350cc or 400? HP or moderate silicone on 11.5 BWD? (Photo)

Went for my consult liked the 350 cc hp but I am afraid it will look small I am 5,5 weight 145 lbs but have a narrow chest. I am also having a lift on one breast with the donut incision. I am currently a 36 B but it's not a full B at all. I like the look of more of an upper fullness of the breast. Very undecided. I am 36 years old 3 children

Doctor Answers 17

Implant volume

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Choosing the right implant for you requires an exam in person. I do agree  that you need a lift as well.  Best of luck.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

350cc or 400? HP or moderate silicone on 11.5 BWD?

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Thank you for your question and photos. From the looks of your photos, it appears that your right breast is significantly larger, and thus sags more, than your left breast. I am not a fan of the "donut" mastopexy as it can make your areola look flat like a dish, plus it would definitely be inadequate to lift your right breast adequately. I would say that a "lollipop" scar would be the minimal mastopexy to achieve the best shape, and an anchor scar would probably be best. Possibly the left could use less of a mastppexy, but it appears you  could use a slight lift there too. The genera rule is, if your nipple is below your inframammory crease, you need a mastopexy.

Regarding size, you will need two different size implants since the left breast is so much smaller. As a matter of interest, there is very little difference in a 350 ml and a 400 ml implant. Your PS will measure your breast width relating to the size of the implants and determine the profile of the implants. My guess is that they will be high profiles.

Have your PS or another PS use "sizers" in your breast t determine the difference in the sizes and what appeals to you. Bring a T-shirt to put over the "sizers" in front of a full length mirror. Also Crisalix 3-D imaging would be very helpful determine the right size. My patients love using that method.

Thank you for your question and photos, and best of luck to you.

You have very complicated breasts so be careful

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From your posted photos it appears that your right breast is almost twice the volume of your left and is much lower. A donut or circum-areolar lift on the right is not enough to give you a good looking result. You need 2 different implant sizes as well as a vertical(lollipop) lift on the right and a donut lift on the left. Many times in this situation I will attempt to get the size and lift matched on an initial surgery and then go back in 4-6 months and place the implants. In that way you can be sure to get the best result. If your plastic surgeon told you that you only need a donut lift on the right then I would be a little apprehensive and seek a second or third opinion. I hope this has helped.

Itzhak Nir, MD, FACS
West Palm Beach Plastic Surgeon
4.9 out of 5 stars 41 reviews

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Choosing implant size for breast augmentation.

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In my practice we have patients try on sizers (specially shaped implants that fit over the breast inside a thin bra) to get an idea of the fullness sought.  A fifty cc difference is negligible in terms of overall effect, so either size you mentioned will be about the same overall.  In general, 200-250 cc is equivalent to a full cup size difference.

Breast lift with implants

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Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  With that being said, based on your photographs, the best shape and contour could be achieved with an implant and a breast lift. Your nipple sits below the inframammary fold and without a lift in addition to the implant, this will not have a natural shape.  A breast lift with an implant can result in a very nice shape if good technique is used.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 173 reviews

Implant size

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Dear yakviv30,

determining the ideal breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient. 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 its 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, everyone of them have 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.

Daniel Barrett, MD, MHA, MS 

Certified, American Board of Plastic Surgery  

Member, Am. Society of Plastic Surgery

Daniel Barrett, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 84 reviews

350 cc moderate profile

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Sounds like a good choice of implant. You have significant right breast ptosis and asymetry.

Consider placing a bigger implant on the left side.

50 cc is very subtle

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Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.

Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 

A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.

When sizing patients, there are a number of useful tools including:

-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)

-Breast sizers (rice bags)

-Goal photos

I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.

Based upon your photos and measurements, your implant selection would seem to be reasonable/appropriate. I would not stress over 50 cc as this volume is equivalent to the volume of a shot glass and will likely make a very subtle difference in your overall result. A higher profile device will provide greater projection and more volume in a similar BWD.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Donovan Rosas, MD
Kissimmee Plastic Surgeon
5.0 out of 5 stars 13 reviews

350cc or 400? HP or moderate silicone on 11.5 BWD?

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Thank you for sharing your question and photographs.  I agree that for optimal results you would benefit both from placement of implants as well as a breast lift procedure but think you will need a more powerful lift than that which the donut affords.  As for your implant size it would be best to "try on" each sizer to have a better representation of what you are interested in obtaining.  A higher profile implant will achieve greater upper pole fullness and projection while having greater soft tissue coverage.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

50 cc difference

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Once the implant is put in, a 50 cc difference, when taken with the combined implant and breast, will represent only about a 7% difference, so try not to agonized over this.  Try on sizers with your surgeon
Best of luck!

Dr. Subbio
Board-Certified Plastic Surgeon
Newtown Square/Philadelphia, PA

Christian Subbio, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 74 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.