How many cc's to go from 38B/C to 38 D/DD?

good evening!looking at your photos, your breast shape and nipple location necessitates a breast lift as well as augmentation for an optimal result.  Sizing will be dependent upon your tissue characteristics - not everyone can hold a 500cc implant and have a perky long lasting result.Remember the bigger the implant, the heavier the implant.  The heavier the implant the more weight is being placed upon your tissues that will lead to early loss of upper pole fullness.From looking at your photos you are not a straightforward case.  Please be sure to see a board certified plastic surgeon well versed in augmentation mastopexy for an evaulation.I hope this helps

Based on your photo, in your case, a breast lift procedure along with an augmentation would likely be recommended. Depending on the individual anatomy and desired results of the patient, estimations and measurements should be made for them individually. The elements that form up the breast shape and size and the overall frame can be different in each person. It will be best to consult a board certified plastic surgeon who is experienced in cosmetic breast surgery in person and discuss your goals and options after a physical examination.Hope this helps,Ali Rıza Öreroğlu, MD FEBOPRASEuropean and Turkish Board Certified Aesthetic, Plastic and Reconstructive SurgeonIstanbul, Turkey

Hello and thank you for your question. You are a great candidate for a breast augmentation.  550cc may be a good size for you, considering you have a wide chest base.  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.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  

Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

At size 38, each 200 cc of implant corresponds to 1 cup size change.  You would need approximately 400 cc to go from a B to a D.  However, implants alone will not resolve your problem.  As others have stated, your breasts are abnormal, too far apart and have descended.  You would benefit from a lift and the technique I recommend is The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained.  At the same time or later, fat transfers can be performed if additional volume is desired.  Implants are not lifetime devices and half are removed by 9.5 years.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

Dear roseOr,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

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. This will ensure that you avoid the dreaded "fake" look.Based on your photos, you exhibit some features of a tuberous breast (narrow base) as well as some ptosis/droop. You would likely benefit from a lift and release of constriction in addition to the augmentation.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

The breast implants that you are showing are larger than a DD. You would probably be looking at  600+ cc implants.In addition,you will definitely need a breast lift.The lift can be done at the same time or as a second stage ,depending on what your plastic surgeon recommends.I usually do  an augmentation and lift at the same time,although I explain to my patients that sometimes you will need a minor revision later

You obviously are an informed consumer and understand the importance of matching an implant to your natural breast width. There are certainly limits to the operation, related to how big an implant can be placed and not drastically change the shape or disrupt the natural attachments that define the breast shape. The photo of the desired result demonstrates a youthful nipple position centered over the breast fullness. You will probably require a lift in order to obtain this appearance. I would recommend you discuss your desires with your plastic surgeon and allow him to help you select the best size and profile of implant for you. Please select a plastic surgeon board certified by the American Board of Plastic Surgery and preferably a member of the ASAPS, (American Society of Aesthetic Plastic Surgeons).

The best cosmetic result in any particular breast augmentation patient depends on a variety of factors, including: Your individual anatomy, realistic expectations, a thorough discussion with the plastic surgeon about the options, and an understanding of the pros and cons of any particular implant choice. Proper sizing is not just about the number of cc’s. The thickness of your tissue, breast dimensions which include the width, height, and projection, as well as chest wall width all need to be considered when choosing an implant. Trying on implant “sizers” of various shapes and volumes while wearing a tight t-shirt, bra, or bathing sit at a preoperative visit will help you and your surgeon choose the optimal implant.

There are no manufacturers' standards for cup sizing in the bra industry. The cups of a 32 D-DD and a 38 D-DD are significantly different. Cup size varies from manufacturer to manufacturer and even within styles from any particular manufacturer. Implants alone without some variation of a lift will not achieve your desired goal.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person. 

Robert Singer, MD FACS

La Jolla, California

Dear RoseOr, 
Sizing of implants can be a challenging concept for many patients as patients perceived cup sizes vary and implants are measured in cc's not by cup size. With that said, the most important factor is being on the same page with your surgeon. If he/she knows your desired results then the sizing can be done appropriately intra operatively. 
One of the advantages of having a private fully accredited surgical center is that we stock breast implants in various sizes and shapes so that we are always prepared to provide the patient with the look they want. 
Sizers are used during the procedure and while the patient is fully asleep the table is lifted, the arms are put to the side so that the implants can be seen in different positions. Once the perfect size is determined then the actual implant is used. 
I hope this is helpful to you. 
Best regards, 
Tarek V. Copty, MD FACS