I’m looking to get breast implants and I’m trying to decide the right size for me. 255cc vs 275cc. Advice? (photos)

Question

I am 5 ft 2, 105 lbs with a skinny build and love fo go to gym. I’m looking for bigger boobs that look natural and not over the top. I’ve been deciding between 255cc and 275 cc moderate plus implants or maybe less. I’m currently a 32A. Any advice is much appreciated! I have attached photos of what I’d like them to look like.

Daniel Barrett, MD · Answer

Dear bananajk1234,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

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. 
With regards to your specific question, I would discourage you from focusing exclusively on a number of cc's but rather find a look you like. The best advice is to start with your BWD and use all of the tools at your disposal to come to a final decision. I would not struggle too mightily over a differential of 20 cc as this is a very small volume and unlikely to make a significant difference in size (5 teaspoons or less than half a shot glass).Based upon your photos, your choices seem reasonable for a conservative up size.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Ralph M. Rosato, MD · Answer

Most people cannot tell the difference between 255 and 275 cc implant. They are millimeters different. I tell patient to be honest with them selves would you rather be too big or too small. If it is too big then use 275. If it is too small use 255. Both implants will give you a natural not over the top look.  Good luck.

Richard Bloom, MBBS (Hons), FRACS · Answer

Hi there bananajk and thanks for posting,You are an excellent candidate for a BAM and your expectations are realistic.I think it is great that you have provided photos of the look you want to achieve, that makes things much easier as a surgeon.The two implants you are choosing from are very similar and unlikely to make a discernible  difference in your outcome.The other factors to consider are whether the implants are being placed subglandular or in a dual plane pocket. The images your have shown all appear to be dual plane.The other issue is implant shape, again the images you have selected look to be anatomic implants rather than round, so that needs to be considered as well.As to the final volume size, it really depends on your breast width and breast height. I think moderate plus projection is about right although it could be moderate, depending on other measurements.So the short answer to your question is really, its not just about implant volume, there are other things to consider, but that is a very realistic outcome.I hope that is helpfulRichard

Don Fontana, MD · Answer

The difference in size is minimal. Either one would be appropriate for you.  Remember, the larger the implant, the more the skin of your breast is stretched, and following pregnancy you may have stretch marks on your breasts if the pregnancy and nursing  causes significant breast enlargement.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.  Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.   I also think that your goal photograph is realistic understanding of course that goal photographs are communication tools not guarantees of exact outcome.
 
  Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully.  Generally I suggest that patients start with the American Society of Plastic Surgery and/or the Aesthetic Society of Plastic Surgery to obtain a list of well experienced board-certified plastic surgeons.
Then, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. 
***Ask to see lots of examples of their work and preferably speak/see patients who have had similar procedures done.  Ultimately it will be important that you feel comfortable that your plastic surgeon have a significant/demonstrable experience consistently achieving the types of outcomes you will be pleased with.   
Besides appropriate training and experience (and certification by the American Board of plastic surgery), looking at before/after photographs (and  preferably talking to previous patients) can be very helpful in this selection process.
****Basically, patients should look at the overall "quality" of the outcomes achieved;  in other words, it will be important that patients see lots of examples of outcomes that they would be pleased with.  In doing so patients will be able to get an idea of each  plastic surgeon's "aesthetic sensibilities".
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining 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” or "C cup” or "over the top" etc may mean different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, best not to discuss your goals and/or judge the outcome of the procedure performed based on achieving a specific cup size. The use of computer imaging may be very helpful during the communication process. The use of in bra sizers may also be helpful. In other words, use as many “visual aids” as possible during the communication process. I encourage patients to meet with me as my times as necessary, to feel comfortable that we are both on the “same page”.
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. I generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.
 One question that might be helpful for you to consider: would you be more disappointed if you are slightly too big or slightly too small after the breast augmentation procedure?
I hope this helps. Best wishes for an outcome that you will be very pleased with.

I’m looking to get breast implants and I’m trying to decide the right size for me. 255cc vs 275cc. Advice? (photos)

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