Should I go with 300cc or 400cc, I’m really scared of going too big. (Photos)

Question

Hi, I’d like your opinion on a few concerns. My surgery is next week. I’m 5’6, 133 lbs, 33-28-42 bra size “32B”. I’m getting sub-muscular, textured, silicone implants. Should i get smooth implants since im going sub-muscular anyway? I’m afraid they won’t drop. I don’t want to go too big, I’d hate a “D”. Would you recommend 300cc or 400cc. And how many cc’s are “lost” by going under the muscle? Also, would you recommend areolar incision? Thanks!

Gary M. Horndeski, MD · Answer

At size 32 B each 100
cc of implant corresponds to 1 cup size change. 
300 or 400 cc implants would take you up 3 or 4 cup sizes.  I recommend you consider a smaller implant if
you want to avoid being a D.  Best Wishes,Gary Horndeski, M.D.

Frank Lista, MD · Answer

Hi there! It's difficult to advise patients on implant volume without a formal sizing appointment, however, if you're concerned about "going too big," then a smaller implant would make the most sense. During your consultation, a board-certified plastic surgeon will give you a range of implant options (including volume and projection) to accomplish your desired look. 
In terms of technique, at my practice, we perform subfascial placement for more natural results and reduced breast animation. We also opt for smooth, cohesive gel implants because they're currently the best and safest option in the market when compared to textured implants. That being said, it's your surgeon's responsibility to advise you on any risks and potential complications with breast augmentation surgery.

Steven H. Wiener, MD · Answer

Many women have difficulty choosing a size implant.  If you are already a B cup, and don't want to be too big, I recommend an implant size of approximately 300cc.  You should consult with a Board Certified Plastic Surgeon and try on sizers with a bra and tee-shirt.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You are a great candidate
for a breast augmentation.  I prefer smooth silicone implants over textured.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  This entire surgery
can be performed with a small incision technique.  
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Diego Fierro, MD · Answer

Hi this is Dr Diego Fierro from Mexico. To become a “D” cup you have to used a very big implant like 450cc this in based of your thorax and the volume in your breast in this moment. If you are afraid of the size let me recommend something:
- you don’t have to decide between 300 cc or 400cc cause there are so many sizes between those number ask your plastic surgeon about it.
- it depends about the trademark of the implanted the type of proyection, the base of the implant, and smooth of it, with that you can decide. 
- the last one is, when you used a under muscle implant it looks smaller than use it on the muscle. If you ask me I use motiva implant and I recommend to you a implant 355cc with full proyection..

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.  Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.  There seems to be is a moderate amount of breast asymmetry and the use of different sizes of breast implants may help to improve overall breast symmetry.   It is not possible to accurately determine how many ccs (if any) a patient would “lose” when undergoing sub muscular breast augmentation surgery. I suggest patients do not make decisions based on statement such as: “you will lose 25 or 50 cc of volume when breast implants are placed under the muscle”. These statements are simply not reliable enough to utilize clinically. 
 
  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. Sometimes, it is necessary to seek several consultations before you feel comfortable about your choice.
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. I have found that the use of words such as “natural” or "C or D cup” etc may mean 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, best not to discuss your goals and/or judge the outcome of the procedure performed based on achieving a specific cup size. The use of computer imaging may be very helpful during the communication process. The use of in bra sizers may also be helpful. In other words, use as many “visual aids” as possible during the communication process. I encourage patients to meet with me as my times as necessary, to feel comfortable that we are both on the “same page”.
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. I generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.
 
I hope this helps. Best wishes for an outcome that you will be very pleased with.

Robin Evans, MD, FRCSC · Answer

Hi and thanks for your question.  I have never had a patient that feels their implants are too big.  However, I have had patients feel they are too small over time.  The photo you provided does give a good idea what you are looking for. I would work with your plastic surgeon to have an in-depth discussion about your goals.

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