Any suggestions on cc selection?

Although I've chosen 485cc, I'm still in limbo of considering 505cc since there will be a loss of 10% after the implant is placed under the muscle. Any thoughts/ recommendations?

Doctor Answers 9

Breast Implants/ Breast Augmentation/ Anatomic Gummy Bear Implants/ Silicone Implants/ Breast Implant Revision Surgery

I appreciate your question.

The size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.

Silicone will give you a fullness at the top (upper pole fullness).
Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.
These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute
#RealSelf100Surgeon




Any suggestions on cc selection?

Thank you for your question and congratulations on your upcoming surgery.  Based on the discussion you had with your plastic surgeon regarding your goal outcome they should be able to steer you to the right implant to best match your exceptions.  Both implants are large and the 20cc difference spread over the entire implant will not make much of a material difference so I would select the implant that you felt best with. Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Choosing the Size of Your Breast Implant

Your Plastic Surgeon will measure you to determine the best shape and size of the #implants to be used. In my practice, about 20% of the patients benefit from #shaped implants.
It's important to know what size bra you currently wear. Is it a 32, 34, 36 bra, and, of course, the cup size? The strap size is important to know because that affects the diameter of the cup and subsequently the diameter of the #breast implant that we choose. It is also very helpful to know your height, your weight, and your dress size as well. These are among the aspects which should be considered when discussing your #implant #options.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Any suggestions on cc selection?

I do not think you would lose any size when implants placed under muscle. Once implants have settled into place by 3 months after surgery size should be full.

485cc versus 505cc

To put things into perspective, 35cc is a shot glass of fluid.  So, the difference between 20cc is very minimal. Typically, I do tell my patients to choose the larger of the two implants if they are torn between two sizes because implants tend to look a little bit smaller once they are under the muscle.  I hope that helps.  Good luck!

What size implants?

 In my experience there is no hard and fast rule about what amount of volume is lost by placing the implant under the muscle versus above it. Most patients mentally simply want to know that they picked the larger of the choices that they were offered. That strategy will work until you get to 800 mL and then there isn't one that's any larger. As long as the base diameter of the implant will fit into your natural breast without undue tension, there's usually a range of sizes, shapes and projection ratios that may accomplish your goals. In our patients, the Vectra 3-D imaging platform is essential in allowing the patients to readily see on a 3-D image of themselves what each implant will look like. If you're not comfortable with your size, go back to your surgeon before your operation. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 46 reviews

Any suggestions on cc selection? =choose the size you definitively want! #ba #breastaugmentation

Patients with questions and concerns about the final size of their breast implants should address that concern by making a second consultation with the plastic surgeon that is performing the operation. 

John Mesa, MD
New York Plastic Surgeon
4.9 out of 5 stars 111 reviews

Breast Augmentation - Size Selection

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Any suggestions on cc selection?

Thank you for the question. Online consultants will not be able to provide you with specific enough advice to be truly helpful. 

In my opinion, it is not possible to accurately determine how many ccs (if any) a patient would “lose” when undergoing sub muscular breast augmentation surgery. I suggest patients do not make decisions based on statement such as: “you will lose 25 or 50 cc of volume when breast implants are placed under the muscle”. These statements are simply not reliable enough to utilize clinically.

Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
Given that your surgery is coming up soon, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.
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.
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. For example, I have found that the use of know words such as “natural” or "D or DD 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, the use of computer imaging has been very helpful during the communication process, in our practice.
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, after the use of temporary intraoperative sizers.
I hope this (and the attached link/video, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

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.