Would 550 - 600 cc implants be too large for my frame? Hoping to regain fullness (photos)

Question

Hello, I am scheduled for a BA next month and obsessing over the size I’ve been recommended. I have had 2 consultations and both Doctors said I am on the cusp of needing a lift but I have quite a bit of breast tissue. I am 5’6 and 130lbs. I have seen mixed reviews but if I went 550-600cc’s do you think that would increase my size to the extreme of looking abnormal? I’ve always had larger breasts, I’d just like the fullness back.

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. 
Based upon your photos alone, it is difficult to offer any real guidance. The best advice that can be given is to respect your BWD and select an implant that fits within that range.
As always, discuss your concerns with a board certified plastic surgeon.

Igor Burko, MD · Answer

Hello, my name is Dr. Burko and I am a Plastic Surgeon at SY Aesthetics in New York City. Breast implant selection is a highly individualized process based on each patient's breast/chest wall anatomy. Typically, the surgeon will measure your breast width and discuss your implant options based on your aesthetic goals. The appearance of each implant will then vary based on volume and implant profile. I find it helpful for patient's to bring in multiple photographs of their desired breast appearance. My recommendation is for you to discuss your questions and concerns with your plastic surgeon so that the surgery is best tailored to your wishes.

Gary M. Horndeski, MD · Answer

If you are already borderline of needing a lift then adding 600 cc implants, which weigh over 1 lb each, will definitely cause more descent. If you are size 32 or 34, each 100 cc of implant corresponds to 1 cup size change. If you are size 36 or 38, each 200 cc of implant corresponds to 1 cup size change. From your photographs, you look like a C, so I do not believe you need 600 cc implants.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

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 and style 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 size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Camille Cash, MD · Answer

More information or an exam is needed to help determine a recommended implant for you.  In addition to a discussion of your goals, measurements of your breasts are taken during a consultation.  Volume is one consideration, but others include type, profile, and shape.  If you are happy with how your breasts look now but just want them larger, then you may be able to avoid a lift.  I've included a video on implant selection that I hope you find helpful.

Connie Hiers, MD, FACS · Answer

Measurements and an examination is needed to be certain, but just based on your photos, 600 cc's will be too large and heavy for your frame and tissue. Going with large heavy implants, your skin will stretch more and your breasts will sag.  If a lift is needed, just getting larger implants does not work long term.

Mats Hagstrom, MD (license on probation) · Answer

Choice of implants is more than just choosing volume.
Personally, I start the process by first, measuring the patient’s actual breast diameter. I try to stay with implants that fit the anatomy of the breast itself. Depending on how much volume the patient is requesting, then helps me determine the profile breast implant selected. For the same size implant a woman with a wide diameter breast should have a low profile implant while a woman with a small diameter breast may be better suited to use a high profile implant.
I generally use pictures for patience to convey what look you’re trying to achieve. This is best done by looking at lots of before, and after pictures of previous patients, who look similar to how you look currently. I like using the website breastaugmentation dot com. That website has lots of good information and you can put in your height and weight and choice of procedure and seed tons of before and after pictures of previous patients who had similar body characteristics to your own. That website also includes the exact shape and size of implants used. Take example pictures from the website and share those with your plastic surgeon, and that we should help him or her understand what you’re hoping to achieve. Discussing how to choose the right shape and size of implants is something each plastic surgeon does their own way based on their experience what they were taught and what works for them.
I find communicating with pictures to be the most accurate, and effective when communicating breast size and shape.
During surgery, I typically bring pictures patients of brought me of what they feel is an appropriate outcome and use temporary sizers during surgery before committing to opening a set of implants. I typically have many different implants to choose from during surgery.
Best,
Mats Hagstrom, MD

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