160cm in height and 52kg, Asian female, 45 years old. Should I consider 320cc or more?I would like a full C or small D. (Photos)

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." Communication is key as you and your surgeon create your custom surgical plan.
Based upon your photos, your choice does not seem unreasonable.
As always, discuss your concerns with a board certified plastic surgeon.

Dear Genuine589721,


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

An easy way to determine whether that you’d like that size is to try on sizers at your surgeons office. These are implants that you can fit into your bra to see your predicted results.

Based on your height, weight, breast measurements, the following sizes will likely deliver that full C, small D result:Motiva demi ergo: 300, 320, 340, and 360 ccSafest bet for a more proportionate look will likely be 320ccHowever, because bra cup sizes are not standardized, I would recommend bringing 2-3 "wish pics" to your surgeon, of girls that have a similar frame to you, and the ideal breast fullness that you desire. These pictures do not need to be plastic surgery before and afters, or nude photos; they can be a girl you follow on social media that you like how she looks in bathing suits, dresses, fitness outfits etc. I would also bring one picture of what you DON'T want. Your surgeon will then be able to evaluate that degree of fullness and translate it to your frame to deliver the exact result you are desiring.

Unfortunately, you have not told us your bra size. If you are size 32 or 34, each 100 cc of implant corresponds to 1 cup size change. If you are size 36 or 38, each 200 cc of implant corresponds to 1 cup size change. 320 cc implant appear quite large and you appear to be a B or C to begin with. I recommend small implants or fat transfers with a simultaneous lift.

Best Wishes,

Gary Horndeski, M.D.

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size 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 is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

From the photos you appear to be a good candidate for breast augmentation. Implant selection is a detailed process that is best done in person with a board certified plastic surgeon. The implant you are considering seems it would in the right range to help you meet your goals, however I would refer to the surgeons who have had the benefit of examining you and speaking to you in detail about your desired look. Many surgeons have sample implants you can "try on" to help you get an idea of how you may look after surgery. I've included a video I hope you find helpful.

Answer from Dr. Sean Hill, Board-Certified Plastic Surgeon at Lone Star Plastic Surgery in Frisco, TX:
This is a very common (and important) question — especially for patients who’ve done their homework and want to feel confident in their decision. Thanks for including your photos and physical details — those make a big difference in giving you personalized feedback.
When choosing an implant size, I always take into account your body frame, breast width, skin elasticity, and goals — not just volume. Based on your photos and proportions, it looks like you could likely accommodate the size you’re considering — and possibly even a slightly larger implant — but only if that aligns with your aesthetic goals.
Many patients worry about going “too big” or “too small,” but the best choice comes down to: • How much upper pole fullness you want • Whether you prefer a natural slope or a fuller, rounder look • Your lifestyle, activity level, and wardrobe preferences
If you’re already considering a size that fits your base width and gives you the fullness you want, you may be right on track. If you’re torn between two sizes, most patients who opt for the slightly larger implant are glad they did, as implants can appear a bit smaller once placed under the muscle.
At Lone Star Plastic Surgery, I use tools like 3D imaging and sizers during consultation to help patients visualize the results on their own body — which often makes the decision easier and more confident.
You’re clearly doing all the right things by getting multiple opinions and thinking carefully. Just make sure your final decision is based on your personal goals, and that you’re working with a board-certified plastic surgeon who is experienced in breast augmentation and can guide you through this with precision and care.
Warmly,Dr. Sean HillBoard-Certified Plastic SurgeonLone Star Plastic Surgery – Frisco, TX

For most patients, there are three variables to determine a breast augmentation outcome.
The first is the patient candidate for the procedure guide.
The second is implant selection.
The third variable is the surgeon ability to put the implant in the correct anatomic location or in other words do the procedure correctly.
Each plastic surgeon will have their own way of guiding patients through the implant selection process.
Some plastic surgeons will ask the patient to make the decision regarding the implant size and type.
Other plastic surgeons will make the decision based on input from the patient.
My personal preference is to work with before and after pictures of previous patients who had similar body characteristics.
I do this until I feel quite certain. I have a good understanding of what the patient is hoping to achieve.
During surgery, I use temporary breast implant sizes to determine what size and shape implant will give the desired outcome.
I typically have a full selection of implants available to me during surgery.
I make the final decision regarding what implants to use Which puts the owners on me after the patient is unhappy.
I think the surgeon is in a better position to make the final decision based on our experience and training.
I don’t find putting implants in a bra is an appropriate way to guide implant selection.
The final outcome tends to be quite different than what the shape and size looks like by putting an implant in the bra.
Some plastic surgeons do this better than others.
It’s always easier for the surgeon if the patient makes the final decision because they’re not on the hook, if the patient is unhappy with the size.
All of that said, anytime accessibly large implants are used the chance of undesirable side effects, complications and need for revision surgery will go up.
This is especially true if the implant diameter is substantially wider than the natural breast diameter.
It’s always safer to go a little more conservative now many patients wish they went bigger after surgery.
Implant envy is a very real thing.
Best,
Mats Hagstrom MD