400cc high profile saline - too big?

Hello, thanks for your question.   Many people want to know their final bra size with implant of a certain volume but unfortunately there is no perfect correlation.  There are other variables like your pre-existing breast size and the type of bra you are buying.  

Hi Matuts,A 400cc implant with a BWD of 11 might be pushing it a little bit, but if you want to go from a B to a D, you better go for the 400HP.  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”

There are good sizing systems to allow you to appreciate how a 400 mL implant is going to change your chest. Work with these before proceeding with surgery.

Hi, thanks for your question
on which implant size would be best for you.
Right now it sounds like you’re considering 400cc. Since there is no way to say definitively
over the internet which size would be optimal for you, take comfort in the fact
that the surgeon uses your unique measurements and is able to provide you with
a general range. In many cases the board
certified plastic surgeon can best be your guide as they’ve met with you in
person and heard your aesthetic goals. You may consider doing 3-D imaging;
however with nearly all the breast cases we’ve performed, we’ve found patients
enjoy doing a live “try on” session where they actually can “try on” the
implant in a non-padded bra in our office.
This does not give an exact measurement of outcome, rather it gives a
nice idea of what to expect. For patients who desire a more natural look we
like to recommend the shaped implant.
For patients who desire a more full, voluptuous look we recommend a
higher profile implant. And remember that all breasts have at least some amount
of asymmetry (we like to say they’re like sisters and not twins). My very best to you. – Dr. Brian Coan

Thank you for the question. 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. In our practice, most of our patients are very pleased with the "keep them guessing" look that you seem to want to achieve.

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” or "D cup” 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.
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.

The best cosmetic result in any
particular breast augmentation patient depends on a variety of factors,
including: Your individual anatomy, realistic expectations, a thorough
discussion with the plastic surgeon about the options, and an understanding of
the pros and cons of any particular implant choice. Proper sizing is not just
about the number of cc’s. The thickness of your tissue, breastdimensions which include the width, height, and projection, as
well as chest wall width all need to be considered when choosing an implant.
Trying on implant “sizers” of various shapes and volumes while wearing a tight
t-shirt, bra, or bathing sit at a preoperative visit will help you and your
surgeon choose the optimal implant.

There are no manufacturers' standards for cup sizing in the bra
industry. The cups of a 36 D and a 40 D are significantly different. Cup size
varies from manufacturer to manufacturer and even within styles from any
particular manufacturer. Nor is there a direct correlation between implant
shape or size and cup size.

Keep in mind that following the advice from a surgeon on this or
any other website who proposes to tell you exactly what to do without examining
you, physically feeling the tissue, assessing your desired outcome, taking a
full medical history, and discussing the pros and cons of each operative
procedure would not be in your best interest. I would suggest that your plastic
surgeon be certified by the American Board of Plastic Surgery and ideally a
member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you
trust and are comfortable with. You should discuss your concerns with that
surgeon in person.

Robert Singer, MD FACS

La Jolla, California

From your frame size, a 400 cc implant may be reasonable for you.  Only with a physical exam, could a surgeon definitively say whether the size you are considering will achieve your goals and be appropriate for you.  Ask your surgeon if you can try the implants on in a bra.  This should give you a good idea as to what you can expect.  Best wishes, Dr. Lepore.

Breast implants come in a variety of volumes, diameters, profiles and shapes. It is not possible to determine what implant is best for a certain patient without an exam.

In my experience, high profile implants, particularly saline look good for about 3-4 months and then the breast tissue/skin starts to drop down over the implants, giving an elongated snoopy appearing breast. Implants must be biometrically sized to fit the patient's chest or build.  Too large or too small or too high profile implants can look abnormal and unflattering.  I would recommend depending on your preference and breast height, I would recommend FM textured anatomic or moderate profile round implant with a diameter less than or equal to 11 cm and less than or equal to 350 cc's.