Stretched & lost tissue from pregnancy, possible to go up to small D or at least 375cc? (Photos)

Question

Back story: I used to be a 34c (guessing based off bra size I used to wear). My measurements now are 29 band 32 cup. A 32b fits well. I have my surgery on April 16 next month but have yet to see the dr (consult on the 15th). Paid for silicone and my portal says he’s doing bilateral, inframmory, submuscular. Q: I’m wanting to go up to a small D or at least 375 cc. Is that possible? I just can’t stop researching and thinking. It’s making me so anxious.

Tyler Frew, MD · Answer

Hi there,
Yes its possible for a 375cc implant however you need to be fully measured to be sized adequately. You want to make sure the implant fills out your chest wall but not too wide. you will also need to discuss the profile of the implant (mod, high, ultra high) with your surgeon and the amount of upper pole fullness you are looking for. Also, discuss the type of gummy bear you are getting as there are three or so types with different silicone thickness. 
I would suggest you ask alot of questions at the consult and see if they will let you try various implants on in your bra.
Good luck and all the best

Daniel Barrett, MD · Answer

Dear Nicgoody23,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gianfranco Frojo, MD · Answer

In general, I strongly recommend against performing a surgery with a physician who has not evaluated you in person and performed a physical examination prior to the surgery date. Surgery is serious and things can go wrong without proper planning and patient counseling. I would recommend seeing if your surgeon can meet with you preoperatively to discuss everything including proper implant sizing.

Ramin Behmand, MD, FACS · Answer

Typically, for individuals with a 34-inch chest circumference, every 125-150cc increase corresponds to a cup size. When the chest circumference decreases to a size 32, every 100-125cc increase equates to a cup size. This adjustment is because a 32 D cup breast is actually smaller than a 34 D cup breast, which is smaller than a 36 D cup breast, and so forth. You may notice this difference when comparing friends with different bra sizes, but the same cup size—the cup size is relative to the circumference size, which is 32 inches in your case.

Given your history of larger breasts and the photos you've shared, your desired outcomes appear both realistic and attainable. Check out the link below for a recent post featuring a patient with close to a similar starting size who underwent augmentation to a D cup and later a reoperation to a full DD. To achieve similar results, smaller implants may be necessary due to your smaller chest circumference.

Dr. B.

Gary M. Horndeski, MD · Answer

At size 32, each 100 cc of implant corresponds to 1 cup size change. 375 cc implant will take you up 4 cup sizes. 375 cc implants will not fit under the muscle. You will not undergo submuscular but dual plane. I recommend a circumareola approach to lift the nipple-areola complex higher and at the same time place submuscular implants.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

This is the most involved part about breast augmentation unless you have certain volume in mind yourself. Procedure requires good cooperation and involvement of both patient and surgeon. An implant of 375 ml. would give you approximately two sizes up , which may be within what you want to achieve. Hope this helps.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Connie Hiers, MD, FACS · Answer

During your consultation, you will be examined and measured and can try on or visually see how you might look with different sizes, including 375 cc's. Your surgeon will help guide you to the correct size. Many women come in with an idea of size but wind up choosing another size once they see how large/small it really is.  The 375 cc implant will probably be a very nice size for you.

Ralph M. Rosato, MD · Answer

It is never a good idea to meet your surgeon the day before surgery!  What if you do not agree on a plan. What if you do not have confidence in them.  An ethical surgeon allows the patient to consider all options and would never operate for elective surgery the day before surgery.

Does you surgeon have local hospital privilege's?  Have you reviewed their reputation in the medical community? ; Will they be available to see you after surgery?

Please consider these questions.

Camille Cash, MD · Answer

Implant selection involves several decisions including volume, type, shape, and profile.  At your consultation your board certified plastic surgeon will measure your breasts (This is different than bra sizing) and discuss your surgical goals with you.  With this combined information a range of possible implants can be recommended.  I've included a video on this process that I hope you find helpful.

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