Worried a 475 HP implant is going to be a bigger result than I want. I don’t want to have the “fake boob look”. (Photos)

Thank you for your question.I routinely perform a Vectra 3-d simulation for all of my breast augmentation patients in order to take the guessing game out of breast implant based surgery.  The Vectra 3-d simulation machine takes a picture of YOUR breasts and allows a thorough consultation to be performed showing YOU, the patient, exactly what different implant sizes, shapes, profiles and manufacturers look like on your body.  The simulation will point out any and all asymmetries and give you a chance to pick the size and profile of your implants after you see what they look like on YOUR body.

I highly recommend that ALL breast augmentation patients have this done prior to picking a size for their breast augmentation.

The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Hello and thank you for your question. You are a great candidate
for a breast augmentation.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  This entire surgery
can be performed with a small incision technique.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. This will ensure that you avoid the dreaded "fake" look. It is important to remember that smaller individuals rarely have exceedingly large breasts, thus for those seeking "natural," conservative sizing is best.With regards to your specific question, 25 cc is a negligible volume difference (5 teaspoons). The profile shift is typically a difference of millimeters. I would recommend Mod (+) for subtlety. A HP is a nice option if you desire greater volume for a given width.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Dear ElleJay83,I understand your concern and it is quite normal to be concerned about the outcome following a breast augmentation surgery. However, you are still in the very early stages of the healing process.Your will need to be patient at this moment and follow what your surgeon has instructed you to do post operatively.At the early stage of the healing process, the tissues around the implants are still swollen. Once the swelling subsides and the implants drop to their final position, you will be able to see the final result of your breast augmentation surgery.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

and you should employ external sizers to help you see what your look will be like.  Larger implants tend to be more 'fake' but I suggest you go for the size you like to avoid regrets down the road as technically, there is nothing natural about implants.  But there are plenty of women who wished they went larger!  And if you like adjacent sizers, its suggested you always go with the larger one.  Your height will allow you to carry them well.

Thank you for your photo. The ideal Implant size cannot be determined by height and weight alone. 25cc is also a very amount and you will not be able to tell a difference between a 450 and 475. It is best to have an in-office evaluation so that careful measurements can be taken to determine the best size implant for your chest diameter, several upper body measurements, and current breast tissue. Once you have the measurements, they are all put together to determine the right implant from the right manufacturer. Breast implants of the same cc's can look and feel extremely different depending on the profile and material. In my office, I have the MENTOR breast implant sizing system where different size molds are used to simulate how you appear in your own clothes and help finalize your decision. Hope this helps!
Johnson C. Lee, MD
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

The perception of what is a "natural
looking breast" is very individual and varies greatly from patient to
patient and from doctor to doctor. A 475 high profile implant will be quite large for a patient with your individual anatomy.
The best cosmetic result in any particular breast augmentation patient depends on a variety of factors, including: Your individual anatomy, desired outcome, realistic expectations, a thorough discussion with the plastic surgeon about the options, and an understanding of the pros and cons of any particular implant choice. Proper sizing is not just about the number of cc’s. or the type of implant. The thickness of your tissue, breast dimensions which include the width, height, and projection, as well as chest wall width all need to be considered when choosing an implant. Trying on implant “sizers” of various shapes and volumes while wearing a tight t-shirt, bra, or bathing suit at a preoperative visit will help you and your surgeonchoose the optimal implant.




Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.




Robert Singer, MD FACS




La Jolla, California


 

Thank you for the question and pictures.  Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.  Although I typically avoid specific online advice, I would share your concerns that the 475 cc high profile breast implants mentioned would be too large. My best advice: more communication.
It is definitely worth spending more time (prior to the date of surgery) with your plastic surgeon to discuss further.  As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.
One question that might be helpful for you to consider: would you be more disappointed if you are slightly too big or slightly too small after the breast augmentation procedure?
Ultimately, careful selection of plastic surgeon and 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.
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 words such as “natural or fake look” or "C or D 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 helps. Best wishes for an outcome that you will be very pleased with.