Would 850cc - 1000cc be right for me? (Photos)

Dear AnC637,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

Good evening!At least one of your goal photos is a patient of mine, and to go above 800cc in the U.S. requires saline implants since silicone implants don't come any larger than 800cc at present.You need a capsulectomy for your scar tissue, a donut mastopexy to lift your implant position, the Internal Bra for support, and 850-1000cc sounds awesome!I perform more than 200 XL augmentations a year- I have attached a link to my XL Augmentation photo gallery for your review- hope it helps!

I appreciate your question.





The best way to determine implant size is based on chest wall measurements that fit your body.  Once we determine that we can choose the profile based on what you want or need to achieve.  





Implants under the muscle, there is less risk of capsular contracture.  Anatomic implants tend to give a more natural shape with more nipple projection.





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 and restorative breast surgery.





Best of luck!





Dr. Schwartz

Board Certified Plastic Surgeon



Director-Beverly Hills Breast and Body Institute



#RealSelf100Surgeon



#RealSelfCORESurgeon

With smooth round implants placed over the muscle, the risk of capsular contracture (scar hardening) is much higher. As a result, switching your implants to a sub muscular position, with possible reinforcement using a material like Strattice, would be a good idea.  However, the size range you are considering is a bad idea in my opinion.First of all, no FDA approved silicone implants in the US are currently larger than 800cc.  To get in the range you are talking about (assuming you had surgery in the US), you would need an overfilled saline, which would be a higher risk implant for rippling and stretching the tissues.  Beyond that, the sheer size and weight of an implant that size will create tremendous wear and tear on your breasts over the years, which can be difficult or impossible to fix.You may like the look of very large, round implants, but you have already experienced some problems and will probably compound them if you go larger.  Ideally, you should visit a skilled plastic surgeon that has a focus in breast revision that can perform measurements and help you select implants that are properly fitted for your body.  You may have to compromise on size, but what you gain in terms of safety, longevity, comfort and proportion should be a very fair trade off.  Good luck!

Thank you for the question.   You will find that online consultants will not be able to provide you with specific advice in regards to selection of specific breast implant size/profile.  Often, patients who are looking for the "larger, round look" benefit from the use of high or ultra high-profile silicone gel breast implants or overfilled saline implants.





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, and computer imaging) will be critical. 







Generally speaking, the best online advice I can give to ladies who are considering revisionary 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. I have found that the use of words such as “perfect size” or "D or DD 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.







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). Viewing the patient's chest wall in the upright and supine positions, with temporary sizes in place, help select the best breast implant size/profile for the specific patient.







I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps. Best wishes.