One Doctor Said I Can Go Up to 800cc Other Said I Can Only Do 400cc? Why Such a Differnce?

Cosmetic breast surgery is an art form as well as a technical procedure.  There are many ways to achieve a good result.  The one surgeon may be firm on the 400cc volume because the diameter fits your chest wall.  The other doctor may be trying to meet your cup size goal.  There are pros and cons that you must understand before having large implants placed.  Skin and breast tissue is permanently stretched.  Fallout and malposition may be more common as well.  Get a thorough explanation.

Breast implants come in multiple shapes and sizes. A breast implant should be placed under the pectoralis major muscle for the majority of cases, both for a natural breast shape and for safety in screening the breast with mammograms. Breast implant size and shape or profile, as well as what the implant is filled with is a very individual decision. It is great that you have seen two different plastic surgeons, and it is not uncommon to receive two different recommendations. I would agree that 400 cc breast implants are on the high side and that 800 cc breast implants should only be reserved for reconstruction. Of course, your goals and your plastic surgeons opinions should meet, however 800 cc is huge and for breast implants, bigger is not always better! 

I hope this helps.

Dr. Trussler

Thanks for your question.
As you have seen plastic surgery is as much of an art as a science.  Two different doctors may have differing opinions about the same surgery.  It can be frustrating.
I think in your case the difference predominantly stems from the size of the implant.  An 800 CC implant is a very generous implant.  Someone who has the right size chest will fit that implant easily, but it could be a struggle in someone who is smaller. Clearly surgeon number two is concerned about whether or not he can fit in the implant given your frame.
Forr people who are likely to be tight staging larger implants will sometimes make sense.
Without the opportunity to examine you I really can guide you about which way will be best for you but you may want to seek another opinion or two and see where the consensus lies.
Both of the options above are reasonable, plastic surgeon number  two is being a bit more cautious and conservative.  While it may be less appealing, sometimes that's a good thing.
Good luck with your choice.
 

I would definitely not recommend the larger implant, as it will definitely lead to implant malposition problems.  Generally speaking,larger implants increase the risk of complications such as implant malposition, which can be very difficult to correct longterm.  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

Surgeons will base recommendations based on the patient's objectives, physical dimensions, lifestyle, lifestage, their own experience and expertise, and their sense of aesthetics. Since different surgeons weigh these factors differently, you need to choose the surgeon first and worry about the size recommendations later. You should choose an experienced and expert board certifiied plastic surgeon who understands your objectives and passionately wants to surpass your expectations.

The one missing component is your current bra size. Shoulders are only a part of the equation. The elasticity of your breast skin is of great importance. If you do not have enough breast tissue to drape over the implant, using too large an implant risks a dehiscence or open wound. Additionally, the diameter of your chest is important. An 800 cc augment is extremely large and places you at much higher risk of complications. It is important for you to clarify what you are trying to achieve with the operation.

It is quite easy to understand why you were asking us questions. the 2 opinions you have received her quite dramatically different. There are number different methods but plastic surgeons used to estimate what is a reasonable size implant for an individual patient. One wound with some as not to use an implant that is wider than the width of the breast. This prevents a predictable unusual postoperative appearance. I would suggest discussing with your surgeon Hal each arrived at the recommendation.it's a 400 cc recommendation is based on measurements I would rely on that suggested. If both surgeons are "eyeballing" he might seek a third opinion. Best of luck.

As you have noted, if you ask 5 plastic surgeons for their opinions, you will receive at least 7 opinions. Different plastic surgeons will give you different opinions based on their training, experience, and personal preferences. This range of opinions you will receive will potentially be confusing.

I would suggest that you do your due diligence carefully and choose your plastic surgeon wisely.  Then allow him/her ( after you have communicated goals clearly with him/her)  to choose the breast implants that will best meet your objectives.

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 "side boob" etc 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.

I hope this helps.

There are a wide number of size options available for any  patient.  Restrictions are based on the individual's anatomy . What one patient feels is perfect another may feel is too small,so there is a bit of individual preference involved as well. I have found computer imaging is very effective in allowing the patient to guage what size implant they will be best suited for.