What Implant Size Will Most Nearly Match a Natrelle Saline Implant Style 45, 460 Cc,

Ater having a nipple sparing mastectomy on my left breast, I am trying to figure out what breast implant size would most equal my reconstructed breast. My reconstructed breast is a Natrelle Silicone style 45, 460cc, 11.4cm width, 5.9 projection. My right side is a Natrelle silicone style 20, 375cc, 11.7 width, and 4.9 projection. My right side implant appears too small. Before surgery and augmentation, my bra size was a 34 A cup. What size implant on my right side will make me more even.

Doctor Answers 5

Post Mastectomy Implant Selection

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Implants for Even Breasts following mastectomy are hard to determine exactly.
It is very difficult to determine the exact size and shape of implant that will even our your two breasts without an examination by a board certified plastic surgeon. This is because several breast landmark measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Although it is helpful to have the measurements/dimensions of the implants you currently have, there are other factors such as amount of supple skin, thickness of the breast flaps, etc.For example a high profile implant may be required if tissues are not flexible which is often the case following mastectomy.  Without knowing these factors it would be tough to answer your question. For example your native base width of your breast will determine in many cases the maximal volume per implant profile that you can accommodate. 

I personally order more than one set of implant sizes and use sterile sizers placed in the pocket during surgery to know in advance exactly which implant would work best for you. Software morphing programs can be helpful in some but not all cases (e.g. doesn't work well in my experience with breast reconstruction, existing implants, sagging or asymmetric breasts).
My advice is to accept advice from your board certified plastic surgeon after a formal consultation and examination with measurements.. If still confused don't hesitate to get a second opinion.

Implant surgery for size change

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So let me get this straight. Your left breast (nipple-sparing mastectomy) is a Style 45, 460mL and you are happy with the size.

Your right breast is smaller and has a Style 20, 357mL.

You want to have surgery on the right to increase the size of the right to match the left.

This is a decision for your plastic surgeon to make at the time of surgery using different size implants/sizers. I would trust your surgeon to make that decision. If you do not trust him/her or you do not feel that he/she will get it right, then seek the opinion of another plastic surgeon.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Choosing an implant to match reconstruction

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Hi there-

I would have to agree with my colleague from New York...

This is a decision you will need to trust your surgeon to make, and both your outcome and your relationship with him will be adversely affected by inserting a bunch of opinions from doctors who have neither met you or been involved in your care to date.

Trust is important in good medicine... You've come this far with your surgeon- unless you have reason to not trust him now, follow his recommendations and instructions.

Using sterile disposable implant sizers during surgery will tell your surgeon which implant size will give you the best symmetry

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You really don't need to be asking yourself this question.  You need to have confidence that your surgeon can make this pretty technical choice during revision surgery.  If you are not sure, get another opinion.

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

Breast Asymmetry After Breast Reconstruction

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The hardest thing in breast reconstruction is getting an implant-reconstructed breast to match the contralateral breast in both size and shape.  This is why most women who undergo a unilateral reconstruction end up having surgery on the opposite side as well at some point.  This allows for better volume and symmetry with the cancer side.  If the augmented, healthy breast appears too small compared to the reconstructed breast, then you simply need to switch to a larger implant.  The hard part is figuring out which one.  Do you need more projection? More or less width?  Without a physical examination, it is hard to say, but given that you have a 45-460 on the left, you may need to go up to that exact implant on the right.  As you go up in size with the style 20, the implant may get too wide for your frame, which is why you may need to go with a style 45 on the good side as well.  It really just depends on how big the disparity is and where you need the volume.  I would discuss it with your surgeon and see what their thoughts are.

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.