Approx Breast size difference?

Question

I'm 5'5" 128 lbs with 32C/34B breasts. I used individual sizers in both 50 cc and 100 cc to get a gauge on breast size difference, and it looked closer to 50 CCs than 100 cc in difference; but looking at photos I feel like they are more different. Do you have a possible estimate? I've had three consultations and one PS said 50, another said 100, and the third let me decide with sizers. I would like my breasts to be as even as possible, so the decision is scaring me. Thank you for your help!

D`Arcy Honeycutt, MD · Answer

The volume difference is a concern for you, and a silicone implant cannot exactly correct it, as they are prefilled.  Sizers are used intraoperatively to see the best match.  Multiple implant options are on hand.  There is more than just a volume difference in the breasts, there is a slight shape difference.  You have a difference in the tissue below the areolae.  One breast is a little more relaxed and full looking.  Sometimes liposuction can remove some targeted excess volume on one side, other times it is resected.  If exact symmetry is one of your main concerns, ask your surgeon how this is best addressed.

Vincent N. Zubowicz, MD · Answer

It looks as though implants alone should allow for correction of breast asymmetry. Sizing systems will get very close to the volume disparity. Most plastic surgeons would you sizers in the operating room to confirm this.

Keith Hodge, MD · Answer

In my opinion, if the small difference in size is bothersome to you, intra-operative sizers could be used to determine the best possible size match. The breasts will never be identical, but that doesn't mean that they won't be attractive. Good luck!

Larry S. Nichter, MD, MS, FACS · Answer

It is very difficult to determine the exact size and shape implant you will require as well as location to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “B” cup to a “D” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below link:#BreastSizeDifference

Sheila S. Nazarian, MD · Answer

Honestly, this is not something that can be determined online or with a photo. I know that your anxious about making the wrong call, but I will remind you that know two breasts are perfectly even in size. Best, Dr. Nazarian

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your question and provided information with pictures as well.. You are a good candidate if you have one of the following conditions:Self-esteem has decreased or you dislike the small size of their breasts.Not feeling comfortable in a bathing suit or tight clothing in the upper portion.Your breasts have become smaller and lost their firmness after having children.Weight fluctuations have changed the size and shape of their breasts.One of your breasts is noticeably smaller than the other.Breast augmentation is one of the most performed cosmetic surgeries and generally provides great satisfaction to the patient. It is usually performed with breast implants.I recommend you to get a consultation with a board certified plastic surgeon!!

Nicholas Tarola, MD · Answer

Thank you for your question.  Difference in breast size is extremely common.  One of the goals of breast augmentation is to improve asymmetries of the breasts.  Once you decide on an approximate volume that you would like with the augmentation, your surgeon should be able to make intraoperative decisions and place the appropriate size implants in the operating room by using temporary "sizer" implants before placing the permanent implants.  Hope this helps!

Daniel Brown, MD, FACS · Answer

Thank you for your questions and photos.  I definitely understand your concerns.  Contemplating surgery can be stressful!  Your breasts are somewhat asymmetric, and if they measured out at between 50-100 cc with the sizer, but closer to 50 cc, I would likely recommend using the 50 cc different implant.  I have found that in similar patients, if an implant difference greater than 50 cc is used to correct asymmetry, it is easily noticed.  An implant that is 100 cc larger will be very obvious, where a 50 cc larger implant (even if the breasts aren't exactly equal in size) will look much more natural.  You have done your research and seen 3 different surgeons.  I would encourage you to go with the surgeon that you feel the most comfortable with and that is able to answer your questions best.  Also please assure that your surgeon is an experienced, board certified plastic surgeon.  Best wishes!

Brian K. Brzowski, MD, FACS · Answer

Without personally examining you, it will be nearly impossible to give you an estimate as to the volume of implants that will provide you with the best match postoperatively.When I encounter people such as you, I spend a lot of time with them performing measurements, looking at how different volume implant sizers affect their symmetry, and I often modify my intraoperative process.  If needed, I offer patients the option to have me select the implant that best matches the opposite breast by using temporary sizing implants in the operating room.  By doing this, we can give the most precise result to patients, and they can be reassured that we are intent on achieving the optimum result.  This extra effort takes time and experience, but if you have the type of mismatch that your photographs reveal, it is well worth the time and effort.I did notice that you've seen three plastic surgeons.  I trust that you were diligent in investigating your surgeon to make certain that he or she was a member of the Utah Plastic Surgery Society.  Our members are all Board Certified Plastic Surgeons and adhere to a rigid set of ethical and professional standards.  You can find the list of members at the attached link.Best of luck.

Stacey Folk, MD · Answer

Dear FitMyAttitude,Most people do have some degree of asymmetry, both before and after surgery. Your natural breast tissue size and shape will always continue to fluctuate over time, so there is not one exact "soul mate" breast size that will never change.When matching asymmetric breasts it is important to get your impression with sizers, and 3D imaging with a system like Vectra can also be very helpful. With significantly asymmetric breasts selecting different profiles (a wider smaller implant in the natural larger breast, and a larger higher profile implant in the smaller breast with both having a similar base widths) is often a very good way to improve symmetry with implants.Intra-operatively the use of sizers and looking at your symmetry from different angles with you positioned both flat and upright is also very helpful. I would not expect a patient to select the best implant pre-operatively, only get me in the ballpark. Having multiple sizers and implants available during surgery is my best way of assuring the closest match. It is also probably better to err on retaining a touch your natural asymmetry rather that overcorrecting and making your small size too large with an implant as you might notice this more.Good luck!

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