I'm 25, 5'9, 131 lbs - I'm between sizes! 430 cc, 455 cc, 480 cc? Implant under the muscle, silicone. Wanting a 32-34 D. (Photo)

Question

My surgery is on June 9th and I'm still unsure of size! Currently I'm 30 inchs around and wear a B. I would like to be somewhere around the 32-34 D. Which implant size would be best? 430 cc, 455 cc, 480 cc? I'm athletic and enjoy weight lifting. I work as a Registered Nutritionist and I would also like the size not to affect my clients opinions. If someone could please help me figure out an appropriate size that would be amazing! If those are too big, I'm open to smaller implants! Thank you!

Larry S. Nichter, MD, MS, FACS · Answer

It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below link

Jaime S. Schwartz, MD, FACS · Answer

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

John L. Burns Jr., MD · Answer

I would suggest using 3D photographic imaging to choose your implant size.  You will be able to see exactly what you will look like with different sizes and profiles.

Tom J. Pousti, MD · Answer

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

Mahmood Kara, MD - Account Suspended · Answer

Hello. Thank you for your inquiry.
You may be an excellent candidate for breast augmentation surgery. Exact end results and cup sizes are usually quite difficult to calculate as everyone has a different starting point.
It is important to have an in-person assessment regarding your concerns as it is difficult to determine virtually.
There are many different factors that go into choosing a breast implant size which will correspond with your body dimensions while concurrently achieving your aesthetic results. Some of these factors are: Implant size (CC's), Implant profile (Low, Moderate, High), Placement of the implant (Subglandular vs. Dual Plane) etc. We utilize smooth round cohesive silicone gel 'gummy bear' implants for the best results.
During a consultation your aesthetic goals are heard and taken into account with the measurements of your breasts and the integrity of your tissue, as well as level of ptosis (sag). From here we collectively can find your 'perfect fit'. You are able to try out sizers and different implants in our office such that you can get an idea of what size you would be post-operation. We also offer Crisalix 3D plastic surgery virtual simulator during our in-person and virtual consultations to preview potential results. After your consultation, you will receive your very own implant sizers to take home with you (at a small cost) whether or not you decide to go forward with your procedure.
I usually recommend that my patients stop smoking, take vitamin C daily, and avoid aspirin/ibuprofen and vitamin E 3 weeks prior to surgery. I specialize in the 24-hour Recovery method which minimizes trauma to the breast and decreases pain post-operatively.
We encourage you to look at our website and Instagram (drkaraplasticsurgery) for lots of before and after pictures!
Please note that this response does not substitute patient-doctor relationship. We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.
During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery.
We invite you to come in to discuss your options more thoroughly. Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!
M.Kara,MD,FRCSC (27+ years experience) - Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind

Payam Jarrah-Nejad, MD, FACS - Account Suspended · Answer

Thank you for your great question.There are many ways to properly determine your implant size. Most important is in-office evaluation and many measurements we perform during a comprehensive evaluation.  This will allow us to determine not only the size (the "cc"s) but also review different types of implants.  Evaluation also includes reviewing photos (which are mostly from our own gallery), sizing/fitting with mirror, and approach.You will have many options be based on your medical history and physical exam which will include the tissue type, location of nipple and areola, breast folds, asymmetries to name a few. The actual implant size (the "cc") is totally individualized.The Breast Augmentation results are mostly dependent on surgeons expertise, experience, dedication, and artistic vision. This is why the results may be very different from one surgeon to another. Make sure you have a thorough consultation with a board certified plastic surgeon who has extensive experience in this procedure. Check her/his experience, credentials, reviews, before and afters, and have a quality consultation.It is preferred for your surgeon to be member of "American Society of Plastic Surgeons" and also member of "American Society for Aesthetic Plastic Surgery". This means they have been evaluated by the society and recognized that the focus of their practice is high volume, honest, and high quality aesthetic plastic surgery.All the best,

Jon A. Perlman, MD (retired) · Answer

Thanks for your question.  Without a face-to-face exam it is difficult to be precise but my best answer for you would be to anticipate an implant between 340 mL and 390 mL to achieve approximately the size and shape of the breasts that you cited as examples of your goal.  The actual appearance of your result will depend upon the natural shape of your breast, nipple position and skin and breast tissue distensability.  The implants in the 400+ cc range would seem to be somewhat large in my opinion.  Good luck with your decision and discuss your choices carefully with your plastic surgeon.  Enjoy your results.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic
Surgery (ASAPS)
Beverly Hills, California

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.   You are very thin and fit and in my opinion the biggest risk that you face is choosing breast implants that are too large and do not match your delicate frame.  The ideal or perfect photo that you show most likely represents breast implants in the 350-400 cc range.  A rough estimate is that 150-200 cc of breast implant will increase you by one cup size in the same style and manufacture of bra that you currently wear. For more information on breast implant sizing please read below:

I'm 25, 5'9, 131 lbs - I'm between sizes! 430 cc, 455 cc, 480 cc? Implant under the muscle, silicone. Wanting a 32-34 D. (Photo)

Answers (8)

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