Mastectomy-Breast Reconstruction-Implant Size Concern. Can I achieve a D cup? (Photo)

LenaBunz
I have always felt that doing bilateral reconstruction was the best way to achieve symmetry rather then trying to match a reconstructed breast to a natural breast. As far as the size being a C cup, I believe you could achieve a larger size with the use of saline implants which can be filled beyond the 800cc which is the maximum size for the gel implant. I do not recommend stacking gel implants. The other option is fat grafting to the breast with each fat grafting session providing the patient has adequate donor fat a patient can expect 1/2 cup size increase per session. This may or may not be an option for you. I hope this helps.

For women with large breasts, it can be difficult to achieve a good size match with implants alone. The largest silicone implant is 800cc, which is about a "C" cup size breast. A saline implant can be placed that can be filled up to about 1000cc, but overfilled implants can have other issues such as unnatural look, a hard feel, and a tendency to deflate. Often times for a good size match the natural breast must be reduced significantly. However, if you are amenable to autologous reconstruction, tissue from your abdomen or thigh may be a better match for your natural breast. In many women, the surgeon can harvest up to or over 1000g from the abdomen, especially for a unilateral reconstruction. Make sure to inquire to your reconstructive surgeon about both options.

Thank you for your question.
When it comes to breast implants, the sizes only go up so far. In a typical breast augmentation procedure, women are able to receive larger volumes due to the fact that there is breast tissue to complement it. However, in breast reconstruction there is no breast tissue meaning that the entire breast volume is created by the implant. If you are interested in larger volumes, I recommend speaking with your plastic surgeon about autologous tissue procedures such as a DIEP or TRAM alongside the use of an implant. They will be able to discuss your candidacy for the procedure and other options available to you depending on your past treatment and other relevant aspects of your medical history.

Dear LenaBunz,
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

Thank you for your question. It is very difficult to tell based on your picture exactly what size implants would look best. Frequently good symmetry and size can be achieved with various methods of breast reconstruction. Your non-mastectomy side can be reduced/lifted in order to match your reconstructed side. Also, in addition to the implant, more volume can be achieved with fat grafting.One option is to use your own tissue, frequently a DIEP flap, Which can be combined with an implant or fat grafting. Good luck

These are excellent questions. Cup size can be variable depending on patient and bra manufacturer. Cup size will be different at different stores. I usually try to avoid discussing cup size with patients because there is no good way to measure it objectively.
Breast reconstruction can be difficult in patients who are large breasted. Much of it depends on the size and shape of the breast as well as the type, size, and location of the cancer. The best recommendation is to discuss with a breast cancer surgeon and a board certified plastic surgeon. Hope this helps!