Have I been sized correctly for a Breast Augmentation or should I get a second opinion? (photos)

Good evening,
Those recommendations sound a bit ridiculous, and you should always always always speak to at least two or three different board certified plastic surgeons before choosing the surgeon who is right for you. I perform 600 augmentations a year, have been doing so for 22 years in private practice, and have rarely ever met a patient who couldn't go up to 400-450cc.

At size 36, each 200 cc of implant corresponds to 1 cup size change. If you want to go up 1 cup size then that would only require 200 cc implants. 400 cc implants would not fit retro-pectoral and would extrude inferior and laterally. The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Thank you for sharing your question and photographs. Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would recommend continuing to discuss your concerns with your plastic surgeon or seek additional consultations to ensure that the implants you decide upon are the right ones to meet your expectations. Best wishes!

Thank you for your question. It is never a bad option to seek a second opinion prior to having a cosmetic surgery procedure if your goals do not align with your surgeon's advice. That stated, it is important to take into consideration your own anatomy when choosing breast implants. Picking implants that are larger/wider than your breast dimensions can increase the risk of rippling, palpability, numbness and other problems. You will get the best advice from a surgeon who has done an in-person examination including measurements, since only limited information can be obtained from a photo.

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 and they choose what looks right for them. 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. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Hi, thank you for sharing your question. You are a good candidate for breast augmentation and it seems you’ve been given the appropriate sizes to match your measurements. Ultimately, the upper limit of implant size is based on your anatomy. Your plastic surgeon can discuss with you what that upper limit may be. I hope this helps.

Dear Ravensgirl62,
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

Your surgeon appears to have sized you correctly based on your frame. However, larger implants can be placed, but may not fit your frame well. Get a second opinion if you want. However, your breasts will do much better long term with implants that fit your frame. Large implant will thin your tissue and sag with time, and may be too heavy on your neck and shoulders.

If you are unsure of the surgical plan with your plastic surgeon you should absolutely seek a second opinion. Surgery is Surgery. If you are unhappy with the plan then you may not be happy with your outcome.

From the information provided it seems you could go a bit larger than was discussed, but it really depends on your goals for surgery. It's always a good idea to visit with a few board certified plastic surgeons for consultations to listen to various viewpoints. Many surgeons offices have sample implants you can "try on" to get an idea of how you may look after surgery.