I️ am 5’2”, 139 lbs with broad shoulders and AA breasts. Does 500cc sound too big? (Photos)

A number of factors must be considered when selecting the correct volume implant for each patient. The breast size, and width, the width of the chest wall, the tightness of the skin coverage are just a few. What you want your breast to look like is also very important. While a 500 cc implant is fairly large, it may not be too big in your case. Select a good surgeon, communicate your desired outcome, and trust them to select the best implant for you.

Depending on the individual anatomy and desired results, estimations and measurements and the decision about the type of the implants to be used should be made for each patient individually along with a detailed mutual conversation and a physical examination. 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

Hi. There are other factors that come into play when making this type of decision. Has the patient had kids? Did she breast feed? How much laxity of skin is there? Posting photos in a blouse and wearing abra does not accurately reflect the condition of your breasts. I could not give you an accurate assesement and recommendation without the benefit of the above. Always seek out the opinion of a surgeon certified by the American Board of Plastic Surgery with years of experience in cosmetic breast surgery. Furthermore request to see before and after photos of previous patients by that doctor....not a clinic or surgery center. Do your homework......research and verify the doctor's credentials. Have they had problems with the Board of Medicine, disciplinary or otherwise. Any law suits? 
How about the center, clinic or facility? Are they accredited by a national organization or do they just have State approval. Understand that at the current time, there are three nationally recognized organizations responsible for the highest levels of patient safety, AAAASF, AAACH and JCHO. You owe it to yourself to position yourself for the best possible results but under the most stringent safety regulations, If you have kids, even more so.
How about anesthesia? Will you have a medical doctor certified by the American Board of Anesthesiology or a certified nurse anesthetist (CRNA)? Understand that there is no substitute for research. Cosmetic surgery, no matter how simple it may be to the patients, are invasive procedures and as such carry certain risks and complications.
In our office, as in others, we use TouchMD which is a web based program in which patients have the ability to load their picture unto the program. I then evaluate them and can actually draw on the picture to show a potential patient where the incisions would be located and how the procedure is to be realized. It's all done to comply with HIPPA which is the federal law that protects the patient's medical information. Look them up.
good luck, Dr PG

Questions regarding implant sizing are best answered in direct consultation with a board-certified plastic surgeon who can examine you in person, listen to your goals, and address your options with regards to  implant style, shape, volume, etc.  In fact, it might not be a bad idea to get a couple of consultations so that you can get differing perspectives from different plastic surgeons.  I don't know what your goal cup size is, however, based on your pictures, I would think that 500 cc's would be very large on your frame.  That is just a thought based on pictures, however, so take it with a grain of salt!

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 500cc is an appropriate size 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.   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.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

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. 
500 cc is a large augmentation on most frames. On a smaller frame, it is even more dramatic. However, if you have been appropriately sized according to BWD it should be possible. In my experience, patients with smaller breasts may need to stage such a significant augmentation with smaller more conservative upsize as a stepping stone.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Thank you for your question and photographs.  Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I agree that trying on different sizers will give a better visual representation as to what they would look like.  Best wishes!

Your plastic surgeon only has to meet your goals. It is best to have your PS place "sizers" on you in a bra with and without a T-shirt in front of a full length mirror to determine size. Also using Crisalix 3D imaging is a big help determining size. Be very clear about your expectations with your PS. You can also bring in photos of other people to assist in determining implant size.My personal opinion is that breasts that are too large in someone your height can make you look quite over-weight.Thank you for your question, photos and good luck.

Are you pictures with your sizers in? The idea of being "too big" is a personal decision and different for each patient and their desired results.  Without knowing your breast measurements, it is hard to judge. Visit with your BSPS and let them know what your desired result looks like. They will be able to recommend an implant size to match your desired outcome.

The best cosmetic result in any particular breast augmentation patient depends on a variety of factors, including: Your individual anatomy, desired outcome, 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. or the type of implant. 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 suit at a preoperative visit will help you and your surgeon choose the optimal implant.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you 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