Teardrop smaller then round equal ccs?

Question

I am getting 400ccs sientra Classic anatomical on Friday. 400 scares me but my bwd is 12.2/13 so 400 works best for a little extra cleavage. I was torn 350vs400. My PS says it will look like 300ccs round when under the muscle. Do shaped implants look smaller then round implants post op? Does a 400 round under the muscle appear the same as 400 anatomical? Or are shaped implants a little smaller looking post op because of shape? Thanks!

Larry S. Nichter, MD, MS, FACS · Answer

Rather than trying to pick the implants yourself, it is far better to pick the shape you want and then let your plastic surgeon know exactly what you desire. It is the plastic surgeon's job to then know which implants will best satisfy your wishes. It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below link.

Richard H. Tholen, MD, FACS · Answer

400cc is 400cc whether round or teardrop.  Any implant below the muscle is compressed, so if you like the look of a 350cc implant in a bra or stretchy top, and have those exact size implants placed in submuscular pockets, you will swear your surgeon put in the wrong ones (too small). In other words, 350cc implants beneath the muscles look like 300cc sizers in a bra. Thus, around 400cc will need to be used if you like the "look" of the 350cc sizers. If you like the "look" of 400cc sizers, your surgeon should consider around 460cc implants. 50cc is barely visible as a difference (it is the same as 3 tablespoons and 1 teaspoon volume).400cc teardrop-shaped implants under the muscles look almost identical to 400cc round implants under the muscles when standing, but teardrop-shaped implants remain teardrop-shaped when reclining, whereas round implants flatten out and drop slightly to the sides when reclining, just like "real" breasts do, making teardrop-shaped implants decidedly NOT "anatomic."This was shown in a study that compared actual women with smooth, round implants to 
women with textured, teardrop-shaped implants. Mammograms were performed
 in upright and supine (lying-down) positions, and digital tracings 
computerized and compared. Both the round and teardrop-shaped implants 
had a sloped, teardrop shape when the women were upright. In fact, in 
upright patients, teardrop and round implants were indistinguishable on 
X-ray. But when a woman is lying down, the natural non-augmented breast 
flattens, drops to the side of the chest, and assumes a round shape, as 
does the round smooth implant. Teardrop-shaped implants stay 
teardrop-shaped in the lying-down position, which makes shaped implants actually 
less "anatomic" than round implants! I hope that clears things up! Best wishes! Dr. Tholen

Todd C. Case, MD · Answer

Your chest and breast dimensions will determine what size implant options are best for you.  The narrower the breast base width, the higher the projection of the implant will need to be if you want to be larger.  Otherwise the implants will be to wide.  Round implants tend to give more upper pole fullness and a round globe look like you see on many magazine covers.  Tear drop, or form stable, implants tend to shape the breast more to match the implant shape.

Remus Repta, MD · Answer

Communication is often the most important part of making the best decision for your breast augmentation goals.  With regards to shaped vs round implants, the cup size change and the shape of the the breasts will determine the size and type of implant.  In the end, the measurements of width, projection, and height of the shaped implant will be more important than the size in cc for the implant.  A shaped implant that meets your goals in terms of width, height, and projection will give you exactly the type of result that you are looking for.  Whatever the volume of that implant is at that point is irrelevant.All the best,Dr. Remus Repta

Steven Wallach, MD · Answer

You really have to compare the dimensions of the implants. Their overall base widths and projections to see if they are similar. More volume will mean more volume in a bra but the shapes will be different.

Heather J. Furnas, MD · Answer

Ask your plastic surgeon for the dimensions of the shaped and the round 400 cc implants. In a shaped implant, compared with a round one, the volume and projection are less in the upper breast, but greater lower down. Your surgeon can draw out the dimensions to give you a better understanding. Often we perceive breast to be larger if they're fuller up top. Meet with your plastic surgeon to discuss your concerns.Click on the link below to see a case with 400 cc round implants.All the best.

Tom J. Pousti, MD · Answer

You are asking good/relevant questions. The answers to these questions should be individualized based on the specific patient's situation; therefore,  best to spend more time communicating with your chosen plastic surgeon. Only then, after a full communication of your goals, concerns... will you be able to receive advice that is specific enough to be truly helpful. 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.  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. Sometimes, it is necessary to seek several consultations before you feel comfortable about your choice.
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 or D cup”  or a "top heavy" etc means 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.
I hope this (and the attached link,  dedicated to breast augmentation surgery concerns) helps.

Lori H. Saltz, MD (retired) · Answer

I do a large number of breast augmentations and a fair number of them with shaped implants.  Volume is volume, but different profiles will look a little larger or smaller because of the way the implant is filled.  In general a round implant will look fuller in the upper aspect of the breast which to the patient makes the breast seem larger.  A shaped implant is specifically weighted 55% in the lower half and 45% in the upper half so there is less fullness at the top even though the volume is the same. There is a very subtle difference in the apparent size, but nowhere near 100 cc; maybe 25 cc at the most. The difference is where the volume is located. Using bwd is the recommended way to find the best implant for your breast, but keep in mind that there are different profiles and shapes in different sizes that will fit the same bwd. No woman knows exactly what she is going to be happy with until she has had the implants for a few months.  That is probably the reason the the most common reason for revisions is size change.

Teardrop smaller then round equal ccs?

Answers (8)