What size would you recommend? I want to increase the size but look natural. (Photos)

Question

I had a consultation today for a breast augmentation but it was such a blur and a little rushed. I asked for natural implants but with still a noticeable chest. I don’t want them to look fake but I want some size. I breastfed for 16 months and I am 50kg 5’5 height. I opted for 235cc but not I am worried I will feel underwhelmed now I have had a chance to come home and see other girls with that amount it doesn’t look much. I am a 32AA

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Daniel Barrett, MD · Answer

Dear dhakans,

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. 
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
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Sibel Atalay, MD · Answer

It makes total sense to feel a little overwhelmed after your consultation, it’s a lot of information all at once, and it’s normal to second-guess once you’ve had time to sit with the decision. Wanting a natural look but still some noticeable enhancement is a very common goal, especially after breastfeeding, and implant sizing plays a big part in that balance.
On your frame (50 kg, 5’5, 32AA), 235cc can actually create a very pretty, natural result. Because you’re starting with a small base, even a modest implant often looks more noticeable than it might on someone with more natural tissue. Still, if you’re worried about feeling underwhelmed, it’s worth discussing one size up (for example, in the 250–275cc range). Many women find that a slight increase gives them the “visible but still natural” outcome they’re after, without pushing into the “fake” look.
The most important part is that you feel confident and excited about your choice. If you’re feeling uncertain, it’s absolutely okay to schedule a follow-up with your surgeon, try on sizers again, and look at before-and-after photos of women with your height, weight, and starting point. That way, you can see what 235cc versus slightly larger sizes might look like on a body like yours.

Brian K. Reedy, MD · Answer

Thanks for your question! If my patients have doubts about their implants after the initial consultation, we offer them the opportunity to come in and try them on again. That way, you can feel confident about your decision. Good luck!

Donovan Rosas, MD · Answer

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing.  Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.  
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." Communication is key as you and your surgeon create your custom surgical plan. 
With regards to your specific question, it is important to establish priorities. If "natural" is your priority then conservative sizing is recommended. I would not compare yourself to others unless they looked similar pre-op. The same implants will look different on different individuals.
As always, discuss your concerns with a board certified plastic surgeon.

Jonathan Heistein, MD · Answer

Hi.  It is such an important decision to make about the size of your implant.  If you feel like the consultation was a blur, then you should go back for a second consultation to make sure that you are getting what you want.  Try on implant sizes and talk to your surgeon BEFORE you have surgery.  It is much better to be sure about your decision before surgery than to be unhappy after surgery.  Hope that helps.  Best of luck!

Gulcin Nujen Cardak, MD, FEBOPRAS · Answer

Hello, thank you for sharing your pictures. After reviewing them, I noticed that you are a slim woman with no sagging. I’d like to explain the decision-making process for choosing the implant size. There are a few key factors we consider when determining the right size.First of all, your personal preference is very important. Then, we take several measurements, such as your breast width, bust size, and the thickness of your existing breast tissue. After evaluating these factors, we decide on the size together with you.So, while it’s not possible to give you an exact recommendation without an in-person consultation, I understand that you prefer not to have large breasts. Based on this, implants between 225–300 cc would provide you with a perky, natural, and proportional breasts.

Jeffrey M. Darrow, MD · Answer

Thank you for your photos. First the good news. You have no ptosis of your nipple. You have symmetrical breasts. You have a fair amount of breast tissue, which will act as a camouflage to any implant.  If you are a double A cup now, approximately 235 cc will make you one cup size larger. Each subsequent increase in the size of the implant adds a few millimeters of width and approximately 20 cc of additional volume, so there is a range of implants which will fit you.  Most patients of your height and weight will find that a 300 or 325 cc implant gives them the additional volume that they are looking for, and leaves them looking natural.  Within the range of implants that would match your breast width, and your desired increase in volume, there is no right or wrong choice. You would have to decide whether you wish to be slightly on the fuller side or slightly on the smaller side. Having said that, it is well known that plastic surgeons hear from their patients that they wish they had gone slightly larger far more often than that you wish they had gone smaller.  Best wishes.

Gary M. Horndeski, MD · Answer

Your breasts are high on the chest wall. You would benefit from breast augmentation. You can have an inframammary approach to place submuscular smooth implants. At size 32, each 100 cc of implant corresponds to 1 cup size change. 200 cc implants would take you from from an AA to a B or possibly a C.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ram Kalus, MD, FACS · Answer

Thank you for your inquiry and photos. An examination in person would be required to properly evaluate you and make specific treatment recommendations. That said, you have what appear to be pretty and symmetric breasts. Implant width and projection are far more important than volume, so learning from you that “a 235” was recommended is not enough j formation to be able to properly respond to your question.

Please select a board certified plastic surgeon whose aesthetic results align with your own preferences, and make sure that you prepare for your consultation with photos of women's breasts you would hope to be able to mimic in your own final result. Do your research, and be open to the possibility that more than one consultation might be in your interest to feel confident with your decision to move forward with scheduling you surgery. Best of luck to you.

What size would you recommend? I want to increase the size but look natural. (Photos)

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