Help me with the best choice on size (Photo)

I have a saggy c the surgeon today has said I either have to have 500 cc implants or uplift with implants he said just implants will make me about a double e maybe hire is that right? I only want dd at most

Doctor Answers 13

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

I appreciate your question.

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.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  

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 liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.

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.

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.

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



Help me with the best choice on breast implants size

Thank you for your question and photo.  The size of breast implant should be based on the base with measurement of your breast.  Your surgeon should have measured the width of the base of your breast and use that number to choose an implant with the same width. The 500 cc implant is quite large  and looking at your photo and implants in the 350 cc range may be a better option if that matches the base width of your breast.

You do have mammary ptosis or sagging in the nipple appears to be below the inframammary crease.  Based on that a combination breast lift with implants may be your best option.  Please read to length below for more information:

Implants and breast lifts

Implants alone do not lift the breasts to any significant amount. A lift will be necessary to raise the nipples and tighten the skin envelope.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Breast Aug

You do not necessarily need a lift and you could look nice with a more moderately sized 350-400 cc implant alone and no lift.  This would give you a natural D cup size.  Best wishes, Dr. T. 

Help me with the best choice on size.

Implant size is probably the most common question we receive, and one we cannot answer with any certainty. You do have two issues, the skin envelope which is rather loose, and the issue of the right amount of volume. The first decision you will have to sort out is what you wish to look like. Your surgeon will know based on the examination, and your goals just what type of lift, if any is best, and what the implant requirement might be to allow you to reach your goal. Best luck.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 39 reviews

Help me with the best choice on size

Thank you for your question and photographs.  Depending on your desired appearance, the best enhancement would be obtained through placement of both implants and a lift in the same operation.  The implant will help restore your lost breast volume, while the lift will help position your natural breast tissue over the new implant, while also removing excess skin and elevating your nipple and areola into a more youthful position.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

Lift with implant

You need to have a lift to raise the nipples and breast into the correct position, as you have grade II ptosis (sagging).  This will restore some cleavage and projection/shape.  Depending on your goals, after that, you may need an implant, but certainly not a 500 cc implant.  The true size would depend on your breast width, followed by desired projection, which I'm guessing moderate plus or high profile, so around 300-350.  That should be more than enough volume once the breast tissue is lifted into the correct position, plus you don't want to put too much pressure on the breast and nipple, after they've been lifted.  Thus, a more modest implant is chosen.  But trust me, you will be plenty big.  If you're desiring E breasts, then what I've just said isn't really for you.  I'm talking about a full C or D cup breast that sits up on the chest in good position and with good cleavage and projection.  

Cain R. Linville, MD
Houston Physician
5.0 out of 5 stars 18 reviews

Dr Kayser

Thank you for your question. You have two conditions which need to be completely separately evaluated. First is the position of your breast which is severely droopy. Second is the volume of your breast which is deflated and small. These two issues are completely independent from each other and must be addressed separately. Clearly, you would benefit from a breast lift. This will restore the position of the breast to a more youthful location on the chest. It will not, and I repeat, will not change your existing cup size. This is no different than removing the wrapping from a present. The size of the box will not change.

Since your breasts are smaller than desired, you may wish to have an implant placed. This will necessarily increase your cup size. This will not, I repeat, will not compensate or correct your breast position. Many surgeons erroneously assume that an implant will help restore the fallen breast, which is referred to as a swing effect which, like the hand on a clock that when moving from the 6 to the 8 o'clock position, simulates a lift affect. This is a perceived effect and does not physically alter the location of the nipple and areola complex. However, with the additional weight of the implant combined with the laxity of skin, it is never a surprise when a patient comes back in a year or two with a completely fallen breast that looks like a rock in a sock. I completely disagree with the surgeon who recommended that a 500cc implant would compensate for your condition. This most likely would exceed the volume that you desire and also continue to stretch out and thin the skin out and thereby compromise your skin envelope leading to further rippling and visible and palpable deformities.

I have no doubt in my mind that if given a single procedure option, you would look better with a lift alone rather than an implant alone and, although I understand that women do not want scars on their chest, I do feel that a small breast look good as always preferable to a big one that doesn't. I would certainly consult with a plastic surgeon who is experienced in these many issues of breast surgery who is also certified by the American Board of plastic surgeons. I hope this helps and have a wonderful day. Dr. Kayser - Detroit

Melek Kayser, MD
Detroit Plastic Surgeon
4.9 out of 5 stars 31 reviews

Help me with the best choice on size

Size and shape of breasts can Often play a critical role in a woman’s self-esteem. Fuller and bigger breasts are often associated with reproducibility therefore it is a desired condition. There are different kinds of breast augmentation operation types. Breast augmentation can be performed either with breast implants or autologous fat transfer. There are also different types of breast implants like teardrop or round implants. These implants also can be placed under or above the muscle. As you can imagine there are several different options for breast augmentation. The best way to understand which one is more suitable for you is to get a physical examination by a plastic surgeon.

It is important for you to understand that you don’t always need a breast implant for breast augmentation. As it was also mentioned above you can also get bigger and natural breasts with Cihantimur Fat Transfer method. In this method we use own fat tissue of the patient in order to increase the size of the breast. Since this tissue is your own tissue there is no risk for any adverse effects. It is safe and fast operation that yields natural results without any incision.


Lift with implants?

From your pictures it looks like you are a good candidate for a lift with implants. Trying to create a pleasing shape in a droopy breast by putting in larger and larger implants is not realistic. If your skin did not hold  up the breast tissue that you already have, how is it going to hold up a much heavier breast? I would seek another opinion. Many factors enter into the choice of size, and that can only be evaluated by an in person consult.

Paul W. Loewenstein, MD
Milwaukee Plastic Surgeon
4.8 out of 5 stars 26 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.