36 year old, Very flat chested AA, Can I achieve a full C-small D? (Photo)

Question

I am 5'7", 140lbs, 32in rib! I am wanting a full C, small D. My surgery date is July 23, 2014. So far I am going with Silicone, round, textured, unders, 401cc rt, and 435cc Lt. In your opinion, is the right choice, and will this get me to where I want to be??

Gary M. Horndeski, MD · Answer

At
size 32 each 100 cc’s of implant corresponds to 1 cup size change.  To achieve a D would require approximately
300 cc implants.  400 cc implants may not
fit retro-pectoral, will extrude inferiorly and laterally requiring
revision.  I always recommend small round
textured silicone gel implants placed retro-pectoral since they look and feel
more natural, are more stable, less likely to ripple or have complications
needing revision.  Implant profile is
irrelevant in the retro-pectoral position since the muscle compresses it.  22% of women who undergo breast augmentation
alone require revision within 2 years because they are dissatisfied with the
result.  A frequent cause of
dissatisfaction is over implantation. Best Wishes,Gary Horndeski, M.D.

Jeremy Pyle, MD · Answer

I suspect your surgeon will be able to show you and allow you to hold an implant around that size.  If you have to opportunity, you will see that the implant alone is pretty close to a C cup.  When put beneath your tissue, I would expect a C cup is a very reasonable goal. That is, however, a fairly big implant and has some of the risks of being a big implant. Your height may allow you to tolerate that size more easily than others with your slight frame.Best,Dr. Pyle

Michael Law, MD · Answer

Most patients want to have the fullest breast profile that still looks natural on their body. The limiting factor for implant size is almost always the appearance of the upper pole. At some implant volume, the upper pole of the breast begins to look excessively rounded or convex, and that is a look that says "breast implants live here".A common
error that leads to an unnatural appearance after breast augmentation, even
with implants of an ideal size, is inadequate lower pole dissection and/or
inadequate release of the pectoralis major origin just above the inframammary
fold. As a result the implants sit too high and appear excessively full in the
upper poles (the area above the nipple-areola complex), while the lower poles -
which should be the fullest area of the breast - are underfilled. Inadequate
muscle release may also result in bizarre-appearing breast implant animation
when the pec major muscle contracts. In some cases this may result in one or
both of their implants jumping up literally to the level of a patient's
collarbones - an alarmingly unnatural look, and one that is totally avoidable

A shaped form stable breast implant can give the patient
the lowest risk of fold and ripples in the lower pole, the lowest risk of a
visible transition between natural breast tissue and implant  (sometime
refereed to as a double bubble) and the lowest risk of breast implant
malposition with the breasts bottoming out. I think there is a performance
difference between form stable breast implants. Consult with plastic surgeon
who have experience and expertise perfuming this particular procedure.

In many breast augmentation patients,
the inframammary fold needs to be lowered in order to allow the implant to rest
at a level that appears natural relative to the position of the nipple and
areola. Ideally the implant should be centered directly behind the
nipple-areola complex (NAC). In profile, the natural-appearing breast is not
convex in the upper pole, and an excessively convex and overly full upper pole
is a dead giveaway that a breast implant sits below the skin. In addition,
inadequate release of the inferior origin of the pectoralis major will allow
the muscle to hold the implant in too high a position, and may even cause the
implant to displace upwards (as high as the collar bone in some patients) when
the muscle contracts. Patients with this problem require reoperation to release
the inferior origin of the pec major and/or the inframammary fold.

Likewise, if the inframammary fold is lowered too far, the
augmented breast will appear 'bottomed out', with an excessively full lower
pole, an empty upper pole, and a nipple/areola that appears to sit too high on
the breast - another situation with a distinctly unnatural appearance, and one
that requires surgical correction: repair of the inframammary fold(s).Find a plastic surgeon with considerable experience in providing natural looking results for women with very minimal breast tissue.

Jourdan Gottlieb, MD · Answer

Since there are no standard and uniform definitions of cup size, I am reluctant to predict size after surgery. Some surgeon estimate a cup size increase for every 150-250 cc.  The cups are smaller on a 32 band than on a 34 or larger, so the 150 cc may be the better guess, and just a guess it is. Since there is so little breast tissue, your breasts will have a shape similar to the implant shape, and will at that size look less natural than they would on someone starting with more breast tissue. In general I would favor a smaller size, and would consider shaped implants.All the best.

Carlos Castaneda, MD · Answer

A full C definitely possible, a 400cc implant is quite big for your build already, and the skin would be stretched out, so, look out for stretch marks, prepare your skin before surgery by hydrating it correctly. Of course, they would have to be put under the muscle, I don't see much need for placing asymmetrical implants because volumewise both sides look very symmetrical, not the level of the nipples though, for this I would suggest a periareolar lift on the lower side.Good luck with your procedure

C. Bob Basu, MD, MPH, FACS · Answer

There are several factors considered for implant sizing.  I consider two factors when selecting implants for my patients:1. Dimensional planning2. Gel Implant Sizing systemDimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look. Hope this helps.Best wishes,Dr. Basu

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question and photograph.  You are very small and thin thus you should have a sub-muscular breast augmentation.  400 cc seems rather large for a petite woman such as yourself.  You should ask your surgeon to perform a breast implant sizing system evaluation on you.  You may also try the Rice test in the privacy of your own home as described in the link below.  There is also some nipple asymmetry.  I do not think this can be addressed by different sized implants and I do not recommend using different sized implants.  Correction of the nipple asymmetry may require a small periareolar lift on the lower side.

Mary Lee Peters, MD (retired) · Answer

Thank you for your question and congratulations on your upcoming surgery. If the numbers you gave in your question are what you and your Board Certified Plastic Surgeon came up with together, then they are probably the right choice for you. There are two major factors in selecting an implant. One, your desired goal. Two, what your anatomy will allow. As you stated, you don't have a lot of breast tissue so going too large will stretch your skin envelope unnaturally. Don't focus on a bra cup size. What matters most is not how it measures, but how you look in the end. Best wishes.

36 year old, Very flat chested AA, Can I achieve a full C-small D? (Photo)

Answers (8)

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