650 cc Saline implants or 750 cc saline implants?

I currently have 450 cc saline breast implants. I had a baby three years ago, and my implants are not as perky as the once were, and I am now a small C sup instead of a DD (like I once was before baby). I had a consult with two different doctors to replace my current implants with new ones. When I tried on the testers I was happy with both 650 cc and 750 cc. I am 5 feet 8 inches, I had broad shoulders, and weigh 134. Do you think these implants are too big for me? Should I downsize to 550 cc instead?

Doctor Answers 11

Can't tell

In general, I would say that those implants are too big for anyone!  You may have broad shoulders, but your breasts are likely all implant.  Saline implants are not optimal because of the rippling.  If a woman is undergoing a size change to feel like she got a size change, you do need to add 100-150cc to the implant, so following that reasoning 650cc is not that far off.  However, I suspect that you will be back someday to have them down-sized and a lift.  Talk to your surgeon about the FUTURE impact of your decisions -- not just today.  Good luck!


Columbus Plastic Surgeon
5.0 out of 5 stars 15 reviews

650 cc Saline implants or 750 cc saline implants?

Thank you for your question.  In my opinion 650 or 750 cc implants are too big for a cosmetic breast augmentation and in my experience are only used in breast reconstruction after mastectomy.  However your plastic surgeon will do measurements of your breast and hopefully make appropriate recommendations.  To learn more about sizing please read below:

Implant sizing

Hello and thank you for your question.   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.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 77 reviews

Size

I would suggest going back to your surgeon, who has measured you, and discuss the range of sizes that best fits your frame and tissue. Large implants over time tend to thin your tissue and sag. Also, since your own tissue has thinned, your tissue may not support such heavy implants well over time.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Implant Size for Optimal Fill

Thank you for your question.

The implant has to fit YOUR body dimensions. The more you deviate from the proper fit, the more fake your breasts will look.

Since you already had a surgery before, you may know about the tissue-based planning to determine the implant size. The planning takes into account the effects of implants on tissues over time, risks of excessive stretch, excessive thinning, visible or palpable implant edges, visible traction rippling, ptosis (Sagging), and breast tissue wasting.

To determine the final implant size, many breast measurements need to be made:  breast width, breast skin stretch and nipple-to-Inframammary fold distance. The combination of the breast width along with these measurements will help determine tissue coverage and the required implant volume to optimally fill the breasts. If the skin covering your breasts is stretchy (>2 cm), or if your nipple-to-inframammary fold distance is greater than 9.5 cm, then more volume is needed for the optimal fill.

Since 450 cc provided an optimal fill last time, you may probably need more than 100 ccs to get back to your original size (i.e., DD). Again it truly depends on your current breast measurements, breast anatomy, and chest wall characteristics.

All this being said, share all your motivations for surgery, expectations and goals with complete honesty to avoid miscommunication and post-operative concerns/regrets. Be as specific as you can about what you like regarding your breasts and what you don’t like. If you trust your surgeon and their judgment and the decision-making method used to choose the implant size, then you should be in good hands.

Hope this helps.

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

What size

Without seeing you in person and being able to delineate the amount of breast tissue overlying the implant it's impossible to make a definitive suggestion. Generally speaking, it takes at least a 100 mL increase over the existing implants in order for it to be visually obvious. As the breast implant size gets larger, it takes a larger increase to be visualized over a larger surface area. The mentor system of overlying Sizer's would certainly be able to delineate the result between 750 and 550 mL. Hope that's helpful.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 43 reviews

Implants, some advices:

Thanks for the question. I recommend you to send your photos to us to give you the advise of the volume you'll need because it depends in many parameters such as the chest diameter.

Kind regards 

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 174 reviews

Extra Large Implants

Hello,

No one can answer whether they are too big for you, that can only be determined with a physical exam. However, large implants like those, especially if they are saline, will take a heavy toll on your breast tissues over time. You should consider silicone gel.  Additionally, you may need a breast lift too based on your history. Best of luck. 

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Breast

Thank you for the question. Online consultants will not be able to provide you with specific enough advice to be truly helpful. 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, and computer imaging) will be critical.  



Generally speaking, patients undergoing revisionary breast surgery should understand that there may be many variables besides breast implant volume that come into play when determining optimal  breast implant selection during revisionary breast surgery.  For example, adjustment of the breast implant capsules may be necessary; this adjustment may be a factor when it comes to selection of appropriate breast implant size/profile.    



Generally speaking, the best online advice I can give to ladies who are considering revisionary 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 "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.  Personally, I find it most beneficial to have a wide range of breast implant types, sizes, and profiles available.

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.  

650 cc Saline implants or 750 cc saline implants?

Hard to answer this question without an in person exam and specific breast measurements. Remember that there is no direct correlation between implant size (cc's) and cup size. Best option is to choose a board certified plastic surgeon who actually takes the time to measure you and examine your breast pocket. Also remember that sizers will only give you a rough estimate. The goal of breast augmentation is to optimally fill your breast pocket, not to overstuff or understuff it. Height and weight have no correlation with breast size. At my practice, we utilize a series of 5 breast measurements that help me determine the ideal implant size, which in turn helps me deliver a 24 hour recovery. Do your research and choose a surgeon who takes the time to sit down with you and discuss your goals/expectations to determine the best size for you. Good luck!!

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.