I am 48 years old, 5'2" 122 lbs, very fit and muscular. Is 425cc too big an implant for a petite figure?

Doctor Answers 16

PETITE FIGURE DESIRES LESS PETITE BREASTS

If you were sitting/standing in front of me it would be an easy question to answer.  Without photos or a personal examination, I can only tell you that...it depends.  The first consideration is how you feel you look in that size when you try them on.  I've found over the years that women who don't get the size they want are never completely happy, no matter how good the rest looks and feels.  So unless there is a physical reason to decline a certain size request, I honor that desire. 
Further complicating the answer to your question is that I don't know how large your breasts are to begin with.  If you are a good B cup, you will have plenty of tissue to cover a 425cc implant.  It would then make you a solid D.  
I consultation with a good surgeon will straighten all this out for you.


Houston Plastic Surgeon
4.4 out of 5 stars 33 reviews

The right size for you

It is very difficult to determine 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 350 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. . 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 below link.

Size is a matter of personal preference

The best way to determine the size that fits your personal perception of the perfect breast is to try on sizers. This way you can see how they fit on you, how they add to your current volume, and whether they fit your frame. Although the surgeon can guide you, only you will be able to tell what is the right size. Try on sizers. HP implants, which are a more modern shape than moderate profile implants, fit most women better. They have a more appropriate base diameter for the average women's chest. Mentor HP profile saline implants have base diameters that range from 8.8 cm (very narrow) to 13.8 cm (moderately wide). The majority of women in my practice have base diameters in the 11 to 13 cm range. The HP implants fit them well. The moderate implants have much wider base diameters for the same volume (often in the 14 to 15.6 cm range). These implants are too wide for most women that I treat. So when the base diameter is measured and correlated with the diameter of the implant, it is most often necessary to use HP implants to achieve the volume the patient is requesting. At the volume selected, my patient's base diameters are too small for moderate profile implants. Measuring a diameter and then telling the patient what volume they can have (in high, moderate or moderate plus implants) in my mind is backwards. The patients should be allowed to choose the volume. Then the surgeon carefully considers the base diameter, projection, profile, manufacturer, and fill material that will achieve the patients goals of size as well as qualitative look (natural, intermediate, or bold upper pole fullness or projection), all the while taking into consideration the patient's anatomic features that will affect the outcome. HP implants can be made to look very natural or very augmented, depending on where in the range the implants are filled to achieve a particular volume. At the low end of the fill range, HP implants do not have the upper pole fullness that most people associate with the fake look. On the other hand, a fake over-augmented look can be created with a moderate profile implant if it is overfilled (a common practice for surgeons that commonly use moderate profile implants). In addition, too wide an implant will put the volume past the anterior axillary fold, which in my opinion, looks more fake than upper pole fullness. So there are many factors that need to be considered. The experience of the surgeon and the degree to which they explain the options to you is of utmost importance. Obviously all of my patients look at photographs and we evaluate the look they are desiring in great detail. For me, high profile implants are the first choice. I rarely find an indication to use moderate or moderate plus implants. This does not make me a better surgeon, or a worse surgeon. Look at the outcomes and judge for yourself. The outcomes should stand on their own. The subtlety in the final outcome is not achieved by which profile implant is used, it is determined by the skill in the creation of the pocket, the choice of volume, and where in the range the implant is filled. Don't let the doctor tell you what would look good on you. They cannot tell what you perceive to be the best size.

