400cc moderate plus too large for me? (Photo)

Question

Hello! I’m a 20 year old, 5’0 tall, 115 pounds . I have my surgery this week and decided on 400cc moderate plus implants under the muscle. I know feel like this is way to big for me and wondering if I should switch to 350cc. Having a lot of anxiety about picking the wrong size and ending up with too large of breasts for my body type . I am now a 32a

Lewis Albert Andres, MD · Answer

Hello! Thank you for your question. In general, implant size does not correlate with bra cup size. The cup size itself will vary from manufacturer to manufacturer as well as who is doing the actual measurements. Thus, cup size is never a reliable indicator for your breast size. I typically encourage my patients not to communicate her desires in cup size but more on the actual look and appearance. 
Good communication between you and your surgeon of your expectations is warranted - choosing your surgeon wisely is the first step. Discussion of your wishes and having an honest and open dialog of your procedure is mandatory (e.g, implant type, incision, placement, lift, etc). I have found that photographs brought by the patient is helpful to get a visualization of the appearance you wish for in terms of size, shape, fullness, etc. In addition, your surgeon's pre and postoperative photographs should demonstrate a realistic goal for you. Once this has been accomplished, allow your surgeon to utilize his/her best medical judgment during the procedure to finesse the best possible result for you after preoperative biodimensional planning and fitting the right implant for your breast width.  Without examination and measurements of your stature, breast width, and overall la it’s of tissue, it is difficult to tell you which I mplants would fit nicely for you. Given your photos, it appears that they would be a nice size and profile for you. However, getting appropriate values would assist greatly in determining the best implant size, type, and profile specifically for you.  Hope me that this helps! Best wishes for a wonderful result! Twee

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. If you think 400 cc is "way too big" then it is. You should be confident with your choice and should not proceed with surgery until you are ready. Discuss your concerns with your plastic surgeon and try on several implants to help decide on what you want.Good luck!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  It would be helpful to know your individual breast measurements in order to determine if 350 or 400cc would be a better choice for you.   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.

Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Gerald Minniti, MD, FACS · Answer

Hello,400 cc implant will not only look really big on your 5 foot frame (but that's a matter of taste, and not what is crucial to me as a surgeon), but they will likely exceed your anatomic soft tissue limit, leading to complications and reoperation. Your surgeon should size you (it's not just breast base width or BWD) to confirm anatomic capacity, and you should use sizers in the mirror to determine your anatomic goal, if achievable. Best of luck!

Payman Danielpour, MD, FACS · Answer

Thank you for your question.  I highly recommend that you see a surgeon that can show you exactly what different sizes look on your frame by performing a vectra 3-d simulation.  This will allow you to take the "guesswork" out of your breast augmentation surgery and give you the results that you are hoping for.

Donovan Rosas, MD · Answer

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. 
Additionally, I would not struggle with a 50 cc differential as this is subtle (equivalent to a shot glass) and unlikely to be discernible post op. That being said, on a smaller frame, conservative is the operative word.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Urmen Desai, MD, MPH, FACS · Answer

The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Farbod Esmailian, MD · Answer

Implant sizing is a complicated process involving a detailed exam and measurement.It would be very difficult for someone here to give you accurate advice without and examination.  Having said that, your surgeon should be the one directing you to obtain the results that you are trying to achieve.If you are uncertain about the size I would perhaps with your surgeon again to discuss the sizing.Hope that helps.

Daniel Barrett, MD · Answer

Dear Leela45,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, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Tim Sayed, MD, MBA, FACS · Answer

Thanks for the question and photos. How did you arrive at the 400cc size? Did you use a sizing kit in the office? Did your surgeon use simulation software like Crisalix or Vectra? These tools help take a lot of guesswork out of size selection. In general, revisions for breast augmentations are more commonly done when the patient wishes she had gone larger rather than wishing she had gone smaller, so I often counsel patients to pick the larger of the two choices if she is on the fence between two closely related implant models. Objectively, it's hard to know exactly whether 400cc might push you a bit larger than you want to be without an exam in the office. The choice of moderate plus vs a higher profile implant should be determined by measurements of your base breast diameter and the nipple to fold distance, so that your implant can be properly centered. Maybe discuss this further with your surgeon and see if some of the sizing/simulation tools are available before you commit, or seek a second opinion with a surgeon who offers these tools.

400cc moderate plus too large for me? (Photo)

Answers (14)

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