Silicone teardrop 330 or 370cc? (Photo)

Question

Stats- 5"9 140. I really want a natural look and so have been recommended anatomical partially under the muscle implants. I always thought that 330 would be fine but looking at other tall woman, most of them go for 350 or over. So now wondering if I should go up to 370? I have such a small upper body that I'm scared it will look really stupid though. Any help/ suggestions would be great. Apologies photos aren't the greatest.

Larry S. Nichter, MD, MS, FACS · Answer

It is very difficult to determine 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 350 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. . 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 a bit.Additional critical decisions will also be made by your plastic surgeon such as: whether your implants will be above or below your pectoralis muscle. These choices are recommended to you based on the look you desire, the amount of sagging you may have, and other deciding factors. For more than 25 years, I have tried just about every method to best understand and achieve the patient’s optimal goal. The following is what I have found to be most accurate: To start with, I have found it most helpful for patients to bring in photos from my or other plastic surgeons’ websites to illustrate what they would like to look like. This gives me detailed standardized views and information both qualitative (shape, perkiness) and qualitative (size) and allows me to discuss with my patients how I can best achieve their objectives as well as realistic expectations. For example, though I always tell my patients that I cannot make them exactly the same as a photo because everyone has different anatomical constraints. However, these ”ideal” breast photos are brought to the operating room for reference during surgery so that I have the advantage of “seeing through my patient’s eyes” to best achieve their wishes. Even if the photo does not match their height or weight, I and most plastic surgeons are very good at translating the proportionality of the photo to your features.I personally order more than one set of implant sizes and use sterile implant “sizers” (temporary implants) placed in the created implant pocket during surgery to know in advance exactly which implant would work best for you in both a sitting and lying down position. This also allows me the opportunity to modify the pocket to meet some of the more subtle shape features desired. This enables me to use my full artistic potential to achieve your desired goals.

Australia Fragoso-Baez, MD · Answer

This is a very important step in your life and the best advise is to go with the recommendatiosn of your PS, there are different opinion about what size will be better but your doctor will know what will fit your chest and body frame also the best technique for your desired results, Good Luck!

Joseph L. Grzeskiewicz, MD, FACS · Answer

Once you have decided that you prefer the look of a shaped implant, the next most important process is the selection of implant size.  Because this is a process that is heavily dependent upon a personal interview for assessment of  your individual goals as well as a physical exam to measure your chest and breast dimensions and try on implant sizers, it will be impossible for us to give you specific recommendations for implant size on this forum.  I can give you some general comments and ideas however, and some observations that have held true in my practice.  First, you are tall and slender, and you have a small volume of your own breast tissue.  In addition, you state that you want a more "natural look," which to me implies a more gradual, sloping, less rounded contour to the upper pole of the breasts.  This typically makes for an ideal candidate for a shaped implant.  Being taller with broad shoulders generally gives you a wider range of implant sizes that will look good on you.  Additionally, with shaped implants, because we don't have such "aggressive" filling of the upper pole, you generally can "cheat" a bit up on the volume and still retain that nice natural appearance that you desire.  For instance, if you are on the fence over a 330 cc implant vs. a 370 cc implant, in my experience you would almost always be happier with the larger size.  For perspective, just think that a 1 oz. shot glass is 30 cc.  That's not a lot of volume, and it won't cause your breasts to be very noticeably larger, yet, typically, if a lady picks the smaller size, she will be more disappointed that she didn't get the fullness that she wanted.  This is especially true with the shaped implants, and that is why I usually tell my patients that if there are two sizes that they think they would be happy with, pick the larger size.  Again, just for perspective, most of the patients your height and frame size in our practice wind up picking implants in the 350 - 400 cc range, and not one of them looks "stupid."  One of the keys with shaped implants is to look at the base dimension and vertical height of the implant.  As long as this doesn't extend beyond the boundaries of your chest wall, the breast should appear quite natural.  Once again, these are just some general thoughts and perspectives to help you, and in no way can they substitute for a good consultation, complete with measurements and sizing.  Good luck.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.   Based on your photographs, you are starting at a good place and should have a very nice outcome with breast augmentation surgery.  Online consultants will not be able to provide you with specific enough advice to be truly helpful; you will be best off spending additional time with your plastic surgeon communicating your goals carefully.  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.  Again, have a full discussion and 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 "C or D cup" 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.   Therefore, I ask that my patients not base their communication preoperatively OR  their satisfaction with the outcome of surgery postoperatively, on achieving a specific cup size. The use of computer imaging may be very helpful during this communication phase.
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.  The use of temporary intraoperative sizers, viewing the patient's breasts in the upright and supine position, are very helpful during the breast implant selection process.
I hope this, and the attached link (dedicated to breast augmentation surgery concerns), helps.  Best wishes.

Steven M. Camp, MD · Answer

Thanks for your question.  Your photos indicate you would be a great candidate for shaped breast implants.  In terms of deciding your ideal size make sure you have opportunity review photos with your doctor and do some sizing.  Both trying on implants to see how they may look and feel is important.  Also some imaging may help as well.  Best of luck to you.Steven Camp, MD

M. Dean Vistnes, MD - Account Suspended · Answer

Your best bet when you are trying to decide on implants is to try on sizers of the exact implant you are considering inside a very tight sports bra. This will give you a close idea of what you will look like. More importantly the dimensions or width of the implants need to match and fit your frame and body. If you are working with a board certified plastic surgeon with an expertise in breast augmentation he or she should be able to help you with this in their office. Good luck! best, Dean Vistnes, M.D

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