475 on one side and 490 on the other - Am I choosing the right implant size? (Photos)

Question

Based on my photos, what cup size can I expect with getting 475 on one side and 490 on the other? Will that sizing look good on my frame? (140lbs, 5'6)

Leila Kasrai, MD, FRCSC · Answer

It’s difficult to give you a guess without knowing more details about your current measurements. Please ask your surgeon's office if you can try on sizers. These are implants you can fit into your bra to give you a better idea of how may look after surgery.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Possibly a C/D look; Choosing the right size and profile breast implants for you. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Sibel Atalay, MD · Answer

That’s such a good question, and one many women ask when planning their surgery. Cup size after augmentation can vary quite a bit depending on your starting breast tissue, chest width, implant profile, and how your body carries volume.
At your height and weight (5’6”, 140 lbs), implants in the 475–490 cc range usually give a full C to small D cup look on most patients. The small difference between your implants, 15 cc, is simply to balance natural asymmetry, and it won’t be visible once healed.
If your surgeon recommended those sizes, it’s because they’re confident they’ll suit your frame beautifully. The goal isn’t just size, it’s shape, proportion, and how naturally the implants blend with your figure.
You can expect a lovely, feminine fullness that still looks balanced and elegant, not overdone. And remember, the best size is always the one that makes you feel confident when you see your reflection.
Dr. Sibel Atalay, MDBoard-Certified Plastic Surgeon & Destination Doctor

Daniel Barrett, MD · Answer

Dear Courageous366,

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

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing.  Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.  
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look."
With regards to your specific question, it is difficult to offer any real advice without an exam/measurements. Your asymmetry is very mild ("sisters not twins") and it is difficult to say whether the 15 ml (3 teaspoons) difference in the implants will make a real difference. 
Communication is key as you and your surgeon create your custom surgical plan. 
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Camille Cash, MD · Answer

I encourage you to visit with a board certified plastic surgeon near you to discuss your concerns.  Many have sample implants that you can "try on" to get an idea of how you may look after surgery.  Based on the implants you are considering you can anticipate increasing multiple cup sizes.  I've included a video on implant selection that I hope you find helpful.

475 on one side and 490 on the other - Am I choosing the right implant size? (Photos)

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