Is 450cc Enough to Go From Full A to a D Cup? Can I Change My Mind At the Pre Op?

If I ask my doctor for a full D and i'm currentlly a large A is it right to get 450cc saline implants (they are under the muscle) when i tryed them on i was leaning towards 475 to 500cc's, i'm wondering if he's just using his own good judgement that they will be full D's or if mabey he will just overfill, because on my chart he wrote 450? I am 5'3" and 135 lbs and a 34 A or small B. Thanks! and If I decide to change my mind on size can I still at the pre op??

Doctor Answers 7

Anxiety over breast implant size choices

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There is nothing that gives a patient more anxiety than implant selection.  This does require making sure that the plastic surgeon understands exactly what you are looking for.  Ultimately a happy patient is one who can look at themselves in the mirror after the surgery and say with confidence I got what I thought I was going to get.  How is this accomplished.  Trust the surgeons judgement and experience in helping you select the correct implant for your size and shape.  The truth is that, with some limitations, we can make the breasts as large as you want but this may not be the bests choice for many reasons.  I like to give the patient an objective ranged of implants to think about and then discuss what the anticipated results might be.  I never like to or will promise a cup size because it is a sure path to failure.   Think more about the size and shape you would like to be and do not focus on cup size.  This being said for your body frame every 175 to 200 cc of implant volume will take you up a cup size thus an implant in the 450 cc range certainly has you in the ballpark.  The newest innovation is a 3D body scanner that will allow you to visualize on your own body the anticipated results.  Plastic surgeons are just beginning to use this technology and I believe that it will change the way we look at breast enhancement surgery.   We are anticipating delivery of our system, called Vectra in mid May.


Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

A to D Cup Breast Augmentation

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Hello Noelogan,

If your doctor has been completely honest with you, he would have told you that there is no way to guarantee a cup size for many reasons, some relating to how your body will react to a given implant, and some relating to the non-standardization of the bra cup sizing system.  The best way to communicate your aesthetic goal to your doctor is to bring in photos of people whose proportions you would like to have.

Additionally, if your doctor has been completely informative regarding the process of breast augmentation, he would have told you that any of the implants you are considering are likely to be too large for your anatomy (breast base width, tissue thickness, tissue stretch, nipple to fold distance, rib cage diameter), and put you at increased risk for all complications.  The national average is 25% in three years, requiring re-operation.

Complications can be reduced 90% when the patient's aesthetic goal is no longer a factor, and the patient's anatomy dictates the size of the breast implant.  Although you are no different than many that preceded you and many that are yet to come, quite frankly your request is unreasonable.  You should have another conversation with your doctor and reconsider you aesthetic goals.

Best of luck.

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Implant selection

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Basing the success of breast augmentation on cup size is not advisable as cup size varies considerably from company to company. Implant selection should be a collaboration between the patient based on her needs/objectives and the surgeon based on his or her expertise and experience. You may be able to achieve the desired appearance at a smaller cup size. Patients can alter the size during the consultation process but you should keep in mind the surgeon's recommendation based on his or her expertise and experience.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Proper Implant Selection

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In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.
Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 95 reviews

Choosing the breast implants

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I never guarantee a cup size because it is too difficult to assess.  Manufacturers of bras make their cups differently. The yes thing for you to do is to go by volume. You can do the baggy test to get an approximate idea of the volume you like.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast Implant Size?

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Thank you for the question.

In order for you to have peace of mind it may be necessary for you to have another communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining which operation and/or 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. I have found that the use of words such as “natural” or "full D” etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

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. In my practice, this decision is usually made during surgery.

I hope this helps.

Breast implant size concerns.

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Your concerns are very legitimate and common. Most women second guess their decision before surgery. I also find most patients are afraid they may be too large preoperatively and wish they were larger postoperatively. I take this into account when selecting the final implant at surgery.


It generally is not an issue to have changes pre op, but make sure your surgeon is aware so the surgical facility can have all sizes available. 

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 13 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.