Would you recommend 400cc or larger at 5'2 and 140lbs? (Photos)

Question

I’m 5’2”, 140 lbs and I’m considering a breast lift and implants of 400cc. Currently wear 36C bra. I’ve had 4 kids.

Roger Tsai, MD · Answer

Great question!  Without more information, it is hard to provide a good recommendation.  Most importantly, how big are you now and how big are are you looking to be?  What kind of look are you going for (this will determine projection)?  What is the width of your breast (this will determine how big you can go)?  Without more information, it is hard to provide you with any accurate recommendations.  You should be able to try on sizes during your consultations so that you have a clear idea of what your end result will look like.  In general, 200cc's is about 1 cup size, so 400cc's will be about 2 cups sizes.  Other than that, you will need a formal consultation so that an appropriate physical examination and the questions I stated above are addressed.Best of luck and hope this information helps!
- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon

Richard Zienowicz, MD · Answer

It is almost impossible to provide advice with a clothes photo as clothing provides a structure that will not help a surgeon be able to examine and provide you with accurate advice. That said, an in person consultation would be the best option, with a board certified plastic surgeon who can help you reach your body goals. When looking in your area, find a surgeon with before and after photos that have results that you like, as it can help you assess if the surgeon will understand your vision. If you like the kinds of results that surgeon provides patients, then you can trust their judgement when they provide you what kind of procedure you should get and what sizes of implants to consider. 3 D Vectra imaging can also assist with showing you what different results would look like. Not all surgeons have this equipment in their office, but some do, and it can help demonstrate why they would choose a specific set of procedures.

Gary M. Horndeski, MD · Answer

At size 36 C, each 200 cc of implant corresponds to 1 cup size change.  400 cc implants would take you to a DD.  Since you have had 4 children you probably need a lift.  Unfortunately, your photographs are inadequate.  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.

Kenneth Hughes, MD · Answer

A board certified plastic surgeon will be able to guide you to the correct size implant for your measurements and desires.  Measurements of the chest wall and breast imprint width as well as knowledge of all breast implant sizes and profiles should make this process easy. Try on a profile bra with various implant sizes under a tailored blouse, tight sweater, swimsuit, workout clothes, and other garments you typically wear so that you have the best idea of whether the garments fit as desired with the implant selected. 
Breast implants are measured in cubic centimeters (ccs). One hundred seventy five to 200 ccs is the equivalent to a one-cup size increase.  Each bra company calculates bra sizes differently, so using cup size alone as a parameter can lead to miscommunication between surgeon and patient. 
I would recommend that you go with the size that boosts your self-esteem, and fits your anatomy.  Choosing an implant based on an aesthetic goal that exceeds your anatomic capacity may lead to complications and possibly revision.  
Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon
Los Angeles, CA

Daniel Barrett, MD · Answer

Dear momof6sjc,
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

Tom J. Pousti, MD · Answer

Thank you for the question.    
 Generally speaking, patients undergoing the breast augmentation/lifting combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery. 
Also, patients undergoing the combination breast augmentation/lifting surgery should understand that there are limits as to how large of an outcome can be achieved, given that breast lifting surgery does involve breast skin removal. On the one hand, breast augmentation surgery is expanding the breast skin “envelope” while breast lifting is (by definition) tightening up the breast skin envelope. These 2 forces are counteracting each other. 
Therefore, it becomes important to remove the appropriate amount of breast skin and to use the appropriate size/profile of breast implants to balance these 2 forces appropriately and to allow for achievement of the patient's goals while minimizing risks of complications. 
In my practice, "tailor tacking" is an important part of the mastopexy and mastopexy/augmentation procedure. It involves TEMPORARY  closure of the skin (for example with temporary skin staples)  to double check the amount of skin that is to be excised during the procedure. This maneuver is done to ensure that enough skin, but not too much, is removed. On the one hand, it is important that enough skin be removed to achieve the aesthetic breast lifting results the patient is looking for; on the other hand, is important not to move too much skin creating tension upon closure and potential wide scars.
 
Also, generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting surgery (regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work. 
2. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural breasts” or "C or D cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during this communication phase.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.
Best wishes.

Curtis Wong, MD · Answer

to help visualize what you will look like with such an implant.  Its easy to determine if your look id good or if you are top heavy by simply just looking at you with sizers on.  You can make a homemade sizer with 1.5 cups of rice/beans in a nylon stocking that you've flattened out with a heavy book and use unlined bra and light colored shirts to help you see for yourself and if it fits on you.  This would create a sizer 360 cc in size and if you like it, the 400 cc implant will be absolutely fine.  If you think its too large, then think downsize.

Would you recommend 400cc or larger at 5'2 and 140lbs? (Photos)

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