What is the Best Way to Decide on How Many Cc's You Need?

Dimensions of implant more important than the number of cc's in determining your final result.  A very wide implant that is 600cc may not project as much as a more narrow implant that is 450cc.  The higher volume may be necessary because of your broad chest, and the implant should more or less fill the base width of your breast.  Saline and silicone volumes equivalent, but again, the dimensions are more important.  Also important in determining implant size is your pre-existing volume.  Because you are B/C and want to increase two cup sizes, a mid range or high profile implant is probably indicated.  Try them on at the doctors office in a non-padded bra with a tight fitting shirt to see how they look and feel.

I choose breast implants for patients based on the dimensions of their existing breast footprint. I'm a proponent of smaller implants, because in the long-run, I think they will look better and require less revisional surgery. Based on your photos, I would caution against the use of a large implant - 600 cc is a big implant in any surgeon's practice. A lift of some sort would be an important part of your surgical plan. Seek out a couple of second opinions before scheduling surgery.

The larger the implant, the higher the risk of complications.  In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

For any patient considering breast augmentation, there is an implant size above which the upper pole begins to look rounded, convex, and unnaturally full. Mild to moderate upper pole fullness can look beautiful and youthful, but excessive upper pole fullness due to overly-large implants looks decidedly fake, and like what most people think of as a 'boob job'.

The actual size of a breast implant, measured in cc's, is really not very descriptive of what a breast augmentation will look like, or what the cup size will be. It is all relative to the size of the breast and the size of the patient preoperatively. A tall, broad-shouldered patient with small A-cup breasts may require 450cc implants to achieve a C-cup breast volume postoperatively, while a shorter patient with medium B-cup breasts may only need a 250cc implant to achieve a C-cup breast volume.

If a natural appearance is the goal, then the way to get the size right is to 'try out' different implant volumes and profiles in the operating room. Once the implant pockets have been created, sterile sizers can be placed in the implant pockets, and the upper half of the O.R. table raised so that the resulting breast appearance can be assessed with the patient in an upright 'sitting' position (chest fully upright) while under anesthesia. These sizers are available not only for each implant size but also for each implant profile: low, moderate and high (in this practice we use high-profile implants only in rare instances). Inflatable sizers are used for saline implant augmentations, and pre-filled gel sizers are used for gel implant augmentations.

For any patient there is obviously a range of implant volumes that would be considered natural-appearing, and a volume at which the upper pole of the breast begins to look very unnatural. While one patient may seek an augmentation that is 'perfectly natural', another may be interested in a result that is more on 'the full side of natural', and many patients do ask that the largest implant volume be selected that does not produce an unnatural fullness in the upper pole. By using breast implant sizers intra-operatively to determine exactly what breast implant profile and volume produces the best breast appearance in the O.R., patients can be provided with the closest possible approximation of their preoperative goals, and can be assured of a natural-appearing result.

Each patient's body is different ---depending on the shape of the chest wall (concave vs. convex), the goal of the patient, etc.  I ask my patients to bring in photos of their likes and dislikes. I ask them for pictures of breasts that are too large as well as too small.  Intraoperatively, I use sizers to see what volume implant will create the result the patient is looking for.  I also believe that a breast lift may be necessary to achieve a nice result for you.

1)  This is the most common type of question on RealSelf.

2)  It is the surgeon's job to pick the right breast implants, not the patient's. Implant selection is really pretty technical.

3)  Make sure your surgeon REALLY understands the look you want. Mentioning a cup size is not enough. Show your surgeon pictures of breasts you like.

4)  Then your surgeon has to tell you if your chosen look is realistic for your anatomy.  The most common mistake is to go too big.

5)  I recommend that  the surgeon NOT make a final implant choice in advance, because this is just an educated guess.

6)  The surgeon should have a large inventory of different size and shape implants available in the operating room.

7)  Then the surgeon can put sterile disposable implant SIZERS in your breasts during surgery, to see what a particular implant really looks like inside you. This is how to make the best choice. A sizer costs only $45, and takes all the guess work out.

8)  Finally, the sizer is discarded, and the correct breast implants (based on what you want and on your anatomy) are opened from the operating room inventory, and put in your breasts to complete the operation.