What is the maximum size implant I will be able to have?

Question

I am 5ft 10, 28 years old and weigh 145 pounds. I have a breast width of 14cm and currently wear a 36A or 34B bra. I have had one child and breastfed him. During this time my bra size increased to a 36C but I have been left with lack of volume in the top of my breasts. I am not seeking the 'natural look' by I also don't want to look heavily augmented, somewhere in the middle would be nice. I want large breasts to balance out my pear shape.many thanks for your advice in advance

Marshall T. Partington, MD, FACS · Answer

At
5:10 you are tall with an ample breasts with of 14 centimeters. Try on a range
of sizers in the mid to upper level. It sounds like you can accommodate some of
the larger implants. Careful what you wish for, the bigger they are the harder
they fall. having said that choose what you want and be sure your plastic
surgeon is comfortable with that for you.

Joe Gryskiewicz, MD, FACS · Answer

Hi Noobs, First and foremost the implant should fit the dimensions
of your breast and tissue cover.  Here are a few
tips for you because this is perhaps the hardest decision for a patient to
make, as well as the surgeon. Also see
the video attached to my answer. Balancing the implant to your
over-all body shape and tissue cover is essential.The main thing is to have the diameter of the implant fit the diameter of
your breast "foot print".  The average
size chosen over our last 7,000 breast implants was “350cc”.BUT, 90% of our patients tell us they wish they were bigger a year after
BA.(We will see you every year for
routine checks at no charge.) It’s like your mind incorporates the "new
you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients
that they will experience an increase of approximately one cup size per 200 cc.
You can try on implants in the office by
placing them into a special bra.The implant is also flattened
somewhat when under the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for
flattening of the implant in the partial sub-muscular pocket. Once you decide on a size you like, then add
on 25cc, because in real life the implant will be flattened slightly by your
tissues.Multiple measurements need to
be taken to fit an implant to your exact anatomy.  Have your surgeon's
office show you the charts of the implant dimensions for the various profiles
of silicone and saline from the manufacturer.  Then you and your surgeon
can piece together the puzzle by matching your measurements, with your wishes,
versus your tissue cover and the available implants to arrive at
a surgical plan.Keep in mind
larger implants tend to have more problems over the years.Since silicone implants wrinkle less than
saline implants, they might be your best bet.You can
also approximate this at home by measuring out an equivalent amount of rice
placed into a cutoff foot of old panty-hose, and put this in your bra.Wear this around the house for a while, and
see what you think.Implant size must
square with assessments of tissue cover, breast diameter, and chest wall width.
Multiple measurements of your chest wall
are taken (seven in total). Implant size
selection has been an issue of much discussion. Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape. A photo album of patient
pictures is maintained to assist them. These photos ultimately help in determining
where the implants will be placed, since they can be shifted inside (to provide
more cleavage), to the outside, up or superiorly, and down or inferiorly during
surgery. In determining the final size
selection, I always place the highest priority on the preoperative measurements
and potential tissue cover.Finally,
your verbal requests are factored into the analysis. We use
the quick-recovery approach, so click on the web reference link below to have
this explained and you can see the list of Quick-Recovery (Flash-Recovery or
Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery
journals.It is a surgical procedure that
uses special instruments and techniques to minimize tissue damage and avoid
touching the ribs. It causes far less trauma to surrounding tissue than
traditional approaches, and it dramatically reduces pain and recovery time. In
published studies of BA patients, 95-percent of women interviewed after the
procedure returned to normal daily activities within 24-hours. Quick-recovery
BA is not a “gimmick.”These specialized
techniques, which actually speed recovery and get you back to your daily
routine, kids and work, are published in our plastic surgery journals.Because these PS journals are “peer-reviewed”
and edited, they are the gold-standard in our field as being valid science.
Therefore, these are sound techniques, not marketing hype.Be sure
to see only a board certified plastic surgeon (by ABPS - The American Board of
Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic
Plastic Surgery) and or a member of ASPS (The American Society of Plastic
Surgeons). Also, ask if the PS has an
established, high volume breast augmentation practice, performing several
hundred breast augmentations each year. Be sure the PS has been in practice for a
while, about 20-years might be a good gauge.Does the PS offer all three incisions?Discuss the implant type (gel or saline), shaped "gummy bear"
or non-shaped, smooth or textured, implant pocket (over or under the muscle)
and the "quick-recovery approach."Ask to see their before and after photos if you didn’t see any on their
website.  If they are experienced, they should have several 100 breast
implant patients for you to view.  I would also recommend that your doctor
offer you the chance to talk to past patients who would be happy to discuss
their experience with you.  You need to feel comfortable, so make sure the
environment is safe as in an accredited surgery center. Also, ask a prospective surgeon if he or she
has ever published journal articles in professional peer-reviewed journals,
which they can provide you.All the
best, “Dr. Joe”

