A cup desiring D cup, Is 495 cc going to make me look too top-heavy? (Photos)

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  The size, profile, and shape 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.   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.  FACS
Harvard-trained plastic surgeon

Dear ayleazhane,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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hello, thank you for the question and sharing your photos.  Many factors including patient's desired breast size, skin envelope (both quality and quantity) and breast width diameter are important in selecting the implant size. The method I have found most useful and is being done by many plastic surgeons is trying a variety of in-bra sizers. Keep in mind that the breasts will look slightly smaller once the implant is placed inside the body as opposed to placing it under the bra, so I always tell my patients to go slightly higher than the in-bra sizer they like. For example, if you like the 475 cc, you will probably need a 500 cc implant. In combination with several other measurements that your surgeon will do, the final implant volume is selected. Another helpful tool, is to look at before and after pictures of your surgeon's results and knowing what implant size was used in each case. This will give you an idea of the kind of results you can expect. Other things to discuss in your consultation are type of implant (saline vs. gel), location of incision and implant pocket (below or above muscle). Best,
Pejman Aflaki, M.D.

Johns Hopkins-trained plastic surgeon

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I do this with my patients, we then look at pictures of women with similar measurements with different size breast implants. My patients tell me that this process is very helpful in determining what size breast implant is right for them.
Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author

The appropriate breast implant size can be determined working together with your surgeon during the consultation process. The size of the implants is based on a combination of a patient's goals and objectives and her anatomy. In order to provide a natural looking augmentation, your surgeon will evaluate many factors including soft tissue coverage, skin laxity, chest wall width, breast imprint width, the shape of the breasts and relative level of constriction to ensure that the breast implants are appropriate for your body.
It is also important to think about what your results to look like. Do you want breast enhancement that makes people think you have lovely, natural curves or makes them wonder who your plastic surgeon is? Most women choose the natural route so they can keep augmentation procedure private. 
You should consider your lifestyle and lifestage to ensure that the surgery fits what is appropriate for you now and over the foreseeable future. 

The implant that is right for you is determined by your infra mammary crease and chest width. Having larger implant placed is not always a great choice in the long run

Hi and thank you for your question!  While 3D imaging can be extremely helpful, they do not take into consideration what size implant your breast can take.  Your breast skin has to stretch in order to accomodate an implant.  Sometimes you reach the limit of the skin stretching, especially in younger patients with smaller breasts.  If a surgeon tries to go past this limit, you would be at much higher risk of your incision opening up, breaking down, and having your breast implant exposed, which would mean it would have to come out and stay out for 6 months.  I tell all my patients that if I feel it is unsafe to put a specific implant in, I will downsize them because part of my job is to be their doctor and have their safety in my mind all the time.With that said, I personally don't think your breasts would fit a 495 UHP.  I generally also don't recommend UHP implants as they give a much more "torpedo" look as opposed to a more natural looking breasts.  My recommendation for you would be High profile implant (Natrelle SRF) in the 350-400cc range.  I think this would fit your frame a lot better because I do think a 495 would make you look too top heavy.  Best of luck!

Thank you for the question and pictures.  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.  I also think that your goal photograph is realistic understanding of course that goal photographs are communication tools not guarantees of exact outcome.
 
  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. Sometimes, it is necessary to seek several consultations before you feel comfortable about your choice.
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 "small D cup” or "top heavy or pornstar look" etc may mean 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, best not to discuss your goals and/or judge the outcome of the procedure performed based on achieving a specific cup size. The use of computer imaging may be very helpful during the communication process. The use of in bra sizers may also be helpful. In other words, use as many “visual aids” as possible during the communication process. I encourage patients to meet with me as my times as necessary, to feel comfortable that we are both on the “same page”.
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 generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.
 One question that might be helpful for you to consider: would you be more disappointed if you are slightly too big or slightly too small after the breast augmentation procedure?
I hope this helps. Best wishes for an outcome that you will be very pleased with.

The size is ultimately your choice.  That being said, whenever you transition from cup size A to D, the look will never be completely natural as you will have a certain degree of upper pole fullness.  I would recommend having further communication with your surgeon about your desired result.  Hope this helps!