HP 500cc vs 600cc implants? What should I get to have a D/DD? 5'3" 160lbs 36B Pre-op. (photos)

I'm having mastopexy with implants in 2 weeks but I'm undecided on the size implants I should get. I am 5'3" 160lbs and 36B currently. Looking to get a full D or DD without looking too fake. My PS discussed submuscular HP 500cc but I'm leaning towards 600cc. I don't want to go smaller and regret not going bigger but I also want them to look as natural as possible. Help! I'm also having abdominoplasty if that helps. I'm also trying to lose some weight before my mommy makeover in 2 wks.

Doctor Answers 14

A different way of thinking about implant size

The question is whether a 500cc or a 600cc high profile breast implant will give you full D or DD result.

The answer is, "I don't know." But neither does your plastic surgeon. Or any other plastic surgeon for that matter. Any answer anyone gives you is a guess for two reasons:

  1. No one knows what a D or DD really is. Seems weird but there is no  standard for this. So you probably have a mental picture of what you mean by DD. And your PS has an image of a DD breast. But you have no way of knowing whether you are both picturing the same thing. Statistically, you probably aren't.
  2. No one knows exactly how a 500cc implant will change your breasts. Ditto for the 600cc. Or the 550. Or the 700. Breasts are complicated and come in infinite variety. No two respond exactly the same way to an implant.

Even though this is the most common way breast augmentation is done, it's like trying to shoot a target you can't see using a gun with no sights. Hitting a bullseye would be a matter of luck. Luck is not what you want to base a surgery on.

May I suggest 3 things you can do to take luck out of the equation and maximize your chance of getting results that really make you happy?

  1. Select some photos of breasts that you like in terms of size and shape. (Fortunately, it turns out there are plenty of photos of breasts on the internet.) This process will refine your vision and clarify for you what it is you really want for your results.
  2. Review the photos with your plastic surgeon. Make sure he or she fully understands your desires and discusses them with you. If you don't have a meeting of minds, don't proceed!
  3. Make sure your PS tests the implants he is going to use on you with intraoperative sizers. These are tester versions of the implants that can be used to determine which implants are absolutely best for you. This step does not have to be a guess!

You have my best wishes for a great result!

Richardson Plastic Surgeon
5.0 out of 5 stars 9 reviews

Deciding on Implant Type and Size with Mommy Makeover

Here are some helpful guidelines. 

Usually if a woman wears a size 36 AB bra and would like to be a C cup, which is the average size that women wear and the average size bra that is sold, she needs a volume of approximately 350 to 390 cc to make that change. This becomes less if she's wearing a 34 bra, because it has a smaller strap size and the cups have a smaller diameter. A smaller diameter implant would then be a volume of approximately 300 to 350 cc. In the same way if she was more petite, maybe a double zero or size one and wore a 32 AB bra, then to become a 32C cup she would only require about 250 to 300 cc. This is a general number, and of course there are other factors that will affect this. 

Each implant have their benefits. #SalineImplants is made with a #silicone outer shell that is filled with saline water during the surgery. It is filled with sterile saline (salt-water). Since saline is like normal body fluid, it is safe and easily absorbed if the implants were to leakThe #implant shell is ordered in a specified size which can be filled to a minimum or maximum fill amount. This allows the plastic surgeon some flexibility with sizing during surgery. Often times a woman has breasts which vary slightly in size. If one breast is slightly smaller than the other, each implant can be filled to a different amount to create better symmetry. Saline tends to be a little less natural feeling than silicone, but it can also create a more dramatic upper breast appearance, which some women prefer. A new saline breast implants option called Ideal Implant™ was recently FDA approved and was created for women who are not comfortable having silicone implants in their body, but desire a more natural feeling implant than traditional saline implants on the market. The unique structure of the Ideal Implant allows for a similar look and feel as silicone with the safety of saline. 
#SiliconeImplants are made with a silicone outer shell and are filled with a gummy-bear consistency silicone on the inside. More women tend to choose silicone breast implants due to the natural feel and appearance. Silicone implants are now made of a cohesive gel which are anti-leak even when cut. Look and feel like natural breasts due to the cohesive silicone gel material. New generation silicone gel implants are far superior than those used in the past and have a proven track record of safety. Silicone implants have gone through more testing than any other medical device and are the preferred choice for over the muscle implant placement. 
To further ensure the safety, the FDA recommends women have periodic MRI testing to ensure their silicone implants are free from any defects. With both implant types there are choices 
#Shaped implants are all #textured and should not rotate when used properly. In my practice, about 20% of the patients benefit from shaped implants. Your Plastic Surgeon needs to measure you and determine the best shape and size of any implants that are used.

Furthermore, a Breast Lift with the Implants may be something to consider. 
Getting #BreastImplants without a #BreastLift is usually said to be mistake by many patients who reflect back on the decision. Most breasts will look larger and more droopy with solely implants. They will sag more and sooner, due to the sudden and excess weight. At times it's possible for a “Snoopy” breast or double bubble to develop as a result.

Other factors which contribute to the outcome are size, shape, and profile. 
The #profile is determined by the amount of #projection versus roundness that the you desire, as well as the #size of the implant and size of your chest. Also, the placement or incision location will also have an effect on profile. 
Another element to a satisfying result of your #augmentation is realistic #expectations.
Talk to your surgeon at greater length and be sure to view before and after pictures and reviews beforehand to gain more reassurance of the procedure.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

500cc vs 600cc Implants To Get A D/DD?