Breast Implants

Hi 3daypatti,
I have started using textured implants on all of the body builders/competitors that I do because in muscular patients the smooth implants tend to displace.  Here are a few tips for you because this is perhaps the hardest decision for a patient to make, as well as the surgeon. Also see the video attached to my answer. We spend up to two hours for our BA consults to be sure there is careful communication. We do a full exam in front of a full-length mirror taking six exact measurements.We put your photos on a large computer screen for imaging, and go over your “ideal-size” photos. We then save this information to your password protected “web account.”
First and foremost the implant should fit the dimensions of your breast and tissue cover. Balancing the implant to your over-all body shape and tissue cover is essential.The main thing is to have the diameter of the implant fit the diameter of your breast "foot-print". Higher profile implants tend to have a smaller diameter.Higher is really a marketing term, but often translates into the same volume implant with a narrower base.Saline implants actually tend to decrease in diameter as they are inflated!The average size chosen over our last 7,000 breast implants was “350cc”.BUT, 90% of our patients tell us they wish they were bigger a year after BA.(We will see you every year for routine checks at no charge.) It’s like your mind incorporates the "new you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients that they will experience an increase of approximately one cup size per 200 cc. You can try on implants in the office by placing them into a special bra.The implant is also flattened somewhat when under the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for flattening of the implant in the partial sub-muscular pocket. Once you decide on a size you like, then add on 25cc, because in real life the implant will be flattened slightly by your tissues.Multiple measurements need to be taken to fit an implant to your exact anatomy. Have your surgeon's office show you the charts of the implant dimensions for the various profiles of silicone and saline from the manufacturer. Then you and your surgeon can piece together the puzzle by matching your measurements, with your wishes, versus your tissue cover and the available implants to arrive at a surgical plan.Keep in mind larger implants tend to have more problems over the years.Since silicone implants wrinkle less than saline implants, they might be your best bet.
You can also approximate this at home by measuring out an equivalent amount of rice placed into a cutoff foot of old panty-hose, and put this in your bra.Wear this around the house for a while, and see what you think.Implant size must square with assessments of tissue cover, breast diameter, and chest wall width. Multiple measurements of your chest wall are taken (seven in total). Implant size selection has been an issue of much discussion.
Therefore, I use a wide variety of methods, but the implant size is always established preoperatively.Also, patients are advised to bring reference photos demonstrating their ideal size and shape. A photo album of patient pictures is maintained to assist them. These photos ultimately help in determining where the implants will be placed, since they can be shifted inside (to provide more cleavage), to the outside, up or superiorly, and down or inferiorly during surgery. In determining the final size selection, I always place the highest priority on the preoperative measurements and potential tissue cover.Finally, your verbal requests are factored into the analysis.
We use the quick-recovery approach, so click on the web reference link below to have this explained and you can see the list of Quick-Recovery (Flash-Recovery or Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery journals.It is a surgical procedure that uses special instruments and techniques to minimize tissue damage and avoid touching the ribs. It causes far less trauma to surrounding tissue than traditional approaches, and it dramatically reduces pain and recovery time. In published studies of BA patients, 95-percent of women interviewed after the procedure returned to normal daily activities within 24-hours. Quick-recovery BA is not a “gimmick.”These specialized techniques, which actually speed recovery and get you back to your daily routine, kids and work, are published in our plastic surgery journals.Because these PS journals are “peer-reviewed” and edited, they are the gold-standard in our field as being valid science. Therefore, these are sound techniques, not marketing hype.
Be sure to see only a board certified plastic surgeon (by ABPS - The American Board of Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic Plastic Surgery) and or a member of ASPS (The American Society of Plastic Surgeons). Also, ask if the PS has an established, high volume breast augmentation practice, performing several hundred breast augmentations each year. Be sure the PS has been in practice for a while, about 20-years might be a good gauge.Does the PS offer all three incisions?Discuss the implant type (gel or saline), shaped "gummy bear" or non-shaped, smooth or textured, implant pocket (over or under the muscle) and the "quick-recovery approach."Ask to see their before and after photos if you didn’t see any on their website. If they are experienced, they should have several 100 breast implant patients for you to view. I would also recommend that your doctor offer you the chance to talk to past patients who would be happy to discuss their experience with you. You need to feel comfortable, so make sure the environment is safe as in an accredited surgery center. Also, ask a prospective surgeon if he or she has ever published journal articles in professional peer-reviewed journals, which they can provide you.
All the best, “Dr. Joe”

Breast Implant Size

This is a very difficult question to answer without out a face to face evaluation. Many factors go into determining what size or range of sizes a plastic surgeon recommends. Breast measurements, amount of breast tissue, if breast sag is present, implant placement, your desired result, your lifestyle, etc.. 

Some woman want dramatic noticeable breasts, while others want to maintain a natural conservative appearance. For those who are athletic and active, larger breasts may be a hinderance to their lifestyle. 

When interviewing board-certified plastic surgeons, be sure you are vocal and clear about your goals with having breast augmentation surgery. Providing images of breasts you like is very helpful as well. And, don't be afraid to ask questions. 

Best of Luck! 

Large implants with a small frame

The most appropriate sized implant for any patient is best chosen with a careful analysis of your base dimension (chest width) and your tissue laxity.  Obviously these assessments are best done by an experienced plastic surgeon.  Oversized Implants can lead to more complications and revision surgery. Certainly in our experience a 425cc implant in a small frame is on the upper range of what we would recommend.  However sometimes possible with high profile implants.  The key to your implant choice is to make sure you choose a surgeon who prides themselves in a low rate of revisionary operations.  Good luck with your future surgery

Denton Watumull, MD
Richardson Plastic Surgeon
5.0 out of 5 stars 18 reviews

48 years old, 5'2" 122 lbs, very fit and muscular. Is 425cc too big an implant for a petite figure?

The best cosmetic result in any particular breast augmentation patient depends on a variety of factors, including: Your individual anatomy, desired outcome, realistic expectations, a thorough discussion with the plastic surgeon about the options, and an understanding of the pros and cons of any particular implant choice. Proper sizing is not just about the number of cc’s. The thickness of your tissue, breastdimensions which include the width, height, and projection, as well as chest wall width all need to be considered when choosing an implant. Trying on implant “sizers” of various shapes and volumes while wearing a tight t-shirt, bra, or bathing sit at a preoperative visit will help you and your surgeon choose the optimal implant.

There are no manufacturers' standards for cup sizing in the bra industry. The cups of a 32 C-D and a 36 C-D are significantly different. Cup size varies from manufacturer to manufacturer and even within styles from any particular manufacturer. Nor is there a direct correlation between implant shape or size and cup size.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest that your plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Implant size

This is a complex answer, as is evident in other responses.  We use Vectra XT a simulation program that allows you to have a better idea of the resultant size after breast augmentation.  You should be very vocal about your desired look and even have some examples of what you like when you discuss implant size with your PS.  He/She will take your desires into consideration and help you make a good decision for you.

Delio Ortegon, MD
San Antonio Plastic Surgeon
4.1 out of 5 stars 24 reviews

Breast implants and sizes

Hello 

Thank you for your question. It is best for you to have an in person exam with a board certified plastic surgeon. This way you can discuss what would be best for your body. You will have an opportuniy to see and feel the implants. 

Best regards

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 425 reviews

I am 48 years old, 5'2" 122 lbs, very fit and muscular. Is 425cc too big an implant for a petite figure?

Thank you for your question.
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 "too big" 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.

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.