Is there any real different between 450cc and 475cc implant?

Dear pjamm19,

Thank you for your question. In my practice, the biggest regret patients have is that they wish they went bigger. With that being said, the difference between a 450cc implant, and a 475cc implant is that of a tablespoon, which is pretty inconspicuous. The way the implants look when you try them on is also different from how they will look once implanted, as they will appear more natural looking. I suggest following up with your board certified operating surgeon to go over this in more detail. Best of luck to you!

I appreciate your question
After performing hundreds of breast augmentations, I have found that the size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Implants that are wider than this can be more palpable, fall more laterally overtime and also be more palpable. After that we will then choose the implant volume based on the measurements and also looking at any asymmetries you might have. You should choose a board certified plastic surgeon that you trust to help guide you in this decision. Bringing photos as well can help us to finalize, but please understand that these are of other peoples bodies and your results will probably be different.
Silicone will give you a fullness at the top (upper pole fullness). Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured. 
Anatomic gummy bear implants might be a good choice to give you a more natural look. These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.
 Implants, indifferent projections. The easiest way to think about it is they called me in a low medium and high projection or profile. Most of the time I use the medium profile which gives people the best in terms of natural look as well as a little bit of projection. High profile implants are for someone that wants  A little bit more of a fuller look. Low profile implants are better for someone that really wants a minimal extremely natural augmentation. Depending upon the anatomic versus round implants there are also subtle differences  in terms of the amount of projection for each profile. 
During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.
We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast.
In order to limit pain from breast augmentation and speed the recovery process I offer patients Botox into their muscles as well as a long acting numbing medication called exparel. 
The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.
best of luck!
Dr Schwartz
Board Certified Plastic Surgeon 
#RealSelf100Surgeon
#RealSelfCORESurgeon

Hi pjamm19,

Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient.

Implant profile is one of the important considerations to make. Many patients wrongly assume that the higher the profile the better. The truth is, the more profile (or projection/height) and implant has, the narrower its base has to become. This is associated with several problematic consequences.

The first issue is that the patient loses width and therefore cleavage of the breast. The second is the breast becomes more narrow and pendulous, often falling lateral and onto the side of the chest, and third, high profile implants have a higher risk of bottoming out because they exert more pressure on the inframammary fold than moderate profile implants.

High profile implants do have a role in symmastia repair (when I need to narrow the base width) but otherwise I try to avoid them.

When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.

Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.

Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.

You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  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.  FACS
Harvard-trained plastic surgeon

Thank you for sharing your question.  There is a dramatic difference not in the sizes between the implants but rather the profile.  Round implants provide a different look in clothing and in final result compared to an anatomic implant and I would revisit your surgeon to discuss your concerns and sizing requests based on your desired goal outcome. Hope this helps.

A 450 anatomic (or teardrop) will not look the same as a round implant when you are sizing. There will be less fullness at the upper pole when you are sizing implants so the 450 will seem smaller than it actually is. When placed into a patient there really doesn't seem to be much difference in appearance, but without your tissues covering the implant it will not fit the same. I would suggest trying on a 450 round before committing.

Hi there! Small increments in breast implant size does not make that much of a difference, however distribution of that volume will make a big difference. The shaped (tear drop) implant will not look as big because the gel is distributed into the upper pole of the implant. The round implant has equal distribution of the gel throughout the shell, so it will appear larger when placed in a bra. I suggest that you compare the volumes by looking at implants of equal shape. 

Unfortunately there are no pictures. The best way to choose your size implant is based on the width of your breasts. If the width of the implant is too small you lose cleavage and upper pull fullness. If you get an implant that’s too wide for your breast it may distort your breast and you may have too much fullness on the side of your chest. When using silicone implants the thickness between a 450 cc and 475 cc is actually very small and you may not even notice it at all. For example the difference in thickness between a mentor 450 cc high profile silicone breast implant and a 475 cc breast implant is only two millimeters. This is very small and you may not notice any difference in thickness. The reason is the diameter of the implant also gets bigger. If you were using a saline implant the difference in thickness of the implant would be more because the saline implants diameter is basically the same. Using round implant sizers placed in your bra before surgery is not the best way to see what the different sizes look like on you. The reason for this is that round implants are not round when placed in your breast. The implant gets compressed (ie flattened) in addition to the overlying breast tissue. Also, the implant is not round when you are standing up. A round implant forms a teardrop shape because when your chest is upright the silicone gel migrates down to the lower part of the implant giving it a teardrop shape. Having said that, mentor does make a very nice system of sizers which are specifically designed to be placed in your bra and to give you an idea how a round breast implant would look on you. FYI teardrop implants have their highest projection over the lower part of the implant while round implants have it in the middle of the implant. Typically if you have a round implant with the same diameter of the shaped implant, and they have the same volume, then the teardrop implants will have more projection over the round implant. I incorporate the bloodless breast technique which I invented (please see the video on our page). Typically there is no bruising after surgery and recovery is quicker than traditional techniques (it is common for surgeons that I operate on to be operating on their own patients five days after surgery). I hope you find this information useful. Please watch the enclosed video.

Dear pjamm19,Thank you for your question.   There is obviously only a small difference between thos two implants volume wise.  However there will be some difference between the width of the implant as well as it projection; this may put you ovetr the edge, so to speak, in what you find acceptable.  If you were using the sizing system from Mentor where the sizers are tear drop shaped that actually is a relatively good approximation of the  appearance in my opinion.  I also think it is better than just putting the implant in a bra.  Does your surgeon have the VECTRA imaging system?  this allows you to get a 3-D image of wht you'd look like with a particular implant.  If your insure, ask to go back to office and re-size.  Bring a bra & a few tops you know fit well and that you like & take your time.Hope this helps & good luck.James Sheridan, MD

Depending on the patient's body type and/or "precision" of her goals,  a 25 cc difference in breast implant volume may or may not create a significant difference in look.My best advice: more communication.


It is definitely worth spending more time (prior to the date of surgery) with your plastic surgeon to discuss further.  As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.  Show your plastic surgeon what your goals using as many visual aids as possible.   As you can imagine, terms such as "natural" or "fake" can be interpreted differently by different people. This additional communication will go a  long way when it comes to helping alleviate your anxiety prior to proceeding. One question that might be helpful for you to consider: would you be more disappointed if you are slightly too big or slightly too small after the breast augmentation procedure?


 Generally speaking, the best online advice I can give to ladies who are considering 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. Sometimes, it is necessary to seek several consultations before you feel comfortable about your choice.


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. I have found that the use of words such as “natural” or "C or D cup” etc may mean 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, best not to discuss your goals and/or judge the outcome of the procedure and Wisconsin, don't was insane so you can start some something one day before to work with the is a surgical note people is said performed based on achieving a specific cup size. The use of computer imaging may be very helpful during the communication process. The use of in bra sizers may also be helpful. In other words, use as many “visual aids” as possible during the communication process. I encourage patients to meet with me as my times as necessary, to feel comfortable that we are both on the “same page”.


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. I generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.


 
I hope this helps. Best wishes for an outcome that you will be very pleased with.