Age 35, 5'7", 200lb, 38B/40B - Best Implant Size?

Choosing the appropriate size for your breast augmentation relies on many factors including your current breast size, the amount of skin you have, your desired cup size, and your breast and body measurements. You should consult with a plastic surgeon performing breast augmentation regularly who will work with you to pick the right size and profile. It shouldn't be just choosing one of two sizes and the right size for you means incorporating both you and your plastic surgeon's recommendations. Sizing bras do help determine an estimate of the size you hope to achieve. In our Jacksonville breast augmentation practice, we utilize silicone gel sizer to help patients feel comfortable with the size they choose. We also help them decisions by informing them that there can be some limitations according to their existing breast measurements as well as that the sizers appear larger in the bra than inside the body. 

Size is a complex decision that is not only based upon your height, weight and current cup/bra size but ALSO on also on your breast diameter, waist, shoulder, and skin envelope measurements. These can only be assessed in person during a consultation. A good place to start is using my "Find your perfect size" tool listed in the left hand column of my bodysculptor.com home page. Another good place to look is the searchable database section of the physicians' photos on implantinfo.com. Best of luck.

The implant selection sound large but there's really no good way to tell without an implant sizer test in the office and a full physical examination to determine what is best for your overall aesthetic improvement.

Best Wishes

I tell all my patients that implant size cannot be determined by looking at photos.

Sizing is a very 'hands-on' process: I have my patients try on implants in front of a mirror until they see a size they like.

The final selection also depends on technical factors such as breast dimensions and the quality of the tissues. In some cases it may not be possible to deliver the size the patient wishes.

In your case it may be necessary to use implants of different sizes. This can also be assessed in front of the mirror.

Find a reputable, experienced plastic surgeon and work with him or her to make the best choices.

In terms of picking the right implants to achieve your goals, generally speaking, 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.Dr.BasuHouston, TX

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

 Much of the final “look” achieved after breast augmentation surgery  depends on several factors:
1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.
3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.

From your pictures it looks like you will most likely need 2 different implants to make your size mismatch closer.  500 cc implants would probably look great on you!  One way to be able to picture what they would look like is to do imaging - many offices offer 3-D picture scans where you can pick your implant size and a simulation will show you approximately how you will look.  Good luck!

Thanks for all the photos and a very detailed description of what you want. However, an exam is key to figure out what your chest would accomodate properly.  The 600's are probably too large.

The best way to determine you implant size is to do some sizing with the surgeon and see how you like the look of various sizes.  Based on your photos I am pretty sure I would recommend a high profile implant and the 550 size range sounds about right.