I Am 5'6, Size 32A my Surgeon is Recommending 220cc Silicone Implants HP Partially Under? (photo)

Question

Im Concerned This Will Be Too Small?

	5'6 weight approx 118 pounds slim long limbed

Steven L. Ringler, MD, FACS · Answer

Thank you for your question. I think you have good reason to be concerned. Many surgeons never use high profile implants and 250 cc is a very conservative size for you. I rarely put in an implant less than 270-300cc but for someone your size it would typically require more volume like a 300-350cc implant. You should discuss this with your surgeon, and consider getting a second opinion. Good luck

Jeffrey Rockmore, MD · Answer

Thank you for your question and for providing photos. While it is impossible to precisely select an implant size without examining you, I would admit that the implant choice would be of concern to me. It is not the absolute volume of 220cc that is of most concern to me. I would be more concerned with the base width of the implant. A breast augmentation always looks its most natural when the width of the implant matches the chest width. This avoids the big space between the breasts that some women get after an augmentation.

	The 220cc high profile implant is a very narrow implant. My concern is that it would leave you with a gap between your breasts and look very implanted. A wider implant would give you a more natural look, and the profile of the implant could then be chosen based on how full you wanted to look. This three dimensional approach to implant selection should help you get a natural and more predictable result.

	Best of luck with your upcoming surgery.

	Jeff Rockmore

Kevin G. Rose, MD · Answer

The two main manufacturers of silicone implants, Mentor and Allergan do not make a 220cc HP implant. You should double check your doctors' recommendation. There is a 200 and a 230cc HP implant from Allergan which are very narrow, 9.7 and 10.0cm respectively. Mentor makes a 200, and a 225cc HP silicone implant. These are also very narrow, 9.7 and 10.1cm, respectively. You do appear to have a narrow chest but I doubt that these implants would fill out the diameter of a breast that would fit perfectly on your chest wall. The problem with implants that are too narrow is that the cleavage is not as close and the side of the brest can seem too flat. The breast should slightly stick out past the edge of the lateral chest wall when looking from the front. After 10 years of experience I never use such narrow implants. The implant diameter is almost always more than 11.0cm. This provides the best proportions. An 11cm implant is 300ccHP. Consider it.

C. Bob Basu, MD, MPH, FACS · Answer

This is the approach I use to help guide my patients with their implant size selection:

	I consider two factors when selecting implants for my patients:

	1.Dimensional planning
	2.Gel Implant Sizing system

	Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.

	Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look.  If you have decided on saline implants, then based on the gel sizer you select, we can guide you to the saline implant that achieves a similar look.
	Hope this helps.
	Dr. Basu
	Houston, TX

Paul Gill, MD · Answer

This depends on your desired end goal in terms of size.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

	Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.

	The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.

	I wish you a safe recovery and fantastic result.

	Dr. Gill

Raj S. Ambay, MD · Answer

I think you will achieve the results you wish. But rather than focusing on the type of implant profile or the number of cc's or bra cup size (with is inaccurate and manufacturer dependent), I would recommend you communicate very clearly your expectations and desires. Your plastic surgeon will decide with you on the profile of the implant based on the breast width, your body shape, skin elasticity and thickness and native breast tissue present. In my practice I usually explain the implant types, profile and rationale for using different implants/ profiles. I also use the a special sizing system pre-op and have patients try them inside a bra so they can get a sense of their look. I never tell them what size I have picked until they show me the "look" they REALLY desire by trying on the sizing system in our office. Then we sit down and evaluate "the look" they have chosen and see if it matches what I have chosen by measurements and physical exam. It does make it both fun and is a healthier partnership between patients and the PS. Speak with your plastic surgeon.

Jeffrey Zwiren, MD · Answer

This does appear to be a rather small implant that your surgeon is recommending. I do not promise a patient a cup size because this is a ticket to disappointment. It is best to look for a shape or contour that you like. In our office we use the Vectra 3D imaging system. This allows the patient to visualize their result prior to surgery. In one year of use and over 100 breast augmentations I have had no patient complain of an implant size problem.

Gregory Sexton, MD · Answer

I think you should be concerned. I rarely put in an implant less than 300cc. 

	You need to discuss it with your surgeon, and if he is not willing to go larger, then get a second opinion.

	Good luck.

Jourdan Gottlieb, MD · Answer

When a surgeon recommends an implant size, he/she takes into account the patient goals, and any limitations of the patient's anatomy that could affect the appropriate choice.

	 

	What I cannot tell is your goal, other than a concern that 220 may be too small. That is a rather small implant for someone 5'6" tall. It would probably increase you by about one cup size from a AA to an A.

	If you have a chance to try on the implants with a stretchy sports bra, you can get an inkling of what that size would look like, and that info can help you and your surgeon decide. 

	Another visit to your surgeon before scheduled surgery is in order.

	Thanks and best wishes.

Darryl J. Blinski, MD · Answer

Over the internet can only guess a size. In my opinion based upon the posted photos I would recommend a 300 to 350 cc UHP MENTOR

I Am 5'6, Size 32A my Surgeon is Recommending 220cc Silicone Implants HP Partially Under? (photo)

Answers (11)

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