How many CCs do I need to go from a 34C AND B to a full D? No more, no less.

Hi CT,Exciting!  I wish you the best on your upcoming surgery.  Here are a few tips for picking the best size.  This is perhaps the hardest decision for
a patient to make, as well as the surgeon. Cup size estimates can be
misleading, but I generally advise patients that they will experience an
increase of approximately one cup size per 200 cc. You can try on implants in
the office by placing them into a special bra.Approximately 50 cc (1-2 oz.) is added to the final volume to account
for flattening of the implant in the partial submuscular pocket. Once you
decide on a size you like, then add on about 25-50 cc, because in real life the
implant will be flattened slightly by your tissues.Multiple measurements need to be taken to fit
an implant to your exact anatomy. Have your surgeon's office show you the
charts of the implant dimensions for the various profiles of silicone and
saline from the manufacturer. Then you and your surgeon can piece
together the puzzle by matching your measurements, with your wishes, versus
your tissue cover and the available implants to arrive at a surgical plan.Keep in mind larger implants tend to have
more problems over the years.Since
silicone implants wrinkle less than saline implants, they might be your best
bet.You can also approximate this at home by measuring out an equivalent
amount of rice placed into a cutoff foot of old panty-hose, and put this in
your bra.Wear this around the house for
a while, and see what you think.Implant
size must square with assessments of tissue cover, breast diameter, and chest
wall width. Multiple measurements of your chest wall are taken (seven in
total). Implant size selection has been
an issue of much discussion. Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape. A photo album of patient pictures is maintained to assist them.
These photos ultimately help in determining where the implants will be placed,
since they can be shifted inside (to provide more cleavage), to the outside, up
or superiorly, and down or inferiorly during surgery. In determining the final
size selection, I always place the highest priority on the preoperative
measurements and potential tissue cover. Then, the patient’s verbal requests
are factored into the analysis.Our
average size over the last 6,000 implants was 350. All the best, "Dr. Joe"

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

There are no manufacturers' standards for cup sizing in the bra industry. The
cups of a 34 D  and a 36 D are significantly different. Cup size varies from
manufacturer to manufacturer and even within styles from any particular
manufacturer.

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

Thank you for the question. There is no accurate correlation between size of breast implant and cup size achieved.

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're looking for. Ask to see lots of examples of his/her work.



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 "full D cup”  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 technology may also be very helpful during this communication process.



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) helps.