Implant Size (Confused About Three Doctors Suggestions)

I've seen three PS for a BA. I'm 5'2", 148 lbs, breast 13 cm wide (170cc), live in Mexico. I don't want them to look round on the top (not high and ball-looking). I want a nice downward slope (not flat). They suggested: 1. Natrelle Soft Touch 120, round, high profile, min 365, max 410cc. 2. Natrelee 410, moderate profile, min 310, max 350 cc. 3. ST 120, round, high profile, max 310 cc. Now I'm confused, seems like too different choices. What would you recommend? Thank you!

Doctor Answers 11

Breast implant sizing

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The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size. 
Much of the final “look” achieved after breast augmentation surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.

2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.

3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.

4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  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 "fake looking" or "top heavy" 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.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.

Recommendation for specific breast size.

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To avoid the round look I would use the moderate profile filled to the upper limits of the volume range.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Implant size and cost

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You do not want the implant to be wider than your breast, so the larger the implant volume, the higher the profile may need to be. With a 13 cm breast, then for volumes 360 or less moderate to moderate plus should be a good option.

Similar sizes

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50 cc differences are a little more than a tablespoon - I don't think you will be able to tell a difference.  One way to get a more natural look and feel, is to use a silicone implant.  A way to better visualize what you will look like is to find a plastic surgeon with 3-D imaging so that you can see what you will look like with different size implants.  Good luck!

High Profile Breast Implants Are Just One Factor That Influences Breast Shape

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All three of those breast implant sizes are not significantly different and will all produce a very similar breast volume. To keep away from the round augmented breast look, I would definitely not use a high profile implant particularly with saline as it will be an even higher profile than that of a high profile silicone gel implant. Remember, however, that the profile of a breast implant is just one factor that influences the final breast shape and it is not even the most important one. The size of the implant and how tight or loose your breast skin is actually makes the most important contribution as to whether you end up with a more rounded look or more of a tear-drop shape. 

Implant choices

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The choices given to you are in terms of volume all in the same ball park.  It is like having chicken soup made by three different chefs, yet it all comes out as chicken soup a bit differently.  Without an exam it is difficult to nail down the implant that is right for you.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Implant selection

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Based on your comment, that you don't want them to look round and ball like, you may wish to eliminate the "high-profile" selections from your list.  That eliminates two choices right there!

Note that there is only about 50 cc difference between the implants - the size of 2 "shot glasses" - so it's a fairly minor size difference, in any event.  You want the implant width to be proportional to your breast width- that's key.  I'd also probably recommend a medium (aka "moderate plus") profile for you.

When I do implant selection with patients, we base choices on their measurements, then they get to try on some sizer implants in a sports bra & T -shirt.  It really helps women to look at the implants in the mirror, and then, they can tell me what they prefer.  I could talk numbers all day, but, as the saying goes, seeing is believing.

All the best,

What size implant is right in breast augmentation?

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Choosing the right implant size is always somewhat confusing.  You are trying to imagine what you will look like now, but also how you will feel about the size several years from now.  Generally the size is best determined by you, not by your physician. I realize that is hard and you definitely want to get suggestions from you doctor. I would ask a physician not just what size is best for you, but also, WHY they think that is the right size for you. Ultimately you should make the decision because you will ultimately feel best about that choice. 

Hope that helps.

Dr. Korman

Joshua Korman, MD
Mountain View Plastic Surgeon
4.8 out of 5 stars 29 reviews

Breast Implant Size

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Go 300 to 330 moderate profile and you will meet your goals.  Larger risks the convex, upper round lump, i have had an implant look.   High profile risks the "implant look"   300 to 330 and moderate profilewill be best for you.

How to pick breast implants.

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How to pick breast implant sizes
Article by George J. Beraka, MD
Manhattan Plastic Surgeon

1) This is the most common type of question on RealSelf.

2) It is the surgeon's job to pick the right breast implants, not the patient's. Implant selection is really pretty technical.

3) Make sure your surgeon REALLY understands the look you want. Mentioning a cup size is not enough. Show your surgeon pictures of breasts you like.

4) Then your surgeon has to tell you if your chosen look is realistic for your anatomy. The most common mistake is to go too big.

5) I recommend that the surgeon NOT make a final implant choice in advance, because this is just an educated guess.

6) The surgeon should have a large inventory of different size and shape implants available in the operating room.

7) Then the surgeon can put sterile disposable implant SIZERS in your breasts during surgery, to see what a particular implant really looks like inside you. This is how to make the best choice. A sizer costs only $45, and takes all the guess work out.

8) Finally, the sizer is discarded, and the correct breast implants (based on what you want and on your anatomy) are opened from the operating roon inventory, and put in your breasts to complete the operation.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.