Because you have more than adequate breast tissue to start with, either size implant will give you a very enhanced look. Not so convinced about the "natural as possible" look, though, with those implant volumes and your height. And remember, the bigger they are, the harder and faster they fall. You'll need another mastopexy sooner with implants that size. Also, there is no guarantee of a bra size, because different manufacturers make cup sizes differently. Disabuse your mind of the "cup size" thing. Don't pin your hopes on becoming a "D/DD" as you'll be disappointed, even frustrated. In one lingerie shop you'll be a D, another a DD, yet another an E...you get the picture. Go based on your proportions, not some arbitrary size. A tummy tuck will make your breasts look bigger as your waist will become smaller, relatively speaking. Finally, safe weight loss is about 1-2 pounds a week, so that amount of weight loss will not really make a big difference for you. Not deterring you from eating more healthily and exercising, as you should always be doing that and it will only work in your favor, but you're not going to lose a significant amount of weight in 2 weeks in a manner that's safe. Crash dieting or starvation before a surgery is not recommended. If you feel strongly about being a healthier weight and BMI (you're currently 28.3) for your surgery and overall health, consider postponing your surgery and getting the aid of a nutritionist and personal trainer. Wishing you a safe surgery and healthy recovery!

Millicent Odunze-Geers, MD, MPH
Sacramento Physician
4.7 out of 5 stars 6 reviews

Choosing breast implants

Thank you for asking about your breast lift and augmentation.

  • I understand completely how hard it is to choose a breast implant.
  • There are many factors to consider, based on examination and discussion with you.
  • You are choosing large implants which can cause healing problems when combined with a lift. 
  • (The large implant pushes on tissues tightened by the lift, cutting off blood flow to tissues.)
  • So review your implant choice with your surgeon, discuss the increased risks you may face with a large implant (they vary with the kind of lift) and go back if possible for a second implant fitting.
  • Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

What size to choose

I would guess that the 500 cc HP implants will give you a great look.  It really depends on your measurements and what kind of lift your surgeon is planning on whether or not the 600 cc would be appropriate.  I don't think you'll feel too small with the 500 cc HP.  Ultimately the bra size is never something we can guarantee because the bra industry has no standard and bra size depends on where you buy your bra.  Discuss your concerns with your surgeon and best wishes.

Levi J. Young, MD
Overland Park Plastic Surgeon
4.8 out of 5 stars 59 reviews

Good sizing systems available to determine the best implant size prior to breast augmentation.

There are very good sizing systems allowing you to see the difference between 500 mL and 600 mL implants on your breast prior to surgery.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

BA sizes

Hello dear, thanks for your post and provided information as well. 

The thing about size is... Did You Know? Implant size (measured by cubic centimeters, or “cc”) only matters as far as it will help you get the look you want. In these photos, can you guess who has the larger sized implants?

What limits how big you should go?

1. Your current breast size. This matters because you’ve got to have enough existing breast tissue to cover the implant. If you haven’t got a lot to spare, some implants may just be too big to fit. 2. Your chest and shoulder width. Fortunately, implants come in different base widths so you can get a size that works well with your frame.

I recommend to make an appointment with a board certified plastic surgeon for a person evaluation and to talk about your goals. 

Good luck :)

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.5 out of 5 stars 398 reviews

The right size for you

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

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Best breast implants for me; breast augmentation/lifting surgery?

Thank you for the question and pictures. Based on your photographs, you should have a very nice outcome with breast augmentation/lifting surgery. You are correct in that there will be limits as to how large of a breast implant can be utilized safely during the procedure.  Remember, that during breast lifting surgery, some skin is removed, thereby limiting the "space" available for breast implants. 

On the one hand, breast augmentation surgery is expanding the breast skin “envelope” while breast lifting is (by definition) tightening up the breast skin envelope. These 2 forces are counteracting each other. Therefore, it becomes important to remove the appropriate amount of breast skin and to use the appropriate size/profile of breast implants to balance these 2 forces appropriately and to allow for achievement of the patient's goals while minimizing risks of complications. 

 Ultimately, you will do well select your plastic surgeon carefully and communicating your goals, questions, and concerns. In other words, careful measurements, dimensional planning, and careful communication will be key.

Also, generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting 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. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or 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 "D or DD cup" etc 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. The use of computer imaging may be very helpful during this communication phase.

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. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.

I hope this, and the attached link, helps. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Breast augmentation with lift, some advices:

Thank you very much for enquire.
After having analyzed all the information and photos provided to us, I realize that you have very sagging and small breasts. In this regard, you need volume (implants) and projection (the lift): Breast Augmentation w/Breast Lift.
I recommend you to use microtexturized highly cohesive silicon implant ("gummy bear" implants), with high projection, and 550ml will be excelent on you, to fill the breasts properly.
Finally, to perform the breast lift I recommend a Periareolar Round Block Breast Lift ("Benelli mastopexy"), which has an unnoticed scar around the areola, and if we see (in the surgery) that we can't obtain adecuate projection just with the Benelli Lift, we have to perform a "Lollipop breast lift".
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 256 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.