I decided on 450cc Allergan Style 20 round. However, I was thinking is this to big for my body frame?

I am scheduled to go in for my second consultation before my surgery in 3 weeks. 5'2" at 138 lbs currently, boob diameter at 13cm Allergan Style 20 round implant i am choosing is at a 12.4 diameter. Does this mean i can go bigger to a 475cc implant 12.6 cm diameter with minimal sagging effect? or am i to small to go big so fast? What does the projection of 5.2 cm for the 450cc implant mean? Looking to achieve a bra size around D i am currently a deflated B after two breastfeed babies.

Doctor Answers 8

The right size for you

It is very difficult to determine the best implant you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implants:

Breast augmentation

I suggest 3D photographic imaging to see what you would look like with this particular implant.  You can simulate not only volume but also specific implants and projections.

John Burns, MD
Dallas Plastic Surgeon
4.6 out of 5 stars 33 reviews

Implant sizing

Implants have several different dimensions.  The most important is the base-width, which is measured in centimeters and corresponds to the width of your chest.  In a round implant, the width and the height are the same and are called the implant diameter. This measurement cannot be changed, so you have to pick an implant that "fits" your chest wall.

Another dimension is the projection.  This refers to how far the implant sticks out. An implant with a projection of 5.2 cm that was lying flat on a table would have stick up 5.2 cm. One option for increasing the size is to pick an implant with a higher projection.

Another dimension is the implant weight, which is measured in grams (or in cc's).  The more an implant weighs, the bigger it will be.  Increases in weight are achieved by making the implant wider (diameter) or making it stick out more (projection).

The ultimate decision about what implant is right for you is best made by meeting with a plastic surgeon and having a discussion of the options.  Often we will use techniques to help estimate size, such as 3D photography or sizers. 

Good luck!

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What size implants


This is a common question asked not only in forums, but also in the offices of cosmetic plastic surgeons. It seems to be a source of some angst for most women as they have tremendous concern for what the final outcome might be. I find that several things over the last 25 years have helped patients decide which type, shape, and projection ratios will best suit their needs. I think it's helpful if the patient brings in several photographs of what the goal look of her breasts might be. Also, if she can bring some photographs of what she doesn't want this will eliminate trying to express in words what “natural”, “high cleavage”, “low cleavage”, “fake”, and “stripper” may mean to her. I have likewise found the Vectra 3-D imaging platform to be the single most helpful tool in trying to visualize what the outcome might be with different sizes of implants. The Mentor shell sizing system, in which a shell of implant material is placed over the breast and in a padless bra, can likewise be helpful in that it can, not only show the size in a bra, but can give the patient some idea as to what the weight of the implant might be.In my opinion, the implants will look best when the base width of the implant is at, or just slightly less, than a natural base width of her breast. Considerations of chest wall abnormalities, location of breast creases, shapes of the breast, amount of overlying breast tissue, stretch ability of the skin and breast over the implant among other things also play a role in trying to best decide which implant will look best. It can also be helpful if the plastic surgeon, during their consultation, can provide some insight into what the likely outcome would be with different sized implants given their experience in breast implant surgery over many years. We ask our patients to bring different types of clothing such as evening gowns and bathing suits as well as a tight shirt to evaluate what the implant might look like under these type of clothing options. It is also possible to make a home made breast size or using grain rice. Approximately 1 ounce of rice equals 30 mL of breast implants volume. The rice can be placed into a pantyhose leg and enough volume left in the pantyhose such that the rice can be flattened out. You can then tie off the pantyhose and cut off the excess. This flattened rice volume pantyhose can be added on top of the breast inside of a padless bra and can give a rough approximation of what the corresponding implant might look like. Besides the size, most plastic surgical consultations for breast augmentation will also deal with the shape of implants, whether round or anatomically shaped. Here I think the Vectra really shines in that you can place two images next to each other, one with the shaped implant and one with a round implant such that the potential breast implant patient can really see what the difference would look like on them. All things considered, this can be a fun process and the vast majority of patients in my practice are quite happy with their end result. Hope your surgery goes well and good luck.


Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 43 reviews

Sizes and implants... what is too big

Thanks for sharing your question. I can appreciate your concern.

The measurements are a guide, but only inperson evaluations and the surgery will determine the best fit for your body. Always remember that the bigger the implant the more the damage to the tissues in the long term. 

Finally, make sure that your doctor is aware of your process. He should be able to guide you best in your care.

Wishing you the best in your journey

Breast Augmentation - Size Selection

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

B

Thank you for the question. Online consultants will not be able to provide you with specific enough advice to be truly helpful.  
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, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
Given that your surgery is coming up soon, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.
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 know 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/video, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

I decided on 450cc Allergan Style 20 round. However, I was thinking is this to big for my body frame?

Please sit down and discuss this with your plastic surgeon before surgery. This is a complex decision that cannot be answered over the internet. The 450 should increase you two cup sizes in the same style bra you currrently wear, See below for more on sizing:

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.