Vincent N. Zubowicz, MD · Answer

Some women who want to be particularly busty can choose implants conspicuously large. The surgeon will choose the proper profile so the diameter of the prosthesis does not violate the normal anatomic borders of the breast.

Bryson G. Richards, MD · Answer

Thank you for your question. You present with the same concern that patients come to me with on nearly a daily basis. They have breast fed and are now looking to restore their breasts. Breast implants are definitely the way to go to restore lost volume associated with having kids.Picking the right implant is an important decision. This is what I recommend to do during your consultation: 1.Bring goal photographs to demonstrate potential
size and shape. This gives your surgeon an idea of “the look” you are going
after.2.Trying on sizers in the office. Sizer will give
a physical/PALPABLE demonstration of how the implants will change the volume of
your breasts. See yourself in a full size mirror while trying on these sizers.
We have tight fitting t-shirts to wear over the sizers to show how you will
look with the implants.3.Using 3D imaging (offered in my office) to
provide a VISUAL demonstration of how the implants will change your breasts and
the look that you will likely achieve. The software is super cool (CRISALIX)
and actually allows me to select the implant manufacturer and size.

Be open with your surgeon and it never hurts to go back a
second time with a loved one to confirm the implant size before surgery.

I hope this helps.-Dr. Bryson Richards (Las Vegas Plastic Surgeon)

Tom J. Pousti, MD · Answer

Thank you for the question. Online consultants will not be able to provide you with specific enough advice to be truly helpful. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical.

Keep in mind, also that seeking several consultations with board-certified plastic surgeons may be necessary before you find the plastic surgeon who is a "good fit" for you.

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.
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. For example, I have found that the use of words such as “natural look” or "C or D cup” or "somewhere in the middle" etc means 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, the use of computer imaging has been very helpful during the communication process, in our practice.
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, after the use of temporary intraoperative sizers.  Personally, I find it most beneficial to have a wide range of breast implant types, sizes, and profiles available.

I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Jeanette Padgett, MD, FACS · Answer

Thank you for posting your question.  It is difficult to answer your question via the internet.  The implant choice is best done during your consultation.  There are many variables to consider:  your breast width, the laxity of your skin, the profile of the implant, the presence (or not) of ribcage deformities, etc, etc.  Your plastic surgeon will discuss all of these with you and make recommendations for an implant size.  You can try on sizers during your appointment to give you an idea of the final result.  Best wishes.

Brian Coan, MD, FACS · Answer

Hi Noobs87, thanks for sharing your question. I suggest consulting with a board certified plastic surgeon, preferably one who is also a member of the American Society of Plastic Surgeons (ASPS). They will complete a thorough evaluation and decide what implant size would best fit your frame. Best of luck to you on your aesthetic journey. -Dr. Coan

Thomas Guillot, MD (retired) · Answer

It is best to do your sizing in the office in person with a bra and shirt and implant sizers.  Then you can see what size and type of implant will best suit your body.  Please see a board ceritifed plastic surgeon for evaluation and treatment.

What is the maximum size implant I will be able to have?

Answers (8)

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