650 cc Saline implants or 750 cc saline implants?

Question

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?

Richard G. Reish, MD, FACS · Answer

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

Emmanuel Mallol Cotes, MD · Answer

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

Gerald Minniti, MD, FACS · Answer

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.

Farah Naz Khan, MD · Answer

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!!

Martin Jugenburg, MD · Answer

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.

Robert S. Houser, DO · Answer

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!

Tom J. Pousti, MD · Answer

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.

Connie Hiers, MD, FACS · Answer

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.

Omar Fouda Neel, MD, FRCSC, FACS · Answer

It is very difficult to say without proper in person evaluation or photos. I would trust your surgeons judgement. I usually advise my patient to go a little bigger than what they try on in the office. Often, patient like the size of their breasts post surgery with swelling..once the swelling subsides some patients wish they had gone slightly larger. Hope this helped and Best of Luck to you !

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

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:

650 cc Saline implants or 750 cc saline implants?

Answers (11)

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