. 

You should pick the size that matches your frame and breast width. Make sure the person you are trying to please is you, and not what someone else thinks or says. Having said that, 450 for someone your height is not unusual at all. It is on the higher side of implants but still pretty common. It will end up being in the D+ range.

You should have several consultations with board certified plastic surgeons before making any final decisions. 

As always, best to be healthy, no smoking, and make sure any health concerns you have are managed by your primary care md. 

Best to you.

Thank you for the question. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.  





Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.







 







Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) 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 are 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. For example, I have found that the use of words such as “natural” or "huge and silly" 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. Again, the use of computer imaging has been very helpful during the communication process, in our practice.



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, after the use of temporary intraoperative sizers.







I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Thank you for your question. Without better photographs and actually examining you, your question is difficult to answer. Basically, your wants, desires, and goals along with your breast size and shape as well as chest wall shape determine your satisfaction after breast augmentation surgery. When making your decision be sure to seek out a board certified plastic surgeon with experience in breast surgery. Good luck!

In my practice, I have my patients show me what size they want to be when the surgery is finished. Most patients know what they want and they can have fun looking through our pictures to pick their desired size. If their choice is realistic, then I will use sizers in the O.R. to assist me in selecting the exact implant that will give them what they want. In this way I can also compensate for preoperative asymmetry. I do not agree with placing implant under a bra to choose size- because it does not take into consideration the variable each patient presents such as quality and quantity of the skin, muscle, breast tissue, and chest wall.